38th Annual Oregon Rural Health Conference Goes Virtual

The 38^th Annual Oregon Rural Health Conference is changing to a virtual format in response to the continued COVID-19 surge. The health and well-being of rural Oregon is our top priority. We do not want to place attendees, rural health care workers, hospitals and clinics under any more pressure than they already face.

The conference will offer sessions focused on rural health care workforce, rural health clinics and mental health first aid. 

The revised schedule is posted on our website.

ORH is Hiring! Program Manager—Population Health

ORH is pleased to announce that it is recruiting for a Program Manager of Rural Population Health! This person in this position will be responsible for:

• The evaluation, planning, program development and administration of ORH’s ongoing population health initiatives. An example of a current initiative in this area is healthy aging in rural Oregon through delivery of the ORH Forum on Aging in Rural Oregon and Elder Service Innovation Grants.
• Coordination and provision of technical assistance/education related to technology tools that support rural health care facilities’ efforts to expand access to and support population health and the delivery of preventive, primary care, specialty care, and emergency care services to patients, and improve health outcomes. Examples of current initiatives include telemedicine and Information Technologist (IT) continuing education.

Learn more here and please share with your networks.

ORH’s 2021 Oregon Areas of Unmet Health Care Need Report Published

ORH is pleased to announce that its 2021 Oregon Areas of Unmet Health Care Need report has been published. This annual report looks at nine variables that measure access to and utilization of primary physical, mental, and oral health care in the state. The high-level categories of these variables include the availability of different provider types by location, a population’s ability to afford care by location, and utilization of health care services including inadequate prenatal care, preventable hospitalizations, and emergency room visits for non-traumatic dental, mental health and substance abuse.

Among many other uses, the report can be utilized as a reference for state partners to prioritize financial and technical assistance and for health care stakeholders to advocate for unmet needs in their community.

The report is available here.

USDA Makes $500 Million Available in Emergency Rural Health Care Funds

The USDA has announced the availability of $500 million in Emergency Rural Health Care Funds under the American Rescue Plan. Grants are available to help rural health care facilities, tribes and communities expand access to COVID-19 vaccines, health care services and nutrition assistance through two tracks.

Track 1 Recovery Funds are intended to increase COVID-19 vaccine distribution and telehealth capabilities; purchase medical supplies; replace revenue lost during the pandemic; build and rehabilitate temporary or permanent structures for health care services; support staffing needs for vaccine administration and testing; and support facility and operations expenses associated with food banks and food distribution facilities. Applications for Track 1 will be accepted on a continual basis until funds are expended.

Track 2 Impact Grants are available to help regional partnerships, public bodies, nonprofits and tribes solve regional rural health care problems and build a stronger, more sustainable rural health care system in response to the pandemic. Applications for Track 2 are due October 12, 2021.

Tele-STELLA Study

Do you care for a family member with dementia? Would you like to learn more about coping with upsetting behaviors and mood? Researchers are working to understand how to help family members who care for someone with dementia.

• All study activities are done from your home, no travel is needed
• Your family member with dementia does not need to live you
• If you do not have a computer, we will loan you one so that you can participate in the study
• Gift cards up to $100 will be provided for completing all study activities

For more information, please contact Dr. Allison Lindauer.

Compassion and Solidarity: Enhancing Ethical Medical Care in Oregon and Beyond

This Oregon Health and Science University Center for Ethics in Health Care virtual lecture series will examine various health care practices through the shared lenses of compassion and solidarity. The goal of this lecture series is to illuminate complex medical topics including ethics in the end-of-life context, justice and equity in the Pacific Northwest, how to improve health literacy and become a more compassionate communicator, why storytelling can help prevent burnout and make clinical practice more humane, and ways in which grief and trauma can be diminished through friendship and solidarity.

CEU credits (one per session attended) are available at no charge.

The schedule is as follows:

• Health Literacy and Systemic Racism: Addressing Oppression Through Clear Communication
  September 10 from 8:00 - 9:00 am PT
• Shifting the Lens: Storytelling for Solidarity
  October 22, 8:00 - 9:00 am PT
• Grief in a Time of Pandemic: How to Respond, How to Heal
  November 19 from 8:00 - 9:00 am PT

Recordings of previous presentations in this series are available.

Oregon ECHO Network Programs Starting in September

The Extension for Community Healthcare Outcomes (ECHO) is a tele-mentoring program that uses videoconferencing technology to combine brief expert presentations with interactive and practical case presentations from participants. The overall goal of ECHO programming is to build new care capacity at the community level. There are new programs starting this September!

