Critical Access Hospital Collaborative

** NC Hospital Foundation grant-funded program**

Click to view map of Critical Access Hospitals

Participating Critical Access Hospitals are working together in a collaborative learning network to improve the quality and safety of patient care through a focus on improving performance in inpatient and outpatient core measures and certain care transition measures as defined by the Medicare Beneficiary Quality Improvement Project (MBQIP), along with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.

NCHA, in partnership with the NC Office of Rural Health, is assisting hospitals in assessing current performance, identifying gaps and developing improvement plans to address identified opportunities. Training on basic quality improvement, data tracking and reporting with access to best practices and subject matter experts will help to establish a foundation for sustainable improvement. This program is part of the federal Medicare Rural Hospital Flexibility (Flex) Program.

 

The action period for this collaborative is January 2016 through August 2018.

*Indicates Critical Access Hospitals participating in the CAH Quality Improvement and Care Transitions Collaborative Learning Network

Alleghany Memorial Hospital*Sparta, NC
Angel Medical Center*Franklin, NC
Ashe Memorial HospitalJefferson, NC
Blue Ridge Regional HospitalSpruce Pine, NC
Cape Fear Valley - Bladen County Hospital*Elizabethtown, NC
Charles A. Cannon Jr. Memorial Hospital*Linville, NC
Chatham Hospital*Siler City, NC
Dosher Memorial Hospital*Southport, NC
Erlanger Murphy Medical Center*Murphy, NC
FirstHealth Montgomery Memorial Hospital*Troy, NC
Highland-Cashiers HospitalHighlands, NC
Pender Memorial Hospital*Burgaw, NC
Pioneer Community Hospital of Stokes*Danbury, NC
St. Luke's Hospital*Columbus, NC
Swain Community Hospital, A Duke LifePoint HospitalBryson City, NC
The Outer Banks HospitalNags Head, NC
Transylvania Regional HospitalBrevard, NC
Vidant Bertie HospitalWindsor, NC
Vidant Chowan HospitalEdenton, NC
Washington County Hospital*Plymouth, NC

Oct. 13, 2016 — MBQIP Data and Reporting Update (QDS)

July 14, 2016 — TeamSTEPPS® Series Part II: Lean Concepts and TeamSTEPPS® Tools – Working Together to Improve Quality Outcomes
Slides Lean Concepts and TeamSTEPPS® Tools – Working Together to Improve Quality Outcomes
Video Lean Concepts and TeamSTEPPS® Tools – Working Together to Improve Quality Outcomes

June 9, 2016 — TeamSTEPPS® Series:  Part I 
Slides TeamSTEPPS® Series:  Part I 
Video TeamSTEPPS® Series:  Part I 

May 12, 2016 — Patients as Partners: Operationalizing PFACs and Utilizing PFAs  (QDS)
Slides Patients as Partners: Operationalizing PFACs and Utilizing PFAs
Video Patients as Partners: Operationalizing PFACs and Utilizing PFAs

April 14, 2016 — Seamless Care: Safe Patient Transitions Between Facilities Part II
Slides Seamless Care: Safe Patient Transitions Between Facilities Part II
Action Planning Template 1 
Action Planning Template 2

March 15, 2016 — Using Quality Improvement Tools Webinar
Slides Using Quality Improvement Tools Webinar

March 3, 2016 — Patient Safety: Immunization Measures Webinar
Slides Patient Safety: Immunization Measures Webinar

Jan. 14, 2016 — Seamless Care: Safe Patient Transitions Between Facilities Part 1 
Slides Seamless Care: Safe Patient Transitions Between Facilities Part 1

Dec. 15, 2015 – CAH Collaborative Orientation Webinar
Slides CAH Collaborative Orientation Webinar
Video CAH Collaborative Orientation Webinar

Nov. 9, 2015 – CAH Collaborative Informational Webinar 
Slides CAH Collaborative Informational Webinar
Video CAH Collaborative Informational Webinar

Critical Access Hospital Rapid Improvement Project

HCAHPS Composite Measure 7 – Care Transitions

Did you know that 20% of patients discharged from the hospital experience an adverse event within 3 weeks? Did you know that within 30 days of discharge, approximately 2.6 million Medicare beneficiaries are re-hospitalized, at a cost of over $26 billion every year? Did you know that medication errors harm 1.5 million people each year in the US at an annual cost of at least $3.5 billion?

These statistics are the result of a complex healthcare system – one key facet being the effectiveness of our transitions of care for patients being discharged.

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey instrument and data collection methodology for measuring patients’ perspectives on hospital care. The measure on Care Transitions is HCAHPS Composite 7 measuring the understanding of your care when you left the hospital. The three questions in the survey are:

  • Q23: During this hospital stay, staff took preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left.
  • Q24: When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.
  • Q25: When I left the hospital, I clearly understood the purpose for taking each of my medications.

As of Quarter 4 2016, North Carolina scored 51% for this measure (US score is 52%). To improve this score, the Critical Access Hospital Quality Collaborative launched a Rapid Improvement Project from February 2018-April 2018.

Improving Care Transitions should impact multiple HCAHPS measures through its blend of nurse-patient communication, communication about medication and discharge information elements.

May 4, 2018 — Session #4: A3 Tools Review and Sharing
Slides (PDF)

April 17, 2018 —  Session #3: Right Side of the A3
Slides (PDF)

March 7, 2018  — Sesson #2: Analyzing the Current State
Slides(PDF)

Resources:
Observation Sheet Instructions (PDF)
Observation Sheet (PDF)
VSM Sample (PDF)

Feb. 13, 2018 — Session #1: Define Your Scope
Slides (PDF)

Homework:
Project Scope Template (doc)
Process Scope Template (doc)

Nov. 17, 1017 — HCAHPS Care Transitions Rapid Improvement Project Orientation Webinar
Slides

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