An analysis of clinical process measures for acute healthcare delivery in Appalachia: The Roane Medical Center experience

Karla Rae Pope¹ , John S Hancock² and Eric Scott Sills³^,4

¹Department of Obstetrics and Gynecology, St. Matthew's University College of Medicine, Grand Cayman, British West Indies

²Division of Public Health Partnerships, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

³Department of Obstetrics, Gynecology and Reproductive Research, Murphy Medical Center, Murphy, North Carolina, USA

⁴Suite D, 75 Medical Park Drive, Murphy Medical Center, Murphy, 28906, North Carolina ,USA

author email corresponding author email

Health Research Policy and Systems 2006, 4:3doi:10.1186/1478-4505-4-3


Published:	29 March 2006

Abstract

Objective

To survey management of selected emergency healthcare needs in a Tennessee community hospital.

Materials and methods

In this descriptive report, discharges and associated standard process measures were retrospectively studied for Roane Medical Center (RMC) in Harriman, Tennessee (pop. 6,757). Hospital data were extracted from a nationwide database of short-term acute care hospitals to measure 16 quality performance measures in myocardial infarction (MI), heart failure, and pneumonia during the 14 month interval ending March 2005. The data also permitted comparisons with state and national reference groups.

Results

Of RMC patients with myocardial infarction (MI), 94% received aspirin on arrival, a figure higher than both state (85%) and national (91%) averages. Assessment of left ventricular dysfunction among heart failure patients was also higher at RMC (98%) than the state (74%) or national (79%) average. For RMC pneumonia patients, 79% received antibiotics within 4 h of admission, which compared favorably with State (76%) and national (75%) average. RMC scored higher on 13 of 16 clinical process measures (p<0.01, sign test analysis, >95% CI) compared to state and national averages.

Discussion

Although acute health care needs are often met with limited resources in medically underserved regions, RMC performed above state and national average for most process measures assessed in this review. Our data were derived from one facility and the associated findings may not be applicable in other healthcare settings. Further studies are planned to track other parameters and specific clinical outcomes at RMC, as well as to identify specific institutional policies that facilitate attainment of target quality measures.