Rural Healthcare Quality Resources - Rural Health Information Hub

Care Redesign Survey: Lessons Learned from and for Rural Health
Explores similarities and disparities between healthcare in rural and urban or suburban areas, and discusses barriers to delivering excellent care in rural areas. Based on survey responses from 730 members of the NEJM Catalyst Insights Council.
Author(s): Amy Compton-Phillips, Namita Seth Mohta
Date: 10/2018
Type: Document
Sponsoring organization: NEJM Catalyst
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2017 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of healthcare quality and access in the U.S., including a discussion of disparities encountered by race/ethnicity and geographic locations along the rural-urban continuum. Addresses access to healthcare, patient safety, person-centered care, care coordination, affordability, healthy living, and effective treatment.
Date: 09/2018
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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2017 QIO Program Progress Report: Putting Patients at the Core
Describes the impact of Medicare's Quality Improvement Organization (QIO) Program throughout the U.S. in 2017. Highlights a number of successful projects in rural areas focused on diabetes management, care coordination, hypertension management, and more.
Date: 09/2018
Type: Document
Sponsoring organization: Quality Improvement Organization Program
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A Core Set of Rural-Relevant Measures and Measuring and Improving Access to Care: 2018 Recommendations from the MAP Rural Health Workgroup
Identifies a set of core measures focused on rural access to care and recommends how to measure them while coordinating data collection efforts. Third in a series of 3 reports documenting the Measures Applications Partnerships Rural Health Workgroup's efforts, a public-private partnership of healthcare stakeholders.
Date: 08/2018
Type: Document
Sponsoring organization: National Quality Forum MAP Rural Health Workgroup
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Rural Health Clinic Participation in the Merit-Based Incentive System and Other Quality Reporting Initiatives: Challenges and Opportunities
Reports on past and current RHC quality reporting initiatives in relation to the Merit-Based Incentive Payment System (MIPS). Explores options for RHCs to voluntarily participate in MIPS and covers challenges for RHCs participating in quality reporting.
Author(s): John A. Gale, Zachariah Croll, Andrew F. Coburn
Date: 07/2018
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Uniform Data Set (UDS) Measure Crosswalk to Other Quality Reporting Programs
Chart listing National Quality Forum measures and the related 2018 measures for the Uniform Data Set (UDS), CMS eCQM (electronic clinical quality measures), CMS Quality Payment Program (QPP), CMS Accountable Care Organization (ACO), and Accountable Care Organization/Patient Centered Medical Home consensus core set. Can be used to identify which UDS measures are being used by other programs.
Date: 07/2018
Type: Document
Sponsoring organization: Stratis Health
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Critical Access Hospital eCQM Resource List
Resource list for electronic clinical quality measures (eCQMs), reflecting new materials and updates from the Centers for Medicare & Medicaid Services for 2018 reporting.
Date: 07/2018
Type: Document
Sponsoring organization: Stratis Health
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MBQIP Fundamentals Guide for State Flex Programs
Provides information about the history and status of the Medicare Beneficiary Quality Improvement Project (MBQIP). Developed for the benefit of Flex Program personnel and subcontractors and includes resources to support their work, including data report release timelines, MBQIP acronyms, and several summaries of required quality measures changes.
Date: 07/2018
Type: Document
Sponsoring organization: Stratis Health
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Quality Peer Group Indicators for Critical Access Hospitals
Describes the results of a study to identify Critical Access Hospital (CAH) peer groups for the purposes of analyzing quality performance indicators.
Author(s): Michelle Casey, Ira Moscovice, Peiyin Hung
Date: 07/2018
Type: Document
Sponsoring organization: Flex Monitoring Team
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National Quality Reporting Crosswalk for CAHs
Provides users with information about Critical Access Hospital (CAH) quality reporting initiatives occurring on a national level, including purpose, measures used, and any overlap in measures across initiatives.
Date: 05/2018
Type: Document
Sponsoring organization: Stratis Health
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Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study
Results of a study of 2,514 nursing homes to assess infection preventionist training and certification, staff turnover, and infection control program characteristics. Features statistics on facility characteristics, with breakdowns by locations in metro, large urban, small urban, or rural areas.
Author(s): Patricia W. Stone, Carolyn T.A. Herzig, Mansi Agarwal, Monika Pogorzelska-Maziarz, Andrew W. Dick
Citation: Inquiry, 55:1-7
Date: 05/2018
Type: Document
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MAP 2018: Recommendations for a Core Set of Rural-Relevant Measures for Hospitals and Selected Ambulatory Care Settings and Measuring and Improving Access to Care
Describes selection criteria and processes used to create a draft core set of measures, lists the measures, and describes measurement gap areas identified by the Measures Applications Partnership (MAP) Rural Health Workgroup, a public-private partnership of healthcare stakeholders. Second in a series of 3 reports documenting the Workgroup's continuing efforts.
Date: 05/2018
Type: Document
Sponsoring organization: National Quality Forum MAP Rural Health Workgroup
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Stroke Care Quality Improvement Initiatives in Critical Access Hospitals
Highlights successful evidenced-based programs implemented by Critical Access Hospitals (CAHs) and other rural hospitals to improve stroke care. Reviews key program elements, quality improvement stroke data measures, and CAH participation for state-level initiatives and covers national stroke care quality improvement initiatives.
