February 15, 2013
Volume 57, Issue 7

Gov. Walker Announces Investment in Physician Education
Walker’s plan aligns with WHA workforce priorities

At stops in four cities—three at hospitals—on Monday, February 11, Governor Scott Walker announced that he will include funding in his state budget targeted at building the infrastructure that is necessary to expand education opportunities for medical students and physicians who will stay in Wisconsin and practice in rural and impoverished urban areas.

The Governor started the day at Prairie du Chien Memorial Hospital where WHA President Steve Brenton applauded the Governor’s commitment to help shore up Wisconsin’s fragile rural health care environment where access to health care services is a top local priority and essential to attract and retain jobs.

"The physician workforce issue is a high priority for WHA and these funding initiatives will go a long way in helping develop the infrastructure necessary to educate and train primary care physician providers who will care for Wisconsin patients and families for years to come," according to Brenton.

WHA has issued two comprehensive reports that have catalyzed high-level engagement and action among stakeholders interested in expanding Wisconsin’s medical education and training system. "100 New Physicians a Year: An Imperative for Wisconsin" is available at: www.wha.org/Data/Sites/1/pubarchive/reports/2011physicianreport.pdf.

WHA’s physician workforce report identified the creation of consortiums as a priority strategy in addressing Wisconsin’s GME challenges. WHA is pleased that the Governor’s plan includes $4 million for grants to help rural hospitals form GME consortiums to help build the infrastructure necessary for rural hospitals to obtain the necessary national accreditation for a residency program.

At a stop at Mayo Clinic Health System in Eau Claire, the Governor briefly outlined his plan to increase the size and scope of programs at the Medical College of Wisconsin and the UW-Madison Medical School that will help address the urgent need for primary health care in rural and high-need urban areas throughout the state.

"There’s really a great need in our state," according to Robert Peck, MD, medical director for Mayo Clinic Health System sites throughout northwest Wisconsin, including Barron, Bloomer, Eau Claire, Menomonie and Osseo, as well as surrounding rural communities. Peck said that medical residents increase patient access to health care in rural settings. "That is why we’re committed to training Wisconsin’s future rural physicians."

At Ministry Saint Mary’s Hospital in Rhinelander, the Governor focused on the fact that physicians may be reluctant to locate to a rural area initially, but once there, "they love it," a fact confirmed by a Ministry Medical Group radiologist who was raised in Antigo and returned to practice in the Northwoods.

The Governor’s last stop was St. Norbert College in Green Bay where he focused on the Medical College of Wisconsin’s (MCW) plans to build two new campuses in the Wausau and Green Bay areas for MCW’s new community medical education program initiatives. In addition, funding will be provided to add 12 new positions to MCW’s family medicine residency program.

For a complete list of Governor Walker’s workforce initiatives, go to: http://walker.wi.gov/Default.aspx?Page=209c350c-3cb3-4099-b84d-cef3dd463bea.

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Walker Announces Medicaid Reforms
Proposal both expands and contracts Medicaid enrollment

At the Wisconsin Manufacturers & Commerce’s annual Business Day in Madison February 13, Governor Scott Walker released preliminary details of his proposal to change the state Medicaid program in his upcoming budget. Due to the availability of insurance subsidies in the Affordable Care Act’s health insurance exchanges, Walker proposes moving thousands of Medicaid recipients with incomes above 100 percent of the federal poverty level ($11,490/yr for an individual) into subsidized coverage in the new Wisconsin federal health insurance exchange. The Governor also proposes opening up the Medicaid BadgerCare Core program to thousands of currently uninsured low-income childless adults with income below 100 percent FPL. In taking this approach, the Governor proposes to turn down 100 percent full federal funding that is available to states through 2017 (dropping to 90 percent funding by 2020) that increases Medicaid eligibility for childless adults with incomes up to 133 percent FPL ($15,282).

According to the Walker Administration, combined, the move would reduce the number of uninsured in the state by nearly 50 percent and provide coverage to an additional 224,580 individuals who are currently uninsured. The Medicaid elements of the plan would only affect non-disabled, non-elderly adults between the ages of 19 and 64. Children on the BadgerCare program will not be affected by the change due to federal maintenance of effort requirements that are in place until 2019.

