The Institute of Healthcare Improvement (IHI) 100,000 Lives Campaign was the focus of a news conference at Camp Randall Stadium in Madison on September 8. Speaking at the conference, Donna Sollenberger, president/CEO, UW Hospital & Clinics emphasized the need to set high goals. "As leaders we can’t be satisfied with anything less and as keepers of the precious and delicate gift of our patients lives and health, we owe it to them never to settle for good enough, but instead, aim for the very best that’s possible."

Also speaking at the news conference was Scott Thompson, MD, regional vice president of medical operations at Aurora Health Care, who related the enthusiasm of the medical community to the 100K Lives Campaign.

"Many of our physicians, quality people and nurses heard about the 100,000 lives campaign and were immediately sold on its importance, value, and how it can be intertwined in the way we do business as hospitals and the way that we compassionately care for patients," Thompson said.

Steven Ebert, PharmD., clinical supervisor of the pharmacy at Meriter Hospital in Madison, spoke to the importance of patients participating in their health care, especially as it related to medication reconciliation, one of the six practices in IHI’s campaign.

"Patients must insist that their pharmacy or other medical provider maintain and give them a list of all current medications," he said. "Only by patients actively partnering with their pharmacist and other health care providers can we ensure that medication reconciliation will be successful."

Speaking on behalf of nurses, Scott Decker, vice president of quality and innovation at ThedaCare in Appleton, asked the audience to think of him as "their son, their loved one," and then envision what care they would expect and demand from their health care provider.

Seven Wisconsin health care organizations form what is called the "Wisconsin node" of the IHI campaign. The node consists of MetaStar, the Pharmacy Society of Wisconsin, Rural Wisconsin Health Cooperative, Wisconsin Hospital Association, Wisconsin Nurses Association, Wisconsin Medical Society, and the Wisconsin Organization of Nurse Executives.

The organizations participated in the Camp Randall event to bring public attention to the work Wisconsin hospitals and health care organizations are doing as part of the national campaign to make sure that life-saving techniques are implemented and become the standard in our hospitals.

This campaign targets six areas for improvement that have been proven to prevent avoidable deaths. The six changes are:

• Deploy Rapid Response Teams…at the first sign of patient decline
• Deliver Reliable, Evidence-Based Care for heart attack patients….to prevent deaths
• Prevent Adverse Drug Events (ADEs)…by making sure the patient’s medications are known by all health care providers
• Prevent Central Line Infections…by implementing a series of steps called the "Central Line Bundle"
• Prevent Surgical Site Infections…by reliably delivering the correct care before, during and after surgery
• Prevent Ventilator-Associated Pneumonia…by implementing a series of steps called the "Ventilator Bundle"

According to Greg Simmons, president and CEO, MetaStar, "When IHI announced the campaign last December (2004) the health care organizations formed the Wisconsin node. These organizations are providing tools and support, and are leading activities that will help hospitals to make the six changes of the campaign a reality. As a health care quality improvement organization in Wisconsin, we are pleased that we have been able to coordinate this group and can actively help Wisconsin hospitals achieve the goals of this campaign."

"We know Wisconsin hospitals are working hard to implement these changes," said Dana Richardson from the Wisconsin Hospital Association. "We also know that patients play a crucial role in improving the health care system, such as making sure they provide health care workers with a full list of their medications or asking questions about their care."

The event was held at Camp Randall stadium in order to illustrate the number of Wisconsin lives that could potentially be saved during the 18-month campaign if all hospitals in the state implement six changes in health care practice. The stadium holds approximately 80,000 people when full, only somewhat less than the 100k Lives Campaign could potentially save nationwide. 6,000 Badger fan seats were sectioned off to show the impact of the campaign in Wisconsin.

Bob Fale, president/CEO, Agnesian HealthCare, Fond du Lac, has been selected by the WHA Nominating Committee to serve as WHA’s chair-elect in 2006 and chair in 2007.

