Wisconsin Governor Jim Doyle used his inaugural address this week to urge legislative leaders to embrace the notion of making Wisconsin a national leader in health care reform. Governor Doyle said that the cost of health care is "one of the great challenges of our time" and described a health care platform that includes: a guarantee that every Wisconsin child is insured; making insurance premiums fully tax deductible; and lowering the price of health care for farmers and small business owners.

"We must all be part of solving it (the health care challenge)," Doyle said. "This is not only an economic crisis, it’s a human crisis and it demands attention now."

Governor Doyle’s address seemed to confirm already strong signals that his biennial budget will include a significant increase in tobacco taxes. The Governor’s Healthy Wisconsin Council is expected to recommend an increase of $1.00 per pack of cigarettes. The new funds will amount to at least $227 million annually. The tax would be targeted to fund expansion of the current BadgerCare program, subsidize insurance premiums for currently vulnerable populations and fund Medicaid provider payment improvements.

"Governor Doyle’s focus on health care is strongly embraced by WHA," said WHA President Steve Brenton. "The Governor’s proposals offer an opportunity for gaining widespread bipartisan support, and align well with our Association’s health care reform principles."

The Governor’s 2007-09 budget is expected to be unveiled in late January or early February.

All rural and/or critical access hospitals in Wisconsin are invited to participate in WHA’s "Rural Hospital Surgical Infection Prevention (SIP) Project." This is the first collaborative SIP project offered in Wisconsin that is specific to small and rural hospitals.

The SIP Project will focus on improving the quality of care and prevent patient injury and deaths through the standardization of certain surgical processes at participating rural hospitals over a period of six months. The strategies will focus on appropriate use of antibiotics, as well as appropriate hair removal and postoperative normothermia for patients having colon, hip replacement, hysterectomy, and knee replacement surgeries. The Rural Hospital SIP Project will include education regarding scientific evidence, as well as the benefits of and successful strategies for preventing surgical infections in rural/critical access hospitals.

According to the national Surgical Care Improvement Project, surgical site infections (SSIs) account for 14 to 16 percent of all hospital-acquired infections and are among the most common complications of care. SSIs occur in two to five percent of patients after clean extra-abdominal operations and up to 20 percent of patients undergoing intra-abdominal procedures. Among surgical patients, SSIs account for 40 percent of all such hospital-acquired infections. Research shows that by reducing SSIs, hospitals on average could recognize a savings of $3,152 and a reduction in extended length of stay by seven days on each patient that develops an infection.

As quality data is reported publicly and payers implement pay-for-performance methods, all hospitals will need to implement procedures using evidence-based research to improve outcomes and results. For Medicare patients, the Deficit Reduction Act of 2005 directed Medicare to reduce payment to hospitals when patients acquire infections during a hospital stay starting October 1, 2008. There is no cost, other than hospital staff time, to participate in this in-state collaborative SIP project, unlike many of the national SIP collaborative projects.

An enrollment brochure is included in this week’s packet and includes more information on the schedule of activities, recommendations for putting together the hospital project team, and enrollment details. The brochure is also available at www.wha.org.

A widespread health care workforce shortage a growing concern in Wisconsin hospitals. With hospitals reporting vacancy rates increasing in their workforce as long-time employees retire, the WHA Employee Pride Program assumes even more importance as a recruitment tool to attract new workers to the field of health care.

The Wisconsin Health Care Employee Pride Program is based on the fact that the decision to work in health care is often made for personal and compelling reasons. The decision to stay in health care is often tied to the same reasons, along with the desire to help others live healthier lives. The Pride Program gives employees the opportunity to share with others why they love their career of service to others, while giving the Association a moment to honor and celebrate their contributions to their hospital, community and profession.

Last year, 60 hospital employees were honored at the Pride recognition dinner and award ceremony. This year we hope to recognize even more employees and to publicize their essays more widely in an effort to interest others in joining the health care workforce.

