March 9, 2012
Volume 56, Issue 10



MCW Presents Community-based Medical Education Plan at WCMEW Meeting

The Medical College of Wisconsin (MCW) presented their community-based medical education plan at the Wisconsin Council for Medical Education and Workforce (WCMEW) meeting at WHA headquarters in Madison February 29.

Representatives from the Medical College said the WHA physician workforce report that suggests Wisconsin will be short more than 2,000 physicians within the next two decades, started a conversation at the Medical College about what they could do to expand their own medical education program. They developed a model that immerses medical students in a community setting where they will receive medical school education, complete their post-graduate work (residency), and then consider establishing a practice there.

"We are focused on increasing the number of primary care physicians practicing in primarily rural and urban underserved areas," said Joseph Kerschner, MD, dean of the Medical College of Wisconsin. "We feel strongly that the more time medical students spend in the community, the higher the likelihood is that they will set up their medical practice there."

MCW officials have also been discussing how medical students could connect with other health professionals in the community, such as nurse practitioners, physician assistants, and dentists.

"The community can teach us about what they need," said Kerschner.

Initially, MCW plans to work with one to three communities, and expand from there. The program will focus on prevention and wellness, provide early clinical experiences for medical students, and create a collaborative, team-based learning experience with other health professionals.

One of the pressures that medical students face is a burden of debt when they finish medical school. Kerschner said they are looking to lower the debt load by reducing the length of medical school from four years to approximately three years.

MCW officials said they are in the process of completing the feasibility study, which will be shared with the Medical College’s Board of Directors.

"The work you are doing to increase the number of medical students in the state puts the issues of graduate medical education squarely on our plate," Graduate Medical Education (GME) Task Force Chair Chuck Shabino, MD, WHA senior medical advisor said. "GME is the choke-point of all our endeavors to grow the number of physicians educated in our state."

Shabino said it is imperative that community physicians be engaged early in the discussion regarding expansion of medical schools and GME programs.

In a recent survey of medical students completed by the Wisconsin Medical Society, of 337 UW School of Medicine and Public Health and MCW students, the majority of whom were in their first or second year of medical school, 23 percent indicated they had no interest in primary care, but the rest "are all targets," according to Medical Society Chief Medical Officer Tim Bartholow, MD, who presented the results to the WCMEW. When asked where they intended to practice, 11 percent indicated a state other than Wisconsin. The remaining 89 percent indicated they were either planning to practice in Wisconsin or willing to learn more about Wisconsin opportunities, which suggests that strategies to engage medical students early in medical school regarding residency training and practicing in Wisconsin may be important.

Recognizing that the health care delivery model is evolving to a team-based approach, the Council discussed inclusion of representatives of additional team member professions, such as nurse practitioners, physician assistants, mental health professionals and pharmacists. The intent is to gain a better understanding of the impact of innovative changes in delivery on physician workforce demands. George Quinn, WHA senior policy advisor, and Shabino will follow up on the suggestions and report at the next meeting.

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WHA’s HIT Task Force Reconvening to Discuss Meaningful Use Proposed Rules

WHA’s HIT Task Force will be reconvening for two meetings in April to discuss the recently-released Stage 2 Meaningful Use and EHR Certification proposed rules. WHA’s HIT Task Force is a multidisciplinary group of hospital CEOs, CIOs, quality improvement leaders, attorneys, and others. Key issues from the proposed rules that the Task Force is likely to discuss are:

  • New proposed measures that depend not on hospital performance but on patient action;
  • Proposed earlier meaningful use compliance dates PPS hospitals would be required to meet to avoid penalties in FFY 2015;
  • New quality measure requirements;
  • A proposed requirement to use SNOMED and how that relates to ICD-10 implementation;
  • Various specific requirements in the meaningful use and EHR certification proposed rules.

In addition, WHA will also be soliciting other input from hospitals on various issues related to the proposed rules in the coming weeks. Altogether, the input will help guide WHA’s comment letter to the Department of Health and Human Services on the proposed rules as well as other WHA advocacy efforts regarding the proposed rules. Comments on the proposed rules are due May 7.

For additional information, contact WHA’s Matthew Stanford at 608-274-1820 or mstanford@wha.org.

