Catholic Health World - October 1, 2019

Pastoral care survey 2 Aquinas honors Fr. Bouchard, OP 7 Preparing for the unexpected 8 PERIODICAL RATE PUBLICATION

OCTOBER 1, 2019 VOLUME 35, NUMBER 17

Chicago hospitals unite to address socioeconomic needs of west side residents AMITA’s Saints Mary and Elizabeth connects emergency department patients to social services

By JULIE MINDA

Courtesy West Side ConnectED

By LISA EISENHAUER

The realization that not only were they seeing the same social needs, but probably even the same people ASCENSION with those needs, over HEALTH and over in their emergency rooms brought four hospitals on the west side of Chicago together, say people who helped start a collaborative called West Side ConnectED. One of those people is Cody McSellers-McCray, executive director of community health for AMITA Health, a joint McSellers-McCray venture between Ascension’s Alexian Brothers Health System and Presence Health, and Adventist Midwest

Housing First effort on track to eliminate chronic homelessness in Cleveland next year It’s an audacious goal but the Sisters of Charity Foundation of Cleveland and its partners in a long-running Housing First supportive housing initiative stand behind their claim: After completing construction of their 13th and final complex of 71 supportive housing units in October next year,

An illustrated map shows the economically disadvantaged Chicago neighborhoods where the West Side ConnectED collaborative is working to identify and address the health and social needs of residents. Four hospitals, including AMITA’s Saints Mary and Elizabeth Medical Center, are part of the initiative. Catholic Charities of the Archdiocese of Chicago is the convening agency that brought the hospitals together.

Health. AMITA is based in the Chicago suburb of Lisle, Ill., and has 19 hospitals.

Its Saints Mary and Elizabeth Medical Center operates one of the busiest emergency

rooms on Chicago’s west side.

McSellers-McCray, who was in CHA’s 2019 class of Tomorrow’s Leaders, said the Continued on 6

By JULIE MINDA

There are numerous medical devices and pharmaceuticals that clinicians affiliated with the Chesterfield, Mo.-based Mercy health system choose from when treating patients. But which products are most effective for patients? And which products return the best clinical outcomes for the cost?

The Real-World Evidence Insights Network that Mercy Technology Services launched in August provides the technology infrastructure needed to track the use of medical devices and drugs for patients throughout the Mercy system and to determine how effective they are for the patients.

(Measures being used to track outcomes include infection rates, length of hospital stays, readmission rates, mortality and quality of life.)

In its formative stages, the database will be a repository for information related to orthopedics, cardiol-

ogy and oncology. Mercy Technology Services will expand it to include other clinical areas over time. Inpatient and outpatient records from across the continuum of care will be part of the database.

Dr. Joseph Drozda, the Mercy system’s director of outcomes research, says that database initially will track products such as coronary stents, pacemakers, catheters, artificial knee and hip joint implants and chemotherapy drugs.

Mercy is inviting other health care systems and facilities to join the network and contribute their data on medical product use and efficacy.

The intent is to create a pooled database of de-identified quantitative and qualitative patient experience information that providers can analyze to make optimal choices when it comes to the medical devices and pharmaceuticals they’ll use with patients.

Dr. Joseph Drozda, director of outcomes research for Mercy of “This all began as a health Chesterfield, Mo., reviews patient data aggregated using Mercy care provider wanting to deterTechnology Services’ Real-World Evidence Insights Network data mine which medical products platform.

Ron Goldfarb, Cleveland

Mercy division creates platform to analyze medical devices, drugs

The Winton is a Housing First property on Cleveland’s near-west side. The Sisters of Charity Foundation of Cleveland backs the Housing First initiative.

there will be sufficient housing stock available to end long-term homelessness in Cuyahoga County, Ohio.

The Housing First collaboration in Cuyahoga County was formed 17 years ago by the Sisters of Charity Foundation, Enterprise Community Partners, and the Cleveland/Cuyahoga County Office of Homeless Services to construct or refurbish rent-subsidized housing and couple it with supportive services for tenants who had been chronically homeless. Enterprise Community Partners is a nonprofit that works with partners nationwide to

Continued on 5

Continued on 4

CHA updating mission leader compentency model

Courtesy Avera Health

Association is asking members to identify essential skills for all career levels

Tornado blasts through Avera Health campus A tornado that struck late Sept. 10 severely damaged the Avera Behavioral Health Center, above, and Avera Health’s nearby corporate headquarters in Sioux Falls, S.D. The office building and parts of the hospital are expected to be closed for several weeks.

Story on Page 3.

By JULIE MINDA

For decades, the Catholic health ministry has been building up and evolving the role of mission leader and has increasingly been recognizing mission leadership as essential to ensuring that Catholic identity is integrated into to every aspect of ministry systems and facilities.

Ministry systems have looked to CHA to establish a consensus

around the qualities and credentials that help make sure that mission leaders are qualified for this expanded role — and that there is a pipeline of able candidates for positions along the mission, chaplaincy and ethics career continuums.

In spring 2018, CHA launched Project Legacy to assist the ministry in talent development and succession planning for mission, ethics and pastoral care positions. After a series of interviews, surveys and data collection from system member human resources departments, a tactical plan was developed and shared with sponsors, system chief executives and mission leaders in spring

2019. This comprehensive threeyear plan called Faithfully Forward aims to address shortages of qualified candidates in these areas. One of the tactics includes CHA updating its mission leader competency model last revised a decade ago. The plan for implementing Faithfully Forward runs through CHA’s 2020 to 2021 fiscal years.

Brian Smith, CHA vice president of sponsorSmith ship and mission services, says CHA now is in the discovery phase of updating Continued on 3

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CATHOLIC HEALTH WORLD October 1, 2019

CMS takes steps, offers tools to address disparities in care

By LISA EISENHAUER

Within the Centers for Medicare & Medicaid Services, several initiatives are underway that are intended to reduce health disparities in vulnerable populations, including racial and ethnic minorities, sexual and gender minorities, and people with disabilities.

Cara James, director of CMS’ Office of Minority Health and co-chair of its Rural Health Council, detailed some of those James efforts during a CHA webinar in early August called “Achieving Health Equity Through Increased Understanding, Sustainable Solutions and Collective Action.”

“We are working to ensure that all of our CMS beneficiaries have achieved their highest level of health and that disparities in health care access and quality are eliminated,” said James, whose office was created as part of the Affordable Care Act. Under her leadership, CMS developed the “Equity Plan for Improving Quality in Medicare” and its Rural Health Strategy – both firsts for the agency. The initiatives are meant to help people understand their coverage and connect to care as well as to improve the quality of demographic and health outcomes data captured by CMS. The data collected so far shows some clear disparities, James said.