General programs:

• Whole-Person Care for Children and Youth in Foster Care
• Gender-Affirming Care Across the Lifespan
• Veterans and Military Behavioral Health
• Team-based Approaches to Diabetes Care Management
• Geriatric Care in an Age-Friendly Health System
• Integrated Behavioral Health for Pediatric Populations

Dental programs:

• Pain Management and Substance Use Disorders Dental ECHO

Addiction medicine programs:

• Hepatitis C: Treatment and Elimination
• Hepatitis C Community of Practice
• Substance Use Disorders in Hospital Care
• Substance Use Disorders in Ambulatory Care
• Addiction Medicine Curbsides and Conversation

Flex Spotlight: FY20 CAH Quality Improvement Successes

As the Oregon Office of Rural Health (ORH) closes out another year of the Medicare Rural Hospital Flexibility Grant (Flex), we celebrate some of the project and activity successes related to quality improvement (QI) efforts and reporting at Critical Access Hospital (CAHs) across Oregon during FY20 (September 1, 2020 - August 31, 2021). Here are some of the highlights: 

• Nineteen staff from five CAHs completed the Sigma Med Solutions Thrive, Don’t Just Survive Virtual Collaborative where they learned QI fundamentals and had the opportunity to choose and complete a QI project while concurrently completing the steps to obtain their Green Belt Certifications. Congratulations to all who completed the collaborative!
• Twelve quality professionals were awarded and completed their Certified Professional in Healthcare Quality (CPHQ) prep courses through NAHQ and successfully obtained their CPHQ certification! Seven additional quality professionals have been awarded and will start their prep courses with the goal of becoming certified in 2022. Thank you, participants, for your commitment to quality! 
• Five CAHs were awarded full and/or partial memberships to the University of Washington Tele-Antimicrobial Stewardship Program (UW-TASP) as they work to improve and maintain antimicrobial stewardship efforts at their facilities. 
• Sponsorship of the Reimagining Healthcare Engagement Summit by Custom Learning Systems, which provided free access to Oregon’s CAH and rural hospital and providers to learn about refreshing the workplace through resilience, agility and kindness. Forty-eight individuals from 19 organizations participated in this event. 
• Supported nine staff members from two CAHs to attend a TeamSTEPPS Master Trainer workshop hosted by Tillamook Regional Medical Center. 
• Hosted the CAH Quality 101 series to teach the fundamentals of CAH QI. The series continues through October 2021 with monthly open office hours that support CAH peer-to-peer sharing and learning opportunities.  

ORH congratulates Oregon CAHs on their commitment to and successes in quality improvement, especially during these difficult times. For questions about the quality activities offered through the Flex program, please contact Stacie Rothwell.

ORH administers Oregon’s Flex program, which is funded by the Federal Office of Rural Health Policy. The Flex Program is intended to preserve access to primary and emergency health care services, improve the quality of rural health services, provide services that meet community needs and foster a health delivery system that is both efficient and effective. The Oregon Flex program supports CAHs in quality improvement, quality reporting, performance improvement, and benchmarking. It also supports CAHs and their associated clinics in finance/operation improvement and population health. The program also focuses on assisting rural and frontier emergency medical services (EMS) in quality and operational improvement.

We will highlight activities for Rural Health Clinics, rural and frontier EMS and population health initiatives in future issues of this newsletter. For questions about the activities related to Rural Health Clinics, contact Rondyann Gerst; for rural and frontier EMS, contact Rebecca Dobert; and for population health, contact Sarah Andersen.

FY20 SHIP Projects Yield Great Results

ORH is pleased to recognize the incredible work of Small Hospital Improvement Program (SHIP) awardees during the 2020-21 grant year. Despite all awardee hospitals maintaining intense response activity during an unyielding public health emergency, ongoing supply chain issues and staff challenges, each and every one completed their SHIP work on schedule. This is nothing short of amazing, and we offer our thanks and appreciation for the commitment to quality improvement and accountable, value-based care. You positively impact your patients and colleagues every day.

Enjoy a look at the high-quality SHIP projects awardees completed during FY20.

Adventist Health Tillamook focused on telehealth access:

Access to care is a key area of focus called out in our triennial Community Health Needs Assessment. Because we are a small rural hospital that is 68 miles from the nearest tertiary care hospital…telehealth services for stroke patients provides timely access to consultation with a stroke specialist.