In a conference call with reporters following the Governor’s announcement, Department of Health Services Secretary Dennis Smith said the proposal would shift roughly 87,000 people above 100 percent FPL from Medicaid into the exchange while adding about 82,000 childless adults to Medicaid who have incomes below 100 percent FPL. Currently, thousands of low income childless adults have been prevented from enrolling in Medicaid due to a 2009 enrollment freeze. The Governor’s announcement did not include details related to the cost of opening up the Core program and moving certain Medicaid recipients into the federal exchange.

In addition, Governor Walker announced that he will provide an additional $644 million in state funds for the Medicaid program’s projected costs to continue over the next two years. Last biennium, the Governor approved nearly $1.3 billion in additional funding for Medicaid, a move that garnered support from WHA and the provider community.

Late last month, and as reported in The Valued Voice, the WHA Board of Directors unanimously endorsed lifting the enrollment freeze in BadgerCare Core for those with incomes up to 133 percent FPL, leveraging full federal funding for that coverage and reducing state taxpayer expense, and cautiously transition others into the exchange.

"Above all, our hospital and health system members—national leaders in innovation and reform—are looking for stability, especially when it comes to covering our most vulnerable populations, and we believe WHA’s position is a measured approach that makes good fiscal and policy sense," WHA President Steve Brenton said in a statement released February 13. "There will be much debate on this issue with valid opinions on both sides, but at the end of the day, in this time of uncertainty, we cannot have fewer people with coverage and more uncompensated care."

See page 3 for WHA’s full statement.

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WHA, WCMEW in DC to Discuss Graduate Medical Education
Full coverage of GME trip to run in February 22 Valued Voice

On February 13, the Wisconsin Hospital Association, in conjunction with the Wisconsin Council on Medical Education and Workforce and other allied organizations, traveled to Washington, DC to meet with members of Wisconsin’s Congressional Delegation to urge Congress to protect Graduate Medical Education (GME). Reductions to GME payments have been proposed in the past and continue to be discussed by Congress as potential means of savings.

This WHA, WCMEW-led trip was designed specifically to discuss the vital importance the federal GME program plays in ensuring Wisconsin is able to meet our future physician capacity needs. In that regard, the DC trip dovetailed nicely with Governor Scott Walker’s announcement the same week of a significant investment in support of rural health care and graduate medical education in Wisconsin.

"The physician workforce issue continues to be a high priority for the Wisconsin Hospital Association and others," said WHA President Steve Brenton. "It will be through a collaborative effort of all stakeholders, including Congress, that Wisconsin will be able to meet our state’s future physician capacity and patient access needs. The federal GME program is a fundamental building block to that success."

Participants in the February 13 trip included: Dr. Kenneth B. Simons and Kathy Kuhn, Medical College of Wisconsin; Dr. Byron Crouse, University of Wisconsin School of Medicine & Public Health; Dr. Jake Bidwell, Aurora Health Care; Dr. Paul Wertsch, Wildwood Family Clinic of Madison; Tim Size, Rural Wisconsin Health Cooperative; Rich Abrams and Chris Rasch, Wisconsin Medical Society; Jon Sender, UW Hospital & Clinics; Paula Roberts, Children’s Hospital of Wisconsin; Maureen McNally, Froedtert Health; Michael Heifetz, SSM & Dean; Dr. Chuck Shabino, George Quinn and Jenny Boese, Wisconsin Hospital Association.

Watch for WHA’s full trip coverage in next week’s Valued Voice newsletter.

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Learn Basics of Graduate Medical Education at Feb. 26 Webinar

Based on member requests and in line with WHA’s physician workforce agenda goals for 2013, WHA is offering a no-cost webinar focused on the basics of Graduate Medical Education (GME) for its hospital members on February 26.

The webinar, "What Hospitals Should Know About Graduate Medical Education," is scheduled from 12 to 1:15 pm on February 26. There is no cost to participate in this webinar, but pre-registration is required. Register today at http://events.SignUp4.com/13GME0226.

