Organization Newsletter

July 2015

In this issue...

1. Whitman Hospital Has Been Recognized by Qualis Health as One of Seven Washington Organizations for Improvements in Healthcare!

2. Targeted Rural/Underserved Student Track (TRUST) Program 

3. The Spokane Shriners Hospital is Bringing Their Expert Orthopaedic Team to the Tri-Cities

4. Get Ahead of the Code: Advanced Simulation for Physicians

Welcome

Welcome to the July 2015 issue of the Washington Rural Health Association e-Newsletter. Inside this issue you will find news and information from the new 2015-2016 president and board of directors, members, and community partners from across the state of Washington. 

If you would like to submit your own story, please click here.

The WRHA e-newsletter is a publication of Washington Rural Health Association, a not-for-profit association composed of individual and organization members who share a common interest in rural health. This e-newsletter seeks to disseminate news and information of interest to rural health professionals and stakeholders to help establish a state and national network of rural health care advocates.

WRHA Members

WRHA members include administrators, educators, students, researchers, government agencies and workers, physicians, hospitals, clinics, migrant and community clinics, public health departments, insurers, professional associations and educational institutions. If you are interested in joining or renewing your membership with WRHA click here.

 Whitman Hospital Has Been Recognized by Qualis Health as One of Seven Washington Organizations for Improvements in Healthcare!

Submitted by Laurie Gronning
[email protected]

Award of Excellence: Critical Access Hospital
Whitman Hospital & Medical Center, Colfax, for their project “Readmission Reduction”

Hospital readmissions are costly and often avoidable. Whitman Hospital & Medical Center aimed to reduce readmissions within 30 days of discharge to skilled nursing facilities, as well as discharges to home, for the diagnoses of Congestive Heart Failure (CHF), Myocardial Infarction (MI) and Pneumonia. The hospital revamped the discharge process and developed a “High Risk for Readmission Assessment” form to evaluate each patient’s individual risk factors for readmission. Each risk level had a corresponding list of interventions to assist the patient after returning to home. For discharges to skilled nursing facilities, communications between the facilities was enhanced and an RN-to-RN warm handover was implemented, along with a guide that included information deemed important by the accepting facilities. After these changes were implemented, readmissions from SNFs decreased from 32.5% in 2013 to 8.4% in 2014. Additionally, readmissions from home decreased for MI by 73.3% and pneumonia by 12.7% since 2012, and for CHF by 6.66% since 2013.

About the 2015 Qualis Health Washington Awards of Excellence in Healthcare Quality
Since 2002, Qualis Health has presented the annual Awards of Excellence in Healthcare Quality to outstanding organizations in Idaho and Washington. Winners have demonstrated leadership and innovation in improving healthcare practices, reflecting the very best in healthcare quality improvement. The awards recognize those who demonstrate outcomes to the three broad aims outlined in the National Quality Strategy:
• Better healthcare (for individuals)
• Better health (for populations)
• Reduced costs through improvement

Winners of the 2015 Awards of Excellence in Healthcare Quality in Washington are selected by a panel of Washington expert stakeholders. Awards were presented at the 2015 Annual Northwest Patient Safety Conference on May 13 in Lynnwood, WA.

Qualis Health is one of the nation’s leading population health management organizations, and a leader in improving care delivery and patient outcomes, working with clients throughout the public and private sector to advance the quality, efficiency and value of healthcare for millions of Americans every day.

In Washington, Qualis Health serves as the Quality Innovation Network – Quality Improvement Organization (QIO) for the Centers for Medicare & Medicaid Services (CMS), the Medicaid External Quality Review Organization (EQRO) under contract to the Washington State Health Care Authority (HCA) and the Department of Social and Health Services (DSHS) Division of Behavioral Health and Recovery, and the Health Information Technology Regional Extension Center (REC) for the Office of the National Coordinator for Health Information Technology (ONCHIT), and provides case management and utilization management services to Washington State Medicaid and the Washington State Department of Labor & Industries.

For more information, visit www.QualisHealth.org.