For example, a study of Medicare Advantage beneficiaries found those who are Asian or Pacific Islanders received bet-

Rural adults who could not see a doctor in past year due to cost by race and ethnicity, 2012–2015 Percent reporting no doctor visit due to cost

25%

25%

23%

20%

19% 16%

15%

17% 15%

10% 5%

All adults

White

Black

Hispanic

Source: James, Moonesinghe, Wilson-Frederick, et al., Racial/Ethnic Health Disparities Among Rural Adults – United States, 2012 – 2015. MMWR Surveill Summ 2017, 66(No. 23): 1-9

ter care than white beneficiaries in over 40 percent of measures of clinical care while Hispanic beneficiaries got worse care than whites on 15 of 35 measures of patient experience and clinical care.

“We’re seeing improvements in a number of the measures that are being tracked, but when you look at the disparities, we largely are not seeing progress in reducing those gaps,” she said.

To tackle those disparities, James said, her office has focused on improving its understanding of the people getting the

Asian/native American Hawaiians/ Indian/Alaska Pacific Islanders native

care and how that care is being delivered.

The office in recent years developed a tool to map disparities in health services received by Medicare beneficiaries. It uses various fee-for-service data from across the nation on a number of conditions and looks at prevalence rates as well as hospitalizations, readmissions, outcomes and cost.

The tool can drill down to the county level and compare data for various population groups and such categories as race or ethnicity, age and gender.

The information gleaned is being used

Deadline near for survey on CHA pastoral care proposal The deadline is nearing for pastoral and spiritual care leaders at ministries within CHA to weigh in on a proposal on standard work and staffing for pastoral care departments.

“This tool is a meaningful continuation in answer to the question of how Catholic health care can fully meet the spiritual needs of our patients and associates as we

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are called to do by the Ethical and Religious Directives for Catholic Health Care Services,” said Carrie Meyer McGrath, CHA’s director of mission services.

A subcommittee of CHA’s Pastoral Care Advisory Committee spent a year studying, dialoguing and crafting the proposal, which: Links chaplain staffing numbers to the essential services of a pastoral care department.

Suggests a three-tiered measure of staffing — understaffed, minimum

and comprehensive — based on annual adjusted patient days.

Offers a tool, via an online calculator, to help determine the appropriate staffing level at a facility.

The deadline to comment on the proposal is Oct. 11. Access to the proposal, online calculator and feedback survey are available through the CHA Service Center at (800) 230-7823. More information can be found at chausa.org/pastoralcare/overview by clicking on the Pastoral Care Standard Work and Staffing heading.

to identify disparities and the best means to address them, James said.

On rural health care, James’ office partnered with the Centers for Disease Control and Prevention for analysis of what she said are very diverse communities with race-based differences in health outcomes and in age distribution. Rural communities tend to have a higher percentage of seniors than the country as a whole. The analysis showed that 24 percent of rural residents are 65 or older, but only 9 percent of Hispanics in the rural U.S. are age 65 or older.

“We very frequently talk about some of the health issues that rural communities face, but we often neglect to reflect on the diversity that’s within rural communities and understand that they are not homogenous communities,” James said.

To help address the needs and disparities that it has identified among nonurban beneficiaries, the CMS rural health strategy intends to improve access to health care in part by advancing telehealth and telemedicine.

One of the resources developed as part of the strategy is a Disparities Impact Statement designed to help organizations identify, prioritize, and act on health disparities. Technical advice to fill out those statements can be requested by email from HealthEquityTA@cms.hhs.gov. The entire strategy is detailed at go.cms.gov/ ruralhealth.

To improve overall care, the equity plan developed by the Office of Minority Health calls for expanding the collection and analysis of data and evaluating the impacts of disparities, among other things. The office also started an initiative for beneficiaries called From Coverage to Care. That initiative includes a number of resources, such as an enrollment tool kit and a guide called “5 Ways to Make the Most of Your Coverage.” The resources are online at go.com. gov/c2c.

CMS also is working on establishing a standardized way for care providers to assess the social determinants of patients’ health, James said, in hopes of figuring out the relationship between such factors as transportation and social isolation and health outcomes.

The goal is to implement a sustainable action plan to end disparities and achieve health equity. “This to me is the critical work we do,” James said.

Upcoming Events from The Catholic Health Association Sponsor Formation Program for Catholic Health Care Session One: Oct. 10 – 12 Chicago (Invitation only)

Faith Community Nursing Networking Call

Ethics Webinar: A Discussion of Why Organized Medicine Must Maintain Its Opposition to Assisted Suicide

Human Trafficking Networking Call

Oct. 24 | 2 – 3 p.m. ET

2020

International Outreach Networking Call

International Outreach Networking Call

Oct. 22 | 3 – 4 p.m. ET

Community Benefit 101: The Nuts and Bolts of Planning and Reporting Community Benefit Chase Park Plaza Royal Sonesta Hotel St. Louis Oct. 15 – 16

Deans of Catholic Colleges of Nursing Networking Call

Nov. 6 | 3:30 p.m. ET

Dec. 10 | 3 p.m. ET

Dec. 12 | Noon ET

Feb. 5 | 3:30 p.m. ET

A Passionate Voice for Compassionate Care® chausa.org/calendar

October 1, 2019 CATHOLIC HEALTH WORLD

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By LISA EISENHAUER

Even as a tornado was blasting through, doctors at Avera Heart Hospital in Sioux Falls, S.D., stayed focused on their job.

“In the middle of the tornado we had a patient who had a severe cardiac event and had his life saved,” said Mick Gibbs, the hospital’s president.

Gibbs was speaking at a news conference just hours after three tornadoes raked Sioux Falls late the night of Sept. 10. One of them damaged Avera Heart Hospital; the immediately adjacent Avera Behavioral Health Center, an inpatient and outpatient facility; and the nearby Avera corporate

Gov. Kristi Noem got a firsthand look at the storm damage and met with Bob Sutton, right, president and chief executive of Avera Health, and David Flicek, center, regional president and chief executive of Avera McKennan Hospital & University Health Center.

Mission leader model From page 1

the mission competency model, working with the Reid Group consultancy to conduct phone interviews with about 60 c-suite executives from ministry systems.

CHA and the Reid Group also are in the process of administering an online survey of mission leaders. The survey went out electronically to about 650 mission leaders last month, with responses requested by Oct. 11.

Smith is encouraging mission leaders to respond to the survey. Based on the results, CHA and the Reid Group will draft new mission leader competency resources by early November and share them with system mission leaders for their input and suggestions. CHA and the Reid Group then will update the draft and host focus groups of mission leaders in the ministry for their input.