Hospital CEOs and other hospital leaders who are involved in a current residency program or may be involved in a future residency program should plan to attend. Participants will gain a basic understanding of GME, the requirements for running a residency program, and the first steps a hospital should take to start their own residency program.

If you cannot attend the webinar, click on http://events.SignUp4.com/13GME0226, and choose the option to receive an audio recording and handouts from the presentation to view at your convenience.

If you have any questions about the content of this session, contact Dr. Chuck Shabino at cshabino@charter.net. If you have registration questions, contact Lisa Littel at llittel@wha.org.

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President’s Column: Statement by Wisconsin Hospital Association on Medicaid Reform

On February 13, Governor Scott Walker shared his plan to expand Medicaid coverage. Below is WHA’s statement in response to the Governor’s announcement.

"As announced today {February 13}, Governor Walker’s 2013-15 budget will extend Medicaid coverage to thousands of uninsured childless adults with incomes below 100 percent of the federal poverty level (FPL) while moving thousands of current Medicaid enrollees to the federal health exchange. In the weeks and months ahead, we look forward to building on the Governor’s initiative when the budget moves to the Legislature.

Last month, the WHA Board of Directors unanimously endorsed (www.wha.org/pubArchive/valued_voice/vv2-1-13.htm#1) lifting Wisconsin’s current Medicaid enrollment freeze for childless adults but only for those with incomes below 133 percent FPL (a reduction from the program’s current limit of 200 percent FPL). This measured approach builds on Governor Walker’s proposal by reserving safety net coverage for very low-income ($15,281/yr) uninsured individuals and cautiously transitioning those above 133 percent FPL off of Medicaid and into the exchange. By leveraging already-authorized federal funding, WHA believes this approach will save the state millions of dollars in the 2013-15 biennium, provide stable safety net coverage to our most vulnerable uninsured, reform Medicaid through measured transition into the exchange and, most importantly, reduce cost shifting to Wisconsin employers.

As our members look to the near future, amidst unprecedented uncertainty surrounding health care financing and delivery, it is essential to ensure stability while pursuing gradual and sound reform. WHA believes the best route to achieving this goal is to lift the enrollment cap for childless adults with income up to 133 percent FPL, while proceeding cautiously if/when transitioning the remaining Medicaid population into the health insurance exchange.

Above all, our hospital and health system members—national leaders in innovation and reform—are looking for stability, especially when it comes to covering our most vulnerable populations. We believe WHA’s position is a measured approach that makes good fiscal and policy sense. There will be much debate on this issue with valid opinions on both sides, but at the end of the day, in this time of uncertainty, we cannot have fewer people with coverage and more uncompensated care.

WHA appreciates Governor Walker’s past commitments to the Medicaid program, and we will work constructively with the Governor and Legislature to enact coverage reforms in the most cost-effective way for Wisconsin’s patients, providers, and employers."

Steve Brenton

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Grassroots Spotlight: Congressman Ron Kind Visits St. Joseph’s (Chippewa Falls)

This week Congressman Ron Kind visited senior leaders at St. Joseph’s Hospital in Chippewa Falls. He was able to discuss important hospital issues as well tour the newly-remodeled emergency services and L.E. Phillips-Libertas Treatment Center. During his time there, Kind was able to see first hand the value of the treatment center by meeting and speaking with a constituent who is a patient there.

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Make an Impact by Attending Advocacy Day on April 23
Registration now open at http://events.SignUp4.com/13AdvocacyDay 0423

As a health care leader in your community, WHA invites you join nearly 800 of your peers at our premier advocacy event, 2013 Advocacy Day. Advocacy Day takes place on Tuesday, April 23 in Madison at the Monona Terrace.

Advocacy Day is designed to educate and mobilize hospitals from across the state on priority issues. WHA has an excellent lineup of speakers again this year, including morning keynote and noted national association leader David Rehr, PhD. Dr. Rehr is the author of the largest, most in-depth study of grassroots advocacy practices and how they are received by elected officials.

With the state budget process unfolding concurrently with Advocacy Day, the ever-popular state legislative panel will provide insight into budget deliberations and other pending health care issues of importance. Plus, Governor Scott Walker is invited as the luncheon keynote presenter.

