Rural Hospitals Initiatives - Program Updates

Rural Hospitals Initiatives - February 2011

The Office of Rural Health is proud to announce that we have scheduled our 3rd Annual Wisconsin Rural Health Summit for May 24th at Chula Vista in Wisconsin Dells. We hope you can join us to learn how the changes on the State and Federal level have impacted rural health care. Don’t miss this opportunity to learn from, and network with, other rural health professionals. This year we are pleased to have Brock Slabach from the National Rural Health Association (NRHA). Brock will provide a legislative update from the federal level. We will also have local rural health experts to provide us with state updates.

After the Summit, take advantage of all Chula Vista has to offer. Stay overnight and attend the Hospital Trustee Training that we will be holding on May 25th. The training is an interactive workshop for rural hospital board members. Registration will be available soon. You may contact Kevin Jacobson with questions.

The Rural Health Summit is just the beginning of what we have in store for training opportunities:

Due to popular demand, we are bringing back the EMS Leadership Academy. The Academy is a two-day course for new, current and future leaders of ambulance services. For those of you who attended the Level One courses that were offered in 2010, we are now offering Level Two classes in Ashland on June 9th and 10th, and in Weston on June 11th and 12th. We have also scheduled Level One classes in Neenah on May 12th and 13th, and in Tomah on May 14th and 15th. We are able to provide these trainings to you free of charge. Registration will be available shortly. If you are not already on our EMS listserv, be sure to sign up, so you don’t miss announcements regarding this, and future trainings. You can contact me at kmiller9@wisc.edu.

We are helping to subsidize the cost of attending the Comprehensive Advanced Life Support (CALS) Course in Oconto, to be held on March 30th and 31st. The CALS Courses are available for Physicians, Mid-levels, nurses and EMS professionals. CALS uses a Universal Approach, is scenario-based, promotes a team environment, teaches the knowledge and skills necessary to treat life-threatening emergencies, and includes emergency management for patients across the age spectrum. If you are from a Critical Access Hospital or a small rural hospital under 50 beds, the Office of Rural Health is providing a subsidy to cover a portion of your registration fee.

Our office is joining with the National Farm Medicine Center of Marshfield Clinic to sponsor the Wisconsin AgriSafe Training. The training is part of a national strategy to develop AgriSafe clinics nationally. The AgriSafe Training Course offers a core curriculum in agricultural medicine and health and Safety. The course is targeted toward to Physicians, residents, mid-levels and other allied health professionals. It is designed to train rural health care providers for the diagnosis, treatment, and prevention of agricultural occupational illnesses and injuries. The course will be held in Marshfield, and is divided into two sessions. Session 1 will be March 31-April 2 (Thursday-Saturday) and Session 2 will be on October 13-15 (Thursday –Saturday).

AgriSafe is also offering a series of webinars. Their next webinar is scheduled for February 2nd at 12pm CST. The topic will be: Health Care Reform can Mean Improving Health of Rural People. The presenter will cover topics such as: provisions in the Affordable Care Act that could be used to improve services in rural communities; how to integrate independent programs to benefit rural communities; how rural residents might benefit from expanded access to affordable health plans; and how to use new programs in health workforce training to improve cost effectiveness of the system. A full list of webinars can be found here.

WHITEC--the Wisconsin Health Information Technology Extension Center is offering a Meaningful Use Forum in Appleton on the evening of February 24th. The Forum is designed for Physicians, practice managers, nurse practitioners, physician assistants and certified nurse midwives practicing in a non-hospital setting, and is being offered free of charge. You will learn how using electronic health records can help improve patient care, boost efficiency, meet new meaningful use requirements and qualify you for federal incentives. Attendees will learn how WHITEC can help and get answers to your questions from speakers with first-hand knowledge and tips. If you have any questions, you may contact Ashley Green, HIT Specialist, WHITEC.

If you have any questions on any of these educational offerings, do not hesitate to contact me. Keep in mind that our office has several listservs that we use to notify you of upcoming events, trainings, Health Care Reform updates and changes in Medicare regulations…just to name a few. We have listservs for Rural Health Clinics, EMS providers, CAH Financial Managers, CAH Nurses and CAH Administrators. If you are not part of our listservs, please contact me and I can get you signed up!

Kathryn Miller, Rural Hospitals & Clinics Program Manager, 608-251-1891

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Rural Hospitals Initiatives - December 2010

I’d like to take this opportunity to wish everyone Happy Holidays and a prosperous New Year! Here at our office, we are busy planning a number of events for 2011. Mark your calendars for May 24^th, when we will be holding our 3^rd Annual Wisconsin Rural Health Summit. The Summit will be held at the Chula Vista Resort in Wisconsin Dells. Be watching for more details.

Due to popular demand, we will be offering more of the EMS Academy Courses in May and June of 2011. We are working to schedule Level Two courses in Ashland and Wausau, as well as some Level One courses in Southern Wisconsin. Datesavers will be sent out shortly. If you are not already a member of our EMS listserv, please contact me and I will get you signed up.

