The document discusses quality improvement in rural healthcare settings in Virginia. It recommends establishing a Rural Health Performance and Quality Advisory Council to support quality improvement efforts. Several databases and quality measures are mentioned that could help measure progress, identify health inequities, and increase transparency of quality data. The document also discusses survey results showing areas for improvement in rural hospitals, such as staffing, handoffs, and nonpunitive responses to errors. It proposes expanding membership of the Advisory Council to include more stakeholders and continue planning quality improvement initiatives.

1. Edna Rensing, RN, MSHA, CPHQ

6. Internal infrastructure or readiness to implement changes

8. AHRQ – Hospital survey Safety Culture Composites Hospitals (22) Rural (9) Urban (13) Mean Median Mean Median Mean Median Overall Perceptions of Safety 64% 64% 67% 67% 62% 61% Frequency of Events Reported 64% 64% 65% 68% 63% 63% Supervisor/Manager Expectations & Actions Promoting Patient Safety 77% 77% 79% 80% 75% 76% Organizational Learning--Continuous Improvement 75% 76% 77% 77% 73% 72% Teamwork Within Units 82% 82% 81% 80% 82% 82% Communication Openness 64% 63% 64% 66% 63% 63% Feedback & Communication About Error 66% 66% 68% 69% 65% 64% Nonpunitive Response to Error 43% 44% 46% 44% 41% 43% Staffing 53% 52% 56% 55% 51% 49% Hospital Management Support for Patient Safety 73% 72% 75% 77% 72% 71% Teamwork Across Hospital Units 56% 56% 58% 57% 55% 55% Hospital Handoffs & Transitions 40% 39% 41% 39% 39% 36%

9. This tool was created at the University of Nebraska Medical Center as part of an AHRQ-funded Partnerships in Implementing Patient Safety Grant (AHRQ Grant 1 U18 HS015822-01). NOTE: This tool was developed in Microsoft Office Excel 2007 and is available at www.unmc.edu/rural/patient-safety.

15. External or needs of the people in the community