Rural Health

According to the Rural Center, 80 of North Carolina’s 100 counties are considered rural, with an average population density of 250 people per square mile or less. Rural populations typically have:

  • Higher rates or proportions: poverty, uninsured, elderly, low income residents, chronic disease, unemployment, minority populations, health disparities, immigrants
  • Lower rates and proportions: income, education attainment, performing schools, early childhood education

NCHA works closely with member hospitals and the NC Office of Rural Health, a division of the NC Department of Health and Human Services, to support rural health improvements and outcomes.

NC Hospital Foundation grant-funded program

In cooperation with the NC Office of Rural Health, NCHA supports the implementation of small, rural hospital improvement projects for 33 small, rural hospitals through the Small Rural Hospital Improvement Grant Program (SHIP). The projects adopted by the SHIP-eligible hospitals include: ICD-10 improvements; ED improvement; addressing core measures and patient satisfaction; lean improvement; and improved care transitions.

NC Hospital Foundation grant-funded program

The Carolinas Lean Improvement Network is built on the innovative foundation of the Carolinas Lean Collaborative. The Collaborative successfully completed a five-year, intensive lean coaching phase, sponsored by The Duke Endowment. This initiative engaged rural hospitals in North and South Carolina in Lean Culture Transformation, achieving  break-through improvements in hospital-based value streams and patient-oriented care services.


  • $72.6 million in total financial impact
  • Over 1,000 lean improvement events implemented
  • 68 healthcare professionals trained as lean coaches and coordinators
  • 5,175 rural health professionals trained in lean improvement
  • Average Return-on-Investment across 29 hospitals was 3.7 to 1

The Mission of the New Carolinas Lean Improvement Network: 

To support and enhance the lean improvement and management services of lean hospitals in the Carolinas.

Core Network Services

  • Conduct gemba workshops (lean hospital site-visits) twice annually.
  • Every-other-month teleconference with lean coordinators to support shared networking.
  • Quarterly webinars on lean transformation or improvement topics relevant to lean hospitals.

Target Audience

Executive leaders, lean improvement sponsors, lean coordinators and facilitators, and value stream managers of hospitals actively engaged in lean management and transformation.

Sponsored by the North Carolina Healthcare Association, the South Carolina Hospital Association and The Duke Endowment, this annual conference focuses on current issues unique to small and rural health care executives. It is designed for hospital, health system, association and governmental employees and hospital and health system trustees. The conference is held in November each year in Charlotte.

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North Carolina Healthcare Association

2400 Weston Parkway
Cary, NC 27513

Main: 919-677-2400
Fax: 919-677-4200

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