Make sure you plan to stay for the highlight of the day—meeting with your legislators in the State Capitol in the afternoon. Having hundreds of hospital advocates in the Capitol to speak with legislators on issues important to your community hospital makes a statement and a difference.

Plan to attend and register your hospital team today, including senior leaders, trustees and volunteers, for this important event. Advocacy Day is a free event, but pre-registration is required.

A program and online registration are available at: http://events.SignUp4.com/13AdvocacyDay0423. For registration questions, contact Lisa Littel at llittel@wha.org. For legislative visit questions, contact Tiffanie O’Hara at tohara@wha.org.

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March 5 Webinar Provides Overview of New HIPAA Regulations

It’s been more than a decade since the HIPAA Privacy Rules were finalized, but on January 17, 2013, the US Department of Health and Human Services (HHS) released an omnibus final rule comprised of four HIPAA-related final rules.

On March 5, WHA offers a 75-minute webinar focused on the final rules, "From HITECH to High Risk: HIPAA Compliance after the Omnibus Rule," scheduled from 12 to 1:15 pm. This session will provide participants with an overview of the new HIPAA regulations, highlighting key changes and deadlines; and providing recommendations for implementation, including required changes to Business Associate Agreements, Notices of Privacy Practices and other policies and practices.

The new regulations become effective March 26, 2013, with covered entities and business associates required to be in compliance by September 23, 2013.

Register today at http://events.SignUp4.com/13HIPAA0305.

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Space is Limited – Register for WHA’s Partners for Patients Event, March 12-13
Kaplan to speak on physicians’ role in quality improvement

Jay Kaplan, MD will present the closing keynote session at the upcoming Partners for Patients event, "Catch the Wisconsin Wave," scheduled March 12-13 in Wisconsin Dells.

Active physician engagement in the adoption of evidence-based practices can be the difference maker for a hospital working to improve. Kaplan has partnered with physicians, hospital leadership teams, medical groups and hospital staff to provide them with tools and tactics to improve patient care while changing the culture of the work environment in a way that inspires and motivates everyone to succeed. As chairman of emergency services for his health system, he led his system’s emergency departments to the 98th percentile in patient satisfaction and his own emergency department was in the greater than 90th percentile for six consecutive years. Kaplan is currently the medical director of The Studer Group and director of service and operational excellence for CEP America.

Hospital leaders, physicians, nursing leaders, improvement leaders and champions, care-giving staff and clinical experts from WHA member hospitals are invited and encouraged to attend this two-day event. In particular, teams from the 108 Wisconsin hospitals participating in WHA’s Partners for Patients collaborative are encouraged to attend.

In addition to Kaplan, the agenda has a variety of national-caliber keynote speakers on hand to inform and inspire staff of Wisconsin hospitals, including:

This is a great opportunity for improvement teams to gear up for their 2013 efforts. The event theme, "Catch the Wisconsin Wave," reflects the great progress Wisconsin hospitals have made toward the 20/40 CMS goals and the continued efforts into 2013.

Hospitals across the state have used Partners for Patients to re-charge their improvement work. There will be breakout sessions on all of the initiative topics with best practice sharing by Wisconsin hospitals. The event offers hands-on workshops and plenty of networking opportunities.

Register today for this important event at http://events.SignUp4.com/13PFP031112. There is no registration fee to attend this event, but pre-registration is required and space may be limited. Direct registration questions to Lisa Littel at llittel@wha.org or 608-274-1820.

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Wisconsin Health Systems will Pilot New Payment, Care Models in ACOs

Wisconsin health care systems are among the most innovative in the country. Many are piloting new payment and care coordination models that will improve patient care and help lower health care costs.

Recently, Bellin Health CEO George Kerwin shared his thoughts on the Bellin-ThedaCare Healthcare Partners accountable care organization (ACO) that will serve northwest Wisconsin. Kerwin’s interview with H &HN Magazine can be viewed here: www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=7520008587.

Below is a brief timeline and description of each Accountable Care Organization model and the Wisconsin health care systems that are participating in it.

