Transcript Addressing Violence and Abuse in the Changing Health Care

Addressing Violence and Abuse in the
Changing Health Care Environment
Ann Budzak-Garza, MD
Kelly Barton, Vice President Clinical Operations
Bob Trine, Senior Vice President Business Strategy
Gundersen Health System
A tradition of excellence
• Gundersen Clinic: Founded
by Dr. Adolf Gundersen in
1891
– Three of his greatgrandsons are caring for
patients at Gundersen
Lutheran today
Dr. Adolf Gundersen (second from left)
• Lutheran Hospital: Opened in
1902
• Organizations merged in
1995 to form Gundersen
Lutheran
Gundersen Health System
• Integrated healthcare
organization
• Serving 19 counties in western
Wisconsin, northeastern Iowa
and southeastern Minnesota
• 325-bed teaching hospital
• Headquartered in La Crosse, Wis.
Gundersen Health System
• Outpatient visits:
1.2 million
• Inpatient admissions:
12,913
• Inpatient/outpatient surgeries:
16,718
*2012 stats
Gundersen Health System
Governance
• Board of Governors
– 9 elected physician members
– CEO chairs
• Board of Trustees
– 6 community members
– 4 physician members
– CEO chairs
• Board of Trustees has final say on all major decisions
– Must pass Board of Governors before going to Board of Trustees
Gundersen Health System
• Network of affiliated
organizations, including:
– Ground and air ambulance
service
– Rural hospitals
– Pharmacies
– Hospice care
– Nursing homes
– And more
Gundersen Health System
Excellence in primary care
•41 regional sites in Wisconsin,
Minnesota and Iowa
•More than 75 clinical
departments and specialties
•Over 700 medical, dental and
associate staff
•Staff of more than 5,500
Gundersen Health System
Excellence in quality care
•HealthGrades 2010 Excellence Awards™
Cardiac Care
Cardiac Surgery
Orthopaedic Surgery
Joint Replacement Surgery
Pulmonary Care
Stroke Care
General Surgery
Gastroenterology (GI) Care
GI Surgery
•2010 HealthGrades
Distinguished Hospital Award for
Clinical Excellence™
•2009 Thomson Reuters 100 Top
hospitals award
•2009 Thomson Reuters 100 Top
cardiovascular hospitals award
Gundersen Health System
Behavioral Health Services
Gundersen Lutheran Behavioral Health has psychiatrists,
psychologists and masters-level psychotherapists specially trained to
work with children who have been maltreated
(some services are grant funded and provided at no charge)
Services Include:
• Individual and group counseling
• Support group
• Crisis Intervention
• Coordination of victim services
• Assistance with Crime Victim Compensation
• Education on abuse
Current Infrastructure
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Physician, Employee, Leadership Compact
Level III certified Medical Home – Pediatrics
New Inpatient Behavioral Health Hospital
Patient Centered Care (Trauma Informed Care
Medical Education
SANE Program
Research Mission
Training Facilities (ICE House)
National Recognition (end-of-life care, cost of care)
Hospital-based Domestic Violence Program
Employee Assistance Program
Disease Management Program
Pastoral Care Program
National Child Protection
Training Center
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Population Health
Commitment to Quality and Excellence
Mission of serving the Community
Migration from healthcare delivery to “health
system”
• Healthcare Reform
• ACE Research
Future Vision
“I believe we can end child abuse in the United
States within three generations. If we start the
clock ticking from this moment, this gives us 120
years to get the job done.” –Victor Vieth, Unto
the Third Generation
2013 Gundersen Health System commits to
becoming part of the solution!
Operational Plan
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Raise Awareness
Educate and Train
Research
Change Internal Process
Raise Awareness – Internal &
External
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“No Hit Zone”
Presentations on maltreatment to our staff and physicians
Internal department journal clubs, case reviews, section meetings
Incorporate NCPTC website, including Webinars, into GL internal website
La Crosse School District presentations as part of the School
Liaison/Mental Health project currently in place in Behavioral Health.
• YMCA Teen House presentations to volunteer staff who work with the
adolescents within that program
• Community Presentations
• Parenting Groups focused around ACE Research
Educate and Train
• Application, modification and expansion of NCPTC training model for
healthcare professionals
• Present at the La Crosse Maltreatment Conference annually
• Present a maltreatment medical track at national/international meetings
• Develop a Gundersen Lutheran National Maltreatment Conference: Long
term goal
• Consultation Services
• Third year medical school lecture series on child maltreatment during
Pediatric Clerkship at Gundersen, then expand to all UW clerkship sites,
expand nationally
• Interprofessional collaborative practice model
• Journal of Child and Adolescent Trauma
Internal Process
• Begin internal efforts with GL staff who are already evaluating/treating
maltreated children: BH, Pediatrics, SANE nurses, TEC physicians, Family
Practice and Sexual Abuse Counseling & Support and use this as our base
to expand these efforts
• Assess patients for adverse childhood experiences by adding these
screening questions utilized at every patient interface within the
healthcare system
• Development of child maltreatment risk factors screening tool for use in
Pediatric medical home at all well visits
• Maltreatment prevention program within medical home
• Develop stronger alliance with other community resources and programs
locally and nationally
Research
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Continue the work by Michele Knox, PhD – Medical Students, Residents, and
Associate Staff in Training (PA, NP)
Validation of child maltreatment risk factor screening tool
Faculty Assessment
High risk pregnancy/substance abuse population study
Evidence based work incorporating ACEs
Child maltreatment prevention program - outcome data
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Other collaborative opportunities (?)
Questions/Discussion