June 20, 2014
Volume 57, Issue 25

Medicare PPS Rule Changes Tracked, Available to WHA Members

The Centers for Medicare and Medicaid Services (CMS) updates the multitude of rules that affect the prospective payment system (PPS) on an almost weekly basis this time of year. WHA tracks and posts these rules and offers several different resources to help PPS hospitals understand and prepare for the yearly rule changes. These valuable resources are available on the WHA website (www.wha.org) and include:

WHA updates the online resource frequently, so check back often. For more information contact Brian Potter at bpotter@wha.org.

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WHA 2014 Nominating, Awards and Bylaws Committee Seeks Nominations

The 2014 Nominating, Awards and Bylaws Committee will meet in August to consider nominating a WHA chair-elect, at-large members for the WHA Board and candidates for the Trustee Award and Distinguished Service Award. Information on these two awards can be found on the WHA website at www.wha.org/award-program-information.aspx.

Nominating Committee members for 2014 are:

WHA members interested in being considered for an at-large WHA Board seat or the chair-elect position should contact either WHA President Steve Brenton at sbrenton@wha.org or WHA Nominating Committee Chair Dan Neufelder at daniel.neufelder@ministryhealth.org.

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WHA Health Law Manuals Webinar Features Mental Health Issues

WHA will continue its months-long complimentary webinar series on June 26 from 12-1:30 p.m. with a presentation of the WHA Mental Health Issues Manual. This webinar will address Chapter 51 of the Wisconsin Statutes, which regulates admission, both voluntary and involuntary, of patients for treatment of mental illness, developmental disability and drug or alcohol abuse. It will include a discussion of the heightened confidentiality requirements and special rights that apply to such patients.

WHA members are encouraged to register for this webinar on the WHA Mental Health Issues Manual as well as any or all of the other webinars in the series. Sign-up information and additonal information about each of the remaining webinars in the series can be found at http://events.SignUp4.net/HealthLawManual. Attorneys in attendance may earn CLE credit.

This webinar will be presented by Heather L. Fields and Nicole S. Rosen of the law firm of Reinhart Boerner Van Deuren. The Health Law Manuals are available for WHA members to view and download at www.wha.org/healthLawManual.aspx. WHA members who would like to access the manuals should contact webmaster@wha.org to request a username and password.

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TCAB Sparks Innovation, Engagement Among Front-Line Staff

When front-line staff ideas and innovation converge, it results in successful projects that contribute to excellent patient care. WHA’s Transforming Care at the Bedside (TCAB) is engaging front-line staff to embrace change and implement new processes that result in success.

"The TCAB visits this week have been exceptional," said Jodi Johnson, vice president of workforce and clinical practice at WHA. "The level of engagement and excitement staff have shared during the visits demonstrates how deeply committed they are to implementing ideas that are improving patient care."

Beloit Hospital highlighted their use of laminated placemats to assist with patient education during joint replacement recovery. Along those same lines, the medical-surgical unit is working on laminated menus instead of paper to decrease waste. The TCAB team maintained their theme of efficiency and waste reduction by standardizing the supplies in each patient room, which has been a quick win for the front-line staff.

Froedtert & The Medical College of Wisconsin St. Joseph’s Hospital campus in West Bend has its first TCAB team in the program, and they are making good progress. Efficiency and workflow have been the focus of several projects by decentralizing supplies to decrease steps nurses will have to take, therefore increasing time at the bedside. Isolation gowns are now available outside every patient room, and intravenous poles are located in every room in preparation for a patient admission. The TCAB team looked at workflow in the nourishment room, which is a high traffic area, to improve staff’s ability to get what they need and return to patient care. The contents in the drawers were changed to reflect how staff would reach for certain items. This simple change has decreased wait time to attain needed items. Johnson says, "It is the simple changes derived from front-line staff ideas that have a large impact."

In keeping with the idea to increase front-line staff time at the bedside, which is a goal of the TCAB program, Froedtert & The Medical College of Wisconsin Community Memorial Hospital (CMH) campus in Menomonee Falls focused on the availability of supplies as well as patient education materials. Medication education for patients is extremely important as an element of high-quality patient care. The TCAB team at Froedtert CMH created medication sheets for each patient room to standardize the teaching process for nurses as they educate their patients. Blood pressure cuffs were often a source of frustration, so the TCAB team embraced a staff member’s idea to keep a blood pressure cuff in every patient room. This simple change provides continuity for patient care and increases front-line staff’s time at the bedside by keeping necessary equipment within arms’ reach.

"Wisconsin TCAB teams and their hospitals should be proud of the progress they have made, as the continued success of their efforts is evident at every site visit I have made over the past few weeks," said Johnson.

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2014 Global Vision Community Partnership Award
Nominations due to WHA Foundation July 15

The 2014 Global Vision Community Partnership Award, presented by the WHA Foundation, is a competitive grant award presented to a community health initiative that successfully addresses a documented community health need. The Award, launched by the WHA Foundation in 1993, seeks to recognize ongoing projects that support community health.

Any WHA hospital member can nominate a community health project. The project must have been in existence for a minimum of two years and must be a collaborative or partnership project that includes a WHA member hospital and organization(s) within the community. The official call for nominations for the 2014 Award is included in this week’s packet.

Nominations are due July 15, 2014. Nomination forms can also be found on the WHA website at www.wha.org/global-vision-comm-partnership.aspx . Honor one of your hospital’s community health projects by submitting a nomination today. For more information about the Award, contact Jennifer Frank at jfrank@wha.org or 608-274-1820.

