September 2021
President’s Column
WCHQ President and CEO
The 2021 WCHQ Board Retreat began with a discussion about WCHQ’s Core Values. Reinforcing and updating our shared values ensures that we have common expectations of WCHQ’s core role and can work together, collaboratively, to achieve our shared mission to improve health care quality and value. As a membership organization, both our staff and our members must agree to use common values to guide our work. Failing to understand how WCHQ works can lead to meandering paths as we drive toward our mission, or, worse, we could be navigating completely off course.
One value that received significant discussion was “participation.” While it was among the highest ranked values by staff and members, the Board debated whether participation was truly a value that drives our work or is it just a given for any improvement-minded entity.
A replacement term was offered in the discussion that resonated with many: engagement. Participation is taking action while engagement is making an investment in the organization. Herein lies the difference: WCHQ is a membership organization where the work we all do is selected collectively and achieved collaboratively. Our goal is not to serve some—it is to support all. The voluntary nature of our collaborative is an asset as it ensures that those who come to our table are invested in the outcomes we seek and willing to roll up their sleeves to do the work.
We look forward to working with each and every one of our members in the years ahead as we all work toward the common goal of improving the quality and value of health care.
Board Reviews WCHQ Organizational Values; Discusses Health Care Value
WCHQ’s Annual Board Retreat on September 21 began with an exercise to review and update WCHQ’s organizational values. Values provide the roadmap for how an organization does its work and are critical to ensure member and employee engagement. The WCHQ Board agreed that several of WCHQ’s original values remain critical to organizational success; namely trust, transparency and active engagement. Staff will review the Board’s feedback and WCHQ President and CEO Gabrielle Rude, PhD, will bring this back to the Board for final endorsement.
Delivering better care is a goal that Washington State and Wisconsin have in common. Speaking at the Retreat, Nancy Guinto, executive director of the Washington Health Alliance (WHA), told Board members that in their quest to deliver better care, WHA has found that the highest quality care is often the most efficient.
In her introduction of Guinto, Dr. Rude emphased that both organizations rely on collaboration to drive improvement. Like WCHQ, WHA uses data and information to assess performance and cost. Guinto said the Alliance does not report on individual providers’ performance but does report on clinic performance; however, all parties involved agree to certain parameters and adhere to strict guidelines on sample size and number of cases, and providers validate the data. She emphasized that provider buy-in is essential to WHA’s work.
“We try to not make it a competition by setting the framework that we should all strive to offer the highest quality care,” Guinto said. “We talk to our medical leaders about quality first and let cost follow. That resonates with them. The leaders of our largest health systems have agreed that they will compete on ‘everything,’ but not quality.”
That resonated with WCHQ Board members, as Wisconsin is known as one of the most collaborative and high-quality states in the nation. Imran Andrabi, MD, president and CEO, ThedaCare, summarized Guinto’s presentation and framed it around WCHQ’s value acceleration work. He challenged the Board to consider how the work on quality improvement can now be leveraged to increase the value of health care.
WCHQ Director of Performance Measurement and Analytics Matt Gigot shared draft data to measure health care quality. WCHQ has a robust repository of clinical quality that can be utilized to identify trends in utilization. Gigot shared that the initial focus of the upcoming reports will be on patients with diabetes.
Board Chair Kori Krueger, MD, chief quality officer, Marshfield Clinic Health System, said WCHQ could start with a program such as Choosing Wisely, which is fact-based and not judgmental. Several Board members agreed that Choosing Wisely could be a good way to begin working on increasing value.
Register Today: “The Impact of the Pandemic on Adolescent and Child Health”
WCHQ Education
“Understanding the Impact of the Pandemic on Adolescent and Child Health”
November 16, 2021
11 AM – 1 PM
One of the most pressing problems brought on by the pandemic is related to ensuring that behavioral health issues can be identified and appropriately treated when children and adolescents present with them.
On November 16, 11:00 AM – 1:00 PM, WCHQ will host a webinar that will help clinicians understand the problem and be able to identify appropriate resources. “Understanding the Impact of the Pandemic on Adolescent and Child Health” will feature several speakers from organizations that are familiar with the problem and offer resources.
The following organizations will present at this webinar:
The Voices of Wisconsin Students Project
This project gathered information about how students are coping during COVID-19 and it identified the challenges and found examples of success and resilience by obtaining feedback about students’ learning experiences. The project will help communities and health systems improve and implement services, programs and supports for Wisconsin youth.
PATCH seeks to enhance communication among adolescents and health care providers and teaches adolescents how to manage their own health care to ensure better outcomes.
The Wisconsin Child Psychiatry Consultation Program (CPCP)
The CPCP provides consultation, education and referral support to enrolled primary care providers caring for children and adolescents. The program provides screening and diagnosis, medication management, and treatment recommendations for behavioral and other therapy. It also provides referral support, education and training for enrolled primary care providers.
Children’s Wisconsin – Telehealth behavioral health services for children and adolescents
Telehealth with children is very different than with adults. Children’s Wisconsin will share what they have found works during a telehealth behavioral health visit with this patient population.
This webinar is at no charge for WCHQ provider members, annual partners and corporate sponsors. If you have questions, contact Mary Kay Fahey.
WCHQ Will Start Collecting Asthma Control Test Data
WCHQ is in the process of deploying an asthma control test measure in its Data Voyager data platform for use by members who are interested in this area of care. This measure will identify patients ages 5-50, with asthma, who had an asthma assessment during the 12-month reporting period. The draft specification in its entirety is ready for review by any health system interested in reporting this measure. Results of this measure are for internal use only.