CHA plans to release the updated mis-

headquarters. The behavioral center and the corporate building sustained the most damage. Parts of the behavioral health center and the entire corporate headquarters are expected to be closed for several weeks, Avera said as Catholic Health World went to press in mid-September.

The tornado left 10 people at the behavioral health hospital with non-lifethreatening injuries. One person who was outside the hospital also was injured. One visitor was injured at Avera Heart Hospital.

There were no reports of severe injuries or deaths from any of the tornadoes. The National Weather Service said the tornado that hit the Avera hospitals and headquarters had winds up to 130 mph.

Much of the damage at the behavioral health center and the headquarters building was to glass parts of the buildings and to areas exposed by blown-out windows, but the headquarters also lost its roof. In addition, a glass walkway that connects the heart and behavioral hospitals was destroyed.

The behavioral health hospital transferred inpatients to other Avera hospitals as soon as it was safe to do so. Some were sent temporarily to Avera McKennan Hospital & University Health Center, also in Sioux Falls.

Avera spokesman Jay Gravholt said the behavioral health center transferred some mental health patients who required continued inpatient treatment to an open section of a state psychiatric hospital 85 miles away in Yankton, S.D., that is being staffed temporarily with Avera personnel.

Within a week of the storm, Avera had reopened outpatient mental health clinics

The tornado that struck with little warning late Sept. 10 left the atrium of the Avera Health headquarters building strewn with glass and other debris.

Photos courtesy Avera Health

Tornado damages Avera Health campus in Sioux Falls, S.D.

in the behavioral health center. Its mental health assessment center never closed.

About 130 workers based at the system’s headquarters, including Avera President and Chief Executive Bob Sutton, have moved to temporary offices nearby. There was also storm damage to a dome that is part of the Avera Sports Institute in Sioux Falls and to some of the health system’s medical offices. Several staffers’ cars were damaged or destroyed.

The tornado had struck the Avera campus just after 11:30 p.m. with little warning.

David Flicek, regional president and

Steering committee members Six ministry representatives are serving on a steering committee to guide CHA’s work on redeveloping the mission leader competency model:

Philip Boyle, senior vice president, mission and ethics, Trinity Health, Livonia, Mich.

Debra Canales, executive vice president, chief administrative officer, Providence St. Joseph Health, Renton, Wash.

Wanda Cole-Frieman, vice president, talent acquisition, Dignity Health, San Francisco Dennis Gonzales, regional vice president, mission integration, CHRISTUS Santa Rosa Health System, San Antonio

Rebecca Urbanski, senior vice president, mission integration and marketing, Benedictine Health System, Duluth, Minn.

Trevor Walker, vice president, learning and development, Ascension Health, St. Louis CHA’s Brian Smith, vice president of sponsorship and mission services, and John Reid, a partner in the Reid Group consultancy, are facilitating the process.

sion leader competency model and materials next summer.

“A lot has happened since CHA last updated its mission leader competency model in 2009,” Smith says. The association wants to understand the changes in the structure and expectations connected with the role and to help mission lead-

FEAST OF ST. FRANCIS Oct. 4

Like St. Francis of Assisi before him, philosopher, writer, Passionist priest and ecologist Thomas Berry calls us to remember our connection to the Earth and to take it seriously: “We come into being in and through the Earth.

Simply put, we are Earthlings. The Earth is our origin, our nourishment, our educator, our healer, our fulfillment. At its core, even our spirituality is Earth derived. The human and the Earth are totally implicated, each in the other.”

— From Thomas Berry, The Spirituality of the Earth See more resources for the Feast of St. Francis at chausa.org/environment/feast-of-st-francis

ers to be relevant and effective, given the changes.

The current competency model centers on the personal qualifications, leadership skills, theological grounding, spiritual awareness, ethics competency and organizational management abilities that mission leaders should have to excel in the role.

chief executive of Avera McKennan Hospital & University Health Center, described the behavioral health center’s staff as courageous. “They had 10 minutes to wake up 102 residents, get them to the center of the building and all are safe and sound,” said Flicek, who also oversees the behavioral hospital.

The Avera Heart Hospital did not close but did temporarily cancel elective procedures and clinical appointments. Just blocks away, the Avera Specialty Hospital that will open this fall on the new Avera on Louise campus was unscathed. Buildings about 3 miles away on Avera’s downtown campus, Avera McKennan Hospital & University Health Center, also were undamaged by the twisters.

Despite the ordeal, Gravholt said staff found signs of reassurance soon after the storm. For one thing, two banners that hang outside on the back of the behavioral health hospital were not damaged. One says “Faith” and one says “Hope.”

A post on the Avera Heart Hospital’s Facebook account showed a chunk of wood that landed in the hospital’s lobby. The wood appeared to have an embedded impression of a cross.

“Our windows may be broken, our building damaged, but even during the roar of the storm, God shows up,” the Facebook post said. leisenhauer@chausa.org

“The Mission Leader Competency Model,” a 16-page electronic booklet published on the CHA website, describes the development of the model, explains the competencies and provides tools to help people develop the competencies.

Also available on CHA’s website is a selfassessment tool for current and prospective mission leaders and a bibliography of resources. CHA will update or replace those materials after it completes the new model.

The association plans to have a new assessment tool and bibliography as well as new video resource by the end of 2020.

Changing roles In the past, mission leaders have been expected to be generalists in their field.

Smith anticipates the survey responses may point to some core competencies needed by all mission leaders, and additional specific competencies that reflect areas requiring specialization. For example, mission leaders responsible for leading formation will need greater skills and competencies in that area. Specialization is also occurring in executive mission positions. “As the role of mission leader has evolved, you see a trend towards specialization, especially in those who hold positions at a regional or system level,” he says.

Smith says it is likely that the updated mission leader competency model will stratify competencies by experience level, setting out qualifications and skills expected of mission leaders depending on whether they are at the start, midpoint or apex of their careers.

Debra Canales is executive vice president and chief administrative officer of Renton, Wash.-based Providence St. Joseph Health and a member of a six-member steering committee advising CHA on this work. She says she sees a very high value in the potential for such a tiered competency model that promotes skill-building over the arc of a career.

“We’re pursuing a vision of future mission leaders who lead to both inspire and influence within our organization and the communities we serve,” she says. jminda@chausa.org

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CATHOLIC HEALTH WORLD October 1, 2019

Housing First

Homelessness in Cleveland

From page 1

finance, build and advocate for affordable housing for low- and moderate-income families.

