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Forty-nine million people live in rural America. Comprising a variety of ethnic groups, varying degrees of remoteness and population densities, diverse economic backgrounds, and a multitude of social characteristics; one common bond is the need to receive quality health care. Concern about the quality of health care in both urban and rural United States has increased markedly since the release of two landmark reports by the Institute of Medicine - To Err is Human (1999) and Crossing the Quality Chasm (2001).

Significant gaps exist across all health care settings and there is no guarantee that consumers will receive quality care, regardless of where that care is provided. To improve care quality requires a number of strategies including a major redesign in health systems, paying for services in ways that encourage the delivery of high quality care, and the development of quality improvement infrastructure that measures care on meaningful indicators to determine where improvement efforts need to be made.

Most of the research designed to address these issues is conducted in urban health care settings. While some of these research findings and quality indicators are highly relevant to rural health care settings, many are not. Recently, increased attention is being paid to quality efforts designed to address the distinctive features of rural health care systems and settings such as limited access to core health care services, shortages in qualified health professionals, and an aging population.

In addition, advances in technology have presented new opportunities for delivering medical care in rural areas. Telemedicine, telepharmacy, electronic medical records and computerized physician order entries have shown to increase quality as well as access to health care particularly with the underserved and vulnerable populations. Most importantly improving care quality requires the participation of a range of stakeholders. Federal and state governments, purchasers of care, insurance companies, as well as health care providers must work together to ensure quality health care for the millions in rural America.

Frequently Asked Questions

Tools

Access for All America: Expanding the Reach of Community Health Centers To Provide Care to Those without a Health Care Home
Web site
Working to reduce the ranks of America’s medically disenfranchised by preserving, strengthening and expanding health centers from a stable base to reach a total of 30 million patients by the year 2015.
Sponsoring organization: National Association of Community Health Centers

AHA Quality and Patient Safety Center
Web site
A resource of the AHA to help hospitals accelerate their quality and performance improvement processes. Features tools, articles and news.
Sponsoring organization: American Hospital Association

AHRQ Patient Safety Tools and Resources
Web site
A list of titles, summaries and links of AHRQ patient safety tools and resources designed for health systems, providers, and consumers.
Sponsoring organization: Agency for Healthcare Research and Quality

AHRQ Quality Indicators Toolkit for Hospitals
Web site
Helps hospitals understand the Quality Indicators (QIs) from the Agency for Healthcare Research and Quality (AHRQ), and support the use of them to successfully improve quality and patient safety in hospitals.
Sponsoring organization: Agency for Healthcare Research and Quality

Clinician-Consumer Health Advisory Information Network (CHAIN)
Web site
Provides information to health-care professionals, patients, family members, medical faculty, and others about emerging issues concerning the safe and effective use of drugs, devices, and biological products.
Sponsoring organization: Agency for Healthcare Research and Quality

Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Web site
A public-private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care.
Sponsoring organization: Agency for Healthcare Research and Quality

ConsumerHealthRatings.com
Web site
Provides a listing of organizations that rate or report performance on specific hospitals, health plans, physicians, nursing homes, home health agencies and other health care providers in the United States. The ratings information is free.

Effective Health Care Program
Web site
Provides health care reports from quality research in formats for consumers, clinicians, and policymakers. Information available in Spanish.
Sponsoring organization: Agency for Healthcare Research and Quality

HCUPnet
Database
Online query tool for accessing Healthcare Cost and Utilization Project data. Provides access to health statistics and information on hospital stays at the national, regional, and State level. Includes data on rural hospital diagnoses and procedures.
Sponsoring organization: Agency for Healthcare Research and Quality

Health Care Innovations Exchange
Web site
Designed to support health care professionals in sharing and adopting innovations that improve the delivery of care to patients.
Sponsoring organization: Agency for Healthcare Research and Quality

Healthcare 411 Audio Series
Web site
Audio program featuring the latest health care research findings, news, and information from the Agency for Healthcare Research and Quality. Users can listen to individual programs or subscribe to the series.
Sponsoring organization: Agency for Healthcare Research and Quality

Healthcare and Quality
Web site
A topic page from the Institute of Medicine (IOM) that contains links to current projects, events, and reports addressing quality and patient safety.
Sponsoring organization: Institute of Medicine

Healthcare Communities
Web site
Provides a forum for the healthcare quality improvement community to share and contribute to each others' work. Includes a resource center with documents and tools related to community-based quality improvement initiatives.
Sponsoring organization: Health Resources and Services Administration

Healthy People 2020
Web site
Presents the schedule for Healthy People 2020, a 10-year national objective for promoting health and preventing disease. Works to achieve increased quality and years of healthy life and the elimination of health disparities.
Sponsoring organization: U.S. Department of Health and Human Services

Hospital Compare
Web site
Provides consumers with information on how well hospitals care for patients with specific medical conditions such as heart attacks, heart failure, or pneumonia, as well as surgical procedures.
Sponsoring organization: U.S. Department of Health and Human Services

Hospital Survey on Patient Safety Culture (Survey Form)
Web site
The Hospital Survey on Patient Safety Culture form which can be used to query hospital staff about patient safety issues, medical error, and event reporting.
Sponsoring organization: Agency for Healthcare Research and Quality

Hospital Survey on Patient Safety Culture (User's Guide)
Research instrument
Describes a survey tool which can be used to assess the safety culture of a hospital as a whole, or for specific units within hospitals, as well as to track changes in patient safety over time and evaluate the impact of patient safety interventions.
Sponsoring organization: Agency for Healthcare Research and Quality

Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report
Web site
Provides data and reporting results from participating hospitals that can be used as benchmarks in establishing a culture of safety. The report consists of a narrative description of the findings and two appendixes, presenting data by hospital characteristics and respondent characteristics.
Sponsoring organization: Agency for Healthcare Research and Quality

Improving Chronic Illness Care (ICIC)
Web site
Offers technical assistance with training and has an online archive of materials to help directors, coordinators and improvement experts in any effort aimed at improving care for the chronically ill.
Sponsoring organization: Robert Wood Johnson Foundation

Medicare Quality Monitoring System (MQMS)
Web site
Information on quality indicators of health care provided to Medicare beneficiaries, national and state-level outcomes, and brief reports on quality for clinical topics, such as heart failure and stroke.
Sponsoring organization: Centers for Medicare and Medicaid Services

MedlinePlus: Patient Rights
Web site
A collection of authoritative information from National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations on the topic of patient rights.
Sponsoring organization: National Library of Medicine

MedlinePlus: Patient Safety
Web site
A collection of authoritative information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations on the topic of patient safety.
Sponsoring organization: National Library of Medicine

My PHR: Personal Health Record
Web site
A guide to understanding and managing your personal health record. Provides step-by-step instructions for creating your own PHR.
Sponsoring organization: American Health Information Management Association

National AHEC Organization - AHEC Directory
Web site
Lists contact information for regional AHECs by state. AHEC's (Area Health Education Centers) work to recruit, train and retain health professionals committed to underserved populations.
Sponsoring organization: National Area Health Education Center Organization

National Healthcare Quality Report State Snapshots
Web site
Provides state-specific health care quality information, including strengths, weaknesses, and opportunities for improvement. Information is based on the National Healthcare Quality Report and National Healthcare Disparities Report and is updated annually.
Sponsoring organization: Agency for Healthcare Research and Quality

National Practitioner Data Bank - Healthcare Integrity and Protection Data Bank
Web site
An alert or flagging system intended to facilitate a comprehensive review of health care practitioners’ professional credentials.
Sponsoring organization: U.S. Department of Health and Human Services

