ORH Newsletter Vol. MMVII Ed. III
By Don Bourland
Published: Monday, April 16, 2007
Early in 2000, we faced a serious problem: It was increasingly difficult to recruit nurses and other health care workers to the central Oregon Coast. Given that the national nursing shortage was forecast to worsen, we had to give serious thought to how Florence, a small rural community, could find nurses for our hospital.
Our challenge was compounded by the fact that the average age of nurses at Peace Harbor Hospital was 50, meaning that many of them would be retiring soon. Additionally, Florence has the highest ratio of adults to youths in the state, at five adults for each younger person. Many of those older people would need our hospital's services.
The challenge was to develop a program using a "grow our own" approach to both reach out to the community for new workers and to tap the potential of our existing entry-level and mid-level work force. This program came to be known as the Career Pathways Initiative.
To help interest potential employees, we developed a High School Health Occupations Program in collaboration with Siuslaw High School. Several graduates of that program are now continuing in postsecondary education for health care careers, and three of the first year's graduates currently work at Peace Harbor Hospital.
One of the graduates, Megan, received a scholarship to pay for certified nursing assistant training during her senior year of high school. After graduation, she spent more than a year working in a veterinary clinic, and she recently was hired as a medical office assistant for one of our family practice physicians.
In order to strengthen our internal pipeline, we identified entry and mid-level workers who had an interest in further training. Those employees receive on-site career advising and support from our staff as well as from career advisers at the Lane Workforce Partnership.
Kim is another promising recruit. She has been a CNA at Peace Harbor Hospital since 2002. She dreamed of being a nurse, but until she moved to Florence she was not able to pursue that dream.
Kim has a small child and is now working on her prerequisites for the nursing program. She recently received a $3,000 scholarship from the Lane Workforce Partnership, as well as additional support for child care.
Kim also makes use of an employee tuition reimbursement benefit, and will apply for a scholarship from Peace Harbor to help pay for the nursing program once she is accepted.
Kim is one beneficiary of our "grow your own" strategy, and we look forward to seeing her fulfill her own dream; as well become a part of our RN team.
Through our experience, we have found that there are three critical elements of a successful "grow your own" program:
- Partnerships with education, work force development and related advocacy groups.
- On-site and ongoing support of employees who are interested in retraining for higher level positions.
- Scholarship, tuition reimbursement and loan repayment programs.
We have invested large sums of dollars to recruit, interview and relocate health care workers from other parts of the country. Our vision is to reallocate many of those dollars into educational funding for those already in our community and in our work force.
We feel this is a much wiser investment, because we are increasing the supply of health care workers versus competing with other health care organizations for the limited number of available health care workers throughout the country.
This "grow your own" strategy is one of many work force solutions that will help to address the coming skilled work force shortage. The model is replicable across many industries that also face problems created by work force shortages.
Don Bourland, regional vice president for human resources for PeaceHealth-Siuslaw Region in Florence, led the Career Pathways Initiative along with Cathleen Coontz, a registered nurse who is now the work force development coordinator for PeaceHealth's Oregon Region. The initiative received a Lane Workforce Partnership and Lane Metro Partnership award for work force development in 2004. This is the fourth in a series of biweekly columns about developing Lane County's work force.
Since its inception in 2005, the Oregon Rural Healthcare Quality Network (ORHQN) has worked to help rural and critical access hospitals stay ahead of the curve on transparency and quality reporting issues. Healthcare regulators, payers, providers and consumers are seeking to understand healthcare data and the relationship between cost and quality. Now, regardless of the metrics and methodology of the measures, both public and private sector payer organizations are moving to pay-for-performance as a strategy to improve healthcare.
Quality outcome reporting initiatives, which have been developed using urban research, may place rural providers at a disadvantage due to their small populations and sample sizes. The urban to rural comparison of healthcare outcomes is often distorted by the inability of rural providers to spread variances over a larger volume of patients. In a small sample, one patient can have a devastating effect on a hospital's performance ranking. Additionally, though many of the quality measures are valid, some are not applicable and do not reflect the type of services typically provided by rural facilities, such as stabilization and transfer of patients.
