north carolina hospital association nc office of rural health and community care nc office of rural...

North Carolina Hospital Association

NC Office of Rural Health andCommunity Care


NC Center for Rural Health

Innovation and Performance




NC Center for Rural HealthInnovation and Performance

NC Center for Rural HealthInnovation and Performance

NC Office of Rural Health and Community CareNC Office of Rural Health and Community Care


Core Measure Improvement CollaborativeCore Measure Improvement Collaborative

• Commitment by 30 small, rural hospitals to improve core measure performance.

• Working to accomplish 95% process reliability.• Partnership with NC Office of Rural Health, NCHA and

CCME.• Small, rural hospitals will enroll in the Hospital Outpatient

Quality Data Reporting Program by submitting data for 11 quality measures for Acute Myocardial Infarction (AMI), Chest Pain (CP), Surgery, and Imaging Efficiency Measures.

• Purpose: Small, rural hospitals working together to achieve high reliability in CMS core measures.

• Outcomes: Over 200% improvement in pneumonia care and more than 120% improvement in heart failure care.


• Expectations: All CAHs participating by submitting relevant measures.

• Funding Source: Assistance made possible through the NC Flex Grant.

• Internet Resources: http://www.qualitynet.org • When: Enrollment starting October 1, 2010• To Enroll: Enrollment is online at

http://www.qualitynet.org • For Questions:• Contact Jeff Spade, NCHA ([email protected]) for

questions about the collaborative.•

Core Measure Improvement CollaborativeCore Measure Improvement Collaborative


95% ReliabilityNC Top 10%


26.4% in 200426.4% in 2004

NC Top 10% NC Top 10%

203% Improvement203% Improvement


95% ReliabilityNC Top 10%


NC Top 10% NC Top 10%

122% Improvement122% Improvement

34.2% in 200434.2% in 2004


Combined IndicatorsCombined Indicators


Outpatient Quality MeasuresOutpatient Quality Measures

OP-1 Median Time to FibrinolysisOP-2 Fibrinolytic Therapy Received Within 30 Minutes of ED ArrivalOP-3 Median Time to Transfer to Another Facility for Acute Coronary InterventionOP-4 Aspirin at ArrivalOP-5 Median Time to ECGOP-6 Prophylactic Antibiotic Initiated Within One Hour Prior to Surgical IncisionOP-7 Prophylactic Antibiotic Selection for Surgical PatientsOP-8 MRI Lumbar Spine for Low Back PainOP-9 Mammography Follow-up RatesOP-10 Abdomen CT Use of Contrast MaterialOP-11 Thorax CT Use of Contrast Material


Questions for YouQuestions for You


Board Governance of QualityBoard Governance of Quality

• Board governance curriculum on the critical topic of Improving Board Governance of Quality and Patient Safety.

• Organized as a four to six-hour board retreat.• designed to help hospital trustees understand, evaluate and

improve their governance of quality by creating a board action plan.

• Quality Curriculum may be offered as a one-day board retreat or a two-day session.

• Purpose: To improve Board Governance of Quality for 30 small, rural NC hospitals.

• Eligibility: Small, rural hospitals and CAHs (rural hospitals less than 50 ADC)


Board Governance of QualityBoard Governance of Quality

• Outcomes: Conducted four pilot Board Retreat sessions, culminating in Governance of Quality improvement plans.

• Expectations: Hospital cost: $1,000 plus meeting expenses. Total value of Board Retreat: over $10,000 for facilitator, materials, and license fees. Hospitals are responsible for organizing the board retreat, scheduling meeting space, developing agenda and ensuring the participation of board members and senior leadership.

• Funding Source: Assistance made possible through the NC Flex Grant.

• When: Reservations accepted for Board Retreats starting November 2010.

• For Questions & To Enroll: Jeff Spade, NCHA


340B Drug Program340B Drug Program

• The 340B Drug Pricing Program is an outpatient drug purchasing program that achieves significant discounts for eligible hospitals. The 340B program was recently expanded to include critical access hospitals and lower disproportionate share hospital (DSH) requirements for sole community hospitals.

• Purpose: To enroll all NC rural hospitals that are eligible to participate in the 340B drug pricing program.

• Eligibility: Non-profit or public hospitals with a DSH percentage > 11.75%. All non-profit and public CAHs. Non-profit and public sole community hospitals with a DSH percentage > 8%.


340B Drug Program340B Drug Program

• Outcomes: 56 NC hospitals enrolled, including 3 CAHs.• Support: Technical assistance made possible through the

NCORH and The Duke Endowment. • Internet Resources: http://www.hrsa.gov/opa/• http://pssc.aphanet.org/default.htm• When: Enrollments are accepted quarterly. Application

materials must be submitted 30 days in advance of the new quarter.

