Top Three Flex Activities in 2009

1. Providing direct funding to Iowa's 82 Critical Access Hospitals and interested network hospitals through request for proposals and request for applications to: build stronger relationships with community partners; provide development, improvement, or expansion of network activities for Iowa's Critical Access Hospitals; provide a measurable improvement to an existing Iowa rural health system using established or innovative initiatives; increase access to healthcare services; engage in activities related to planning; engage in quality and/or performance improvement activities; improve patient safety; enhance and expand health information technology; and implement rural health networks. Special emphasis will be given to fund activities that provide and increase access to quality health care services through Iowa Critical Access Hospitals by using information technologies that will reduce medical errors, improve the quality of care, expand staff skills and knowledge, and improve the workflow environment.
2. Providing educational workshops, meetings, training, or conference opportunities on a variety of issues and best practices for hospitals and EMS providers through quarterly CAH Peer User Group meetings, EMS regional meetings, Flex annual conference, and providing funding to send CAH staff to national workshops and conferences.
3. Collaborating with stakeholders such as the Iowa Hospital Association, the Iowa Foundation for Medical Care, and the Iowa Healthcare Collaborative to assist Iowa's Critical Access Hospitals in receiving training and implementing TeamSTEPPS, participating in and reporting national hospital quality measures, and implementing best practices for patient safety.

Flex Program Success Story

Providing funding that increases access to service that saves lives at the local Critical Access Hospital is just one of many success stories.

Van Buren County Hospital, located in Keosauqua, IA, recently used Flex grant funding to increase access to health services and improve patient safety and the quality of care by purchasing and implementing the use of a Bi-Pap (Bi-Level Positive Airway Pressure) machine. The machine helps people get more air into their lungs. In many cases, having access to this machine allows patients to remain at their local hospital instead of being transferred to a larger facility. It has allowed immediate intervention and use of a noninvasive procedure to treat patients who enter the emergency room in acute respiratory distress, especially those with Chronic Obstruction Pulmonary Disease or Congestive Heart Failure. Since utilizing the Bi-Pap, the hospital has noticed a decrease in the number of transfers and length of patient stays. Jim Richmond, PA, who staffs the hospital's emergency room, states, "I have seen firsthand that Bi-Pap can be life saving. It is important in a rural hospital to have the equipment to meet our patients' needs."

Most Significant Achievement

Working in partnership with Iowa Critical Access Hospitals (CAHs) and stakeholders, such as the Iowa Hospital Association and the Iowa Foundation for Medical Care to develop and implement a rural relevant benchmarking and quality measures tool. CAH leaders such as administrators, directors of nursing, and quality coordinators volunteered their time to meet. Over a two-plus-year period they developed quality measures that are valuable to their rural patients because they are utilizing and implementing the CMS quality measures. Measures and definitions were developed for collection of data on medication errors, falls, acute myocardial infarction care in the ED, acute coronary syndrome care in the ED, obstetrics, and hospital-acquired infections. The group was careful to not create yet another reporting requirement, but to use information and best practices to create a tool that could improve the quality of care, allow comparison, and align with national measures where possible. The tool is now housed within and operated by the Iowa Hospital Association under the name: IHA DATABANK Quality Reporting Program. The tool is now used not only by Critical Access Hospitals, but has expanded to larger rural referral and tertiary hospitals. A CAH quality coordinator's group continues to meet on an as needed basis to provide input and suggestions for changes to continually improve the tool.

Flex Program Details

Location: Iowa Department of Public Health
Number of CAHs: 82
Web site: http://www.idph.state.ia.us/hpcdp/Flex_program.asp

State Rural Health Plan
Rural Assistance Center State Resources