Top Three Flex Activities in 2009

1. Development and use of the Balanced Scorecard in over 30 CAHs.
2. Apply TeamSTEPPS in over 30 CAHs. TeamSTEPPS is a tool to enhance communication and teamwork to improve quality and reduce patient errors. The results are measured using the AHRQ Hospital Survey on Patient Safety Culture before and after TeamSTEPPS has been used in the CAH.
3. Development of the CAH Executive Fellowship Program. This program is sponsored by the Office of Rural Health, the QIO, and the Nebraska Rural Health Association. The purpose of this program is to provide the leadership competencies and tools that are necessary to build a culture of change and transform the hospital into a high performance organization. It is a nine-month program that is designed to help the participants become effective leaders and oversee one or more performance improvement projects. A total of 16 CAH administrators have completed or are participating in the program.

Flex Program Success Story

The FLEX program has collaborated with the University of Nebraska Medical Center (UNMC) to support the TeamSTEPPS project. Over the past two years, more than 30 CAHs in Nebraska have been participating in the program. The goal of TeamSTEPPS is to ensure safe care for patients by improving the communication and teamwork skills of the medical and hospital staff. After an initial readiness assessment, a rural-adapted version of the AHRQ Hospital Survey on Patient Safety Culture is conducted in each of the participating CAHs. After the survey, a train-the-trainer workshop is held to teach hospital staff about the tools that are available and how to use them effectively. Thus far, a total of 107 master trainers have completed the TeamSTEPPS training and they are now training other CAH staff. Throughout the process, staff from UNMC conduct bi-weekly conference calls, as well as a lessons learned conference. One of the lessons learned is the importance of training all members of the team. When a problem such as disruptive behavior occurs, an action plan is developed with the goal of obtaining buy-in from all team members, and treating every individual on the team so that they feel valued and respected.

In March of 2009, the Hospital Survey on Patient Safety Culture will be re-administered to all of the CAHs that participated in TeamSTEPPS. The results of the survey will be used to asses the impact of TeamSTEPPS on the patient safety culture in each CAH.

Most Significant Achievement

Development and use of the Balanced Scorecard.

Flex Program Details

Location: Nebraska Department of Health and Human Services
Number of CAHs: 65 and no new conversions are expected.
Web site: http://www.hhss.ne.gov/orh

State Rural Health Plan
Rural Assistance Center State Resources