Perkins County Health Services | Nebraska

The Perkins County Health Services (PCHS) in Nebraska is committed to antibiotic stewardship. In collaboration with University of Nebraska Medical Center Antimicrobial Stewardship Assessment and Promotion Program (ASAP), PCHS created a multi-disciplinary team that successfully identified opportunities to optimize the use of antibiotics at their facility, participated in educational activities focused on implementing the Centers for Disease Control and Prevention’s (CDC) Core Elements of Antibiotic Stewardship Programs, and applied quality improvement strategies to plan and implement a stewardship project. Strategies and lessons learned were shared with the entire Telligen HQIC cohort.

Northeastern Health System | Oklahoma

Northeastern Health System (NHS), seat of the county Cherokee Nation in Tahlequah, Oklahoma, reduced antibiotic resistance by allowing use of first- and second-line agents for urinary tract infection (UTI) treatment and saw a 20% decrease in overall utilization of restricted antibiotics. NHS implemented a multidisciplinary antimicrobial stewardship team that was laser-focused on launching pharmacy-driven protocols following the recommendations of the Infection Disease Society of America’s guidelines and the best practices outlined in the Centers for Disease Control and Prevention (CDC)’s Core Elements for Hospital Antibiotic Stewardship Program. The provider-embraced restricted medication policy outlined use of antibiotics reserved for severe infections or guided by the local antibiogram. Every course of a restricted antibiotic is reviewed regularly and opportunities for improvement are discussed among providers.

Phelps Memorial Health Center | Nebraska

Telligen HQIC’s subcontractor partners at the Nebraska Hospital Association (NHA) and hospitals in their state are actively focused on addressing challenges around transitions of care. Phelps Memorial Health Center has a new and exciting approach to discharge planning which includes implementing a high-risk readmission assessment with specialized discharge planning for patients receiving services in the Emergency Department. The assessment allows the team to determine various discharge needs such ensuring a primary care physician (PCP) referral or appointment upon discharge or assigning a primary care physician PCP if the patient does not have one. The team also stratifies readmissions by diagnosis and return timeframe, separating 7-day from 30-day readmissions to better pinpoint points of failure.

Idaho Hospital Association | Idaho

To increase telehealth accessibility, the Idaho Department of Health and Welfare supplied freestanding privacy rooms, portable partitions and technology to rural libraries across the state. Privacy rooms are utilized for telehealth services to ensure greater health access for individuals in rural communities. The Idaho Hospital Association was asked to assist with disseminating this information and providing education to all hospitals. All HQIC hospitals were educated on the resources and their respective local opportunities to take advantage in their communities.

Valley County Rural Health Clinic | Nebraska

At Valley County Rural Health Clinic, a focus on hypertension per the needs of the hospital, Valley County Health System (emergency department throughput) and community (public awareness), has allowed the rural clinic to launch a Hypertension Improvement Project. The clinic successfully partnered with the Critical Access Hospital Network and leveraged this alliance by educating nursing and support staff to accurately assess blood pressure. Next steps include working with providers to serve patients that have uncontrolled hypertension, as well as determine the impact on the number of ED visits in order to further pinpoint needs post-training efforts.

Oklahoma Hospital Association (OHA) Excellence in Quality Awardees

Three HQIC hospitals were recipients of the Oklahoma Hospital Association (OHA) Excellence in Quality Award. These hospitals were recognized for their exceptional efforts to improve outcomes in clinical quality performance practices, capabilities and results; and represent the highest level of professional acknowledgement from the Oklahoma Hospital Association Council on Quality & Patient Safety. The 2022 HQIC hospital awardees were:

• Fairview Regional Medical Center (CAH, <25 beds) – Project Title: Patient Fall Reduction for Med/Surg Unit
• Jackson County Memorial Hospital (Rural, 26-100 beds) – Project Title: Clostridioides Difficile: Appropriate Testing, Treatment, and Teaching
• OU Health University of Oklahoma Medical Center (Urban Targeted, >300 beds) – Project Title: VTE Reduction in an Academic Level 1 Trauma Center