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CMS to Host March 12 Call on Stage 2 "Meaningful Use" Requirements

The Centers for Medicare & Medicaid Services (CMS) will host a March 12 conference call on its proposed requirements for Stage 2 "meaningful use" of electronic health records. CMS last month released a proposed rule defining meaningful use of EHRs for Stage 2 of the Medicare and Medicaid EHR Incentive Programs, which CMS proposes begin October 1, 2013 for eligible hospitals and critical access hospitals. For details on the call and to register, click here.

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New Legislator Profile: Rep. Roger Rivard (R-Rice Lake)

Roger Rivard has a passion for Wisconsin’s Northwoods. Rivard, who was born and raised in Rice Lake, and has now been a business owner there for the past 40 years, wants to help open doors for young people to have the same opportunities that he has had to build a small business.

"My biggest priority during my term in the Legislature is to make sure we create an atmosphere where small business can survive because it is key to economic growth," Rivard said. He noted that 70 to 80 percent of the jobs in Wisconsin are with small businesses.

Rivard noted the important role that the medical community has in the economic health of the Rice Lake area. As a member of the health care task force in Rice Lake, Rivard said the growth in the medical community over the past years has spurred an interest in ensuring that this important sector is accommodated in such ways as ensuring transportation is in place to get people to and from medical appointments. It has also generated conversations about what auxiliary businesses might be co-located near the hospital and clinics, such as medical suppliers, to reduce shipping costs and create new jobs in the community.

It is a term that Rivard calls, "economic gardening." That is, create an atmosphere that fosters small business growth.

Medicaid costs are a concern for Rivard, a program that he believes is a viable safety net, but which may have gotten out of control by growing beyond its original intent.

"We need to finally get to the point where the Medicaid program is serving the truly needy, that due to circumstances beyond their control, cannot access insurance," Rivard said. "We’ve gotten to the point where the truly needy group is going to be actually harmed because some people are on the program that should be on their employer’s health care program or in a different program."

A strong supporter of WiscNet, Rivard points out that reliable Internet and phone service are essential to economic development in Northern Wisconsin. As a fan of limited government, he is quick to point out that there is a "place for government," and ensuring that residents have access to reliable, affordable telecommunications is an appropriate role for government.

"We have to make sure that all parts of Wisconsin have access to the Internet," according to Rivard. "And that is the dividing line; when it is economically not feasible, that is when you need a public-private partnership."

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WHA Expands Quality Dept Staff to Gear Up for "Partners for Patients" Initiative
106 hospitals will work with WHA staff on quality improvement

WHA is busy gearing up for the launch of its major quality improvement initiative, "Partners for Patients." To date, 106 hospitals have signed up to participate in WHA’s hospital engagement network (HEN) and 19 more are participating in other networks. (See list of the 106 hospitals participating with WHA here and a list of the 19 hospitals participating with out-of-state networks here.

Four new employees have joined the WHA quality department to work on the "Partners for Patients" initiative.

Jennifer Muehrcke
will be the administrative assistant for the project. She brings a wealth of experience in project administration, website management, and the use of databases for reporting measures.

Katy Nickel has joined the staff of the WHA Information Center as a clinical data analyst. Her duties will also include providing technical services for the quality improvement work that will occur in the Information Center in collaboration with the WHA Quality Department. Nickel worked with MetaStar for 16 years as an IT contractor and as a health care analyst providing IT, analytical, and reporting services for MetaStar’s Medicaid fee-for-service contract with DHS. Nickel holds a bachelor’s degree from the University of Wisconsin-Whitewater.

Tom Kaster and Travis Dollak will both be serving as quality coordinators in support of the Partners for Patients project. Each will be a content expert for a specific area of improvement in the project and will also be the quality coach and "go to" person for an assigned group of participating hospitals.

Tom Kaster has an MBA from Edgewood College with a focus on quality engineering. Kaster most recently worked as an operations and learning development consultant at Humana. He has experience in the use of quality tools, leadership development, team building, training and project management. Kaster received his bachelor’s degree from the University of Wisconsin-Platteville in business administration/human resources.

And since March Madness is soon upon us, it should be noted that Tom is also a WIAA state basketball tournament official.

Travis Dollak earned both his bachelor and master’s degrees in industrial engineering from the University of Wisconsin-Madison. He comes to WHA from the UW Medical Foundation (UWMF), where he had been the lead consultant and project manager for the UWMF diabetes improvement project. Dollak has experience with project management, team building and clinical process improvement.

