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Rural Health
Resources by Topic: Healthcare facilities

Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals
Presents strategies for implementing antibiotic stewardship programs in critical access hospitals (CAHs). Includes examples of improved antibiotic-use strategies and guidelines for the prescribing physician, nurses, and pharmacists.
Date: 07/2017
Sponsoring organization: Centers for Disease Control and Prevention
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Promising Practice: Advisory Group in Washington State Works to Bring Palliative Care to Rural Patients
Describes the Palliative Care Rural Health Integration Advisory Team (PC-RHIAT) initiated by the Washington State Office of Rural Health (WA SORH), which aims to bring palliative care to rural patients through the use of telehealth and community engagement. The WA SORH facilitates this process by bringing experts in palliative care, rural health and telehealth, together with hospitals, clinics, and community team members to develop an action plan based in the rural community and within their healthcare organizations.
Author(s): Beth Blevins
Date: 06/2017
Sponsoring organization: National Organization of State Offices of Rural Health
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Changes in Hospital Quality Associated with Hospital Value-Based Purchasing
Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
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Potentially Preventable Medication-Related Hospitalizations: A Clinical Pharmacist Approach to Assessment, Categorization, and Quality Improvement
Examines pharmacist-led quality improvement practices, implemented across rural and urban counties in Hawaii, to identify and categorize potentially preventable medication-related hospital admissions. Describes how data collected during the investigation is used to improve pharmacist interventions focused on reducing medication-related readmissions.
Author(s): Karen L. Pellegrin, Elizabeth Lee, Reece Uyeno, Chris Ayson, Roy Goo
Citation: Journal of the American Pharmacies Association, 57(6), 711-716
Date: 06/2017
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Medical Center Barbour Reduces Readmission Rates
Highlights the accomplishments of Medical Center Barbour (MCB), a prospective payment system (PPS) hospital located in Eufaula, Alabama, as it progressed through a Small Rural Hospital Transition (SRHT) quality of care and transition of care project. MCB's top accomplishments include reducing readmissions, improving communication among staff and patients, and enhancing the discharge process.
Additional links: One-Page Summary
Date: 06/2017
Sponsoring organization: National Rural Health Resource Center
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Hospital Value-Based Purchasing: CMS Should Take Steps to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses
Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Sponsoring organization: Government Accountability Office
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CMS Hospital Quality Star Rating: For 762 Rural Hospitals, No Stars Is the Problem
Examines the characteristics of rural hospitals with and without quality star ratings, and explains how the current methodology disproportionately affects rural hospitals. Makes recommendations for improving the utility of the Hospital Quality Star Rating system, especially for the purpose of comparing quality among rural hospitals or between rural and urban hospitals.
Author(s): Kristie W. Thompson, Randy K. Randolph, Kristin L. Reiter, George H. Pink, G. Mark Holmes
Date: 06/2017
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2017
Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Sponsoring organization: Medicare Payment Advisory Commission
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Identifying Adverse Drug Events in Rural Hospitals: An Eight-State Study
Analyzes adverse drug events (ADEs), or events involving patient injury resulting from medication use, and identifies ways to improve medication safety in rural hospitals. Uses 2013 data from 8 states with significant rural populations, and examines ADE rates based on hospital characteristics and across 4 main categories: steroids, antibiotics, opiates/narcotics, and anticoagulants. Companion brief lists resources that can be used to reduce and prevent ADEs in rural hospitals, including rural prospective payment system (PPS) hospitals and Critical Access Hospitals (CAHs).
Additional links: Resources to Reduce Adverse Drug Events in Rural Hospitals
Author(s): Michelle Casey, Peiyin Hung, Emma Distel, Shailendra Prasad
Date: 05/2017
Sponsoring organization: University of Minnesota Rural Health Research Center
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Surgeries in Hospital-Based Ambulatory Surgery and Hospital Inpatient Settings, 2014
Provides national data on surgeries performed in hospital inpatient and hospital-based ambulatory surgery (outpatient) settings. Table 1 includes data for rural, urban teaching, and urban nonteaching hospitals. Revised February 2018 and July 2020.
Author(s): Claudia A. Steiner, Zeynal Karaca, Brian J. Moore, Melina C. Imshaug, Gary Pickens
Date: 05/2017
Sponsoring organization: Agency for Healthcare Research and Quality
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