National Quality Measures Clearinghouse
Web site
A public repository and database for evidence-based quality measures and measure sets. Includes standardized abstracts containing information about measures and their development; a utility for comparing attributes of two or more quality measures; and links to full-text quality measures and/or ordering details for the full measure.
Sponsoring organization: Agency for Healthcare Research and Quality

Partnership for Patients: Patient Safety Webinars
Web site
Schedule of the National Priorities Partnership Patient Safety Webinar Series that includes both future and past presentations along with meeting details, speaker bios and slides.
Sponsoring organization: Health Resources and Services Administration

Patient Safety Program Resource Guide
Web site
Designed to engage, educate and equip readers with products, services, tools and solutions made available by the PSP (Patient Safety Program) to help ensure the safe delivery of health care in the MHS (Military Health System.)
Sponsoring organization: U.S. Department of Defense

Patient Safety Tools: Improving Safety at the Point of Care
Web site
Tools designed to help health care institutions and clinicians provide - and consumers receive - safe, quality health care at various points in the health care process.
Sponsoring organization: Agency for Healthcare Research and Quality

Performance Snapshots
Web site
An authoritative online resource about health system performance. Tracks health system performance and provides access to more than 180 charts and associated narratives.
Sponsoring organization: Commonwealth Fund

Physician Quality Reporting System
Web site
Consists of a voluntary physician quality reporting program established by CMS providing financial incentive for eligible professionals.
Sponsoring organization: Centers for Medicare and Medicaid Services

PSNet: Patient Safety Network
Web site
A continuously updated, annotated, and selected collection of patient safety news, literature, tools, and resources.
Sponsoring organization: Agency for Healthcare Research and Quality

Quality Improvement & Risk Management Training
Tutorial
Five training modules on integrating quality and risk management led by George Rust, MD, MPH, deputy director of the National Center for Primary Care at Morehouse School of Medicine.
Sponsoring organization: Health Resources and Services Administration

QualityNet
Web site
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.
Sponsoring organization: Centers for Medicare and Medicaid Services

QualityTools
Web site
Web-based clearinghouse providing practical tools for assessing, measuring, promoting, and improving the quality of health care. Includes sections for health care providers, health plans, policymakers, purchasers, patients and consumers.
Sponsoring organization: Agency for Healthcare Research and Quality

Rural Health Clinics Technical Assistance Conference Call Series
Web site
An ongoing series of technical assistance conference calls for Rural Health Clinics. Includes transcripts from past calls and related resources and tools.
Sponsoring organization: Office of Rural Health Policy

Rural Health Research: Quality
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of health care quality, produced by the Office of Rural Health Policy's funded rural health research centers.
Sponsoring organization: Rural Health Research Gateway

Rural Hospital Education Gateway
Web site
A one-stop shop for rural hospitals to access distance and web-based educational resources on topics including community engagement, hospital finance, management and leadership, performance improvement, workforce and quality.
Sponsoring organization: National Rural Health Resource Center

State Scorecard 2009
Web site
An interactive U.S. map to view state-specific rankings and results compared to benchmarks, and to view the number of lives and dollars each state could save by achieving benchmark levels of performance.
Sponsoring organization: Commonwealth Fund

TalkingQuality
Web site
Designed for people and organizations trying to educate consumers about health care quality. It is intended to help those who are providing consumers with information on the performance of health plans and providers.
Sponsoring organization: Agency for Healthcare Research and Quality

TeamSTEPPS Tools and Materials
Web site
Is an evidence-based teamwork system aimed at optimizing patient outcomes by improving teamwork skills among health care professionals. It includes a comprehensive set of ready-to-use materials and training curricula necessary to integrate teamwork principles successfully into your health care system.
Sponsoring organization: Agency for Healthcare Research and Quality

Value-Driven Health Care
Web site
Provides health care consumers with the information necessary to choose health care providers based on value.
Sponsoring organization: U.S. Department of Health and Human Services

Veterans Rural Health Resource Centers: Central Region
Web site
Located in Iowa City, this center focuses on evaluating rural health programs and piloting new strategies to help Veterans overcome barriers to access and quality.
Sponsoring organization: Veterans Health Administration's Office of Rural Health

WhyNotTheBest.org
Web site
Tracks performance on various measures of health care quality. Enables organizations to compare their performance against that of their peers in both rural and urban locations.
Sponsoring organization: Commonwealth Fund

Your Guide to Choosing Quality Health Care
Web site
Website to help consumers choose the best healthcare provider for them.
Sponsoring organization: Agency for Healthcare Research and Quality

Funding

2012 KaiserEDU.org Essay Contest
A student essay contest with the topic of the Patient Protection and Affordable Care Act (ACA).

2012-2013 Patient Safety Leadership Fellowship
A yearlong intensive learning experience dedicated to preparing the next generation of health care leaders.

AHRQ Grant Program for Large or Recurring Conferences (R13)
Grants to support conferences that help to further its mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

AHRQ Health Services Research Demonstration and Dissemination Grants (R18)
Funding for Large Research Demonstration and Dissemination (R18) Projects

AHRQ Health Services Research Projects (R01)
Funding for Large Research (R01) Projects, and expresses AHRQ portfolio priority areas of interest for ongoing extramural health services research, demonstration, dissemination, and evaluation grants.

AHRQ Small Grant Program for Conference Support
Grants to support conferences that help to further its mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

Annual Monato Rural Essay Prize
Annual award for the University of Wisconsin's best rural health paper regarding networking, cooperatives, and rural communities .

Award for Excellence in Medication-Use Safety
An award program to honor a pharmacist-led multidisciplinary team for its significant institution-wide system improvements relating to medication use.

Community Based Care Transition Program
Funding to test models for improving care transitions for high risk Medicare beneficiaries.

Nursing Home Abuse.net - Awareness and Prevention Scholarship
This scholarship is awarded exclusively to an applicant who is pursuing a career that will help combat nursing home abuse.

Partnerships in Implementing Patient Safety II (R18)
Funding to support Research Demonstration and Dissemination (R18) grant applications to implement safe practice interventions.

Robert Wood Johnson Foundation Unsolicited Proposals
Grants to address health care workforce, innovative health care solutions, and health care to vulnerable populations.

Small Research Grant to Improve Health Care Quality through Health Information Technology (IT) (R03)
Funding to support the development and enhancement of expertise in health IT and related disciplines, including research and evaluation methods.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Regulations, Forms & Other Useful Documents

2007 Guide to State Adverse Event Reporting Systems
Author(s): Jill Rosenthal, Mary Takach
Sponsoring organization: National Academy for State Health Policy
A snap shot of the current scope and operations of state adverse event reporting systems and compares current information with information from previous NASHP work.
Date: 12 / 2007

2008 Update on Consumers' Views of Patient Safety and Quality Information
Sponsoring organization: Kaiser Family Foundation
Charts highlight data from the updated Kaiser Family Foundation and U.S. Agency for Healthcare Research and Quality survey conducted in July and August 2008. The survey captures the public's views and knowledge of medical errors and their experiences with improving the quality of their care.
Date: 10 / 2008

Access to U.S. Department of Veterans Affairs Healthcare: How Easy is it for Veterans-Addressing the Gaps
Author(s): Andy Behrman
Sponsoring organization: U.S. House of Representatives
Discusses current VA successes in providing quality care for rural veterans and suggestions for further improvements in quality of care. This is a written testimony by NRHA Rural Health Policy Board Chair Andy Behrman for the Health Subcommittee of the House Committee on Veterans' Affairs on April 18, 2007.
Date: 04 / 2007

Accountable Care Organizations: Will They Deliver?
Author(s): Marsha Gold
Sponsoring organization: Mathematica Policy Research, Inc.
Broadly examines the accountable care organizations (ACOs) by defining the concepts and rationale for interest in it, reviewing what has been learned from previous initiatives, and placing ACOs in the context of the broader health care system.
Date: 01 / 2010

