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Dec. 13, 2015
TOP READS
packingEnhancements to the informed consent process
Submitted by Ryan Mackey, RN, BSN, CNRN, Patient Safety Consultant
A recent communication error has revealed opportunities for improvement in workflows and practices of informed consent. In an attempt to more strictly adhere to our consent policy and to improve patient safety, changes have been made to the order "Patient to sign consent."

If a physician wishes to have a RN complete the consent form and take it into the patient room for signature, the physician must place the "Patient to sign consent" order using the exact language required for the consent. From the order, the RN can copy and paste the exact wording into the consent form which is accessible from the hyperlink seen in the order.

Once signed, the RN will place the consent on the patient hard chart. If the physician wishes to complete the consenting process themselves, they can click on the Epic button in the top left corner of the electronic chart and open a copy of the consent under informed consent.

Additionally, a new hyperlink to the consent form has been added to the physician links list of your opening dashboard, for your convenience. Be aware you can't print from computers in the patient rooms.

You can access a screen shot of the revised "Patient to sign consent" order here with new directions for MDs and RNs, as well as an email from Dr. Johnson introducing these changes. (Because of the proprietary nature of Epic, the screen shot file is kept behind the Salem Health firewall.)
   
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modaOHSU, Moda and Salem Health 
Submitted by OHSU
Questions have arisen as the result of recent media coverage of a business agreement between Moda Health and OHSU. Below are our responses:

What's the story with Moda and OHSU?
In 2014, OHSU invested $50 million in Moda Health in the form of a surplus note - a common financial instrument used by the insurance industry to provide capital. In November 2015, OHSU and Moda Health signed a letter of intent to pursue additional collaborations, including giving OHSU an option to convert the surplus note into a 25 percent equity stake in Moda Health. OHSU has not made a decision on whether to exercise this option.

Moda, along with Providence, Kaiser and Regence, are the top payers in Oregon. Each have about 15 percent market share.

Why did OHSU invest in Moda?
Like the rest of the nation, the healthcare market in Oregon is rapidly consolidating. As part of this trend, healthcare providers are aligning with healthcare payers to create health systems that can be successful under new reimbursement models.

The relationship with Moda is another partnership that provides opportunity and flexibility as we work to provide care to Oregonians. It gives access to the data needed to find efficiencies and give patients better outcomes for less cost.

If consolidation leads to closed payer systems that restrict patients to a single health system, Oregonians are at risk of losing access to the specialized care provided at OHSU. OHSU hopes to ensure alignment with multiple payers to preserve broad access to its services. Additionally, OHSU believes strongly in the need for Oregonians to have the option of an Oregon-based health system, and is responding to the market in order to ensure this through the formation of OHSU Partners and its affiliations with Salem Health and others. 

What does this mean for physicians in Salem?
The OHSU Partners structure supports a pluralistic physician model, and the intent is to build on existing strengths, including employed and independent physicians.

The advantages of closer alignment between providers and payers can extend to local, independent physicians. The new world of healthcare reimbursement demands close collaboration between all parties. The work being done by OHSU Partners can provide benefits to independent providers, hospitals and insurers, as well as patients.

We won't be able to please everyone, but we believe there are opportunities for a diverse range of providers. We hope to establish open dialogue and to keep the focus on our shared objectives, such as the best possible outcomes for patients.

The world of healthcare is changing, and all providers (independent and employed physicians and hospitals) and insurers need to change along with it. We believe we have the ingredients to be successful if we work together.

cardioCardiovascular Care: An affiliation success story
Submitted by Cheryl Wolfe, RN, Salem Health CEO
The affiliation is officially only a few weeks old, but the Salem community is beginning to see the first tangible examples of what partnership with OHSU can mean.

Physician recruitment was an area Salem Health hoped would improve with access to OHSU's larger network, research and education expertise, and a strong brand. This was put to the test when recent changes in the cardiothoracic surgery program created a gap in surgical positions that immediately became a high priority to fill.

Recruiting for this type of position has been a challenge in the past despite our cardiovascular program's established local and national success, often drawing an inadequate number of applications. Through our affiliation with OHSU and working in partnership with Dr. Juan Oyarzun as the associate medical director, we have been able to attract a significant number of applicants and are finalizing hiring for these positions.

What's more, two of the positions will serve on the OHSU faculty, but live and work primarily in the Salem region, bringing added clout to the program and another opportunity for collaboration and connection between the two organizations. One of these physicians will also serve as medical director.

This is just one practical example of the positive improvements that can come from affiliation. The broad goal of affiliation is to build integrated clinical enterprises, which will provide value for the patient and help physicians and providers make the transition to value-based care.
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insulinOHSU affiliation: Logo and brand update
Submitted by Jan Miller, System Director of Marketing and Communications
Salem Health is two weeks into the official affiliation with OHSU. One change you may have noticed is the new logo that has appeared around the hospitals in Salem and Dallas.

Following the example of other hospitals that have gone through name changes, we will take our  time changing to the new logo across Salem Health. The process for rolling out our new look will be driven by the patient's perspective. We want to help patients easily connect the dots between the various encounters they have with staff, print materials or facilities.

