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Wisconsin Collaborative for Healthcare Quality

January 2021 Newsletter


President's Column

President Gabrielle Rude, PhD
Gabrielle Rude, PhD

Board Sets Direction for WCHQ in 2021

At its January meeting, the WCHQ Board approved our strategic plan for 2021. Looking forward, WCHQ was asked to focus on three key strategic priorities:

  • Facilitate alignment as we improve the value of health care. Aiming to improve everything at once will result in slow (or perhaps no) improvement. WCHQ is uniquely positioned to support improvements in value by providing actionable information and facilitating collaborative discussions among disparate partners. For improvement to occur quickly, we must limit the number of priorities, align incentives and drive for dramatic results.
  • Reduce health disparities. As a state, Wisconsin has exceptional health care quality. Now is the time to identify and improve disparities in health as highlighted in WCHQ’s two recent reports on the topic to ensure all patients have equitable outcomes.
  • Provide tools and resources for the unique communities served by each member. WCHQ has nearly completed rolling out our new Data Voyager data platform. We are excited to offer our members more ways to evaluate their own patient populations with more robust tools and dashboards that can drive targeted improvement.

WCHQ staff are developing detailed operational plans to accomplish our new priorities. We are hopeful that in 2021 we will be able to offer in-person meetings as part of our strategy. That said, 2020 demonstrated that collaboration and improvement are still possible in a virtual environment as we more than doubled the number of educational events we offered in 2020 compared to the prior year.

In addition to the strategic priorities selected by the Board, WCHQ is also evaluating the impact of the pandemic on patient care and outcomes. We will release new public quality measures in February and members will likely see some impact on results for patients that have been seen in the past year. We are also actively evaluating the impact on patient volumes to understand how the pandemic has affected patients we did not see during the pandemic.

WCHQ’s members are doing incredible work to care for patients and to immunize our community. We are proud to support your work. This week we released COVID mortality maps through the Neighborhood Health Partnership Program portal to support immunization plans in our communities. See the article in this issue for more information.

It is a privilege to serve you – reach out to WCHQ team members at any time.

 

- Gabrielle Rude

Register Today for this Important 2/4/21 Webinar

Webinar Presenters

“Prioritizing COVID-19 Vaccine Outreach and Communications by ZIP based on Potential Barriers to Vaccination on COVID-19 Mortality Risk”

February 4, 2021
12 PM – 1 PM CST

(There will be time for a Q&A - Webinar will be recorded)

All WCHQ members are engaged in vaccinating their communities. While every neighborhood is at risk for COVID-19 infection, some neighborhoods may have more residents who are at higher risk of death if they contract COVID-19.

On February 4, 12 PM – 1 PM, WCHQ will present a webinar to provide WCHQ members tools that can be used to identify people living in their service territories who are at higher risk of mortality from COVID-19 by ZIP code, using the latest CDC revised guidance. The tools include a communications risk ranking by ZIP code that will be of great assistance to those involved in planning, implementing and the communications associated with immunization clinics.

The CDC and others have learned more about the risk factors for COVID-19 since the Neighborhood Health Partnership (NHP) program first shared ZIP level estimates for the risk of severe illness with WCHQ members in April 2020. Based on this new information, we are now able to share estimates of the relative risk of COVID-19 mortality for many Wisconsin ZIPs and an analysis of the potential barriers to successfully vaccinating the residents in those ZIPs for COVID-19. These new tools are available to WCHQ provider members in the NHP portal.

From the onset of the pandemic, the NHP has been working with WCHQ and the UW Health Innovation Program (HIP) to provide EHR data to help community decision makers mitigate risk in their planning, outreach and resource allocation.

Jessica Bonham-Werling, director of the Neighborhood Health Program, will explain how to use the new tools and field questions about how they can help health systems and public health effectively identify and communicate with community members who may not have a medical home.

Ann Lewandowski co-chairs the State Disaster Medical Advisory Committee Vaccine Subcommittee. The sub-committee was established to develop guidance to DHS for the allocation of limited numbers of vaccine doses during the COVID-19 pandemic, especially in the first month following vaccine release. Ms. Lewandowski will field members’ questions related to the sub-committee’s work and describe a new a statewide campaign called “Vaccine Voices, Vaccine Choices” to address COVID-19 vaccine hesitancy. This state-level campaign, launched by the Wisconsin Immunization Neighborhood, will be complemented by a national campaign she convinced and partnered with Vaccinate Your Family to execute.

*If you are from a member, partner or sponsoring organization, there is no charge for this webinar; however, you MUST first have an account in WCHQ’s Online Community. If you do not have an account go to JOIN. If you are unsure whether your organization is a member, sponsor or partner, click here for provider members; here for corporate sponsors/annual partners.

WCHQ’s Winsand Will Chair Dane County Immunization Coalition

Cara Winsand

Cara Winsand, WCHQ director of practice transformation, was elected chair of the Dane County Immunization Coalition (DCIC) Board of Directors at the January meeting. DCIC is a partnership of individuals and organizations with a shared mission to facilitate the improvement of childhood and adult immunization rates. Members of the Coalition represent public and private health care providers, businesses, service organizations, pharmacies, educational institutions, and pharmaceutical companies. The Coalition is led by Board Members with representation from various community organizations.  WCHQ members, Access Community Health Center, Associated Physicians, SSM Health, UW Health, and UnityPoint Health Meriter are also on the Board.

For more information on the Dane County Immunization Coalition, visit their website.

