March 2021

President's Column

President Gabrielle Rude, PhD
Gabrielle Rude, PhD
WCHQ President and CEO

Wisconsin has a strong history of measuring health care outcomes and transparently sharing information; cultural practices that proved beneficial in identifying trends in spread, populations at risk, and strategies for effective immunization. Throughout the pandemic, health care providers and support organizations have gathered information to share with county, state and federal partners as well as publicly reported it to facilitate rapid innovative solutions. The data WCHQ members submit to our central repository was, for example, used to provide information on high-risk populations for COVID-19 complications.

Within our industry, we know a myriad of individuals and organizations have worked tirelessly to support frontline health care providers by turning a multitude of data points into information that have been used to understand and may eventually quell the spread of COVID-19. In recognition of this important work, WCHQ will be focusing our June annual improvement event on examples of innovation in utilizing data to benefit health. The event will be held as a hybrid of virtual and in-person participation on June 29 and feature a keynote presentation from Bellin President and CEO Chris Woleske. WCHQ will also be recognizing member-nominated individuals and departments that collect data and translate it into information. More details are coming soon.

The next several months will be pivotal as more people are immunized and herd immunity reaches levels that will decrease the chance of contracting COVID-19. Life will slowly return to a new, more cautious, normal. As a collaborative, we know the power of networking to expand learning and spread improvement. While virtual experiences have exceeded our expectations in their ability to deliver excellent just-in-time excellent content, we look forward to the day when we can once again meet in-person and facilitate the networking opportunities that a so much a part of WCHQ’s culture.

We are privileged to serve the health care community in Wisconsin. We look forward to the opportunities that lie ahead.

- Gabrielle Rude

WCHQ Pilots Colonoscopy Quality Measure

WCHQ is currently piloting a new measure of colonoscopy quality, titled “Screening Colonoscopy Adenoma Detection Rate.” Two WCHQ members are collecting data on the rate of adenomas detected by clinicians during screening colonoscopies with the goal to report the measure at the individual provider level. WCHQ members perform highly on the Colorectal Cancer Screening measure, with a statewide rate of 78.97% compared to the national rate of 68.8%. The Adenoma Detection Rate measure will allow WCHQ members to continue to advance quality in colorectal cancer screening.

Adenoma Detection Rate is considered the “gold standard” of measurement for colonoscopy quality. An adenoma detection rate of at least 25% for a mixed gender population significantly protects against incidence of colorectal cancer. WCHQ continues to consider other measures of colonoscopy quality to develop and report alongside Adenoma Detection Rate to provide a more complete picture of quality.

Based on the response to the pilot, WCHQ plans to offer this initial program to other WCHQ members. Members who are interested in participating in an expanded pilot or who would like more information on data collection should contact Abbey Harburn.

New Obesity Advisory Group Formed

WCHQ announced a new initiative to improve care for individuals living with obesity. This is a multi-year initiative, focused in the first year on education and information gathering, and in subsequent years the focus is on developing quality measures that will support members in their efforts to improve care in this population.

WCHQ formed an advisory group in conjunction with this project comprised of providers and staff from Ascension Wisconsin, Advocate Aurora Health, Aspirus, Marshfield Clinic Health System, and Gundersen Health System. The group met March 24 and shared their health systems’ approaches to treating and managing patients with obesity in their organizations. Future meetings will focus on identifying educational opportunities for clinical staff and better support for those patients living with obesity.

For more information or to volunteer to participate on the advisory group, contact Jen Koberstein.

Career Opportunity: Quality Improvement Specialist

WCHQ is seeking two Quality Improvement Specialists. Candidates should have a minimum of a bachelor’s degree and five years of quality and/or process improvement experience and previous experience leading and/or participating in effective quality improvement teams. The ideal candidate will have experience working on grant-funded projects related to chronic disease and maternal and child health and improving related performance metrics.

Major responsibilities include:

  • Facilitating improvement teams and leading projects related to WCHQ members’ top improvement priorities;
  • Identify and assist member organizations to reduce unwanted clinical practice variation and achieve improvement targets; and,
  • Effectively collaborate with physician leaders, quality improvement professionals and clinic operations leadership to improve performance on clinical quality metrics.

For more information and to apply, click here.

Direct questions on these positions to Cara Winsand.