Fale has served in many leadership positions at WHA. Currently, he chairs the WHA Community Benefits Task Force. In addition, he has served in the following positions:

• Finance Council, 1997-2002
• Chair, Workforce Development Council, 2004
• Chair, HFS 124 Task Force, 2001-2003
• Chair, Task Force on Community Benefits, 2005
• WHA Board, 1999-2005
• Executive Committee, 2004

Agnesian HealthCare, Inc. is a fully integrated health care delivery system serving Fond du Lac, Winnebago, and Dodge, Green Lake, Winnebago, and Waushara Counties. Prior to joining Agnesian HealthCare, Fale served as president and CEO of facilities sponsored by Catholic Health Initiatives, one of the largest non-profit health care systems in the country. After receiving his bachelor’s degree in nursing from the University of Wisconsin-Oshkosh, he went on to receive his masters in health administration from Washington University in St. Louis, Missouri. Fale is an adjunct faculty member at the Washington University Health Administration Program and was a guest lecturer at Northwest Nazarene University.

"Bob has a long history of active leadership in a variety of key WHA program activities, including our current focus on community benefits," said WHA President Steve Brenton. "We are fortunate to have him in the chair leadership queue as we work to advance WHA’s ambitious strategic agenda."

The WHA House of Delegates will meet September 22 in Wisconsin Dells to elect members to serve as at-large members on the Board of Directors starting January 1, 2006. The WHA Nominating Committee tapped the following eight individuals to serve as at-large members and AHA Delegates. The Nominating Committee report will be presented to members attending WHA’s Annual Business meeting on September 22 in Wisconsin Dells.

David Grundstrom
(1st full term)
President/CAO
Flambeau Hospital, Park Falls

• Medical & Professional Affairs 
  Council, 2003-205
• Governance Council,
  1992-1997
• North Central Region
  President, 2003-2004
• WHA Board 20050

Leo Brideau
(2nd term)
President/CEO
Columbia St. Mary’s, Milwaukee

• WHA Board, 2003-2005
• Task Force on Wisconsin’s Future Physician Workforce, Co-chair, 2003
• Past AHA Board member

• Medical & Professional Affairs 
  Council, 2004-2005
• President, Wisconsin Organization of Nurse Executives, 2004-2005

Nick Turkal, MD
(1st term)
Sr. Clinical V.P./Chief Medical Officer
Aurora Health Care, Milwaukee

• Medical & Professional Affairs
  Council, 2002-2003
• MPA Council Chair, 2004-2005
• Executive Committee, 2004-2005

Greg Roraff
(1st term)
President/CEO
Memorial Health Center, Medford

• Rural Health Council, 1991-1993, 1999-2005
• WHA Financial Solutions Board, 1999-2002
• WHA FS Board Chair, 2003-2005
• Advocacy Committee, 2003-2005
• Nominating & Awards Committee, 2004

Sandra Anderson
(1st term)
President
St. Clare Hospital & Health Services, Baraboo

• Southern Region President, 2005
• Advocacy Committee, 2005
• Nominating & Awards Committee, 2004
• Task Force on Wisconsin’s Future Physician Workforce, 2003

Terri Richards
(AHA Delegate)
Executive Vice President
Saint Joseph’s Hospital, Marshfield

• Public Policy Council, 1996-1999; Chair 2000
• Medical and Professional Affairs Council, 2003-2005
• Task Force on Community Benefits, 2005
• WHA Board, 1994-2002; Chair 2001
• WHA Foundation Board, 2004-2005
• WHA Information Center Board, 2004-2005
• Executive Committee, 2000-2002
• Advocacy Committee, Chair 2002
• Nominating & Awards Committee, 1997-2001, Chair 2002

Ford Titus
(AHA Delegate)
President/CEO
ProHealth Care, Waukesha

• Finance Council, 1988-1997, Chair 1998-2000
• WHA Board, 1995-2003; Chair 2002
• WHA Information Center Board, Chair 2004-2005
• Executive Committee, 2001-2003
• Advocacy Committee, Chair 2003
• Nominating & Awards Committee, 2001-2002; Chair 2003
• Property Committee, 2003-2004

