1. Kansas Rural Health Options Project Quality Improvement Committee CAH QI Survey Results Spring, 2002 Survey administered and analyzed, on behalf of KRHOP, by Stephen Blattner, MD

2. Executive Summary

3. CAH QI Survey Results - 12/2001Page 3/39 Executive Summary Survey Responses - 1 Responses were felt to be representative of CAHs There was substantial dissatisfaction regarding the value of some current QI measurements at CAH –Administrators were more likely to express dissatisfaction –Few respondents indicated that QI measures are linked to the broader performance of the organization (strategic/business planning) or community health Responses revealed that basic QI tools and processes are not routinely utilized by CAH QI staff –This was more likely to be seen in respondents who lacked access to new information technology (IT) –Penetration of IT to management appeared higher than to “line staff” –Respondents indicated they were more interested in training focusing on project selection and design rather than in tools –Although existing measurement tools may be inadequate, there was high interest in projects for improving patient care, outcomes, and processes

4. CAH QI Survey Results - 12/2001Page 4/39 Executive Summary Survey Responses - 2 Most systems for tracking QI performance are “home grown” Penetration of information technology (including hardware, software, and functional Internet access) to non-managers is limited –In several questions, respondents distinguished between access for staff and access for managers. Managers are aware of this and see it as a problem –The primary impact may be that implementing improvement activities at the front line level is limited by access to IT There may be a secondary impact – lack of access to IT may be associated with a diminished desire to learn QI tools or a lack of awareness regarding what tools exist Internet access, internal networking, and network level electronic linkages are sub-optimal in configuration and distribution among staff and management Hospital wide QI reporting among CAHs is not uniformly frequent and, in some cases, inadequate to support a meaningful QI program Clinical pathways for management of common conditions are not utilized extensively by CAHs Financial metrics are not often included in QI indicators used by CAHs

5. CAH QI Survey Results - 12/2001Page 5/39 Executive Summary Survey Responses - 3 There is widespread interest in peer benchmarks for CAHs There is little formal collaboration between EMS providers and CAHs in the assessment and improvement of emergency medical care and transport Desired focus areas for QI Technical Assistance indicated by responses: –Training, Tools, Technology –Staff Development –Project Selection and Design –Patient Care Operations/Processes –Network Functionality/Peer Benchmarking –Continuum of Care Issues –Clinical Outcomes –Customer/Market Focus –EMS –Care of the Elderly –Achieving Community Health Goals

6. Survey Questions and Responses

7. CAH QI Survey Results - 12/2001Page 7/39 CAH QI Survey Respondent Characteristics - 1 42 CAH respondents –4 non-CAH (excluded) Range of time at institution was 6 mos. – 40 years Range of time at position was 3 mos. – 20 years –Administrators: 6 mos. – 17 years –Managers/Directors: 3 mos. – 20 years –Participants: 9 mos. – 19 years No instance of duplication within a hospital (i.e. Administrator and QI Manager)

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40. CAH QI Survey Results - 12/2001Page 40/39 Question 23: If a Statewide Rural Health Quality Initiative was to be undertaken, it should focus on the following (pick up to 10):

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