Supporting Quality Improvement Initiatives in Rural Mississippi Delta Hospitals

Challenge

For the Health Services and Resources Administration (HRSA), the Rural Hospital Performance Improvement Project (RHPI) supports quality improvement initiatives in rural hospitals with fewer than 200 beds in the Mississippi Delta region. The project promotes best practices, business tools, and technical strategies to help these hospitals achieve performance goals. To evaluate the impact of this work, RHPI-participating and non-participating hospitals were compared using quality measures associated with MBQIP (Medicare Beneficiary Quality Improvement Project), CMS’ Hospital Compare, HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), and other sources.

Solution

Atlas Research worked with the National Rural Health Resource Center to develop a program evaluation approach to assess quality measures within the Delta hospitals eligible for RHPI participation. All hospitals were compared to facilities that had a consultation in FY 2011 and 2012, to hospitals within their regions, and to hospitals across the country. The assessment targets key process and outcomes indicators associated with Hospital Compare, MBQIP, and HCAHPS.  Building on a wide variety of data, Atlas produced a comprehensive analysis on the status of both the quality reporting processes employed by Delta RHPI hospitals as well as health quality and safety outcomes.

To increase understanding of quality reporting in the Delta hospitals and evaluate program impact, Atlas:

  • Aggregated zip-code based demographic data into the dataset for comparison of environmental factors that contribute to regional health system use;
  • Determined the level of reporting and identified trends in reporting for certain measures and geographies;
  • Highlighted quality trends for those scores available compared to national and regional averages; and
  • Provided recommendations for these hospitals to improve their data collection strategies and scores.

Result

The assessment will enable the National Rural Health Resource Center and HRSA’s Office of Rural Health Policy to implement service improvements and allow for future quality/safety improvement strategies. Hospitals in the Mississippi Delta region will build internal capacity to manage and sustain performance goals. In defining a successful rural hospital, Atlas has provided an analytic roadmap to allow HRSA to continually assess the impact of best practice adoption and use of quality improvement strategies.