Quality

Completed Projects

Acute and Post-Acute Care Bundled Payments and Care Coordination in Rural Environments
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Quality
The purpose of this project is to: 1) Identify opportunities and potential unintended consequences for rural providers of current proposals for implementing bundled payments for acute and post-acute care episodes; 2) Describe modifications to current bundling proposals that will address rural-specific issues; and 3) Identify quality measures related to care coordination that are relevant for rural patients whose services are reimbursed by a bundled payment.

Analysis of 2004-2005 State Flex Grant Plans
Research centers: Maine Rural Health Research Center , Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Networking and collaboration, Quality
This project will analyze state Flex grant applications and related budget and work plan revisions focusing on state activities in the core Flex program areas of networks, quality improvement, and EMS.

Analysis of Critical Access Hospital Inpatient Hospitalizations and Transfers from CAHs to Other Acute and Post-Acute Care Settings Using State Inpatient Databases
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality, Technology
The purpose of this project is to analyze Critical Access Hospital (CAH) inpatient hospitalizations and transfers from CAHs in order to help inform the development of quality indicators for CAHs, especially quality indicators focused on the transfer process.

Assessing the Rural Relevance of Hospital Outpatient Quality Measures
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality
The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.

Assessment of Small Rural Hospital Activities to Report Medication Errors
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality
This research will determine how small rural hospitals have responded to the environmental pressure to improve patient safety and quality by implementing safe medication practices and by reporting and monitoring medication errors.

Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality
The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare.

Critical Access Hospital Participation in the Hospital Quality Alliance and Initial Quality Measure Results
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
This project examined the participation of Critical Access Hospitals (CAHs) in public reporting of quality measures in the Centers for Medicare and Medicaid Services Hospital Compare database. It presented the initial Hospital Compare results for CAHs and comparisons with other groups of hospitals on quality measures for three conditions: acute myocardial infarction (heart attack), heart failure and pneumonia.

Critical Access Hospital Readiness for CMS Value-Based Purchasing
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health care financing, Quality
The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals.

Determinants of Quality of Care in Rural Communities: How Does The Health Care Infrastructure Affect Quality of Care in Rural America?
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Quality, Workforce

Developing a Quality Performance Measurement System for Critical Access Hospitals
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
This project continues to support activities related to quality performance measurement relevant for Critical Access Hospitals. By the end of 2005, the technical expert panel had reviewed the findings of the initial field test of the small rural hospital quality measure set and made recommendations for revisions.

Developing Quality Measures and Communication Strategies for Rural Patient Transfers
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Quality
The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers.

Developing Relevant Quality Indicators for Rural Hospitals
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality

Establishing Evidenced-based Safety Standards for Rural Hospitals - Phase 1
Research center: Minnesota Rural Health Research Center
Funders: Agency for Healthcare Research and Quality (AHRQ) , Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality
This project will develop and test evidence-based safety improvement interventions in rural hospitals by identifying key patient safety areas and interventions of particular relevance to rural hospitals that have the potential to reduce medical errors and improve patient safety.

Evaluation of an Outpatient Modified Paper Prescription Form
Research center: ORHP-funded Individual Grantees
Funder: Office of Rural Health Policy (ORHP)
Topics: Pharmacy and prescription drugs, Quality
This project will evaluate a modified paper prescription form that may be implemented in rural primary care settings cheaply and quickly with the goal of outpatient prescription error reduction.

Health Information Technology and Quality in Rural Hospitals
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health information technology, Hospitals and clinics, Quality
The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas.

Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth
The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients.

Implementing Quality Assessment and Performance Improvement Systems in Rural Health Clinics: Clinic and State Agency Responses
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Legislation and regulation, Quality, Rural Health Clinics (RHCs)

Improvement in the Quality of Care for Acute Myocardial Infarction (AMI): Have Rural Hospitals Followed National Trends?
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality
This project will determine whether overall improvements in the quality of care for AMI among Medicare patients, as measured by adherence to guidelines, have taken place in both rural and urban hospital settings.

