Orgainization Newsletter

November 2012

In this issue...

  1. President's Message
  2. State Office of Rural Health: A Creative Idea Worth Funding
  3. Critical Care Ambulance Added to Palouse Base
  4. Focus on Safety and Quality Earns Northwest MedStar AAMS "Program of the Year" Award
  5. 2013 Neuroanatomy Conference - A Clinician's Review
  6. Regional Health Care System Planner
  7. Life Flight Network's New Top of the Line C-MAC PM
  8. Life Flight Network Double Active & EMS Teamwork Saves Lives

Welcome

The Washington Rural Health Association 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 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.


President's Message

submitted by: John Hanson, WRHA President

[email protected]

As President one of my concerns is that the Washington Rural Health Association be effective in its goal to help strengthen our rural healthcare system.  Our Mission Statement reads as follows:

The Washington Rural Health Association’s mission is to collaboratively strengthen and improve the health of rural communities.

The Washington Rural Health Association was formed in 1988, an outgrowth of the developing vision of many individuals and organizations who recognized the value of uniting to support rural health care throughout the state of Washington. WRHA is a strong advocate for enhanced access, quality and stability for rural health services.

Some of the key words in this statement are “collaboratively” and “uniting.”  We do not see ourselves as trying to force an agenda of change on rural communities, but rather, we choose to work, as the statement says, collaboratively with individuals and organizations for the mutually attainable quality and quantity of the healthcare that you need.

In that vein your Board of Directors has decided to once again reach out to communities and hold town hall format community meetings in order collaborate with you about the health issues that mean the most to you.  We want to hear from you what you need from the health care system.  What’s working and what isn’t?  Maybe you live in one of those communities where the healthcare system is working fine and your needs are met.  Or you could be living in a place where some necessary services are lacking.  We have nearly 200 members in the Association.  Chances are that some of them live in your town.  When we visit communities we will certainly invite our own members to join us in these collaborative sessions.

In what ways can we help?  We can bring your messages to state legislative and congressional members.  We can communicate and work with other healthcare organizations when necessary.  We can work with policy makers within state government.  In short we will stand up for you, doing our best to see that you get the healthcare you need, when you need it.

In that spirit of collaboration we are happy to announce that for some of these meetings we will be working with the Washington State Hospital Association (WSHA) and its Rural Program, which has recently gathered statistical data on rural health from around the state.  WSHA is our partner in some of these meetings and its interests are aligned with WRHA’s, i.e., looking at the rural healthcare system as a whole, not just at hospitals.

Need for more Board members

On another topic, the Board of Directors currently has five unfilled positions and expects to have one more before out annual meeting in March.  This leaves six opportunities for members to serve as Directors.  A full complement of board members would give the Board more power and flexibility to get the job done.  I invite any member who thinks they might have an interest in serving on the Board to view the structure and duties of Board members by looking at the eligibility requirements on the WRHA website at http://wrha.com/about/bylaws.  Scroll down to Article III.  Submit a resume through this email address: [email protected] or mail it to Washington Rural Health Association, PO Box 1495, Spokane, WA, 99210.  Please include a statement about why you want to serve and what you could add to the group.  We could use your help.

return to top


State Office of Rural Health: A Creative Idea Worth Funding


The State Office of Rural Health (SORH) is a virtual office, which, in addition to people within the Department of Health (DOH) includes partners throughout the state.  Together we are the Statewide Office of Rural Health (SwORH).   One of those partners, the Western Washington Area Education Center (WWAHEC) recently responded to a Request for Proposals from the National Organization of State Offices of Rural Health (NOSORH).  NOSORH was looking to individual state SORHs to create collaborative projects that would expand the SORH’s capability to meet rural health needs.

After consulting with potential partners, including the Area Health Education Center of Eastern Washington (AHECEW) and DOH, the CEO of the WWAHEC, Jodi Perlmutter, MSW, wrote a proposal to develop a system that would do a better job of integrating returning veterans into the rural healthcare employment marketplace.

While the Affordable Care Act will enable the majority of our state’s population to have health insurance, many will not be able to access health care due to workforce shortages.  However, Washington State is 10th in the nation for the number of returning veterans reentering the civilian workforce.  At Joint Base Lewis McCord returning soldiers are expected to re-enter civilian life at rate of 600 per month for the next 5 years.  Of those Veterans returning with specific skills, education and experience in health care 39% are unemployed.

According to the Veterans Health Administration Office of Rural Health about 3.4 million Veterans nationwide (41% of total) who are enrolled in the Department of Veterans Affairs (VA) Health Care System live in rural or highly rural areas of the country.  Washington is no exception.