Columbia Memorial and Silverton Legacy Hospitals targeted improvements related to their surgical programs:

CMH has developed an in-house data and reporting team. SHIP funds were used to purchase software licenses and software support costs for an application…to extract quality data and build quality reporting dashboards and reports. The Surgery Block Utilization dashboard has allowed the hospital to better manage its operating rooms. Key indicators are available timelier, allowing for better decision making.

Currently, Legacy Health is undergoing a systemic shift in its approach to quality and process improvement…a recent project at Legacy Silverton Medical Center revamped the process for identifying which instruments are needed for surgeries to eliminate waste and minimize wait times for patients as a result of having extra or not having the correct instruments prior to surgery.

Asante Ashland Community Hospital, Coquille Valley Hospital, Curry Health Network, Grande Ronde Hospital, Harney District Hospital, Lake Health District, Mid-Columbia Medical Center, Wallowa Memorial Hospital and West Valley Hospital all used awards to maintain HCAHPS and other data collection and analysis to inform continuous quality review and target improvement with training and learning opportunities. Some hospitals have seen targeted scores more than double with the consistent ability to collect and analyze data. Work includes expanding staff access to reporting and analysis and its meaning; purchase of technology to improve data collection; and implementation of rounding and huddle policies related to improvement efforts.

Grande Ronde Hospital reported:

…leadership rounding improved several HCAHPS and EDCAHPS domains by approximately 5%. The SHIP program allows our staff to grow with education and training that would otherwise not be available due to limited funding and priorities.

Harney District Hospital shared:

Having this data available has allowed our facility to become better informed about how the patient sees us and more responsive to possible issues. We appreciate data…and use it to inform our goals. Results: direction for setting work plan goals and annual metrics [including]:

• Weekly updates on patient satisfaction “Would Recommend” score on Tier 2 & 3 huddle boards throughout organization;
• Ability to develop composite metrics to target specifics, for example “Understand”’ questions across all service lines or a domain area like Inpatient Discharge & Transition;
• Monthly satisfaction score report to Patient Safety & Quality Committee;
• Regular reports for care provider…featuring feedback from their own patients; and
• Skill information and resources to target lower performing areas.

Blue Mountain Hospital, CHI St. Anthony Hospital and St. Charles Prineville Hospital (SPCH) used funds to support participation in the University of Washington Tele-Antimicrobial Stewardship Program (UW TASP) cohort of hospitals from Arizona, Idaho, Oregon and Washington.

SCPH reported:

Our pharmacist… was able to share cases, collaborate and present on the work that was happening within our own health system and at a local level. [The pharmacist] presented…to our quality and patient safety committee and shared early learnings and the intent of the program to our physician and executive leaders. This then prompted the opportunity for our physicians to ask questions, provoke thoughtful conversation, and awareness to a physician’s practice in prescribing antibiotics. 

Because of the ongoing partnership and collaboration…our pharmacy team has now collaborated with a new pharmacy manager, second critical access hospital (within the health system) and emergency department provider to create a “northern campus antimicrobial team.” This team has been created to sustain learnings, evaluate change, and identify opportunities within the organization and at the two critical access hospitals. 

Good Shepherd Health Care System, Lower Umpqua Hospital, Pioneer Memorial Hospital and St. Charles Madras Hospital used awards to participate in trauma simulation programming to enhance coordination of trauma patient care and target improved patient outcomes.

Over 100 staff and providers across the four facilities participated in the simulations. Hospitals had the chance to practice real-time team roles during trauma responses, and self-identify areas to target for improvement such as:

• Trauma coordinator to work with EMS and ED management to develop a standardized set of questions regarding OB/Trauma patients.
• ED staff will receive [additional] training on OB charting, to be updated and reinforced with annual trauma skills day training.
• Implement closed loop communication and clarify assigned roles for team members during trauma response.

Samaritan Lebanon Community Hospital, Samaritan North Lincoln Hospital, Samaritan Pacific Communities Hospital and Southern Coos Hospital and Health Center supported access to national level training opportunities.

The funds allowed…leaders to attend the Institute for Healthcare Improvement Virtual Forum. This was the first time being able to attend this national conference by all but one of the attendees. Fourteen people were able to attend the virtual conference.

Improvements in clinical care as a result of the projects were many…

• Cleanliness of environment project – The hospital scores had dropped…in Q3 2020. By the end of Q4 we had increased...
• C. diff prevention action plan…the action plan is very detailed and includes multiple disciplines…we are on track to meet our goals.
• Dr. communication in the ED…improved…by several percentiles. 

