Starting with the August 3 issue of The Valued Voice, WHA will begin to transition to a new email delivery system that offers many advantages over the current carrier.

"We’re excited about implementing a new email system for our member communications that will allow us to customize the email template and deliver content in a format that will be easier to read on a wider range of portable devices," said Mary Kay Grasmick, WHA vice president, communications.

The Valued Voice will be published in both the HTML and a traditional print layout (PDF). If you are now receiving a hard copy of the newsletter and you would like to start receiving only the email version, send your request to Grasmick at mgrasmick@wha.org.

Our goal is to make WHA your premiere source of information on Wisconsin health policy and legislative activity. We always welcome member feedback as we continuously strive to be a valuable partner with and information resource to our member hospitals.

WHA is launching a statewide campaign today, starting with a full page ad in the Milwaukee Business Journal. Over the next several months, WHA will communicate directly with Wisconsin’s leading employers and opinion leaders, focusing on hospitals’ growing commitment to improve quality and outcomes and value for their health care dollars. Employers will be encouraged to talk with their local hospital leaders to learn how they are improving the quality of care locally and, more importantly, how they can work together to improve the health of their community and workforce. The ad directs the reader to visit WHA.org, which links to a health care value section on the Association’s website (www.wha.org/healthCareValue.aspx).

The current ad is similar to one that ran five years ago when the federal Agency for Healthcare Research and Quality (AHRQ) ranked Wisconsin health care the best in the nation. The AHRQ’s latest Wisconsin ranking, which is the basis for the ad, has Wisconsin at #2 (just .10 percent behind Minnesota). Watch for a similar ad next week in dailies across the state and in other business publications over the next few months.

Medical-surgical nursing units in 15 Wisconsin hospitals are enrolled in Transforming Care at the Bedside (TCAB). TCAB is a project designed to involve direct care providers in patient care improvements using strategies that allow for rapid change cycles. The project has been underway for more than a year, and visits to each location enrolled in the project are taking place this summer. Judy Warmuth, WHA vice president, workforce, continued with five more visits across Wisconsin.

Ministry Good Samaritan Health Center in Merrill reported on many unit-based improvements including a redesign of the nursing station. TCAB tools and strategies are being introduced throughout the hospital, and the TCAB updates are shared with both local and system leadership.

Stoughton Hospital continues with implementation of "quiet time" and is working with the geropsychiatry unit on fall prevention strategies. "All About Me," an initiative that introduces patient’s personal interests to staff, first implemented by this team, has become one of the most frequently "borrowed" ideas in this TCAB project.

A proposed new practice model for patient care is one outcome of the TCAB initiative at Holy Family Memorial in Manitowoc. The model will be piloted on a small unit where an interdisciplinary team of caregivers will have the opportunity to test and refine the model. The TCAB project will be spread to the ICU next. The team continues to post their work, measures and innovations where all staff can see the project’s impact on care.

At Reedsburg Area Medical Center Transforming Care at the Bedside has moved to a hospital wide project with the "Transitions in Care" project. Lead by the emergency room, this project, which aims to improve care for patients as they move from one unit to another, has used data to prioritize changes and reinforce current practices. This team measured nurse time at the bedside at the beginning of the project, and a recent second measure showed an increase. The team hopes to improve again with computer data entry at the bedside.

Two nursing units participated in TCAB at Aspirus Wausau Hospital. Renovations and unit moves have created new challenges for the teams but innovations have continued. Equipment labeling and placement, unit noise, and continued work on fall prevention along with strategies for keeping staff informed and involved are action items for these teams. Aspirus has a plan to expand TCAB to other nursing units.

All Wisconsin hospitals have been invited to participate in the next TCAB project which begins this fall.

The Rural Health Initiative, designed to improve the health of people living in rural communities, is one of five programs to win a national award from the American Hospital Association (AHA) that focuses on community health.

In 2003, ThedaCare and Shawano Medical Center launched the Rural Health Initiative in Shawano County in partnership with the county extension service, the county public health department, and local schools, with regional agribusiness collaborative and financial partners. Last year, Shawano Medical Center became part of ThedaCare.

"As part of the Rural Health Initiative, a nurse makes free house calls to all interested farm families to provide health information, education, referrals to area services and listen to the families’ health concerns," said Rhonda Strebel, executive director of the non-profit program.

Established in 1993, the AHA NOVA Award recognizes hospitals and health systems for their collaborative efforts toward improving community health.

The Rural Health Initiative will receive the AHA NOVA Award at a national health forum and leadership summit in San Francisco on July 21.

ThedaCare CEO and President Dean Gruner, MD, said the health of the nation’s farm families is in crisis since many lack easy access to health care providers, don’t have health insurance or have insurance policies with high deductibles that keep them away from regular doctor visits.

"The Rural Health Initiative is a great example of how problems involving health care can be resolved when the community comes together with health providers," Dr. Gruner said. "From the beginning, we worked with the community to develop a plan that would work for them."

For more information about the Rural Health Initiative, visit www.wiruralhealth.org.

Kyle Bakkum will succeed Garith Steiner as CEO of Vernon Memorial Healthcare (VMH) in Viroqua effective July 21.

Bakkum has been chief operating officer at VMH since 2008, and before that he was manager of clinic operations for seven years. Bakkum worked in materials management and purchasing at Gundersen Lutheran and VMH prior to that.

