This project continues to support activities related to quality performance measurement relevant for Critical Access Hospitals. By the end of 2005, the technical expert panel had reviewed the findings of the initial field test of the small rural hospital quality measure set and made recommendations for revisions. Efforts to date have focused on the following activities:

• Refinement of the Emergency Department (ED) Measures - Since national quality measurement efforts are collecting detailed information on inpatient quality measures related to AMI, CHF, and pneumonia, we have concentrated the revisions to our measure set in the area of ED measures.
• Implementation of the Field Test of the Revised Quality Performance Measures with CAHs in One State - Our goal for this activity was to implement a field test of the revised ED measures in Washington state through a new training and support model that facilitates quality improvement in CAHs. We used a train-the-trainer model, which will build state capacity to support CAH activities related to quality measurement, and data collection, reporting and use.

CAHs in Washington State participated in this phase of the project. Data collection began in February 2006 and was completed by May 2006, followed by analysis of the data. Each participating hospital was provided with a report that summarizes their results, all participating hospitals' results, and the results from rural hospitals that participated in our earlier field tests.

Publications

• Rural Hospital Emergency Department Quality Measures: Aggregate Data Report
  University of Minnesota Rural Health Research Center
  Date: 03/2007
  This report shares findings from a project testing emergency department (ED) quality measures in critical access hospitals in Washington state. The quality measures focused on patients presenting to the ED with chest pain/acute myocardial infarction or trauma and patients seen in the ED who were transferred to another hospital for care.