Author(s): Megan Lahr
Date: 05/2018
Type: Document
Sponsoring organization: Flex Monitoring Team
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Quality Measures for CAH Swing Bed Patients
Presentation slides presented at the 2018 NRHA Annual Conference identifying quality measures to assess the quality of care provided to swing-bed patients in Critical Access Hospitals (CAHs). Also discusses the implementation of a field test of the quality measures.
Author(s): Ira Moscovice, Michelle Casey, Henry Stabler
Date: 05/2018
Type: Presentation Slides
Sponsoring organization: University of Minnesota Rural Health Research Center
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QIOs in Action: Promoting Antimicrobial Stewardship in Rural Alaska
Describes efforts of Mountain-Pacific Quality Health and the Indian Health Service as they work together to provide education and resources to promote antimicrobial stewardship best practices among Alaska residents and providers.
Citation: QIO News
Date: 04/2018
Type: Document
Sponsoring organization: Quality Improvement Organization Program
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Critical Access Hospital Swing-Bed Quality Measures: Findings from Key Informant Interviews
Results of a study to examine how Critical Access Hospitals (CAHs) are assessing the quality of care given to swing bed patients. Uses data from interviews with representatives from CAH networks, consultants, and staff members responsible for swing bed services at 10 CAHs and 2 rural PPS hospitals in 10 states.
Author(s): Michelle Casey, Ira Moscovice, Henry Stabler
Date: 04/2018
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI). Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Catalog includes descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
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Making Better Use of Health Care Data
Describes the development of the Sanford Data Collaborative, a partnership between a rural hospital system and academic institutions to collaborate on data analysis to improve healthcare quality and lower costs. Strategies to improving care include predictive algorithms to evaluate clinical and behavioral characteristics in order to better manage chronic conditions and algorithms to measure patient engagement in their healthcare based on a patient's pre-existing behavior.
Author(s): Benson S. Hsu, Emily Griese
Date: 03/2018
Type: Document
Sponsoring organization: Harvard Business Review
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Hospital Compare Quality Measure Results for CAHs, 2016
Examines Hospital Compare inpatient and outpatient process of care and structural measures among Critical Access Hospitals (CAHs) in 2016. Includes data on reporting rates and performance for specific quality measures, and state-by-state comparison of CAH reporting rates for inpatient and outpatient measures.
Additional links: State-Specific Reports
Author(s): Megan Lahr, Alex Evenson, Tongtan Chantarat, Michelle Casey
Date: 03/2018
Type: Document
Sponsoring organization: Flex Monitoring Team
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2018 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report
Evaluates the effects of measures used in the Centers for Medicare & Medicaid Services (CMS) quality reporting programs on achieving high quality, affordable healthcare. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to healthcare facilities located in rural areas.
Additional links: Appendices ZIP file
Date: 02/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Identifying a Core Set of Rural-Relevant Measures for Hospital and Ambulatory Settings
Describes selection criteria and processes used to create a draft core set of measures, lists the measures, and describes measurement gap areas identified by the Measures Applications Partnership Rural Health Workgroup, a public-private partnership of healthcare stakeholders. First in a series of 3 reports documenting the Workgroup's continuing efforts.
Date: 02/2018
Type: Document
Sponsoring organization: National Quality Forum MAP Rural Health Workgroup
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Patient Safety and Adverse Events, 2011 and 2014
Reports on patient safety and adverse events and medical or surgical cases that may be at risk for a patient safety or adverse event, based on data from 34 states. Data is for all community, non-rehabilitation hospitals and discharges from all payers, including the uninsured. Includes overall patient safety data for rural and urban hospitals.
Author(s): Pamela L. Owens, Rhona Limcangco, Marguerite L. Barrett, Kevin C. Heslin, Brian J. Moore
Date: 02/2018
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Consumer Assessment of Healthcare Providers and Systems Overview: Vendor Directory
Provides information about the benefits and challenges of implementing a HCAHPS survey process in small rural hospitals, specifically Critical Access Hospitals (CAHs). Includes a full directory of vendors currently authorized to perform HCAHPS data collection.
Date: 02/2018
Type: Document
Sponsoring organization: National Rural Health Resource Center
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An Interim Evaluation Report of the Innovative Projects Portfolio of the Medicare Flex Grant Program
Provides background on the Flex Program and the Integration of Innovative Health Care Models (Innovative Projects) program area. Evaluates the impact of the Innovative Projects program area across seven participating states, focusing on activities involving the transition to value-based care, telehealth, care coordination, quality improvement, and system delivery in rural communities.
Author(s): Sara Kahn-Troster, John Gale, Anush Hansen, Andrew Coburn
Date: 01/2018
Type: Document
Sponsoring organization: Flex Monitoring Team
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Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain
A guide to help primary care providers, practices, and healthcare systems manage patients who are on long-term opioid therapy. Provides an evidence-based prescribing guideline, quality improvement measures, and practice-level care coordination strategies. Appendix F provides examples of comprehensive management approaches, including discussion of telehealth approaches that could be used in rural communities.