If you have any questions, please contact me at 608-261-1891 or kmiller9@wisc.edu

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - November 2010

Mark your calendars for Thursday, December 2^nd. At 11:00 a.m., we will be holding Part Two of “Be Prepared, Take Charge of the Survey Process.” Katherine Kuchan of Hall, Render, Killian, Heath & Lyman will present a continuation of her first webinar held on August 23^rd. Be looking for more information, which I will be sending out on the cahnurses and cahcoalition listservs. If you are not a member of these listservs, and would like to join, simply contact me at kmiller9@wisc.edu.

Rural Health Clinics: you will want to consider attending the WHITEC Meaningful Use Forum on November 18, 2010. WHITEC (the Wisconsin Health Information Technology Extension Center) is the Wisconsin’s federally-designated entity responsible for assisting primary care providers, and now rural hospitals, as they work to meet the challenges of EHR adoption. The WHITEC Meaningful Use Forum is free. Attendees will learn how using electronic health records can help improve patient care, boost efficiency, meet new meaningful use requirements and qualify for federal incentives. The Forum targets physicians, practice managers, nurse practitioners, physician assistants, certified nurse midwives, dentists, chiropractors, optometrists and podiatrists practicing in a non-hospital setting who want to understand how the government’s meaningful use requirements will impact their practice. To register for the Forum, you may visit www.whitec.org. If you have any questions, you may call 1-866-710-4212.

Critical Access Hospitals and Small Rural Hospitals: I would also like to take this opportunity to tell you about an exciting opportunity for your hospital to reduce pressure ulcers prevalence in your facilities. The Wisconsin Pressure Ulcer Coalition (WPUC) is now accepting enrollment into their ongoing collaborative. WPUC is a collaboration of hospitals, skilled nursing facilities, home health and hospice agencies, and assisted living facilities. Their mission is to prevent pressure ulcers while fostering cross-setting communications. In 2009, WPUC participants decreased their pressure ulcer prevalence by 33% and their facility-acquired rate by 24%. The current self-reported data for 2010 shows WPUC members have reduced pressure ulcer prevalence by 14%!

Through federal funding offered by our office, Critical Access Hospitals can join the WPUC at a reduced rate of $250 (normally $750). Note: hospitals of less than 50 beds are also eligible. For more information, or to sign up, visit: http://www.metastar.com/web/Default.aspx?tabid=376.

If you have any questions, please contact me at 608-261-1891 or kmiller9@wisc.edu

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - August 2010

As you’ve no doubt heard by now, CMS has released the final HIT Incentive Rule. We are fortunate to have the expertise of Louis Wenzlow of the Rural Wisconsin Health Cooperative, who has dedicated himself to understanding and explaining each key component of the Rule. Please take a moment to visit Louis’ blog, on our website, where he is reporting on each of the Meaningful Use objectives.

On Tuesday, August 17, we will be sponsoring the annual CAH/Rural Hospital Financial Workshop at the Holiday Inn in Tomah. Topics for this year’s workshop will include Meaningful Use, Medicare Cost Reports (including Uncompensated Care), Medicare Updates, 340B, and the 2011 Hospital Assessments for PPS and CAHs. The Workshop is offered to you free of charge. Registration is required – the deadline is August 5.

Mark your calendars for Monday, August 23. We will be offering a free Webinar at 11:00 a.m., entitled “Be Prepared – Take Charge of the Survey Process.” The featured speaker is Katherine Kuchan of Hall, Render, Killian, Heath & Lyman. Ms. Kuchan will cover the “key” considerations of pre-survey preparedness and the legal issues in medical record documentation. Please be watching for connection information, which I will be sending on the listservs (cahnurses and cahcoalition). If you are not a member of one of these listservs, please contact me and I will get you signed up!

If you have any questions, please contact me at 608-261-1891 or kmiller9@wisc.edu

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - May 2010

I want to extend my thanks to those of you who attended the 2^nd Annual Wisconsin Rural Health Summit on May 10^th. In all we had 115 participants representing a variety of rural health care sectors. The day started out with a presentation from Rural Epidemiologist, Shaun Golding, who provided data and statistics that shed some light on the current “state” of Rural Wisconsin, with a focus on rural inequities. The morning concluded with presentations on the American Recovery and Reinvestment Act (with a focus on meeting “Meaningful Use” requirements), and a review of Health Care Reform as it impacts rural providers. In the afternoon, attendees were able to choose from four breakout sessions. All sessions centered on collaborative efforts between health care sectors, and innovative programming opportunities: 1) Rural Hospitals and Clinics, 2) Rural Hospitals and Skilled Nursing Facilities, 3) Rural EMS Providers and Rural Hospitals, 4) Rural Communities and Oral Health Programs. If you were unable to attend the summit, please click here to view the handouts from the presentations.

