Small Rural Hospital Blueprint for Performance Excellence and Value

For nearly a decade, the U.S. health care industry has been undergoing profound change in payment and service delivery; and growing increasingly complex. The past year has layered on several additional opportunities and challenges including the need for pandemic and emergency preparedness, massive growth in the acceptance and use of telehealth, spotlighting of social needs as a core component of health, and the systemic and persistent disparities facing people of color. Small rural hospitals face the challenge of being successful in fee-for-service payment systems while preparing for and entering into value-based payment arrangements, at a time of financial stress and uncertainty. This is all occurring while hospitals serve as a cornerstone of support and resources for their staff and community.

Complexity and change are best managed by using a comprehensive systems-based framework, including a balanced set of key strategies, initiatives, targets, and measures. These systems frameworks are currently being used by many successful rural hospitals to achieve clinical, operational, and financial excellence.

The Blueprint is intended to be a tool to assist rural hospital leaders in implementing a comprehensive systems approach to achieving organizational excellence. It contains an outline of the key inter-linked components of the Baldrige Framework, along with critical success factors relevant to small rural hospitals. Challenges and strategies are also addressed. Comments reflecting the Summit discussion are highlighted in each of the seven Blueprint components. A companion resource focused on related strategies and resources for state Flex programs is also available.

The State Flex Program Companion Resource focuses on related strategies and resources for Flex programs wanting to support their hospitals in implementing a comprehensive systems approach to achieving organizational excellence.

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