Quality Challenges in Rural Communities

Abstract

In a few short weeks the Rural Nursing Organization will sponsor their annual conference on quality health care in the rural environment. What do we really by the term quality? The U.S. Institute of Medicine (IOM) defines "quality" as: the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. IOM released the report, "Crossing the Quality Chasm: A New Health System for the 21st Century" (IOM, 2001) calling for fundamental reform of the U.S. health care system. This report identified six aims for health care quality improvement: safe, effective, patient-centered, timely, efficient, and equitable. These six aims are just as appropriate in a rural environment as they are in an urban setting. They are also appropriate across all levels of prevention and across a variety of health care settings. To accomplish these aims in the rural environment The IOM in their report, "Quality Through Collaboration: The Future of Rural Health Care" (IOM, 2004) identified a five point strategy for rural communities: • Adopt an integrated, prioritized approach to addressing both personal and population health needs at the community level; • Establish a stronger quality improvement support structure to assist rural health systems and professionals in acquiring knowledge and tools to improve quality; • Enhance the human resource capacity of rural communities, including the education, training, and deployment of health care professionals, and the preparedness of rural residents to engage actively in improving their health and health care; • Monitor rural health care systems to ensure that they are financially stable and provide assistance in securing the necessary capital for system redesign; and • Invest in building an information and communications technology (ICT) infrastructure, which has enormous potential to enhance health and health care over the coming decades