Rural Health

During the COVID-19 pandemic, Phelps Health in Missouri noticed a sudden increase in central line-associated bloodstream infection (CLABSI) rates. In response, they created a multidisciplinary team to address the issue. The project team developed, trialed and reassessed multifaceted interventions for effectiveness. Two such activities included conducting daily central venous line necessity checks during morning rounds and encouraging nurses to speak with physicians daily to review and assess central venous line necessity. Additionally, facilitators presented all findings and interventions at mandatory staff meetings, and staff were provided education on their CLABSI rates, charting deficiencies and rationale for the interventions that had been implemented. As a result of this project, Phelps Health’s CLABSI rate is the lowest it has been in six years.

Mosaic Life Care-Maryville in Missouri launched initiatives to reduce readmission rates within their rural community. Inpatient interventions included ensuring patient discharge instructions were patient-friendly and complete; improving communication at the daily huddle and adding a palliative care nurse to provide inpatient consults. Post-discharge interventions included follow-up phone calls and appointment scheduling, use of remote monitoring and seeing all nursing home patients post-discharge weekly for four weeks. Additionally, Mosaic’s population health strategy incorporated community and regional partnerships. As a result of these initiatives, Mosaic improved their patient satisfaction scores, provided greater access to health care, reduced health care spending, improved care coordination and avoided financial penalties.

Carnegie Tri-County Municipal Hospital (CTCMH) implemented changes to improve care and outcomes for psychiatric patients in rural Oklahoma. They improved processes for evaluating, stabilizing and, if needed, transferring psychiatric patients while providing a safe environment. Interventions included training staff on psychiatric protocols, implementing and educating providers on an electronic psychiatric order set, updating procedures for identifying individuals at risk and developing a plan of care for psychiatric patients. The data results showed a 94% completion rate for the designated suicide risk screening, a 59% completion rate for the designated patient safety checklist and a 65% completion rate for the designated psychiatric nursing flowsheet. As a result of these changes, CTCMH has met all their quality benchmark goals.