Insurance Status and Quality of Care for Children in Rural Areas: 1993-2000
Research center: South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Health insurance and the uninsured, Minority health, Poverty, Quality

Measuring Quality in Rural Health Services: Are Hospital and Health Plan Accreditation Standards Appropriate for Rural Areas?
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Quality

Measuring Quality Performance in CAHs
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
The purpose of the project is to update our previous analyses of CAH participation in Hospital Compare, analyze trends over time, and explore additional sources of quality data for CAHs.

Medicare Beneficiary Outcomes in Rural and Urban Home Health Agencies
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Home health, Medicare Prospective Payment System (PPS), Quality
This study will compare the performance of rural and urban home care agencies, and identify agency characteristics that contribute to better patient care outcomes.

National Rural Hospital Flexibility Program Tracking Project: Analysis of CAH Quality Improvement (QI) Strategies
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality

Nursing Home Quality: A Comparison between Rural and Non-Rural Nursing Homes
Research center: Southwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Long term care, Quality, Rural statistics and demographics
The research examines the effect of location (rural/non-rural) on the characteristics of nursing homes and residents, and on various indicators of quality of care.

Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality, Workforce
The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals.

Patient Assessments and Quality of Care in Rural Hospitals
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Quality
This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions.

Pay-for-Performance and Quality Improvement in Rural Hospitals
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Hospitals and clinics, Quality
This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality.

Potentially Preventable Rural Hospital Readmissions
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality
This project focuses on the analysis of potentially preventable rural hospital readmissions, a potential quality indicator receiving considerable attention from policymakers and payers. Using 3-M algorithm software and MedPAR inpatient claims data from 9 geographically representative states, this study will explore the relationship between readmission rates and geographic regions, categories of rural hospitals, discharge destination, clinical diagnoses and patient attributes.

Preventing Errors in Rural Hospitals
Research center: Minnesota Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality

Quality and Financial Status of Critical Access Hospitals: A Preliminary Analysis
Research centers: Minnesota Rural Health Research Center , North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health care financing, Quality
The purpose of this project is to continue to investigate the relationship between CAH financial performance and quality of care. UMN and UNC will jointly develop hypotheses related to the finance-quality link and statistical models suitable for testing hypotheses.

Quality Differences between Rural and Non-Rural Nursing Homes
Research center: Southwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Long term care, Quality

Quality Improvement Organizations' Contributions to Rural Hospital Performance
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health information technology, Hospitals and clinics, Quality
This qualitative study is designed to gather information on best-practices in Quality Improvement Organization (QIO)-rural hospital partnerships. Specifically, this study will identify successful and replicable examples in which QIOs have worked with rural and critical access hospitals to improve processes of care, implement health information technology and promote organizational safety culture.

Quality of Care for Acute Myocardial Infarction Patients in U.S. Rural Hospitals
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality

Quality of Women's Care in Rural Health Clinics: A National Analysis
Research center: ORHP-funded Individual Grantees
Funder: Office of Rural Health Policy (ORHP)
Topics: Quality, Rural Health Clinics (RHCs), Women
This study will analyze the rates at which women patients receive five recommended preventive screening interventions in a national, geographically stratified random sample of Rural Health Clinics. Results of the analysis will be used to derive implications for rural health policy.

Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Emergency medical services (EMS), Hospitals and clinics, Quality, Workforce
This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers.

Rural Quality Improvement Focus on Diabetes
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Quality
This project focused specifically on diabetes care management and quality improvement programming in rural areas as a way to understand the adaptability and policy implications of using chronic care coordination and other models in a rural environment.

State Flex Program Quality Improvement Activities
Research center: Maine Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality

Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology
Research center: Upper Midwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Technology
This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals.

Urban and Rural Differences in Access to Care and Treatment for Medicare Beneficiaries with Cancer
Research center: ORHP-funded Individual Grantees
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Health services, Medicare, Quality
Little is known about the differences in the diagnosis, treatment and outcomes of care for cancer patients across urban and rural regions of the country. This study will extend our understanding of the challenge of providing high-quality cancer care to Medicare beneficiaries and how provider availability influences access to needed care in urban and rural areas.

