In 2021, the Improvement Advisory Committee (IAC) meetings will have an overarching focus on disparities. At the February IAC meeting, members explained what disparities they were focused on and how they were implementing change in their organizations. WCHQ members said they were identifying disparities by using care gap lists and comparing results based on payer, including Medicaid. Operational teams use the lists to reach out to patients on a monthly basis. At WCHQ, improvement teams emphasis is health care disparities as they relate to populations at risk for chronic disease.

Members also reported that their areas of focus align with WCHQ improvement priorities, which includes chronic disease, specifically diabetes A1c control and blood pressure control, along with cancer screening. Members said they are working on food insecurity and developing food programs to improve A1c rates and the health of their patients with diabetes. Most health systems are partnering with community organizations to reach patients who are food insecure.

COVID-19 and competing priorities remain challenges for members while they are attempting to refocus their efforts on quality improvement.

If you are a health care provider and would like to join the Improvement Advisory Committee, contact Cara Winsand.

Behavioral Health

A recent article published by the NYU Grossman School of Medicine highlighted the increased risk of living with schizophrenia during the pandemic.

Researchers identified schizophrenia as being second, only to age, as the most significant risk factor for morbidity during the COVID-19 outbreak. According to the research, people with schizophrenia are 2.7 times more likely to die if they contract COVID-19. The lead study author, Katlyn Nemani, MD, went on to say that the increased risk is not related to co-morbid medical conditions of those with schizophrenia so at present time, the reason for the increased risk is unknown

What should health care providers do with this research? The WCHQ Behavioral Health Improvement Team discussed interventions such as providing better masks, increasing efforts to educate this population about social distancing and good hand hygiene, and promote efforts to educate people who suffer from schizophrenia about the importance of getting vaccinated. It is also important to prioritize outreach and medical care for people with schizophrenia who contract the virus.

The WCHQ Behavioral Health Improvement Team continues to work on the effects of COVID-19 on people suffering from behavioral health issues. The team meets monthly to discuss these issues, current research, and evidence-based practices. For more information or to join the improvement team contact Jen Koberstein.

Chronic Disease

The Chronic Disease Improvement Team continues to prioritize the improvement of hypertension and diabetes measures and the adoption of best practices despite the frenzied COVID-19 vaccination efforts. Even Wisconsin Lt. Governor Mandela Barnes has taken action to promote heart health. February is American Heart Month and here’s a video from him asking everyone to join in the efforts to improve the heart health of Wisconsinites.

WCHQ is an active partner in the chronic disease network in Wisconsin, which encompasses entities such as the WI Department of Health and Human Services, public health departments, other health-related associations, and community health organizations. The beginning of 2021 has brought a flurry of new resources and opportunities for participation in improvement activities from this partnership. Please review a summary of these below and if an opportunity interests you or if you’d like to join in the collaborative discussions or receive more chronic disease resources and information, please contact Sarah Sky.

1. Diabetes Affinity Group through the online WI Heart Health Community of Practice
2. With access to this community, sponsored by a Centers for Disease Control and Prevention (CDC) grant, you will be introduced to other diabetes providers and stakeholders committed to helping and serving people with diabetes by providing a set of skills and practices to enable them to manage their disease. This community will identify and zero in on education and teaching practices that work and benefit patients. The community will offer relevant articles, tools, ideas, polls, and opportunities for conversations with professionals working on diabetes initiatives.
3. This group is free to join. Join here.
4. WCHQ Chronic Disease Workgroups
5. Beginning in July 2021, WCHQ will host three new workgroups for members focusing on hypertension, diabetes, and team-based care. Each health system joining a workgroup will work toward completing a quality goal by the end of the 12-month program. Workgroups will meet quarterly and be given resources, peer support, and best practice sharing to help them achieve their goals.

Adolescent and Child Health

As the COVID-19 pandemic continues, the mental health of children and adolescents must be brought to light, especially as their environments continue to change. Social distancing prevents children and adolescents from spending time with friends and family. Schools change their policies from virtual to in-person and back to virtual again. Children are thought to be resilient, but a closer look on the impact of this pandemic might reveal that to be a misconception.

A rapid system review of published articles on this subject revealed that the risk of depression and anxiety increases among children and adolescents during social isolation and loneliness. The depression and anxiety affects could also be seen up to nine years after the event. Surprisingly, the biggest factor in the degree of mental health systems is due to the duration of social isolation and loneliness and not necessarily their intensity. The article suggests that managing mental health symptoms and preventing loneliness among children and adolescents should be a current priority instead of waiting for a potential big wave of mental health needs to arise in the future.

The Adolescent and Child Health Improvement Team will continue to discuss the health and wellbeing of children and adolescents in 2021. The group is reviewing current goals for 2021, which include the following:

• Percent of children, ages 9 months to 71 months, receiving a developmental screening using a parent-completed screening tool.
• Percent of adolescents age 12-17 years who receive a well-care visit in the last year.
• At least one additional measure selected from the CMS Child Core Set prioritized by current improvement team members.

If you’re interested in joining the discussion or have an opinion on which CMS Child Core Set measure the improvement team should select, contact Sarah Sky.

Oral Health Collaborative

The WCHQ Oral Health Collaborative continues to meet regularly to discuss issues related to medical-dental integration, dental measurement outcomes, cross-cutting medical and dental measures, and the recovery from the pandemic. Recent meetings have focused on planning the annual WCHQ Oral Health Summit. The Summit, which draws oral health providers statewide, will be held in La Crosse this July.

Since first publicly reporting oral health quality measures in October, WCHQ has learned of many groups throughout the nation that are working to further oral health outcomes. That has opened an opportunity for WCHQ to share its work broadly.

The collaborative members have determined that patient reported dental outcome measures are a priority for this group going forward. Mike John, PhD, DMD, MPH teaches the University of Minnesota School of Dentistry and was recently awarded a federal grant to develop patient reported dental outcomes for use in dental offices. Dr. John will discuss his work with the Collaborative members in July and use their feedback to inform his work.

To learn more about patient reported dental outcome measures, check out Dr. John’s new resource published in November 2020 by the Dental Quality Alliance.

For more information on the Oral Health Collaborative, contact Jen Koberstein.‍