The program follows the “housing first” approach that is being applied in cities nationwide. According to information from the National Alliance to End Homelessness, housing first prioritizes providing permanent housing to people experiencing homelessness. The alliance says the approach is guided by the belief that people need basic necessities like food and housing before attending to tasks like finding a job or seeking addiction treatment.

Housing scarcity Susanna Krey is president of the Sisters of Charity Foundation of Cleveland and senior vice president of Sisters of Charity Health System. The health system established and endowed the foundation with proceeds from the sale of 50 percent interest in one of its two Cleveland hospitals to a for-profit company. As a “health care conversion foundation” the Sisters of Charity Foundation of Cleveland is tasked with pursuing aims in line with the health, education and social service apostolates of the Sisters of Charity of St. Augustine.

Affordable housing has been a standing funding priority since the organization’s founding, according to information from the foundation.

Krey says the foundation chose housing as its focus, in part because when it was established in the late 1990s, homelessness was increasing in Cleveland.

Also, the Sisters of Charity who founded the health system had been addressing housing and homelessness issues in Cleveland for decades, and so the system had built up expertise.

Krey says the foundation — along with Enterprise and the Cleveland/Cuyahoga County Office of Homeless Services — commissioned research on how best to address the increase in homelessness.

Based on the research, these partners concluded that the housing first approach that had shown much promise in other U.S. cities would hold the most potential for Cleveland and environs. The partners built consensus among stakeholders throughout Cuyahoga County on the merits of the housing first approach.

In 2002, the foundation, the city and county homeless services office, and Enterprise formed Housing First.

Krey says the foundation and system have stuck with the housing first approach over the long term because having safe housing “deeply impacts health outcomes.”

Financial resources Six Cleveland nonprofits anchor the collaborative. Enterprise is the convener and leader of the collaborative; CHN Housing Partners is the lead property developer and co-owner and Emerald Development and Economic Network is the property manager, co-developer and co-owner. FrontLine Service is the outreach, mental health and social services provider for Housing First. Care Alliance is Housing First’s mobile health provider.

Ron Goldfarb, Cleveland

A resident at The Winton enters the one-bedroom apartment he calls home after years of housing instability and homelessness. The Winton is a supportive housing complex on Cleveland’s near-west side.

Sisters of Charity Foundation provides extensive leadership, operational and technical expertise, staff time and strategic planning help. “They’ve been in the trenches with us,” says Jennifer Eppich, senior program director for Enterprise.

Housing First has brought more than $130 million in capital investment into CleveEppich land’s neighborhoods.

The collaboration relies heavily on programs from the U.S. Department of Housing and Urban Development for funding.

Since 2002, the Sisters of Charity Foundation has provided about $3 million in funding to build the capacity and necessary infrastructure of the collaboration.

Resident-centric design Housing First has opened 711 units in 12 apartment buildings. Additionally, it has opened scattered sites for families and individuals. Eppich says all of the properties are “beautifully designed and well-maintained.”

Social service providers are on-site at

each complex in highvisibility locations with lots of foot traffic. Angela D’Orazio, senior program officer for housing for the Sisters of Charity Foundation, says the social service, mental health D’Orazio care and mobile health care providers are tasked with making their services accessible and appealing to residents.

D’Orazio estimates that Housing First has housed and helped upwards of 2,000 people who had been homeless. She notes that about 20 percent of tenants eventually move out to live elsewhere, and about 75 percent remain stably housed with Housing First. Less than 5 percent return to homelessness. These outcomes stack up favorably against many other approaches to permanently house the chronically homeless, notes D’Orazio.

The work has had an impact on health care usage and outcomes, with analysis of resident data showing tenants access preventive care and comply with medical instructions. Tenants also have cut their rate of hospital readmissions since

Ron Goldfarb, Cleveland

Lowering barriers Significant numbers of chronically homeless people suffer from mental illness and substance dependence. The housing first approach used in Cleveland and elsewhere does not require people to be sober or medication-compliant to stabilize symptoms of mental illness.

Staff work with tenants who violate lease agreements or are loud and disruptive to encourage them to address their behaviors. While it is not mandated that tenants access the mental health and social services available to them onsite, the Housing First collaborators in Cuyahoga County estimate 97 percent of tenants take advantage of these offerings.

A

The Liberty, one of Cleveland’s 12 Housing First properties, has a fenced-in courtyard where residents can relax, play lawn games and spend time with the cats who live on the premises.

ccording to a point-in-time homelessness count taken on Jan. 23, 2018, and analyzed in a report by the U.S. Department of Housing and Urban Development, there were 1,808 people who were homeless in Cleveland and Cuyahoga County, Ohio. Of that number, 1,597 were in emergency shelters, 133 in transitional housing and 78 unsheltered.

Out of the group of 1,808 people who were homeless, 172 were chronically homeless. That group included 111 in emergency shelters, 16 in transitional housing and 45 unsheltered.

Members of Cleveland’s Housing First collaborative say given that there always will be some turnover as people move on from the Housing First units into other housing, units will be available for occupancy by new applicants. The collaborative says this turnover should allow it to bring the count of chronically homeless people to “functional zero.”

— JULIE MINDA

attaining housing.

Mark McDermott is Enterprise vice president and market leader for Ohio. He says the positive outcomes have to do with the fact that most homeless people are ready to be housed — the housing provides them with the stability McDermott they need to address the other health risk factors in their lives.

D’Orazio says another reason for the encouraging results is that on-site service providers are highly engaged in the residents’ lives, listening to them, being attentive to their hopes, dreams and fears and designing services around their needs.

With their 13th and final housing complex set to come online in October 2020, Housing First plans to extend the coalition’s work to other vulnerable populations. This could include unaccompanied homeless youth, disabled youth and those transitioning out of foster care, and former prisoners reentering society.

According to information from Cleveland’s Housing First collaborative, to achieve “functional zero” homelessness among the chronically homeless — as is the goal — will require more than bricks and mortar. “We expect to attain functional zero after completion of the last site, but maintaining functional zero will require continued focus, collaboration and secure funding well past 2020,” the collaborative says in a statement. jminda@chausa.org

Trafficking victim finds sanctuary through Housing First O

ne of the most recent successes of Cleveland’s Housing First collaborative is a 49-year-old grandmother, who wishes to remain anonymous. Originally from Oklahoma City, she’d become homeless. She says a former friend betrayed her and forced her to ingest illegal drugs. She says, “He allowed multiple men to pay him to sexually assault me.”

She quickly found herself trapped — a victim of sex trafficking — with the man and his friends threatening harm to her and her family if she tried to leave.