The new members of the team join WHA Chief Quality Officer Kelly Court, and project managers Stephanie Sobczak and Jill Hanson in the WHA quality department.

"Partnership for Patients" is a national initiative supported by the Centers for Medicare and Medicaid Services (CMS). CMS awarded $218 million to organizations that will develop a "hospital engagement network." The American Hospital Association, who has been designated as a CMS primary contractor, has sub-contracted the hospital quality and safety improvement work in Wisconsin to WHA.

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Two Congressional House Committees Vote to Repeal IPAB

Legislation to repeal the Independent Payment Advisory Board (IPAB) was approved by two Congressional committees on March 8. Both the U.S. House Committee of Energy and Commerce and the Committee on Ways and Means voted in favor of HR 452, the Medicare Decisions Accountability Act.

"Hospitals continue to be the Medicare ‘piñata,’" said WHA President Steve Brenton. "Repealing this unelected board is essential to protecting hospitals from continued Medicare provider payment attacks."

IPAB was created under the health reform law—the Patient Protection and Affordable Care Act—as a cost control body. Under that law, a group of 15 unelected individuals were given the power to balance the Medicare budget annually. Essentially the only tool available to that body to do so will be adjusting provider payments to match Medicare revenues with expenses.

House Ways and Means Chairman Rep. Dave Camp (R-MI) released a statement after his committee’s vote. "Repealing IPAB reinforces that doctors and patients—not a board of unelected bureaucrats—should be making health care decisions."

Both Committees approved the legislation by voice vote with the full House expected to vote on the measure in the coming weeks.

Reps. Ron Kind and Paul Ryan serve on the House Ways and Means Committee. Rep. Tammy Baldwin serves on the House Energy and Commerce Committee. Reps. Sean Duffy and Reid Ribble are co-sponsors of the Medicare Decisions Accountability Act, HR 452.

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Register Today for 2012 Advocacy Day
April 24, 2012 *** Monona Terrace, Madison

Make an impact in Madison by attending Advocacy Day on April 24. Register your hospital team today, including your senior leaders, trustees and volunteers, for this important event. Online registration is available at: http://events.SignUp4.com/AdvocacyDay12.

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AHA Annual Meeting in Washington, DC May 6-9
WHA to host two member events and coordinate Hill visits

American Hospital Association (AHA) members should have received materials for the AHA’s Annual Meeting to be held May 6-9 in Washington, DC. The Wisconsin Hospital Association (WHA) will coordinate a number of special member events during this time, including a luncheon issue briefing, a members-only dinner and Hill visits on Tuesday, May 8, with Wisconsin’s Members of Congress.

"This year’s Capitol Hill visits will allow Wisconsin leaders to continue to describe the negative impacts additional hospital cuts will have on top of what are already billions of dollars in reductions facing our hospitals," said WHA President Steve Brenton. "It is important for hospitals to utilize this opportunity to talk with their legislators and explain first-hand how these continued reimbursement threats impact our hospitals, our economies and our communities."

WHA Board Chair Sandy Anderson, president, St. Clare Hospital in Baraboo, will lead the group heading to Washington, DC from Wisconsin. Attendance at the AHA Annual Meeting is not required in order to participate in WHA specific events or Hill visits. To facilitate Hill visits, WHA staff will make appointments with members of the Wisconsin delegation on your behalf.

If you are planning to be in Washington at this time and would like to participate in WHA member events and Hill visits, please contact WHA’s Jenny Boese at jboese@wha.org or 608-268-1816.

If you plan on attending the AHA Annual Meeting, register directly with the AHA at: www.aha.org/advocacy-issues/annual-meeting/12-index.shtml.

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WHA Seminar Offers Guidance on Community Health Needs Assessment
Co-Sponsors: UW Population Health Institute and Healthy Wisconsin Leadership Institute

While many hospitals have either participated in or led a community health needs assessment (CHNA) process in the past, now is the time to consider bringing a fresh perspective to the process. The UW Population Health Institute has added a number of new tools that hospitals can use to conduct a successful CHNA that will help hospitals identify key partners, set priorities, and follow through with implementation and measure the results.

