A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.
OBJECTIVE
To investigate the effectiveness of a quality improvement educational program in rural hospitals.


METHODS
Hospital-randomized controlled trial.


METHODS



METHODS
A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool.


METHODS
The 47 hospitals were randomized either to receive formal quality improvement educational program or to a control group. The educational program consisted of two 2-day didactic sessions on continuous quality improvement techniques, followed by the design, implementation and reporting of a local quality improvement project, with monthly coaching conference calls and annual follow-up conclaves.


METHODS
Performance on core measures for community-acquired pneumonia and congestive heart failure were compared between study groups to evaluate the impact of the educational program.


RESULTS
No significant differences were observed between the study groups on any measures. Of the 23 hospitals in the intervention group, only 16 completed the didactic program and 6 the full training program. Similar results were obtained when these groups were compared with the control group.


CONCLUSIONS
While the observed results suggest no incremental benefit of the quality improvement educational program following implementation of a web-based benchmarking and case-review tool in rural hospitals, given the small number of hospitals that completed the program, it is not conclusive that such programs are ineffective. Further research incorporating supporting infrastructure, such as physician champions, financial incentives and greater involvement of senior leadership, is needed to assess the value of quality improvement educational programs in rural hospitals.
Filardo
Giovanni
G
Institute for Health Care Research and Improvement, 8080 N. Central Expressway, Suite 500, Dallas, TX 75206, USA.
Nicewander
David
D
Herrin
Jeph
J
Edwards
Janine
J
Galimbertti
Percy
P
Tietze
Mari
M
McBride
Susan
S
Gunderson
Julie
J
Collinsworth
Ashley
A
Haydar
Ziad
Z
Williams
Josie
J
Ballard
David J
DJ
D019985:Benchmarking; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control; D006333:Heart Failure / Q000628:therapy; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D013781:Texas