Nonetheless, she managed to escape to a shelter, and then to board a bus out of town. On the run in multiple cities and states for months, she finally decided in

Cleveland to stop running. She was living at a shelter when she connected with social services provider FrontLine Service and learned of Housing First. Despite fears of somehow exposing her location to the traffickers by applying for housing, she believed FrontLine’s assurances of anonymity and submitted her application.

In June, she entered her efficiency apartment for the first time. “It was very emotional. I cried, because I’d been running and hiding for three years. When I put the key in the door, it was a joyful moment because of all I’d been through.”

She says her first few weeks in her new home she caught up on her rest. It had been extremely stressful, as well as physically and

emotionally exhausting, to live in shelters and encampments and to constantly fear being found by her traffickers. She says that with a safe home, she can relax now.

She’s accessing mental health services to deal with the trauma of being trafficked. And, she is looking forward to working with the Housing First service providers to “relearn” how to live — how to access social services, follow a budget, get a driver’s license, start job training, and eventually gain independence.

She says of Housing First: “I would not have made it if it wasn’t for these services.”

— JULIE MINDA

October 1, 2019 CATHOLIC HEALTH WORLD

Data mining From page 1

are best, and at the best cost,” says Curtis Dudley, Mercy Technology Services vice president of enterprise analytics. “But our data alone is not enough — we need the data from others as well” to make informed determinations.

Dudley

Information gap Dudley says there are numerous manufacturer, industry and government reports on the efficacy of products, as well as various analytical reports from private consultants — all intended to help health care providers with product selection.

There also is much information available on best practices for treating health conditions, which points to certain products or drugs with best outcomes.

However, most such analyses lack significant data on how patients fare with specific products “in the real world,” Dudley says.

According to Mercy Technology Services, while the results of clinical trials necessary for U.S. Food and Drug

5

Administration approval entists and clinicians have been of new medical devices developing coding that can are generally published in translate raw data into a stanmedical journals, patientdardized form, to make it comlevel data necessary to parable across health systems validate outcomes is usuin the consortium and therefore ally not published after usable, the company said. the devices are marketed.

In addition, manufacturBuilding blocks ers do not usually conduct Steps that Mercy Technolhead-to-head comparisons ogy Services has been taking in between competing prodthe decade-plus since Mercy ucts before or after a new adopted the Epic electronic product is brought to marmedical record system laid ket. The real-world data in the foundation for the Realthe Mercy data bank holds World Evidence Insights Netthe potential to answer the Dr. Robert Frazier, a physician at Mercy Hospital Washington in Washington, work, according to Dudley and question of how devices Mo., consults a patient outcomes dashboard developed using Mercy TechnolDrozda. compare to one another as ogy Services’ Real-World Evidence Insights Network data platform.

For about a decade, Mercy they are actually used by Technology Services has led clinicians and patients. individual health systems can’t do head- FDA-funded demonstration projects to Drozda says that much of the data and to-head comparisons on a wide range of barcode coronary stents, and to mainanalysis available to providers up to now competing products. tain related clinical records in a database amounts to “data dumps.” And, Dudley Also, he says, it is extremely difficult to tracking patient outcomes. adds that while individual health systems extract, curate and analyze bits of inforThe company included in the pilots have data in their electronic health record mation from medical record systems, in de-identified patient data from Mercy, systems on medical devices, pharma- part because of a lack of standardization Intermountain Healthcare and Geisinger ceuticals and patient outcomes, the data in the way entries are made. Even differ- Health system. Drozda has been helping often is skewed toward a relatively small ences in how people format a date of ser- to lead these barcoding studies. number of vendors or products that are vice delivery must be dealt with.

Mercy Technology Services also has in heavy use at each system. As a result, Mercy Technology Services’ data sci- undertaken similar industry-funded projects with other devices.

And separately, in recent years, Mercy Technology Services has been working with the SAP technology company to create the platform and related software needed to pull de-identified data on patients using medical devices and pharmaceuticals from the electronic medical records of Mercy and other health systems, orchestrate that data into usable blocs of information and apply analytical tools to make the information useful for decision-making.

Dudley notes that Mercy Technology Services has a team dedicated to finding the best ways to curate raw data so it is useful for analysis, including by using “natural language processing,” a type of artificial intelligence that helps computers “understand” and use human language.

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‘Regulatory-grade’ info Mercy Technology Services says it will welcome health care providers with the capability to supply data to be part of a consortium that both populates and uses the database. Dudley says data providers will be paid for their data. He adds that to protect patient privacy all of the data will be stripped of information that links it to a particular patient before that data exits each provider’s firewall and goes into the database’s cloud-based information storage.

Drozda says Mercy Technology Services will be pulling in data from more sources over time. For instance, it may incorporate patient input entered through the patient portal, MyMercy, and it may pull in data from insurance companies.

Dudley notes that the platform is set up to process the data in a way that is “regulatory-grade,” or of a quality that would be acceptable to the FDA. Blue sky possibilities Mercy Technology Services envisions multiple uses for the platform. Mercy plans to provide access to academic researchers, to manufacturers and to regulators overseeing product safety. Those using the platform for commercial purposes will pay subscriber fees to access the database and analytical tools.

Dudley says the database will be useful for monitoring the safety and efficacy of new devices, to flag device defects or problems before the products are used on a mass basis.

Dudley and Drozda say numerous health care providers have expressed interest in joining the consortium, and three global manufacturers have contracted to become subscribers, with others expressing interest as well. jminda@chausa.org

6

CATHOLIC HEALTH WORLD October 1, 2019

West Side ConnectED From page 1

Our Challenge 16-year gap in life expectancy between the Loop and West Side communities

Seven questions The tool has taken the form of a set of seven questions that ask about needs such as primary care, housing and food. (See sidebar.)

Representatives from the hospitals drafted the questions in a series of sessions that went on for several months. The screening is specifically meant to get at the needs of residents of 10 neighborhoods on Chicago’s west side — places where rates of infant mortality and chronic disease far exceed the national average and residents face inequities in education, employment, food access, violence and access to transportation. Rates of diabetes, asthma and hypertension are of particular concern in these west side neighborhoods.

In one of those neighborhoods, West Garfield Park, the life expectancy of 69 years at birth is 16 years below that of residents in affluent neighborhoods on the lakefront just 2 miles to the east. The average life expectancy at birth for the city of Chicago as a whole is 77.3 years.

Kathy Donahue, acting administrator, president and chief executive at Catholic Charities of the Donahue Archdiocese of Chicago, said some people might see statistics like that and assume that violence is the root cause of the shortened life expectancy. But she said many factors are at play, including a lack of preventative care and health screenings.