Those tools and processes will be shared on March 23 when WHA, in partnership with the University of Wisconsin Population Health Institute and the Healthy Wisconsin Leadership Institute, hosts a one-day seminar, "Community Benefit for Health Improvement: Hospital, Public Health and Community Partnerships," at the Kalahari Resort in Wisconsin Dells.

The seminar will cover the basics of the Accountable Care Act and IRS requirements and acquaint participants with tools, strategies and resources that will be helpful as community health assessments are developed and implemented.

Four breakout sessions are aimed at providing participants with available tools and resources.

  1. Getting Started: Setting Priorities, Sharing the Workload, Managing Conflict
  2. Core Data Sets – How Much Data Is Enough?
  3. Focus on What Works: A Demonstration of the "What Works" Database
  4. Thinking About Implementation and Funding: How Do We Support Our Efforts?

Hospitals are encouraged to bring their community benefits team to this conference, including the public health officer. To register, go to http://events.SignUp4.com/CommunityBenefit12.

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W-ONE Statewide Nurse Leader Convention, March 28-30
Hotel reservation cut-off extended to March 14

Registration is still open for the Wisconsin Organization of Nurse Executives (W-ONE) annual convention for nurse leaders and managers, scheduled March 28-30 at The Osthoff Resort in Elkhart Lake. With a focus on its theme of "Inspired Leadership…Inspired Care," the convention will be opened by nationally-recognized speaker and best-selling author Rich Bluni, RN.

Anyone who has responsibilities for leading and managing RNs will benefit from the educational agenda and is welcome. You do not need to be an RN or a member of W-ONE to attend. The agenda also includes a legislative and advocacy update, and sessions on nurse leader succession planning and managing difficult people. The convention includes opportunities to network and share with other nurse leaders and managers.

A full convention brochure is included in this week’s packet and available online, along with online registration, at http://events.SignUp4.com/WONE12. Also, make your hotel reservation today by calling The Osthoff Resort at 800-876-3399. The W-ONE group rate has been extended through March 14.

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Grant Regional Health Center Receives 2011 Wisconsin Forward Award

The Wisconsin Forward Awards, the state’s premier organization for the promotion and recognition of high performance management principles, honored Grant Regional Health Center at a ceremony at the American Family Conference Center in Madison February 23. Grant Regional Health Center was recognized for advancing to the Proficiency Level.

Wisconsin Department of Health Services Secretary Dennis Smith presented the awards that recognized Wisconsin Forward Award recipients who submitted applications for review between July and December, 2011.

"Wisconsin hospitals and health systems are recognized as providing some of the highest quality health care in the country, and the fact that they are continuously striving to improve demonstrates their commitment to excellence," according to WHA President Steve Brenton. "The Forward Award winners always deserve the visible recognition that they receive as they stand as a real benchmark for others to emulate."

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Wisconsin Hospitals Community Benefits: Injuries and Violence

A teen arrives in the emergency department by ambulance following a terrible car accident. A child receives head injuries while bicycling without a helmet. A woman walks into the emergency department with injuries inflicted by an abusive spouse. These are stories of pain and tragedy that hospital personnel see all too often. Injury is the most under recognized major public health problem facing the country and it is the leading cause of death in people ages 1 to 44 in Wisconsin. Wisconsin hospitals devote significant resources to reduce the number of intentional and unintentional injuries that occur in the communities they serve.

Mayo Clinic Health System offers Car Control Class to help teens be safer drivers

Mayo Clinic Health System has teamed up with Chippewa Valley Technical College to provide an educational driving class for teen drivers to teach them how to avoid accidents and become safer drivers.

The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. In fact, per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash. The goal of Car Control Class is not to teach teens how to drive. Rather, trained professionals will coach teens on how to be safer drivers while having them experience driving situations that frequently cause panic and overcorrection resulting in accidents.

Parents accompany their teens during the class. Vicki Knutson of Eau Claire enrolled both of her sons in the class and says she feels more comfortable with them driving alone.

"I wanted Matthew (19) to take it to give him more confidence. He was too cautious behind the wheel," Vicki says. "Timothy (17) was overconfident. I wanted him to have more instruction on how to be a safer driver."