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Betsy Chapin Taylor to Lead Hospital Foundation Workshop, August 7

On August 7, Betsy Chapin Taylor, award-winning author, speaker and consultant on health care philanthropy, will lead a day-long interactive workshop for Wisconsin hospital foundation directors, staff and board members. "Prescription for Success: A Workshop for Hospital Foundations" will focus on strategies for foundation staff and board members to identify the various levers to enhance the foundation’s performance, strategies to identify and engage key allies, and strategies to approach messaging through storytelling.

In partnership with and support from the Wisconsin Office of Rural Health and the Rural Wisconsin Health Cooperative, WHA is making this workshop available at no cost to hospital and hospital foundation staff; however, pre-registration is required.

Attendees will learn from Chapin Taylor, who has more than 15 years of experience as chief development officer and foundation president in various health care organizations. She is also a faculty member for the American College of Healthcare Executives, teaching CEOs and other senior health care executives about positioning philanthropy as a key revenue resource for health care; is a speaker with the American Hospital Association’s Speakers Express speaker’s bureau; and is a Fellow of the Association for Healthcare Philanthropy.

The hospital foundation workshop will be held Thursday, August 7 at Stoney Creek Hotel & Conference Center in Rothschild. The full day’s agenda and online registration are available at http://events.SignUp4.net/Foundation14.

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Rural Hospitals Find Staff Engagement Key to Quality Improvement

The WHA Partners for Patients initiative, now in its third year, has helped Wisconsin hospitals improve performance by giving teams the tools they need to raise quality. Site visits to participating hospitals are an important part of the assistance that WHA staff makes available. Recently, Tom Kaster, WHA quality coordinator, visited three hospitals in northern Wisconsin that have been active contributors to the WHA Partners for Patients collaborative since its inception in 2012. Kaster saw first-hand the results of two-and-a-half years of committed quality improvement work at each hospital he visited.

Memorial Medical Center (Ashland)

Team leader Nancy Dufek at Memorial Medical Center (MMC) in Ashland has been extremely engaged in Partners for Patients. Early in the collaborative, MMC focused on reducing readmissions and catheter-associated urinary tract infections (CAUTI). Sara Waby, who led the CAUTI project, did an exceptional job of rapidly gaining support and achieving early results. From there, she was able to leverage the early momentum and build house-wide commitment, which enabled her to decentralize ownership of the initiative and sustain excellent results throughout the organization.

In their readmissions initiative, led by Kathy Tuttle, MMC has focused on developing and improving transitions of care within their service area. To do this, they built a collaborative with area long-term care, home health and social welfare agencies. In house they have identified nurses who are uniquely skilled in customer service to call patients who are at high risk for a readmission to ensure their needs are met. In addition, a social worker consult is provided to all patients prior to discharge to identify any obstacles that may keep them from seamlessly transitioning into their next care setting.

For 2014, MMC is setting their sights on eliminating surgical site infections as well as engaging patients and families to help improve all aspects of their health care system.

"Big picture, Memorial Medical Center has accomplished significant results and is poised to continue making progress toward their goal of improving quality and patient satisfaction," according to Kaster.

Hayward Area Medical Center (Hayward)

Similar to Ashland, Hayward Medical Center has been a consistent contributor to WHA Partners for Patients from the beginning. Trina Sjostrom, Hayward’s medical-surgical nurse manager, has been the driving force behind several of their improvement initiatives, including preventing falls and pressure ulcers, and reducing readmissions. On readmissions, they have been able to analyze their data to determine key patient types who are at high risk to readmit within 30 days. They then facilitated targeted post-discharge phone calls to ensure the patient’s needs are met when they reach their next care setting. To better coordinate with post discharge care settings, Hayward has established a community collaborative for care transitions. Community agencies participating in the collaborative are improving communications, allocating resources and identifying common unforeseen causes of readmissions.

For falls and pressure ulcer prevention work, Hayward’s early work to ensure evidence-based preventive processes were consistently applied has paid off. They have established high levels of performance and are now able to sustain their progress.

To round off their achievements, through the leadership of Chris Stark in the OB department, Hayward has standardized an early elective delivery hard-stop policy that requires leadership to review all elective deliveries prior to 39 weeks. Their delivering physicians have been supportive, and more importantly, fewer babies are at risk.

Flambeau Hospital (Park Falls)

Flambeau Hospital has been another gem of exceptional improvement work in northern Wisconsin, specifically in their falls and readmission prevention projects. Flambeau Hospital has positioned itself as an exemplar hospital through their outstanding work and measurable results in their falls improvement program. Not only have they been able to address all key drivers of patient falls, they have been early leaders in integrating their therapy department into all aspects of their falls prevention processes.

To help reduce readmissions, Flambeau has established post-discharge phone calls to all patients and is increasing rehabilitation services for their COPD patients who are at a higher risk of being readmitted.

As their next challenge, Flambeau has joined WHA’s Sepsis Mortality Reduction initiative, which is a newer advanced topic, started in 2014.

"From a purely demographic standpoint, these hospitals have many similarities. They are smaller rural hospitals in northern Wisconsin. They have rapidly aging service areas that have extensive needs for strong care coordination and transitions between care settings. Even their quality of care has some shared characteristics," according to Kaster. "Each hospital has a culture focused on the patient, and they are always striving for continuous improvement.

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