CRHC’s Quality Improvement Initiative Helped to Reduce Readmission Rates and Improve Communications For Critical Access Hospitals

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The iCARE program achieved its goal of lowering costly readmission rates and improving communications for participating Critical Access Hospitals

Colorado Rural Health Center (CRHC) recently shared the results of its quality improvement initiative, iCARE, at the Institute for Healthcare Improvement’s Annual National Forum on Quality Improvement in Health Care. The iCARE program achieved its goal of lowering costly readmission rates and improving communications for participating Critical Access Hospitals (CAH) in Colorado.

“Because CAHs are often overlooked in national and statewide healthcare initiatives, CRHC created iCARE as an opportunity to engage CAHs in a statewide improvement initiative aligning with national trends, funding priorities, and with a rural focus,” said CRHC Critical Access Hospital Program Manager Jennifer Dunn. “The goal of iCare was to improve communication in transitions of care, maintain low readmission rates, and improve clinical processes contributing to readmissions.”

Eleven CAHs from around Colorado volunteered to participate in the first year of iCARE, including Conejos County Hospital, Family Health West, Heart of the Rockies Regional Medical Center, Melissa Memorial Hospital, Pikes Peak Regional Hospital, Rangely District Hospital, Rio Grande Hospital, St. Vincent General Hospital District, Sedgwick County Health Center, Southeast Colorado Hospital, Spanish Peaks Regional Health Center.

All iCARE hospitals participated in monthly webinars, which provided a forum to bring participants together for education, and sharing of hospital challenges, successes, lessons learned and best-practices. CAHs were asked to define an individual goal related to one of the three primary iCARE goals and were encouraged to submit data for heart failure, pneumonia, and readmissions to facilitate trending and measurement. Aggregate data was shared and discussed during the monthly project webinars.

CRHC also offered iCARE hospitals free technical assistance in the form of a Lean/Six Sigma (LSS) training series, by SigmaMed Solutions, to provide them with a framework for improvement.

The results of iCARE includes the following:

  •     CRHC exceeded its goal of having 10 CAHs sign up for iCARE. Eleven CAHs participated with 5 of those hospitals also taking part in the iCARE Lean Six Sigma training series.
  •     The average 30-day readmission rate for iCARE hospitals submitting data between September 2010 and July 2011 (most recent available data) increased slightly from 0 to 1.3. That increase may be attributed to the increase in hospitals submitting this measure over that timeframe. The January 2011 to July 2011 data (when more hospitals were consistently reporting) shows an overall improvement from 4.9 percent to 1.3 percent.
  •     The average Pn Immunization rate for iCARE hospitals submitting data between September 2010 and July 2011 (most recent available data) was 100. The January 2011 to July 2011 data (when more hospitals were consistently reporting) shows an overall improvement from 68.3 percent to 100 percent

“Through iCARE, we’ve learned that successful initiatives can be created for rural providers through understanding of the unique challenges rural communities face, by offering flexibility, by building capacity of providers with skills that can be transferred both internally and externally will help ensure sustainability and success,” said Michelle Mills, CRHC director of programs.

About The Colorado Rural Health Center
CRHC was founded in 1991 as Colorado’s nonprofit State Office of Rural Health. CRHC works with Federal, state and local partners to offer services and resources to rural healthcare providers, facilities and communities. CRHC has a diverse and inclusive statewide constituency of over 3,500 people and organizations. For more information on CRHC call 303-832-7493 or go to http://www.coruralhealth.org.

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