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HELPING
HOSPITALS
UM Researchers Examine
Health Care Issues in Rural Hospitals
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| Researchers Helena Hoas (left) and Ann Cook help rural health care providers improve services. |
Through the National Rural Bioethics Project, a collaborative multistate partnership located at UM-Missoula, research professors Ann Cook and Helena Hoas work to improve the quality of health care in rural settings. The professors’ cutting-edge research recently earned UM a National Institutes of Health grant, which allows Cook, Hoas and others to continue research that examines the relationship between working conditions and medical errors and other adverse events that occur in rural hospitals. The grant was awarded by the NIH Agency for Health Care Research and Quality.
Associate Professor Timothy Stratton, chair of UM’s Department of Pharmacy Practice, and University of Washington Associate Professor Sarah Shannon worked with Cook and Hoas on the grant proposal that earned UM more than $1 million of the $8 million the NIH agency awarded to 20 universities.
“This research involves what has become an important issue in health care — the need to reduce medical errors and adverse events,” Cook says. “To date the best approaches for reducing errors and adverse events in rural hospitals have not been identified, in part because the research needed to identify those approaches has not been conducted in rural hospitals. This is the first time that a bioethics initiative involving errors and adverse events specifically will involve hospitals in the rural West.”
Previous research by Cook and Hoas led to the current NIH grant award. In 1997, through the support of the Culpeper-Rockefeller Foundation, the researchers performed studies to identify bioethics-related issues that emerge in rural health care settings. Their investigation with researchers from four other universities then continued with the support of the Greenwall Foundation. In all, nine studies were conducted encompassing 14 states.
Cook and Hoas have identified numerous differences between rural and urban health care. One important difference, they say, is the relationship between the providers and their patients. In urban settings, relationships are often solely professional in nature, while in rural settings, most health care providers characterize their relationships as both personal and professional. Rural health care providers also work with limited access to continuing education or bioethics resources to help them deal with their unique circumstances.
Working with teams of physicians, nurses and pharmacists from participating rural hospitals in Montana, Wyoming, Alaska, Minnesota, North Dakota, South Dakota and Washington, the researchers will continue to examine how health care providers and residents in rural communities identify, discuss and resolve complicated ethics-related issues.
The project will help hospital personnel critically evaluate the collected data to improve their services. Researchers will focus on practices that reduce medical errors in rural hospitals and will assist with policy changes to facilitate those practices. They also will develop resources for rural health care providers, which will be broadly field-tested and disseminated with the help of collaborators from four other universities that have participated in National Rural Bioethics Project research initiatives.
“This research will give rural health care providers a voice and will help them define best practices and shape what optimal rural health care should look like,” Hoas says. V
—Mike Santana