Quality Improvement Organizations or QIOs (located in each state and territory) are under contract to the Centers for Medicare and Medicaid Services (CMS) to provide technical assistance to providers - hospitals, nursing facilities, home health agencies, and physicians - to promote quality improvement. Included among the providers to which QIOs are required to offer technical assistance are rural and critical access hospitals (CAHs). Specifically, QIOs are expected to assist these hospitals to improve performance on clinical process measures, promote the implementation and use of health information technology (IT) and advance organizational safety culture. QIOs are evaluated based on the extent to which providers achieve CMS performance expectations in each of these areas.

This qualitative study is being conducted to identify examples - which may be replicated by other rural hospitals that choose to obtain technical assistance from QIOs - in which rural hospitals have worked successfully with QIOs to improve performance in the areas listed above. As part of this study Walsh Center staff will interview CMS, QIO, and rural hospital staff to identify "best practices' in the each of three areas: (1) process improvement, (2) health IT implementation, and (3) safety culture change. It is expected that the information gathered through this project will assist both rural hospitals and QIOs to advance quality of care and CMS in shaping its QIO policies so as to ensure continuous quality improvement among rural hospitals and CAHs.

Publications

• Achieving Success in QIO and Rural Hospital Partnerships (Final Report)
  NORC Walsh Center for Rural Health Analysis
  Date: 02/2009
  This report describes four case studies that highlight the strategies employed by Quality Improvement Organizations (QIOs) to help small rural hospitals implement successful quality-improvement initiatives.