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University of Wisconsin–Madison

Assessing and Improving Community Health in Wisconsin

Aurora Shebyoygan Memorial Medical Center

Implementation Approaches

  • Provide Recovery Coaching through a WIRCO grant to establish hospitalbased recovery coaches in our ED to work with patients presenting with addiction issues
  • Support Mental Health America AODA Resource Fair
  • Sponsor Teaming Together for a Brighter Tomorrow to address binge drinking in Kiel and New Holstein school districts
  • Provide KidShape in the Classroom program for two first grade classes at Fairview Elementary School. This six-week program focuses on creating lifelong healthy habits for the entire family. The weekly lessons will be offered during class time and will be interactive, focusing on nutrition and physical activity. The parents and entire family will be engaged through completion of weekly at-home activities
  • Provide Meals on Wheels program for our vulnerable congestive heart failure patients for 30 days post-discharge to assure availability of nutritious meals
  • Provide meals for Salvation Army day care
  • Support for SCIO Farmers Markets in Sheboygan and Plymouth
  • Provide Medication-Assisted Treatment (MAT), which combines behavioral therapy and medications, to treat patients with opioid abuse disorders
  • Provide Recovery Coaching through a WIRCO grant to establish hospitalbased recovery coaches in our ED to work with patients presenting with addiction issues
  • Partner with Healthy Sheboygan County 2020 Mental Health Committee to build broad-based community systems change and support for: - SBIRT (Screening, Brief Intervention, & Referral to Treatment) in schools based on results of a Community Health Needs Assessment Call-to-Action Day - Two drug take-back days per year to reduce the availability of opioids (street drugs) within the community
  • Support Mental Health America AODA Resource Fair
  • Collaborate with WIRCO to initiate The Wisconsin Voices of Recovery Hospital-based Recovery Coaching model annually to provide a team of recovery coaches who operate on an on-call basis and respond to overdose patients presenting to local emergency departments
  • Provide appropriate follow-up with non-emergent patients using the emergency department (ED) for primary care
  • Refer uninsured and self-pay patients using our ED for primary care to Lakeshore Community Health Center; develop tracking mechanism to determine number of referred persons who are seen at LCHC
  • Actively screen patients for coverage through the Marketplace or financial assistance programs and assist with application processes
  • Provide operating costs to maintain reliable transportation services for patients in Plymouth
  • Support Anchor of Hope Health Center through provision of lab testing • Provide hospital tours for recent refugees or other community members with English as a second language to increase their comfort levels in accessing care. Tours cover an orientation to health services, including: - Registration process, forms required - Demonstration of Interpretation Services - ED process for patients and families - Visit a patient room demonstrating bed functionality, call lights, equipment, and family lounge - Women’s Health, NICU delivery rooms, and bassinets
  • Support United Way’s Providing Access to Healing (PATH) program for students, a school-based program designed to improve access to mental health services for children and youth who are unable to obtain care elsewhere in the community
  • In partnership with United Way, Family Connections and the Family Resource Center, sponsor the Welcome Baby Program, in which nursing staff conduct an assessment for all first-time and NICU moms to determine if they could benefit from a visit by a Resource Specialist and further referral to home visits from Parents as Teachers
  • Provide Geriatric/ED Nurse Case Manager to support the needs of our growing geriatric population by assessing how individuals manage their activities of daily living and offer options of services that could improve a person’s support upon discharge
  • Provide palliative care and advance care planning utilizing Goals of Care: - Home visits by a nurse practitioner or chaplain - Dementia care
  • Conduct a low-dose CT screening program for persons at high-risk for lung cancer identified in the electronic health record (55 years or older with significant smoking pack history) - Refer as appropriate for long-term follow-up and tobacco cessation
  • As part of a system-wide population health strategy, identify and screen patients at risk for hepatitis C; treat those who test positive
  • Provide stroke education and blood pressure (BP) screenings. As part of Stroke Awareness month (May), provide stroke education materials to 40 local businesses and work with grocery stores and pharmacies to include stroke education material in 500 shopping bags - Attend at least four other events to actively take blood pressures and educate participants on symptoms of stroke
  • In collaboration with Advance Care Planning Coalition, provide community palliative care/advance care education on various topics including: - Advance Care Planning and completion support - Memorial services - Grief support
  • Provide cancer programs and support groups, including: - Look Good Feel Better - Prostate Cancer support group - Touched by Cancer support group - I Love Someone with Cancer support group - Breast Cancer Support Group
  • Provide Meals on Wheels program for our vulnerable congestive heart failure patients for 30 days post-discharge to assure availability of nutritious meals
  • Provide ABHS referrals through tele-intake services in our ED and through inpatient tele-psychiatry consultations
  • Provide intensive outpatient (IOP) care for patients with alcohol and other drug abuse (AODA) disorders
  • Provide partial hospitalization for behavioral health patients
  • Participate in the county-wide Zero Suicide initiative, predicated upon a commitment by healthcare leaders to: - make suicide a “never” event so that not one person dies alone and in despair - promote a just culture where caring, competent and confident staff are supported to continuously improve and learn together - keep patients actively engaged and supported to talk about suicide and despair and rediscover hope and finding ways to thrive
  • Provide Medication-Assisted Treatment (MAT), which combines behavioral therapy and medications, to treat patients with opioid abuse disorders
  • Provide Recovery Coaching through a WIRCO grant to establish hospitalbased recovery coaches in our ED to work with patients presenting with addiction issues
  • Partner with Healthy Sheboygan County 2020 Mental Health Committee to build broad-based community systems change and support for: - SBIRT (Screening, Brief Intervention, & Referral to Treatment) in schools based on results of a Community Health Needs Assessment Call-to-Action Day - Two drug take-back days per year to reduce the availability of opioids (street drugs) within the community
  • To address suicide, provide Question. Persuade. Refer. (QPR) to train participants how to recognize the warning signs of suicide and how to question, persuade and refer someone to help
  • Promote careers in behavioral health services by hosting Lakeland College Behavioral Health Student Intern program
  • Sponsor Teaming Together for a Brighter Tomorrow to address binge drinking in Kiel and New Holstein school districts
  • Support United Way’s Providing Access to Healing (PATH) program for students, a school-based program designed to improve access to mental health services for children and youth who are unable to obtain care elsewhere in the community
  • Support “There is Hope” walk for suicide awareness and prevention
  • Support Mental Health America AODA Resource Fair
  • Collaborate with WIRCO to initiate The Wisconsin Voices of Recovery Hospital-based Recovery Coaching model annually to provide a team of recovery coaches who operate on an on-call basis and respond to overdose patients presenting to local emergency departments
  • Provide upon request, infant car seat checks and installations free of charge to all members of the community
  • Host a Community Car Seat safety inspection event
  • In coordination with local police and fire departments, provide free bike helmet fit tests
  • Conduct community trainings on how to care for and work with victims of crime using trauma-informed care techniques, including: – Sexual Assault Response Teams (SART) training for law enforcement – Abuser Training – Department of Justice SANE training
  • Support the Tri-county (Sheboygan, Ozaukee, Washington) Child Advocacy Center in Saukville to provide care to children who are suspected to have experienced domestic/sexual abuse
  • In conjuction with SCHTT, develop community-wide action plan to address the issues of human trafficking and sexual assault among all populations of Sheboygan County
  • Support Safe Harbor to provide services and advocates to victims of sexual/ domestic violence who have been treated at Aurora Sheboygan Memorial Medical Center