A designated leader from administration, human resources, public relations or patient care from WHA member hospitals is asked to coordinate the program. Employees are encouraged to submit to the hospital a one-page essay, poem, or story that explains why they chose to work in health care. From those essays, a committee at the hospital will pick one employee to represent their hospital. That employee will be honored at a reception and dinner April 26 at the Kalahari Resort in Wisconsin Dells.

The Wisconsin Hospital Association, along with the Wisconsin Society of Healthcare Human Resources Administration, the Wisconsin Organization of Nurse Executives, and the Wisconsin Healthcare Public Relations and Marketing Society, is proud to sponsor the Wisconsin Health Care Employee Pride Program 2007.

Pride Program materials are included in this week’s packet. In addition, these materials are available on WHA’s Web site at www.wha.org. Don’t miss this opportunity to participate in the 2007 Pride Program. For more information contact Mary Kay Grasmick at mgrasmick@wha.org, or Shannon Nelson at snelson@wha.org or call 608-274-1820.

Happy New Year! Very special thanks to Mary Starmann-Harrison for her year of service as WHA Board chair. I am looking forward to working with staff, members and our many collaborating partners over the next 12 months, and I appreciate the pace that Mary has established in the past year.

I also want to thank the Board of Directors and the members for the confidence you have placed in me. My pledge to you is that I will work hard on your behalf to further our agenda.

Here’s my take on our issues/program priorities as we begin the New Year:

• We need to sustain and evolve our statewide community benefits initiative. It’s an impressive fact that all 132 Wisconsin hospitals participated in our 2006 effort. The results, released this past October, demonstrated convincingly that our hospitals— as nonprofit organizations — are living our missions daily. Legislators are asking very important questions of us and there is much more that we can do to inform and educate proactively.
  
  In 2007, we need an enhanced effort to measure and report our community-based benefit activities. In surveying our members this year, it was apparent that many of us are not fully capturing information associated with public health improvement and outreach activities. In order to best tell our story, it will be important to enhance this reporting area for our 2007 report. I also believe our statewide report needs to include hospital-specific information in the not-too-distant future. Our commitment to transparency and accountability should make this a "must do."
  
• Just three years ago, the WHA Board endorsed progressive billing and collection guidelines that have served the field well. In 2007, WHA should improve the current guidelines by addressing several new areas, including: standard discounts for the uninsured; discounts for uninsured patients with incomes between 100 percent and 200 percent of the federal poverty level; financial assistance for higher income/asset patients with catastrophic health care bills; firming up oversight of collection agency relationships; and making collection and billing information more available to the public.
  
• Health care reform will certainly be a high profile issue in 2007. I want to see WHA actively engaged in shaping the coming debate by utilizing the recently adopted health care reform principles to address the access/coverage issues that will be swirling around the Wisconsin State Capitol. The Association’s Task Force on Improving Access and Coverage should reconvene early this year to identify specific reform initiatives deserving the Association’s strong support.
  
• Finally, I’d like to see our members — all of us — commit to a more active role in our Association. The 2006 member survey results were spectacular, and it’s clear that we understand and appreciate the value we receive from WHA membership. We’ll have plenty of opportunities to be involved next year and it’s our participation that helps make WHA the strong association that it is. Lets us each commit to increasing our personal involvement during 2007 by participating in the work of committees and task forces, by attending the regional and statewide meetings, and giving us feedback on a consistent basis.

Bob Fale,
2007 WHA Chair

The second annual "Physician Leadership Development Conference," for both new and potential physician leaders, will be offered by WHA Friday, March 16 and Saturday, March, 17, 2007, at The American Club in Kohler, Wisconsin. The full conference brochure, with the final agenda, registration and resort information, is included in this week’s packet and at www.wha.org.

