New Mexico State Flex Profile
Top Flex Activities
The New Mexico Office of Primary Care and Rural Health (OPCRH) will contract with the New Mexico Hospital Association (NMHA) to support hospitals in their continued shared accountability of patient safety by offering hospital staff, senior leaders and physicians on-site education regarding their roles in quality, patient safety and process improvement through plan-do-study-act (PDSA), high reliability organizations and team training. Hospital staff will be able to understand their role in creating a strong patient safety culture and improving quality of care. In the area of Quality Improvement, New Mexico will:
- Foster a learning organization environment by improving support for hospital quality directors including data and analytics, performance improvement, regulatory and accreditation, population health, quality review and accountability and patient safety
- Provide ongoing quality improvement support to the quality improvement leads through email, phone calls, site visits or training and education opportunities
- Host quarterly virtual meetings and one in-person opportunity per year for all the Quality Directors representing the 13 participating hospitals to network and share learnings. Quality improvement leads will be able to be able to identify and demonstrate the full set of quality improvement competencies needed to support their hospital’s quality improvement program
- Improve patient safety on select, nationally accepted Flex-related indicators by providing webinars on specific clinical topics
- Promote and support hospital participation in patient safety trainings and other educational meetings provided by NMHA. Hospital staff will implement evidence-based practices and professionally-designed and accepted processes to reduce harm and improve patient outcomes
New Mexico critical access hospitals (CAHs) are all using different systems and methods of reporting data and all have different methods of sharing data with staff. This year, OPCRH is subcontracting to bring together quality directors by providing technical assistance focused upon quality improvement (QI) around the Medicare Beneficiaries Quality Improvement Project (MBQIP) measures. The subcontractor will provide access to data that the OPCRH will use to assist New Mexico rural hospitals in identifying areas of quality improvement and use a network-based approach to facilitate best practice exchanges among the participating hospitals.
Each of the New Mexico CAHs will be supported in the development of a targeted Performance Improvement Plan. This will result in the implementation of a state-wide performance measurement and benchmarking system of financial and operational and quality measures consistent with MBQIP for New Mexico rural hospitals. Establishing quality benchmarks will enable the Flex Program to identify poor performing CAHs for education and support. Additionally, CAHs will receive access to market, quality, safety, patient satisfaction and financial performance data for comparative analysis. A representative from the subcontractor will attend at least one New Mexico rural health network Quality Improvement meeting to “kick-off” the New Mexico quality improvement and MBQIP benchmarking project.
Financial assessment benchmarking will be determined by a group of small rural hospital and CAH leadership within the first year. These benchmarks will be ten financial indicators, plus any others the facility leaders feel would benefit. Improvement goals will be determined and financial improvement activities will be organized by the small hospital network.
OPCRH has subcontracted to complete a needs assessment from emergency services and CAH emergency staff. The assessment reviewed population health issues in their areas, training needs, barriers for service and community outreach programs. A plan is now being developed to organize on-site joint trainings for emergency medical services (EMS) and CAH emergency staff. The subcontractor also provides RETRAC meetings on a regular basis all over the state where emergency services and hospital emergency room (ER) staff can discuss cases and how improvements can be made to better serve the public.
New Mexico has a strong community support system. New Mexico OPCRH will focus on how all the contractors being utilized in Flex can work together with the hospitals and emergency services in improving quality scores as well as overall improvements in quality of care. Based on assessments conducted, all hospitals and emergency service areas have concerns regarding behavioral health issues. This will be a focus for some of this year’s joint trainings, along with addressing improvements in quality measures.
New Mexico has two new hospitals interested in CAH designation and OPCRH will assist these hospitals in the process.
OPCRH is in negotiations with New Mexico Black Lung Program. This will provide New Mexico a resource to see a correlation between black lung patients with diabetes and give the number of patients in areas where this correlation is higher. Since the Black Lung Program travels to very remote areas of New Mexico, they have the ability to test patients that are not getting treatment because they have difficulty traveling or their diabetes may not be treated because they were never tested prior to this program. This information will provide the CAHs in those areas information to do more outreach for this population.
OPCRH has conducted face-to-face visits with quality directors and hospital Chief Executive Officers (CEOs) to discuss upcoming Flex activities and encourage their participation. Quality directors are excited to have opportunities to get together with other quality directors on a regular basis, while CEOs already meet regularly at New Mexico's Small Rural Hospital Network meetings. Some of these quality directors have multiple roles in the hospital and may not have a clear understanding of how to promote quality or even understand value-based care. Bringing these individuals together to discuss what is being practiced, explaining what some of the quality scores are showing, and providing best practices from the higher performers will be key parts in this transition.
New Mexico has a strong Small Rural Hospital Network where CEO's meet face-to-face on a quarterly basis. Leadership staff meet with each other over the phone to discuss best practices and areas of concern. NMHA has been contracted to bring together the quality directors of the hospitals on a visual conference call so they can start discussing best practices. The Small Rural Hospital Network has also brought together the Chief Financial Officers (CFOs) to work on financial improvements for the hospitals, and they are sharing financial data and best practices on a regular basis.
New Mexico and Arizona have had discussions about collaboration, but have not yet developed a project.
New Mexico OPCRH has made quite a few changes in how services are provided, based on face-to-face visits and discovering what projects the hospitals were actually wanting to work on as well as hospitals' areas of difficulty in understanding or lack staff to create significant change. Understanding the areas of struggle for the hospitals helped match them with contractors who could provide the support and guidance they needed.