Let me take this opportunity to tell you about some important upcoming events. The Wisconsin Hospital Association’s 2010 Wisconsin Rural Health Conference is being held June 23-25 at the Kalahari Resort in Wisconsin Dells. Our office is once again a proud sponsor of this event, as well as MetaStar, the Rural Wisconsin Health Cooperative, and the Wisconsin Primary Health Care Association. The Wisconsin Rural Health Conference is designed to highlight public policy issues affecting rural health care; identify how the delivery and access to rural health care are changing; and identify ways in which technology is improving health care access for rural populations. CEO’s, administrators, CFOs, controllers, medical directors, quality managers, hospital board of trustees, and public health officials are all encouraged to attend! To learn more about the event, or to register, click here. The registration deadline is June 2^nd.

Another exciting event is also being held at the Kalahari Resort from June 23-25: the 42^nd Annual Emergency Care and Trauma Symposium. The University of Wisconsin School of Medicine and Public Health organizes the Symposium every year, with sponsorship from several organizations including the Office of Rural Health. The Symposium is designed to help emergency medical personnel improve their professional performance in the field. This conference will benefit all levels of EMS, emergency nurses, and other allied health professionals. The Symposium is authorized for 2.4 continuing education units (CEUs), or 24 hours! For more information, or to register, click here.

If you have any questions, please contact me at 608-261-1891 or kmiller9@wisc.edu

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - March 2010

The Wisconsin Office of Rural Health will be sponsoring the 2nd Annual Wisconsin Rural Health Summit on Monday, May 10th at the Kalahari Resort in the Wisconsin Dells. Don’t miss this opportunity for all rural health sectors to discover ways that we can collaborate to improve rural healthcare in Wisconsin.

We’ll be gathering providers and stakeholders from across the state, from all sectors of Rural Healthcare:

Hospitals
Clinics
EMS
Public Health
Long Term Care
Dental Health
Advocates
Legislators

We’d like you to be there as we step out of the comfort zone of our own communities and facilities, and take a more global approach:

How can we most effectively work with other healthcare sectors in our own communities?
What can we accomplish when our hospitals and EMS collaborate?
How can our community Skilled Nursing Facilities become more viable? What can the hospital do? What can the community do?
How can we work together to communicate the needs of rural health to our legislators?

This year’s Summit will feature Louis Wenzlow, Director of Health Information Technology at the Rural Wisconsin Health Cooperative. Louis will present: CMS Proposed Meaningful Use Requirements: What Providers Need to Know.

In his presentation, Louis will be discussing the CMS proposed requirements for the meaningful use of electronic health records. He will provide answers to questions such as: (1) who will qualify? (2) what are the timelines? (3) how much will be paid?, and (4) what is "meaningful use?"

Be watching for registration materials! As always, registration is free, and breakfast and lunch will be provided!

We will be reserving a block of rooms at Kalahari, at a special discounted rate. Bring your family for a fun-filled weekend, then stay for this can’t-miss event! Note: The room-block will open up once the registration materials have gone out.

If you have any questions, please contact me at 608-261-1891 or kmiller9@wisc.edu

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - February 2010

On November 13, 2009, WI-ORH held the “2009 Meeting for Wisconsin Rural Health Clinics” at the Rural Wisconsin Health Cooperative in Sauk City. Jeff Bramschreiber from Wipfli presented “Topics in RHC Billing, Cost Reporting and Reimbursement.” Bill Finerfrock, Executive Director of the National Association of Rural Health Clinics (NARHC), provided a legislative update, and the Coker Group shared information on the challenges that RHCs face with ARRA. If you did not have the opportunity to attend in-person, you can go to http://www.worh.org/Ruralwork#workshops to view the recorded sessions. For an additional training opportunity, don’t forget, the Annual Rural Health Clinic Forum will be held in Green Bay on March 23-24, 2010. The Forum is hosted by Wipfli and provides a wonderful opportunity to network with other RHCs across Wisconsin. The above link provides conference details and full speaker bios!

I am in the initial stages of planning training and educational events for 2010. Part of our mission at WI-ORH is to provide free, quality training opportunities to Wisconsin’s rural health providers. Last year’s events included two in-person Grant Workshops, and two webinars on Recovery Audit Contractors (RAC) & Proper Coding Procedures. We also hosted our annual Hospital Finance Workshop which included topics such as: ARRA/Stimulus funding, HPSAs and RHCs, Medicare Cost Reporting, and a CAH Regulatory Update. At the current time I am gathering topic ideas. I encourage you to keep me advised of what training needs that you and your facilities have. What training topics would CAH Nurses like to see? What are the educational opportunities that we could provide for CAH Financial staff? What would you like to know about Medicare reimbursement, CAH Regulations, or state surveys?