Achieving Accountable Care: Are We on the Right Path?
Author(s): Stuart Guterman, Mark A. Zezza
Sponsoring organization: Commonwealth Fund
Analysis of how the proposed rules for the new Medicare Shared Savings Program of the Affordable Care Act recently released by the Centers for Medicare and Medicaid Services (CMS) achieves the aims of better health, better care, lower costs and remains responsive to the needs of health care organizations, payers, and patients.
Date: 04 / 2011

Achieving Success in QIO and Rural Hospital Partnerships
Author(s): Janet Pagan-Sutton, Lauren Silver, Jyoti Gupta
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Describes four case studies that highlight the strategies employed by QIOs to help small rural hospitals implement successful quality improvement initiatives.
Date: 02 / 2009

ACO Toolkit
Sponsoring organization: National Association of Community Health Centers
Provides a path forward for the implementation of Accountable Care Organizations (ACOs) for a diverse range of health care provider groups across the country.
Date: 01 / 2010

Advancing Health in Rural America: Maximizing Nursing’s Impact
Author(s): Mary S. Gorski
Sponsoring organization: AARP Public Policy Institute
Provides a link between the evidence-based nursing solutions in the IOM Future of Nursing: Leading Change, Advancing Health report and the health care challenges facing rural America. Outlines the challenges of providing access to quality, affordable care in rural areas, followed by examples of initial progress in additional support to key programs.
Date: 06 / 2011

Aiming Higher: Results from a State Scorecard on Health System Performance
Author(s): Joel C. Cantor, Dina Belloff, Cathy Schoen, Sabrina K. H. How, Douglas McCarthy
Sponsoring organization: Commonwealth Fund
Assesses health system performance on 32 measures of access and quality, avoidable hospital use and costs, equity and healthy lives. Intended to assist states in identifying opportunities to better meet their residents current and future health needs and enable them to live long and healthy lives.
Date: 06 / 2007

Building Medical Homes in State Medicaid and CHIP Programs
Author(s): Neva Kaye, Mary Takach
Sponsoring organization: Commonwealth Fund
Discusses how Medicaid and CHIP have strong foundational bases to develop policies that support medical homes and achieve the goals of quality improvement and cost containment.
Date: 06 / 2009

Checkup on Health Care Markets
Author(s): Patricia E. Powers, Michael W. Painter
Sponsoring organization: Robert Wood Johnson Foundation
Findings of a study of 14 selected communities that provides a roadmap for community-level improvements in the quality of health care for people with chronic illnesses.
Date: 2007

Clinical Nurse Leader and Rural Hospital Safety and Quality
Author(s): Angela Jukkala, Rebecca Greenwood, Kathleen Ladner, Laura Hopkins
Sponsoring organization: Rural Nurse Organization
Describes how the role of a Clinical Nurse Leader (CNL) can help in implementing quality and safety initiatives in rural health care.
Journal citation: Online Journal of Rural Nursing and Health Care Volume 10 Issue 2 Pages: 38-45
Date: 2010

Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies: Volume 7—Care Coordination
Sponsoring organization: Agency for Healthcare Research and Quality
Defines and discusses care coordination as a key strategy for improving the effectiveness and efficiency of the health care system in mostly urban but also in rural settings.
Date: 06 / 2007

Committed to Safety: Ten Case Studies on Reducing Harm to Patients
Author(s): Douglas McCarthy, David Blumenthal
Sponsoring organization: Commonwealth Fund
Ten case studies of health care organizations, clinical teams, and learning collaborations that have designed innovations in five areas for improving patient safety nationally: promoting an organizational culture of safety, improving teamwork and communication, enhancing rapid response to prevent heart attacks and other crises in the hospital, preventing health care - associated infections in the intensive care unit, and preventing adverse drug events throughout the hospital. Participating organizations ranged from large integrated delivery systems to small community hospitals.
Date: 04 / 2006

Covering Kids & Families Evaluation: Health Care for the Uninsured; Low-Income Parents’ Perceptions of Access and Quality
Author(s): Genevieve M. Kenney, Jennifer M. Haley, Jennifer E. Pelletier
Sponsoring organization: Robert Wood Johnson Foundation
Examines low-income parents’ perceptions of health care access and quality of care.
Date: 10 / 2009

Critical Access Hospital Quality Improvement Activities and Reporting on Quality Measures: Results of the 2007 National CAH Survey
Author(s): Michelle Casey
Sponsoring organization: Flex Monitoring Team
Indicates that Critical Access Hospitals continue to be actively involved in a wide range of quality improvement initiatives, with patient safety and medication safety in particular as major areas of focus.
Date: 03 / 2008

Critical Access Hospital Year 5 Hospital Compare Participation and Quality Measure Results (Briefing Paper)
Author(s): Michelle Casey, Michele Burlew, Ira Moscovice, Adam Hofer
Sponsoring organization: Flex Monitoring Team
Report examines 2008 participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare public reporting database for hospital quality measures.
Date: 03 / 2010

Critical Access Hospital Year 5 Hospital Compare Participation and Quality Measure Results (Policy Brief)
Author(s): Michelle Casey, Michele Burlew, Ira Moscovice
Sponsoring organization: Flex Monitoring Team
Policy brief examines the fifth year participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare public reporting database.
Date: 03 / 2010

Critical Access Hospital Year 6 Hospital Compare Participation and Quality Measure Results
Author(s): Michelle Casey, Michele Burlew, Ira Moscovice
Sponsoring organization: Flex Monitoring Team
Examines 2009 participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare public reporting database for hospital quality measures.
Date: 04 / 2011

Dartmouth Atlas of Health Care
Sponsoring organization: Robert Wood Johnson Foundation
The Dartmouth Atlas project is a funded research effort of the faculty of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School. The Atlas project brings together researchers in diverse disciplines - including epidemiology, economics, and statistics - and focuses on the accurate description of how medical resources are distributed and used in the United States.

Disparities in Children's Health Care Quality: Selected Examples from the National Healthcare Quality and Disparities Reports, 2008
Sponsoring organization: Agency for Healthcare Research and Quality
This fact sheet discusses differences between groups in terms of relative rates, which is the ratio of the comparison group (e.g., Black) to a baseline group (e.g., White).
Date: 06 / 2009

Electronic Consultations Between Primary and Specialty Care Clinicians: Early Insights
Author(s): Kathryn Horner, Ed Wagner, Jim Tufano,
Sponsoring organization: Commonwealth Fund
Explores the promise of electronic consultation (e-consultation) for enabling primary care clinicians and specialists to communicate about patients at times that are mutually convenient and in rural areas where there is a shortage of specialists.
Date: 10 / 2011

Evidence-Informed Case Rates: A New Health Care Payment Model
Author(s): François de Brantes, Joseph A. Camillus
Sponsoring organization: Commonwealth Fund
Reports on a new payment model, based on evidence-informed case rates (ECRs) as a way to address the flaws of traditional health care payment methods, and to improve health care quality and support a patient-centered, consumer-driven environment.
Date: 04 / 2007

Examination of the Healthcare Workforce Issues in Rural America
Author(s): Mary Wakefield, Patricia Moulton, Gary Hart
Sponsoring organization: U.S. Department of Health and Human Services
Eighth Annual Report to the Secretary of the United States Department of Health and Human Services and the United States Congress regarding workforce issues in rural America: enhancing health care for rural populations through interdisciplinary training and quality improvement; and rural health workforce status.
Date: 09 / 2008

Flowers Hospital: Nearing Perfection on Core Measures
Author(s): Jennifer Edwards
Sponsoring organization: Commonwealth Fund
In 2007, Flowers Hospital, a for-profit hospital in rural Alabama, achieved 99.7 percent compliance with CMS core measures, the second-highest score in the country. This report identifies the critical elements this hospital used to achieving high performance.
Date: 12 / 2008