Award Presentation held May 13, 2015 at the 2015 Northwest Patient Safety Conference in Lynwood, WA 

Qualis Health Representatives:
Jonathan Sugarman, MD, MPH, President & CEO (left)
Peggy Evans, PhD, PCMH CCE, Vice President, Quality & Safety Initiatives (far right)

WHMC Representatives:
Erin Kroll, ED/MSU Manager
Kate Getz, RN
Kathleen Haley, LICSW

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Targeted Rural/Underserved Student Track (TRUST) Program 

Submitted by John McCarthy, MD
[email protected]

Across Washington State for the last 7 years, the University of Washington School of Medicine has been intentionally working to place medical students in smaller hospitals in an  effort to create the workforce for tomorrow. The Targeted Rural/Underserved Student Track  (TRUST) Program is now starting to spin out practicing physicians.

The program has taken some of our brightest rurally invested students and matched them with our most ambitious and thoughtful physicians. The goal is to allow them to spend a significant amount of time in rural communities, thereby solidifying their interests in rural medicine and showing them the pleasures of longitudinal care. In my estimation, this is an easy sell. If we train more students and residents in rural environments, they are more likely to stay there. And in contrast, if we train them in tertiary hospital environments, they are more likely to stay there.

The program has grown over the last five years such that we now have 40 Washington students (and eventually will have 120 WWAMI students) in the school at any one time who have voiced an interest and are choosing to practice in rural/smaller community medicine environments. Those of us who understand workforce issues realize this is a start and there needs to be residencies which continue to support this valuing of the rural workforce.

In future WRHA newsletter issues we would like to introduce some of our students to you. We hope to help you better understand the world of medicine through the eyes of the future physicians of the state.

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The Spokane Shriners Hospital is Bringing Their Expert Orthopaedic Team to the Tri-Cities

Submitted by Kristin Monasmith
[email protected]

For 90 years Shriners Hospitals for Children - Spokane is where families who want the best pediatric orthopaedic care have been bringing their kids.

Now the Spokane Shriners Hospital is bringing their expert orthopaedic team to the Tri-Cities. The hospital treats kids from the entire state of Washington and cares for many kids from the Tri-Cities region. ”We want to better serve the needs of the families in Central Washington by bringing our specialty medical staff closer to the communities where they live,” said Spokane Shriners Hospital Chief of Staff, Paul Caskey, M.D.

The hospital has established a satellite clinic co-located at the Northwest Orthopaedic & Sports Medicine (NOSM), a division of Proliance Surgeons, in Richland. The Shriners Hospitals for Children Satellite Clinic will contain a full team of surgeons, nurses and other critical staff. It is ultimately an extension of the Outpatient Clinic in the Spokane hospital; kids will see the same expert medical staff just in a different location.

The Spokane Shriners Hospital treats conditions ranging from serious orthopaedic issues to simple fractures or sports injuries. From club foot babies to teens living with scoliosis, the surgeons from the Spokane Shriners Hospital are experts in their field. The Satellite Clinic medical team will see patients in an outpatient setting at NOSM and refer them to Spokane for surgery or additional services such physical or occupational rehabilitation.

Pediatric Orthopaedic Care:
• Scoliosis & Spinal Deformities
• Hip Dysplasia
• Clubfoot & Other Foot Deformities
• Cerebral Palsy & Other Neuromuscular Conditions
• Sport Injuries
• Knee & Hip Disorders
• Foot and hand injuries
• Prosthetics & Orthotics
• Osteogenesis imperfecta (brittle bone disease)
• Limb Discrepancies
• Fractures & Ligament Injuries
• Burn scar revisions

Shriners Hospitals for Children treats kids, ages 0-18. A person is very different when they are growing than when they are done growing. The surgeons at the Spokane Shriners Hospital are fellowship trained in pediatric orthopaedics. What that means to the families in the Tri-Cities region is they will be seen by physicians with the highest level of specialty training in pediatric orthopaedics.

“Remember, children are not just small adults. When your child has an orthopaedic concern, it is critical to see an expert pediatric orthopaedic specialist who understands growing bones and joints so that your child has the best possible outcome.” says Bryan Tompkins, M.D., one of four pediatric orthopaedic surgeons at the Spokane Shriners Hospital.