As far as training opportunities for EMS Professionals, we are planning on holding two EMS Leadership/Management trainings across the state. Additionally, we’ll be developing a series of on-line educational opportunities, designed to help EMTs and First Responders to maintain their licensure/certification requirements. Please let me know what types of training you would like to see, and I’ll do my best to incorporate them.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - November 2009

I am pleased to announce that the “2009 Meeting for Wisconsin Rural Health Clinics” has been scheduled for Friday, November 13 from 8:30-3:30 at the Rural Wisconsin Health Cooperative. Don't miss this opportunity to come together with other Wisconsin RHCs for a chance to network, learn about new rules and regulations, and receive an update on what's happening at the national level. This meeting includes lunch, and is being offered to you free of charge through financial support from the Wisconsin Office of Rural Health

We are offering an exciting agenda. Bill Finerfrock, Executive Director of NARHC will be joining us from D.C. via webinar. We are also bringing in an expert on ARRA (AKA "Stimulus"), who will be joining us from Pennsylvania, also via webinar. If you are unable to attend in-person, I will be sending information out on the RHC listserv on how to connect to the webinars. If you are not signed up for the RHC listserv, please contact me at kmiller9@wisc.edu and I will get your name added.

Jeff Bramschreiber from Wipfli, Mary Peterson from Mile Bluff, and myself will all be presenting on-location. All of these presentations will be taped for future viewing. Download a full agenda; registration is due by November 6. You can email, mail or fax the form directly to me.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - October 2009

I wanted to take the opportunity to tell you about the "Club Scrub” Program. “Club Scrub” is a program designed to expose 7th and 8th grade students to health care careers in a way that engages them and opens their minds to possibilities in career choices that they may not have considered, and to do so at an early age.

WI-ORH has collaborated with the Rural Wisconsin Health Cooperative to bring you a comprehensive Club Scrub “Toolkit” that has everything you will need- forms, letters, and lesson plans. You are encouraged to customize these materials to your own hospital. To learn more about Club Scrub, please go to: http://www.worh.org/ClubScrub. The complete Toolkit is available for a free download, in Word and PDF formats.

Also now available on our website: The “Financial Effects of Wisconsin CAH Conversion 2009” report. This is the fourth report of its kind that the Rural Wisconsin Health Cooperative has produced for us. The report can be found at: http://www.worh.org/CahDataRpts. You will also find reports from past years at the same location.

Finally, I want to remind you of our recent collaboration with the Wisconsin Hospital Association: the Health Care Performance Improvement Education Series. This series features four quality improvement methodologies commonly used by healthcare organizations. They are: Six Sigma Process Improvement Methodology, the Model for Improvement and the Lean Model for Performance Improvement. Also featured is a module that helps you choose the right tool based on the type of the facility and type of project. This series can now be viewed on WI-ORH’s website at http://www.worh.org/Ruralwork#present.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - August 27, 2009

In the past couple of months, I have had the opportunity to be a part of some very exciting educational events. I encourage you to go to http://www.worh.org/Ruralwork, where you will find recent webinars, and recorded educational events.

On July 8th, WI-ORH sponsored the second webinar, in a two part series, “Reporting Accurate Codes.” This webinar was a follow up to the June 22^nd webinar, “RACs are Here, Now What.” We partnered with Eide Bailly on both sessions. You will find both webinars at the above noted web address.

On July 31^st, WI-ORH held the “EMS Leadership & Management Workshop” at the Rural Wisconsin Health Cooperative (RWHC) in Sauk City. “EMS leadership education” was defined as a priority in our Rural Wisconsin Emergency Medical Services Needs Assessment, 2007:. As a result, the WI-ORH designed this workshop, offering three topics related to EMS leadership and management. The three areas include: managing human resources, operations education/training issues, and medical direction: working with your medical director. You will find video/audio of each speaker, as well as their PowerPoint presentations on WI-ORH’s website.

On August 11^th, I attended the Wisconsin Hospital Association’s (WHA) Recovery Audit Contractor (RAC) Forum, held at the American Family Education Center in Madison. The Forum provided a chance for hospitals across Wisconsin to learn about the impending RAC Audits. Both CMS and CGI Federal (Wisconsin’s Contractor) where in attendance to provide information and field questions. The Forum was recorded, and is available at http://www.wha.org/governmentRelations/rac.aspx. You will find other up-to-date and helpful information regarding RAC on WHA’s website.

On August 19^th, WI-ORH sponsored the Rural Hospitals Finance Workshop. The workshop was held at the Rural Wisconsin Health Cooperative, with 35 people in attendance. This workshop is held annually, and we are always able to offer it free of charge with the help of the Medicare Rural Hospital Flexibility Grant. Each year we work with our partners, WHA and RWHC to develop topics of interest to CFO’s and other financial staff at Critical Access Hospitals in Wisconsin. In addition to WHA and RWHC, we had planning assistance and wonderful presentations from Hall, Render, Killian, Health & Lyman, as well as the Wisconsin Department of Health Services, Division of Public Health. If you weren’t able to attend in-person, you will find the recorded presentation on WI-ORH’s website.

Please keep in mind that I am always very open to ideas for future topics, not only for finance professionals, but any other groups of healthcare providers as well. Part of our mission here at the Office of Rural Health is to provide healthcare professionals with free or low-cost educational and training opportunities. In fact, it won’t be too long before our office will be planning the next CAH Nurses Workshop. It was members of our CAH Nurses Listserv that encouraged us to provide education on the upcoming Recovery Audit Contractor (RAC) Audits, so I’ll be looking to that group, once again, to tell me what the “hot topics” are, as well as the areas of training that are currently needed.

