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University of Wisconsin–Madison

Assessing and Improving Community Health in Wisconsin

Aurora Medical Center in Summit

Implementation Approaches

Impact goal: Increased linkages to appropriate care for behavioral health

Strategies:
For our patients:

  • Provide ABHS social worker in our ED to assess and appropriately expedite referrals for behavioral health services
  • Provide behavioral health consults and referrals through ABHS telepsychiatric program


For our community:

  • Provide Chronic Pain Self-Management program, free and open to the public

Impact goal: Increased linkages to appropriate care for behavioral health
Strategies:
For our patients:

  • Provide ABHS social worker in our ED to assess and appropriately expedite referrals for behavioral health services
  • Provide behavioral health consults and referrals through ABHS telepsychiatric program
  • Provide Just Listen support program in which a “mentor” will be contacted either by ED staff or inpatient staff after a patient has come in with an issue related to opioid or heroin use. The mentor follows the patient after discharge and encourages appointments with mental health professionals or rehab programs with an end goal of sobriety.

For our community:

  • Provide Chronic Pain Self-Management program, free and open to the public

Impact goal: Increased access to care

Strategies:

For our patients:

  • Provide appropriate follow-up with non-emergent patients using our emergency department (ED) for primary care
  • Actively screen patients for coverage through the Marketplace or financial assistance programs and assist with application processes
  • Refer uninsured and self-pay patients using our ED for primary care to Lake Area Free Clinic in western Waukesha County or St. Joseph’s Medical Clinic in the City of Waukesha
  • Ensure access for seniors and other persons with transportation barriers by providing vouchers for Silver Streak Cab Company or Lake Country Cab Company

For our community:

  • Provide free diagnostics and specialty care to patients referred from LAFC and SJMC through referral voucher program
  • Provide hospital leadership to serve as board members for LAFC and SJMC

Impact goal: Increased access to educational opportunities for EMS providers

Strategies:

  • Provide educational sessions for EMS with speakers on evidence-based best practices including cardiac emergencies, trauma, working with pediatric patients and obstetrics
  • Provide clinical experiences for paramedic students, both in our ED and ancillary areas of the hospital
  • Provide Advanced Cardiac Life Support classes for paramedic students
  • Provide Sim Man/Sim Baby trainings for paramedic students

Impact goal: Increased opportunity for prevention and management of chronic disease

Strategies:

For our patients:

  • Provide Cancer Nurse Navigator (CNN) services for all cancer patients, regardless of payer status
  • Provide low dose lung CT screenings and referrals
  • Provide chiropractic and therapeutic massage sessions free to cancer patients
  • Administer cancer distress tool and provide appropriate referrals for follow-up
  • Hold annual cancer survivorship event for patients and their caregivers to provide information about cancer support resources and to address quality-oflife issues during and after treatment
  • As part of a system-wide population health strategy, identify and screen clinic patients at risk for hepatitis C; treat those who test positive

For our community:

  • Provide free community education classes for chronic diseases
  • Provide evidence-based Healthy Living with Diabetes programs, free and open to the public, to cover understanding diabetes, getting the right healthcare, monitoring blood glucose, learning about food and diabetes, adding activity to one’s life, understanding medications and living with diabetes
  • Provide free community diabetes support groups, facilitated by diabetes educators, with presentations by Aurora providers on topics including physical fitness, nutrition, rehab, pharmacy and well-being
  • Provide community outreach blood pressure screenings at various community events
  • Provide cancer screening events, free to the public
  • Continue to partner with the YMCA at Pabst Farms to offer Habit Heroes free health and wellness program to fifth through eighth grade students. Program goals are to:
    – Positively impact children’s well-being
    – Prevent health risks associated with inactivity and poor nutrition
    – Teach habit tracking and its importance
    – Provide incentives for personal growth and habit adoption
    – Create opportunities to replace poor habits with healthier ones
  • Develop a Junior Chef Cooking Club for children ages seven through twelve years of age aimed at teaching about healthy cooking methods and eating habits

Senior Care

Impact goal: Increase awareness of health issues among seniors

Strategies:

For our community:

  • Host monthly Summit Senior Breakfast Club, providing educational sessions on a variety of health topics including chronic disease, fall prevention and medication adherence
  • Provide Stepping On, a high-level, evidence-based program proven to reduce falls and build confidence in older people
  • Host Boost Your Brain and Memory program, an evidence-based, seven week workshop focused on brain fitness through physical activity, emotional health, intellectual activity, nutrition, spirituality and social engagement
  • Host AARP Smart Driving focused on teaching driving techniques that make a difference in the elder population by keeping them active, engaged in their communities and their homes. Seniors will learn safe driving strategies and refresh their knowledge of the latest rules and hazards of the road
  • Provide Advanced Directives classes, free and open to the public

Impact goal: Increased linkages to appropriate care for behavioral health

Strategies:

For our patients:

  • Provide ABHS social worker in our ED to assess and appropriately expedite referrals for behavioral health services
  • Provide behavioral health consults and referrals through ABHS telepsychiatric program
  • Provide post-traumatic stress disorder (PTSD) screening calls to trauma patients 30-45 days after discharge; provide referrals to mental health provider
  • Provide Just Listen support program in which a “mentor” will be contacted either by ED staff or inpatient staff after a patient has come in with an issue related to opioid or heroin use. The mentor follows the patient after discharge and encourages appointments with mental health professionals or rehab programs with an end goal of sobriety.

For our community:

  • Provide peer-led trauma support groups, open to the public, for anyone who has experienced traumatic injury
  • Provide Chronic Pain Self-Management program, free and open to the public
  • Provide community education presentations including: Living Alone without Being Lonely, Caring for the Caregiver, Autism, ADHD, etc.

Impact goal: Increased opportunities for stable employment

Strategies:

For our community:

  • Partner with area school districts to support High School of Health Sciences in Kettle Moraine, providing educational sessions
  • Provide job shadowing experiences for students of Pewaukee INSIGHT program, with rotations including radiology, lab, nursing, medical assistant, primary care physician, pharmacy, Emergency Department, and rehab
  • In partnership with the Wisconsin Division of Vocational Rehabilitation (DVR), facilitate the system-wide Temporary Work Experience internship program for individuals with cognitive and physical barriers, creating new and diverse talent pipelines for those with diverse abilities. The fully-compensated, 90- day internship is intended to give job seekers first-hand experience on job duties, role expectations and workplace culture. Interns have the support of an assigned job coach who stays with them throughout the duration of the internship and works with them to develop an individual plan and transitional steps to meet job role expectations. At the end of the internship, a review takes place with the goal of hiring the intern into a permanent position as a team member.