Date: 2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Patients’ Experiences in CAHs: HCAHPS Results, 2016
Shares results from the calendar year 2016 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, summarizing reporting rates and performance among all U.S. Critical Access Hospitals (CAHs). Includes detailed tables that allow state-by-state comparison of response rates and overall CAH performance.
Author(s): Megan Lahr, Alex Evenson, Tongtan Chantarat, Michelle Casey
Date: 12/2017
Type: Document
Sponsoring organization: Flex Monitoring Team
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Antibiotic Stewardship Program (ASP) Case Study: Critical Access Hospital - Southwest Health System
Outlines the governance structure, implementation strategies, key milestones, and outcomes from Cortez, Colorado-based Southwest Health System's antimicrobial stewardship program.
Date: 12/2017
Type: Document
Sponsoring organization: Health Research & Educational Trust
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The Merit-Based Incentive Payment System for Small and Rural Practices
Brief guide to inform practitioners from small and rural practices about reporting requirements and resources to help them succeed with the Merit-Based Incentive Payment System.
Author(s): Sadhana Chalasani
Citation: Bulletin of the American College of Surgeons, 102(10), 52-54
Date: 10/2017
Type: Document
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Improving Healthcare Value in Rural America
Identifies and explains the challenges facing rural communities as they work to improve healthcare value. Discusses the distinct differences between urban and rural value initiatives, highlights promising strategies for achieving rural value, and makes the case for using customized approaches rather than one-size-fits-all models.
Date: 10/2017
Type: Document
Sponsoring organization: Healthcare Value Hub
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2016 National Healthcare Quality and Disparities Report: Chartbook on Rural Health Care
Summarizes trends in healthcare quality and disparities for rural populations. Includes quality measures for access to healthcare, patient safety, person- and family-centered care, care coordination, affordability, healthy living, and effective treatment.
Author(s): Barbara Barton, Irim Azam
Date: 10/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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What is the Quality Payment Program?
Provides an overview of the Quality Payment Program (QPP) and its two associated payment tracks: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). Describes how the QPP may affect rural practices, and includes links to additional resources.
Date: 09/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Medicare Performance-Based Payment Adjustment Programs
Briefly explains the three Medicare Performance-Based Payment Adjustment programs for hospitals and how such programs may affect rural hospitals. The programs are the Hospital Acquired Condition Reduction Program (HACRP), the Hospital Readmission Reduction Program (HRRP), and the Hospital Value-Based Purchasing Program (HVBPP).
Date: 09/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Advances in Patient Safety and Medical Liability
Explains the Agency for Healthcare Research and Quality's (AHRQ) Patient Safety and Medical Liability (PSML) Initiative, and shares contributions and findings from the PSML planning and demonstration grant projects. Includes two commentaries and nine papers organized around two main themes: improving communication and improving patient safety. Rural-specific considerations discussed throughout.
Author(s): James Battles, Irim Azam, Mary Grady, Kathryn Reback
Date: 08/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Creating a Framework to Support Measure Development for Telehealth
Report intended to advance telehealth quality measurement by developers, researchers, analysts, and other members of the healthcare community. Includes case studies of several programs geared toward patients in rural areas.
Date: 08/2017
Type: Document
Sponsoring organization: National Quality Forum
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Network Spotlight: North Dakota Critical Access Hospital Quality Network
Describes the North Dakota Critical Access Hospital (CAH) Quality Network through an interview with Senior Project Coordinator, Jody Ward, and Associate Director, Lynette Dickson, from the University of North Dakota, School of Medicine and Health Sciences' Center for Rural Health. The North Dakota CAH Quality Network serves as a voluntary platform for facilitating best practices and quality improvement initiatives across all of North Dakota's 36 CAHs. Focuses on the North Dakota CAH Quality Network's characteristics, lessons learned, accomplishments, and challenges.
Date: 08/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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FY 2018 – 21: Medicare Beneficiary Quality Improvement Project (MBQIP) Measures
Chart outlining the required and optional MBQIP measures for the grant cycle beginning in fiscal year 2018. Measures are broken down into four domains: patient safety, patient engagement, care transitions, and outpatient. MBQIP is a Medicare Rural Hospital Flexibility (Flex) quality improvement grant program for Critical Access Hospitals.
Date: 07/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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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
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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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
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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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 eight states with significant rural populations, and examines ADE rates based on hospital characteristics and across four 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
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Strategies for Superbugs: Antibiotic Stewardship for Rural Hospitals
Discusses the need for antibiotic stewardship (AS) and challenges rural hospitals face in implementing AS programs. Highlights efforts underway for a group of hospitals in Utah and at Critical Access Hospitals in Idaho and Utah.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Getting Started with the Quality Payment Program: An Overview of MIPS for Small, Rural, and Underserved Practices
Provides a webinar recording discussing the effects of the Merit-based Incentive Payment System (MIPS) on small, rural, and underserved practices. Includes sections on eligibility, participation, reporting, performance categories, and submission and scoring methods. Outlines specific eligibility requirements for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs), and provides a checklist for preparing and participating in MIPS.
