This paper discusses quality improvement strategies and best practices in critical access hospitals. Critical Access Hospitals (CAHs), the smallest rural facilities, face many challenges in implementing quality improvement (QI) initiatives, including limited resources, low volume of patients, small staffs, and inadequate information technology. A primary goal of the Medicare Rural Hospital Flexibility Program (MRHFP) is to improve the quality of care provided by CAHs. The purpose of the current study is to describe the continuing evolution and maturation of CAH QI activities, and to document the best practices of two CAHs that have developed innovative QI programs. This study is part of the overall monitoring effort of the MRHFP funded by the federal Office of Rural Health Policy.
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