“There’s a lot of reasons why people don’t get the preventative care that they should get,” Donahue said. “It’s women with cancer who never follow through with getting a mammogram because they’re working three jobs, for one example.”

United effort Catholic Charities is the convening agency that brought the hospitals together and linked them with partner agencies that provide the social services needed by so many patients.

Part of the funding to cover Catholic Charities’ costs for coordinating West Side ConnectED is coming from West Side United, a broader nonprofit initiative aimed at improving the health as well as the economy, educational opportunities and physical environment of west Chicago neighborhoods. Other funding is coming from the Illinois Health and Hospital Association.

Donahue said the fact that the hospitals were willing to collaborate for West Side ConnectED is telling as to how important they view the need for identifying and addressing socioeconomic needs that impact the health outcomes of their emergency department patients.

She said that initially there was some resistance to the screening being done in emergency rooms where doctors and nurses

T

hese are the questions that are being asked of emergency department patients at the four hospitals that are part of the West Side ConnectED collaborative.

1. Do you have a doctor (primary care physician) or nurse that you see regularly?

Yes No Declined to Answer

Source: West Side ConnectED

A slide from a PowerPoint presentation on West Side ConnectED shows the disparities in lifespans among an affluent neighborhood along Chicago’s lakefront and neighborhoods in the West Side ConnectED initiative. West Side ConnectEd is working to address those disparities by screening patients on social needs that impact health outcomes and connecting them with social service providers.

are often overwhelmed with the volume of patients and therefore reluctant to take on more tasks that could slow their workflow.

But she was among those who felt strongly that the screening was best done in emergency departments. Patients with low health literacy may repeatedly rely on ERs for primary care, she said.

“If you fix a problem in the emergency room, you’ve made a difference and you’ve saved the hospital so much money and you’ve saved those patients from repeated trauma,” Donahue said.

Building support One of the keys to getting all the hospitals to agree to ask the questions in emergency rooms was having the support of three of the four hospitals’ medical directors, including the medical director from Saints Mary and Elizabeth Medical Center.

“They said: ‘We have people sleeping in our waiting rooms who are homeless. We’re becoming the de facto shelters for the city of Chicago,’” Donahue recalled. “That doesn’t help your workflow, when you have nurses having to deal with people who haven’t eaten and are sleeping alongside patients who have the flu. Somebody needs to be intervening in the social needs of patients who are multiple visit users.”

The patient care managers at the hospitals, some of them nurses and some of them social workers, are doing the emergency department screening.

At all four of the west Chicago hospitals, the information from the screenings is assessed and matched with services from social service agencies listed in social service platforms used by the respective hospitals. The care managers then connect the patients with those agencies. In some cases, the screeners make calls and in some cases they pass along the contact information from the agencies to the patients.

Finding partners Catholic Charities helped set up links with about 30 partner agencies that were ready to take the handoff from the emergency departments and provide services.

The hospitals then established their own relationships with the partner agencies.

McSellers-McCray said Saints Mary and Elizabeth Medical Center taps additional agencies whose services are listed in the

platform it uses, AMITA Health Community Connect, which is powered by the human services database Aunt Bertha. The platform vets all the programs that are included.

All of the programs in the platform are either free or low cost to the user.

She said AMITA saw Aunt Bertha as the best option to spread the screening across its system and is using it as part of its Accountable Health Communities project (see sidebar). The other three hospitals are using a platform called NowPow. The launch dates for using the screening questionnaires varied. It was September 2017 for Rush University Medical; mid-August 2018 for University of Illinois Hospital; March 2019 for Saints Mary and Elizabeth Medical Center; and April for Mount Sinai Hospital. Donahue said Catholic Charities is collecting information about the screenings — such as how many patients each hospital is screening and what needs are being identified.

Closed loop The goal is for the screenings to be a closed-loop process, with the participants confirming to care managers that services were provided and thus needs were met.

“It’s important to ask the questions, it’s important to have a resource and to follow up and to see if it’s improving health,” Donahue said.

Just based on anecdotal information from early in the process, the screening appears to be having some success, with patients reporting that they are getting help from the agencies with whom they’ve

2. Do you have health insurance or a medical card?

Yes No Declined to Answer 3. A. Do you currently have a place to stay/live?

Yes No Declined to Answer B. In the next two months, will you have a place to stay/live?

Yes No Declined to Answer 4. A. Are you worried that your food will run out before you have money to buy more?

Yes No Declined to Answer B. In the last 2 months, have you run out of food that you bought, and didn’t have money to get more?

Yes No Declined to Answer 5. In the last 2 months, have you had difficulty paying your electric, gas, or water bill?

Yes No Declined to Answer 6. Do you have a hard time finding transportation to and from your medical appointments?

Yes No Declined to Answer 7. Is there anything else in your life that’s impacting your health that you want to share?

Yes No Declined to Answer

been connected.

McSellers-McCray said the mission of the collaborative goes beyond meeting the health needs of the individual patients and reducing the costs of their care to helping policymakers figure out how best to address the community’s needs.

“Having this data, we can say, hey, there’s a shortage on the west side of Chicago for housing or food,” she said, “and so what policy changes should be made at the state level or the city level to influence that so there is better access to whatever that need is versus (the hospitals) trying to navigate and do all things for everybody?” leisenhauer@chausa.org

Courtesy Rush University System for Health

idea of AMITA collaborating with other hospital systems that it normally competes with made sense within the parameters of a project to identify and address socioeconomic needs that factor into health outcomes for vulnerable patients.

“We wanted to learn, just like the rest of the hospitals, what are we seeing and then what can we do about it,” she said.

AMITA also wanted to use the model created through the collaboration to build an overall strategy that could be used in all of its hospitals, even outside of the emergency department.

With those goals in mind, staff from Saints Mary and Elizabeth Medical Center have partnered with their counterparts from the University of Illinois Hospital, Rush University Medical Center and Mount Sinai Hospital to develop and use a screening tool to assess and address the needs of patients who get care in their emergency departments.

West Side ConnectED questions assess sociomedical need

Residents exercise at Walk4Wellness this summer in Garfield Park on the west side of Chicago.

Rush University System for Health and the American Medical Association sponsored the event.

AMITA is helping CMS identify social needs in the frail elderly population T he screening for social determinants of health being done in the emergency department at Saints Mary and Elizabeth Medical Center is not new to AMITA Health, the hospital’s parent company.

The use of questions to determine the social needs of vulnerable patients actually got started when the Alexian Brothers Health System (which formed a joint operating company with Adventist Midwest Health in 2015 to become AMITA) was awarded an Accountable Health Communities Model grant from

the Centers for Medicare and Medicaid Services.

