Quality

Current 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.

Critical Access Hospital Readiness for CMS Value-Based Purchasing
Research centers: North Carolina Rural Health Research and Policy Analysis 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.

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.

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.

Examining the Applicability of the AHRQ's Inpatient Quality Indicators to Rural Hospitals and the Implications of the Relationship Between the Indicators and Financial Measures for Medicare Payment Policies
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health policy, Hospitals and clinics, Quality
This study will investigate how the Agency for Healthcare Research and Quality's inpatient quality indicators can be applied to rural hospitals and will explore the application of those indicators in answering relevant policy questions.

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.

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.

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.

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.

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.

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.

The 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.