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National Doctors Day

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By Dr. Kevin Martin, Chief Medical Officer KVH

March 30 will mark the 182nd anniversary of the first use of anesthesia in surgery by Dr. Crawford Williamson Long, and so that is the day we celebrate National Doctors Day. At Kittitas Valley Healthcare, we take that as an opportunity to celebrate all of our providers and thank them for their commitment to our health and our community.

All the healing professions have an oath, pledge, or declaration that promises to respect and serve people.  Mine, The Declaration of Geneva – 1994, started, “I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity.”  Osteopathic physicians, physicians’ assistants, and nurse practitioners make similar promises.

Healing work, our service, takes many forms. It might be fixing a surgical problem, or diagnosing a medical one, or facilitating life’s inevitable transitions. It was the latter that drew me to family medicine, delivering babies and providing hospice care. Each of us finds the work that fulfills us, but that work is always about humanity.

When I started in private practice in 1998, probably 90% of my time at work was spent in the exam room with patients and families.  I would come out of a room, spend a couple of minutes with a Dictaphone, and head to the next room. If I had someone in the hospital, I would make rounds at 7:00, at lunch, and at 5:30.  I routinely saw 25-30 patients a day and was home for dinner or a kid’s game or recital. Primary care providers (PCPs) in a mature practice would have up to 3,000 people in their care. A workforce of 20 PCPs and a handful of surgeons, gynecologists, and other specialists could easily care for today’s population of Kittitas County.

That is not the work today. There is much more that we are expected to document at every visit. Some of the requirements come from the government and many more from insurers. Typing at a computer is slower than dictating. Studies and procedures need prior authorization from payers. Studies have shown that today’s primary care doctors spend 1-2 hours outside the exam room for every hour they spend in it, and the same is true to some extent across all specialties. High functioning primary care providers see 16-18 patients a day, frequently work into the night from home, and can only care for perhaps 1,500 people; 1,250 is probably a better number. The care that 20 PCPs could do before 2000 now needs at least 40, probably closer to 45.

Many providers are retiring earlier, especially since 2021, and we are not graduating new doctors fast enough to keep up. In 2023, the American Association of Medical Colleges (AAMC) reported that 83% of practicing physicians are over 40 and 23% are over 65.  Nationally, some estimate we are short up to 30,000 providers, and AAMC expects that shortage to grow to as much as 139,000 by 2036. The shortage hit rural areas in the South and West hardest, and we feel it.

Every year at KVH, we put a table in the lobby for the month March with note cards and pens. If a provider has helped you, has impressed you, please share that. We share the cards with each provider. It’s a little thing, but it helps remind us why we do this work and for whom we do it. You can also thank your provider by visiting: https://qrco.de/drday24.

A Message from the Board of Commissioners Regarding the Future of OB Care at KVH

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Early today, KVH received a resignation letter from KVH Women’s Health provider Holly Dawson, DO, effective October 12, 2023. In true accordance with our value of Transparency, we want to take this opportunity to be open and honest with you on the current status, and future plans of KVH Women’s Health and the KVH Family Birthing Place.

At KVH, we talk a lot about our strategies and how they shape the work we do. When you look at the KVH strategies, Access is at the top of the list. For us, Access means that KVH is intentional in providing the needed services in our community and we work to anticipate the resources needed to serve our community.

In April 2022, the Women’s Health Clinic was staffed with four OB/GYN or FPOB physicians and two advanced practice providers. These staff shared the responsibility of OB/GYN care at KVH Women’s Health and OB call and deliveries at KVH Hospital. KVH providers were supported by staff at Community Health of Central Washington (CHCW), however their call coverage has been significantly hampered due to their own staffing issues. Since then, three physicians and one advanced practice provider have left the practice for issues around work-life balance and professional burnout. We have been actively recruiting OB/GYN and FPOB candidates since the Fall of 2022 and have seen some success with the arrivals of Dr. Wageneck and Anna Phillips.