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It was with a touch of irony to have listened earlier this week to a high ranking Centers for Medicare and Medicaid Services (CMS) official effusively praise the nation’s hospitals and physicians for the outpouring of voluntary support offered up to local government agencies and private charities in support of Gulf Coast flood victims. These are the same hospitals that have been slapped around over the past 12 months by trial attorneys and some members of Congress for a variety of exaggerated sins—largely related to the claim that not-for-profit hospitals are failing to earn their tax-exempt status via demonstrated community benefits.

The fact is, at least as of this writing, the number of volunteers and stockpiles of medical supplies awaiting shipping far surpass the short-term demand for this goodwill. That may change as relief efforts mature and longer term, chronic needs of evacuees are managed. Nevertheless, the nationwide response from the hospital community has been stunning.

In Wisconsin, WHA staff has also been overwhelmed by voluntary offers of assistance from caregivers, hospitals looking to donate supplies and offers to provide monetary assistance. Special recognition to Mary Kay Grasmick for her good work in coordinating communications at a time when external communications have been uneven. And Bill Bazan’s special efforts in coordinating Milwaukee-based activity should also be noted.

What all of this demonstrates is the fact that community hospitals continue to excel at being first responders…first responders at the local level when emergency services are needed 24/7—and—first responders on the national level as demonstrated this past week when the crisis of cataclysmic proportions struck Louisiana, Mississippi and Alabama.

Finally, we’ve received a number of donations to a special relief fund we established just last week to assist victims of Hurricane Katrina who work in Louisiana, Alabama and Mississippi hospitals. That fund, "Wisconsin Hospitals Caring for Those Who Care," provides a vehicle for Wisconsin hospitals and hospital employees to help their counterparts in the badly battered Gulf States rebuild their lives. Contributions to the Wisconsin Hospitals Caring for Those Who Care Fund can be sent to the WHA Foundation, P.O. Box 259038, Madison, WI 53725-9038. Every dollar given to the Fund will go to organizations set up to directly aid hospital workers.

Steve Brenton
President

On September 2, WHA President Steve Brenton announced the creation of a fund designed to help victims of Hurricane Katrina who work in the Gulf state hospitals. The "Wisconsin Hospitals Caring for Those Who Care" fund provides a vehicle for Wisconsin hospitals and hospital employees to help their counterparts in the badly battered Gulf States re-build their lives after their homes and personal possessions were lost to ravaging floodwaters.

WHA will work with the hospital associations in the Gulf States to ensure that the funds are distributed to hospital employees there who need assistance. WHA contributed $1,000 to the fund, and has extended an invitation to Association employees to participate as well. Every dollar given to the fund will go to organizations set up to aid hospital workers.

Contributions to the "Wisconsin Hospitals Caring for Those Who Care" fund can be sent to the WHA Foundation, PO Box 259038, Madison, WI 53725-9038. Please make checks payable to WHA Foundation and note that it is for Hurricane Katrina victims. For more information, contact Mary Kay Grasmick, mgrasmick@wha.org or 608-274-1820.

Speaker Gard’s Task Force on Medical Liability held its second meeting this week, entertaining testimony from invited representatives regarding the impact of the Ferdon decision on Wisconsin medical liability insurers.

Jorge Gomez, Commissioner of Insurance for the State of Wisconsin, gave testimony to the Task Force regarding the operations of the Wisconsin Injured Patients and Families Compensation Fund (formerly Patients Compensation Fund) as well the potential impacts of the Ferdon decision on the Fund and private insurance carriers in the state.

"Wisconsin has the most sound and functional medical malpractice environment in the country," stated Gomez. Gomez also noted that Wisconsin has enjoyed a competitive market for private medical malpractice insurance.

