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(From time to time, the blog features recipients of the IHA Iowa Hospital Heroes Award. These outstanding hospital employees come from across the state and work at hospitals of every size. They exemplify the courage, caring and community focus that are the hallmarks of the hospital mission in Iowa.)

Cathie Alff is a member of the Cass County Health System cardiac rehabilitation team, where she performs her clinical job duties in outstanding fashion every day. But it is the compassion, the empathy, the trust that she fosters from her patients and the caring she integrates into her work that make her a hero.

Some examples of how she goes above and beyond include: driving 20 miles in her own vehicle on her own time to assist a very anxious homebound patient with a Holter monitor device; taking a patient home who was too ill to drive; stopping to pick up a monitoring device to save a patient a trip to the hospital and goiCathieG1ng to the nursing home to hook up a monitoring device so the patient would not have the stress of being transported to the hospital. Cathie’s good work ranges from volunteering to help a co-worker move her in-law into a nursing home to taking the time to sit with patients who are frightened or depressed and talking with them, comforting them, consoling them and crying with them. All of these actions are driven by a true sense of compassion and love for her patients and co-workers. Cathie has a unique insight into seeing the good in people and helping them see it too, so that it overshadows the weaknesses and becomes a strength to promote healing.

Cathie understands the big picture – she knows it is not about her; it’s about the patient. For her, every day at the hospital is not just “another day” at work; instead, it is a profound moment in her patients’ lives and it’s their needs that have priority. Even when supporting her father and her significant other as they battled their own serious health issues, Cathie never wavered in her support and encouragement of the cardiac rehab patients she continues to care for every day. Cathie Alff truly embodies the meaning of what it is to be an Iowa Hospital Hero.

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employee wellnessIHA and Iowa Business Council have partnered to produce a new report designed to help businesses, health care providers and employees work better together to improve health and control health care costs.

Using case studies from 19 large Iowa employers, “Partners for Health: How Iowa Businesses, Health Care Providers and Employees are Collaborating to Create Value” offers specific real-world examples of successful programs Iowa businesses have implemented to engage employees in their health and improve individual and organizational wellness. Sectors represented in the report include manufacturing, retail, health care, education and energy.

“Iowa businesses are deeply invested in the health of their employees,” said Michael Wells, chair of the IBC board and president and CEO of Wells Enterprises Inc. in Le Mars. “But we realize we must do more than provide health care coverage. We must engage employees in their health, incent and support good habits and work with health care providers. These case studies show collaboration is crucial.”

We applaud Iowa businesses that have joined with their employees and health care providers to ensure good health,” said Marie Knedler, chair of the IHA board and president of CHI Health Mercy Council Bluffs. “We know in the health system that coordination of care is necessary for successful outcomes. We also realize that coordination not only involves providers, but our patients and their employers working together toward prevention and wellness. That is how value is cultivated in health care.”

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Community Workers Changing Health Care

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Walfred Lopez, a community health worker at the Los Angeles County-USC Medical Center, visits patient Maria Rivera, 48, at her home in La Puente, California, on Friday, October 9, 2015. Rivera says she depends on Lopez to understand what is happening with her health (Photo by Heidi de Marco/KHN).

Walfred Lopez, a community health worker at the Los Angeles County-USC Medical Center, visits patient Maria Rivera, 48, at her home in La Puente, California. Rivera says she depends on Lopez to understand what is happening with her health. (Photo by Heidi de Marco/KHN).

(This article, by Anna Gorman, was provided by Kaiser Health News.)

Month after month, Natalia Pedroza showed up at the doctor’s office with uncontrolled diabetes and high blood pressure. Her medications never seemed to work, and she kept returning to the emergency room in crisis.

Walfred Lopez, a Los Angeles County community health worker, was determined to figure out why.

Lopez spoke to her in her native Spanish and, little by little, gained her trust. Pedroza, a street vendor living in downtown Los Angeles, shared with him that she was depressed. She didn’t have immigration papers, she told him, and her children still lived in Mexico.

Then she mentioned something she hadn’t told her doctors: She was nearly blind.

Pedroza’s doctor, Janina Morrison, was stunned. For years, Morrison said, “people have been changing her medications and changing her insulin doses, not really realizing that she can’t read the bottles.”

Health officials across the country face a vexing quandary – how do you help the sickest and neediest patients get healthier and prevent their costly visits to emergency rooms? Los Angeles County is testing whether community health workers like Walfred Lopez may be one part of the answer.

Lopez is among 25 workers employed by the county to do everything possible to remove obstacles standing in the way of patients’ health. That may mean coaching them about their diseases, ensuring they take their medications or scheduling medical appointments. Their help can extend beyond the clinic walls, too, to such things as finding housing or getting food stamps.

The workers don’t necessarily have a medical background. They get several months of county-sponsored training, which includes instruction on different diseases and medications, as well as tips on how to help patients change behavior. They are chosen for their ability to relate to both patients and providers. Many have been doing this job for friends and family for years – just without pay.

“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t,” said Dr. Clemens Hong, who is heading the program for the county. “That helps break down barriers.”

