Gonzales Healthcare Systems Strives for Improvement       Gonzales Healthcare Systems has recently joined two projects aimed at measuring and improving the quality of patient care rendered in its facilities. The first, the National Voluntary Hospital Reporting Initiative, is a cooperative effort between the Centers for Medicare and Medicaid Services (CMS) and the American Hospital Association (AHA), as well as other groups. Hospitals who voluntarily participate in this project will electronically submit data to a national data warehouse on 10 quality measures on the treatment of patients with pneumonia, heart failure, and acute myocardial infarction. Once a statistically valid amount of data has been submitted, hospitals will be able to compare their performance with other facilities. The public will also be able to access results of the study through the CMS website at www.cms.hhs.org. The second project is related although it has a more local flavor. To assist rural facilities in Texas in complying with the Medicare Conditions of Participation (licensing requirements), regarding quality assessment and performance improvement, the Texas Medical Foundation — which is the Quality Improvement Organization (QIO) for Texas — formed the Alliance of Rural and Community Hospitals (ARCH). ARCH members meet at least quarterly to review their performance in the 10 indicators noted above, as well as others related to those diagnoses, and assist those member facilities in using the data. They will benchmark their performance against each other, identify those areas needing improvement, learn and apply quality improvement methodologies, and network with other rural, community, and critical access hospitals in the area to learn from their experiences. Gonzales Healthcare Systems has recently completed its first quarter of monitoring and reporting. These results will serve as a baseline for quality improvement efforts. Initial analysis indicated that patient vaccination for pneumonia and influenza may be an area on which to focus and one in which patients can actively participate in improving their health outcomes. Further evaluation is currently being conducted.