The Spokane Hospital’s medical staff will care for the full spectrum of pediatric orthopaedic problems, including fractures. Patients will receive fracture care that could include (as needed): reduction/re-alignment, casting and post-fracture follow-up. Any surgical cases will be sent to the Spokane Hospital.

“Children's bones heal faster than adult's bones. In the event of an injury, the child needs proper treatment before the bone begins to heal, because the long-term consequences may include limbs that are crooked or of unequal length,” Dr. Tompkins continues.

To make an appointment to see one of the expert pediatric orthopaedic surgeons at the Spokane Shriners Hospital Satellite Clinic takes just a phone call. A parent can call directly to the hospital appointment line or families can ask their physician for a referral. Contracts are now in place with most major insurance networks, but whether or not a family has insurance has never been a factor. Acceptance for care is based only on medical need and all care and services are provided regardless of the families’ ability to pay.

For more information or to request an appointment, call 888-895-595

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Get Ahead of the Code: Advanced Simulation for Physicians

Submitted by John J. Nance

Most of us have, at one time or another, embraced and used the word ”virtual“ to describe a computer-based experience in which computer-aided humans participate or communicate with someone or something at an electronically aided distance.

In a game of virtual chess, for instance, the game exists in the player’s minds, but the chess board is a construct of 1's, zero’s, and pixels floating in that ”virtual” world.

In a sense, simulation-whether aviation or nautical or medical-mines the same willing suspension of selective disbelief as that chess game, aiding the process of pretending to fly an airplane, drive a ship, or perform a medical procedure, all for the purpose of practicing and improving skills without taking chances.

In aviation, multi-million dollar flight simulators have almost completely replaced the real airplane in training pilots to be ready to fly. And in healthcare, simulation is just now in its infancy, with sophisticated dummies (such as “Noel”) available to greatly aid the tactile learning of nurses, techs, and physicians on a wide variety of invasive procedures without imperiling a real human.

 In it’s infancy? Why? Where can it go from here? That, you see, is the exciting promise on the horizon, because perhaps the most effective use of simulation will be in training professional humans to operate like a finely-tuned team, supporting and communicating seamlessly with each other for the best interests of the patient.

I call it ”Empty-Room Simulation”, because it doesn’t require expensive dummies or real ORs pulled out of service. In fact, the only thing required for a highly effective training center is that empty room with a table, the room festooned with small HDTV cameras, a seasoned medical team (from the OR, the ED, the Cath Lab, etc), and a very well-trained facilitator. With the participants talking the facilitator and themselves through the steps they would take in a real procedure, the facilitator throws a wide variety of problems and variations their way (“Okay, Doc, you just nicked an artery. Talk me through your response”).

The prime deficiency in medical practice is teamwork fueled by poor communication and hierarchical blockages to communication of timely information. Simulation enables us to attack such deficiencies with devastatingly effective confrontations in which the poor or deficient or even defiant actor is confronting their own performance on video. You have not been fully chastised for poor performance in communication, coordination, and teamwork until you have watched yourself, through video, falling short of the mark. The motivating force of that alone is very important as we enter the dawn of a massive cultural shift in medicine from the lone-eagle practice to teamwork.

Health care organizations are beginning to embrace this type of critical skills training. They’ve seen how skills gained through real-life situations are one of the most important factors to impact patients’ safety as well as physicians’ long-term wellbeing. Physicians Insurance, a medical professional liability insurance company, recognizes this principle with their “Get Ahead of the Code: Advanced Simulation for Physicians” event. In partnership with InSytu Advanced Healthcare Simulation and Pacific Northwest University, they have put together simulation training of eight medical procedures and five different ER codes for their members, as well as the broader community of physicians in the Northwest.

In this, the “crank telephone” stage of simulation, it is vital that the headlights of any hospital or healthcare system’s program be focused way down the track. There is much to be done and to be learned, and we’re just beginning.

For more information about the September 19th event, visit www.PhyIns.com/AheadOfTheCode or call (800) 962-1399.

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