Arizona Center for Rural Health
Top Flex Activities
CAH Quality Improvement
The Arizona Flex Program (AzFlex) continues to provide training and education to Arizona’s critical access hospitals (CAHs) on the Medicare Beneficiary Quality Improvement Project (MBQIP) by monitoring and evaluating data, creating and disseminating reports to CAH leadership, and reviewing best practices so that Arizona can get to and sustain 100% MBQIP reporting. Activities include: quarterly webinars with the Arizona CAH Quality Network; onsite technical assistance site visits to educate and assist CAHs in MBQIP; monthly MBQIP reminders and tips; customized reports with hospital scorecards on the MBQIP domains; and a quality listserve to support CAHs and share best practices.
CAH Operational and Financial Improvement
AzFlex is working with the Arizona Hospital and Health Care Association (AzHHA) to address financial and operational issues. At each meeting, they will invite one of their CAH “experts” to present best practices they have successfully used or implemented at their facilities to address identified topics. Following the presentation and discussion, next steps will be identified as well as follow-up with hospitals. Follow-up will focus on practices that have been implemented, or if not, what steps would need to be taken to implement the practice or process. Consultants will be used as appropriate to augment in-house “expert” presentations. This year AzFlex collaborated with Southern Arizona Hospital Alliance (SAHA), Stroudwater Associates and hospital leadership, to develop a performance improvement network comprised of healthcare providers that service the southern Arizona geographic region.
CAH Population Health Improvement
AzFlex will assist Arizona CAHs to address existing health needs as identified through 2016-2018 community health needs assessments (CHNAs) through community collaboration and integration with statewide health initiatives. The health needs include: access to care; behavioral health services, healthy lifestyle factors, and the needs of an aging population.
Rural Emergency Medical Services (EMS) Improvement
AzFlex continues to collaborate with the Arizona Department of Health Services (ADHS) Bureau of Emergency Medical Service (EMS) and Trauma System, and the 40 trauma centers (Level I, III and IV) in the state. The Arizona Trauma Managers Work Group has been meeting regularly for over seven years and continues to meet face-to-face quarterly, rotating through trauma center sites around the state. Over 100 people actively participate in a Trauma Program Manager listserv that is managed and maintained by Arizona Flex to share ideas, policies, best practices, etc.
AzFlex also will collaborate with the Arizona Department of Health Services Bureau of EMS and Trauma System to assess and support the quality of services identified
If your Flex Program was funded for one of the eight competitive Flex EMS awards, please describe your project, your partners, and intended long-term outcomes.
Arizona Rural EMS Advanced Telemedicine Demonstration Initiative (AzREADI) will improve access to high-quality EMS care by implementing a rural, EMS-based telemedicine program linked to board-certified emergency medicine physicians. Recent improvements in wireless broadband capability (FirstNet), allow rural EMS agencies to extend communications and facilitate comprehensive, real-time vital sign patient telemetry and diagnostics to board-certified EMS physicians. The established Arizona Treat and Refer system – with its Medicaid cost recovery - and the proposed AzREADI platform,will be timely, feasible, effective, and sustainable. AzREADI is being piloted with two rural EMS agencies with the goals of reducing unnecessary and/or long-distance ambulance transports, assuring high quality and sustainable pre-hospital care, and improving patient satisfaction.
Two rural EMS agencies serving southern Arizona will work with the University of Arizona (UA) Department of Emergency Medicine and the Arizona Rural Hospital Flexibility Program to implement a telemedicine demonstration program (AzREADI), test its ability to improve rural EMS care, and decrease unnecessary air transport costs. The two partner EMS agencies are the Rio Rico Fire and Medical District, serving the rural area just north of the Arizona-Mexico border, and the Sonoita-Elgin Fire District, serving rural communities between Tucson and Sierra Vista, Arizona. The UA Department of Emergency Medicine provides medical director oversight for both. Their EMS service areas include 19,941 Arizona citizens and spans 792 square miles in southern Arizona.
Please provide information about network activities in your state to support Flex Program activities.
As mentioned in the financial and operational section, AzFlex is working with the Arizona Hospital and Health Care Association (AzHHA) to address financial and operational issues in a program called the AzCAH Leadership Group Project.
AzFlex also runs a Quality Network to help AZ CAHs in reporting MBQIP measures. The focus in past years has been to get CAHs just to report. Now with most reporting, the Flex Program can work on improving measures.
And lastly, the AzFlex runs a State Trauma Managers workgroup. This group meets quarterly and works on supporting and improving trauma programs statewide.
Please describe how your state Flex Program is reaching out to non-traditional partners to support its work.
By way of the Rural Veteran Access Grant proposal submitted in February 2019, AzFlex was able to establish a new partner, The Arizona Coalition of Military Families. The Flex Program did not receive funding for this grant, however, they were able to pull resources together and help rural veterans access services through the "Be Connected" Program. Jill Bullock was invited to attend the Governor's Challenge to Prevent Suicide Among Service Members, Veterans and their Families. Other states that were in attendance had no awareness to their State Offices of Rural Health.
|Type of Organization||University|
|Number of CAHs||15|