All the quality and IP staff were new going into 2019, so the training we have been able to receive has contributed greatly to the success of our department.

Finally, St. Charles Redmond Medical Center supported Trauma Care After Resuscitation (TCAR) training. 

The course is designed to train inpatient nurses to be able to identify, understand, and anticipate changes for their patients with traumatic injuries. The hospital was able to register 34 nurses to take the online, self-paced course. 

Learners then had the opportunity to apply concepts by participating in interactive, expanding case scenarios focused on admission-to-discharge patient care. Cases include the surgical, medical, and nursing management of patients with:

• Thoracic trauma;
• Abdominal trauma;
• Musculoskeletal trauma;
• Craniocerebral trauma; and
• Spine and spinal cord trauma.

The outcomes being measuring are: decreased mortality, decreased length of stay, and nurse satisfaction. 

We chose the TCAR course for many reasons. For starters, caregivers are starving for education and this course will not only provide learnings to the caregivers taking the course, but also caregivers they work with. The impact of learning from peers is more valuable than learning from someone you do not know. The impact from the TCAR course will affect every unit in St. Charles Redmond, increasing staff knowledge, providing better patient care, decreasing complications and improving patient outcomes.

For questions about any aspect of the SHIP awards, contact Field Services Program Manager Rebecca Dobert at dobert@ohsu.edu | 971-271-0481.

Request for Grant Proposals: CAH and EMS Partner Project

ORH is pleased to offer a grant opportunity for one Oregon CAH and a partner EMS agency, with funding up to $5,000.

The application period is anticipated to open in October 2021, with online application posted to the ORH Grant and Scholarship webpage.

Interested CAH-EMS partners should propose work to improve targeted outcomes by strengthening the coordination between pre-hospital and hospital providers, policies and/or programs. Applicants may propose to expand existing programming or implement new projects. Proposals must target a minimum of two improved outcomes for care of patients transferred from pre-hospital EMS to hospital providers.

Grantee requirements:

• Complete planning and progress report telephone calls and/or on-site meetings with ORH staff.
• Identify a minimum of two target improvement measures and baseline benchmarking.
• Create a brief final evaluation report.
• Provide final budget and spend details at the conclusion of the project period.

For more information, please contact Rebecca Dobert | 971-271-0481.

Loan Repayment Option for Mental and Behavior Health Professionals

The Oregon Behavioral Health Loan Repayment Program (OBHLRP) is now open for health care professional applications. OBHLRP supports rural and urban underserved communities in the recruitment and retention of high quality mental and behavioral health professionals. These professionals work in inpatient, outpatient, and community care settings serving patients regardless of their source of coverage (Medicaid, Medicare, private insurance, etc.).

OBHLRP accepts applications from Qualified Mental Health Associates (QMHAs), Qualified Mental Health Professionals (QMHPs), pre-licensed and licensed mental and behavioral health care providers In exchange for service at a qualifying practice site, participants receive tax-free funds to repay qualifying educational loan debt.

Eligible behavioral health professionals are highly encouraged to apply as early in the application cycle as possible to allow time for information requests from ORH. Completed Oregon Behavioral Health Loan Repayment Program applications, and all required attachments, must be submitted no later than noon (Pacific Time) on December 2, 2021. For more information on OBHLRP, including the provider application and FAQs, visit the program webpage.

Oregon Health Care Provider Loan Repayment Program Updates

Oregon Health Care Provider Incentive Loan Repayment offers licensed health care providers, as well as pre-licensed mental health providers, an opportunity to apply to receive tax-free funds to repay qualifying educational loan debt. The program recently increased its total possible award amount from $35,000 to $50,000 per obligation year. Also, in the past, the program required that providers be working at least 40 hours per week to be considered for a full-time award; the program now only requires 32 hours of direct patient care for a provider to be considered for a full-time award.

The current provider application cycle closes at noon (Pacific Time) October 7, 2021. Eligible providers are highly encouraged to apply as early in the cycle as possible to allow time for information requests about their application. For more information on the program, including qualification requirements, FAQs, and applications visit the program webpage.  

The Oregon Partnership State Loan Repayment Program is Accepting Applications

The Oregon Partnership State Loan Repayment Program (SLRP) is currently accepting applications for its 2020-2021 cycle. Unlike most loan repayment programs, SLRP’s provider application process is not competitive. As long as SLRP funds are available, if an eligible provider (meeting all program requirements) working at a SLRP qualifying practice site submits a complete SLPR application, that provider will be awarded.

