Background: Despite being reimbursed on a cost-basis, several research studies have shown that Critical Access Hospitals (CAHs) continue to operate under significant operational and financial pressure due to internal and external factors. As part of the 2016-2018 cycle of the Flex Financial and Operation Improvement Grant, an academic-practice partnership was established between an academic institution and 14 Critical Access Hospitals (CAH), in one state. The purposes of this partnership are to collaboratively identify opportunities for improvement in CAH financial and operational management processes and to establish action plans for implementing evidence-based sound financial and operational improvement strategies. This ongoing initiative includes the development of a tailored, intensive training system that incorporates primarily web-based modules on Lean Six Sigma principles and on-site projects. Lean or Six Sigma can be challenging to implement and maintain within healthcare organizations. However, when successfully implemented, evidence suggests that healthcare organizations can reap significant dividends.

Process: The academic partner is currently administering the Lean Six Sigma training program to hospital representatives from the participating CAHs, providing coaching in hospital-selected projects using the Six Sigma DMAIC methodology, and offering ongoing technical support to each participating CAH. The anticipated project completion date is September 2017.

Results: We will report on the changes in the perception and knowledge of training participants on Lean Six Sigma principles. The challenges and opportunities to integrating Lean Six Sigma principles into the clinical and administrative operations of small rural hospitals will also be discussed.

Practice Implications: The academic-practice partnership team will discuss the determinants of successful, formal Lean Six Sigma implementation within the context of small rural hospitals. Presenters will identify factors central to the establishment of strong partnerships between academic and practice communities for the purpose of improving rural health systems using evidence-based financial and operational management strategies.