For now, they work with about 150 patients, many of whom have mental health issues, substance abuse problems and multiple chronic diseases. The patients haven’t always had the best experience with the county’s massive health care system.

“They tell us, ‘I am just a number on this list,’” Lopez said. “When you call them by name and when you know them one-on-one … they receive that message that I care for you. You are not a number.”

By spring, Hong said he hopes to have hundreds more patients in the program.

Community health workers have been used for decades in the U.S. and even longer in other countries. But now officials in various counties and states — including Massachusetts, Pennsylvania and Oregon — are relying on them more as pressure grows to improve health outcomes and reduce Medicaid and other public costs, experts said.

“They are finding a resurgence because of the Affordable Care Act and because health care providers are being held financially accountable for factors that occur outside the clinical walls,” said Dr. Shreya Kangovi, assistant professor of medicine at the University of Pennsylvania and director of the Penn Center for Community Health Workers.

Kangovi said community health worker programs, however, are likely to fail if they don’t hire the right people, focus too narrowly on certain diseases or operate outside of the medical system. They also need to be guided by the best scientific evidence on what works.

“A lot of people think… they can sort of make it up as they go along, but the reality is that it is really hard,” she said.

Hong, who designed the program based on lessons learned from other models, said Los Angeles County is taking a rigorous approach. It is conducting a study comparing the costs and outcomes of patients in the program against similar patients without assigned workers.

The patients are chosen based on their illnesses, how often they end up in the hospital and whether doctors believe they would benefit.

To Lopez, 43, the work is personal. A former accountant from Guatemala, Lopez has a genetic condition that led to a kidney transplant. Like some of his patients, including Pedroza, he is now on dialysis.

He tries to use his experience and education to get what patients need. But even he runs into snags, he said. One time, he had to argue with a clerk who turned away his patient at an appointment because she didn’t have identification.

“The hardest part is the system,” Lopez said. “Trying to navigate it is sometimes even hard for us.”

Lopez and his fellow community health worker, Jessie Cho, sit in small cubicles in the clinic at Los Angeles County-USC Medical Center, the county’s biggest and busiest public hospital. Throughout the day, they accompany patients to visits and meet with them before and after the doctor does. They also visit patients at home and in the hospital, and give out their cell phone numbers so patients can reach them quickly.

Cho said the patients often can’t believe that somebody is willing to listen to them. “Nobody else on the medical team has it as their job to provide empathy and compassion,” she said.

Morrison, the clinic physician, said both workers have become an essential part of the health team.

“There is just a limited amount I can accomplish in 15 or 20 minutes,” Morrison said. “There are all these mysteries of my patients’ lives that I know are getting in the way of taking care of their chronic medical problems. I either don’t have time to get to the bottom of it or they are never going to really feel that comfortable talking to me about it.”

Natalia Pedroza, who wears a colorful scarf around her head and speaks only Spanish, is a perfect example. Morrison said before Lopez came on board, “I wasn’t getting anywhere with her.”

Initially, Lopez had a hard time helping her understand her health conditions and overcoming her distrust of the system. When they first met, Pedroza believed the dialysis that kept her kidneys functioning was the cause of her health problems. And she didn’t get why Lopez was always around.

But he helped her — by getting her appointments, for instance, and helping arrange for Pedroza to get pre-packaged medications so she wouldn’t have to read the directions. Now Pedroza thinks Lopez is helping her to get better.

On a recent afternoon, Lopez sat down with Pedroza before her medical appointment.

“How are you feeling?” he asked in Spanish.

Pedroza responded that her hair was still falling out and that she still felt sick. She also said she hadn’t been checking her blood sugar because she didn’t know how to use the machine. Lopez calmly demonstrated how the machine worked, and then the two spent several minutes chatting about her job and her neighborhood.

Lopez said he believes he has a made a difference for other patients as well. On a recent Sunday, a 43-year-old patient with chronic pain who initially refused his help texted that he planned to go to the emergency room because of a headache. Lopez reached Morrison, who agreed to squeeze him into the schedule a few days later. And the patient didn’t go to the ER.

Lopez persuaded another patient, a 56-year-old woman, to take her blood pressure medication before her appointments so that when she arrived, the doctors wouldn’t get worried about her numbers and send her to the hospital.

In one case, his ability to bond with a patient almost undermined his goal of getting the man the help he needed. The patient, who was depressed, said he didn’t want to go see a mental health counselor because he was more comfortable talking to Lopez.

“It was touching,” Lopez said. “I was about to cry.”Comm

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IHA Names Hospital Heroes

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HospitalHerosAward_LogoA new group of outstanding Iowa hospital employees was honored earlier this month at the IHA Annual Meeting as “Iowa Hospital Heroes.”

The 11 individual awards given this year went to employees at hospitals of every size, both rural and urban, in all parts of the state. Though their roles in their hospitals vary, they are all high-achieving employees who have shown unique and selfless ways to contribute to their hospitals’ missions of caring. While a few of these recipients have stepped forward in an instant to save a life, all have proven their dedication to improving the lives of Iowans.