Finally, I want to tell you about a very exciting collaboration between WI-ORH and WHA – the Health Care Performance Improvement Education Series. This series features four quality improvement methodologies commonly used by healthcare organizations. They are: Six Sigma Process Improvement Methodology, the Model for Improvement and the Lean Model for Performance Improvement. Also featured is a module that helps you choose the right tool based on the type of the facility and type of project. These modules can be found within the University of Wisconsin’s IME Video Library at: http://videos.med.wisc.edu/event.php?eventid=95

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - July 1, 2009

We had an outstanding turnout for the Webinar that we hosted, “RACS are here, now what?” which was held on June 22. ORH worked in collaboration with JoNell Moore, RN and Principal at Eide Bailly, LLC. JoNell presented a general overview of the history of RAC Audits, what to expect at your audit, and how to prepare your facility. Over 80 hospital CEO’s, CFO’s, Nurses and other staff participated. If you didn’t have the opportunity to join in, you can view the Webinar in its entirety at http://worh.acrobat.com/p40629838/

On Thursday, July 9, ORH will be hosting a second RAC Webinar, entitled “Reporting Accurate Codes.” The Webinar will be held at 1:00 p.m., and will be presented by Sue Roehl, RHIT, CCS and Manager at Eide Bailly. Sue will review the ICD9-CM Official Guidelines for Coding and Reporting, hot topics identified by previous RAC reviews, medical necessity and Physician documentation requirements, and other coding compliance issues. I will be sending a link to Sue’s presentation via our listservs (CahCoalition, CahFinancialManagers and CahNurses.) If you are not currently a member of one of these listservs, please contact me at kmiller9@wisc.edu and I will be sure you receive the link.

In other news, ORH has been working with the Wisconsin Hospital Association and the American Heart Association on the “Rural Hospital Stroke Improvement Project.” The project, which is currently in its second year, strives to improve stroke care in Wisconsin’s rural hospitals. Each hospital that participates enters patient stroke data in the “Get With The Guidelines Patient Management Tool,” which includes the consensus measures endorsed by the American Stroke Association. This collaborative project has recently received recognition in the May issue of the “Circulation: Cardiovascular Quality and Outcomes” Journal, a publication of the American Heart Association. The article draws an insightful conclusion that “targeting rural hospitals through a stroke improvement project contributes to development of a state stroke system of care, understanding gaps in care and specific stroke measure improvement.”

The long-awaited Recovery Audit Contractor (RAC) Forum will be held on August 11 from 1-4 pm at the American Family Education Center in Madison. A big thanks to the Wisconsin Hospital Association (WHA) for organizing this important educational opportunity! Registration is required. The program is available for live in-person attendance or via teleconference.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - May 29, 2009

I am in the process of developing several educational events. In late June or early July we will be hosting a two-part webinar on Recovery Audit Contractor (RAC) Audits. The first in the series will provide general information on RAC Audits, with a focus on 1) What the contractors are looking for, and 2) What you should be doing to prepare. The second part of the series will review proper coding practices, with a focus on what coding mistakes that the contractors are commonly seeing in their audits. The webinar series will be offered at no charge. Please be watching the website for more details, as I will be selecting the date(s) shortly.

Additionally, I am working with the financial experts at the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative to plan our annual “CAH Financial Workshop.” We are targeting this event for August. Again, please be watching the website for details. Remember, if you are not currently signed up for one of our listservs, please consider signing up. The listservs are a quick and handy way for me to send out notices of upcoming educational events. Additionally, the listservs are a valuable source for legislative updates and policy changes, and provides you with the chance to communicate with other professionals in your healthcare sector. We offer three different listservs specific to Critical Access Hospital staff (one for nurses, one for financial managers, and another for administration). In addition to the CAH listervs, we also host a listserv for Rural Health Clinics and another for EMS Providers. Please do not hesitate to contact me if you’d like more information, or if you’d like sign up.

As always, if your facility and/or staff have any educational/training needs, or know of any “hot” topics that our office could design a training for, please contact me. I am always ready to hear new ideas.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - April 28, 2009

I want to thank everyone who was able to take time out of their busy schedules to attend the Rural Health Summit on April 22. The Summit was held at the Kalahari Resort in Wisconsin Dells, with 109 people in attendance! What a wonderful turnout! We had representation from all healthcare sectors: Rural/Critical Access Hospitals, Rural Health Clinics, Community Health Centers, EMS, Long Term Care, Public Health and Oral Health.

Each sector was given the opportunity to meet together with other like-providers, with the goal of identifying the top issues affecting each of their respective sectors. Data from those sessions were compiled, and all sectors worked tighter to identify the top issues facing the Rural Healthcare System as a whole.

The end result of the Rural Health Summit will be a final report to be presented to Wisconsin Legislators. This will be an important first step toward not only identifying the issues, but working toward potential solutions. Your participation in the Summit will go a long way in bringing these issues to light and educating our legislators on the challenges we face as rural healthcare providers. As soon as the final report is completed, it will be made available on the Rural Health Summit Website (www.ruralhealthsummit.org). The report will include the top issues identified by each sector, as well as the top issues affecting the rural healthcare system as a whole.

