T CHEMUNG COUNTY HEALTH DEPARTMENT PROFESSIONAL ADVISORY COMMITTEE MINUTES July 11, 2018 Call to order A meeting of the Chemung County Health Department Professional Advisory Committee was held at the Health Department on July 11, 2018 at 12pm. Attendees Attendees included: Dr. Terence Lenhardt Kaitlin Coats, ST Lisa Kruckow, BSN, RN Kim Schrolucke-Smith, PT Lisa Buckley, BSN RN Susan Larson, OT Kim Rosekrans, MSW Peter Buzzetti III MPH Chris Standt, BSN, RN Rena Terwilliger Jonathan Keough Members not in attendance Members not in attendance included: Billee Chaffinch, Mary Krebbs Approval of minutes The March 7, 2018 meeting minutes were distributed for review and accepted as written. Written items distributed for review CHHA Report Public Health Report WIC Report Reports: CHHA REPORT Lisa Buckley, Chris Standt and Nicole Barton STAFFING Lisa reported that the RN that had been off on long term medical leave has resigned. The position has been filled and the new RN is scheduled to start on 7/30. All positions are now filled.
QUALITY ASSURANCE PERFORMANCE IMPROVEMENT (QAPI) Lisa Buckley reviewed the QAPI Reports: 1. QAPI Committee meets the first Thursday of every month. Committee consists of DPS, Nursing Supervisor (QA), Nursing Supervisor (Clinical Manager), RN (coder, QA) and a RN case manager (on a rotating basis). Continued Improvement in Re-hospitalization rate - from 19.4% to 17% - Continued encouragement for patients to call us before going to the ER. Continued training with staff and patients. - Decreasing our re-hospitalization PIP (Performance Improvement Plan) was developed with the goal being for our re-hospitalization rate to be below the state average of 16.4% - Risk for re-hospitalization tool was developed and will be given to the clinicians to help them determine the patient s risk and the appropriate interventions to put in place to help reduce their chances of being re-hospitalized. Improvement in medication management from 92.5% to 100% - Focusing on the importance of medication education with our patients. Slight decrease in improvement of ambulation from 98.5% to 94.2% but still well above the state average of 72.3%. Increase in Depression assessment conducted from 96.2% to 100% Emergent Care Report/Potentially avoidable events Heart failure continues to be a main cause of ER visits and re-hospitalization. - To assess frequency of visits, weight logs etc. to see if something could have been done to prevent the re-hospitalizations. - Instruct the staff to call the office prior to sending any patient to the ER, unless it was for acute chest pain/ difficulty breathing or other life threatening conditions. - The office staff will call case managers at the MD offices to see if same day visits or medication orders would be appropriate. Wound infection/deterioration continues to be another reason for our patients seeking emergent care. - A wound care brochure was developed and approved to be given to all of our wound care patients. - Short term PIP on improving our wound outcomes will include the brochure, supervisory visits, wound care education. INFECTION PREVENTION AND CONTROL Chris Standt reported that they continue to track all patients who have been started on an antibiotic since opened for services. They track the date, the source of the infection, the clinician and the antibiotic. She Page 2
stated that they had an increase in the number of wound infections in the month of April with a slight decrease in May. No patterns were identified with any specific clinician. - She stated that they developed a teaching brochure for their wound care patients that includes infection control measures, how and where to store dressing supplies, how to dispose of dirty dressings, as well as the specific wound care directions. - They will be enrolling clinicians after the summer into the HHQI University online wound care class. INCIDENTS AND COMPLAINTS Nicole Barton stated that there were no complaints or incidents for March or April May complaint from a patient s son that there were too many nurses involved in his dad s care and that visit times were being changed frequently. Resolution- scheduled the visit times per the son s request. The scheduler and the case manager were informed that the visit day and time were not to be changed. It was also agreed that only the case manager and 1 LPN would be scheduled to see the patient. Pts son was in agreement with the resolution. June - complaint from a patient s daughter regarding discrepancies in patient s weights. She stated that the nurse documented the incorrect weight for her mother. She also complained that wound care supplies were not returned to a bin and saline leaked out onto an antique table. Resolution- PRN visit was made. Weight was found to be correct. No damage was noted to the table and the patient s wound are supplies were replenished. Patient