Topics Centers Researchers Other Resources Search		Quality Completed Projects Acute and Post-Acute Care Bundled Payments and Care Coordination in Rural Environments Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Quality The purpose of this project is to: 1) Identify opportunities and potential unintended consequences for rural providers of current proposals for implementing bundled payments for acute and post-acute care episodes; 2) Describe modifications to current bundling proposals that will address rural-specific issues; and 3) Identify quality measures related to care coordination that are relevant for rural patients whose services are reimbursed by a bundled payment. Analysis of 2004-2005 State Flex Grant Plans Research centers: Maine Rural Health Research Center , Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Networking and collaboration, Quality This project will analyze state Flex grant applications and related budget and work plan revisions focusing on state activities in the core Flex program areas of networks, quality improvement, and EMS. Analysis of Critical Access Hospital Inpatient Hospitalizations and Transfers from CAHs to Other Acute and Post-Acute Care Settings Using State Inpatient Databases Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality, Technology The purpose of this project is to analyze Critical Access Hospital (CAH) inpatient hospitalizations and transfers from CAHs in order to help inform the development of quality indicators for CAHs, especially quality indicators focused on the transfer process. Assessing the Rural Relevance of Hospital Outpatient Quality Measures Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures. Assessment of Small Rural Hospital Activities to Report Medication Errors Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality This research will determine how small rural hospitals have responded to the environmental pressure to improve patient safety and quality by implementing safe medication practices and by reporting and monitoring medication errors. Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare. Critical Access Hospital Participation in the Hospital Quality Alliance and Initial Quality Measure Results Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality This project examined the participation of Critical Access Hospitals (CAHs) in public reporting of quality measures in the Centers for Medicare and Medicaid Services Hospital Compare database. It presented the initial Hospital Compare results for CAHs and comparisons with other groups of hospitals on quality measures for three conditions: acute myocardial infarction (heart attack), heart failure and pneumonia. Critical Access Hospital Readiness for CMS Value-Based Purchasing Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health care financing, Quality The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals. Determinants of Quality of Care in Rural Communities: How Does The Health Care Infrastructure Affect Quality of Care in Rural America? Research center: Walsh Center for Rural Health Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Quality, Workforce Developing a Quality Performance Measurement System for Critical Access Hospitals Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality This project continues to support activities related to quality performance measurement relevant for Critical Access Hospitals. By the end of 2005, the technical expert panel had reviewed the findings of the initial field test of the small rural hospital quality measure set and made recommendations for revisions. Developing Quality Measures and Communication Strategies for Rural Patient Transfers Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topic: Quality The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers. Developing Relevant Quality Indicators for Rural Hospitals Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality Establishing Evidenced-based Safety Standards for Rural Hospitals - Phase 1 Research center: Minnesota Rural Health Research Center Funders: Agency for Healthcare Research and Quality (AHRQ) , Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality This project will develop and test evidence-based safety improvement interventions in rural hospitals by identifying key patient safety areas and interventions of particular relevance to rural hospitals that have the potential to reduce medical errors and improve patient safety. Evaluation of an Outpatient Modified Paper Prescription Form Research center: ORHP-funded Individual Grantees Funder: Office of Rural Health Policy (ORHP) Topics: Pharmacy and prescription drugs, Quality This project will evaluate a modified paper prescription form that may be implemented in rural primary care settings cheaply and quickly with the goal of outpatient prescription error reduction. Health Information Technology and Quality in Rural Hospitals Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Health information technology, Hospitals and clinics, Quality The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas. Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients. Implementing Quality Assessment and Performance Improvement Systems in Rural Health Clinics: Clinic and State Agency Responses Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Legislation and regulation, Quality, Rural Health Clinics (RHCs) Improvement in the Quality of Care for Acute Myocardial Infarction (AMI): Have Rural Hospitals Followed National Trends? Research center: WWAMI Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality This project will determine whether overall improvements in the quality of care for AMI among Medicare patients, as measured by adherence to guidelines, have taken place in both rural and urban hospital settings. Insurance Status and Quality of Care for Children in Rural Areas: 1993-2000 Research center: South Carolina Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Children, Health insurance and the uninsured, Minority health, Poverty, Quality Measuring Quality in Rural Health Services: Are Hospital and Health Plan Accreditation Standards Appropriate for Rural Areas? Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topic: Quality Measuring Quality Performance in CAHs Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality The purpose of the project is to update our previous analyses of CAH participation in Hospital Compare, analyze trends over time, and explore additional sources of quality data for CAHs. Medicare Beneficiary Outcomes in Rural and Urban Home Health Agencies Research center: Walsh Center for Rural Health Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Home health, Medicare Prospective Payment System (PPS), Quality This study will compare the performance of rural and urban home care agencies, and identify agency characteristics that contribute to better patient care outcomes. National Rural Hospital Flexibility Program Tracking Project: Analysis of CAH Quality Improvement (QI) Strategies Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality Nursing Home Quality: A Comparison between Rural and Non-Rural Nursing Homes Research center: Southwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Long term care, Quality, Rural statistics and demographics The research examines the effect of location (rural/non-rural) on the characteristics of nursing homes and residents, and on various indicators of quality of care. Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality, Workforce The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals. Patient Assessments and Quality of Care in Rural Hospitals Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Quality This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions. Pay-for-Performance and Quality Improvement in Rural Hospitals Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Health care financing, Hospitals and clinics, Quality This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality. Potentially Preventable Rural Hospital Readmissions Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality This project focuses on the analysis of potentially preventable rural hospital readmissions, a potential quality indicator receiving considerable attention from policymakers and payers. Using 3-M algorithm software and MedPAR inpatient claims data from 9 geographically representative states, this study will explore the relationship between readmission rates and geographic regions, categories of rural hospitals, discharge destination, clinical diagnoses and patient attributes. Preventing Errors in Rural Hospitals Research center: Minnesota Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality Quality and Financial Status of Critical Access Hospitals: A Preliminary Analysis Research centers: Minnesota Rural Health Research Center , North Carolina Rural Health Research and Policy Analysis Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health care financing, Quality The purpose of this project is to continue to investigate the relationship between CAH financial performance and quality of care. UMN and UNC will jointly develop hypotheses related to the finance-quality link and statistical models suitable for testing hypotheses. Quality Differences between Rural and Non-Rural Nursing Homes Research center: Southwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Long term care, Quality Quality Improvement Organizations' Contributions to Rural Hospital Performance Research center: Walsh Center for Rural Health Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health information technology, Hospitals and clinics, Quality This qualitative study is designed to gather information on best-practices in Quality Improvement Organization (QIO)-rural hospital partnerships. Specifically, this study will identify successful and replicable examples in which QIOs have worked with rural and critical access hospitals to improve processes of care, implement health information technology and promote organizational safety culture. Quality of Care for Acute Myocardial Infarction Patients in U.S. Rural Hospitals Research center: WWAMI Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality Quality of Women's Care in Rural Health Clinics: A National Analysis Research center: ORHP-funded Individual Grantees Funder: Office of Rural Health Policy (ORHP) Topics: Quality, Rural Health Clinics (RHCs), Women This study will analyze the rates at which women patients receive five recommended preventive screening interventions in a national, geographically stratified random sample of Rural Health Clinics. Results of the analysis will be used to derive implications for rural health policy. Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Emergency medical services (EMS), Hospitals and clinics, Quality, Workforce This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers. Rural Quality Improvement Focus on Diabetes Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Chronic diseases and conditions, Quality This project focused specifically on diabetes care management and quality improvement programming in rural areas as a way to understand the adaptability and policy implications of using chronic care coordination and other models in a rural environment. State Flex Program Quality Improvement Activities Research center: Maine Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology Research center: Upper Midwest Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Technology This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals. Urban and Rural Differences in Access to Care and Treatment for Medicare Beneficiaries with Cancer Research center: ORHP-funded Individual Grantees Funder: Office of Rural Health Policy (ORHP) Topics: Chronic diseases and conditions, Health services, Medicare, Quality Little is known about the differences in the diagnosis, treatment and outcomes of care for cancer patients across urban and rural regions of the country. This study will extend our understanding of the challenge of providing high-quality cancer care to Medicare beneficiaries and how provider availability influences access to needed care in urban and rural areas.