Project Seeks to Identify Barriers to HPV Vaccination in Rural Clinics

Rural clinics may face unique opportunities and challenges when it comes to vaccinating adolescents against HPV. To better understand and address these challenges, Elizabeth Cox, MD, a pediatrician and health services researcher at the UW School of Medicine and Public Health, has partnered with WCHQ for a research project. The project will interview clinic staff at rural clinics as well as health system leaders and quality improvement (QI) specialists.

Dr. Cox is actively recruiting additional participants from WCHQ’s membership serving rural populations. Eligible staff include doctors, nurse practitioners, nurses, medical assistants, or schedulers at a rural pediatric or family medicine clinic in Wisconsin, as well as health system leaders and QI specialists. The interviews take approximately 45 minutes by web conference or phone. Interviewees will receive $40 for their participation.

If you are interested in participating, please complete this short survey (1-2 minutes)

Please share information about this opportunity with other doctors, nurses, and clinic staff who may be interested via email, at staff meetings, or by posting in clinics. For questions, contact the research team reserach team, 608-263-1202 or Jen Koberstein at WCHQ.

Upcoming Education

Behavioral Health Assembly
April 30, 2021
9AM – 12PM

The effects of the pandemic will be felt for many years. One area that is of concern for clinicians is the impact it has had and will continue to have on their patients’ mental health.

The Behavioral Health Assembly on April 30, 9AM-noon, will focus on subject areas identified by the WCHQ Behavioral Health Improvement Team as being of great importance to our patients in the months ahead. Topics to be presented include: Zero Suicide; peer-run respite care and Warmline services; stigma and bias in the treatment of obesity; and, a holistic approach to psychosis.

See the FLYER for details.

REGISTRATION is open to all WCHQ members, annual partners, and corporate sponsors.

For information contact Mary Kay Fahey.

WCHQ Improvement Event
“Recognizing the Importance of Data in Evidence-Based Care”
June 29, 2021
Monona Terrace, Madison WI
9AM – 1 PM
Featuring Chris Woleske, President and CEO, Bellin Health

“Diabetes Summit”
Immediately following the WCHQ Improvement Event
June 29, 2021
1PM – 4PM
Monona Terrace

Chris Woleske Speaker for WCHQ
Chris Woleske

WCHQ is excited to announce that Bellin Health President and CEO Chris Woleske will keynote the WCHQ Improvement Event, June 29, 2021 at Monona Terrace in Madison. As a member of the executive leadership team for more than 22 years, Woleske has been involved in strategic planning and operational execution of key initiatives for Bellin Health. She is the past chair of the Greater Green Bay Community Foundation Board where she led initiatives focused on improving health by addressing the social determinants of health.

The theme of the event is “Recognizing the Importance of Data in Evidence-Based Care.” Data and analytics have a critical role in a health care organization as they are used to inform clinical improvement work, provide valuable information to guide patient care decisions, and support administrative operations. WCHQ will recognize several organizations in Wisconsin for their work in making data available that was critically important during the pandemic. It will also acknowledge members’ data and analytic teams and individuals in a special ceremony during the event. More information will be forthcoming on how members can nominate a team or individual for recognition at the event.

Starting at 1 PM on June 29, WCHQ will host a “Diabetes Summit” in partnership with Novo Nordisk. WCHQ members will be able to register for both or just one of the events. Registration and agendas will be released soon.

Recent Education Events

WCHQ’s Matt Gigot was featured presenter on a March 25 national webinar sponsored by the Network for Regional Health Improvement. Gigot’s presentation focused on the WCHQ partnership with the UW Neighborhood Health Innovation Program that built a tool to help health systems prioritize COVID-19 vaccination efforts. Read more here.

Here are links to two recent education programs:

  • “WCHQ and Novo Nordisk announce partnership to improve care to those living with obesity.” Recording of the presentation is here.
  • “Asthma Control in Clinical and School Settings” presented March 24 by Nicholas Antos, MD. Recording of this webinar is here.

WCHQ Welcomes New Corporate Sponsor

Sanofi Logo

WCHQ is pleased to welcome Sanofi as a corporate sponsor.