In his May 12, 2005 report on the impact of the $350,000 cap (adjusted to inflation) struck down in Ferdon, Commissioner Gomez wrote, "Tort reform of 1995, along with well regulated primary carriers and a well managed and fully funded Injured Patients & Families Compensation Fund has resulted in the stable medical malpractice environment, and the availability of health care in Wisconsin." He also made it clear in that report that "… rate stability could be dramatically impacted for both the Fund and primary carriers should the caps be removed and insurers face unlimited non-economic damages."

Barbara Kuhl, General Counsel at Marshfield Clinic, briefed the Task Force on Marshfield Clinic’s experience as a health care entity that has been self-insured for medical liability since 1978. She also discussed the impact of the Ferdon decision on physician recruiting.

"Physician recruitment is already difficult and competitive in light of a national shortage of physicians." said Kuhl. "Recruiting physicians to rural areas is particularly challenging. "The malpractice climate comes up regularly in discussions with candidates who interview for positions at Marshfield Clinic. It also comes up as physicians who are in our residency program decide whether to stay in this state to practice or go elsewhere."

According to a nationwide survey of employers conducted by United Benefit Advisors, the rate of increase for consumer-driven health plans (CDHP) increased by 3.4 percent in 2005. Traditional health plan premium increases averaged 9.6 percent in 2005, and they are expected to rise by an average of 12.2 percent in 2006.

Only 2.6 percent of employers currently offer consumer-driven plans and 1.9 percent of all employees are enrolled in the plans, although a significantly larger percentage of employers are considering adding a CDHP next year.

Among other survey findings:

• Employee choice continues to proliferate, as more than one-third of all employers now offer their employees two or more plan options.
• Premiums for single coverage average $327 a month, with employees contributing an average of $53 to the cost. Premiums for family coverage average $927 a month, with employees paying $381 of that cost.
• Nearly 64 percent of employees are enrolled in a preferred provider plan that provide both in-network and out-of-network benefits, while only 20.1 percent of employees are enrolled in an HMO or exclusive provider plan that typically provides no non-network benefits.
• The median single PPO deductible is $500, while in-network and out-of-network coinsurance is 80 percent and 60 percent, respectively.
• Prescription drug plans with four co-payment tiers are becoming more prevalent, while just 10.9 percent of plans have only two co-payment tiers.

How do these findings compare to that of Wisconsin hospitals specifically? If you have completed the 2005 Wisconsin Hospital Group Benefit Survey, you will receive this information and much more. If you have not yet participated in the survey, you have until Friday, September 16, after which the survey will be closed. To access the survey, go to www.whafs.com. If you have misplaced your user name and password, contact Jenny Boudreau at jboudreau@wha.org to have it emailed to you.

The Wisconsin Society of Healthcare Human Resource Administration (WSHHRA) fall conference is scheduled for October 5-7, 2005, and the event’s theme is becoming an employer of choice.

The conference’s keynote presentation will be offered by Brian Jones of the Baptist Health Care Leadership Institute. He will discuss how to become an employer of choice by selecting employees well suited to your organization’s culture, structuring initiatives that engage and empower employees, and defining the leader’s role in selecting and retaining great employees.

Learn to identify and dismantle the vagueness of complex managed care contracts with many of the classic and not-so-classic problem terms, conditions and "gotchas" frequently encountered in HMO, PPO, Silent PPO, and other managed care agreements. Also, learn practical solutions, as well as a technique to address negotiation jitters through non-confrontational methods of negotiation. Upon completion, attendees will feel more adept at the conversion of the boilerplate terms into clearly negotiated objectives, expectations and measurable actions.

This seminar is for business office managers, reimbursement managers, contract specialists, chief financial officers and others, both new and experienced, charged with managed care contract evaluation and negotiation.

The conference will be held on October 25, 2005, from 9 am to 4 pm at the Hotel Mead in Wisconsin Rapids. A brochure and a registration form are included in this week’s packet and on the Web site at www.wha.org. Easy, on-line registration is available as well.