A special thank you to Representative Jon Richards, who took time out of his schedule to join us. Representative Richards presented updates on current healthcare legislation, talked about rural health issues facing the State, and fielded questions from the audience.

If you were unable to attend, please take a moment to visit the Summit website at www.ruralhealthsummit.org. This website contains Joan Curran’s (Gunderson Lutheran) presentation on the Stimulus package and Health Reform Initiatives, and John Eich’s (Office of Rural Health) presentation on the “State of the Rural State.” As more Summit results and other key information becomes available (such as the final report), it will be made available to you on the Rural Health Summit website.

In other news, I have the privilege of attending the National Rural Health Association (NRHA) Annual Conference May 5-8. One of the hi-lights of the conference will be a seminar on “Accessing Stimulus for Your Community.” The seminar will provide an overview of the American Reinvestment and Renewal Act (ARRA), with a special focus on Health Information Technology (HIT) implementation. I hope to gain a lot of valuable information that I can bring back to share with rural healthcare providers here in Wisconsin.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - March 31, 2009

WI-ORH staff have been very busy planning the Rural Health Summit, which will be held on April 22 at the Kalahari in Wisconsin Dells. Over 100 rural health providers will be in attendance, representing each rural healthcare “sector,” including: critical access hospitals, rural health clinics, EMS, Public Health and Long Term Care. The Summit will include a review of the “State of Rural Health in Wisconsin,” and a presentation on the Stimulus Package & Health Reform Initiatives. Most of the day will be dedicated to hearing from each of the rural healthcare sectors. We’ll be asking, “What do you need to do your job better?” What are the areas of concern that you’ve identified? What are the barriers to providing quality healthcare? The goal of the Summit is to identify and prioritize the top issues in each sector that impact the overall Rural Healthcare System. We will begin thinking about how we all, as rural healthcare providers, can collaborate together to improve the state of rural healthcare in Wisconsin. The end result of the Summit will be a professionally-prepared report to Governor Doyle. For more information on this exciting event, please visit: www.ruralhealthsummit.org.

In addition to Summit planning, I am currently working on plans for an educational workshop for Critical Access Hospital Nurses. I am working on finding a presenter of the topic of Recovery Audit Contractors (better known as “RAC Audits.”) The workshop will go over RAC readiness, what to expect, what the contractor is looking for, and other general concepts. I hope to make this event available on-line. Please be on the lookout for more information...coming soon.

I am always looking for educational topic ideas, of interest to CAH and RHC staff- including nursing staff, CFO’s, CEO’s and/or Clinic Managers. Please do not hesitate to contact me with any training and/or technical assistance needs that you or your staff have.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - February 25, 2009

I have now been in the position of Rural Hospitals and Clinics Program Manager, here at the Wisconsin Office of Rural Health for five months. In this time, I have had the wonderful opportunity to visit some of the Critical Access Hospitals around the state. In 2009, I plan to do some more traveling around the state to visit even more hospitals and rural health clinics.

I want to take this opportunity to tell you about several upcoming events.

On Wednesday, April 22, the Wisconsin Office of Rural Health is hosting the Wisconsin Rural Health Summit. The Summit will offer a brief review of statewide rural health projects (and their outcomes), and will present data on the “state of the rural health and healthcare.” Each type of provider (hospitals, clinics, EMS and public health) will have the opportunity to meet with their fellow providers to discuss “Rural Health Needs in 2009.” Invitees include: Representatives from Wisconsin Critical Access Hospitals, Rural Health Clinics, Emergency Medical Services (EMS) providers, the Wisconsin Hospital Association (WHA), the Rural Wisconsin Health Cooperative (RWHC), the Department of Health Services (DHS), the Wisconsin Primary Health Care Association, and MetaStar. The Summit will be held in Wisconsin Dells (specific location TBA). There will be no charge for this event. Breakfast and Lunch will be provided. More information on this “can’t miss” event will soon follow. If you have any questions, please do not hesitate to call me!

On Thursday, April 2, 2009, the 6th Annual Wisconsin Comprehensive Cancer Control Summit will be held at the Holiday Inn Hotel and Convention Center in Stevens Point. The focus of this year’s Summit is Rural Cancer Issues. There is no registration fee for the Summit or Pre-Summit Reception. Continental breakfast and lunch will be provided. Light appetizers will be served at the Pre-Summit Reception. Don't miss this wonderful opportunity!

