Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #120465

Jennifer Lundblad, PhD, MBA, Stratis Health, 2901 Metro Drive, Suite 400, Bloomington, MN 55425, (952) 853-8523, JLUNDBLAD@mnqio.sdps.org

Background and Purpose: In recent years, there has been increased interest from accreditation organizations, purchaser coalitions, and government agencies in the measurement of hospital quality. However, due to contextual characteristics, such as location, size, scope of services, staffing, structure, and affiliation, rural hospitals face unique challenges. Quality measurement should be sensitive to these differences. The purpose of this project was to field test the feasibility of collecting a set of relevant quality measures from rural hospitals. The study also preliminarily assessed the internal and external usefulness of the measures, as well as the ease of data collection. The study was funded by the Centers for Medicare & Medicaid Services, and was conducted through a collaborative effort by Stratis Health, HealthInsight, and the Rural Health Research Center at the University of Minnesota. Methods: Twenty-two hospitals of 50 beds or fewer across three states participated in the field test. Hospital staff were trained and then collected data from April 2004 to September 2004. Inpatient measures included the topics of heart failure, pneumonia, and surgical infection prevention. Emergency department measures included chest pain/ AMI, pneumonia, trauma vital sign monitoring, and transfer communication. Cross-cutting measures included advance directives, medication teaching, and medication safety checklist. Administrative measures were cesarean-section rate, laparoscopic cholecystectomy rate, medication error rate, adverse drug event rate, and Medicaid denial rate. Data reports were sent to the hospitals after three months of data collection, and again after six months. Hospital staff were surveyed prior to the study, mid-study, and post-data collection. After the field test was completed, a national Technical Expert Panel was convened in April 2005 to provide input on how generalizable the measures are nationally and priorities for measure refinement. Results: In general, staff at the participating hospitals found the data collection to be easy and the data to be useful, and many of the hospitals began improvement efforts even before the project ended. Detailed results from the six months of hospital data collection and quantitative and qualitative findings from the post data collection survey of hospitals will be shared. Based on the field test and preliminary assessment of the Technical Expert Panel feedback, three new areas of measurement are particularly promising: 1) ED chest pain/AMI, 2) Transfer Communication, and 3) Medication Safety Checklist. The comprehensive results from the Technical Expert Panel will be available at the time of the conference.

Learning Objectives: