June 27, 2008
Volume 52, Issue 25
{The following is a news release sent to the statewide press on June 25, 2008.}
Wisconsin joins more than a dozen states that are standardizing their approach to hospital color-coded alerts. The move to have all hospitals standardize to the same colors was initiated by the Wisconsin Hospital Association.
Many Wisconsin hospitals use color-coded alerts as a way of quickly identifying important information about patients. Wristbands, stickers and placards are commonly used to identify allergy warnings, fall risks, or do-not-resuscitate (DNR) orders. However, until now, there has not been a standard that offers direction to hospitals as to what color identifies which alert. Many health professionals work in multiple health care settings, so they must memorize multiple, sometimes conflicting, color-coded alert systems.
The move to standardize color-coded alerts was fueled by reports of serious medical errors being narrowly averted. Last year in Wisconsin, a patient was being treated at Upland Hills Health in Dodgeville with a serious heart condition. Later, he was transported to a Madison hospital for advanced heart care. Upon arrival at the Madison hospital, a nurse commented on his "DNR" wristband. "Randy" and his wife were horrified to learn that the patient name band used for identification at Upland Hills Health in Dodgeville was the same blue color as the wristband the Madison hospital used to identify patients with a "Do Not Resuscitate" wish. Fortunately, the misinterpretation was immediately clarified and the wristband was removed before any life-sustaining care was withheld. These "near misses" highlight a potential source of error and an opportunity to improve patient safety by re-evaluating the use of color-coded alerts.
Fourteen states to date have standardized color codes while several more are considering it. While there is not an official national standard, a majority of states that have standardized have chosen the same colors. With the help of a WHA Task Force that included representatives from Upland Hills Health and other hospitals and health care organizations, Wisconsin is now in the process of implementing color-coded alert standards.
The standardized colors chosen for alerts in Wisconsin are:
Dana Richardson, WHA vice president, quality initiatives, said the move to standardize was praised by hospital leaders.
"We have a lot of movement of both patients and health care providers in multiple settings, even across state lines," Richardson said. "Standardizing how we alert these professionals to patient conditions just makes good sense. It is our hope to eventually see a national color standard set for these alerts." Wisconsin and Minnesota have standardized to the same set of colors, while Illinois, Michigan and Indiana are currently reviewing their alert systems.
Richardson said hospitals are asking patients to remove "social cause" wristbands, which can also be a potential source of confusion for care givers.
While this is a voluntary program, the Wisconsin Hospital Association’s goal is for 100 percent of hospitals to make the transition to the standardized colors by March 1, 2009.
For more information related to the color code alert standards and patient safety, visit:
www.wha.org/qualityAndPatientSafety/colorAlertStandardization.aspx.Top of page
WHA Comments on CMS 2009 Inpatient Rule: CMS Needs to Use WHA’s "Inclusive and Collaborative Approach" for Implementing Quality Measures
WHA has submitted its comments to CMS on the proposed Medicare 2009 Inpatient Rule. Each year, CMS proposes changes in its payment methodology for hospital inpatient services for Medicare beneficiaries. What makes this year different is that CMS is proposing the addition of 43 new quality measures that hospitals would be required to report.
WHA comments that while we are very supportive of quality measurement—in fact, Wisconsin is a national leader in this area—we do not support CMS’ proposal to add so many new and largely untested measures in such a rapid fashion. Such an approach will be detrimental to quality improvement efforts because it will overtax resources and not allow hospitals to focus on priority areas.
In our letter, we recommend that CMS use a more inclusive and deliberative process, such as the one we have used in Wisconsin in our CheckPoint initiative. The Wisconsin Quality Steering Committee (which includes providers, payers, and consumers) considers measures approved by the National Quality Foundation (NQF) as one important source, and chooses those that are most relevant and capable of implementation in our hospitals. Using this method, Wisconsin has added about 40 measures over the last four years, a process that allows hospitals to more easily incorporate the measures into their quality improvement processes.
Relative to hospital-acquired conditions, WHA states that the conditions selected by CMS do not fulfill the statutory requirement that they be reasonably preventable through the application of evidence-based guidelines, and recommends that CMS develop an advisory panel of clinicians and scientists to provide the agency with guidance on which conditions are appropriate for inclusion under this policy.
CMS has also been mandated by Congress to implement value-based payment, and is seeking comments on its plan. WHA comments that in their testing phase, CMS should allow individual hospitals to see the results of any simulations, and the public should be able to see aggregate results and make comments. In addition, we recommend that CMS convene a technical advisory panel to review the preliminary results and provide comments and recommendations on improvements.
The rule is very broad, and WHA provided comments on other elements of the proposal:
WHA’s comment letter can be seen at
www.wha.org/financeAndData/pdf/WHA2009IPPSCommentLetter.pdf.Top of page
Political Action Fundraising Campaign Soars Past $100,000 Mark
Roughly two months in, the Wisconsin hospitals state political action funds fundraising campaign has already topped $100,000. The state political action funds include a political action committee and a conduit account. To date, the campaign received a total of $115,454 in contributions. This is $18,000 more than when compared to this same time last year and puts the 2008 campaign at 55 percent of its $210,000 goal.
Individual contributors are up as well. In 2008, 246 individuals have contributed an average of $469. At this same time last year, 225 individuals had contributed.
As in previous years, individual contributors will be listed in The Valued Voice by name and affiliated organization on a regular basis. 2008 contributors to date are listed below. Contributors are listed alphabetically by contribution category.
For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.
Contributions Ranging from $1 - $249
Abels, Maya Aurora Health Care
Ashbeck, Norbert Good Samaritan Health Center of Merrill
Ayers, Mandy Wisconsin Hospital Association
Bernklau, Robert Memorial Health Center
Bjork, Ted Westfields Hospital
Brauer, Theresa Aurora Medical Center - Manitowoc
Brenny, Terrence Stoughton Hospital Association
Busch, Rebecca Spooner Health System
Byrne, MD, Frank St. Mary’s Hospital
Carr Lee, Mary Meriter Hospital
Censky, Bill Holy Family Memorial Medical Center
Cich, Dawn St. Mary’s Hospital of Superior
Cisler-Cahill, Lorna Children’s Hospital of Wisconsin
Clapp, Nicole Grant Regional Health Center
Cleveland, Herbert Children’s Hospital of Wisconsin
Coblentz, Kathy Jo St. Joseph’s Community Health Services
Colby, Daniel Mercy Health System
Colpaert, Gary Froedtert Memorial Lutheran Hospital
Davis, Kathleen Children’s Hospital of Wisconsin
DeWitt, Pamela St. Joseph’s Community Health Services
Dittrich, Peggy Memorial Health Center
Dougherty, Kim Children’s Hospital of Wisconsin
Dwyer, Maxine St. Mary’s Hospital
Erickson, William Sacred Heart-St. Mary’s Hospitals
Ewing, Thomas Aurora Health Care
Facey, Alice St. Clare Hospital and Health Services
Fink, MD, Jordan Children’s Hospital of Wisconsin
Floyd, Duane Watertown Memorial Hospital
Gilmore, Ronald
Godden, Scott Children’s Hospital of Wisconsin
Gorecki, Susan Children’s Hospital of Wisconsin
Govier, Mary Holy Family Memorial Medical Center
Hieb, Laura Bellin Memorial Hospital
Hoege, Beverly Reedsburg Area Medical Center
Jacobsen, Joan Meriter Hospital
Jain, Raj St. Mary’s Hospital
Jelle, Laura St. Clare Hospital and Health Services
Jensema, Christine St. Nicholas Hospital
Johnson, Pat Hayward Area Memorial Hospital and Nursing Home
Jones, Linda Children’s Hospital of Wisconsin
Karoliussen, Dave Sacred Heart-St. Mary’s Hospitals-Tomahawk
Kempen, Patricia Children’s Hospital of Wisconsin
Koeppl, Gina St. Mary’s Hospital
Korff, Sally St. Nicholas Hospital
Lynch, Sue Franciscan Skemp Healthcare-La Crosse
Marks, Susan Children’s Hospital of Wisconsin
Marsch, Jean St. Vincent Hospital
Maulson, Andrea St. Mary’s Hospital
Maurer, Mary Holy Family Memorial Medical Center
McCoic, Kristie St. Joseph’s Community Health Services
Meicher, John St. Mary’s Hospital
Meyer, Markie Community Memorial Hospital
Mickelson, Ronald St. Clare Hospital and Health Services
Morauske, Michelle WHA Financial Solutions, Inc.
Mulder, Doris Beloit Memorial Hospital
Myre, Judy Sacred Heart-St. Mary’s Hospitals-Tomahawk
Neitzel, Kristin Children’s Hospital of Wisconsin
Nemeth, Joseph Mercy Health System
Norell, Brett Children’s Hospital of Wisconsin
Oerter, Tracy Children’s Hospital of Wisconsin
Olson, Bonnie Sacred Heart Hospital
Peck, Lori Memorial Health Center
Penovich, Carrie Aurora Health Care
Peters, Kenneth Bellin Memorial Hospital
Policello, Louise Bay Area Medical Center
Pollard, Dennis Community Memorial Hospital
Powers, Mary Children’s Hospital of Wisconsin
Roethle, Linda Bellin Psychiatric Center
Rothfuss, James Meriter Hospital
Roundy, Ann Columbus Community Hospital
Schaefer, Mark Froedtert Memorial Lutheran Hospital
Schaetzl, Ron St. Clare Hospital and Health Services
Selberg, Heidi St. Mary’s Hospital Medical Center
Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home
Sood, Manu Children’s Hospital of Wisconsin
Stefonek, Duane Sacred Heart-St. Mary’s Hospitals
Stelzer, Jason St. Clare Hospital and Health Services
Swiderski, Julie Wheaton Franciscan Healthcare
Totka, Joan Children’s Hospital of Wisconsin
Werner, Andrea Bellin Memorial Hospital
Westbrook, Diane River Falls Area Hospital
Wiedeman, Karen Sacred Heart-St. Mary’s Hospitals
Woleske, Chris Bond Health Center
Wymelenberg, Tracy Aurora Health Care
Contributions Ranging from $250 - $499
Abitz, John WHA Financial Solutions, Inc.
Ashenhurst, Karla Ministry Health Care
Bestor, William Community Memorial Hospital
Biros, Marilyn SSM Health Care-Wisconsin
Borgerding, Dana
Brandel, Patrick Holy Family Memorial Medical Center
Bruss, Lori The Roberts Group
Bukowski, Cathy Our Lady of Victory Hospital
Calhoun, William Mercy Medical Center
Callies, Julie WHA Information Center
Canter, Richard Wheaton Franciscan Healthcare
Carlson, Dan Bay Area Medical Center
Clough, Sheila Howard Young Medical Center
Conwell, Lisa WHA Financial Solutions, Inc.
Cryns, Janice Children’s Hospital of Wisconsin
Curran, Joan Gundersen Lutheran Medical Center
Deich, Faye Sacred Heart Hospital
Dettman, Amy Bellin Memorial Hospital
Dietsche, James Bellin Memorial Hospital
Dooley, Richard Children’s Hospital of Wisconsin
Greene, Roxanne Our Lady of Victory Hospital
Grundstrom, David Flambeau Hospital
Gutekunst, Penny Children’s Hospital of Wisconsin
Hammel, Jennifer Children’s Hospital of Wisconsin
Harding, Edward Columbus Community Hospital
Hilt, Monica Sacred Heart-St. Mary’s Hospitals
Huys, Geoffrey Ministry Health Care
Jablonski, James Children’s Hospital of Wisconsin
Jamieson, Donna Children’s Hospital of Wisconsin
Jenks, David Aurora Health Care
Jensen, Christopher Children’s Hospital of Wisconsin
Jentsch, Lisa Children’s Hospital of Wisconsin
Johnson, Charles St. Mary’s Hospital
Johnson, Roy Children’s Hospital of Wisconsin
Jones, Tom St. Joseph’s Community Health Services
Kaufman, Bruce Children’s Hospital of Wisconsin
Kersten, Juliet Children’s Hospital of Wisconsin
Klauck, James Froedtert Memorial Lutheran Hospital
Klunk, Timothy Children’s Hospital of Wisconsin
Kolb, Marvin O. West Allis Memorial Hospital
Kostroski, Sharon Saint Joseph’s Hospital
Mantei, Mary Jo Bay Area Medical Center
Melzer-Lange, Marlene Children’s Hospital of Wisconsin
Nelson, Nanine ProHealth Care
Olive, Willie Children’s Hospital of Wisconsin
Ordinans, Karen Children’s Hospital of Wisconsin
Pandl, G. John Froedtert Memorial Lutheran Hospital
Pandl, Therese Columbia St. Mary’s-Milwaukee Campus
Pedretti, Julie Children’s Hospital of Wisconsin
Post, A Charles Children’s Hospital of Wisconsin
Potts, Dennis Aurora Health Care
Ross, Forrest WHA Financial Solutions, Inc.
Roth, Stephen Children’s Hospital of Wisconsin
Sanicola, Sue Columbia St. Mary’s
Schmidt, Richard C.G. Schmidt
Schulz, Janet ProHealth Care
Sisney, Mary Children’s Hospital of Wisconsin
Sperka, Julie Children’s Hospital of Wisconsin
Stewart, Jeff Children’s Hospital of Wisconsin
Stout, Johni WHA Financial Solutions, Inc.
Tapper, Joy Milwaukee Health Care Partnership
Thiel, Mike Children’s Hospital of Wisconsin
Thometz, John Children’s Hospital of Wisconsin
Twinem, Thomas Children’s Hospital of Wisconsin
VanCourt, Bernie Bay Area Medical Center
Warmuth, Eric
Weisman, Steven Children’s Hospital of Wisconsin
Werner, Cinda Children’s Hospital of Wisconsin
Woodward, Jim Meriter Hospital
Worrick, Gerald Door County Memorial Hospital
Contributions Ranging from $500 - $999
Allison Stonebraker, Pat Children’s Hospital of Wisconsin
Anderson, Sandy St. Clare Hospital and Health Services
Bloch, Jodi Wisconsin Hospital Association
Braddock, Michelle WHA Financial Solutions, Inc.
Brasseaux, Mary St. Nicholas Hospital
Buerstatte, Gary ProHealth Care
Devermann, MD, Robert Aurora Medical Center of Oshkosh
Duncan, Larry Children’s Hospital of Wisconsin
Dunigan, Thomas Children’s Hospital of Wisconsin
Falvey, Patrick Aurora Health Care
Fehring, Chuck Ministry Health Care
Frank, Jennifer Wisconsin Hospital Association
Guffey, Kerra Meriter Hospital
Gutzeit, Michael Children’s Hospital of Wisconsin
Heifetz, Michael SSM Health Care-Wisconsin
Herzog, Mark Holy Family Memorial Medical Center
Jones, Michael Children’s Hospital of Wisconsin
Kerwin, George Bellin Memorial Hospital
Korom, Nancy Children’s Hospital of Wisconsin
Maxson-Cooper, Pamela Froedtert Memorial Lutheran Hospital
McNally, Maureen Froedtert Memorial Lutheran Hospital
Merline, Karen
Merline, Paul Wisconsin Hospital Association
Mettner, Michelle Children’s Hospital of Wisconsin
Miloszewicz, Angela Wisconsin Hospital Association
Minkus, Michelle SSM Health Care-Wisconsin
Mlynarek, Robert Waukesha Memorial Hospital
Neufelder, Daniel Affinity Health System
Niemer, Margaret Children’s Hospital of Wisconsin
Noll, Gerald Rogers Memorial Hospital
Norton, Andrew Froedtert Memorial Lutheran Hospital
O’Connell, Blaine Froedtert Memorial Lutheran Hospital
Olson, David Bay Area Medical Center
Potter, Brian Wisconsin Hospital Association
Quinn, Connie
Radoszewski, Pat Children’s Hospital of Wisconsin
Reynolds, Sheila Children’s Hospital of Wisconsin
Robertstad, John Oconomowoc Memorial Hospital
Roeper, Randy Aurora Medical Center of Oshkosh
Sachdeva, Ramesh Children’s Hospital of Wisconsin
Sale, Nora Children’s Hospital of Wisconsin
Schafer, Michael Spooner Health System
Schoof, Susie Essie Kammer Group
Shabino, MD, Charles Wisconsin Hospital Association
Ship, Mark Children’s Hospital of Wisconsin
Teigen, Bobbe Aurora Medical Center - Manitowoc
Titus, Rexford ProHealth Care
Welch, Kimberly Aurora Health Care
Wong, George Children’s Hospital of Wisconsin
Contributions Ranging from $1000 - $1999
Bazan, Bill Wisconsin Hospital Association
Birkenstock, Timothy Children’s Hospital of Wisconsin
Boese, Jennifer Wisconsin Hospital Association
Bruce, Bill St. Joseph’s Community Health Services
Christensen, Cinthia Children’s Hospital of Wisconsin
Cutler, Dave WHA Financial Solutions, Inc.
Eddy, Lee Anne Children’s Hospital of Wisconsin
Eichman, Cynthia Our Lady of Victory Hospital
Ela, Susan Aurora Health Care
Gazzana, Thomas Children’s Hospital of Wisconsin
Grasmick, Mary Kay Wisconsin Hospital Association
Kachelski, Joe WHA Information Center
Karuschak, Michael Amery Regional Medical Center
Koehler, Thomas Aurora BayCare Medical Center
Kosanovich, John Watertown Memorial Hospital
Kryda, MD, Michael Saint Joseph’s Hospital
Leitch, Laura Wisconsin Hospital Association
Martin, Jeff Ministry Health Care
Mohorek, Ronald Ministry Health Care
Moulthrop, David Rogers Memorial Hospital
Munson, Kenneth Children’s Hospital of Wisconsin
Nestor, Donald Aurora Health Care
O’Brien, Mary Aurora St. Luke’s Medical Center
Olson, Edward Waukesha Memorial Hospital
Richardson, Dana Wisconsin Hospital Association
Roller, Rachel Aurora Health Care
Size, Pat
Smith, Linda Aurora BayCare Medical Center
Stanford, Matthew Wisconsin Hospital Association
Starmann-Harrison, Mary SSM Health Care-Wisconsin
Van Cleave, Bruce Aurora Health Care
Warmuth, Judith Wisconsin Hospital Association
Westrick, Paul Columbia St. Mary’s-Milwaukee Campus
Contributions Ranging from $2000 - $2999
Bjork, Tanya
Borgerding, Eric Wisconsin Hospital Association
Braddock, Jonathan WHA Financial Solutions, Inc.
Brenton, Mary E.
Buser, Kenneth Wheaton Franciscan Healthcare - All Saints
Fale, Robert Agnesian HealthCare
Petasnick, William Froedtert Memorial Lutheran Hospital
Quinn, George Wisconsin Hospital Association
Rudolph, Colin Children’s Hospital of Wisconsin
Vice, Jon Children’s Hospital of Wisconsin
Contributions $3000 and up
Brenton, Stephen Wisconsin Hospital Association
Desien, Nicholas Ministry Health Care
Turkal, Nick Aurora Health Care
Size, Tim Rural Wisconsin Health Cooperative
Guest Column: Non-payment for Adverse Events: Quality Improvement …or Just Another Payment Cut from Insurers?I was talking with a reporter from Modern Healthcare not long ago about the increasing movement of insurers towards nonpayment of adverse events. This reporter told me about the New York state Medicaid program’s decision to no longer pay for any of the 28 serious adverse events listed by the National Quality Forum (NQF).
She had seen WHA’s press release about our adverse events initiative and wanted to know why we picked only nine. First, I indicated that our initiative was just one more step in our four-year-long quality improvement and transparency effort. But I answered her specific question by telling her that we had our clinical advisors look at the entire list, and they recommended the nine by determining which of the NQF 28 were actually in the control of the hospital.
The reporter also wanted my thoughts on why the payers have so many different lists and have more events listed on them than our nine. I said that their motives are different from ours: Wisconsin hospitals are focusing on quality, while payer motives may have more to do with cost containment. Furthermore, I said that "we don’t improve quality out of fear of non-payment."
I also said that the proliferation of many different and uncoordinated approaches on measures is not helpful in advancing quality improvement because it’s difficult for hospitals to focus on what they consider to be important when you have the cacophony of payer "great ideas for quality improvement" to sort through.
It reminded me of a press release from a major payer a couple of months ago that claimed by not paying for adverse events (I recall their list having 11 events), it was improving quality for its insureds. Now, that’s what I call quality improvement!
These and other episodes we have seen lately illustrate how a seemingly good idea—focusing on serious adverse events in order to eliminate them—turned into merely another payment cut from insurers and other payers.
And as I indicated in my comments above, the fact that every payer seems to have its own list will only add confusion to this effort. Which list should a hospital focus on? Is it the one generated by their largest payer…or the one that the hospital and its medical staff consider best meets their quality improvement strategy?
Providers should view these types of efforts from payers for what they are—transparent payment cuts—and continue to focus on providing high quality health care. After all, hospitals don’t improve quality out of fear of non-payment.
Three More Hospital Associations Launch PricePoint Web SitesHospital associations in Nebraska (nhacarecompare.com), Arizona (azhospitalchoice.org) and Rhode Island (ripricepoint.org) have each launched their own versions of the PricePoint Web site, under contract with WHA Information Center.
The three additions bring to 15 the number of states using a PricePoint system. WHA Information Center has several additional PricePoint Web sites under development with expected launch dates before the end of 2008.
Hospitals Assist Flooded Communities: Offer Shelter, Food, ResourcesHospitals responded to the recent flooding in southern Wisconsin by offering shelter, food and other sorely-needed resources. Thankfully, Wisconsin hospitals escaped the brunt of the floods, unlike several hospitals in neighboring Iowa.
Here is a brief report on hospital flood-related activity based on submissions from member hospitals:
The unprecedented rise in the nearby Rock River caused an extraordinary reaction from Fort Memorial Hospital staff and physicians. At the height of the flooding in Fort Atkinson, elective surgeries were postponed, emergency vehicles from areas south and east of the hospital were diverted to other hospitals, and patients received meals on disposable plates.
In response to the City of Fort Atkinson’s plea to all area businesses and residents to conserve as much water as possible, thereby reducing the amount of water being discharged to the over-taxed wastewater utility, the hospital began to re-schedule elective surgeries.
Support services staff and others were continually monitoring rising water levels on streets adjacent to Fort HealthCare facilities and had started to sand bag at the 512 Wilcox location to keep water out of the building’s lower level.
Fort HealthCare’s Fort Atkinson clinics and Fort Memorial Hospital have been preparing for an organized, pro-active response to the continuing flooding emergency declared for Fort Atkinson and Jefferson. Because of the recent heavy rains and resultant rise in the Rock River level, flooding and other utilities-related problems could potentially cause disruption of services and affect patient care.
The hospital and clinics located along McMillen Street were one of the areas of greatest concern as stated in the Emergency Flooding Update notice distributed June 11 by the City of Fort Atkinson.
Paul Hable, director of safety and laboratory services, is the organization’s representative to the Jefferson County Disaster Preparedness organization. During the flooding he said, "On a regular basis, Fort Memorial Hospital staff does exercises and drills that mimic real-life disaster events like tornadoes, multiple injury incidents and flooding. Regarding the potential crisis at hand, we’ve already implemented portions of our disaster plan and given much thought to our response. We’ve begun to mobilize many of the resources we anticipate needing."
The flood-related damage in the City of Jefferson was not unnoticed by Fort HealthCare staff. With that in mind, Fort Memorial food service staff donated their time and items from the kitchen’s pantry to make gallons of soup for volunteers fighting the rising floodwaters. The soup was loaded onto the Red Cross Disaster Assistance Vehicle and sent to volunteers at the Jefferson County Highway Department facility where hundreds of volunteers were filling sandbags.
Fort HealthCare staff also delivered cases of drinking water, band-aids, spray antiseptic and first aid kits to the volunteers in Jefferson.
Hospital officials had announced a Code Black, which is the designation for a severe weather condition or tornado warning that necessitates moving patients and residents from the hospital and Care Center to areas of safety in inner hallways.
About 3:15, members of three baseball teams who were playing games in Edgerton’s Racetrack Park showed up in the lobby. They were escorted to safe areas in the hospital lower level to wait out the storm.
At that time, six chartered buses, full of students traveling from Marshfield to Florida for a band competition, pulled into the front driveway and requested shelter from the storm. They had followed the blue hospital sign they noticed on the Interstate to Edgerton Hospital and Health Services’ front door.
Hospital staff from the registration and emergency departments quickly assigned the students to safe hallways and rooms, away from windows, and assured them they would be secure in these areas. They were offered water and other refreshments while being assured they were in no danger from the storm.
IHA Launches Relief Fund to Help Hospital Employees Rebuild LivesKay Herbst, who works at the Kickapoo Valley Medical Clinic in Soldiers Grove, and Sandy Mason, who is a staff member of the VMH patient registration department, had two to four inches of mud on the main floors of their homes. Several members of the clean-up team helped with cleaning and removing of materials that were soaked with flood water. Mason’s house is basically uninhabitable and she may never be able to move back in. Staff helped pack up her belongings that were on the first floor and have her prepared to move. Staff also power-washed the floors and walls. She had 29 inches of water on her first floor. At this time there is nothing more staff can do until she can find some storage space and a place to live for an extended period of time.
Herbst has moved back into her home. She had about eight inches of water on the main level and was able to save most everything.
The VMH Clinic in LaFarge had about 41 inches of water in its basement. Many boxes of medical records were damaged in spite of being on storage shelves a foot off the floor. Members of the plant services and maintenance departments were called into action and moved most everything out of the basement including the furnace and water heater, which will have to be replaced. The walls and floors were scrubbed down with virex.
Hundreds of Iowa hospital employees suffered devastating losses from the recent tornado and flooding. Some lost everything, yet they continued caring for their patients and neighbors who were ill or suffered injury as a result of these tragedies.
In an effort to help these heroic health care workers rebuild their lives, the Iowa Hospital Employee Disaster Relief Fund has been established. All donations made to this fund will be disbursed to hospital staff in the affected areas of the state. The fund will be administered through the Iowa Hospital Education and Research Foundation, a 501(c)(3) charitable organization associated with the Iowa Hospital Association (IHA).
IHA estimates 400-500 hospital employees have been displaced by these far-reaching disasters. Through the support of the IHA, IHERF and the American Hospital Association boards, the fund has been jumpstarted with a $150,000 contribution. Buchanan County Health Center in Independence and St. Anthony Regional Hospital in Carroll have already committed to donating $5,000 and $2,500, respectively. Other major donors are expected, with the goal to raise, in the next two weeks, at least $250,000.
Donations by check should be made out to "Iowa Hospital Employee Disaster Relief Fund" and sent to: Iowa Hospital Association, 100 E. Grand, Suite 100, Des Moines, IA 50309-1835. Credit card donations will also be accepted through the IHA Web site at
www.ihaonline.org.Top of page
Division of Quality Assurance Provides Hospital Citation Report, Other Information
DQA, WHA, RWHC collaboration continues
WHA’s George Quinn and Laura Leitch met with Division of Quality Assurance (DQA) staff Cremear Mims and Jane Walters in the most recent "Hospital Forum," a quarterly meeting of staff from DQA, WHA, and the Rural Wisconsin Health Cooperative.
DQA staff presented the state and federal Hospital Citation Report for January 1 through March 30, 2008. DQA staff noted that both patient rights and infection control issues were among the citations in the first quarter. Copies of the reports with a brief description of the frequent citations are available on the WHA Web site at the link below.
"Wisconsin hospitals’ primary focus is on quality health care. These reports provide useful information concerning what DQA staff is currently identifying as important from a regulatory compliance standpoint," observed WHA Senior Vice President George Quinn.
DQA staff also noted that the number of complaints against hospitals increased during the first quarter. DQA pointed to the new online and toll free complaint filing options as a contributing factor. DQA has provided a notice of the new complaint filing system to all hospitals; hospitals are required to provide this new information to their patients.
DQA warned that CMS is directing state survey agencies to look for recalled Heparin products that have not been removed from the hospital. CMS is concerned that the products might be found in locations people might not have checked, like crash carts. If DQA surveyors find recalled Heparin products, they will issue citations.
CMS has updated the State Operations Manual and has provided a copy to state survey agencies. DQA advised that the updated version should be posted to the CMS Web site in the near future.
To view the documents provided by DQA for the Hospital Forum, go to
www.wha.org/legalAndRegulatory/dqa.aspx.Top of page
Wisconsin Hospital Association Expresses Concern About HFS 129 Revision
Following hearings this week, the Wisconsin Hospital Association filed comments with the Division of Quality Assurance (DQA) on proposed new rule HFS 129. Of primary concern in WHA’s comments was failure of the rule to address concerns that an individual remains on the registry when a complaint has been made against the individual and an investigation is ongoing or DQA has found wrongdoing and an appeal is in process. During this time, hospitals and nursing homes may unknowingly employ these nurse aides. WHA’s comments included:
WHA also commented on portions of the rule which are a restatement of federal requirements for nurse aides as unnecessary, and on limiting facilities to offering clinical experience to only two nurse aide groups at a time.
Judy Warmuth, WHA vice president of workforce development, participated in a group serving as an advisory panel to DQA for these rules. Many of the issues she raised during that time have been addressed, including a change in qualification for instructors of hospital programs and advance posting requirements for student assignments.
"While some of WHA’s concerns have been addressed in this rule, I remain concerned that it still does not adequately protect vulnerable patients by ensuring that employers are informed about ongoing investigations of misconduct by nurse aide applicants," said Warmuth. "Employers rely on the Nurse Aide Registry to accurately reflect an aide’s eligibility for employment."
Quality and Safety Improvement Projects Due July 15 for Inclusion at 2008 ForumThe deadline to submit your quality and safety improvement projects for inclusion in the 2008 Wisconsin Quality & Safety Forum Project Showcase has been extended to July 15. Consider submitting your project this year. Projects that have not previously been submitted are eligible, as are new phases of a previously submitted project. A full project submission brochure, describing all submission criteria, is available on WHA’s Web site at www.wha.org as well. Those with an accepted project receive one complimentary registration to the 2008 Wisconsin Quality & Safety Forum.
Those projects submitted by July 15 will be included in the 2008 Wisconsin Quality & Safety Forum Showcase, included on the CD-ROM of all submitted projects, be considered to offer a breakout presentation at the Forum, and highlighted in a future issue of the Wisconsin Medical Journal.
Showcase projects must be submitted via the online submission form at www.wha.org/QSFshowcase. The online form is now available and all submissions are due to WHA by Tuesday, July 15, 2008. For questions about project submission, contact Brian Competente at 608-274-1820 or bcompetente@wha.org.
A full agenda and registration information for the 2008 Forum, scheduled October 20-21 in Wisconsin Dells, will be distributed in August. If you have any questions about the 2008 Forum, contact Dana Richardson or Jennifer Frank at 608-274-1820, or via e-mail at drichardson@wha.org or
jfrank@wha.org.Top of page
Medical Examining Board Considers Options for Streamlining Licensure Process
Board agrees to extend period support documents are valid to one year
The Wisconsin Medical Examining Board (MEB) considered several options presented by Department of Regulation and Licensing (DRL) staff aimed at cutting the time it takes to get a physician licensed in this state. DRL staff members Tom Ryan and Cathy Pond presented eight options to the Board that would shorten the turnaround time, reduce costs, cut paperwork and improve the efficiency of the physician credentialing process.
The Board approved one of the eight options and made an immediate change in policy that will lengthen the period of time that the supporting documents are considered valid from six months to one year. In the current licensing process, many primary source documents submitted for initial licensure are valid for only six months. Since the licensure process often exceeds the six-month time frame, physicians may be forced to request and submit the same documentation a second time, creating additional cost and further time delays in licensing.
Some of the options presented by Ryan and Pond would require statutory changes, some would require changes in administrative rule, and others would require only a policy change by the MEB. DRL staff compared current Wisconsin practice with other states and shared an evaluation of each option by the Federation of State Medical Boards. The report can be found at www.wha.org/workForce/medExaminingBoard.aspx.
There was extensive discussion of the seven remaining points. The Board directed staff to further investigate some options and propose rule revisions for others. All of the seven remaining options will return to the Board’s July agenda. While both the Board and department staff made it clear that they wanted a safe licensure process that they could be confident would protect the public, there was also much willingness to ask why things were done in a certain way, how processes could be streamlined and when changes could be made. Both groups seemed committed to developing a faster, smoother process for initial licensure.
Concern about the turnaround time it takes for a physician to obtain a Wisconsin license prompted the Wisconsin Hospital Association and the Wisconsin Medical Society to meet with officials from the DRL earlier this month. The group discussed existing concerns to identify solutions for the prolonged delays facing physicians when they apply for a Wisconsin license. Prior to the meeting, WHA and WMS provided DRL Secretary Celia Jackson with a letter outlining concerns from members of both organizations.
The meeting ended with an agreement to meet again in six months to analyze progress, evaluate benchmarks and discuss additional strategies. Overall, WHA and WMS staff were satisfied with the proactive efforts identified by DRL leadership but agree that follow up will be necessary.
Global Vision Community Partnership AwardNominations must be received by the WHA Foundation no later than 5 p.m. on Tuesday, July 15.
Need to review the nomination brochure and form?
Visit the WHA Web site: www.wha.org/about/globalvision.aspx
Send entries to Jennifer Frank at the WHA Foundation via email at jfrank@wha.org or via U.S. Mail to PO Box 259038, Madison, WI 53725-9038. For questions, contact Jennifer at jfrank@wha.org or at 608-274-1820.
HHS Secretary Announces Selection of Wisconsin Medical Society, MetaStar and WCHQ as One of 12 Sites for Major EHR DemonstrationA collaboration of key Wisconsin health care stakeholders has been selected to take part in a national Medicare demonstration project. The five-year, first-of-its kind project provides incentive payments to physicians for using certified electronic health records (EHR) to improve the quality of patient care at the local level.
"The use of electronic health records, and of health information technology as a whole, has the ability to transform the way health care is delivered across our nation," Department of Health and Human Services Secretary Leavitt said at in Madison June 13. "We believe that EHRs can help physicians deliver better, more efficient care for their patients, in part by reducing medical errors. This project is designed to demonstrate these benefits and help increase the use of this technology in practices where adoption has been the slowest—at the individual physician and small practice level."
Partners in this collaboration are the Wisconsin Medical Society, Metastar, and the Wisconsin Collaborative for Healthcare Quality (WCHQ).
"We are extremely pleased to have been selected as one of the 12 sites to participate in the EHR Demonstration," said Susan Turney, MD, CEO, Wisconsin Medical Society. "In our shared commitment to expanding the use of electronic health records, we have noted that smaller physician office practices have been slower to adopt EHRs than many of the larger health systems in Wisconsin. We each feel strongly that health information technology is an important tool for improving health care quality, and we look forward to working with CMS as we move forward. We know that through this collaboration we will be able to accomplish more."
According to the 2006-2007 Wisconsin Ambulatory Information Technology Survey, 86 percent of large systems have adopted health information technology compared to 25 percent of independent or small system sites. The reasons why doctors in small practices have not adopted EHRs vary from start-up costs and maintenance, to lack of computer knowledge and technical support, to security concerns. For some physician practices, there are a number of barriers to implementing EHRs. This initiative will provide financial incentives to 100 small to medium-size primary practices in Wisconsin to use certified EHR systems.
Save-The-Date: August 6, RAC Seminar Offered by WHA and HFMADeveloping a daily process for complying with the utilization review standards of Medicare’s Conditions of Participation is key to audit preparedness, and is especially important in light of the Recovery Audit Contractors, or RAC, audits that will be coming to Wisconsin in 2009.
Mark your calendar for Wednesday, August 6, for a live, one-day education program, "Minimize Compliance and Financial Risk While Preparing for the RAC." This program is sponsored by WHA and the Wisconsin Chapter of HFMA, and was developed as a recommendation of the WHA RAC Task Force.
Plan to join this program, presented by Dr. Joe Zebrowitz of Executive Health Resources (EHR) and John Bartell of Bay Area Healthcare Consulting, for insight into building and optimizing your U.R. committee and processes, ensuring an effective observation status and one-day stay certification, why these issues have become a major compliance concern, and why hospitals often lose significant revenue from inappropriate observation claims. Also, learn about verification processes to ensure claims are supported by clear and irrefutable documentation, as well as the importance of accurate chargemaster descriptions, capture procedures and claim generation processes.
A full agenda, registration information and online registration will be available the week of July 7 and included in the July 11 issue of The Valued Voice. If you have any questions about this session before then, contact Brian Potter or Jennifer Frank at 608-274-1820, or via e-mail at bpotter@wha.org or
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Community Benefits: Stories From Our Hospitals - Aurora Medical Center, Kenosha
Sexual Assault Nurse Examiner Program
Confused, scared, and upset, Carrie (not her real name) sat before a Sexual Assault Nurse Examiner trying to put into perspective what happened to her just a few hours before. Sexual assault isn’t an easy subject to discuss, but at Aurora Medical Center in Kenosha, the establishment of a Sexual Assault Nurse Examiner (SANE) program is an important step in helping victims deal with the trauma of sexual assault.
Sexual Assault Nurse Examiner is a nationally recognized program that features specially trained registered nurses who offer care to sexual assault survivors. The nurses work with other emergency staff, social services, law enforcement, district attorney offices, and other community agencies.
"My incident wasn’t handled as easy as they make it look on TV,’’ said Carrie. "The Sexual Assault Nurse Examiners helped me the most.’’
Carrie learned about the program after her mom spotted an article detailing it in the local newspaper. The story appeared the day after she was assaulted. It was a chaotic scene that morning—the details still remain sketchy in Carrie’s mind—but she clearly remembers what happened when she entered the hospital.
"I felt the most comfortable as I could, given my situation,’’ she said. "The nurses showed great empathy. They treated you as the victim, not the other way around. I felt like a person.’’
Carrie said the Sexual Assault Nurse Examiner made her feel comfortable and that helped in recounting the details. She said the nurse always let her know what was going on, explained in detail each next step, and answered her questions.
The Sexual Assault Nurse Examiner program in Kenosha also partners with Pathways of Courage and other agencies to help provide a continuum of care that begins when the patient walks in the door and continues throughout the recovery period. In Carrie’s case, Pathways of Courage and UW-Parkside were involved with helping her put her life back together.
A key benefit of the SANE program is that the survivor works with a nurse who understands the emotional and physical complexities involved with sexual assault. Nurse examiners are on call seven days a week, 24 hours a day. They receive extensive training that covers medical forensic care for evidence-gathering, post-traumatic rape syndrome, venereal disease, and the use of a colposcopic instrument that takes pictures of injuries to the anatomy for documentation in court.
The statistics suggest that there is a need for this type of resource in the community. In 2006, Aurora Medical Center in Kenosha treated 94 patients. The program is also offered at nearby Aurora hospitals, including Aurora Lakeland Medical Center which treated 57 patients in 2006 and Aurora Memorial Hospital of Burlington where 31 cases were recorded.
Community Benefits: Stories From Our Hospitals - Westfields Hospital, New RichmondWestfields Hospital has been awarded the C.L. Grieber Award of Merit by the Wisconsin Association for Career & Technical Education (WACTE) for its efforts to promote, improve and develop career and technical education in Wisconsin.
Companies recognized must have demonstrated a concern for career and technical education as evidenced through activities such as sponsored programs, personal services, supportive publications, financial support, or meritorious activities.
Larry Gee, Dean of Instructional Operations, Wisconsin Indianhead Technical College (WITC) commended the hospital’s efforts at the WACTE annual conference held in Stevens Point by saying, "Westfields Hospital has been a solid partner in education through its many contributions and services to our district."
He cited Westfields Hospital for providing numerous clinical opportunities for WITC’s associate degree nursing program. "They have been very flexible in working with our day and evening clinical sectionals allowing teaching opportunities on their medical campus. Westfields Hospital staff members are instructors and facilitators for these clinicals."
"In addition," Gee continued, "both equipment and supplies have been donated to WITC by Westfields Hospital for use in the classrooms to advance the curriculum competencies. They provide additional assistance and support in ordering nursing supplies and small equipment. Our nursing program has greater success thanks to the leadership and direction of Ginger Murphy, Vice President of Patient Services for Westfields Hospital, who as a member of the WITC program advisory committee has been a positive contributor of the associate degree nursing advisory committee for a number of years."
Not only has Westfields Hospital been a dedicated supporter of our existing programs, but members of Westfields Hospital executive leadership have also played an active role in WITC’s Health Alliance Task Force. Through collaborations Westfields Hospital and WITC invited other hospitals in the region to join efforts to raise awareness across the district for health careers. This task force sought solutions for the shortage of health care workers in the WITC district and surrounding areas. Efforts of the Alliance have resulted in advocacy programs, videos for middle school and high school career fairs and a presence at the technical college job fair. Thanks to the persistence of the Alliance, WITC will add a full-time instructor in the health field in the fall. This will enable WITC to start a new associate degree nursing section each semester, thus shortening the wait times to begin the nursing program."
"It is truly an honor to be able to present this award to Westfields Hospital," says Gee. "But an even greater satisfaction comes when we see the results of successful training. Many WITC graduates receive the highest recommendation in the form of employment at Westfields Hospital, not only in nursing field, but also graduates of our accounting program, medical administrative specialist program, and medical assistant program."
Wisconsin Association for Career & Technical Education is comprised of nearly 1,000 employees from the state’s technical college system. Each year each of the 16 districts may nominate individuals or businesses for the C.L. Greiber Award. This year Westfields Hospital was chosen from a field of seven businesses and six individuals nominated from the 16 districts in the state.
Submit hospital community benefit stories to Mary Kay Grasmick, editor, at
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Member News: Shaw Takes on New Role at St. Mary’s Hospital of Superior
Mary Shaw has taken on the dual roles of administrator and chief operating officer of St. Mary’s Hospital of Superior and the Duluth Clinic–Superior. These were previously two separate positions.
Shaw has served as Duluth Clinic-Superior administrator since November 1999. Prior to joining SMDC Health System, she held management positions with the Mayo Health System in Austin, Minn. She received a master’s degree in health administration from the University of Minnesota.
Shaw has also achieved Fellow status in the American College of Medical Practice Executives. She has been active in the Wisconsin Medical Group Management Association, and currently serves as its president. She recently completed a term as president of the Superior/Douglas County United Way Board.