The intent of this conference is to offer nationally recognized, CME-qualifying education necessary to develop physicians’ leadership skills and make the transition from clinician to physician leader at both a reasonable price and with more limited travel time and expense than the national conferences. Feedback from 2006 attendees was extremely positive and showed overwhelming support to continue the conference as an annual event, for both new and repeating attendees.

The 2007 conference agenda will focus on the topics of quality and patient safety, and aspects of health law, which are different topics than at the 2006 event, but were chosen based on the feedback from 2006 attendees. Those who attended in 2006 are encouraged to continue their education as a physician leader, and those who may be attending for the first time will find it invaluable.

Any physicians new to their leadership roles or who have leadership/management interest or potential should plan to attend this conference. Also, chiefs of staff, medical directors, chief medical officers, new medical staff presidents, new clinical department chairs, and new committee chairs are encouraged to attend or designate a physician with leadership potential to attend, as part of your organization’s succession planning.

One of the most interesting observations from the 2006 conference, both formally via the attendee evaluations and anecdotes from those in attendance, was the value of attending the conference as a team – physician leader and management leader – allowing for invaluable informal, one-on-one conversation during the one-and-a-half day event. This opportunity will once again be available at the 2007 conference.

A discounted "early bird" registration fee is available to those registering by February 1, as well as a group discount to those registering early. Additionally, a "host" registration option, which includes all meals, is available to those hospital representatives/management leaders who would like to accompany their attending physicians to the conference but do not need the CME credit.

The American College of Physician Executives (ACPE) is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The American College of Medical Education designates this educational activity for a maximum of 10 category 1 credits toward the American Medical Association’s Physician Recognition Award. Each physician should declare only those credits that he/she actually spent in the activity. Additionally, these programs are part of the ACPE and CCMM requirements toward a graduate degree or certification in medical management.

The WHA Foundation has raised more than $55,000 in 2006, and the Foundation Board extends its appreciation to each organization and individual who has made a contribution to this effort.

The funds raised through the Foundation’s annual fundraising campaign will be used to fund the WHA Foundation Scholarship Program at the state’s 16 technical colleges, the Nurse Leadership Succession Project, the Global Vision Community Partnership Award, a Health Literacy Summit in 2007, and other statewide initiatives that support hospitals throughout Wisconsin.

Thank you to those who have made a campaign contribution:

Champion Donors – gifts of $5,000 or more

Aspirus Health Foundation, Wausau
Columbia St. Mary’s, Milwaukee
UW Hospital & Clinics, Madison
WHA Financial Solutions, Madison

Contributions from Organizations

Agnesian HealthCare, Fond du Lac
Amery Regional Medical Center, Amery
Black River Memorial Hospital, Black River Falls
Divine Savior Healthcare, Portage
Flambeau Hospital, Park Falls
Hayward Area Memorial Hospital, Hayward
Memorial Medical Center, Ashland
SSM Health Care of Wisconsin, Madison
St. Nicholas Hospital, Sheboygan
St. Vincent Hospital, Green Bay
Westfields Hospital, New Richmond
Wisconsin Hospital Association

Contributions from Individuals

Loren Anderson, Aurora Health Care – Southern Region
Jenny Boese, Wisconsin Hospital Association
Eric Borgerding, Wisconsin Hospital Association
Steve Brenton, Wisconsin Hospital Association
Jennifer Frank, Wisconsin Hospital Association
Mary Kay Grasmick, Wisconsin Hospital Association
Dan Hymans, Memorial Medical Center, Ashland
Joe Kachelski, WHA Information Center
Mike Karuschak, Amery Regional Medical Center, Amery
Ron Paczkowski, Franciscan Skemp, La Crosse
Tom Plantenberg, Froedtert Hospital Foundation, Milwaukee
Brian Potter, Wisconsin Hospital Association
Joe Neidenbach, St. Vincent Hospital, Green Bay
Terri Richards, Saint Joseph’s Hospital, Marshfield
Kevin Stranberg, Memorial Medical Center, Ashland
Judy Warmuth, Wisconsin Hospital Association

With sponsorship in part from the WHA Foundation, Wisconsin Literacy has partnered with the UW Foundation and Dr. Paul Smith, Wisconsin Literacy’s Health Literacy Committee chair and Board member, to host a free one-day "Health Literacy Summit" on June 21, 2007, at the Chula Vista Resort in Wisconsin Dells.

