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Rural Health

Rural communities have different health care needs and challenges than their metropolitan counterparts. Rural providers serve fewer people but have a greater proportion of elderly patients, who tend to have more advanced and chronic conditions. Rural communities face significant shortages in medical personnel and many small rural hospitals, the critical access hospitals, produce financial margins too low to support the investment needed to update facilities and technology to improve care. Quality improvement projects designed for large urban providers generally don’t fit rural providers. That’s why Stratis Health collaborates with other organizations to identify health care issues unique to rural providers and to develop technical assistance projects—tailored to the rural setting—to make improvements both in Minnesota and nationally.

Palliative care

Stratis Health is leading the Minnesota Rural Palliative Care Initiative, in partnership with Transitions and Life Choices, the palliative care program of Fairview Health Services, to establish or strengthen palliative care programs in rural Minnesota communities. We are assisting in developing programs that focus on improving the quality of life for patients facing chronic or life-threatening illness. We assist clinical and non-clinical professionals build skills to improve care planning, symptom management, communication, coordination, and delivery of care for those with chronic diseases and for those receiving hospice care. The first phase of this initiative includes 10 Minnesota communities. More >

Redesigning care delivery

Stratis Health assesses the impact of state and national policies on rural health and helps rural providers take advantage of opportunities to sustain and improve local services. In partnership with the Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis at the University of Iowa, Stratis Health is developing, testing, and disseminating tools and resources, and is providing technical assistance to rural health care providers to help them participate in demonstrations projects to improve care coordination, enhance patient outcomes, and lower health care costs. More >

Patient safety culture

Stratis Health recruits and works with rural hospitals and CAHs to assess and improve patient safety culture—an organization’s overall commitment to health and safety management. We support the hospitals in conducting the Agency for Healthcare Research and Quality patient safety culture survey, analyzing and understanding the results, and making changes to systems, processes, and their organizational cultures to improve patient safety. Through our 2005-2008 Medicare Quality Improvement Organization (QIO) contract, we worked other QIOs in South Dakota, Iowa, and Nebraska and the Sanford Health System to provide this assistance to rural hospitals. We currently are conducting similar work with a small group of CAHs in northwestern Minnesota, under a Minnesota Department of Health (MDH) grant.

Rural emergency department transfer communication project

While emergency care is important in all hospitals, the emergency department is particularly important in rural hospitals where the distance to urban medical centers makes the effective triage, stabilization, and transfer of patients essential. For example, when a patient arrives at an emergency department needing time-sensitive care that includes transfer to a tertiary care center, the rural hospital’s ability to quickly assess, arrange, and get the patient out the door with the necessary and appropriate information can be of life or death importance.

Data indicating how well a rural hospital serves this important stabilize-and-transfer, care transition role is not currently widely available. This pilot project will provide and support rural hospitals to be trained to collect information on emergency department transfer communication, and use the data to improve quality of care, safety, and outcomes for patients transferred from their emergency departments.

This work seeks to further implement the Emergency Department Transfer Communication Measures developed and tested under a CMS special study completed in 2005 by Stratis Health and the University of Minnesota Rural Health Research Center, which have been used on a small scale in a few states over the past several years. The National Quality Forum endorsed these measures in 2007. More >

Quality measures

Stratis Health led a national project, in partnership with Health Insight and the University of Minnesota, to develop quality measurement systems to be more relevant and useful to rural hospitals. This work established a more accurate way to demonstrate and improve the quality and safety of care delivered by rural hospitals. The project developed and field tested the measures that are now part of the Centers for Medicare & Medicaid Services Emergency Department AMI/chest pain Outpatient Prospective Payment System measures.

Health information technology (HIT)

Stratis Health developed the Health Information Technology Toolkit for Critical Access and Small Hospitals, a toolkit to provide critical access hospitals with tools, tested in the CAH environment, to aid in planning for and making informed choices for HIT. The toolkit was originally distributed nationwide on CD through the Rural Hospital Flexibility program. More >

Health information exchange

Stratis Health worked on several rural Minnesota health information technology projects in order to improve health care quality, safety, efficiency, and costs. These included a regional health information exchange to allow for accurate information sharing in a standard and secure manner, consulting services to a critical access hospital health information technology network, and educational consulting to a collaboration of health care organizations in northern Minnesota.

National hospital improvement support center

Stratis Health provided training, technical assistance, and support to Medicare QIOs across the country in rural hospital improvement, serving as the Rural Hospital Improvement QIO Support Center from 2005-2008. Areas of focus included CAH data collection and reporting, clinical improvement in heart failure and pneumonia, and organizational safety.

Rural health An overview of Stratis Health’s work. (1-page PDF)

Contact Stratis Health for assistance with your quality improvement and patient safety needs.

If your organization has projects it would like to work on, contact us to discuss how we can work together to support initiatives related to rural health.