The measure description follows:
The percentage of patients age 5 to 50 who have an active diagnosis of Asthma that have had an age-appropriate standardized asthma assessment in the 12-month measurement period. Examples of recognized assessments are as follows:
• Childhood Asthma Control Test (C-ACT)
• Asthma Control Test (ACT)
• Asthma Control Questionnaire (ACQ)
• Asthma Therapy Assessment Questionnaire (ATAQ)
If your health system is interested in reporting this measure or if you’d like the full measure specification, contact Jen Koberstein.
Improvement Teams
Behavioral Health
Suicide Prevention is a Continued Priority
The Behavioral Health Improvement Team identified suicide prevention as a priority earlier this year and it is planning additional education events on suicide prevention topics, including Zero Suicide. According to the Wisconsin Department ofHealth Services, 861 residents died by suicide in 2020. WCHQ health systems recognize the need to continue to offer intensive behavioral health services to their patients.
WCHQ recently began collaborating with Prevent Suicide Wisconsin to include health systems in the state suicide prevention plan. The work is just beginning and WCHQ has been participating in the planning meetings. The current suicide plan does not address suicide prevention in health systems and the goal is to include the health systems in the next version of the plan. WCHQ will coordinate with Behavioral Health Improvement Team members to ensure the health systems are represented during this process.
If you are interested in learning more about this effort or in joining the Behavioral Health Improvement Team contact Jen Koberstein.
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Obesity
Obesity Advisory Group Begins Measurement Work
The WCHQ Obesity Advisory Group, comprised of health care professionals focused on improving care for their adult patients with obesity, has been meeting monthly since earlier this year. The group has covered a lot of topics, from nutrition counseling, medication management to surgical solutions. With 39 percent of Wisconsin residents identified as obese, this works takes on an added sense of urgency as it is a major contributor to chronic health conditions.
The Advisory Group determined that now is the time to begin capturing data to better inform their work. After reviewing and discussing measurement in detail, the group said it will continue to consider the following measures:
• Obesity diagnosis
• Obesity prevalence within population
• Obesity blood pressure control
• Obesity pre-diabetes and diabetes HbA1c control
• Obesity weight loss with medication
The Advisory Group requested that WCHQ program these measures into its Data Voyager platform and begin collecting data on them. The results will then be shared with the participating Advisory Group members and be used to design improvement work. Later, the Advisory Group members will request that the WCHQ Measurement Advisory Committee consider the measures for public reporting on WCHQ.org.
If you are interested in participating on the Obesity Advisory Group or learning more about their work on this topic, contact Jen Koberstein.
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Adolescent and Child Health
Preparing for Flu Season During COVID-19 Pandemic
The 2021 flu season is approaching and clinicians, patients, and the community are preparing to address influenza as the COVID-19 pandemic continues. Wisconsin health systems are planning their flu vaccination clinics and working on logistics related to vaccinating the public against influenza and COVID-19 simultaneously. Because it is possible to develop influenza and COVID-19 concurrently, magnifying the severity of respiratory symptoms, it is more important than ever to encourage the public to receive their flu vaccines prior to the height of flu season.
Current CDC guidance states that the flu vaccine and COVID-19 vaccine can be given simultaneously. This presents a unique opportunity to vaccinate more eligible children and adults against COVID-19 when they present for an influenza vaccine. This year, CDC also recommends a specific timeframe for flu vaccination, stating that ideally all patients would be vaccinated by the end of October.
This month, the Adolescent and Child Health Improvement Team focused their discussions on how members are preparing to vaccinate patient sand to educate both patients and their parents on the importance of continuing regular flu vaccines. Many Improvement Team members are working on vaccination clinics that would offer both flu and COVID-19 vaccines to eligible patients. To join these discussions and participate in the Adolescent and Child Health Improvement team, contact Abbey Harburn.
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Chronic Disease
Advocate Aurora Presents on Remote Monitoring and Care Management
At the WCHQ Chronic Disease Learning Collaborative meeting on September 27, Julie Chappelle, MSN, RN, CEN at Advocate Aurora Health shared how the health system is efficiently and effectively improving quality outcomes, as well as the quality of life, through a combination of remote monitoring and care management. Chappelle provided examples of how the program could be scalable within a variety of settings.
Following the presentation, the group spent time discussing how to better understand the members’ needs as they continue to make staffing adjustments during these challenging times. It’s clear, it will take a longtime before the health systems begin to stabilize. The value of networking for WCHQ members has never been greater.
Wisconsin communities still need support as the number of chronic conditions continues to climb and the implications of health care disparities and the pandemic linger. The question is how can care providers position themselves to do their best work? Specifically: Does the new WCHQ Chronic Disease Learning Collaborative structure support the health systems at what they do best by reducing the learning curve by quickly disseminating best practices and relevant content that improve processes and provide better care? And, if not, what needs to be done differently? WCHQ staff is reaching out to members to address those questions. As feedback is received, it will be shared with members.
WCHQ staff is updating the chronic disease toolkits for hypertension and diabetes; the links are below for reference. The group is seeking member input on the toolkits and is looking for volunteers to join a steering committee that will guide this work. Contact Sheryl Pierce for more information.
Links to Toolkits:
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Oral Health Collaborative
The Future of the WCHQ Oral Health Collaborative
WCHQ has been publicly reporting dental measures since October 2020 and is planning a data refresh in October on the three current measures. The refresh will include data for the new cross-cutting medical and dental measure that identifies patients with diabetes and periodontal disease. This data will cover the time during the pandemic when many dental offices were closed and will provide important clues into the issues related to access to care for this population.
Implementing a patient reported outcome tool is a priority for the oral health collaborative in the coming year and they will continue to discuss how to begin collecting that data. The group also decided to implement a strategic planning process to guide future priorities and identify the necessary resources for implementation during this time. To learn more, contact Jen Koberstein, program manager.