Thirty organizations got the federal funding to help figure out how addressing social needs can improve health outcomes and reduce costs. The five-year Accountable Health Communities initiative started in 2017.

AMITA is using its grant to screen patients who qualify for either Medicare or Medicaid, or both. People insured by both Medicaid and Medicare are often in poorer health than the general population. The pilot

program is intended to develop effective ways to identify and assist “high-risk beneficiaries with accessing services to address health-related social needs,” according to the CMS website.

That process is underway at the same time Saints Mary and Elizabeth Medical Center is collaborating in West Side ConnectED, which means a subset of patients there may be screened twice on social determinants of health.

— LISA EISENHAUER

October 1, 2019 CATHOLIC HEALTH WORLD

7

Aquinas Institute to honor CHA theologian for impactful preaching St. Louis-based Aquinas Institute of Theology will award one of its two annual Great Preacher Awards to CHA theologian Fr. Charles Bouchard, OP The Dominican priest joined CHA in 2015 and is the association’s senior director of theology and sponsorship. He and Fr. Craig Holway, who is pastor of St. Louis’ St. Joan of Arc Parish, will receive the Great Preacher Award at a Nov. 7 event that will include preaching, prayer and dinner.

Fr. Mark Wedig, OP, Aquinas Institute president, says Fr. Bouchard “really embodies what this award is all about” — which is celebrating preachers who proclaim, in word and deed, the Gospel of Jesus Christ and the coming and presence of the reign of God. Fr. Wedig says Fr. Bouchard “has a wonderful way” of bridging Christian tradition and the Gospel to today’s age.”

Frs. Wedig and Bouchard both are priests of the Order of Preachers, established by St. Dominic de Guzman in 1216 in Europe. Fr. Wedig explains that to Dominicans, preaching is not just about the time spent delivering homilies at Sunday Mass.

“It’s about instruction, and understanding, and helping people appreciate their faith and gain an understanding of how the word

Jerry Naunheim Jr./© CHA

By JULIE MINDA

Fr. Charles Bouchard, OP, administers Holy Communion to Dominican student friars at St. Dominic Priory in St. Louis. Aquinas Institute of Theology in St. Louis is honoring Fr. Bouchard for his exemplary preaching.

of God enters into all we do as Christians.”

The Dominicans established a presence in the U.S. in the 1800s. They founded the

Aquinas Institute in 1926 in River Forest, Ill., moving it to St. Louis in 1979. Today, the institute has a dual purpose of preparing

jminda@chausa.org

PRESIDENT/CEO

ADMINISTRATIVE CHANGES

KEEPING UP

CHA Senior Director, Mission Integration and Innovation This position provides thought leadership in the areas of mission innovation and integration. As an interdisciplinary position, the focus is to identify, develop and coordinate programs, products and services for ministry leaders responsible for mission integration.

Additionally, this position is responsible for connecting mission executives through committee meetings to facilitate the development and sharing of successful practices in these areas.

Travel is required.

The Catholic health ministry is the largest group of nonprofit health care providers in the nation. It comprises more than 600 hospitals and 1,600 long-term care and other health facilities. To ensure vital sponsorship and a vibrant future for the Catholic health ministry, CHA advocates with Congress, the administration, federal agencies, and influential policy organizations.

Taylor

Haynes

Doug Strong to interim chief executive of Holy Cross Hospital of Fort Lauderdale, Fla., from chief executive of the University of Michigan Hospitals and Health Centers, now called Michigan Medicine. He will work alongside Dr. Patrick Taylor until Taylor departs Oct. 30 as Holy Cross Hospital president and chief executive.

Share the joy of the season with a Christmas message to the ministry

Minimum qualifications: CHA is seeking candidates with a minimum of five years working in a leadership position in mission integration at a local, regional or national health care level. This position requires a minimum of a master’s degree in theology or related field (or equivalent work experience).

To view a more detailed posting for this position, visit the careers page on chausa.org.

Interested parties should direct resumes to: Cara Brouder, Senior Director, Human Resources Catholic Health Association 4455 Woodson Rd. St. Louis, MO 63134 Phone: 314-427-2500 For consideration, please email your resume to HR@chausa.org

Dominican student brothers for ordination in the priesthood and preparing both clergy and laity for careers in Christian ministry.

Fr. Bouchard was ordained in 1979 and earned a doctorate in moral theology from the Catholic University of America in 1987.

He was Aquinas Institute president and associate professor of moral theology for 18 years. He was vice president for theological education at Ascension Health from 2008 to 2011 and then was provincial of the Dominican Province of St. Albert the Great from 2011 to 2015.

Fr. Michael Mascari, OP, academic dean of Aquinas, says that in his every role, Fr. Bouchard has made preaching central to his ministry.

Fr. Bouchard says in his preaching he aims to relate the Gospel to people’s lives to help the faithful reflect on their experiences in the context of the Catholic faith.

He says the greatest reward of preaching “is if it changes someone’s life, even if just a little bit,” for the better.

Include your organization’s Christmas message in the Dec. 15 issue of

Catholic Health World invites you to extend a

holiday greeting to your employees and to colleagues in the Catholic health ministry.

Visit chausa.org/Christmas for more details. Send an email to ads@chausa.org to reserve your ad space. Ads due by Nov. 18.

Jean Haynes to chief population health officer of Bon Secours Mercy Health of Cincinnati.

Catholic Health of Buffalo, N.Y., and one of its hospitals have made these changes: Dr. Hui Jiang-Saldana to executive vice president and chief operating officer of Catholic Health. Heather Telford to vice president of patient care services for Kenmore Mercy Hospital of Kenmore, N.Y. John Bennett to chief executive of ambulatory services for PeaceHealth in Vancouver, Wash.

Brian Kane joins CHA as senior director of ethics Brian Kane, a professor of health care ethics, is joining CHA as senior director of ethics. He will be part of the mission services department led by Brian Smith.

“We are thrilled to have Brian Kane joining the mission and ethics team,” said Smith, who is CHA vice president of sponsorship and mission services. “His academic Kane and clinical bioethics experience will provide our members with the resources and thought leadership they have come to expect from CHA.” To take on his new role at CHA, Kane left his positions as head of the division of liberal arts and social sciences and director of international academic affairs at DeSales University, a Catholic institution in Center Valley, Pa., and as a consultant to the ethics program at Lehigh Valley Hospital and Health Network in Allentown, Pa. Kane has a doctor of philosophy degree in Catholic moral theology from Marquette University, a master’s in theological studies with a focus on social ethics from Boston University and a bachelor’s from Manhattan College.

He was to begin his new job Sept. 30 and will be based in CHA’s St. Louis office.