Cathie Alff, Nursing Technician
Cass County Memorial Hospital, Atlantic

Kevin Bradley, Radiology Manager
Mercy Medical Center - Centerville

Kathy Burris, Registered Nurse
Jefferson County Health Center, Fairfield

Michelle Callahan-Moore, Nurse Supervisor
Fort Madison Community Hospital, Fort Madison

Patrick Cogley, Physician
Grinnell Regional Medical Center

Laine Custer, Registered Nurse
Greene County Medical Center, Jefferson

Stacey Cyphert, Assistant Vice President for Health Policy
University of Iowa Hospitals and Clinics, Iowa City
(awarded posthumously)

Joseph Hoagbin, Physician
CHI Health Mercy Council Bluffs

Barbara Miller, Social Worker
Great River Health Systems, West Burlington

Ania Renteria, MRI Technologist
Iowa Specialty Hospital-Clarion

Joanna Shade, Social Worker
Marengo Memorial Hospital

IHA will begin taking nominations for the 2016 Hospital Heroes Awards next spring. The IHA blog will publish profiles of the Hospital Heroes throughout the coming year.

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Awards were presented last week at the IHA Annual Meeting to five outstanding members of Iowa’s hospital leadership community. The awards were announced at the Chair’s Celebration on October 7.

Excellence in Leadership Award: Russell Knight, president and CEO at Mercy Medical Center-Dubuque. Knight has diligently served for 18 years as the CEO of not one, but two Iowa hospitals – Mercy Medical Center-Dubuque and Mercy Medical Center-Dyersville. In that time, he rose to become a highly respected leader through the many accomplishments made on behalf of his hospitals and for health care across the state. He is also a past chair of the IHA Board.

A colleague commented that Knight “inspires people to do the right things and to do things right” and this is no doubt a reflection of the trust his staff have in him. That’s because he understands that health care is a “relationship business” which requires trust, clear communication, consistent behavior and a high level of integrity.

In addition to his professional responsibilities, Knight still makes time to contribute to his local community by serving on the local chamber of commerce, economic development corporation and United Way boards.

Young Executive Achievement Award: Matt Wille, CEO of Dallas County Hospital (DCH) in Perry.  Letters supporting Wille’s nomination praise him as a forward-thinking leader who thoughtfully approaches today’s health care challenges. In his time at DCH, he has risen to a level of utmost respect from his staff and colleagues through his leadership and positive demeanor. His leadership has led to accomplishments such as exceeding Mercy Health Network’s benchmark scores for patient satisfaction, with a score beyond the 90thpercentile. His colleagues also praise his leadership which helped maintain and grow market share and in recruiting great talent to their hospital.

Mary Kitchell

Mary Kitchell

A fellow executive had this to say in support of Wille’s nomination: “In my career of more than 43 years I can honestly say that Matt rises to the top of being an outstanding young executive. He is knowledgeable and a visionary who allows his staff to grow into new opportunities and uses experienced staff to enhance his own expertise.”

Excellence in Governance Award: Mary Kitchell, trustee at Mary Greeley Medical Center in Ames.  For the past 15 years, Kitchell has passionately served on the governing board of this hospital and is a steadfast advocate for the American Hospital Association and IHA. She was among the first to receive the voluntary Trustee Education Certification from IHA and has received, in total, three consecutive two-year certifications and was integral in helping her hospital’s board achieve 100 percent certification.

Debra Stock, vice president of member relations for the American Hospital Association, had this to say about Kitchell: “There are few trustees who have done as much to advance hospitals and to advocate for the underserved. It is with pleasure and confidence to recommend Mary for this award.”

Jackie Anhalt

Jackie Anhalt

Outstanding Nurse Executive: Jackie Anhalt, vice president of patient services and chief nurse executive with Genesis Medical Center in Davenport.  Anhalt has been a member of the Iowa Organization of Nurse Leaders since 2003 and was also honored as one of the 100 Great Iowa Nurses in 2007. So it’s no surprise that in support of her receiving this award, hospital President Jordan Voigt referred to her as his “go-to individual”.

Likewise, her colleagues noted that Anhalt not only leads and inspires her colleagues through her passion and integrity but is also known to go the extra mile with patients, often spending hours visiting with them and ensuring that they receive the best care. Additionally, her advice and creativity drive and inspire other nurse leaders at the hospital.

Outstanding Nurse Leader: Daphne Willwerth, nurse manager of emergency services at UnityPoint Health-Trinity Regional Medical Center in Fort Dodge.  With more than 33 years of experience, Willwerth is highly regarded by her peers as a high performer in the organization. She’s renowned for the significant accomplishments made in the effort of cross-continuum work between public agencies, skilled nursing facilities and clinics. All of this done in pursuit of a passion to improve the care of the patients in her community.

As is common with outstanding nurse leaders, Willwerth oversees the direction and coordination of services for her hospital’s emergency department (ED), ambulance department and ED physician services for a total staff of 28 RNs, 24 emergency medical services staff and two unit clerks. Her colleagues describe her as reliable, dedicated, diligent and “eternally upbeat.”

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