Critical access hospitals in Idaho have markedly improved care for heart and pneumonia patients by working directly with Qualis Health in partnership with the Idaho State Office of Rural Health and the Idaho Hospital Association.
Fourteen critical access hospitals—rural hospitals with 25 beds or less—worked together to share information and resources in the just-concluded eight-month Idaho Critical Access Hospital Collaborative.
Qualis Health provided tools and intervention materials, as well as clinical expert education for participant hospital teams with evidence-based strategies for treating heart and pneumonia patients. Qualis Health also conducted a series of “learning sessions” where participating hospital staff shared their experiences.
The Idaho Hospital Association (IHA) provided data management tools and analysis reports.
“Not only did the participating hospitals make significant strides in improving healthcare in their own facilities, they also committed themselves to helping each other and improving patient care statewide,” according to Janel Galbraith, director of performance improvement for IHA.
“Even though the project is technically over, the commitment is still there. Participating facilities are working together to improve quality because it is the right thing to do for patients.”
The Idaho Office of Rural Health and Primary Care provided grant funding from the Medicare Rural Hospital Flexibility Program. The grant strengthens rural health infrastructure through network development, integration of emergency medical services and activities to enhance healthcare quality.
“This project provided an excellent opportunity to strengthen partnerships and optimize resources at the organizational level between our office, Qualis Health and the Idaho Hospital Association,” said Mary Sheridan, health policy supervisor for the Idaho Office of Rural Health and Primary Care. “Idaho’s critical access hospitals responded with tremendous energy and dedication and the results are impressive.”
How McCall Memorial Hospital improved care
McCall Memorial Hospital is a 15-bed full service acute care hospital that serves a rural community nestled against protected wilderness areas in a popular skiing area of Idaho. It’s more than 100 miles away from the nearest tertiary hospital, so its services are a matter of life-and-death not only for tourists but also residents within a 50-mile radius.
Heart patients make up the largest single category of acute visits to the McCall emergency room, according to Vice President of Patient Care and Nursing Linda Klind. That’s why the hospital was eager to participate in a project to improve care for heart and pneumonia patients in critical access hospitals.
By working with Qualis Health, the Idaho State Office of Rural Health and the Idaho Hospital Association, McCall made significant improvement in timely administration of medications for heart attack patients, and incorporated pneumococcal vaccinations into standing orders for the first time.
“We’re at virtually 100 percent of on-time administration of aspirin and ACE inhibitors for heart patients, and there’s definitely been a dramatic improvement in pneumonia immunizations,” Klind said.
The project reflects the growing awareness among public health policymakers of the need to provide smaller, rural hospitals with resources adequate to deliver best practice, evidence-based care. It was specifically mentioned in “Quality through Collaboration” recently published by the Institute of Medicine.
“There are other overall results that reflect the success of the collaborative,” according to Jane Burgman, RN, co-manager of the project with Sharon Wilson, RN, BS, of Qualis Health. “Some are measurable, such as 100 percent participation in learning sessions, 96 percent submission rate for monthly reports and 75 percent participation rate in conference calls.
“Some are not quantifiable but just as successful. All teams shared their work, ideas and forms, and each team member built a family-like relationship with other participating members that reaches beyond the structured sessions,” she said. Collaborative teams are now the local experts in the quality improvement process and can share their skills with other rural hospitals.”
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