Geographic Variation in Health Care Spending
Sponsoring organization: Congressional Budget Office
Examines the amount of and trends in geographic variation in health care spending, mostly in the Medicare program, and the causes of that variation. Also examines the relationship between spending and quality of care.
Date: 02 / 2008

Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-up Care Among Medicare Beneficiaries with Diabetes
Author(s): Kevin J. Bennett, Robert Chen, Medha Vyavaharkar, Saundra H. Glover, Janice C. Probst
Sponsoring organization: South Carolina Rural Health Research Center
Provides estimates of hospital admission rates for rural Medicare beneficiaries with diabetes, tracks the proportion of patients who receive adequate outpatient care post discharge, and assesses subsequent readmissions to the hospital. It also explores the potential for race-based disparities in care for diabetes.
Date: 09 / 2011

Health Care Opinion Leaders Survey: Views Vulnerable Populations
Author(s): Kristof Stremikis, Julia Berenson, Anthony Shih, Pamela Riley
Sponsoring organization: Commonwealth Fund
Reflects results from the Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey. Collection of documents includes a press release, data brief, chartpack, and tables.
Date: 08 / 2011

Health IT and Patient Safety: Building Safer Systems for Better Care
Sponsoring organization: Institute of Medicine
Examines the safety of health IT products and their effects on patient safety. Chapters two, four, and seven discuss safety specific to small practices and hospitals.
Date: 11 / 2011

Health Literacy: Program Brief
Sponsoring organization: Agency for Healthcare Research and Quality
Lists and describes research supported by the Agency for Healthcare Research and Quality (AHRQ) to improve health literacy as it pertains to prevention, healthy living, chronic disease management, patient-centered health care, cultural competence, and health disparities.
Date: 09 / 2007

Healthy People 2010 Final Review
Sponsoring organization: Centers for Disease Control and Prevention
Provides the final tracking data used to present a quantitative assessment of progress for the 969 objectives in the 28 Healthy People 2010 Focus Areas. Also includes a summary of progress for the Healthy People 2010 Leading Health Indicators.
Date: 10 / 2011

Healthy People 2010 Final Review: Executive Summary
Sponsoring organization: Centers for Disease Control and Prevention
Contains a progress assessment of the nation's health goals over the last decade. Determined that Americans had met or were moving towards meeting 71% of the program's 2010 targets.
Date: 10 / 2011

High Performance Rural Health Care System of the Future
Author(s): Keith J. Mueller, Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, Sidney D. Watson
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Describes a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness.
Date: 10 / 2011

Historic Opportunity: Wedding Health Information Technology to Care Delivery Innovation and Provider Payment Reform
Author(s): Todd Park, Peter Basch
Sponsoring organization: Center for American Progress
Reports on the integration of health information technology with care delivery innovation and provider payment reform.
Date: 05 / 2009

Hospital Performance Improvement: Trends in Quality and Efficiency--A Quantitative Analysis of Performance Improvement in U.S. Hospitals
Author(s): Eugene A. Kroch, Michael Duan, Sharon Silow-Carroll, Jack A. Meyer
Sponsoring organization: Commonwealth Fund
Presents results of a quantitative examination of the dynamics of hospital performance: the degree to which hospitals are improving (or deteriorating) in quality and efficiency over time.
Date: 04 / 2007

Hospital Quality Improvement: Strategies and Lessons From U.S. Hospitals
Author(s): Sharon Silow-Carroll, Tanya Alteras, Jack A. Meyer
Sponsoring organization: Commonwealth Fund
Focuses on the dynamics of hospital performance: how hospitals achieve and sustain improvements over time.
Date: 04 / 2007

Hospital Survey on Patient Safety Culture: 2009 Comparative Database Report
Sponsoring organization: Agency for Healthcare Research and Quality
Based on data from over 600 U.S. hospitals, this report provides initial results that hospitals can use as benchmarks in establishing a culture of safety.
Date: 04 / 2009

Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project
Author(s): Walter Gregg, Ira Moscovice, Denise Remus
Sponsoring organization: Upper Midwest Rural Health Research Center
Reports the findings of a national study designed to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration Project.
Date: 09 / 2006

Implementing Patient Safety Initiatives in Rural Hospitals: An Evaluation of the Tennessee Rural Hospital Patient Safety Demonstration
Author(s): Jill Klingner, Ira Moscovice, Mary Wakefield, Marlene Miller
Sponsoring organization: Upper Midwest Rural Health Research Center
Executive summary of a report describing a project to improve patient safety in eight rural hospitals by strengthening their capacity to implement priority patient safety initiatives. Full report available by contacting raasc001@umn.edu.
Date: 08 / 2007

Improving Medicaid Managed Care for Youth with Serious Behavioral Health Needs: A Quality Improvement Toolkit
Author(s): Kamala Allen, Sheila A. Pires
Sponsoring organization: Annie E. Casey Foundation
Details promising practices tested by nine participating health plans from the Center for Health Care Strategies: Collaborative on Improving Managed Care Quality for Youth with Serious Behavioral Health Needs.
Date: 09 / 2009

Improving Quality of Health Care Relies on Effective Language Services
Sponsoring organization: Robert Wood Johnson Foundation
Highlights how data are helping hospitals improve the way they provide language services to America's increasingly diverse patient populations.
Date: 09 / 2007

Innovations in Reducing Preventable Hospital Admissions, Readmissions, and Emergency Room Use: An Update on Health Plan Initiatives to Address National Health Care Priorities
Sponsoring organization: AHIP Center for Policy and Research
A review of successful health plan programs to revitalize primary care, improve care coordination, and help patients avoid adverse health events.
Date: 06 / 2010

Institute of Medicine Rural Health Report: Next Steps in Legislation and Programs
Author(s): Keith J. Mueller, Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Rebecca T. Slifkin, Mary Wakefield
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
Recommends federal policies that will improve patient safety and health care quality in rural America. The Panel's recommendations include innovative resource redirection and program coordination that will increase the value of federal quality improvement programs and ultimately improve the health of rural people and communities.
Date: 02 / 2006

Knowing What Works in Health Care: A Roadmap for the Nation
Sponsoring organization: Institute of Medicine
Results of the Robert Wood Johnson Foundation request that the Institute of Medicine convene a committee to recommend methods to better identify the most effective health care services. This report provides a blueprint for a national clinical effective assessment program.
Date: 2008

Leading Health Indicators for Healthy People 2020: Letter Report
Sponsoring organization: Institute of Medicine
Identifies a set of leading health indicators that could be used by Healthy People 2020. Includes a conceptual framework to develop these topics, indicators, and objectives.
Date: 03 / 2011

Lessons from Amazon.com for Health Care and Social Service Agencies
Author(s): Eric Brown, Larry Fulton
Sponsoring organization: California HealthCare Foundation
Discusses how health care organizations and social service agencies can maximize efficiencies, reduce errors and unnecessary costs by applying service-oriented architecture (SOA) strategies to their own system.
Date: 03 / 2009

Market for Medical Care: Why You Don’t Know the Price; Why You Don’t Know about Quality; And What Can Be Done about It.
Author(s): Devon M. Herrick, John C. Goodman
Discusses the issues regarding the differences in the way health care is marketed and ranked for quality, and discusses the solutions that are challenging these traditional practices.
Date: 02 / 2007

Marshfield Clinic: Health Information Technology Paves the Way for Population Health Management
Author(s): Douglas McCarthy, Kimberly Mueller, Sarah Klein
Sponsoring organization: Commonwealth Fund
Illustrates how Marshfield Clinic serving rural Wisconsin can improve patient outcomes and reduce costs by undertaking a population-based approach to ambulatory care management supported by information technology.
Date: 08 / 2009