Additional links: Presentation Slides, Transcript, Webinar Playlist by Section
Date: 02/2017
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Emergency Department Transfer Communication Brief
Provides background information and an overview of the Emergency Department Transfer Communication (EDTC) quality measure, which is being implemented by Critical Access Hospitals (CAHs) in the Medicare Beneficiary Quality Improvement Project (MBQIP). Includes tables and charts that illustrate reporting and improvement trends from Q1 2015 through Q3 2016.
Date: 02/2017
Type: Document
Sponsoring organization: Stratis Health
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Interpreting MBQIP Hospital Data Reports for Quality Improvement
Designed to help Critical Access Hospital (CAH) staff use Medicare Beneficiary Quality Improvement Project (MBQIP) Hospital Data Reports to support quality improvement efforts and improve patient care in their facility. Includes examples of how to interpret MBQIP reports, links to additional resources, and a glossary of key words and definitions.
Date: 01/2017
Type: Document
Sponsoring organization: Stratis Health
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Grantee Directory: Small Health Care Provider Quality Improvement Program, 2016-2019
Provides contact information and a brief overview of the 32 initiatives funded by the Federal Office of Rural Health Policy through the Small Health Care Provider Quality Improvement Grant Program in the 2016-2019 funding cycle. The program supports rural primary care providers implementing quality improvement activities, with the goal of promoting the development of an evidence-based culture and delivery of coordinated care in the primary care setting.
Date: 2017
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Quality Improvement Basics: A Collection of Helpful Resources for Rural Health Care Organizations
Designed for healthcare professionals who are new to the field, lists prominent organizations, learning resources, and programs related to healthcare quality improvement. Also includes a short list of recommended reading.
Date: 12/2016
Type: Document
Sponsoring organization: Stratis Health
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Network Spotlight: North Coast Clinics Network
Highlights the Eureka, California based North Coast Clinics Network (NCCN), which works to improve efficiency and quality of care across its Federally Qualified Health Center (FQHC) members. Covers NCCN's characteristics, lessons learned, accomplishments, and challenges faced through an interview with Director of Education and Innovation, Trisha Cooke, and Executive Director, Tim Rine.
Date: 10/2016
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Medicare Accountable Care Organizations: Quality Performance by Geographic Categories
Using CMS 2014 and 2015 Medicare Accountable Care Organization (ACO) data, this brief examines the differences in ACO performance on 4 domains of quality measures: Patient/Caregiver Experience (PCE), Care Coordination/Patient Safety (CCP), Preventive Health (PH), and At-Risk Population (AtR) in rural and urban areas, and discusses the overall quality score of Medicare Shared Savings ACOs by geographic category.
Author(s): Xi Zhu, Keith Mueller, Thomas Vaughn, Fred Ullrich, A. Clinton MacKinney
Date: 09/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Stroudwater Population Health
An 8-part video series designed to help rural healthcare organizations transition from payment for volume to payment for value, and advance population health strategies. Each part discusses an important strategy for achieving population health including quality and efficiency, network relationships and service rationalization, employer-sponsored health plans and fee-for-service payments, shared savings plans, and full risk payments and capitation.
Date: 06/2016
Type: Video/Multimedia
Sponsoring organization: Stroudwater Associates
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Telehealth: Mapping the Evidence for Patient Outcomes From Systematic Reviews
A review of literature resulting in an evidence map for telehealth impacts on clinical outcomes for use by policymakers and other healthcare leaders. Identifies key areas that lack evidence-based research and suggests future studies needed to aid systematic review.
Author(s): Annette M. Totten, Dana M. Womack, Karen B. Eden, et al.
Date: 06/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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National Healthcare Quality and Disparities Chartbook on Care Coordination
A summary of trends in Care Coordination from the National Healthcare Quality and Disparities Report (QDR) for 2015. Includes data and statistics by metropolitan statistical area with a focus on groups with disparities in care coordination regarding hospital and emergency department visits, discharge, readmission, use of ED for chronic health care and potentially avoidable hospitalizations. Also highlights the use of electronic health records and electronic exchange and how that affects care coordination and quality.
Date: 06/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Quality Measures and Sociodemographic Risk Factors: The Rural Context
Demonstrates how rurality and sociodemographic variables may impact patient outcomes for rural populations using rural appropriate quality measures. Estimates the impact of adjusting quality measurement for the rural environment.
Author(s): Carrie Henning-Smith, Katy B. Kozhimannil, Shailendra Prasad, Michelle Casey, Ira Moscovice
Date: 05/2016
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Transforming Clinical Practice Initiative
Recording of an April 2016 webinar on the Transforming Clinical Practice Initiative (TCPI) model, featuring representatives from the Centers for Medicare & Medicaid Services and two Practice Transformation Networks.
Additional links: Presentation Slides
Date: 04/2016
Type: Video/Multimedia
Sponsoring organization: Federal Office of Rural Health Policy
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Module 5: RHC Performance Measurement and Quality Improvement
Provides guidance for State Offices of Rural Health (SORHs) working with Rural Health Clinics (RHCs) to help them meet the RHC Conditions of Participation (CoPs) in areas of program evaluation, quality improvement, and quality assurance and performance improvement (QAPI). Includes a summary of the requirements related to quality for RHCs and a concise history of their development. Part of the Rural Health Clinic Technical Assistance Educational Series.