We are currently developing a timeline for the roll-out of logo changes between now and June of next year. As you can imagine, there are hundreds, if not thousands, of instances of the logo on print materials, signage, forms, digital properties, clothing, vehicles, software applications, etc., that need to be changed.

Our goal is to prioritize the changes, starting first with those impacting the greatest number of people (i.e. main entry signage, website, name badges, etc.) and moving on to an area-by-area rollout. That way we can coordinate all of the materials for a specific service so the change appears as uniformly as possible on all public-facing communication or materials.

You can find more information about affiliation in past issues of Common Ground or on the Better, together page.
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sepsisNew process: Fax rather than phone the ED
Submitted by Mary Maberry, Physician Office Liaison
The Salem Hospital Emergency Department is requesting your help in implementing a new  process to relay important information to the ED care team for continuity of patient care. Under the direction of Linda Johnson, MD, the ED has created a fax form to close the gap in the transfer of treatment information.

The ED is requesting that all clinics begin using this new process when sending a patient to the ED. Rather than calling the ED and providing a report, we're asking you to now fax this information instead. Here are the instruction sheet and the fax form. Pads of these forms are being created and will be distributed to your clinic over the next month. In the meantime, please use this fax form.

Please avoid calling the ED unless patient care is critical and physician to physician discussion is required. In that case, please call the switchboard at 503-561-5200 and request to be transferred or call the ED triage desk at 503-814-1122.

By adhering to this new referral process ED physicians will have valuable, timely and complete information on your patients that will allow for faster, more efficient diagnosis and care. Thank you for your help! 

And a big thank you to Ken Graven, MD, and Salem Clinic South who was our test site for this new process.  Questions? Please contact Mary Maberry, Physician Office Liaison.

pophealthSalem Health's population health strategy 
Submitted by Michael Gay, Internal Communications Coordinator
As part of the changing landscape of healthcare, hospitals and practices across Oregon are seeking new models of care. This new approach is often called "population health." It begins to shift the standard care model from "sick care" to "well care" for entire populations of individuals within a service area.

Population health:
  • Improves the quality of care by integrating wellness, prevention and care delivery to reduce or eliminate chronic conditions.
  • Manages people's health rather than their sickness by being proactive, rather than reactive.
  • Keeps people healthier to reduce their need for hospital care.
  • Accommodates individual patient values and preferences.
  • Results in coordinated care from clinical and non-clinical staff.
  • Is driven by analytics and maintained by reporting and communication.
Success hinges on a willingness to embrace change that will support and improve patient health. This new approach to care management requires highly engaged providers, patients, families and leaders. Such engagement demands productive interactions between informed, activated patients and families and a prepared, proactive primary care team.

Salem Health and Propel: Healthcare for a changing world
In 2014, Salem Health helped found Propel Health, an organization that unites several of Oregon's most prominent healthcare companies under common goals: to improve patient outcomes, enhance the patient experience, and better manage costs. Our partnership with Propel Health will help us build the tools, technology and resources we need to more effectively manage health. This support will be instrumental as we develop a new model of care focused on the health of specific populations.

What's next?
As part of this transformation, we will be offering a new service with Propel called Care Advising to eligible employees and their dependents who are enrolled in one of Salem Health's health insurance plans. Care Advising will provide personalized, confidential, one-on-one support to patients who need extra help managing their health.  

PRACTICAL MATTERS
babyMedical staff website shutdown 
Submitted by Jan Miller, System Director of Marketing and Communications
Communication was identified as an area of improvement in the medical staff engagement survey conducted earlier this year. In an effort to enrich communications and increase effectiveness, we will be enhancing the Common Ground e-newsletter by moving it to a web platform and updating the design. This move will allow us to measure the effectiveness of the content so we can make changes intended to improve the value of the newsletter to providers. This new platform will essentially eliminate the need for the existing medical staff website. Therefore, beginning December 1, the old website will be shut down. The new e-newsletter web platform will be implemented in late January. 
   
recruitementInstructions re: fall prevention signage
Submitted by Dana Hawkes, MSN, RN, NE-BC, Director of Adult Health Services
Help prevent patients from falling!

Patients who have this duck sign outside their door should not be up without assistance. This posted sign indicates a "no pass zone" when walking by patient rooms. If you see the patient mobilizing independently, kindly help the patient and/or alert unit staff.

If it's your patient with the duck sign:
  • Remind them not to mobilize without help and to follow the instructions (as their cognition allows) of their nurse and CNA.
  • Review the patient's MAR for opportunities to de-prescribe sedating drugs as appropriate.
Fall prevention is a team sport. Thank you for your help.

 
comboardService lines featured monthly on Common Ground communications board
Submitted by Mary Maberry, Physician Office Liason
The Common Ground Communication Board is located in Building A on the wall outside the physicians' lounge.  The purpose of this board is to provide another communication medium for our medical staff to receive current hospital news.  Please check it monthly for new information.
 
Service line focus for December: Women's and Children's Services.
Learn more about the Baby Friendly Hospital Initiative, why Salem Hospital would benefit from this distinction and other reasons why Salem Hospital is a great place to have a baby.
 
Common Ground Newsletter Editorial Board 
For past issues of this newsletter, visit
Email us anytime with feedback, suggestions, or something for the next issue!  Dr. Ian Loewen-Thomas, Chair, Compact Implementation Committee
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