Matthew attended the October 2010 class and used his newly-acquired skills soon after when he skidded and fishtailed while turning a corner on the ice that winter. "I was able to keep the car fairly straight and recovered," Matthew says. "I learned that in the Car Control Class. It has made me a more confident driver."

Timothy was riding in the car with Matthew during the incident and was impressed by his brother’s ability to handle the car. He enrolled in the April 2011 class.

"The class definitely helped me with my driving," Timothy says. "The day after I took the class, a truck pulled out in front of me, and I had to make a quick lane change. Had that happened before I took the class, I would not have known what to do. The class taught me what to do when there is not enough time to just stop."

During the class, teens and their parents participate in classroom sessions and have an opportunity to drive through a specially designed road course. In the classroom, they are taught the physics and geometry of driving, how to eliminate distractions, how classroom instruction relates to the real world and how to avoid a crash before it ever happens.

Teens have the chance to feel how their cars respond during situations such as emergency and wet braking, bringing a car out of a skid, recovering when a tire goes off the road, shifting lanes to avoid an accident, side-to-side weight transfer and throttle steering.

Vicki says she would definitely recommend the Car Control Class to other parents of teen drivers.

"I loved it," Vicki says. "It definitely prepares them for real-life driving conditions."

Mayo Clinic Health System, Eau Claire


Safe Mom Safe Baby: Surviving day by day

Safe Mom Safe Baby (SMSB) is a collaborative model for providing sensitive services to pregnant women who are experiencing intimate partner violence (IPV) and children. Its primary goal is to enhance the health and safety of abused women by helping them navigate through their prenatal experience within healthcare settings, as well as through the complexities of the criminal justice, legal, and social service systems within the community.

During the past five years, Tina Watts, RN, Case Manager for SMSB program at Aurora Sinai Medical Center, along other providers, have improved the lives of nearly 500 pregnant women and new mothers who are at risk for, or living with, intimate partner violence. "This is a support program providing life skills training for those who are in desperate need," said Tina, "as well as a tender hand-off to other community resource programs.

Courage is hard to find, especially for a person who is dealing with an abusive relationship. Briana (not her real name) is a 22 year-old Milwaukee woman who has two children and is uninsured, unemployed and pregnant. Before she was admitted into the Emergency Department (ED) at the Aurora Sinai Medical Center (ASMC) for severe abdominal bleeding, Briana had purchased three Greyhound bus tickets to Phoenix, Arizona to escape, with her children, from an abusive relationship and to seek temporary shelter with her aunt in Phoenix. No one knew of her plan to leave Milwaukee with the exception of her aunt.

Briana had walked several miles with her children to reach ASMC. She was met by Tina Watts, RN, Case Manager with the Safe Mom Safe Baby program. Tina noted, "Her pants were soaked with blood because of the bleeding and long walk."

Of major concern to Briana was losing the tickets and the money she had spent to obtain them to gain access to another life, because the doctor required her to stay overnight to have the baby monitored. Tina continued:

"I was on the phone with the Greyhound representative, and they told me her tickets would only be good for 24 hours and if she did not show up, the tickets would expire."

Tina assured Briana that the ED program would find a way to assist her with purchasing new tickets, because Briana’s health and her baby were the priority at the time.

"I called Briana’s aunt and made sure that she was going to be at the Greyhound bus station in Phoenix the next day to pick up Briana and her children when they arrived, because our program requires someone to be present during pick-up."

Briana was discharged from ASMC the next day and agreed to bed rest once she arrived in Phoenix.

Aurora Sinai Medical Center, Milwaukee


Summer programs geared toward child safety

Each summer, Aspirus Wausau Hospital and Safe Kids Wausau Area host Splash Into Safety, a water safety program for children. During the program, kids between the ages of five and 14 learn about boating safety, life jacket safety, deep water safety, reach and throw assists, wading assists and hypothermia safety.

Children who participate in the program receive a free life jacket, and a free family swim follows the event.

This year, Aspirus and Safe Kids also partnered with the General Motors Foundation to provide education about the dangers of leaving children alone in cars in hot weather. The Never Leave Your Child Alone in a Car program unites coalition partners to share prevention tips with parents and caregivers to address the dangers to children in vehicles.

The program includes demonstrations at community events as well as tip sheets and posters that are handed out at child care centers, hospitals, police and fire stations.

Aspirus Wausau Hospital


Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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