1. Rural Hospital Collaborative for Excellence Using IT AHRQ UC1 HS15431 Kathy Mechler, MS, RN, CPHQ Texas A&M University Health Science Center Rural and Community Health Institute

2. Grant Partners Baylor Health Care System Institute for Health Care Research & Improvement Dallas-Fort Worth Hospital Council Data Initiative Texas Medical Foundation Health Quality Institute

3. Project Objective Improve patient safety and quality of care in rural and critical access hospitals by providing: Access to web-based state of the art data processing and analytic tools Education and training Ongoing support and encouragement specific to performance measurement and using AHRQ quality and safety indicators in their respective performance improvement efforts

4. Taught basic concepts of : patient safety & quality improvement data analysis & interpretation required a project from each participating hospital Education Course

5. Study Eligibility Hospitals in counties with population ‹100,000 General Medical/Surgical (n=129) Critical Access (n=59) Eligible hospitals – 188 Funding for 62 hospitals – 66 hospitals in the study Agree to submit and share administrative data Agree to abstract and submit CMS Core Measures

6. Participants – 66 Hospitals

7. Hospital Discharge Data, CMS and AHA Quality Measures Technology Implementation Market Data Financial Data Operational Data Patient Safety & Quality Data Quality Improvement Process Strategic Planning Process Improved Patient Quality and Strategic Planning Technology Model for Improvement

8. How the data being used…

12. What have we learned? Data exports were challenging for rural hospitals Education and Support is critical to success Exceeded budgetary expectations Small numbers have been an issue Limited resources: Budget and Equipment Limited human resources Manpower, financial Independent, have a tendency to resist outside influence Short term view is focused on revenue to survive Different problems with patient safety Knowledge is broad but superficial Some of the hospitals do not take the time to code self paying patients due to no change or impact on their reimbursement

14. What are the hospitals saying?

15. How are the hospitals using the data?

16. Types of Assistance Used

17. Quality of Experience

18. Next Steps Evaluation Technology evaluation ongoing (qualitative & quantitative) Measurably improved data integrity Sustainability plan underway Additional funding for ambulatory data and other data initiatives

19. Thank you Contact Information: Kathy Mechler 979.862.5004 mechler@tamhsc.edu