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University of Wisconsin–Madison

Assessing and Improving Community Health in Wisconsin

Aurora St Luke's Medical Center

Implementation Approaches

Activities:

  • Provide participants with knowledge, skills and social support to improve dietary behaviors and increase physical activity through CORE/El Centro programming

Activities: 

  • Participate in the Milwaukee Health Care Partnership Emergency Care Coordination Initiative to link Medicaid-eligible and uninsured patients with medical homes and dental care in the Milwaukee area by scheduling appointments in the ED
  • Coverage to Care: Provide 24/7 intensive and systematic case-management for hospital ED high utilizers incorporating healthcare literacy, healthcare advocacy, healthcare coordination and healthcare homes
  • Provide patients being discharged from ASLMC with primary care or specialist appointments within seven days of discharge for follow-up through our Transitional Care Management initiative
  • Provide all patients being discharged from ASLMC with a follow-up phone call in their preferred spoken language through our Discharge Phone Calls initiative. Discharge Phone Call staff will also be trained on protocols for suicide assessment and linking patients with support for opioid and other drug issues.
  • Provide outpatient care to uninsured and underinsured patients
  • As appropriate, refer to AHCMG physician specialists through Aurora’s Specialty Access for Uninsured Program (SAUP)
  • As part of the Refugee Health Coordination Program, provide health screenings to new refugees
  • Through the Transitional Clinic program, provide care to new formerly incarcerated individuals

Activities: 

  • Continue to participate in the Wisconsin Collaborative for Healthcare Quality (WCHQ) and contribute data related to the ambulatory services provided. WCHQ validates the data, ensuring that it accurately reflects evidence-based standards, and publishes the results at http://www.WCHQ.org
  • Provide patients with health system navigation, connection to resources, health education, problem identification, cultural mediation and advocacy through Community Health Workers (CHW)
  • Provide culturally appropriate care for Spanish-speaking patients through our Spanish Cancer Clinic

Activities: 

  • Provide Well-Integrated Screening and Evaluation for Women (WISE Woman) program for cardiovascular screening including blood pressure, blood sugar, weight and blood cholesterol levels and provide treatment
  • Provide breast and cervical cancer screenings through the Wisconsin Well Woman Program (WWWP)
  • Provide breast cancer education, screening reminders and low or no-cost breast cancer screening resources to underserved women through the CHANGE grant
  • Administer heart risk appraisals at Karen Yontz Women’s Cardiac Awareness Center
  • Provide resources for Karen Yontz Women’s Cardiac Awareness Center educational events
  • Conduct health risk assessment quizzes related to heart disease and risk factors, offer behavioral contract
  • Provide education on heart-health implications from certain types of cancer treatments
  • Offer cancer prevention, detection and early diagnosis education through various community venues and events in our community and at our facility
  • Advance our ASLMC Cancer Nurse Navigator program
  • Provide staff for the educational component of the Living Well Beyond Cancer program for breast cancer survivors at the Women’s Pavilion at Aurora West Allis Medical Center
  • Partner with Aurora Family Services to provide supportive cancer counseling services
  • Actively promote and refer patients and their families to programs, services and activities hosted by Aurora Cancer Services across our geographic area
  • Screen patients for hepatitis C in primary care and specialty clinics
  • Diagnose, manage, treat and track all patients with hepatitis C
  • Provide treatment for patients diagnosed with hepatitis C regardless of insurance status
  • Screen patients for abdominal aortic aneurysm (AAA) in primary care and specialty clinics
  • Diagnose, manage, treat and track all patients with AAA
  • Provide treatment for patients diagnosed with AAA regardless of insurance status

ACC education and screening events take place year-round across Metro Milwaukee. These events and activities benefit people and communities we serve and to which we refer and support through our participation:

  • Sankofa – Aurora Sinai Medical Center
  • Team Phoenix– Aurora Sinai Medical Center
  • Reflections of Wellness – Aurora West Allis Medical Center
  • Living Well Beyond Cancer – Aurora West Allis Medical Center
  • Spanish Cancer Clinic – Aurora St. Luke’s Medical Center
  • Milwaukee Public Schools HPV Education Program - Milwaukee Metro
  • Southeast Asian Community Health Forums and Cancer Curriculum development - Milwaukee Metro
  • Aurora Cancer Care Speakers Bureau
  • Know Your Family History Program
  • Milwaukee-area partnerships developed through the Wisconsin’s Collaborative Approach to Increase Colorectal Cancer Screening grant
  • Workplace education and screenings across our metro area

Activities:

  • Provide counseling with a team led by a bilingual PhD Psychologist and four counseling students

Activities:

  • Conduct specialized advanced health professional education for EMS providers in our broader service area
  • Provide EMS/Trauma Coordinator to serve as liaison to the community, providing education on Comprehensive Stroke Care
  • Conduct specialized disaster-planning education for fire departments in our broader service area
  • Conduct specialized advanced health-professional education on our hyperbaric chamber
  • Provide shadowing experiences for medical and nursing students

Activities: 

  • Provide bilingual social services to help underserved patients navigate the healthcare system and access safety-net resources, obtain legal documents, address domestic violence issues and receive family counseling/family planning information