Improvement Teams Update

Oral Health

Wisconsin State Dental Director Dunkel Shares How the Pandemic Has Affected Dentistry

An article in the December issue of the American Dental Association ADANews discussed how the pandemic has affected dentistry from the perspective of five state dental directors. Russell Dunkel, DDS, the Wisconsin State Dental Director, was one of the people interviewed for the article. In the ADA article, Dr. Dunkel talked about the history of dentistry being siloed from other health care entities and the need to break down the barriers and work together.

WCHQ staff had the opportunity to meet with Dr. Dunkel to explore the topic further. Speaking to WCHQ’s Jen Koberstein, Dr. Dunkel noted that the pandemic created many challenges, but one of the major ones was that patients were not able to or hesitant to access dental services for several months in 2020.

“When patients are not coming in for regular preventive visits, their issues became urgent and some progress to require immediate attention,” according to Dr. Dunkel. “This can be a stressful and oftentimes painful situation for the patients as they may seek care in a health system’s emergency department. This care can be expensive and emergency departments are not always equipped to treat dental pain.”

While patient volumes are still lower than normal, dental offices are seeing patients return for routine care. This is important, according to Dr. Dunkel, as it demonstrates that people in the community have confidence that their dentist is controlling the environment in accordance with evidence-based practices that reduce the potential for exposure to COVID.

The pandemic has triggered some practice changes around infection prevention and protecting patients and staff. Prior to the pandemic, dental offices were discussing increasing the use of personal protective equipment. Those modifications have now been made, along with how patients check in for an appointment, which will likely continue post-pandemic.

Dr. Dunkel said he is currently working with the Wisconsin Department of Health Services (DHS) and the Department of Safety and Professional Services (DSPS) on the issue of whether Wisconsin dentists can be one of the professions approved to administer the COVID-19 vaccine. He also said that dentists are on Group 1A for receiving the vaccine.

“The pandemic has changed the relationship between dental and medical professionals by highlighting the importance of the dental and whole-body connection,” Dr. Dunkel said. “That said, the reimbursement system should also recognize greater equity between medical and dental services.”

Some of the issues involved in coordinating medical and dental care in the past are being addressed through technology, such as the ability to share records, and a better understanding of the connection between oral and physical health.

The pandemic has accelerated the adoption of new protocols and will forge new relationships among providers. Dunkel concludes, “As we continue to navigate the challenges the pandemic heaps upon us, it’s important to remember, we’re a TEAM – Together Everyone Accomplishes More.”

Chronic Disease

This year WCHQ’s chronic disease work will continue with a grant from the Wisconsin Department of Health Services, Division of Public Health. The work under this grant aligns with WCHQ’s members’ priorities. They include diabetes blood sugar, A1c control and hypertension blood pressure control.

The Chronic Disease Learning Collaborative will continue to meet to share and discuss best practices and resources to improve chronic disease health outcomes. A new resource released by the American Heart Association and the American Medical Association is a compilation of evidence-based activities health systems can implement to help patients achieve better blood pressure control. The resource can be found here.

The format of the Chronic Disease Learning Collaborative will make a slight shift starting in July. WCHQ will be creating two new workgroups, one on diabetes and the other on hypertension. Both workgroups will have overarching themes of team-based care and reducing disparities. Separately, the workgroups will convene quarterly between July 2021 and June 2022 to discuss diabetes or hypertension improvement strategies. Each health system participating in one or both workgroups will create their own improvement goal to be achieved by the end of June 2022. The larger Chronic Disease Learning Collaborative will convene at least twice in that timeframe to discuss chronic disease resources, education, and update the diabetes and hypertension toolkits.

To learn more about this group or to join the Chronic Disease Learning Collaborative or either of the workgroups, contact

Behavioral Health

The Behavioral Health Improvement Team met in early January to set the WCHQ health system goals for 2021. The WCHQ Improvement Advisory Committee (previously the Quality Planning Committee) recommended a performance goal of 79% for health systems’ Screening for Clinical Depression measure. During the last reporting period, the WCHQ rate of screening for clinical depression was 75.68%. The Behavioral Health Improvement Team will work with members to identify ways to achieve this goal in 2021. Team members will also focus on depression response and remission.

The Improvement Team will also address access to care issues, which include telehealth and integrated behavioral health. Members are particularly interested in ensuring that telehealth is used appropriately, and that protocols are developed to help determine who can benefit from telehealth services and who should be seen in person at the clinic. Members also requested information on the foundational practices of suicide prevention. Suicide prevention has been a long-standing issue in Wisconsin and is even more important as the effects of the pandemic exacerbate this issue.

If you are interested in joining the Behavioral Health Improvement Team, contact

Adolescent and Child Health

The Adolescent and Child Health Improvement Team is excited to continue its informational and in-depth meetings in 2021. WCHQ has a new scope of work with the Wisconsin Department of Health Services, under the Maternal and Child Health grant, which funds the Improvement Team’s work. The goal is to improve the quality of care and health outcomes for children and adolescents in Wisconsin.

This coming year, members will review current and new measures, particularly those that align with The Centers for Medicare & Medicaid Services’ (CMS) Child Health Core Set. The team will also monitor and discuss performance data to achieve statewide goals, which include developmental screenings, adolescent well visits and immunization status. One of the greatest benefits for members by participating in this year’s Adolescent and Child Health Improvement Team will be sharing best practices to improve adolescent and child health outcomes. This sharing will be encouraged from member health systems, partners and statewide experts. Tools and resources will then be translatable to day-to-day practices within individual health systems.

WCHQ is actively recruiting members to join this Improvement Team. To join or to learn more, contact