Meaningful User of an Electronic Health Record System Describes Its Clinical and Financial Benefits
Author(s): Sarah Klein
Sponsoring organization: Commonwealth Fund
Summary of a rural family practice doctor's experience to be one of the first certified as a meaningful user of health information technology.
Journal citation: Quality Matters
Date: 06 / 2011

Measuring Efficiency: The Association of Hospital Costs and Quality of Care
Author(s): Ashish K. Jha, E. John Orav, Allen Dobson, Robert A. Book, Arnold M. Epstein
Sponsoring organization: Commonwealth Fund
Reviews a study exploring the relationship between cost and quality of care in more than 3,700 U.S. hospitals, including rural hospitals, treating Medicare patients.
Date: 05 / 2009

Measuring Hospital Performance: The Importance of Process Measures
Author(s): Anthony Shih, Stephen C. Schoenbaum
Sponsoring organization: Commonwealth Fund
Discusses measures that can have an impact on quality and health outcomes and identifies activities hospitals can do to improve performance.
Date: 07 / 2007

Models For Quality Improvement In Critical Access Hospitals: The Role Of State Flex Programs
Sponsoring organization: Flex Monitoring Team
Examines the range of multi-Critical Access Hospital (CAH) quality improvement and performance measurement reporting (QI) initiatives supported by the Medicare Rural Hospital Flexibility Program in nine states; assessed the role of State Flex Programs in developing and supporting these initiatives; and explored their impact on the QI programs of CAHs.
Date: 03 / 2010

Modernizing Rural Health Care: Coverage, Quality and Innovation
Sponsoring organization: UnitedHealth Center for Health Reform and Modernization
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; 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

Moving from Research to Practice: Evaluation Report II
Author(s): Donna O. Farley, Sally C. Morton, Cheryl L. Damberg, M. Susan Ridgely, Allen Fremont, Michael D. Greenberg, Melony E. Sorbero, Stephanie S. Teleki, Peter Mendel
Sponsoring organization: Agency for Healthcare Research and Quality
The second report in a four part series of evaluation reports. Documents activities, progress, and issues involved in conducting the AHRQ-funded patient safety projects; building the infrastructure to support improved patient safety practices; and disseminating research results and products.
Date: 2007

Multicultural Health Care: A Quality Improvement Guide
Sponsoring organization: National Committee for Quality Assurance
Provides a quality improvement framework for health care organizations seeking to promote culturally appropriate care, provide equitable access for individuals with limited English proficiency and reduce health care disparities.
Date: 2008

Multinational Comparisons of Health Systems Data, 2006
Author(s): Jonathan Cylus, Gerard F. Anderson
Sponsoring organization: Coalition for Health Services Research
A chartbook of data collected by the Organization for Economic Cooperation and Development (OECD) to compare the health care systems and performance in nine industrialized countries—Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, the United Kingdom, and the United States.
Date: 05 / 2007

Munson Medical Center: Constant Focus on Patient Satisfaction
Author(s): Sharon Silow-Carroll
Sponsoring organization: Commonwealth Fund
Munson Medical Center, a large non-profit hospital serving patients in 24 primarily rural counties, was identified as providing higher patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This case study describes the strategies and factors that contributed to their success.
Date: 12 / 2008

National Healthcare Quality Report, 2009
Sponsoring organization: Agency for Healthcare Research and Quality
A comprehensive national overview of the quality of health care in the United States. Includes measures of effectiveness, patient safety, timeliness, and patient centeredness.
Date: 03 / 2010

National Healthcare Quality Report, 2010
Sponsoring organization: Agency for Healthcare Research and Quality
Measures trends in effectiveness of care, patient safety, timeliness of care, patient quality, and efficiency of care.
Date: 02 / 2011

National Scorecard on U.S. Health System Performance, 2008: Chartpack
Sponsoring organization: Commonwealth Fund
Presents data for all indicators scored in the National Scorecard on U.S. Health System Performance, 2008. Charts display average performance for the U.S. as a whole and the range of performance found within the U.S or compared with other countries.
Date: 07 / 2008

On the Road to Better Value: State Roles in Promoting Accountable Care Organizations
Author(s): Kitty Purington, Anne Gauthier, Shivani Patel, Christina Miller
Sponsoring organization: Commonwealth Fund
Highlights key areas in which states have played a role in supporting the development of the ACO model. Provides state and national policymakers with information that can stimulate further innovation. Includes rural examples.
Date: 02 / 2011

Outcomes of Community Health Worker Interventions
Sponsoring organization: Agency for Healthcare Research and Quality
Results of a systematic review on the characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. Includes references to rural.
Date: 06 / 2009

Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way (Executive Summary)
Sponsoring organization: Commonwealth Fund
Offers recommendations for a comprehensive set of insurance, payment, and system reforms that could guarantee affordable coverage for all by 2012, improve health outcomes, and slow health spending growth by $3 trillion by 2020.
Date: 02 / 2009

Patient Assessments and Quality of Care in Rural Hospitals (Final Report)
Author(s): Michelle Casey, Gestur Davidson
Sponsoring organization: Upper Midwest Rural Health Research Center
Analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care.
Date: 06 / 2010

Patient Assessments and Quality of Care in Rural Hospitals (Policy Brief)
Author(s): Michelle Casey, Gestur Davidson
Sponsoring organization: Upper Midwest Rural Health Research Center
Analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics.
Date: 06 / 2010

Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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.
Date: 09 / 2010

Pay-for-Performance in State Medicaid Programs: A Survey of State Medicaid Directors and Programs
Author(s): K. Kuhmerker, T. Hartman
Sponsoring organization: Commonwealth Fund
Examines the current and planned P4P activities of state Medicaid programs, based on a survey and follow-up interviews with state Medicaid directors and their staffs as well as review of related documents.
Date: 04 / 2007

Paying for Quality: Understanding and Assessing Physician Pay-for-Performance Initiatives
Sponsoring organization: Robert Wood Johnson Foundation
Addresses five questions which are 1) What explains the current widespread interest in physician P4P; 2) How are current incentive programs structured and how prevalent are they; 3) What performance measurement issues does physician P4P raise; 4) How do physicians perceive quality incentive programs; and 5) What is the research evidence on the impact of P4P?
Date: 12 / 2007

Physician Pay-for-Performance in Medicaid: A Guide for States
Author(s): Karen LLanos, Joanie Rothstein, Mary Beth Dyer, Michael Bailit
Sponsoring organization: Center for Health Care Strategies
Provides actionable steps to help states design and implement physician-level P4P strategies.
Date: 03 / 2007

Prevalence of Evidence-Based Safe Medication Practices in Small Rural Hospitals
Author(s): Gary Cochran, Katherine Jones, Liyan Xu, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Describes the prevalence of evidence-based safe medication practices, including the use of voluntary medication error reporting, in small rural hospitals.
Date: 04 / 2008

Primary Care Access: An Essential Building Block of Health Reform
Sponsoring organization: National Association of Community Health Centers
Examines why primary care can be the foundation of any health care reform effort, and how building on the success of Community Health Centers could anchor primary care health access in communities that have been unable to sustain sources of stable, high quality health care.
Date: 03 / 2009

Proposed Rules for Accountable Care Organizations Participating in the Medicare Shared Savings Program: What Do They Say?
Author(s): Mark A. Zezza
Sponsoring organization: Commonwealth Fund
Summary of the proposal of the Centers for Medicare and Medicaid Services (CMS) to establish a Medicare Shared Savings Program that will allow a new form of health care provider, the accountable care organization, to participate in the Medicare program.
Date: 04 / 2011

Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing? (Final Report)
Author(s): Laura-Mae Baldwin, Leighton Chan, C. Holly A. Andrilla, Edwin Huff, L. Gary Hart
Sponsoring organization: WWAMI Rural Health Research Center
Compared the quality of care between admissions to hospitals associated with urban and three levels of rural locations as defined by RUCA codes.
Date: 03 / 2010

Quality Through Collaboration: The Future of Rural Health Care (Executive Summary)
Sponsoring organization: Institute of Medicine
Summary of an Institute of Medicine (IOM) report that examines the quality of health care in rural America. Includes key findings on rural health care quality and patient safety, as well as recommendations.
Date: 11 / 2004

Racial and Ethnic Disparities in Access to and Quality of Health Care
Author(s): José J. Escarce,
Sponsoring organization: Robert Wood Johnson Foundation
Takes a critical look at the research evidence on racial and ethnic disparities in health care.
Date: 09 / 2007

Realizing the Transformative Potential of Personal Health Records
Sponsoring organization: Kaiser Permanente
Explores the potential of Personal Health Records (PHRs) to transform the way care is delivered and received. Examines how consumer-centric health records and related technologies can improve the quality, efficiency, and effectiveness of health care. Also defines PHRs and the variety of existing technologies
Date: 04 / 2007

Reducing Racial and Ethnic Disparities: A Quality Improvement Initiative in Medicaid Managed Care
Author(s): Constance Martin, Lindsay Palmer
Sponsoring organization: Center for Health Care Strategies
This toolkit presents promising approaches and tools for addressing disparities as well as improving the quality of care.
Date: 01 / 2007

Reforming Physician Payments to Achieve Greater Value in Health Care Spending: A Position Paper of the American College of Physicians
Author(s): Brett Baker, Robert Doherty,
Sponsoring organization: American College of Physicians
Contains the American College of Physicians recommendations aimed at comprehensive reform of the payment system to physicians and that improves coordination of care across providers including rural practices.
Date: 2009

Reinventing Health Care Delivery: Innovation and Improvement Behind the Scenes
Author(s): Bonar Menninger
Sponsoring organization: California HealthCare Foundation
Leaders at health care innovation organizations nationwide, including rural, share perspectives about how their centers operate, the objectives they are pursuing, and some of the challenges they face.
Date: 09 / 2009

Relevant Quality Measures for Critical Access Hospitals
Author(s): Michelle Casey, Ira Moscovice, Jill Klingner, Shailendra Prasad
Sponsoring organization: Flex Monitoring Team
Policy brief describes quality measures relevant to Critical Access Hospitals (CAHs) and identifies policy implications.
Date: 01 / 2012

Report to Congress: National Strategy for Quality Improvement in Health Care
Sponsoring organization: U.S. Department of Health and Human Services
Discusses the National Strategy for Quality Improvement in Health Care (the National Quality Strategy) plan, which is required by law. Report describes the initial strategy and plans for implementation.
Date: 03 / 2011

Resource Guide for Implementing the JCAHO 2007 Patient Safety Goals on Suicide
Author(s): Douglas Jacobs
Sponsoring organization: Screening for Mental Health
A resource guide for implementing the Joint Commission on Accreditation of Healthcare Organizations 2007 National Patient Safety Goals on suicide.
Date: 2007

Roadmap to Health Insurance for All: Principles for Reform
Author(s): Sara R. Collins, Cathy Schoen, Karen Davis, Anne K. Gauthier, Stephen C. Schoenbaum
Sponsoring organization: Commonwealth Fund
Explores the different health insurance coverage options and how they improve quality and efficiency as well as gain control over spiraling health care costs.
Date: 10 / 2007

Securing High Quality Health Care in Rural America: The Impetus for Change in the Affordable Care Act
Author(s): A. Clinton MacKinney, Jennifer P. Lundblad, Andrew F. Coburn, Timothy D. McBride, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
The ACA calls for the development of a National Health Care Quality Strategy and Plan (National Quality Strategy) that will affect health care that is delivered to millions of Americans who live in rural areas and thousands of health care providers who care for them. The goal of this paper is to answer the question, “What rural considerations should be addressed in a National Quality Strategy?”
Date: 12 / 2010

Selected Findings on Child and Adolescent Health Care From the 2007 National Healthcare Quality and Disparities Reports
Sponsoring organization: Agency for Healthcare Research and Quality
Presents findings from the 2007 National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR) on health care quality, access, and utilization for children and adolescents.
Date: 03 / 2008

Starting on the Path to a High Performance Health System: Analysis of the Payment and System Reform Provisions in the Patient Protection and Affordable Care Act of 2010
Author(s): Karen Davis, Stuart Guterman, Sara R. Collins, Kristof Stremikis, Sheila Rustgi, Rachel Nuzum
Sponsoring organization: Commonwealth Fund
Report analyzes the new health reform law's provisions that will affect health care providers’ financial incentives, the organization and delivery of health services, investment in prevention and population health, and the capacity to achieve the best health care and health outcomes for all Americans.
Date: 09 / 2010

State of Health Care Quality, 2010: Reform, The Quality Agenda, and Resource Use
Sponsoring organization: National Committee for Quality Assurance
Produced annually by NCQA to monitor and report on performance trends over time, track variations in patterns of care and provide recommendations for future quality improvement.
Date: 2010

State of the USA Health Indicators: Letter Report (Report Brief)
Sponsoring organization: Institute of Medicine
Provides guidance on how to measure the health including the efficiency and efficacy of the nation using 20 selected indicators.
Date: 12 / 2008

State Roles in Delivery System Reform
Sponsoring organization: National Governor's Association
Outlines the evidence in health system reforms, and the opportunities for governors to lead these efforts. Provides tools and levers available to states to create a more efficient and effective health care system in both rural and urban environments and in accordance with the Affordable Care Act.
Date: 2010

States' Roles in Shaping High Performance Health Systems
Author(s): Catherine Hess
Sponsoring organization: Commonwealth Fund
Presents findings from the State Health Policies Aimed at Promoting Excellent Systems project, undertaken by the National Academy for State Health Policy, with support from The Commonwealth Fund.
Date: 04 / 2008

TeamSTEPPS: Better Hospital Teamwork Increases Patient Safety
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Discusses the TeamSTEPPS system, which improves patient safety by fostering better communication and teamwork among health care professionals.
Journal citation: Rural Monitor
Date: 11 / 2011

Telehealth: AHRQ's Health IT Portfolio
Author(s): Brian E. Dixon, Julie M. Hook, Julie J. McGowan
Sponsoring organization: Agency for Healthcare Research and Quality
An analysis of grants in AHRQ’s health IT portfolio that are focused on implementing or evaluating telehealth in order to improve care for patients, increase efficiency, and contain costs.
Date: 12 / 2008

Testimony-Health and Wealth: Measuring Health System Performance
Sponsoring organization: Commonwealth Fund
Discusses how establishing national goals for the U.S. health system, setting priorities for improvement, and making an annual report to Congress on health system performance can ensure access to and accountability of healthcare that is essential to the well-being of all Americans.
Date: 03 / 2008

To Err is Human: Building a Safer Health System (Report Brief)
Sponsoring organization: Institute of Medicine
A summary of a report on a specific quality concern - patient safety. Discusses types of errors that occur in hospitals and strategies for improving patient safety.
Date: 11 / 1999

Transforming Hospitals: Designing for Safety and Quality
Sponsoring organization: Agency for Healthcare Research and Quality
Reviews the case for evidence-based hospital design and how it increases patient and staff satisfaction and safety, quality of care, and employee retention, and results in a positive return on investment.
Date: 09 / 2007