In June 2012, at the Washington State Hospital Association’s (WSHA) rural hospital conference, a panel presented on this issue in order to gauge interest of rural hospital administrators in employing veterans.  The interest by administrators attending the presentation was overwhelmingly positive.  Many were veterans themselves, others already employ veterans.  At the presentation representatives from the SwORH, veteran organizations, MEDEX Northwest (the Physician Assistant program), WSHA, the Allied Center of Excellence, and rural hospital administrators were very interested in working together to develop a strategic plan on employment of veterans into rural facilities.

The results have not been announced yet from NOSORH, so we don’t know if WWAHEC will be awarded the grant, but regardless, we salute Jodi Perlmutter and WWAHEC for putting together an idea that would benefit veterans and their families, to say nothing of the patients that they would potentially serve.

return to top


Critical Care Ambulance Added to Palouse Base



Critical Care Ambulance Added to Palouse Base
Northwest MedStar is adding a ground ambulance to its Palouse base at the Pullman-Moscow Regional Airport beginning in November. The ambulance will be used to support the ongoing air operations of Northwest MedStar and will not replace existing emergency ground services in the area.

“We are pleased to hear news of Northwest MedStar adding a ground ambulance to their facility at the Moscow-Pullman Airport,” said Ed Button, fire chief of the Moscow Volunteer Fire Department & Ambulance Company. “The addition of another ambulance in our region provides additional options of service to the citizens of Moscow, Pullman, Latah and Whitman Counties. It has always been a mission of the Volunteers of the MVFD to serve the community and we’re happy to have Northwest MedStar as partners in providing additional medical transport services to our communities.”

“The Pullman Fire Department are all for patient care and seamless intervention from one point of transport to another. The helicopter and fixed–wing transportation options allow for rapid transport and intervention for patients that are critical,” said Scott LaVielle, fire chief of Pullman Fire Department. “Having an additional ground transportation option during inclement weather and from hospital to airport will enhance a solid Emergency Medical Services delivery system even further.”

The NW MedStar ground ambulance will be used to transport critically ill and injured pediatric and adult patients in inclement weather when the helicopter is unable to fly. It will also be used when patients are transported from the hospital to the airport when the NW MedStar fixed-wing aircraft is needed.

“Our ground ambulances are staffed and equipped exactly the same as our aircraft with everything the critical care team might need including a ventilator, hemodynamic monitors, medications, isolette for neonates and other medical supplies,” said Eveline Bisson, director for Northwest MedStar. “This insures that every patient receives the same level of care and expertise no matter what the mode of transport, improving access and availability to critical care and transport to patients in the Palouse region.”

Northwest MedStar, a Commission on Accreditation of Medical Transport Systems (CAMTS) accredited critical care transport program, provides high-quality care and transport to over 3,700 patients each year from its bases in Spokane, TriCities, Moses Lake and Pullman, Washington. All flights are conducted by, and operational control over all aircraft is exercised solely by Metro Aviation, Inc. A division of Inland Northwest Health Services (INHS), Northwest MedStar also offers a membership program that shields people from emergency air transport costs not covered by health insurance. For more information about Northwest MedStar or the membership program, visit www.nwmedstar.org. To support Northwest MedStar’s ongoing services through a commitment to the foundation, visit www.inhs.org/foundation or call (509) 509) 473-6370.

return to top


Focus on Safety and Quality Earns Northwest MedStar AAMS "Program of the Year" Award 



Focus on Safety and Quality Earns Northwest MedStar AAMS “Program of the Year” Award

Northwest MedStar, was named 2012 Program of the Year by the Association of Air Medical Services (AAMS) for exemplifying the best of the air-medical and critical care transport programs internationally.

“It is an honor for Northwest MedStar to receive this prestigious award from our peers and colleagues,” said Eveline Bisson, Northwest MedStar program director. “Northwest MedStar works with health care providers in the region to bring the best care and highest level of professionalism to critically ill and injured patients. We are proud to serve the communities of eastern Washington, northern Idaho, western Montana and northeast Oregon.”

Awarded by the industry’s international association serving providers of air and ground medical transport systems, the AAMS 2012 Program of Year award recognized Northwest MedStar for demonstrating safety consciousness, patient care excellence, commitment to quality improvement, community service, strong leadership and visionary innovation. All AAMS air medical programs worldwide are eligible for the Program of the Year honor.

“The team is highly-trained with ICU and emergency department experience,” said Dr. James Nania, medical director with Northwest MedStar. “The cases that Northwest MedStar handles are at the high end of tough, and the care they provide is at the high-end of wonderful.”

Communications Specialist Receives “Communicator of the Year”
Also honored at the AAMS Award Banquet on Monday, October 22, 2012 was Northwest MedStar Communication Specialist Stephen Thompson who received the 2012 “Communicator of the Year” award from the National Association of Air Medical Communication Specialists (NAACS). Stephen’s strong work as part of the Northwest MedStar communications team and his leadership over the Northwest MedStar safety committee made him standout among his peers.