ORHQN hospitals are currently working together to understand the impact of reimbursement of clinical performance using urban standards for small and rural hospitals.
One of the most significant impacts is the amount of resources required to collect and report data. Pay-for-performance methodologies increase the amount of data collection and reporting a hospital must do. Rural providers are looking for solutions to address these additional requirements for performance measurement and data collection without further taxing an under-resourced and overworked staff. Pay-for-performance requirements are still voluntary for critical access hospitals, but are currently in place for rural prospective payment hospitals.
ORHQN provides a forum for rural providers and stakeholders to achieve consensus on the most relevant measures to determine rural healthcare quality. By working together, rural providers are able to problem solve, share best practices, and work toward standardizing and simplifying data collection. Currently nineteen Oregon hospitals are participating in a performance measurement initiative.
The ORHQN performance measurement initiative will allow participating hospitals to aggregate data and benchmark key performance indicators. For the initiative, ORHQN selected the Rural Performance Management (RPM) developed by Stroudwater Associates, of Portland, Maine, as a standard data collection and reporting platform. RPM provides a secure web- based service that allows hospitals to enter data into a framework; linking strategy to actions that will achieve improved performance.
RPM offers a core set of metrics in the domains of finance, customer, learning and growth, and quality and business processes. In addition, RPM provides customizable options for hospital-specific metrics. Using RPM reports, hospitals are able to analyze performance and then to identify underlying causes and gaps, which, once addressed, will lead to lasting improvement.
ORHQN is dedicated to helping rural hospitals improve quality by offering tools and services to improve performance. The performance measurement initiative and the peer review network are some of the examples of how ORHQN is keeping rural providers ahead of the curve.
East Linn physician Tim Hindmarsh, MD, of Samaritan Health Services, has jumped from airplanes, water-skied barefoot and pushed his physical limits in the last two years, all to raise money for and awareness of diabetes. In what he has dubbed the " Act Alive Decathlon," Hindmarsh races around Oregon as he attempts to complete 10 action sports in 24 hours or less. The decathlon is designed to highlight the best way to avoid Type II diabetes: exercise. It has also raised more than $10,000 for diabetes education.
Skydiving, windsurfing, slalom waterskiing, barefoot waterskiing, wakeboarding, snowboarding, downhill skiing, running, cycling and motocross make up the full slate of Act Alive events.
Hindmarsh recently announced plans for the 2007 Act Alive decathlon - scheduled for July 13 - and they include dramatic changes.
The second half of the decathlon will take place in east Linn County, and Hindmarsh wants as many people as possible to participate in the cycling and running segments with him.
“I’m going to complete the motocross event in Sweet Home, cycle from Sweet Home Family Medicine to the Lebanon Airport, hop in an airplane, skydive over Lebanon, land at Pioneer Elementary school and finish off the day with a five-mile run across town,” Hindmarsh said. “And I want people to come out and join me. The goal is simply to get out in the beautiful summer weather and make a statement about exercise and diabetes.”
The Santiam Spokes cycling club and the Build Lebanon Trails group have endorsed Act Alive, with the Spokes committing to join Hindmarsh for the cycling portion and Build Lebanon Trails committing to participate in the running and walking event.
Act Alive participants will be able to do anything from cycling and running the full distance with Hindmarsh to simply walking one mile during the final leg of the decathlon. Participants may raise money by obtaining pledges, with all proceeds going to the Diabetes Education fund at the Lebanon Community Hospital Foundation, which provides diabetes education scholarships to low-income east Linn residents.
“Every penny that we raise through Act Alive will go to the Diabetes Education fund,” Hindmarsh said. “We have a huge percentage of people in our community who need to take diabetes classes and I’m very serious about helping them.”
The Oregon Office of Rural Health honored Hindmarsh with the “2006 Outstanding Contribution to Rural Health Award” for his efforts with Act Alive.
Specific event times and more information will be posted to www.samhealth.org. Simply click on the link to “ Samaritan Lebanon Community Hospital.” The site also features a video of last year’s Act Alive decathlon.