Date: 03/2016
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Jump Start Stewardship: Implementing Antimicrobial Stewardship in a Small, Rural Hospital
Presented in workbook format, provides small hospitals with guidance, tools, and resources for creating a successful antimicrobial stewardship program.
Author(s): Jamie Moran, Marisa D'Angeli, Kelly Kauber
Date: 03/2016
Type: Document
Sponsoring organization: Qualis Health
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Reducing Potentially-Preventable Readmissions in Critical Access Hospitals
A policy brief describing evidence-based readmission prevention programs and strategies shown to be effective at reducing readmission rates for small rural hospitals, including Critical Access Hospitals (CAHs).
Author(s): Emma Distel, Michelle Casey, Shailendra Prasad
Date: 03/2016
Type: Document
Sponsoring organization: Flex Monitoring Team
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Small Health Care Provider Quality Improvement Grant: A Cultural Shift in Quality for Providers
Features four grantees who undertook quality improvement programs supported by Federal Office of Rural Health Policy grants. Includes videos featuring the work of two of these grantees.
Author(s): Zachary Toliver
Citation: Rural Monitor
Date: 02/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Pilot Testing a Rural Health Clinic Quality Measurement Reporting System
Policy brief with results of a study focusing on assessing the feasibility and utility of the reporting system and quality measures for 61 participating Rural Health Clinics in 6 states. Includes statistics related to core measures and their perceived value as well as challenges or barriers to their use.
Author(s): John Gale, Anush Hansen, David Hartley, Andrew Coburn
Date: 02/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Rural Hospital and Physician Participation in Private Sector Quality Initiatives
Results of a study to analyze 12 quality reporting and quality improvement programs being used by dominant insurers in Alabama, Kansas, Michigan, New Hampshire, South Carolina, and Utah, between 2011 and 2013.
Author(s): Amanda Diehl, Michelle Casey, Alex Evenson
Date: 10/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Hospital Value-based Purchasing: Initial Results Show Modest Effects on Medicare Payments and No Apparent Change in Quality-of-Care Trends
Evaluates the initial effects of the Hospital Value-based Purchasing (HVBP) program on Medicare bonus payments and penalties, the quality of care provided, and selected quality improvement efforts during FY 2013-15. Analyzes data from safety net, small urban, and small rural hospitals.
Additional links: Full Report
Date: 10/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Performance Measurement for Rural Low-Volume Providers: Final Report
Identifies challenges to measuring healthcare performance among low-volume rural providers, and presents recommendations to meet these challenges. Primary focus is on finding appropriate quality measures for use within Centers for Medicare and Medicaid Services' (CMS) pay-for-performance programs and encouraging rural participation in CMS quality improvement initiatives.
Date: 09/2015
Type: Document
Sponsoring organization: National Quality Forum
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Comprehensive Quality Improvement in Rural Health Care
Policy paper addresses comprehensive quality improvement for rural healthcare by incorporating and tailoring strategies from the National Quality Strategy (NQS) aims of better care, healthy people/communities and affordable care to better suit rural healthcare. Includes four broad steps to help guide rural facilities through the quality improvement process.
Author(s): Kevin Driesen, Gretchen Holmes, Mary Smith
Date: 02/2015
Type: Document
Sponsoring organization: National Rural Health Association
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Rural Clinician Evaluation of Children's Health Care Quality Measures: An Oregon Rural Practice-based Research Network (ORPRN) Study
Results of a survey in which 172 physicians identified which measures were most useful in reporting and improving care in their daily practice.
Author(s): Lyle J. Fagnan, LeAnn Michaels, Katrina Ramsey, et al.
Citation: Journal of the American Board of Family Medicine, 28(5), 595-604
Date: 2015
Type: Document
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Grantee Directory: Small Health Care Provider Quality Improvement Grant Program, 2013-2016
Provides contact information and a brief overview of the 29 initiatives funded by the Federal Office of Rural Health Policy through the Small Health Care Provider Quality Improvement Grant Program in the 2013-2016 funding cycle. The program supports rural primary care providers implementing quality improvement activities, with the goal of promoting the development of an evidence-based culture and delivery of coordinated care in the primary care setting.
Date: 12/2014
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Geographic Variation in Potentially Preventable Hospitalizations for Acute and Chronic Conditions, 2005-2011
Examines potentially preventable hospitalizations for adults from 2005 to 2011. Includes data for acute and chronic conditions by location of patient residence for large and small metropolitan, micropolitan, and remote rural areas.
Author(s): Celeste M. Torio , Roxanne M. Andrews
Date: 09/2014
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Quality: Tough Issue!
Discusses whether quality measures and patients’ wishes may be at odds, and how that affects the perception of whether rural hospitals provide quality care.
Author(s): Wayne Myers
Citation: Rural Monitor
Date: 08/2014
Type: Document
Sponsoring organization: Rural Health Information Hub
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Characteristics of Adverse Drug Events Originating During the Hospital Stay, 2011
Provides hospital inpatient data on the four most common adverse drug events (ADEs). Table 1 and Figure 4 list data on ADEs for rural compared to urban hospitals.