• To Enroll: Register through Office of Pharmacy Affairs, HRSA: www.opa.net.hrsa.gov/OPA

• For Questions and Technical Assistance: Jeff Spade([email protected])


• The NC Center for Hospital Quality and Patient Safety has partnered with The Patient Safety Group to provide an electronic tool to administer this important measurement of culture.

• The AHRQ survey is easy to setup, simple to administer and the results are instant.

• Hospitals can benchmark results to the national AHRQ data.

• Purpose: All CAHs and small, rural hospitals (< 30 ADC) to perform AHRQ survey to guide quality and patient safety improvements.

• Eligibility: CAHs and small, rural hospitals (< 30 ADC).

AHRQ Culture of Patient Safety SurveyAHRQ Culture of Patient Safety Survey


AHRQ Culture of Patient Safety SurveyAHRQ Culture of Patient Safety Survey

• Expectations: Conduct AHRQ survey, review comparative results and participate in collaborative learning opportunities.

• Cost: Enrollment with Patient Safety Group is subsidized.• Funding Source: Assistance to pay for survey and access to

tools provided by the NC Center for Hospital Quality and the NC Flex Grant.

• Internet Resources: www.ncqualitycenter.org• www.patientsafetygroup.org• When: Reservations accepted from CAH and small, rural

hospitals starting October 2010.• To Enroll: Dean Higgins, NC Center for Hospital Quality

([email protected]) (919) 677-4212


• A national, standardized survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience and their perspectives of care.

• Purpose: To ensure that all small, rural hospitals and CAHs collect, report and improve HCAHPS measures.

• Eligibility: All hospitals are eligible for technical assistance.• Outcomes: 11 CAHs currently reporting HCAHPS measures. • Funding Source: Assistance made possible through the NC

Flex Grant. • Internet Resources: www.hcahpsonline.org• To Enroll: Complete an application for Flex Funding.• For Questions: Matt Womble, NCORHCC

([email protected])•

HCAHPSHCAHPS


• 29 SHIP-eligible hospitals joined together to form the NC Collaborative for Medication Safety (NCCMedS).

• The pilot began September 1, 2010, through August 31, 2011.• Purpose: To collectively improve the safety of inpatient

medication delivery.• Eligibility: Only SHIP-eligible hospitals can participate at this

time.• Expectations: Hospitals voluntarily submit SHIP funding for

the project and are expected to participate in the on-site consultation and engage the hospital and medical staff in the medication safety improvement effort.

Medication Safety ProjectMedication Safety Project


• Funding Source: 100% funded by participating SHIP-grant dollars

• Internet Resources: SHIP grant website: http://www.raconline.org/funding/funding_details.php?funding_id=64

• NCCMedS website in development• When: SHIP grant cycle deadline is April 2011.• To Enroll: SHIP-eligible hospitals that wish to join should

submit their SHIP application during the next SHIP grant cycle (April 2011) to be part of the NCCMedS.

• For Questions: Matt Womble, NCORHCC ([email protected])

•

Medication Safety ProjectMedication Safety Project


• Purpose: A state-wide effort to improve the system of care for patients who suffer from traumatic injury, myocardial infarctions and stroke.

• Funding Source: Rural Trauma System Coordinator is funded 100% by the NC Flex Grant.

• To Enroll: Express interest in participating in a community assessment to Matt Womble, NCORHCC.

• For Questions: Beth Diaz, Rural Trauma System Coordinator with the NC Office of EMS: ([email protected]) or 919-855-3965.

• General questions: Matt Womble, NCORHCC ([email protected])

Trauma Cardiac and Stroke System DevelopmentTrauma Cardiac and Stroke System Development


• Expectations: Hospitals and physicians drive this facilitated process locally and regionally. Staff and support will be provided for this effort but hospitals and their medical staff must take a very active and participative role in this effort to ensure its success.

• Funding Source: Rural Trauma System Coordinator is funded 100% by the NC Flex Grant.

• To Enroll: Express interest in participating in a community assessment to Matt Womble, NCORHCC.

• For Questions: Beth Diaz, Rural Trauma System Coordinator with the NC Office of EMS: ([email protected]) or 919-855-3965. For general questions: Matt Womble, NCORHCC ([email protected])

Trauma Cardiac and Stroke System DevelopmentTrauma Cardiac and Stroke System Development


• Rural Hospital Lean Culture Transformation

• HIT Strategic Planning

• Community Paramedicine Program

• Critical Access for Pediatric Emergencies

Rural HospitalPilot ProjectsRural HospitalPilot Projects

north carolina hospital association nc office of rural health and community care nc office of rural...

Documents

improvement slide

reliability nc

community care slide

performance slide

rural health innovation

community care nc center

rural hospitals

performance nc center