Improvement Teams

Behavioral Health

Tools for Implementing Collaborative Care

In United States primary care, helping patients with depression is a daily crisis. Over the past decade, Collaborative Care has emerged as the new standard for depression treatment in primary care. Recommended by the United States Preventive Services Task Force, this model speeds improvement through increased engagement, symptom monitoring and rapid treatment adjustment.

While Collaborative Care is a proven solution to this crisis, implementing it in any medical system exposes unexpected challenges. As an implementation group shapes a Collaborative Care model to fit their local environment, there is no systematic method to determine which parts of the model can be modified or where flexibility might undermine success.

The Core Principles and Tools for Implementing Collaborative Care defines a serviceable framework for making implementation decisions to integrate mental health treatment into primary care. When decision-makers agree not just on goals, but on the core principles those goals are based on, all decisions get filtered through a lens of shared values, and fall into one of two categories: "fidelity required” or “flexibility allowed.” This discrete, shared understanding enables anyone involved to ensure decisions have integrity.

To access the toolkit for free, follow this link.

Addressing Tobacco Dependence in the Behavioral Health System: Training in the “Bucket Approach”

Individuals coping with mental illness and/or other addictions, who use tobacco, are interested in quitting, can quit, but need more support. With funding from the Bureau of Prevention, Treatment, and Recovery in the Wisconsin Department of Health Services, the University of Wisconsin Center for Tobacco Research and Intervention has developed a free, online training to equip behavioral health clinicians with the skills to support patients on their quit journey. Addressing Tobacco Dependence in the Behavioral Health System: Training in the “Bucket Approach” launched in October of 2019 and is based on the Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence. The training is tailored both to the motivational readiness of smokers coping with mental illness and/or addiction, who may need more time and resources to quit, and the busy clinician who has limited time to address tobacco dependence. The training takes a system change approach to tobacco treatment integration and includes information about how to measure outcomes and implementation fidelity.

The Bucket Approach training consists primarily of videos that demonstrate each of the intervention’s clinicians can provide to enhance motivational readiness and success in quitting. The interventions are brief and designed to build upon the skills clinicians already possess. Available at helpusquit.org, the training can be completed at the clinician’s pace and offers up to 8.25 free CE credits. To date, 898 people have enrolled and 446 of these have been from Wisconsin.

Chronic Disease

Self-Measured Blood Pressure (SMBP) is a strategic method to help patients control their hypertension and determine if undiagnosed patients have hypertension. With clinical support, SMBP has shown to positively effect health system blood pressure control rates. SMBP involves the patient and the clinical care team. The patient uses a portable blood pressure device at home, checking and recording their blood pressure multiple times a day over a matter of several days. The results are then sent to the primary care team where an analysis might include changing the patient’s blood pressure medication or diagnosing them with hypertension if not done so already. When used with home-based blood pressure checks, patient counseling, education and visit follow-ups, patients are more likely to be on track and better understand and manage their hypertension.

Resources that can help your health system kick-start this strategy are the following:

SMBP was discussed during the March Chronic Disease Learning Collaborative meeting and the collaborative will continue to explore new ways to manage chronic conditions in the future. If you would like to be a part of the conversation, contact Jen Koberstein.

Adolescent and Child Health

The WCHQ Adolescent and Child Health Improvement Team focused on child and adolescent mental health at their March meeting. The meeting provided an opportunity to dig deeper into the subject and review resources as members shared their own best practices on addressing mental health among children and adolescents.

Member health systems emphasized the importance of integrated behavioral health when addressing child and adolescent mental health. One member stated they have a pilot program where primary care providers can request a 15-minute consultation between the patient, caregiver, and a psychologist during either a routine or acute appointment. Patients are then scheduled for follow-up behavioral health appointments as needed. Another member discussed the benefits of having a behavioral health consultant on staff as part of the primary care team. Patients are less likely to fall through the cracks with this type of model in place. In addition, it helps patients, who might fear speaking with a stranger or are nervous about the counseling process, better understand the normalcy of talking to someone and that counselors are regular people. One member noted that using their patient portal where patients can fill out their depression screenings ahead of time, allows the care team to prep for the patient’s visit more efficiently.

Resources related to Child and Adolescent Mental Health:

If you’re interested in joining the discussion or the Adolescent and Child Health Improvement Team, please contact Abbey Harburn.

Physical address

301 S. Westfield Rd.
Suite 320
Madison, WI 53717