Author(s): Audrey J. Weiss, Anne Elixhauser
Date: 10/2013
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Findings and Lessons from the Improving Quality Through Clinician Use of Health IT Grant Initiative
Details the findings of 24 Agency for Healthcare Research and Quality (AHRQ) funded projects, both in rural and urban settings, examining how health IT applications can assist healthcare providers in providing evidence based care. Discusses multiple factors related to improving quality through health IT including supporting clinical workflow and coordinating care.
Date: 09/2013
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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2013 National Rural Emergency Department Study: Establishing Rural Relevant Benchmarks
Evaluates performance measures in rural hospitals' emergency departments in comparison to their urban counterparts during the 2012 calendar year.
Date: 07/2013
Type: Document
Sponsoring organization: iVantage Health Analytics
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Obstetric Services and Quality Among Critical Access, Rural, and Urban Hospitals in Nine States
Compares the characteristics and quality of obstetric care in Critical Access Hospitals, other rural hospitals, and their urban counterparts.
Author(s): Katy Kozhimannil, Peiyin Hung, Maeve McClellan, et al.
Date: 06/2013
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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An Overview of Lean: A Guide for the Small Rural Hospital Improvement Grant Program
Explains the key Lean concepts as they relate to rural healthcare delivery, and outlines the necessary steps that will help rural healthcare facilities reduce waste, improve productivity, and provide better patient care.
Date: 04/2013
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Guide: Using HCAHPS to Drive Patient and Employee Satisfaction
Describes the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and data collection process. Explains how rural providers can use the survey findings to improve hospital operations, patient outcomes, and quality scores. Includes case studies of two hospitals that used HCAHPS data to successfully drive patient and employee satisfaction.
Date: 03/2013
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Emergency Transfers of the Elderly from Nursing Facilities to Critical Access Hospitals: Opportunities for Improving Patient Safety and Quality
Examines the evidence and best practices to improve the nursing facility-to-hospital transition of care. Provides tools to improve communication between patients, nursing facilities, and hospitals. Includes recommendations for the role of state Flex Programs in the transition of care process.
Author(s): Karen B. Pearson, Andrew F. Coburn
Date: 01/2013
Type: Document
Sponsoring organization: Flex Monitoring Team
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Evidence-Based Surgical Care Quality Improvement Programs and Strategies for Critical Access Hospitals
Focuses on evidence-based surgical care QI programs and strategies applicable to inpatient and outpatient surgeries in CAHs. One in a series of policy briefs identifying and assessing evidence-based patient safety and quality improvement interventions for use by state Flex Programs and Critical Access Hospitals (CAHs).
Author(s): Jill Klingner, Michelle Casey, Shailendra Prasad, Walter Gregg, Ira Moscovice
Date: 08/2012
Type: Document
Sponsoring organization: Flex Monitoring Team
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Evidence-Based Acute Myocardial Infarction (AMI) Quality Improvement Programs/Strategies for Critical Access Hospitals
Discusses evidence-based AMI Quality Improvement (QI) programs and strategies that are applicable to Critical Access Hospitals (CAHs). Covers Centers for Medicare and Medicaid (CMS) AMI quality measures.
Author(s): Shailendra Prasad, Jill Klingner, Michelle Casey, Walter Gregg, Ira Moscovice
Date: 08/2012
Type: Document
Sponsoring organization: Flex Monitoring Team
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Public Reporting of Quality by Critical Access Hospitals: The Key Issues
Policy paper reviews the progress made in rural hospital public reporting of quality from 2005-2012 with an increased emphasis and use of data for measuring performance and maintaining payment. Describes the current challenges Critical Access Hospitals (CAHs) face when participating in quality reporting.
Date: 01/2012
Type: Document
Sponsoring organization: National Rural Health Association
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Quality Incentives for Federally Qualified Health Centers, Rural Health Clinics and Free Clinics: A Report to Congress
Discusses current initiatives and incentives that apply to primary care clinics regarding quality of care and the use of health information technology.
Date: 01/2012
Type: Document
Sponsoring organization: George Washington University Department of Health Policy and Management
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Relevant Quality Measures for Critical Access Hospitals
Policy brief describes quality measures relevant to Critical Access Hospitals (CAHs) and identifies policy implications.
Author(s): Michelle Casey, Ira Moscovice, Jill Klingner, Shailendra Prasad
Date: 01/2012
Type: Document
Sponsoring organization: Flex Monitoring Team
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TeamSTEPPS: Better Hospital Teamwork Increases Patient Safety
Discusses the TeamSTEPPS system, which improves patient safety by fostering better communication and teamwork among health care professionals.
Author(s): Candi Helseth
Citation: Rural Monitor, 2011(Fall)
Date: 11/2011
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Health Networks Prove There is Strength in Numbers
Discusses how quality is increasing measurably for hospitals enrolled in rural health networks in Michigan and Montana.
Author(s): Candi Helseth
Citation: Rural Monitor, 2011(Fall)
Date: 11/2011
Type: Document
Sponsoring organization: Rural Health Information Hub
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Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients
Assesses how bundled payments may affect both healthcare quality and access among rural providers, and explains the financial and operational challenges associated with implementing bundled payments in low-volume providers such as Critical Access Hospitals (CAHs).
