Quality Challenges in Rural Communities


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

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