U.S. Variations in Child Health System Performance: A State Scorecard
Author(s): Katherine K. Shea, Karen Davis, Edward L. Schor
Sponsoring organization: Commonwealth Fund
Examines variations among states’ child health care systems, building on the State Scorecard published by The Commonwealth Fund Commission on a High Performance Health System.
Date: 05 / 2008

Using Physician Payment Reform to Enhance Health System Performance
Author(s): Marsha Gold, Suzanne Felt-Lisk
Sponsoring organization: Mathematica Policy Research, Inc.
Explores using physician payment to improve health system performance, suggesting that future priorities reward physicians for influencing the totality of a patient’s care across all providers and settings.
Date: 12 / 2008

What is Health Care Quality and Who Decides?
Author(s): Carolyn Clancy
Sponsoring organization: Agency for Healthcare Research and Quality
A statement defining three basic dimensions of health care quality: structure, process, and outcome; given by Carolyn Clancy before the Subcommittee on Health Care, Committee on Finance, U.S. Senate.
Date: 03 / 2009

Who Pays for Medical Errors?: An Analysis of Adverse Even Costs, the Medical Liability System, and Incentives for Patient Safety Improvement
Author(s): Michelle M. Mello, David M. Studdert, Eric J. Thomas, Catherine S. Yoon, Troyen A. Brennan
Sponsoring organization: Commonwealth Fund
Study shows that hospitals may lack the financial incentives needed to improve safety.
Date: 12 / 2007

Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients (Policy Brief)
Author(s): Robert Town, Walter Gregg, Ira Moscovice, Shailendra Prasad, Jill Klingner
Sponsoring organization: Upper Midwest Rural Health Research Center
Assesses the financial and quality challenges of implementing bundled payments for rural health providers and patients.
Date: 09 / 2011

Journals

Health Affairs
Peer-reviewed publication focusing on U.S. health policy and health care. Content is available free online after three years.

Joint Commission Journal on Quality and Patient Safety
A peer-reviewed journal, available through subscription, which serves as a forum for practical approaches to improving quality and safety in health care. Articles provide in-depth case studies that help readers to adopt or adapt methods, programs, and strategies to their own settings. Abstracts are available online and articles are available online for purchase. Sponsoring organization: Joint Commission

Joint Commission Online
Monthly news brief from the Joint Commission, an independent, not-for-profit entity that sets standards and accredits health care organizations. Sponsoring organization: Joint Commission

Research Activities
Includes announcements of the Agency for Healthcare Research and Quality (AHRQ), their products and projects, and summarizes research findings from studies supported by the Agency. Sponsoring organization: Agency for Healthcare Research and Quality

Organizations

Agency for Healthcare Research and Quality (AHRQ)
Federal government
Sponsors and conducts research that provides evidence-based information on health care outcomes, quality, cost, use, and access. The information helps health care decisionmakers - patients and clinicians, health system leaders, purchasers, and policymakers - make more informed decisions and improve the quality of health care services.

American Health Quality Association
National organization
A charitable, educational, not-for-profit national membership association dedicated to health care quality through community-based, independent quality evaluation and improvement programs.

American Hospital Association (AHA)
National organization
Represents and serves all types of hospitals, health care networks, patients and communities.

Association of Clinicians for the Underserved (ACU)
National organization
A nonprofit, transdisciplinary organization of clinicians, advocates, and health care organizations working to improve the health of America's underserved populations and to enhance the development and support of the medical and dental clinicians serving these populations.

Center for Medicare Advocacy (CMA)
National organization
Consists of a national non-profit, non-partisan education and advocacy organization that identifies and promotes policy and advocacy solutions to ensure that elders and people with disabilities have access to Medicare and quality health care. Focuses on people with chronic conditions and those in need of long term care.

Centers for Medicare and Medicaid Services (CMS)
Federal government
Operates the Medicare and Medicaid programs - two national health care programs that benefit millions of Americans. Part of the U.S. Department of Health and Human Services. Website includes access to research, statistics and data related to their programs.

Delta Rural Hospital Performance Improvement Project (RHPI)
Federal government
Brings technical expertise, information and business tools to small rural hospitals in the Mississippi Delta.

Flex Monitoring Team
National organization
Performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program) conducted by the Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine.

Institute for Healthcare Improvement (IHI)
Nonprofit/Foundation
Drives the improvement of health by advancing the quality and value of health care. Provides conferences, seminars, and practices that can be implemented and measured to help facilitate improvement of health care quality. Their website includes a knowledge center with tools and information related to all aspects of health care quality.

Institute for Safe Medication Practices (ISMP)
National organization
Mission is to understand the causes of medication errors and provide time-critical error-reduction strategies to the healthcare community, policy makers, and the public.

Institute of Medicine (IOM)
National organization
Works to advance and disseminate scientific knowledge to improve human health. Part of the National Academy of Sciences.

Joint Commission
National organization
Works to improve safety and quality of care provided to the public through health care accreditation and related services that support performance improvement in health care organizations. Evaluates and accredits nearly 17,000 health care organizations and programs in the United States.

Leapfrog Group
Nonprofit/Foundation
Composed of more than 150 public and private organizations that provide health care benefits. Works with medical experts throughout the U.S. to identify problems and propose solutions that will improve hospital systems that could break down and harm patients. Representing more than 34 million health care consumers in all 50 states, Leapfrog provides information and solutions for consumers and health care providers.

National Area Health Education Center Organization (NAO)
National organization
Supports and advances the AHEC network in improving the health of individuals and communities by transforming health care through education.

National Association for Healthcare Quality (NAHQ)
National organization
An organization that promotes the continuous improvement of quality in healthcare by providing educational and development opportunities for professionals at all management levels and within all healthcare settings.

National Committee for Quality Assurance (NCQA)
Nonprofit/Foundation
Works with large employers, policymakers, doctors, patients, and health plans to improve health care quality. Provides recognition standards for patient-centered medical homes, and accreditation, certification, distinction, and other recognition programs.

National Initiative for Children's Healthcare Quality (NICHQ)
National organization
An education and research organization dedicated solely to improving the quality of health care provided to children.

National Patient Safety Foundation (NPSF)
Nonprofit/Foundation
A resource and a central voice for individuals and organizations committed to improving the safety of patients.

National Quality Forum (NQF)
National organization
Works to develop and implement a national strategy for health care quality measurement and reporting.

National Rural Health Association (NRHA)
National organization
Promotes leadership, ideas, information, communication, education, research, advocacy, and methods to improve rural health. Composed of individual and organizational members who share a common interest in rural health.

National Rural Health Resource Center (RHRC)
National organization
Provides technical support for the State Offices of Rural Health and their flex coordinators for the Rural Hospital Flexibility Program, focuses on rural practice opportunities for healthcare providers in Minnesota and the surrounding region, does performance improvement with hospitals across the country, and develops the Rural Health Resource Directory of rural consultants and speakers found throughout the United States.

Office of Rural Health Policy (ORHP)
Federal government
Promotes better health care service in rural America. Part of the Health Resources and Services Administration, U.S. Department of Health and Human Services. Focuses on matters affecting rural hospitals and health care, coordinating activities within the department that relate to rural health care, and maintaining a national information clearinghouse.

Qualis Health
State/regional organization
Serves as the Quality Improvement Organization (QIO) for Idaho and Washington. Also provides service to Alaska.

Quality Health Foundation (QHF)
Nonprofit/Foundation
Works to improve the health of individuals and communities. Provides grants to organizations that wish to undertake improvement projects.

Risk Management and Patient Safety Institute (RMPSI)
National organization
Developed to meet the risk, quality, claims management and patient safety needs of the health care industry with a primary focus on clinical risk reduction, quality patient outcomes, education and claims management.

Stratis Health
Nonprofit/Foundation
Non-profit independent quality improvement organization that collaborates with providers and consumers to improve health care.

