PRP153: Remaining open and resilient: Strengthening rural health care delivery systems in Colorado post COVID-19

Lauren Hughes, MD, MPH, MSc, FAAFP


Context: Rural health care delivery systems have experienced adverse clinical, operational, and financial impacts during the COVID-19 pandemic. These systems are now navigating how to safely resume providing services within their communities in the short run, knowing that they need to prepare for additional surges of COVID-19 in the coming months.
Objective: The objective of this study is to develop a playbook containing a set of focused tools, assessments, and best practices that rural health care delivery systems can use to develop strategies to better prepare for the financial, operational, and clinical challenges that accompany future surges of COVID-19. The guidance will address clinical care, systems operations, and good governance practices.
Study Design: Qualitative study involving: 1) a review of tools rural health care delivery systems use to assess community health needs and organizational capacity and capabilities; 2) a focused literature search of best practices rural health care delivery systems use to mitigate financial, operational, and clinical challenges; and 3) thematic analysis of up to 25 key informant interviews representing administrative, governance, and clinical leaders and different types of rural health care delivery systems across Colorado.
Setting or Dataset: Rural health care delivery systems across 47 rural and frontier counties in Colorado comprise the target population, specifically rural hospitals, rural public health, and rural primary care, including hospital-based outpatient clinics, rural health centers, federally qualified health centers, and independent solo, small-, and medium-sized primary care practices.
Population studied: The key informants will be selected via a purposeful sampling strategy; criteria may include, but are not limited to, geography, financial performance, clinical performance, size of clinical operations, rural population health status, community characteristics, and clinician type.
Outcome Measures: Primary study outcome is to produce a rural-specific toolkit that is useful, relevant, and practical for rural health care delivery systems that desire to strategically plan for and mitigate the impact of future waves of COVID-19.
Results: Results to be reported at a future date.
Outcomes: Key outcomes will include evidence-based best practices to improve clinical care, operations, and governance practices during public health emergencies and how to tailor assessment tools for the rural context.

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