To sign up for Act Alive, or for more information, contact Brad Canfield, public relations manager at Samaritan Lebanon Community Hospital, at 451-7161 or bcanfield@samhealth.org.
Good News! The Deschutes Rim Health Clinic, serving the South Wasco County community, is here! After six long years, the board of directors is finally celebrating an actual clinic building on property just east of Canyon Rim Manor, in Maupin.
In November, 2000, south Wasco county voters approved a $.25/thousand tax base to establish the White River Health District. Originally part of a planned assisted living facility, White River Health and Living, the health district branched off and became a tax-based Oregon Special District, White River Health District, with its own board of directors and tax district regulations. The first board of directors, consisting of Bob Ashley, Tom Rinearson, Jerri Parman, and Doug Jones, began work on all the background needed to build and staff a health clinic. It soon became apparent that the main concern would be funding.
Generating approximately $40,000 per year in tax revenue, the board realized that it would be quite a few years before enough accumulated taxes would build and staff a clinic. So Doug Jones, the present chairperson, wrote and applied for a low-interest loan. The White River Health District received a loan of $260,000 from the Special Districts Association of Oregon. And then came a real stroke of luck when Wasco County deeded over property it owned to White River Health District! The property is on the rim rock overlooking the Deschutes River – hence the name: Deschutes Rim Health Clinic. Then began the job of contracting for a modular clinic building, with all the attendant financial considerations and regulations. A company and design were approved. It didn’t happen quickly. Design changes, communication problems among the contractor, sub contractors and the board delayed the construction again and again. But forging ahead, the board of directors contracted with Michelle Davis to provide much needed “set-up” services for the clinic, which Michelle did with great dedication.
Last year, the board hired its new Office Manager/Medical Assistant, Diana Gerber. She is a local resident, who knows the area. Diana has been busy continuing all the background work in setting up a clinic and staff. Soon to join Diana will be our Physician’s Assistant, Sharon DeHart, and our over-seeing physician, Dr. Stephen McLennon. Dr. Lee Balentine will also have his new dental office in the clinic building. Current board members include Doug Jones, Dennis Beechler, Karletta Carrithers, Mark Peterson and Jerri Parman. Budget Committee members are Marge Gustafson, Cathy Cameron, Sherry Holliday, Virginia Fuller and Pam Ashley.
Services provided by the clinic will include routine physical and sports exams, diagnosing and treating acute and chronic illness, treating minor injuries, administering vaccinations, alcohol and drug prevention and treatment, health education, counseling and wellness promotion. Dental services will be provided by Dr. Balentine.
The Deschutes Rim Health Clinic will be a functioning clinic by June, 2007. The many years of hard work, dedication and hope for a facility to serve South Wasco County residents will have paid off. The goals of the clinic are to provide quality primary health care services and to provide health education that is oriented toward health maintenance and prevention for all members of our community.
Please see our website at www.deschutesrimhc.com or e-mail us at info@deschutesrimhc.com
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have launched A Healthier US Starts Here, an initiative focused on motivating seniors and others with Medicare to make the most of Medicare's preventive services.
During the spring and summer, the Medicare Prevention tour bus will visit each of the 48 continental United States to promote conversations between people with Medicare, families, caregivers, health professionals, and community organizations. Many disease prevention advocates, employers, and civic and state leaders have joined our efforts to create awareness of disease prevention and wellness.
Data show that the increased use of Medicare preventive benefits can help prevent and detect chronic diseases early in their course, when they are most treatable, and can save lives. For example:
- More than 34 million Americans have low bone mass, placing them at increased risk for osteoporosis; osteoporosis can be prevented and early diagnosis and treatment can reduce or prevent fractures from occurring.
- Decreasing total cholesterol levels by 10 percent in the U.S. population could result in a 30 percent reduction in the incidence of coronary heart disease.
- One pneumonia vaccine, which is free to Medicare beneficiaries, can be life saving-yet only about two thirds of those with Medicare report receiving the service and 46,700 U.S. adults die annually from vaccine preventable diseases.
A Healthier US Starts Here will also teach people how to make the most of the CMS web site, www.mymedicare.gov. This is a one-stop, user-friendly web site that gives registered Medicare users access to personalized information on benefits and services.