July 2011 - Medicare Physician Group Practice Demonstration (PGP)

The Physician Group Practice (PGP) Demonstration was the first pay-for-performance initiative for physicians under the Medicare program. The demonstration created incentives for physician groups to coordinate the overall care delivered to Medicare patients, rewarded them for improving the quality and cost efficiency of health care services and created a framework to collaborate with providers to the advantage of Medicare Benefits.

December 2011 –Wisconsin Participants in the Pioneer ACO Model

The Pioneer Accountable Care Organization (ACO) Model is a CMS Innovation Center initiative designed to support organizations with a new payment model, allowing them to provide more coordinated care to beneficiaries at a lower cost to Medicare. The Pioneer ACO Model tested the impact of several innovative payment arrangements to support these organizations in achieving the goals of better care and outcomes at a lower cost.

April 2012 – First Medicare Shared Savings Program Participants Announced

The Centers for Medicare & Medicaid Services established a Medicare Shared Savings Program to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. The Shared Savings Program rewards ACOs that reduce their growth in health care costs while meeting quality performance standards. The program requires coordinated care for all services provided under Medicare FFS.

July 2012 – Medicare Shared Savings Program Accountable Organizations – Second Performance Period

The following organizations began participating in the second performance period for the Medicare Shared Savings Program:

January 2013 – 106 New Accountable Care Organizations Announced

On January 10, the Centers for Medicare and Medicaid Services (CMS) announced the formation of 106 more ACOs, covering an estimated 4 million Medicare beneficiaries. There are now more than 250 ACOs nationwide and CMS projects $940 million in shared savings to the Medicare program over four years.

January 2013 – Bundled Payments for Care Improvement Initiative

On January 31, 2013, CMS announced health care organizations selected to participate in the Bundled Payments for Care Improvement initiative. Under this initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care, designed to lead to higher quality, more coordinated care at a lower cost to Medicare.

For more information on all of these payment models, visit the CMS Center for Medicare and Medicaid Innovation at: http://innovation.cms.gov.

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First Round of Transforming Care at the Bedside Site Visits Complete

The WHA-led Wisconsin Transforming Care at the Bedside (TCAB) project has a goal of increasing the involvement of direct care staff in patient care improvements. As part of the project, each site receives a site visit after three months and again at the end of the project. Judy Warmuth, WHA vice president, workforce, has been conducting site visits at the 22 nursing units participating in the TCAB project. Warmuth said the site visits help to ensure that each team has successfully launched TCAB on their unit.

The first round of site visits is complete with the visits below, and it is clear that TCAB is fostering innovations and improvement to the quality and safety of patient care—and participants are anxious to share what they have learned.

The TCAB team at Aurora Lakeland Hospital in Elkhorn has instituted a variety of strategies to improve the unit’s response to patient call lights. A "no pass zone" is one of the strategies, but they have involved all staff in developing additional ways to improve. The team has also worked on finding the best location for hand cleanser and the blanket warmer. They are auditing the use of white boards in patient rooms.

It is not unusual for units to experience confusion about the relationship between TCAB and their shared governance model. This TCAB team wrote a letter to nursing staff explaining the roles of TCAB and of shared governance on their unit to prevent confusion and clarify roles. The two have some shared projects but are also doing individual work.

The first success for the TCAB team at Ministry Health Care’s Howard Young Medical Center in Woodruff was "bed ahead." This project ensures that a room is available, stocked and prepared for the next admission. Checklists and procedures needed several rounds of improvements, but the staff is pleased to know that when they admit a patient to the "bed ahead," they will find a room fully ready for patient care. This group is also working on nurse-to-nurse communication and bedside shift report. Numerous "small" changes have been made by staff suggestion.

This team had done a self-assessment prior to the site visit. They had analyzed their strengths and had already outlined improvements in their own process.

The Wisconsin TCAB initiative is an 18-month project that will end March 2014. Participants will each be expected to outline a plan to sustain the project after that date. Transforming Care at the Bedside is a WHA project funded through the Wisconsin Collaborative for Healthcare Quality by the Robert Wood Johnson Foundation.