On Friday April 17, from 1-4:45 p.m., the UW School of Medicine & Public Health and UW-Health are sponsoring the “UW Health Stroke Conference.” The conference will be held in the Health Sciences Learning Center (HSLC), 750 Highland Ave., Room 1325. HSLC is located adjacent to UW Hospitals and Clinics. The conference fee is $100, and includes educational credits. Free attendance is available without educational credits, but registration is still required. The registration deadline is April 10, 2009. This conference is intended for physicians, physician assistants and nurse practitioners who work with patients in acute stroke and stroke prevention settings. For questions about registration, you can contact Jeannie Doescher at 608-263-5420 or doescher@neurology.wisc.edu.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - October 31, 2008

I would like to take this opportunity to introduce myself. My name is Kathryn Miller. I started here at the Office of Rural Health on September 29th, as the Rural Hospitals & Clinics Program Manager. I will be primarily responsible for managing the Medicare Rural Hospital Flexibility Program, or “FLEX” (a federal grant that supports rural communities in preserving access to primary and emergency health care services).

On October 14th, I had the honor of attending the Rural Health Clinic & Critical Access Hospital Conferences held by the National Rural Health Association (NRHA). This presented a wonderful opportunity to meet many professionals in the rural health field and to begin my journey into learning more about rural health.

On October 21st I attended the “FLEX Program Workshop” in Duluth, MN. The workshop was presented by the Rural Health Resource Center. At this workshop, I met other professionals from Rural Health Offices across the United States. This presented a wonderful opportunity for me to learn not only what I will be doing as the Rural Hospitals & Clinics Program Manager, but also how other states and Rural Health Offices are using their FLEX funding to help rural hospitals and clinics.

This is indeed an exciting opportunity for me. As I continue to increase my base of knowledge, I look forward to becoming one of the resources that rural health clinics and critical access hospitals will be able to turn to for technical assistance. Furthermore, I am excited to be part of a wonderful and skilled team who are making a difference in rural health care in Wisconsin.

Kathryn Miller, Rural Hospitals & Clinics Program Manager

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Rural Hospitals Initiatives - May 23, 2008

Greetings,

Once again, it has been my pleasure to work with all of you. I can not believe how quickly the past 3 months have gone, while I have been filling-in here at the Office of Rural Health. The interview process for the Rural Hospital Program Manager is currently underway.

I am pleased with the progress of this year’s federal Flex Grant and found great satisfaction being able to assist in the writing of next year’s grant. In addition, the Wisconsin Rural Health Plan is in the final stages of development, after background information was collected, and focus groups and a statewide rural health planning meeting have been held.

My best wishes and farewell, again, Char White

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Rural Hospitals Initiatives - March 28, 2008

It is great to be back at the Office of Rural Health. There is so much going on right now. We are busy working on the Wisconsin Rural Health Plan, reviewing the Proposed Federal Rule on the Designation of Medically Underserved Populations and Health Professional Shortage Areas, writing our Federal Flex Grant application and making final arrangements for our upcoming workshops and meetings.

Please plan on joining us on April 24 for the Hospital Financial Workshop at Tomah Memorial Hospital (the registration will be available on April 3) and the Grant Writing Workshop on June 5.

Char White, Interim Rural Hospital Coordinator

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Rural Hospitals Initiatives - February 2008

Wow, what a day!! I just got back from attending the kick-off meeting for the Rural Hospital Stroke Improvement Project hosted by WHA and sponsored by the ORH and what an amazing turn out and participation.

The day started out with the opportunity to network and then introduce another hospital participating in the stroke project. What a great way to learn that they’re “not in this alone.” Some hospital staff learned they have similar challenges as other hospitals and others shared what works for them and questions surfaced that applied to all.

Facilitator, Kathleen Caron, MBA, Director of Quality Systems, WHA and the speakers added such value to the project and their presence shows the level of care and commitment that it takes to improve stroke outcomes for patients and better healthcare in Wisconsin. A huge thank you goes to WHA for coordinating this project and speakers Justin A. Sattin, MD and Assistant Professor at UWSMPH, Madison; Jackie Carter, MD, MBA, Medical Director –Stroke Center for Columbia St. Mary’s Milwaukee; Michelle Gardner, MBA, Director of Quality Improvement Initiatives, American Heart/Stroke Association; Victoria O’Brien, MBA, Director of State Health Alliances, American Heart/Stroke Association; and Diane Park, Stroke Coordinator, Agnesian Healthcare, Fond du Lac.

Please stay tuned as this Rural Hospital Stroke Improvement project evolves over the next few months. And on a side note, it was interesting timing, but front page news of USA TODAY for Wednesday, January 23 was “Heart disease deaths plummet ahead of 2010 goal.” With the efforts from the staff above and all participating hospitals, we can hopefully say the same about stroke in the very near future!

January 30 – Kick-off meeting for the Emergency Department Quality Improvement Initiative, stay tuned for that report!

Peggy A. Sivesind
Rural Hospital Initiatives Program Manager and Flex Coordinator

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Rural Hospitals Initiatives - December 2007

I’d like to wish warm greetings to each of you and your families this holiday season. I enjoy getting out to meet you and learn about your work families as well as your families at home. Whether you’re in a large or small hospital/community, I find that there is great dedication on the home front to allow the community and hospital grow and work together. May we all be thankful this holiday season for the healthcare services we have available.