Kane said he looks forward to participating in the national discussion about bioethical issues, particularly palliative care and end-of-life decision making. “I think we can do an awful lot of good with that,” Kane said.

8

CATHOLIC HEALTH WORLD October 1, 2019

SSM Health simulation center prepares clinicians for the unexpected and the routine In an environment where it’s safe to make mistakes, staff build competency, sharpen critical thinking skills

By LISA EISENHAUER

I

Amber Wood, SSM Health’s system director for learning and development, said the eventual goal is to use the simuWood lation center to train the entire SSM Health workforce at those hospitals, including workers who aren’t in direct care roles, such as people who check in patients and environmental service workers.

The center’s training will reach across SSM Health’s four-state system. Staff at hospitals in Wisconsin, Oklahoma, Illinois and other Missouri markets are able to tune in remotely for live demonstrations of new practices and protocols, Wood said, and they will be doing their own simulations based on the curriculums and protocols developed at the simulation center.

Photos by Sid Hastings/© CHA

t was supposed to be a routine procedure to remove the sheath a cardiologist had used to thread a catheter to a patient’s heart. But as the tubing was being pulled the patient reported feeling light-headed and the bedside monitors showed her blood pressure and heart rate were dropping.

The five nurses who ringed the bed talked through their response and their interventions, which included administering Atropine to speed up the heart rate and using a femoral compression device to stop the bleeding from the sheath site. Within minutes, the patient’s vital signs were rebounding, and the crisis was over.

The fact that the emergency was only a simulated one using a lifelike, high-fidelity manikin that was under the command SSM Health nurses Megan McBride, center rear, and Haley Reyland respond to a simulated emergency at the SSM Health of human operators in a nearby Training and Simulation Center near Fenton, Mo. Nursing trainer Dianne Herbst, right foreground, instructs them on proper control room didn’t mean that it procedures to stabilize a patient encountering complications following a cardiac catheterization.

Sharing best practices wasn’t stressful, said Haley ReyWood also had a lead role in land, one of the nurses maternal morbidity and establishing the simulation cenwho took part in the mortality. They include ter and sees the training provided training. protocols for preeclamp- there as a means to instill best The nurses were ransia, shoulder dystocia, practices systemwide. domly matched up for cardiac arrest, postparIn addition to the mock ER, the simulation that was tum hemorrhage and patient room and birthing suite, the second part of a twoemergency C-section. the simulation center has a pediday session for about 20 “We run through atric examination room and an nurses from SSM Health those so that our nurses apartment-like section with a hospitals across the St. and physicians have the kitchen, living room, bedroom Louis region. The session experience of the high- and bathroom so providers can focused on managing the est-risk patients and of train on home health care praccare of cardiac patients, how to effectively man- tices with actors brought in to including through the use age those in real time,” pose as patients. of telemetry equipment.

Venezia said.

Mental health training will The first day of trainThe OB trainings probably start later this year and it ing was earlier in the week make use of a birth- also will involve the use of actors. and done in a classroom. ing mother and infant Clinicians caring for that populaAll of the training was manikins. tion would get training on a range held at the SSM Health of scenarios, such as how to deTraining and Simulation Support staff escalate situations in a behavioral Center that opened in SSM Health training supervisor Beth Moore, right, watches through an observation window as SSM training care setting.

June near Fenton, Mo. nurses work with a high-fidelity manikin simulating a serious drop in blood pressure and heart rate folSSM Health’s training Herbst said that while simula“It can be really nerve- lowing an invasive cardiac procedure. As part of the clinical training exercise, the nurses will gather for center, which in addition tion is not new in medical trainracking as a nurse because a debriefing to review a video of their response and discuss challenges. to the simulation rooms ing, the center’s high-tech tools you know you’re being includes classrooms and and realistic settings has allowed video recorded and watched,” the patient room is a mock emer- The studies reported improve- the conference room, fills the sec- SSM Health to take its training to Reyland said of the simulation gency room where wheeled cots ments after simulation-based ond floor of a 55,000-square-foot another level. The simulations training. “But in the end, it’s a great and examination tools are sepa- mastery learning in several building just across Highway 141 are so lifelike that they give the way to practice those real-life sce- rated by curtains. Down the hall, areas, including procedure per- from SSM Health St. Clare Hos- trainees a chance to polish the narios without any of the bad con- another room is outfitted like a formance, task success, patient pital. The building once housed teamwork and communication sequences.” Reyland is an RN at modern birthing suite. discomfort, procedure time and a now-defunct business college. skills that are essential in clinical SSM Health St. Joseph Hospital – complication rates.

SSM Health invested $2.5 million settings.

St. Charles in St. Charles, Mo. Spectrum of care As part of the training for obste- in the simulation and training “The facility is just like what The simulation center is tricians and obstetrics nurses center. we’re used to,” Herbst said. “This Close to reality meant to reflect a broad section at the simulation center, VeneInitially, the center is being is what the units are like where That’s the type of response that of hospital and at-home care. zia said they work on mastering used to train doctors and nurses we work and so the nurses can educators at the training center And, consequently, the training the medical protocols for emer- from the health system’s eight really immerse themselves in the said they were hoping to get. provided there is gencies known to lead to high hospitals in the St. Louis area. situations.”

Dianne Herbst, who was meant to cover among the trainers in the session the best treatment that Reyland was part of, sees the practices under a simulation training as invaluable gamut of expected because it so closely mimics the and unexpected situations that nurses actually patient scenarios.

Venezia face.

“The hope is “I think this is how nurses learn that it leads to better care,” said and how they will remember Dr. Guy Venezia, medical directhese things,” said Herbst, who is tor for obstetrics at SSM Health manager of clinical education at St. Clare Hospital – Fenton, part SSM Health’s St. Joseph hospitals of the team that created the simuin St. Charles, Lake St. Louis and lation center to provide realistic Wentzville, Mo. training to doctors and nurses in After the telemetry simulation, all specialties. the nurses took part in a debriefVenezia is sold on the effecing on the emergency and their tiveness of simulation training. response in a conference room Such training has been required where they could watch a play- for SSM Health pediatricians and back of their performance on a obstetricians for about 10 years large video screen. and Venezia is convinced it has That conference room is just improved patient outcomes. across from where the telemetry A review of simulation studies SSM Health nursing trainer Kayla Yost, right, works with nurses Kirsten Settle, left, and Brooke Glore as they perform CPR on training took place in what looked published by Academic Medicine a medical manikin at the SSM Health Training and Simulation Center. SSM Health invested $2.5 million in the center, which like a typical patient room. Next to in November 2015 supports this. opened in June.