The Chronic Disease Learning Collaborative met on January 30, 2023, to share their improvement goals and outcomes in a poster presentation format. Aspirus, Associated Physicians, Gundersen, Marshfield Clinic (3), Prevea, and Primary Care Associated of Appleton shared their improvement goals and the work they are doing in their health systems.

We will highlight each health system and its improvement projects monthly. Aspirus has been focused on accurate blood pressure readings and focused on controlling hypertension measure. If a patient is roomed with a high blood pressure reading (139/89 or above), the protocol is to re-check that blood pressure during the appointment. The blood pressure reading does not need to be lower, it just needs to be re-checked for accuracy. They have discovered that if the blood pressure is re-checked during the office visit, 25% of the time the blood pressure reading is within the normal range. Aspirus is tracking this within the EHR and providers can see if they are meeting their target for those blood pressure re-checks. The re-check also allows for the provider to engage with the patient and provide blood pressure education.

If you’re interested in this collaborative work, please contact Renee Sutkay, Quality Improvement Specialist, at rsutkay@wchq.org for more information.

This month we focus on Heart Awareness Month and the importance of healthcare quality in the fight against heart disease.

Our contributions at WCHQ to improve heart health quality care is centered around the data we analyze to reveal gaps for opportunities and by fostering collaboration among the membership. One of the measures we use to assess heart health across the state is how well we are controlling high blood pressure. Below is the membership’s aggregated performance on this measure over the last few years:

Up until the COVID-19 pandemic, the membership had been consistently performing in the 83%-85% range on this measure. Following the arrival of COVID-19, however, we saw a stark decline. Concerned about the impact that a shift like this can have on the health of the state’s population, WCHQ made this an improvement priority.

Our hypertension workgroup began experimenting with a few different strategies to improve rates. These included:

1. Authorizing RNs to adjust dosages and order a one-month supply of medication, if needed, for antihypertensive medications
2. Implementing a self-measured blood pressure workflow and trained teams to use the Self Monitored Blood Pressure Monitoring model
3. Implementing workflows to recheck blood pressure readings during an encounter with a high initial reading
4. Creating reports of patients that qualify for the WCHQ controlling high blood pressure measure

These strategies, coupled with WCHQ’s reporting, have helped to boost the scores by 2% since the performance dip experienced starting in June of 2020.

“The team of transformation specialists at WCHQ have worked closely with our members to understand what strategies have worked well around the state. We’ve been able to support these teams by providing them data to track their specific improvements,” said Director of Transformation and Analytics, Abbey Harburn, MPH. “While we aren’t there yet, we believe we have the experience, data and collaboration among the membership to continue to drive these numbers back up to where they were previously, if not above.”

To learn more about WCHQ’s Hypertension workgroup, please contact Abbey Harburn at aharburn@wchq.org.

The WCHQ Antibiotic Stewardship Improvement Team kickoff meeting was held Thursday, January 19, 2023, with a broad variety of member health system departments represented. Pharmacy, Infectious Disease, Clinic Operations, Quality and antibiotic stewardship leaders from health system members made up the group. This improvement team will continue to meet every other month.

The team was addressed by Dr. Lindsay Taylor, from DHS’s Healthcare-Associated Infections (HAI) Prevention Program. She provided an overview of the importance of antibiotic stewardship work in Wisconsin, informing the team “the most important modifiable risk factor for antibiotic resistance is inappropriate prescribing of antibiotics.”  

This improvement team will review data submitted by participating health systems to better understand best practices and prescribing trends around antibiotics. The group’s goal is to reduce unnecessary prescribing of antibiotics for patients 3 years of age and older for acute sinusitis, bronchitis and upper respiratory infection during outpatient visits. Armed with this data, the team can then devise interventions to decrease unnecessary prescriptions.   

We are still looking for membership participation from your Antibiotic Stewardship, Quality or Pharmacy departments to join this improvement team. If you feel this aligns with work happening at your health system, please contact Lori Bue, Quality Improvement Specialist.

HPV Vaccine Project Open to WCHQ-Member Health Systems and Clinics‍

Sign up now to join the 2023 UW-UNC HPV Vaccine Project to improve adolescent vaccination in your health system

In collaboration with WCHQ, the UW-UNC project team will work with health systems to deliver a brief, evidence-based HPV vaccination communication workshop, known as Announcement Approach Training. Content includes traditional approaches, such as using presumptive announcements, as well as newer ones, such as how to start discussions about HPV vaccine with parents whose child is age 9. WCHQ data will be used to track improvements.

Health systems will receive a 1-hour CME/CNE communication workshop for providers and clinical staff in primary care clinics and additional training for one or more Vaccine Champions. Champions will deliver the HPV vaccine communication workshops to half of the health system’s participating clinics and experts from the project team will deliver workshops to the remaining clinics. If applicable, small stipends are available to support system participation.

This workshop has been shown to increase HPV vaccination by five percentage points (Brewer et al, Pediatrics, 2017) and save physician time during clinic visits (Malo et al., Implementation Science, 2018). It will also help clinical staff build relationships with families and defuse conflict.

The project team will provide all training and materials needed. While this project currently focuses on HPV vaccination, health systems may adapt these materials for sustainable quality improvement as they wish after the project is over.

This project is funded by the National Cancer Institute. Project leads are Elizabeth Cox, MD, PhD, a pediatrician and health services researcher, and Meghan Brennan, MD, MS, an infectious disease physician and health services researcher, both at the University of Wisconsin; along with Melissa Gilkey, PhD, a behavioral scientist at the University of North Carolina.

Training will begin shortly with workshops delivered to participating clinics in Spring 2023.

Thank you to the health systems currently working with us! We look forward to hearing from other interested health systems.

Interested in participating or have questions?

Contact Jen Koberstein or the UW-UNC project team at prokids@pediatrics.wisc.edu or 608-263-1202. The team will set up a brief meeting to discuss the project and answer questions.

Wisconsin Zero Suicide Training

June 21, 22, 23

Live Online via Zoom 

Mental Health America of Wisconsin, with support through a grant from the Wisconsin Department of Health Services, Division of Care and Treatment Services, is inviting applications from eligible entities to participate in the 9th Annual WI Zero Suicide Training and subsequent learning community. 

‍Note: The WZST is a training for people in health or behavioral health care organizations who will be working on ZS quality improvement as a team, not a skills training for individuals. See Suicide Care Trainings for Individuals for information on those types of opportunities!

An Applicant Q&A Webinar for interested health and behavioral health care organizations will be held via Zoom (details below) on Wednesday, March 1 at 12:00 pm CT. If you cannot attend live, a recording will be posted to the website when it becomes available.

Join Zoom Meeting: https://us02web.zoom.us/j/5790305177

Meeting ID: 579 030 5177

Applications and Organizational Self-Studies are due Monday, March 31 at 11:59 pm CT.

‍