An awardee’s practice site must provide 50% of the award amount, plus a 10% administrative fee. If an awardee is funded at an amount that is fiscally unfeasible for their practice site to participate, the awardee and practice site may negotiate an award amount that would allow the practice site to participate. For more information on this program, including provider and site applications, please visit the program webpage.

New Psychiatric Mental Health Nurse Practitioner Eastern Oregon Cohort Announced

Northeast Oregon Area Health Education Center (NEOAHEC) was awarded a Healthy Oregon Workforce Training Opportunity (HOWTO) grant of nearly $1 million to increase the psychiatric mental health nurse practitioner (PMHNP) workforce in eastern Oregon.

Based in Eastern Oregon, the OHSU PMHNP distance education program gives learners the flexibility to learn from home and have clinical experiences in their communities. Again this year, significant scholarships will be available for tuition and other expenses.

In the third year of this generous HOWTO grant, NEOAHEC has announced that a second cohort of students have accepted admission into the OHSU PMHNP program. Welcome to the program Chelsea Matthews, Nikki Billman, and Toni Bliek.

NEOAHEC Receives Grant from the Wildhorse Foundation to Start Pre-Health Society

Congratulations to NEOAHEC, which was selected to receive a $10,000 grant from the Wildhorse Foundation to establish a new Pre-Health Society program.

There are 10 students in the inaugural cohort who are pursuing dental, medical, physician assistant and physical therapy schools.

Northwest Public Health & Primary Care Leadership Institute 2022

January 19-21, April 27-29 & September 14-16, 2022

The Leadership Institute is an offering from the Northwest Center for Public Health Practice and the Northwest Regional Primary Care Association. The program (in Seattle, WA and virtual) builds on the long-standing training programs of the two collaborating organizations and is designed to help mid-career public health and primary care professionals become the next generation of leaders in their fields.

Email questions.

National Rural Health Day Promotional Toolkit Now Available

National Rural Health Day (NRHD) is quickly approaching. Promote the #PowerofRural with the new 2021 Promotional Toolkit full of customizable tools, such as planning calendars, coloring books, postcards, graphics, and more! These free tools can help enhance your community outreach efforts to schools, media, businesses, etc. While you’re at the powerofrural.org, be sure to fill your cart with some fun swag from the official NRHD Shop!

Rural Health Research Gateway

The Rural Health Research Gateway provides easy and timely access to research conducted by the Rural Health Research Centers, funded by the Federal Office of Rural Health Policy. Gateway puts new findings and information in the hands of subscribers, including policymakers, educators, public health employees, hospital staff, and more.

KCI Community Partnership Funds 13 Projects Across Oregon

The Knight Cancer Institute’s (KCI) Community Partnership Program has awarded $320,000 to projects that address cancer-related needs. The latest round of funding supports 10 new projects and continues funding for three others, together targeting a diverse range of cancer types and demographics. The KCI program has invested more than $4 million in 152 projects since 2014.

National Hispanic Heritage Month is September 15 to October 15, 2021

National Hispanic Heritage Month occurs every year mid-September through mid-October to honor cultures, traditions and history of Hispanic and Latinx Americans. National, state and local events occur (although many remain virtual) which create opportunities to engage in learning and celebration during this month. Explore resources below:  

• National Hispanic Heritage Month
• Portland Hispanic & Latinx Events
• 27^th Hispanic Heritage Dinner 
• 12 Hispanic Heritage Month Activities to Try This Year

National Recovery Month

For thirty-two years, September has been recognized by SAMHSA (Substance Abuse and Mental Health Services Administration) to bring attention to National Recovery Month. The month is highlighted to bring awareness and understanding of mental health and substance use disorders while also encouraging individuals in need of treatment and recovery services to seek help.

Recovery Month celebrates individuals living lives in recovery and recognizes the dedicated workers who provide the prevention, treatment, and recovery support services that help make recovery possible. 

Working Together for Crook County

Read about the 75-year partnership between St. Charles Prineville’s Emergency Department and Crook County Fire & Rescue.

Have You Visited the ORH Website Lately?

Check in regularly with the Oregon Office of Rural Health website for continuously updated information on upcoming events, rural resources, and related news. You can also connect with us on LinkedIn, Twitter, Facebook, and Instagram!

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