Improving Patient Safety In Rural Hospitals

A Workshop With Wisconsin Health Care Leaders

By Kara Coluccio and Daniel Campion

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This workshop explored key issues regarding improving patient safety in rural hospitals. It was held in Madison, Wisconsin, October 22-23, 2001.

This Workshop Summary Report provides a summary of each of the substantive workshop sessions, followed by a synthesis of the discussions that took place in three workgroups.

Select to download print version (PDF File, 220 KB; PDF Help). Copyright Notice.

Funded by the Agency for Healthcare Research and Quality (AHRQ), U. S. Department of Health and Human Services
About the Workshop Sponsor.

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Introduction

The Employer Health Care Alliance Cooperative (The Alliance) sponsored a workshop entitled "Improving Patient Safety in Rural Hospitals: A Workshop with Wisconsin Health Care Leaders" on October 22-23, 2001 in Madison, Wisconsin.

The purpose of this workshop was to allow a diverse group of stakeholders to discuss the research evidence related to certain patient safety interventions, explore their own goals and concerns related to changing the current systems, and brainstorm potential patient safety standards that they could view as feasible and measurable. Participants explored issues related to improving patient safety in rural community hospitals in Wisconsin, including hospital and health system administrators, physicians, employers, State officials, and health services researchers.

The group discussed relevant research findings, implementation issues, and both advantages and obstacles that rural community hospitals encounter in reducing medical errors. Participants also considered potential roles that regional and statewide organizations could play to support patient safety initiatives in rural facilities.

The specific workshop objectives were to better prepare participants to:

• Understand the perspectives of major stakeholder groups concerned with improving patient safety in Wisconsin (e.g., employers, hospitals, physicians).
• Discuss the characteristics of "high reliability organizations" and implications for developing a "culture of safety" in hospitals.
• Identify research-based evidence related to the staffing of intensive care units (ICUs) and the reduction of medication errors.
• Describe the kinds of barriers/obstacles that rural community hospitals are likely to face when implementing new patient safety practices, as well as their strengths/assets for launching these initiatives.
• Identify the roles that regional and statewide stakeholders can play to help rural community hospitals institute new patient safety measures.

The invitational workshop was a day and a half in length, with plenary presentations and panel discussions by researchers, business leaders, and practitioners on the first day. On the second day participants formed three workgroups to address in greater depth issues related to:

• ICU safety.
• Medication safety.
• How local, regional, and statewide organizations can contribute to a culture of safety.

Building on systems-based quality improvement programs has proven to be effective in reducing medical errors, and this workshop presented evidence on patient safety strategies in the areas of staffing and managing intensive care units, and reducing adverse drug events, including many strategies identified by the Wisconsin Patient Safety Institute. Since most patient safety research studies to date have taken place in large, urban-based hospitals, and Wisconsin is a largely rural state, participants and faculty explored how concepts, techniques, and lessons from urban-based studies can inform rural health care providers and purchasers. In light of growing recognition that reducing medical errors requires more than changing the behaviors of individual workers, participants considered how rural hospitals can make safety improvement an explicit organizational goal and implement the kinds of systemic changes needed to make it a cultural norm.

AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.

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