RCHC Community Project Abstracts

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Rapid Influenza Testing in the Cottage Grove Community Hospital
Date of project: 8/3/2009

The goal of this project is to determine the number of positive and negative cases of influenza that have been detected with the QuickVue rapid influenza test at the Cottage Grove Community Hospital (CGCH) between 7/9/09- 8/25/09. CGCH encompasses an emergency department, medical ward, and outpatient clinics in Cottage Grove, a community of 18,000 in the southern part of Lane County, Oregon. The first screening test used by CGCH in the workup of acute influenza is the QuickVue Influenza test, which detects influenza A and B antigens directly from a patient’s nasal sample. The basic demographics of the patient population tested at CGCH during the study period is outlined, and the most common symptoms of patients presenting with influenza are identified. The sensitivity and specificity of the QuickVue test is discussed along with the prevalence of influenza (specifically the novel H1N1 influenza A virus) in the region.

Reimbursement without insurance: The cost of free medical care at the Cottage Grove Emergency Department.
Date of project: 6/29/2009

The burden of loss of healthcare insurance has been a politically hot topic recently as our country’s leaders are struggling to find a solution to our failing healthcare system. I investigated the problem of uninsured patients seeking healthcare in the Emergency Department at the Community Hospital in Cottage Grove, Oregon, by analyzing financial records and determining total charges and reimbursement characteristics over several years. Comparison of data from 2005, 2008 and estimates for 2009 indicated a steadily increasing proportion of charges were made charged to uninsured patients. Furthermore, there was a coinciding steady decrease in the amount of charges made to patients with commercial insurance. These results indicate a shift in charges, which coincide with national trends indicating increased loss of insurance as unemployment levels continue to rise and other factors are contributing to patients’ loss of insurance. Through programs such as PeaceHealth’s “Bridge Assistance,” our regional healthcare systems are struggling to stay afloat as Congress continues to debate healthcare reform and the Federal Government continues to bail out major healthcare systems across the nation.

Trauma Management at the Cottage Grove ED: Change in Process
Date of project: 2/9/2009

Trauma preparedness in small community hospitals remains a Catch-22. On the one hand, these hospitals may not be designated formally as a trauma center – any organized emergency response units recognizing a serious trauma would bypass these hospitals and take the patient to a larger center. On the other hand, the community at large may at any moment arrive with serious trauma, unaware of the specific capabilities of their nearest hospital. Thus, these hospitals must be as prepared for trauma as possible despite often limited resources. Cottage Grove Community Hospital is one such hospital, located in a small town of 9,000 in Cottage Grove, OR. Last year a trauma event that was not handled optimally initiated a major revamping of the hospital’s trauma-preparedness on many levels. This project is aimed at outlining and understanding the process of change thus far, primarily via several discussions with the Emergency Department operations manager, Naomi Grace. Both the process of review of the event as well as the specific modifications made thus far were described in detail. Lastly, Ms. Grace indicated that her next step was to be a literature review of rural trauma. The final contribution of this project was the completion of a literature review and presentation of those findings to her.

Access to Orthopedic Services in Cottage Grove, Oregon
Date of project: 8/4/2008

Access to health care services meets many barriers in rural communities and the experiences of community members in South Lane and North Douglas Counties are no exception. While Cottage Grove Community Hospital is generally successful in meeting its community’s primary care needs, the availability of specialty services continues to be lacking. Through observation, interviews of patients and the medical community, and data compilation, the need for orthopedic services in Cottage Grove, Oregon, was assessed. Based on the data and observations, it can be concluded that Cottage Grove Community Hospital patients face significant obstacles to receiving orthopedic care. Furthermore, it can be suggested that there is sufficient patient demand for orthopedic services for CGCH to consider bringing orthopedic services to the facility. It is hoped that this assessment will raise the awareness of specific barriers to health care and provide a direction in which to work to minimize the obstacles Cottage Grove Community Hospital staff and patients face in providing and receiving specialty care, specifically orthopedics.

Educating patients in Cottage Grove Oregon about the many consequences of cigarette smoking
Date of project: 9/10/2007

Tobacco causes more deaths each year than car accidents, suicides, murders, HIV, and illegal drug use combined, according to the CDC. People that are the most likely to smoke are those with lower level of education, lower socioeconomic status, and/or live in rural communities. Sadly, smoking rates are also higher during pregnancy and postpartum in these groups, leading to increased fetal and infant mortality rates. The goal of this project is to educate the community about the dangers of smoking during pregnancy, and exposing children to secondhand smoke, along with educating patients on the multiple consequences of smoking that effects their own bodies. The need for this project was recognized while interviewing patients and parents of patients at South Lane Medical Group in Cottage Grove. Additional information was gathered from government agency websites and from a literary review of studies on the consequences of tobacco use. Patient handouts were created to educate patients on the harmfulness of smoking, and to aid physicians in smoking cessation counseling. These handouts have been made available in patient rooms, so the patient can read them while waiting to see there health care provider, or so that the physician can hand them out to patients to take home to read.

Barriers to Utilization of the Human Papillomavirus (HPV) Vaccine at the Cottage Grove Hospital & Clinic; Development of Provider Education Materials
Date of project: 9/11/2006

The Human Papillomavirus (HPV) is responsible for up to 99.7% of cervical cancer. A new HPV vaccine recently approved by the FDA has demonstrated significant efficacy in preventing persistent, high-risk HPV infections when administered prophylactically. Due to the novelty of this vaccine, however, many providers are unaware of the details of its availability and of their patients’ ability to procure the vaccine at affordable rates. In addition, vaccination is not yet widely accepted by patients or parents, for a variety of reasons. The goal of this project was to investigate the barriers to vaccination at the hospital and clinic in Cottage Grove, Oregon, a facility serving approximately 18,000 patients, 31.5% of whom are aged <25. A literature search was performed for information regarding HPV and the efficacy of the vaccine. Availability of the vaccine was confirmed by the hospital’s pharmacy. Several major insurance carriers were contacted regarding coverage for the vaccine. Availability and insurance coverage of the vaccine was found to be much greater than most providers had previously believed. A secondary goal of the project was to develop provider education materials aimed at minimizing barriers to immunization with this promising new vaccine. This was achieved by the production of a single-page, double-sided, tri-fold informational handout. Provider response was positive, and several providers who had not previously prescribed the vaccine offered it to their patients, some of whom began the 3-shot series immediately.

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