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WHA Staff Visits Westfields Hospital for TCAB, Partners for Patients

Judy Warmuth, WHA vice president, workforce development, and Thomas Kaster, WHA quality coordinator, traveled to New Richmond Wisconsin to meet with Westfields Hospital’s Transforming Care at the Bedside (TCAB) and Partners for Patients improvement teams. Both Warmuth and Kaster agreed that "Westfield is definitely on the right track and developing a robust culture that focuses on patient safety and continuous improvement."

The TCAB team has involved the members of the direct care staff in recommending improvements that result in better care to patients. Efforts to improve the bedside reporting process were already in place at Westfields Hospital. The TCAB team joined forces with that group to implement one-nurse/one-patient trials and a recommended template for the report. They have already received positive feedback from patients and families, and they will consider how to include patient requests as part of the report.

With a focus on staff communication around patient care, the TCAB team at Westfields has changed the CNA report process and reporting of intake and output. They are reviewing the use of white boards in patient rooms. The group has a pilot communication board in the nursing station that provides easy-to-find information for all care staff in a very visible location.

The TCAB team has made both small and large changes to nurse practice, unit supplies and procedures with a goal increasing time spent in direct care of patients, the quality of care and patient satisfaction.

Westfields focused on readmission and the Comprehensive Unit Safety Program (CUSP)

Westfields project lead on CUSP, Elizabeth LaVelle, has done an excellent job integrating CUSP concepts and ideas throughout their facility and into their improvement projects. Through feedback received from the CUSP Staff Safety Assessment, LaVelle has been able to solicit feedback from front-line staff in regard to opportunities for potential harm in their facility.

"Through LaVelle’s guidance, Westfields has taken the concepts of CUSP to heart and is using the insights gained to guide their improvement efforts." Kaster said.

Michelle Klechefski, Westfields Readmission lead, shared their work on reducing readmissions with Warmuth and Kaster as well. Since Partners for Patients has started, Westfieds’ 30-day all-cause readmission rate has consistently trended down. They attribute their improvements to ensuring that follow-up appointments are scheduled prior to discharge and their new post-discharge phone call process. Jen Osterbauer, Westfields new case manager, has been making the calls, which have proven to not only decrease unnecessary readmissions, but also have grown community appreciation for the "extra touch."

In one post discharge callback, Osterbauer worked with a pneumonia patient who had not picked up important antibiotic medication because he was waiting for approval from the insurance company. Osterbauer immediately called the insurance company and expedited the approval. As a result, the patient was able to get their prescription within the hour.

In another situation, Osterbauer helped a family find the needed level of care. The family had initially intended to take care of their relative at home. When Osterbauer called 24 hours after discharge, the family member had come to the realization that they could not provide the level of care needed. "Within the day, Jen had him into a local long term care facility," Michelle Klechefski said.

It is stories like these that attest to the importance of community out-reach and support. It is no wonder that post discharge callback processes have been directly linked to the reduction of unnecessary readmissions.

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Wisconsin Hospitals Community Benefits: Access to High Quality Health Services

Hospitals do what they can to move health care services out of the clinical setting into the heart of the community. Community health screenings and education classes help raise awareness of steps that individuals can take to improve their health. When people learn more about how their lifestyle decisions affect their health, they make changes that ultimately lead to better health, which raises the health status of the entire community.

Women’s Health Night

It was a night just for women and their health. More than 350 women of all ages enjoyed some pampering while learning more about their own health and wellness at the Tomah Memorial Hospital Women’s Health Night held March 22 at Tomah’s Cranberry Country Lodge.

Widely known Health Blogger and Author Eliz Greene of Milwaukee spoke to a standing room crowd.

"As women, we tend to put everybody else first, and take care of ourselves last and sometimes not take care of ourselves at all." Greene said if women don’t "pay attention to themselves, they can’t do a good job taking care of others."

As the Director of the Embrace Your Heart Wellness Initiative, Greene travels the country energizing and inspiring audiences in keynotes, workplace wellness programs and programs on women’s heart health, stress management, and life balance. She also writes one of the top 50 health and wellness blogs. Greene recently received the Heart Hero Award from the American Heart Association for her work as a national spokesperson, advocate, and volunteer and was named an Outstanding Volunteer by the Girl Scouts of Wisconsin Southeast.

