About OSCC

Improving patient safety in hospitals has emerged as a top priority across the country. A large and growing body of evidence clearly demonstrates that errors associated with hospital care cause significant harm to patients while adding major costs to health care delivery. The Centers for Medicare & Medicaid Services has focused its quality improvement efforts on insuring patient safety and encouraging hospitals to demonstrate quality of care in their communities -- http://www.hospitalcompare.hhs.gov/. The Joint Commission approved its first set of six National Patient Safety Goals (NPSGs) in 2002 and has released its 2007 Goals for Hospitals and Critical Access Hospitals. Several other national organizations (Leapfrog, IHI, AHA, etc.) have established patient safety as a top priority.

IPRO has embarked upon an Organizational Safety Culture Change (OSCC) project supporting the use of proven patient safety practices in hospitals to improve both the quality of care and patient safety. Hospitals across the state are participating, with the primary goal of improving their patient safety climate and eliminating mistakes and errors. A group of rural and critical access hospitals is participating in an identified participant group (IPG) specific to the special circumstances of care delivery in rural environments.

Rural and Critical Access Hospital Focus

Improving patient safety in small rural and critical access hospitals presents a special challenge and a unique opportunity. This section serves as a gathering place and repository of information for small rural and critical access hospitals.

Background

Today's complex health care environment makes providing high quality medical services a challenge for all hospitals, but perhaps even more so for small rural and critical access hospitals. The limited scale of operation and resources frustrate efforts to gather meaningful quality data. In addition, national quality guidelines and initiatives that may be appropriate in larger hospitals are less applicable in small, rural hospitals. Certainly, hospitals of all sizes and locales share the universal challenges of medication errors and infection control. But health care in the rural setting is much different than in urban facilities. Its quality must be evaluated with measures specifically designed for the rural environment.

Challenges posed by the rural environment often exacerbate already complex health policy problems. Our nation as a whole is struggling with issues related to providing access to care for the large and growing number of uninsured persons; caring for an aging population; aligning financial incentives for payers, providers, and patients; and integrating population-based services with personal health care services. In rural areas, these problems are further complicated by geographic isolation; transportation barriers; populations that are generally older and less affluent; and shortages of financial, human, and capital resources. Although the challenges facing rural communities are formidable, the opportunities for improving health and health care services are also great.

The overarching goal of the Organizational Safety Culture Change IPG is simply to make hospital care safer by assisting rural and critical access hospitals to develop resources and knowledge for conducting quality improvement projects. To this end, IPRO is committed to support participants in accomplishing the following specific objectives:

Use comparative performance data to benchmark against other hospitals similar in size
Use comparative data to focus on areas of greatest opportunity for improvement
Accelerate improved performance on national inpatient quality measures and patient safety
Help staff learn and apply quality improvement methodologies and evidence-based strategies to improve patient care
Network with other rural, community and critical access hospitals to share experiences and learn from each other
Demonstrate to the community the hospital's commitment to quality