Author(s): Robert Town, Walter Gregg, Ira Moscovice, Shailendra Prasad, Jill Klingner
Date: 09/2011
Type: Document
Sponsoring organization: Upper Midwest Rural Health Research Center
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Modernizing Rural Health Care: Coverage, Quality and Innovation
Examines health needs of rural populations, and how well the health care system addresses them. Presents new data on rural care quality; on the views of people living in rural areas; rural networks; rural telemedicine; and what their physicians see as the major challenges to overcome. This is the sixth in a series of working papers by UnitedHealth Group focusing on health reform topics.
Date: 07/2011
Type: Document
Sponsoring organization: UnitedHealth Group
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The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look
Summarizes six issue areas of the Affordable Care Act (ACA) and discusses implications for access to services and improving the health status of rural residents. These issue areas are: health insurance coverage; Medicare and Medicaid payment; quality, financing, and delivery system reform; public health; healthcare workforce; and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller
Date: 09/2010
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Patient Assessments and Quality of Care in Rural Hospitals
Analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care. Includes some breakdowns for Critical Access Hospitals (CAHs).
Additional links: Policy Brief
Author(s): Michelle M. Casey, Gestur Davidson
Date: 06/2010
Type: Document
Sponsoring organization: Upper Midwest Rural Health Research Center
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Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing?
Compares the quality of care provided by rural and urban hospitals for patients with acute myocardial infarction. Includes breakdowns by admission characteristics, such as concurrent conditions, and for remote rural areas.
Additional links: Policy Brief
Author(s): Laura-Mae Baldwin, Leighton Chan, C. Holly A. Andrilla, Edwin Huff, L. Gary Hart
Date: 03/2010
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Models for Quality Improvement in Critical Access Hospitals: The Role of State Flex Programs
Examines the scope of multi-Critical Access Hospital (CAH) quality improvement and performance measurement reporting initiatives supported by the Medicare Rural Hospital Flexibility Program (Flex Program) in nine states. Reports that the Flex Program has been instrumental in funding and providing leadership for the development of Critical Access Hospital (CAH) quality improvement initiatives.
Additional links: Policy Brief: The Role of State Flex Programs in Supporting Quality Improvement in Critical Access Hospitals
Author(s): Andrew Coburn, John Gale, Melanie Race, Mark Richards, Anush Hansen
Date: 03/2010
Type: Document
Sponsoring organization: Flex Monitoring Team
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Quality Through Collaboration: The Future of Rural Health Care
Examines healthcare quality in rural America and offers a strategy to address the quality challenges in rural communities. Includes key findings on rural healthcare quality and patient safety, as well as recommendations.
Additional links: Read Online
Date: 2005
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Crossing the Quality Chasm: A New Health System for the 21st Century
Examines the healthcare delivery system in rural America and recommends a fundamental redesign to ensure high quality, safe, and effective healthcare provision for all Americans. (Free, registration required.)
Author(s): Committee on the Quality of Health Care in America
Date: 03/2001
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Rural Quality Advisory Council - Rural Quality Improvement Technical Assistance (RQITA)
The advisory council informs the work of RQITA, which provides technical assistance related to quality reporting and improvement for Federal Office of Rural Health Policy quality initiatives. Provides access to Rural Quality Advisory Council meeting summaries and lists advisory council members, key partners, and staff.
Type: Website
Sponsoring organization: Stratis Health
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Eligible Hospital / Critical Access Hospital eCQMs
Features updated electronic clinical quality measures (eCQMs) for Hospital Inpatient Quality Reporting (IQR) Program and the Medicare and Medicaid Promoting Interoperability programs for 2019 reporting in Eligible Hospitals and Critical Access Hospitals (CAHs).
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Stratis Health 2017 MIPS Estimator
Web-based tool allows providers to calculate a composite Merit-based Incentive Payment System (MIPS) score. Presents data submission methods to produce the highest base-line score and enables workflow adjustments to improve patient outcomes.
Type: Tool
Sponsoring organization: Stratis Health
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Hospice Compare
Provides information on quality of care provided by Medicare-certified hospice agencies, using data related to patient preferences and effectiveness in managing pain and treating symptoms.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Support for Small, Underserved, and Rural Practices
Section of the Quality Payment Program (QPP) website, enabling practices with 15 or fewer clinicians to receive free, customized technical assistance, including help choosing and reporting on quality measures, guidance with strategic planning, and support optimizing health information technology.
Type: Website
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MBQIP Monthly
A monthly electronic newsletter providing Critical Access Hospitals (CAHs) information and support for quality reporting and improvement. Includes news items about the Medicare Beneficiary Quality Improvement Project (MBQIP).
Type: Journal/Newsletter
Sponsoring organization: Stratis Health
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Physician Compare
Provides consumers with information on physicians that accept Medicare patients. Includes practice location, physician specialties, hospital affiliation, and participation in selected Centers for Medicare and Medicaid Services quality improvement programs.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Quality Check-Up Tool
Tool used for the self-evaluation of community health programs, for the purpose of promoting quality in mobile health clinics, identifying public health strengths, and identifying quality improvement goals for strategic planning. Defines 5 of the U.S. Department of Health and Human Services' 9 aims for public health quality.