Thayer County Health Services | Nebraska

Thayer County Health Services (TCHS), a critical access hospital in Nebraska, completed considerable fall prevention work in their facility. After recognition of an increasing patient fall rate, the team at Thayer County created a multidisciplinary fall prevention team to drive process improvement. From this team, many initiatives were implemented that allowed TCHS to show a significant patient safety improvement and fall rate reduction. Fall rates decreased from 12.50 for January of 2021 to 1.13 at the end of June 2022. The last inpatient fall was July 19, 2021, which put TCHS at over 260 days fall-free. TCHS is proud to have been awarded the Critical Access Hospital Quest for Excellence Award 2022.

South Peninsula Hospital | Alaska

South Peninsula Hospital (SPH) in Homer, Alaska, made great strides in the management of severe sepsis and septic shock by leveraging their approach to leadership commitment, accountability and multi-professional expertise. Under the guidance of their CEO, SPH revamped their focus on sepsis by establishing a multi-disciplinary committee that met at regular intervals, creating a comprehensive sepsis scorecard where measures such as percentage of patients who received appropriate care for sepsis and/or septic shock were tracked and the group discussed opportunities for improvement to foster interdepartmental collaboration. These efforts resulted in an impressive improvement in sepsis scores – from 50% to 90%. SPH showcased its sepsis improvement journey at the 2023 American Hospital Association conference.

Idaho Hospital Association | Idaho

The Idaho Hospital Association (IHA) is pursuing an innovative approach to nursing staff recruitment and retention in rural areas. IHA is working with the Idaho Department of Health and Welfare (IDHW) to facilitate a Rural Nursing Loan Repayment Program (RNLRP). This program offers an opportunity for nursing education loan repayment for rural nurses providing direct care in a Health Professional Shortage Area (HPSA) – defined as areas with a population center less than 20,000 persons.

Successful applicants receive $5,000 for a minimum of one year of continuous employment in an eligible area. Nurses may reapply annually and receive up to $25,000 total from the program. This program was designed by a multi-disciplinary team, presented to Idaho legislators and passed in 2023. IHA was named as a co-facilitator of this program along with IDHW.

Gordon Memorial Hospital | Nebraska

Gordon Memorial Hospital met an essential need of their employees and community with the implementation of a daycare center. In August 2023, the Gordon Memorial Hospital team celebrated the opening of its first facility daycare center, Busy Bees Childcare Center. The project stemmed from the universal need for quality, reliable daycare in the communities served by Gordon Memorial Health Services. The project also helped stabilize staffing at the hospital, clinics and nursing homes during a time in which many healthcare facilities are struggling to retain and recruit staff, including licensed nursing staff.

According to their community population data collected during their Community Health Improvement Plan, the labor shortage was compounded by the need for daycare for those who have needed job skills but are raising young families. Historically in their community, daycare placement for ages 18 months and younger was particularly difficult. Discussions with community partners also confirmed that other businesses in their community struggled with keeping skilled workers due to lack of daycare. The addition of the Busy Bees Childcare Center helped to create a thriving workplace at Gordon Memorial and its surrounding area.

Idaho Hospital Association | Idaho

The Idaho Hospital Association, in collaboration with the University of Idaho, will be hosting “Echo Idaho; Healthcare Vitality,” a learning series that began in April 2024. Burnout may not come as a surprise given the continuous pressures on the healthcare system including a lack of workers, an aging population with more complicated medical demands, the challenges of delivering integrated care in a disjointed system and shrinking profit margins. This series, which will be conducted by an interdisciplinary panel of Idaho-based wellbeing experts, will provide healthcare administrators and professionals a forum for information sharing, skill development and mutual support to assist healthcare teams in making wellbeing a top priority.