Visit nwmedstar.org for more information about Northwest MedStar.

return to top


2013 Neuroanatomy Conference - A Clinician's Review



Friday, January 18, 2013 – DAY 1, 3:30 – 8 p.m.
Saturday, January 19, 2013 – DAY 2, 7:30 a.m. – 5 p.m.


Course Description
This course will provide an in-depth review of neuroanatomy of the central nervous system for medical professionals. Neuropathology and clinical correlation are also incorporated for application in the clinical setting. The intended audience is allied health professionals who have previous exposure to pertinent coursework in neuroanatomy. The structure of the course provides an opportunity for review of functional neuroanatomy in both children and adults and translation of that knowledge to clinical treatment.
Intended Audience: Physical Therapist/Physical Therapist Assistants; Occupational Therapists/Certified Occupational Therapist Assistants; Speech Language Pathologists; Nurses; and Psychologists.


Location
St. Luke’s Rehabilitation Institute, 711 S. Cowley, Spokane, WA

Accreditation
OT/COTA/PT/PTA CEU: 10.5 Hours
ASHA CEU: 10.5 Hours
Clock Hours: 10.5 Hours

Cost
Before December 17, 2012: $195
After December 17, 2012: $245
*Registration and payment must be received by noon of January 11, 2013.
For additional information, to register online or to view the brochure, visit www.st-lukes.org, click For Providers.

About the Instructor
Bernadette Gillick, PhD, MS, PT received her BS in Physical Therapy from Marquette University in 1993, her advanced masters in Neurologic PT from Chicago Medical School in 1998 and completed her PhD in Rehabilitation Science with a minor in Neuroscience at the University of Minnesota in 2011. Her thesis work in pediatric neuroplasticity incorporated transcranial magnetic stimulation and constraint-induced therapy in children and was funded by an NIH Challenge Grant. Dr. Gillick combines her clinical and academic work in pediatrics and neuroscience and has been a University Instructor in Neuroanatomy, Anatomy,Physiology, Electrotherapeutics, Human Growth and Development and Pediatrics. Her research lab investigates the use of non-invasive brain stimulation and behavioral interventions in children with stroke. She has been invited to speak internationally on topics surrounding neuroplasticity, neurorecovery and neuroanatomy. Dr. Gillick’s funding support includes the National Institute of Health, the Minnesota Medical Foundation, the Foundation for Physical Therapy and the American Academy of Cerebral Palsy and Developmental Medicine.

return to top


Regional Health Care System Planner


Have you connected with your local Health Care Coalition? They’re an excellent resource for networking with health care providers, EMS services, emergency management and others in your area. Their main focus is emergency preparedness & response planning to make our health care system more resilient during an emergency, but the value of participating is far beyond those objectives. Each coalition functions a bit differently, though most offer excellent meeting content and training opportunities that you may not otherwise have access to. Learn more by connecting with your region’s Health Care Coalition today!

Region 7 (Okanogan, Chelan, Douglas, Grant, Kittitas counties): [email protected]
Region 8 (Benton, Franklin, Klickitat, Walla Walla, Yakima counties): [email protected]
Region 9 (Ferry, Stevens, Pend Oreille, Lincoln, Adams, Spokane, Whitman, Columbia, Garfield, Asotin counties): [email protected]

return to top


Life Flight Network's New Top of the Line C-MAC PM




submitted by: Erick Borland, LFN Director of Marketing

The ability for a critical care medical team to safely and quickly insert an endotracheal (ETT) tube in less-than-ideal pre-hospital environments can ultimately make the difference between life and death. The importance of this critical step in patient care was the deciding factor in Life Flight Network’s (LFN) recent purchase of 12 Storz C-MAC PM “pocket monitor” video laryngoscopes at the Air Medical Transport Conference (AMTC) in Seattle last month. The C-MAC PM is a small lightweight device recently approved by the FDA to help care providers insert endotracheal tubes in emergent situations. LFN is the first flight program in the Western United States, and one of only two in the country, to utilize this device offering the latest technology.

Dominic Pomponio, LFN’s Director of Clinical Operations for eastern Washington, explains, “The 2.4 inch video monitor on the C-MAC PM provides a contrast-rich image to guide the process of inserting the endotracheal tube, even in bright sunlight. This medical device offers many benefits, but the visual guide provided by the video system significantly enhances our ability to intubate patients quickly and safely with the highest degree of confidence. Our selection of the C-MAC PM intubation technology is one of many examples of how LFN supports our critical care teams by providing the most effective medical and flight equipment. Every purchase is measured by how it will help us work effectively with local EMS providers to prepare patients for emergent critical care transport and deliver the highest level of care possible.”