According to the National Institute for Health, $73 billion (in 1998 dollars) is lost every year on health care costs due to patients’ low level of literacy skills. Their inability to read prescription labels or follow doctors’ instructions causes them to return to health care providers, often in crisis, to receive further treatment. The Institute of Medicine’s definition of health literacy is "the degree to which individuals have the capacity to obtain, process and understand basic information and services needed to make appropriate decisions regarding their health."

The goal of the Health Literacy Summit is to bring together health care providers, public health officials, Wisconsin technical colleges and community-based adult literacy organizations to open the discussion about literacy as it impacts health and health care. Following the Summit, Wisconsin Literacy plans to develop a statewide plan to raise awareness about literacy, partner health care providers with local literacy councils to collaborate on future local projects, and bring together community-based and technical college adult literacy organizations to discuss health literacy curriculum.

When asked how he would characterize the interest of the health care community on this issue, Smith said, "Nationally, there is a lot of interest in the issue of literacy…and, specifically, health literacy. In Wisconsin, there is a lot of interest by the people that hear presentations about the issues, but the general level of awareness is very low." Smith gave a presentation on the topic of health literacy at WHA’s 2006 Quality & Safety Forum, and at various WHA council meetings during 2006.

Smith said the Summit will include workshops focusing on how to write documents for low-literate adults, for those health care providers already aware of the magnitude of the problem. For those not aware, he says he hopes "they leave with a sense of urgency that this is a big, often hidden problem that they need to start addressing in their organization."

For more than three years, teams of medical and dental personnel from Fond du Lac-based United Hearts for Health - a coalition of community churches of different faith traditions, organizations and health care providers - have visited Rosita, Nicaragua to assess its health care situation and help to improve the standard of health care for the community of Rosita.

The group, which was established by the Holy Family Parish, Fond du Lac, in collaboration with the Santa Rosa Parish in Rosita in 2001, has been raising funds and organizing shipments of medical and dental supplies, building awareness of Rosita’s health care needs, and encouraging appropriate action by private and governmental agencies here and in Nicaragua.

Last year during one of several medical mission trips, John Lent, MD, a Fond du Lac cardiologist with Aurora Health Center and United Hearts for Health member, met Maria Meyling Onsang-Peralta, a 41-year-old Rosita resident after she was referred to him by a Nicaraguan physician. Following a series of cardiac-related tests, it was determined that Maria had severe aortic heart valve disease and would require a heart valve replacement.

At that time, it was decided to begin the process of bringing Maria from Rosita to a Fond du Lac hospital for the procedure due to lack of adequate open-heart valvular surgical facilities in Nicaragua and the fact that Maria’s symptoms were not severe.

However, last spring during another mission trip, it was clear that Maria’s symptoms had worsened and that the surgery would need to be pushed ahead. With assistance from U.S. Congressman Tom Petri’s office, Maria’s visa was approved and she was admitted to Agnesian HealthCare’s St. Agnes Hospital in Fond du Lac for her procedure on March 23. The procedure was performed by Dennis Woodhall, MD, a thoracic and cardiovascular surgeon with Agnesian HealthCare.

Agnesian HealthCare and its physicians, as part of its core mission, are providing care to Maria at no cost to the family. Edwards Lifesciences has donated the valve, and St. Jude Medical Cardiac Rhythm Division has donated a permanent pacemaker.

Submit hospital community benefit stories to Mary Kay Grasmick, editor, mgrasmick@wha.org or call 608-274-1820.

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