A framework and action agenda for quality improvement in rural health care.

PURPOSE: The Agency for Healthcare Research and Quality and the federal Office of Rural Health Policy collaborated to convene an expert group to address issues of quality improvement in the rural health care environment. OUTCOMES: The group identified issues, barriers, and opportunities related to bringing rural health care into the mainstream of the national quality "revolution." A framework for rural quality and specific action steps was proposed. Recommendations were made in the areas of workforce, organizational performance, measurement, dissemination of innovation, and external factors impacting quality. Specific recommendations included fostering development of rural consortia, relevant quality measures for the rural environment, technical assistance capacity, appropriate financial incentives, leadership capacity, and databases.