Type: Tool
Sponsoring organization: Harvard Medical School
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Residents of Rural Areas Quality Measures Compared to Achievable Benchmarks
Compares National Healthcare Quality Report quality measures for rural areas to achievable benchmarks. Identifies measures where rural areas achieved or exceeded the benchmark, were close to the benchmark, and far from the benchmark. Includes links to the data.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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National Healthcare Quality and Disparities Reports Data Query
Interactive tool for accessing national and state data from the National Healthcare Quality and Disparities Reports, including trends. To view national rural data, select "Priority Populations" under subject area and "Residents of Rural Areas" under topic.
Type: Database
Sponsoring organization: Agency for Healthcare Research and Quality
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CMS Quality Initiatives - General Information
Lists the various Centers for Medicare and Medicaid Services (CMS) quality initiatives with narration and links.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Dartmouth Atlas of Health Care
Provides access to Medicare data on enrollee demographics, reimbursement, utilization and quality. Map-based interface with profiles by hospital and region. Also includes national maps and data by topic.
Type: Website
Sponsoring organization: The Dartmouth Institute for Health Policy and Clinical Practice
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Toolkit for Using the AHRQ Quality Indicators
Resource for hospitals planning to use the Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs), including the Patient Safety Indicators (PSIs), to track and improve inpatient quality and patient safety. Also serves as a general guide to applying improvement methods in a hospital setting.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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QualityNet
CMS-approved website for secure communications and healthcare quality data exchange between: quality improvement organizations (QIOs), hospitals, physician offices, nursing homes, end stage renal disease (ESRD) networks and facilities, and data vendors.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Beneficiary Quality Improvement Project (MBQIP)
Resources designed to help Critical Access Hospitals understand and execute the MBQIP measures. Includes tools and strategies rural hospitals can use to report, analyze, and translate their data into actual quality improvement.
Type: Website
Sponsoring organization: National Rural Health Resource Center
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State Flex Profiles
Profiles of each state's Rural Hospital Medicare Flexibility (Flex) Program activities related to supporting Critical Access Hospitals (CAHs). Includes state Flex program contacts.
Type: Website
Sponsoring organization: Technical Assistance and Services Center
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PubMed Search: Health Care Quality and Rural Health Services
Searches PubMed's collection of journal article citations on the topic of rural healthcare quality.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
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National Practitioner Data Bank
Repository of reports on medical malpractice payments and certain adverse actions related to healthcare practitioners, providers, and suppliers.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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Health System Data Center
An interactive U.S. map providing access to state and hospital referral region data and comparative rankings on healthcare access, quality, cost, and outcomes. Provides access to the Commonwealth Fund's Scorecard on State Health System Performance.
Type: Website
Sponsoring organization: Commonwealth Fund
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WhyNotTheBest.org
Tracks healthcare quality performance measures. Enables organizations to compare their performance against that of their peers in both rural and urban locations. Includes reports, maps, and improvement tools and resources.
Type: Website
Sponsoring organization: Commonwealth Fund
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TeamSTEPPS Curriculum Tools and Materials
An evidence-based teamwork system aimed at optimizing patient outcomes by improving teamwork skills among healthcare professionals. Includes a comprehensive set of ready-to-use materials and training curricula necessary to successfully integrate teamwork principles into your healthcare system.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Survey on Patient Safety Culture
Hospital staff survey designed to help hospitals assess the culture of safety in their institutions. Includes survey form, items, components, user's guide, and a comparative database.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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AHA Quality and Patient Safety
Listing of resources from the American Hospital Association (AHA) to assist hospitals accelerate their quality and performance improvement processes. Features tools, articles and news.
Type: Website
Sponsoring organization: American Hospital Association
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AHRQ Health Care Innovations Exchange
Provides access to innovations, tools, learning opportunities, and networking opportunities all designed to assist with the implementation of new and better ways of delivering healthcare.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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National Healthcare Quality and Disparities Reports
Provides access to reports and data on healthcare quality and disparities information, including strengths, weaknesses, and opportunities for improvement. State View provides information on how each state compares to national healthcare quality benchmarks.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Consumer Assessment of Healthcare Providers and Systems (CAHPS)
A public-private initiative, funded and overseen by AHRQ, that develops and maintains standardized surveys for the purpose of measuring patients' experiences and satisfaction with their healthcare services.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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PSNet: Patient Safety Network
Highlights the latest patient safety literature, news, and expert commentary. Includes resources addressing patient safety in rural settings.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Compare
Provides information on the quality of care provided by Medicare-certified hospitals. Includes data on patient experiences, timely and effective care, complications and deaths, unplanned hospital visits, use of imaging, and payment and value of care.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Home Health Compare
Provides information on quality of care provided by Medicare-certified home health agencies, including skilled nursing care, physical and occupational therapy, and home health aide services.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Nursing Home Compare
Provides detailed information on every Medicare- and Medicaid-certified nursing home in the United States. Includes facility-level information on health inspections, fire inspections, staffing, quality of care, and any penalties.
Type: Database
Sponsoring organization: Centers for Medicare and Medicaid Services
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