In this issue, I’d like to ask for your input on workshop topics that you and your staff would like from our office. There will be approximately six workshops from January through July of next year and we’ve had some great suggestions from some of you already, however we’d like some more. Please let me know by emailing me at sivesind@wisc.edu what topics that are listed are of greatest interest to you by numbering them (with 1 as your most preferred topic) and also feel free to suggest other topics that may not already be on the list. So far we have the following:

Overall staff topics:

Strategic planning and financing for hospital renovations and/or rebuilding

Financial topics:

Hospital Finance (standard annual workshop) – would you like to continue it?

Nursing topics:

Advance Care Planning – about future medical care in case of being unable to make decisions
Pain topics:
- Pain Management: Analgesic/opioid dosing guidelines
- Pain Management: Equianalgesic dosing guidelines
- Pain Management: Managing specific pains; adverse effects

Communicating bad news
Legal issues related to palliative care
End of life patient issues:
- Depression, anxiety, delirium
- Gaps in end-of-life care
- Elements and models of palliative care
- Physician-assisted suicide/euthanasia
- Whole patient assessment
- Negotiating goals of care
- Grief counseling

Managing sudden, critical illness

Misc. topics presented by consultant from Creative Health Care Management:

Leadership, accountability, anything on Competency assessment (Donna Wright, Sturgis, SD)
Reigniting the Spirit of Caring (Sue Edstrom, Eau Claire, WI)
“Magnet” –. This is an award that a nursing dept or a hospital gets for attracting people to the healthcare profession. (Gen Guanci from Boston, MA)
“Bullying in the Work Place,” (Lynda Olender, NJ)
“Evidence Based Practice,” Ability to bridge practice and academia (Susan Wessel, Chicago, IL)
Middle management training (Alice Weydt, Mankato, MN)

General/suggested topics:

Hospitalist
Medication Reconciliation
Hospitalist program
Patient safety
Current Nursing regulations
Care Coordination

Additional suggestions:

Thanks for taking the time to review this and I look forward to seeing you at the workshops!

Peggy A. Sivesind
Rural Hospital Initiatives Program Manager and Flex Coordinator

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Rural Hospitals Initiatives - November 2007

This month was definitely a busy one. I had the opportunity to get out of the office a few days to go visit some of Wisconsin’s finest Critical Access Hospitals (CAHs). Let’s see what’s happening in the CAH communities:

Amery Regional Medical Center opened a beautiful new hospital on October 15th. I was fortunate enough to attend their open house the weekend of October 6/7th. Please be sure to “visit” their new facility in person when you’re passing through or by viewing their website at http://www.amerymedicalcenter.org/. CEO, Mike Karuschak, Jr. and staff did an amazing job to host thousands of community members through the new facility on tours during the two-day open house. Congratulations to you and your staff as well as the community to open such a nice facility, which will continue to provide quality health care in rural Wisconsin!

Pictured: From right to left, Mike Karuschak, Jr.; CEO of ARMC; Very Reverend John Drummy, St. Joseph Catholic Church; Nancy Cain, ARMC Registered Nurse; Dr. Fred Whitlark, Retired ARMC Physician; Harvey Stower, Mayor of Amery; and State Representative Ann Hraychuck. (Nancy Cain, who is still employed at ARMC, & Dr. Whitlark opened the doors of the original hospital back in November 1956.)

Chippewa Valley Hospital-Durand: Administrator, Doug Peterson gave me a warm welcome to their hospital that is in a beautiful setting on the hill overlooking the beautiful Chippewa River. This hospital has had several equipment and facility upgrades over the last few years and has staff and an environment that make any patient or family member comfortable in. Thanks so much Doug for your time and giving me the opportunity to get you know you and your hospital.

Franciscan Skemp Healthcare-Sparta: Because of a little glitch in my scheduling, Administrator, Mr. Bob Tracey was almost as gracious and welcoming to see me as an unexpected visitor as my mom would have greeted me, thanks Bob. For an administrator to take time out of his busy schedule to visit with me about their CAH indicates what this individual is willing to do for his staff and patients at Franciscan Skemp. I see great things happening in Sparta!

Our office likes to be available to assist our CAHs whenever and however possible! From meeting just three hospital leaders I can see that our rural communities and patients are in very good hands. I’m looking forward to meeting more of you within the next few months. My visits are not “site visits” in the sense of an audit, please consider mine a social call to get to know you, your staff and learn what being a CAH has meant to your community or what more we can be doing to assist you.

Next stops: Grant Regional Health Center, Lancaster and Upland Hills Health, Dodgeville.

Back at the office:
We’re making great strides with the ED/QI initiative with a significant number of CAHs interested in standardizing the ED transfer form. The initiative will be piloted in southwestern WI, but we look forward to implementing this form with hopes of going state-wide in the future.

Improving Stroke in Rural Hospitals: WHA or AHA/ASA will be if they haven’t already be contacting you to inquire about your interest in the Stroke Care program to report 10 stroke consensus measures. If you have questions, please don’t hesitate to contact me.

Your Rural Hospital Initiatives Program Manager and Flex Coordinator,
Peggy A. Sivesind