Bakkum said, "I am thankful to have had the opportunity to work with Garith Steiner and want to thank him for his mentorship. I plan to continue Vernon Memorial’s strong tradition of providing high quality care, close to home. VMH has done a wonderful job of identifying the needs of our communities and then meeting those needs."

Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day last year. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.

Charity care story

It was with trepidation that Rita of Stone Lake went to Spooner Health System’s (SHS) emergency room in June 2010—and not just because of her injury, but because she had no insurance.

"We were visiting our son in Spooner, and coming out from their house, I fell—just tumbled right over," she said. "I landed on my shoulder, and I was obviously in a lot of pain. My husband and son talked me into going to the hospital to get it checked and x-rayed and so forth. I got there, and it was just amazing. No problem, they took me right in. My husband went to the front office and explained that we had no insurance."

Meanwhile, the staff treating Rita was "just very cordial, very caring. They didn’t know where I stood financially. They never asked. They did what needed to be done. I was in pain, but at the same time, my mind was thinking, ‘I don’t want to do this. How am I going to pay for this?’ Each time they did something, all I could think of was, ‘What’s this going to cost?’"

When a health issue recently forced her husband, Jim, now 64, to retire from carpentry, he and Rita, 62, and the owner of a small daycare in their home, hoped they could "make it to 65 without needing health insurance."

With their reduced income, they simply couldn’t afford the insurance premiums.

"I’ve tried so often to enroll in BadgerCare," Rita said, "but there’s such a waiting list. I finally gave up on it and just hope that we can stay healthy for a few years."

Instead, the emergency x-rays showed she had chipped a bone and damaged her rotator cuff.

"They couldn’t do anything for the shoulder, but they said I would need follow-up work, physical therapy and such," Rita said. "So I went home, and I just worried about this bill. I didn’t know what was going to happen, but it all turned out just great. I just marveled, first of all at the care. It was excellent. They were very caring."

And then she learned about Spooner Health System’s Financial Assistance Program. With encouragement, Rita applied for the assistance program.

Rita was astonished when Spooner Health System offered to cover 90 percent of her bill, based on the couple’s income.

"I was quite relieved. Very much so," Rita said. "I was just elated to find out they were going to cover 90 percent of it, which left a small balance. That balance, even, was something we could not pay outright, so they asked, ‘What do you feel you are able to pay?’ They asked me – they didn’t demand. I gave them an amount, and that was just fine."

"They have helped me, and I’m surely responsible for taking care of my end. Because they were there, I got the help that I needed – obviously I’m going to pay what I can. I’m really appreciative of their help. I couldn’t be more thankful."

A life was at risk

Tiffany, age 47, was rushed by ambulance to the Emergency Department (ED) at Aurora Lakeland Medical Center. Her symptoms included confusion, rapid heartbeat, heavy breathing, shivering and sweating. She had red spots all over her body and a high fever.

The ED doctor diagnosed Tiffany with septicemia and a urinary tract infection. Septicemia is a bacterial infection in the blood that can be fatal if not treated immediately. She was closely monitored in the Intensive Care Unit until she could be moved to a patient room.

Tiffany was unemployed and uninsured. She was a registered nurse who lost her job two months prior to being hospitalized. Her only source of income was unemployment insurance, which she used to pay for her home rental.

An inpatient for 22 days, facing one medical setback after another, Tiffany was extremely fearful to see her medical bills. Financial Counselor Myra Steinke reviewed all of the possible payment options, but Tiffany was not eligible for any of the entitlement programs. Her only option was to apply for the Aurora Helping Hand Patient Financial Assistance Program.

On the day of discharge, Myra presented Tiffany with the medical bill totaling $78,441.61. Myra recalls, "Her face was so pale after looking at the bill, but I told her that she received a 100 percent discount through the Aurora Helping Hand Patient Financial Assistance Program. The color returned to her face, and Tiffany was extremely thankful for our services."

"Now I know I will get better."

A stroke changed Marykay’s life forever. "The doctors say it was a small stroke, but it was still devastating! I couldn’t walk and my arm was like a big paperweight," says Marykay.

In spite of all Marykay went through, she now sees the stroke as "a wake-up call" because she also learned that she had type 2 diabetes that was out of control.

Marykay worked hard to get better. She pushed herself in her therapy sessions. "I worked hard at everything – but I was the best at speech therapy, probably because I love to talk! Now I read everything I can about diabetes – what I can and cannot eat, and I am doing well physically so I can move around more."

But as Marykay pushed herself hard through rehabilitation, she and her husband, Paul, had other things on their minds - Marykay’s mounting medical bills. "I tried really hard not to get depressed," recalls Marykay, "Paul and I live frugal lives. We live below our means. Sure, we had some money saved but not enough to cover everything."

"I will never forget the day Yvonne from Financial Assistance called and told me the bill was forgiven. I just burst into tears. I guess I was crying so hard that she was worried that something else was going on so she called Paul at work to tell him I was upset." Marykay laughs as she recalls the conversation, "Upset!? Those were tears of joy! She just took 600 tons of stress off of us."

"Yes, my life was changed forever because of my stroke and learning about my diabetes. But, if it wasn’t for the Financial Assistance program, everything would have been worse. Without Meriter’s help, the rest of my days would have been spent in a wheelchair with a dark cloud of debt hanging over our heads. Now, I know I will get better. I will be able to enjoy my life with my wonderful and handsome husband, and with no dark clouds."