The New England Performance Improvement (NEPI) network was developed in 2004 as a collaboration among the Rural Hospital Flexibility (Flex) programs in Maine, New Hampshire, Vermont and Massachusetts.  The network, coordinated through the New England Rural Health RoundTable (NERHRT), utilizes a portion of each state‚Äôs Flex grant funds to offer quality improvement resources for Critical Access Hospitals (CAH) and small rural hospitals.

Small, rural hospitals face many challenges due to their small size and limited population of their catchment areas. Yet they are critical parts of the rural landscape. NEPI brings much needed opportunities for training and certification without cost to the small hospitals. Other efforts have also been undertaken by the NEPI group including an expansion of the RoundTable website, hosting Performance Improvement Summits, funding individual hospital projects, and conducting rural-relevant research.