North Mississippi Medical Center: a focus on quality, safety, and financial critical success factors.

BACKGROUND

North Mississippi Medical Center (NMMC), the largest rural hospital in the United States, offers a continuum of health care services stretching from high-tech trauma and/or cardiac care through to compassionate home, long-term, or hospice care.

OVERALL APPROACH TO QUALITY AND SAFETY

NMMC uses a care-based cost management (CBCM) approach to performance improvement, which is used to look beyond traditional cost drivers (people, equipment, supplies) to the care issues that have a much greater impact on the actual cost of care-practice variation, complications, and social issues.

APPROACH TO ADDRESSING THE SIX IOM QUALITY AIMS

The CBCM approach addresses NMMC's quality, safety and financial critical success factors and is applied to address the six Institute of Medicine quality aims. For example, by conceptualizing "patient safety" to include appropriate care for every patient, CBCM leads directly to IOM aims and evidence-based practice. Physician champions and nurse outcomes managers liaison with providers to achieve decreased complications, analyze practice variation from best practice, and address social issues that impair care improvement.

CHALLENGES AND LESSONS LEARNED

One of NMMC's greatest challenges is to continuously improve the health of the people in its region. Since 1995, it has partnered in periodic community health assessments to examine its wellness initiatives and plan programs.