In discussing the investment in this medical technology, Life Flight Network’s CEO Michael Griffiths states, “The service we provide has us treating people on one of the worst days of their life. We have consistently provided our critical care teams with the tools they need to save lives and provide better outcomes for our patients. There are a number of less expensive alternatives to the C-MAC PM, but none match the benefits this new tool will deliver to our teams and their patients.” The C-MAC video laryngoscopes will be put into service at all helicopter bases providing service in Washington by the end of November.

return to top


WRHA Awards


submitted by: Linda Steele, RN/Life Flight Network Customer Service Manager

Brian and Tracy Arness are uncertain what happened the night of July 28, 2012. One thing is for certain, their lives depended upon the teamwork of numerous people after their convertible Cadillac roadster left the road in Cathlamet, Washington. Hitting an embankment at 45 mph caused immediate life threatening injuries.

Carol Wedhagl, Cathlamet Fire Department EMS Battalion Chief was outside enjoying the weather when Cathlamet Fire, Wahkiakum County District #4, and the Wahkiakum County Sheriff’s Office received the call for help. Life Flight Network was placed on standby based upon the dispatch report. The responding agencies arrived on scene simultaneously and recognized the significantly damaged vehicle belonged to the Arness family.

Upon arrival Jodie Twater RN / EMT assessed the situation, requested the helicopter and determined Brian, who was moaning with visible left-sided weakness, was the most critical patient and needed to be flown to a trauma center. Tracy had significant facial bleeding; however she was conscious and able to answer questions appropriately. Jodie helped to rapidly extricate Brian out of the vehicle and transport him to the landing zone. Life Flight 7 arrived in less than 10 minutes from its Longview, WA base.

Flight nurse Jeff Santella recalls, “Cathlamet Fire was well prepared for our arrival with the patient packaged and ready to go.” He and flight medic Rick Schneider recognized Brian showed symptoms of a traumatic brain injury and an increasing inability to maintain his own airway. Rick comments, “His treatment, especially securing the airway, was a real team effort. The crew was outstanding and helped make a difficult call go smoothly.” Using a CMAC-PM, Rick placed an endotrachael breathing tube and the crew kept Brian sedated during the flight. They closely monitored him for neurological changes as they flew to the nearest Level II trauma center, Southwest Medical Center in Vancouver, Washington. Dr. Febinger and the trauma team were standing by.

Meanwhile, Tracy was being transported to St. John Medical Center in Longview by Cathlamet EMT-IV Technician Dan Bigelow. As the Cathlamet BLS unit approached the county line, they were met by an American Medical Response ALS unit. They determined Tracy’s declining mental status and complex facial injuries needed rapid transport to a high-level trauma center. They activated Life Flight 2 from Aurora, OR and met them at a pre-designated landing zone in Cowlitz County.

The critical care team (Trevor Liston, flight nurse, and Val Beedell, flight medic), determined an advanced airway was needed as Tracy’s face began to swell and she began vomiting uncontrollably. Val inserted an endotracheal breathing tube and administered pain medication and sedation for the transport. Tracy remained stable en route as the crew worked to control the copious amounts of blood from her facial injuries prior to arrival at Southwest Medical Center.

Brian’s injuries included traumatic brain injury with resulting left hemiparesis, subarachnoid hemorrhage, multiple facial fractures with complex facial lacerations and posterior rib fractures on the right side. He remained in the hospital for 10 days before going to inpatient rehab for another week.   Tracy sustained a complex LeFort 3 fracture, orbital floor blowout facial fracture, and a shattered right ankle. She stayed in the hospital for eight days, and has required further multiple facial surgeries to repair her fractures.

Brian and Tracy’s injuries are less than four months old, and while continuing the healing process they are trying to maintain normalcy in their life with their two “loving” mastiffs and two Chesapeake dogs. Brian continues to have remnants of left-sided paresthesias and struggles with constant pain in both his head and jaw. Tracy lost vision in her right eye and requires additional facial surgeries. Family members and the Cathlamet community have provided the Arness family with an enormous amount of help and support, including fundraisers in Tracy’s hometown of Astoria and in Wahkiakum County.

Carol notes, “We all understand how difficult it is to control yourself when caring for someone you know – which happens regularly in Cathlamet.” She adds, “Having Life Flight Network available to quickly transport our patients to a higher level of care has absolutely saved lives and improved outcomes. Life Flight Network’s critical care teams are focused, calm and make us feel as extensions of care. We look forward to a continued EMS care team approach to better serve the residents of Wahkiakum County.”

“The ability to provide more than one helicopter in a multiple patient scene is just one of the benefits Life Flight Network’s community-based approach can provide,” states Brad Delorme, Director of Clinical Operations for Region 1. He continues, “The early decision to put Life Flight Network on standby, followed by this timely double activate and the teamwork shown by all EMS crews involved certainly helped secure a better outcome for this injured Cathlamet couple.”

return to top