and her daughter have not verbalized any further concerns or complaints. PUBLIC HEALTH REPORT Lisa Kruckow COMMUNICABLE DISEASE Two Chemung County residents have been associated with national Salmonella outbreaks. The first one involved a recall of Honey Smacks cereal and the second outbreak investigation has not resulted in a recall yet. STTAC Southern Tier Tobacco Awareness Coalition has hired a Public Health Educator, Michelle Larimore to fill the Community Engagement Coordinator position. This position also involves 10 hours per pay period to assist in Public Health with community education initiatives. Interviews are being conducted to fill the Senior Clerk position. LEAD The Lead Coalition has formed subcommittees to focus on topics of public policy, education, housing and resource development. Health Dept. staff are tabling at Wisner Park monthly on children s day to promote lead education to parents and families. Page 3
COMMUNITY HEALTH ASSESSMENT The community health assessment survey is now available online at www.myhealthstory2018.com Data collected is used by counties for developing community health improvement plans. GOLD SHOE/STEP IT UP & The Gold Shoe/Step It Up program had 263 people attend and 185 shoes turned in. 108 evaluations were completed and 89% reported their use of the parks would increase as a result of the program. Most of the other 10% reported they already use the parks regularly. 57% reported visiting one or more parks for the first time. 75% feel healthier. Over half would change nothing, some want more advertising, more shoes, more parks, and some less shoes! PARK PRIZE PURSUIT Chemung County residents can get moving and win great prizes during the brand new Park Prize Pursuit starting June 11 th. This free scavenger hunt, open to all ages, awards participants for finding the answers to clues in local parks. Between June 11 th and September 4th residents can look for clues at local parks and trails throughout the County. Each clue that is answered correctly will earn the person an entry into the random prize drawing to be held on September 10th. Additional weekly clues will be announced each week giving people a greater chance to win prizes. The more correct answers a person has the greater their chance to win a prize. Prizes include a $100 Clemens Center gift certificate and Wegmans gift cards. Others are geared to physical activity and include a Fit Bit, corn hole, ladder ball, jarts, bocce ball, and hiking poles. Residents can go to www.chemungcountyhealth.org or click here https://www.surveymonkey.com/r/gssiu2018reg to download the clues and to register. CANCER SERVICES Cancer Services currently has 43 active patients of which 15 are new this year. In April, a local TV interview was done about colonoscopies which resulted in 8 new patient referrals. Outreach continues in Millport, Erin, VanEtten, Pine City and Wellsburg at local food pantry truck deliveries. Summer outreach is beginning this week with Wisner Park and East Side Market. BREASTFEEDING Breastfeeding Friendly Awards will be held at Wisner Park on Aug. 2, 2018 during World Breastfeeding Week. These awards go to people or businesses that have accommodated breastfeeding in their place of business. The cutoff date for nominations is July 23 rd. To date there have been close to 25 nominations and more are expected. SUMMER MEAL PROGRAM Page 4
Public Health nurses will be attending Summer Meal sites to educate children around Lead prevention. Children will be taught how to wash hands; ways to eat a diet high in Vit. C, Iron and Calcium and they will be given a small paper house to assemble that highlights areas of lead exposure risks. Parents will get a booklet with recipes that contain Vit. C, Iron, and Calcium. QUALITY IMPROVEMENT Chart reviews were completed for TB, Lead, Immunization and Communicable Disease. Documentation meets standards with minor corrections. PATIENT COMPLAINTS/INCIDENTS The Health Dept. had no complaints or incidents reported in the past quarter. WIC REPORT Rena Terwilliger Rena discussed the WIC Updates: Expanding program services o Temporary WIC clinic at HRC has been approved. Moving forward with purchasing new equipment to transport back and forth. Clinic will be once a month to start e-wic is getting closer! o 10/8/18 10/12/18 Two staff (Katrina Kelly and Rena Terwilliger) will attend Super User training in Rochester to learn the new system. o 10/15/18 10/19/18 Clinic will be closed so Katrina and I can train all staff and everyone can practice on the new system before we start taking participants. o 10/22/18 Rollout date!! Staff changes o Casmira Rickard resigned to take an RD position at St. Joes. o Hired Jessica Seaward to take Casmira s place. Next Scheduled Meeting: Professional Advisory Committee September 5, 2018 @ 12:00 PM Health Department Conference Room Page 5