When beneficiaries log on, they can check which preventive benefits they need; check their Part B deductible status; view eligibility and enrollment information-including for the Part D prescription drug program; and take care of administrative issues such as verifying an address, ordering replacement Medicare cards, check on the status of claims, and get on-line forms and publications. People with Medicare can also get this information by calling 1-800-Medicare.
Medicare currently covers:
- One time ''Welcome to Medicare'' physical (including an abdominal aortic aneurysm screening)
- Cardiovascular screenings
- Smoking cessation counseling
- ancer tests - mammogram screening for breast cancer, pap test and pelvic exam screenings for cervical and vaginal cancer, colorectal cancer screenings, and prostate cancer screening
- Shots and vaccines - flu, Pneumococcal, Hepatitis B
- Bone mass measurement
- Diabetes screening, glucose monitoring supplies, and self-management training
- Medical nutrition therapy for people with diabetes or kidney disease
- Glaucoma test
In addition to community partners, an array of HHS agencies are participating in the A Healthier US Starts Here initiative, including the Office of Minority Health, the President's Council on Physical Fitness and Sports, the Office on Women's Health, the Office of Disease Prevention and Health Promotion, the Office on Disability, the Centers for Disease Control and Prevention, the National Institutes of Health, the Health Resources and Services Administration, and the Agency on Healthcare Research and Quality.
Annual ORH Conference Rural Oregon Calendar Photo Contest
Deadline: July 15, 2007
As a part of the Annual Oregon Rural Health Conference, the Office of Rural Health (ORH) is sponsoring a Rural Oregon Calendar Photo Contest. ORH invites participants to take their best photos of rural Oregon--people, places, things- and submit them to the ORH by July 15, 2007. Pictures chosen will become part of a Rural Oregon Calendar that will be used as a fundraiser for student scholarships to future Rural Health Conferences.
If you have questions, please contact Bob Duehmig at the ORH at 503-494-4450 or duehmigr@ohsu.edu.
Nominations Solicited for the 2007 Oregon Rural Health Conference Awards (ORHCAs)
The ORHCAs honor individuals and organizations that demonstrate outstanding commitment to improving the quality and availability of health care in rural Oregon.
Many unique individuals devote their time and energy to ensuring the physical and mental health of the rural Oregon communities they serve. We all know at least one person or group that has demonstrated an extraordinary commitment to health care in our community. The ORHCAs were created to honor those efforts.
Think about nominating someone whose actions have had a notable positive impact on the health of the community or a successful program that has been implemented that other communities might want to replicate. How about a teacher or coach with a unique approach to educating students on health care risk prevention, or a health care provider, clinic or health department that has demonstrated a unique devotion to the populations they serve?
Nominate a deserving individual or group in your rural community today! Nomination forms are available here.
Nominations will be accepted through July 5, 2007.
- The Challenges of Conducting Peer Review in Smaller Hospitals
May 30, 2007
Online
For more information and to register, please click here.
- Hospital Medicare Cost Reports
May 30 & 31, 2007
Pendleton, Oregon
- The Telehealth Alliance of Oregon (TAO ) in-service trainings for Critical Access Hospitals & Rural Health Clinics
June 1, 2007
Sites across the state will be announced soon
For more information, please click here.
- Fifth Annual Western Region Flex Conference
June 7-8, 2007
Jackson Hole, Wyoming
For more information, please click here.
- 4th Annual Rural Nurse Conference: "Rural Nursing: Growing Quality"
June 13-15, 2007
Richland, Washington
More information about the call for abstracts and the conference may be found here.
- Rural Women’s Health Conference
August 13-15, 2007
Omni Shoreham Hotel, Washington DC
Registration and conference details, click here.
- 24th Annual Oregon Rural Health Conference
September 13th - 15th, 2007
Salem Conference Center
For more details, please click here.
- 30th Annual Oregon Nurses Association's Nurse Practitioners of Oregon (NPO) Education Conference
November 2-4, 2007
Salishan Lodge on the Central Oregon coast
For more information, please click here.
