Rural Hospital Quality Improvement Trainings

There have been three rural hospital quality improvement trainings sponsored by the Flex Program in collaboration with the Health Services Advisory Group (the state’s Quality Improvement Organization – QIO) during 2003 to 2005. These included: the Pneumonia Model for Quality Improvement Workshop (June 2003), the Congestive Heart Failure Quality Improvement Videoconference (July 2004), and Medication Reconciliation Videoconference (May 2005). In addition, Darlene Bainbridge of D.D. Bainbridge & Associates, Inc. conducted Building Leadership and Managerial Skills: A Train-the-Trainer Workshop (February 2006). 

Pneumonia Model for Quality Improvement Workshop: Pneumonia and influenza were sixth among the top 10 leading causes of death of Arizona residents in 2001, and were among the five leading causes of death of elderly Arizona (65 years and older) from 1990-2000. The primary objective of the one and one-half day conference (June 2-3, 2003) held in Phoenix was to provide participants with the knowledge, processes, and tools to improve compliance with performance measures for patients hospitalized for pneumonia. The quality improvement technique presented at the conference was the Collaborative Model for Healthcare Quality Improvement, which encompasses the Plan, Do, Study, Act (PDSA) cycle. There were 15 hospitals that participated in the conference (7 CAHs and 8 non-CAHs).

Congestive Heart Failure Quality Improvement Videoconference: Health Services Advisory Group reported about one-third of Arizona’s Congestive Heart Failure (CHF) hospitalizations occurred in rural hospitals annually, and the number of CHF hospitalization in rural Arizona increased 8.4 percent during 2000 through 2003. The videoconference was held simultaneously at the Arizona Health Sciences Centers in Phoenix and Tucson on July 8, 2004. The primary objective of the videoconference was to provide participants with the knowledge, processes, tools to improve compliance with the Centers for Medicare and Medicaid Services (CMS) Heart Failure (HF) Project’s inpatient quality indicators. The quality improvement framework used during the videoconference was the Chronic Care Model.  Twenty rural hospitals attended the videoconference in which eight were CAHs and seven facilities served Native American Indians.   

Medication Reconciliation Videoconference: The Institute of Medicine 2000 Report, To Err is Human:  Building a Safer Health System, stated that medication-related errors have been estimated to account for 7,000 deaths annually, and adverse drug events occur in 6.5 of every 100 hospital admissions, with 42 percent of these events being either serious or life threatening.  The videoconference was presented simultaneously at the Arizona Health Sciences Centers in Phoenix and Tucson, and at the White Mountain Regional Medical Center in Springerville. The primary objective of the one-day videoconference (May 17, 2005) was to provide the attendees with the knowledge, processes, tools to improve understanding of medication reconciliation efforts both nationwide and statewide. The quality improvement technique presented at the conference was the Collaborative Model for Healthcare Quality Improvement. Nineteen rural hospitals attended the videoconference in which seven were CAHs and 12 were other rural hospitals.

Building Leadership and Managerial Skills: A Train-the-Trainer Workshop: To be successful in implementing quality improvement strategies, one has to have good leadership and management skills. A one and a half day training in Phoenix (February 23-24, 2006) was provided for Critical Access Hospital and other small rural hospital management teams. The scope of the workshop came from feedback received in a hospital management focus group sessions organized by the Flex Program staff. Participants learned how to best build effective teams, identify ways to turn problems into opportunities, and discussed approaches to deal with conflict issues. As hospitals move towards implementing and managing various quality initiatives, these skills will be of most value. Twenty seven participants from 11 rural hospitals attended the meeting.

If you would like information on future Arizona Flex Program trainings, call Jim Laukes at (520) 626-0721 or e-mail him at jlaukes@u.arizona.edu.