Disparities
Disparities Focus Groups Set to Gather Health System Perspectives
The Disparities Improvement Team met in January 2022 to continue their conversations around the structure and purpose of the team. A key theme from these discussions was the importance of engaging with community groups, partner organizations, and stakeholders throughout Wisconsin who are actively working to eliminate health disparities and break down barriers to high quality care. The Disparities Improvement Team recognizes the importance of bringing diverse voices together when addressing health disparities. Over the next month, the team will craft a strategy to bring community groups representing traditionally underserved populations, payers, and health care stakeholders into this work.
In addition to the work of the Improvement Team, WCHQ and its grant partners are hosting health disparities focus groups to learn more about the processes used by health systems to select and implement improvement strategies aimed at decreasing health disparities. These invitation-based small group discussions aim to understand the health system perspective on selecting and implementing interventions that improve overall quality, target certain groups to address disparities, and determine whether they are focused on all patients, certain groups or geared toward an individual. These sessions will allow WCHQ members to provide their own perspectives and expertise while learning how other organizations approach intervention selection and implementation.
For information on WCHQ’s health disparities-related work or to participate in the Disparities Improvement Team, contact Abbey Harburn.
Obesity
H-E-B Shares Experience on Employee Benefits Related to Obesity Services
With more than 120,000 employees, H-E-B is one of the largest grocery chains in the country. Over the years, H-E-B has piloted many innovative approaches to employee wellness. On January 5, the WCHQ Obesity Advisory Group invited Abigail Ammerman, MPH, manager of benefits program at H-E-B to share their experience related to offering obesity-centered services to their employees.
Ammerman said they started offering health and wellness incentive-based programs in 2008. A few years after, they transitioned to a clinical-engagement stage aimed at those who had biometric scores outside of the expected ranges. Employees were encouraged to “know their numbers” and participate in programs aimed at improving their health.
Program components were focused on clinical engagement and classes that were led by registered dietitians, nurses, and health educators. Upon completion, the H-E-B employee was eligible for previous premium incentives that they did not qualify for before they completed the class.
Ammerman said H-E-B offered a mix of programs and services suitable for specific populations and jobs, such as truck drivers. For them, they put a primary care clinic closer to where they work. Pharmacy teams that are in their stores work with employees on their medications and offer in-store employee screenings.
As a self-insured employer, H-E-B tracks and stores their own data and they have an analytics partner. Ammerman emphasized that they use data to drive their programs and to monitor their progress. She noted that the coming year will be one of rebalancing to account for the pandemic’s impact on many of their key metrics related to diabetes, hypertension, and BMI.
Adolescent and Child Health
HPV-Related Cancers and Vaccination Coverage in Wisconsin
The WCHQ Adolescent and Child Health Improvement Team heard a presentation titled “HPV-Related Cancers and Vaccination Coverage in Wisconsin” by Alexandria Cull Weather, Outreach Specialist at the Wisconsin Cancer Collaborative, at their January meeting. In her presentation, Cull Weather highlighted the burden of disease associated with HPV, the disparities that exist in these cancers, and the role of vaccination in preventing HPV-related cancers. HPV causes approximately 600 cases of cancer among Wisconsinites each year. The most common types of cancer caused by HPV infections are oropharyngeal and cervical cancers. The incidence of HPV-related cancers and deaths vary by race, with African Americans, Native Americans, and Asian/Pacific Islanders having nearly twice the rate of new cancer cases when compared with Whites.
The Advisory Committee on Immunization Practices (ACIP) recommends vaccinating everyone ages 9-26 against HPV. The routine recommendation is that all children receive the vaccine at 11 to 12 years old, with the goal of providing immunity prior to exposure. The Adolescent and Child Health Improvement Team discussed the importance of the HPV vaccine and strategies to combat vaccine-hesitancy among parents. For more information or to join the improvement team, contact Abbey Harburn.
Behavioral Health
Integrated Behavioral Health Improves Access
WCHQ is partnering with the Collaborative Family Healthcare Association and the Medical College of Wisconsin to launch a 12-webinar series on increasing integrated behavioral health in member organizations. The work is funded by Advancing a Healthier Wisconsin and runs through July 2024. The focus in 2022 is working with the nine member health systems that are participating in this project to help them begin, increase, or improve the integrated behavioral health services offered within their health systems. This work will be shared with the entire WCHQ membership throughout the year.
To learn more about this project, contact Jen Koberstein.
Chronic Disease
Chronic Disease Learning Collaborative, Team-Based Care Workgroup
The first Chronic Disease Learning Collaborative group meeting focused on team-based care (TBC) was held December 27, 2021. Similar to other WCHQ Chronic Disease Learning Collaborative (CDLC) workgroups, this group supports the development of strong relationships and resources to help members establish impactful strategies. This workgroup will establish a TBC goal to work on in 2022 with an additional opportunity to address health disparities.
The first workgroup meeting featured a team-based care presentation from Mayo Health System, La Crosse by Carrie Apuan, RN, BSN; JuneMee Chae, MD; Kristine Jimenez, MSN, RN; Sarah Thompson, MS; and Tia Meyer, MHA. The presentation inspired members to start thinking about the value-added components of TBC.
Whether in an ambulatory or hospital setting, utilizing team-based care presents opportunities to positively impact patients, families, and health care providers. Apuan defined team-based care (TBC) as “two or more health care professionals who work collaboratively with patients and their caregivers to accomplish shared goals” (Smith et al., 2018, p.1).
A TBC approach can help develop trusting partnerships with patients and families, which improves patient satisfaction, as they engage in the process. Additionally, a team-based approach has also been known to improve job satisfaction and provide a support system that can reduce burnout. Relationships developed within a team provide a supportive network and opportunities for interdisciplinary learning.
At Mayo Health System, La Crosse, interdisciplinary rounding within their intensive care unit (ICU) is a notable example of a team-based approach that has existed at Mayo for some time with enhancements made over the years. Key features include building a team, involving patients and families, established rounding time(s), checklist(s), goal of the day, and monitoring quality metrics. Mayo’s TBC approach has allowed them to improve quality and safety, reduce adverse events and length of stay, and decrease costly readmissions.
Contact Sheryl Pierce for more information about joining the Team-Based Workgroup meetings.
Oral Health
Oral Health Priorities in 2022
WCHQ is entering its fourth year of work in oral health and the members have big plans for future activities. Measurement has been an important part of the efforts of this group and will have a continued emphasis in 2022 with two new cross-cutting medical and dental measures. The Oral Health Evaluation of Adults with Diabetes measure will be publicly reported in early 2022 and members plan to collaborate with their medical counterparts to develop the second measure.
The group has committed to work on value-based care and is currently outlining a plan to initiate this work. Implementation of a patient reported outcome tool has been a priority and a pilot with at least one member organization will begin in 2022.
To learn more about the oral health collaborative contact Jen Koberstein.
