Building a network of pathfinders to improve rural health

People in rural communities live an average of three years fewer than their urban counterparts and have a 40% higher likelihood of developing heart disease compared with their counterparts in small metropolitan and urban areas, a gap that has grown over the past decade.[1] Data also indicates that rural residents are at 30% higher risk of stroke.[2] Compounding these dynamics, rural communities face a critical shortage of health care professionals, including public health workers, which can impact care. These rural residents are vulnerable to increased morbidity and mortality that could be prevented with risk factor modification, and timely acute cardiac and stroke event identification, triage and treatment.

The American Heart Association is committed to bringing equitable care to all by prioritizing closing the gap between rural and urban health outcomes. To that end, the Association has launched the Rural Health Care Outcomes Accelerator to ensure Americans living in rural areas have the best possible chance of survival and the highest quality of life attainable by promoting consistent, timely and appropriate evidence-based care.

“The unique health care opportunities and challenges in rural areas call for innovative solutions; the Rural Health Care Outcomes Accelerator gives rural hospitals access to comprehensive no-cost cardiac and stroke programs aimed at improving equitable cardiovascular care for all,” said Eduardo Sanchez, M.D., MPH, FAAFP, chief medical officer for prevention at the American Heart Association.

A valuable resource for rural hospitals

A 2020 presidential advisory from the American Heart Association/American Stroke Association identified gaps in relevant rural stroke and cardiac quality performance metrics.[3] The advisory emphasized the importance of meeting the unique needs of people in rural America in achieving equitable healthy life expectancy nationwide. Since issuing the advisory, the Association has launched tailored rural quality programs focused on optimizing hospital care by streamlining data collection and applying a methodology that works for surveilling lower annual patient volumes.

To that end, the Rural Health Care Outcomes Accelerator offers up to 700 rural hospitals no-cost access to add new Get With The Guidelines® Rural quality programs for coronary artery disease, heart failure, and stroke. These programs allow hospitals to measure compliance of evidence-based guidelines, benchmark with peers, and improve on quality of patient care, while simultaneously bringing up-to-date information to inform health care guidelines.

“The Association’s Get With The Guidelines is an acute care quality program proven to improve patient outcomes across cardiovascular and stroke focus areas.” Sanchez said. “When your hospital or health system participates in a Get With The Guidelines program, you can expect improved consistency of care delivery across the board, which lends itself to better outcomes, certification opportunities and reimbursement benefits.”

In addition to the benefits of The Get With The Guidelines programs, hospitals participating in the Rural Health Care Outcomes Accelerator work with American Heart Association quality improvement consultants to optimize the delivery of eligible cares to patients appropriate for their setting. Each participant is invited to join the rural learning collaboratives, adapt successful strategies and protocols shared by peers, and increase knowledge through stroke and cardiac professional continuing education modules provided by the Association's Lifelong Learning Center, as well as connect with clinical experts and thought leaders at conferences and during webinars.

The Rural Community Network is also available to all rural hospitals, regardless of status or enrollment with the accelerator. The network encourages peer-to-peer connection of health care professionals within the inpatient and outpatient communities through an innovative, accessible and interactive platform.

Maximize impact, get recognized for your commitment

To maximize impact, rural eligible hospitals will be prioritized based upon their potential to impact the largest number of patients in geographic areas with the highest CVD mortality. Federally designated critical access hospitals, as well as short-term acute care facilities and rural hospitals geographically classified as Large, Small or Isolated by Rural Urban Commuting Area classifications are eligible.

Independent of the Rural Health Care Outcomes Accelerator, the American Heart Association recognizes that rural hospitals care for a wide variety of patients conditions. For that reason, all rural hospitals participating in Get With The Guidelines - Stroke or Coronary Artery Disease (and Heart Failure, beginning in 2024), whether enrolled in the accelerator or not, are eligible to utilize the Rural Acute Measures and receive awards for achievement of excellence in adherence to this unique set of performance metrics.

To learn more about the Rural Health Care Outcomes Accelerator or to understand your hospital’s eligibility, visit

[1] American Heart Association issues call to action for addressing inequities in rural health. February 10, 2020.; American Heart Association. Public Health AmeriCorps to address health inequity in rural communities. April 6, 2022.

[2] Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association. Circulation. 2020;141:e615–e644.

[3] Ibid.

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