You’re Never Too Small to Save a Life: Quality of Care in Critical Access Hospitals
Expanding Health Care Coverage
September 20, 2007
New York State has 13 Critical Access Hospitals that serve as lifelines to the communities where they are located. Critical Access Hospitals tend to have tight operating budgets, small staff volumes, and unpredictable revenue, all circumstances under which quality improvement courses, techniques, and campaigns are generally not feasible. Moreover, communication between these 13 Critical Access Hospitals is limited, with no opportunities for them to learn from each other or consult on shared concerns.
The Northern New York Rural Health Care Alliance’s mission is to facilitate a healthy community by assisting interested agencies and organizations in developing and implementing a rural health care delivery system and improving health outcomes through coordinated services, sharing resources, and educating both consumers and providers. The Alliance’s activities under this grant include technical assistance on quality improvement efforts, conflict resolution, team building, professional development, grant-writing training, Emergency Medical Service leadership, and establishing a pharmacy with the New York State AIDS Institute.
New York State has 13 Critical Access Hospitals (CAHs) that serve as lifelines to the communities in which they are located. With tight operating budgets, small staff volumes, and unpredictable revenue, quality improvement courses, techniques, and campaigns are not feasible. CAHs need to learn and practice improvement methodologies modified to fit their small volumes. The project will last one year and will involve a quality improvement collaborative with 12 workshops based on the Institute for Healthcare Improvement’s 5 Million Lives Campaign, a two-year voluntary initiative to protect patients from medical harm. A Project Quality Coach will visit each CAH participating site to facilitate group meetings, assist in goal setting, and conduct team-building, conflict resolution, and leadership exercises. The Model of Improvement and Plan-Do-Study-Act cycle methodology (testing a change by developing a plan to test the change, carrying out the test, observing and learning from the consequences, and determining what modifications should be made to the change model) will become a natural part of the CAHs’ delivery of care, resulting in a higher quality of care for all patients, especially rural residents in underserved areas.