Consistent within Aurora’s system-wide Sexual Assault Nurse Examiner (SANE) program and AHAS, provide:

  • 24/7 trauma-informed and victim-sensitive services, including forensic evidence collection and SDFI®-TeleMedicine forensic photodocumentation system based on the Federal Rules of Evidence
  • Referrals as appropriate to medical, clinical, counseling and advocacy services
  • Introduce a Safe Mom Safe Baby (SMSB) program, a case-management service provided to pregnant or recently delivered women experiencing intimate partner violence

To increase opportunities to learn about and secure employment in the healthcare field, provide:

  • Three Career Experience sessions per year in collaboration with Lakeshore Health Care Alliance, enabling local high school students to hear presentations from up to six different clinical departments
  • Job-shadowing experience between four and 24 hours in length for high school students who have completed a Career Experience and college students
  • 17 scholarships for students pursuing degrees related to healthcare
  • Clinical site experiences for local technical schools and universities
  • Participate in the science, technology, engineering and math (STEM) conference at UW-Sheboygan

Women's and Children's Health

  • In partnership with United Way, Family Connections and the Family Resource Center, sponsor the Welcome Baby Program, in which nursing staff conduct an assessment for all first-time and NICU moms to determine if they could benefit from a visit by a Resource Specialist and further referral to home visits from Parents as Teachers
  • Provide free community classes including: - Labor, Birth & Beyond - Bringing Home Baby - Big Kid New Baby - Teenage Pregnancy - Breastfeeding - EMMI Post-partum Depression
  • Host Footprints on our Heart program, a memorial service for families who have experienced the loss of a baby through miscarriage, stillbirth, or neonatal death. Also hold a memorial service at a group cemetery
  • Provide upon request, infant car seat checks and installations free of charge to all members of the community
  • Host a Community Car Seat safety inspection event
  • In coordination with local police and fire departments, provide free bike helmet fit tests
  • Provide KidShape in the Classroom program for two first grade classes at Fairview Elementary School. This six-week program focuses on creating lifelong healthy habits for the entire family. The weekly lessons will be offered during class time and will be interactive, focusing on nutrition and physical activity. The parents and entire family will be engaged through completion of weekly at-home activities
  • Attend Women’s Health Expo, resource fair. Provide upon request, information on women’s health issues and sexual assault and abuse response services