Surgical Care Improvement Project (SCIP)
National organization
A national partnership of organizations committed to improving the safety of surgical care through the reduction of post-operative complications.

United Health Foundation (UHF)
National organization
Works to improve the quality and cost effectiveness of medical outcomes, to expand access to health care services for those in challenging circumstances and to enhance the well being of communities.

Terms & Acronyms

Accreditation Process that gives public recognition to institutions that meet certain standards. It is a promise that an institution will provide the quality of services it claims to offer.

Balanced Scorecard (BSC) An integrated framework for describing and translating strategy through the use of linked performance measures in four balanced perspectives: Customer, Internal Processes, Learning and Growth, and Financial. The Balanced Scorecard acts as a measurement system, strategic management system, and communication tool.

Clinical Performance The degree of accomplishment of desired health objectives by a clinician or health care organization.

Clinical Performance Measure A subtype of quality measure that is a mechanism for assessing the degree to which a provider competently and safely delivers clinical services that are appropriate for the patient in the optimal time period.

Computerized Provider Order Entry (CPOE) A system that includes both inpatient orders and the electronic ordering of outpatient prescriptions often referred to as e-prescribing. The CPOE allows physicians and other caregivers to input orders directly into a computer, thereby eliminating problems with handwriting legibility and order transcription.

Electronic Medical Record (EMR) A generic term used to describe a computer-based patient medical record that includes patient information regarding diagnoses, test/procedure results and other relevant medical information such as medical appointments and correspondence.

Health Information Technology (HIT) A significant infrastructure that involves the application of computer technology to generate, validate, secure and integrate healthcare data so it can be effectively utilized to support the decision-making activities of clinical and administrative professionals. HIT can provide immediate access to patient information, care guidelines for clinicians, or health services that transcend geographic distances.

Measure A mechanism to assign a quantity to an attribute by comparison to a criterion.

Medical Homes Also referred to as a Patient-Centered Model Home, a Patient Centered Medical Home, a Personal Medical Home, or a Health Home. This is a model of care, originally used in reference to the care of children with special needs, and now expanded to include the care of all patients. The principles are: each patient receives care from a personal physician; the personal physician leads a team of providers who are responsible for a patient's ongoing care; the personal physician is responsible for the "whole person"; a patient's care is coordinated across the health system and community; quality and safety are hallmarks of the practice; enhanced access to care is offered through open scheduling, expanded hours, and new care options such as group visits; and the payment structure recognizes the enhanced value provided to patients.

Medicare Conditions of Participation (CoP) CMS conditions that health care organizations must meet to participate in the Medicare and Medicaid programs. Used to improve quality and protect the health and safety of beneficiaries.

Medicare Rural Hospital Flexibility Program (Flex Program) Federal initiative created by the Balanced Budget Act of 1997 that provides funding to State Governments to strengthen rural health. Requires the development of state rural health plan. Provides funding to States network development, quality improvement, designation of Critical Access Hospitals (CAHs), and improvement of rural EMS.

Pay-For-Performance A reimbursement concept whereby a provider's pay is based upon quality of care provided.

Personal Health Record (PHR) A collection of important information about a person's health or the health of someone a person is caring for, such as a parent or child. The PHR is actively maintained and updated by both the healthcare provider, the care giver, and the person for whom it belongs.

Quality Improvement Organization (QIO) QIOs review Medicare services. They work with consumers, physicians, hospitals, and other caregivers to make sure patients get the right care at the right time, particularly among underserved populations.

Quality Measure A mechanism to assign a quantity to quality of care by comparison to a criterion. The definition of a quality measure relies on the definition of, "Clinical performance," "Clinical performance measure," "Measure," and "Quality of care."

Quality of Care The degree to which health care services for individuals and populations increases the likelihood of desired health outcomes and are consistent with current professional knowledge.

Rationale for the Measure A brief statement describing the patients and the specific aspect of health care to which the measure applies. The rationale may also include the evidence basis for the measure, and an explanation of how to interpret results.

Regional Health Information Organization (RHIO) A cooperative organization which can enable the regional constituents to securely and reliably exchange patient healthcare information. Their purpose is to improve patient health services and care through information sharing, advocacy, collaboration, technical innovations, and community affiliations.

Regionalization The identification of available resources within a geographic area, and the coordination of services to meet the needs of a specific group of patients.

TASC (Technical Assistance and Services Center) The technical assistance center for the Medicare Rural Hospital Flexibility Program (Flex Program). Provides information, tools and resources on all aspects of the Flex Program, including CAH, networking, EMS, and quality improvement. TASC is run by the Rural Health Resource Center in Duluth, MN.

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Page last updated 2/3/2012
Topic last reviewed 11/15/2011

Events
Feb 15, 2012
How To Improve Performance on the AHRQ Inpatient Quality and Patient Safety Indicators: Introducing a Toolkit for Hospitals
Agency for Healthcare Research and Quality
2:30 - 4:00 pm ET
Registration required
Webinar

Mar 2, 2012
2012 Spring Into Quality Symposium
Indiana Rural Health Association
Primo West Conference and Banquet Center
Plainfield, IN
Contact:
  Tina Elliott
  812.478.3919 x222
  telliott@indianarha.org


Mar 13 - 14, 2012
2012 NCAL Spring Conference
National Center for Assisted Living
Royal Sonesta Hotel
New Orleans, LA
Contact:
  202.842.4444
  meetings@ahca.org


Mar 18 - 20, 2012
13th Annual International Summit on Improving Patient Care in the Office Practice & the Community
Institute for Healthcare Improvement
Gaylord National Resort and Convention Center
National Harbor, MD
Contact:
  617.301.4800
  info@IHI.org


Apr 5 - 6, 2012
2012 Annual Patient Safety and Quality Improvement Conference
Idaho State Office of Rural Health and Primary Care
The Riverside Hotel
Boise, ID
Contact:
  Chanda Neth
  800.488.1118 x5939
  chandan@qualishealth.org


Apr 17 - 20, 2012
2012 International Forum on Quality and Safety in Healthcare
Institute for Healthcare Improvement
Palais des Congrès des Paris
Paris, France
Contact:
  617.301.4800
  info@ihi.org


Apr 24 - 25, 2012
Flex Program Workshop
National Rural Health Resource Center
Contact:
  Nicole Clement
  218.727.9390 x228
  nclement@ruralcenter.org


May 7 - 8, 2012
Advancing the Methods for Healthcare Quality Improvement Research
Academy for Healthcare Improvement
Washington, DC
Call for Abstracts - Deadline Mar 12, 2012

Jul 18 - 20, 2012
2012 Rural Quality and Clinical Conference
National Rural Health Association
Renaissance Seattle Hotel
Seattle, WA
Contact:
  Kathy Siress
  816.756.3140 x12
  siress@NRHArural.org


Sep 7 - 11, 2012
2012 Annual NACHC Community Health Institute (CHI) & EXPO
National Association of Community Health Centers
Peabody Hotel
Orlando, FL
Call for Presentations - Deadline May 3, 2012
Contact:
  Monica Gordon
  301.347.0400


Oct 29 - 31, 2012
2012 S/RPCA Conference
Theme: Partnering for Positive Change in Health Care

National Association of Community Health Centers
Doubletree Guest Suites
Charleston, SC
Contact:
  Narine Hovnanian
  301.347.0400


Dec 9 - 12, 2012
2012 24th Annual National Forum on Quality Improvement in Health Care
Institute for Healthcare Improvement
Orlando World Center Marriott Resort & Convention Center
Orlando, FL
Contact:
  617.301.4800
  info@ihi.org


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John Supplitt, American Hospital Association

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Kathy Spencer
kathy@raconline.org



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Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.