The Quality Improvement Organization (QIO) Program supports small, rural and critical access hospitals and facilities that care for vulnerable and underserved patients as well as Indian Health Service-managed hospitals. These hospitals and health systems receive no-cost quality improvement tools and resources that help hospital leaders and clinical teams implement processes to improve care coordination and transitions of care, prevent hospital-acquired infections, reduce opioid misuse and prevent adverse drug events. Hospitals also receive assistance with implementing processes that support health equity and reduce health disparities in the American Indian Alaska Native community.

QIO Program initiatives for hospitals focus on four priority areas:

Opioid Utilization and Misuse

The QIO Program collaborates with hospitals to spread evidence-based practices and resources to decrease adverse drug events and deaths from opioids. It also assists hospitals with implementing pain management and opioid use best practices such as medication-assisted treatment (MAT), prescription monitoring, naloxone distribution and other community-based strategies.

Care Coordination

People with Medicare who live in rural areas are less likely to seek follow-up care after hospital visits which may put them at an increased risk for visits to the Emergency Department and for hospital readmissions. The QIO Program helps hospital leaders develop processes to better coordinate care with post-acute providers, patients and their families and improve communication when patients transition across care settings. Hospitals also receive assistance with connecting patients to community services so they can stay healthy at home.


The COVID-19 pandemic has greatly impacted hospitals, straining their capacity to care for patients due to staffing shortages and burn out and reducing their financial stability. The QIO Program delivers timely information to hospitals about regulations and guidance along with promising practices and resources that address hospitals’ most pressing needs. These include overcoming vaccine hesitancy and adopting quality improvement practices to support effective and efficient health care delivery in their work.

Patient Safety

An estimated 2.7 million harm events affecting hospital inpatients occurred in 2016, leading to more than 80,000 deaths at a cost of nearly $29 billion. According to the Centers for Medicare & Medicaid Services, nearly 44 percent of these events and deaths could have been prevented. Hospitals participating in QIO Program initiatives receive no-cost tools and resources to reduce all-cause harm, readmissions and adverse drug events.