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Rural Hospital Information Technology Implementation for Safety and Quality Improvement: Lessons Learned


CIN: Computers, Informatics, Nursing: July-August 2009 - Volume 27 - Issue 4 - p 206-214
doi: 10.1097/NCN.0b013e3181a91aaa

This grant involved a hospital collaborative for excellence using information technology over 3-year period. The project activities focused on the improvement of patient care safety and quality in Southern rural and small community hospitals through the use of technology and education. The technology component of the design involved the implementation of a Web-based business analytic tool that allows hospitals to view data, create reports, and analyze their safety and quality data. Through a preimplementation and postimplementation comparative design, the focus of the implementation team was twofold: to recruit participant hospitals and to implement the technology at each of the 66 hospital sites. Rural hospitals were defined as acute care hospitals located in a county with a population of less than 100 000 or a state-administered Critical Access Hospital, making the total study population target 188 hospitals. Lessons learned during the information technology implementation of these hospitals are reflective of the unique culture, financial characteristics, organizational structure, and technology architecture of rural hospitals. Specific steps such as recruitment, information technology assessment, conference calls for project planning, data file extraction and transfer, technology training, use of e-mail, use of telephones, personnel management, and engaging information technology vendors were found to vary greatly among hospitals.

Author Affiliations: Nursing Research and Informatics, Dallas-Fort Worth Hospital Council, Education and Research Foundation, Irving, TX (Dr Tietze); and Texas A&M University System Health Science Center, Rural and Community Health Institute, College Station (Drs Williams and Galimbertti).

This study is funded through the Agency for Healthcare Research and Quality grant AHRQ UC1 HS15431-01.

Corresponding author: Mari F. Tietze, PhD, RN-BC, 250 Decker Dr, Irving, TX 75062 (

© 2009 Lippincott Williams & Wilkins, Inc.