It was the 13th year the Tomah Memorial Hospital Community Outreach and Center for Occupational Health and Wellness coordinated the event, which featured more than 40 informational exhibits geared toward women’s health topics, along with free health screenings like bone density, cholesterol, blood pressure and blood sugar.

The hospital’s Nutrition Services Department also provided complimentary samples of healthy breakfast items, along with refreshments.

Tomah Memorial Hospital, Tomah

Expanded school nurse program has life-changing impact on students’ health

"I thought he’d die from an asthma attack." Chris Keim, a nurse from Children’s Hospital of Wisconsin’s Community Health School Nurse Program, shared the story of a third grade student she worked with at Hopkins Lloyd Community School in Milwaukee. "He was to the point where his mother was calling 911 and going to the hospital to manage the asthma," said Keim. "Now, he has an understanding of what his medications are and what they’re used for. He knows what to do and how to take his meds. He now swims – before he needed an inhaler after walking up the stairs."

Asthma is one of the most common chronic diseases affecting Milwaukee’s central city students. Unfortunately, many of these students and their parents don’t know how to properly manage the disease. Keim’s story of this third grader illustrates how the Children’s Hospital’s Community Health School Nurse Program is working to address students’ immediate health needs as well as issues impacting their overall wellness.

When students are in pain or not feeling well, they don’t perform well in school, which can limit them from developing to their fullest potential. Children’s Hospital provides one half-time and seven full-time registered nurses at designated Milwaukee Public Schools at no charge to the schools. The nurses follow the Centers for Disease Control and Prevention’s coordinated school health model, which means they take a more active role with the school staff and administration, students and students’ parents. They attend to the community’s immediate health needs and educate children and families about preventive care.

"We’re taking a comprehensive look at the school environment and working in partnership with administrators, teachers, students and families to make changes that will impact overall health," said Sara Siedenburg, school health nurse manager, Children’s Hospital.

Community Health School Nurse Program nurses are trained in disease prevention. They provide direct care to students and screenings, including vision and hearing. For chronic illnesses - such as asthma, diabetes, seizures or sickle cell anemia - they monitor students’ lifestyles and recommend ways they can better manage their illnesses. The nurses also coordinate care with physicians, social workers and insurance companies.

In addition, the nurses collaborate with Children’s Hospital’s Community Health Outreach Education staff to provide education on a variety of health topics, including anger management, drugs and alcohol use prevention, human growth and development, hygiene, nutrition and stress.

"Because nurses now spend the entire day in one school, every school day, they have time to really work with families, building relationships and trust," said Siedenburg.

"Many of the kids have so many health issues that it’s hard for them to learn," Keim said. "We have a responsibility to be an advocate for the kids. We want families to get the resources and the help they need."

Children’s Hospital of Wisconsin, Milwaukee

Medfest provides medical screening opportunities for Special Olympics athletes

A partnership between Special Olympics Wisconsin (SOWI) and Ministry Health Care recently provided a unique medical screening opportunity for Special Olympics Athletes.

The third annual MedFest was held in December in conjunction with the Northern Fall Sports Tournament in Wausau.

MedFest is a Special Olympics Healthy Athletes™ screening program that facilitates the required standard sports physical examination for current and prospective Special Olympics athletes. The physical examinations are conducted by volunteer medical professionals and are free to current and prospective athletes.

A team of more than 40 medical volunteers from Ministry Medical Group Clinics in Weston, Merrill and Stevens Point as well as Ministry Saint Clare’s Hospital in Weston, Ministry Saint Michael’s Hospital in Stevens Point and Ministry SAINTS Health Services for Business provided the free exams.

These exams included registration and assessments of medical history; height and weight measurements; blood pressure; heart, lung, abdominal and musculoskeletal evaluation; and referral for follow-up care as needed.

Of the 42 athletes who received free physicals, 23 were flagged as needing a follow-up appointment, most due to high blood pressure.

"We were happy to provide this opportunity for these athletes and their families," said Michael Clark, MD, director of emergency medical services at Ministry Saint Clare’s and state medical director for SOWI. "We are already in the planning stages for Medfest to return to Wausau for the 2012 Northern Fall Sports Tournament which will be held in December."

Ministry Saint Clare’s Hospital, Weston

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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