We are very proud of our Women’s Health teams in the clinic and the hospital and we want to support them. As KVH Women’s Health began to experience the provider departures felt throughout the country, leadership began exploring new options to support this service. The key to any service line offered is that it must be RELIABLE for our community and SUSTAINABLE for our providers and staff. Women’s health has faced unprecedented challenges in 2023, and we are committed to addressing them. Due to staff shortages, we have been forced to limit the number of new OB and GYN patients we can accept. We’ve had to reach into our Family Medicine providers to assist with newborn call coverage. We can no longer depend on the traditional model of single clinic physician coverage and must think deeper and broader.

Eight months ago, leadership brought forth a new model of obstetrics care for our KVH provider team to consider. This model is similar to the models we are using in MedSurg/CCU, the Emergency Department, and Anesthesia where dedicated, professional teams with significant bench strength are brought in to provide services for our patients in our facility. At that time, our providers felt they could still meet the needs of our community and asked that we continue to put our efforts into recruiting new KVH-employed providers. This has not worked. Today, our providers are leaving for opportunities to work in the very models we were bringing forward.

Across the state and throughout the country, OB programs are closing. We only expect to see this trend continue. We know that rural OB programs are fragile everywhere. KVH is committed to finding a reliable and sustainable OB program for our community and welcomes the involvement of our community partners. We will be holding a special board meeting on Thursday, July 20 at 5:00 p.m. to discuss our efforts and next steps. In the meantime, please be assured that we are committed to a full-service women’s health program at Kittitas Valley Healthcare.

Matt Altman

President, KVH Board of Commissioners

KVH Chief Ancillary Officer and Roslyn community member Rhonda Holden named to new Federal Advisory Committee

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On Tuesday, December 13 the Biden-Harris Administration announced that local resident Rhonda Holden, RN, BSN, MSN was one of 17 individuals throughout the country selected to join the Ground Ambulance and Patient Billing (GAPB) Advisory Committee. This new federal advisory committee was created in November of 2021 to improve the disclosure of charges and fees for ground ambulance services and to better inform consumers of insurance options for such services and protect consumers from balance billing.

Ms. Holden will provide the committee with insight into the unique needs of rural communities that rely on ground ambulance services, not only to respond to accidents and emergencies but also to transport patients long distances to a higher level of care. “I believe we can work together to revise the payment structure for ground ambulance transports which will ultimately alleviate burdensome financial challenges for consumers. Financial concerns should not be a barrier to access life-saving care for any American,” states Holden.

Rhonda’s career as a registered nurse has been spent largely serving rural communities. She is a long time resident of Roslyn with an in-depth experience in advisory roles. She currently serves as the Chief Ancillary Officer at Kittitas Valley Healthcare (KVH) and is the Director of Strategic Initiatives for Kittitas County Public Hospital District #2, which operates Medic One, the only advanced life support (ALS) ambulance service in Upper County.

“Ms. Holden is well qualified to articulate the unique challenges that rural ground ambulance consumers and providers experience and will represent the rural perspective,” stated KVH Commissioner Robert Davis in her nomination letter. Ms. Holden’s nomination was supported by Kittitas County Hospital District 1 and 2’s Boards of Commissioners, the Legislators of Washington State’s 13th District, the Washington State Hospital Association, the Washington State EMS and Trauma Steering Committee, the Washington State Emergency Cardiac and Stroke Technical Advisory Committee and the American Hospital Association’s Rural Health Services.

For more information on the Ground Ambulance and Patient Billing Advisory Committee appointments see Members of New Federal Advisory Committee Named to Help Improve Ground Ambulance Disclosure and Billing Practices for Consumers | CMS and 2022-27263.pdf (federalregister.gov).

For information on the GAPB committee and charter see Advisory Committee on Ground Ambulance and Patient Billing (GAPB) | CMS

For inquiries on the GAPB please contact press@cms.hhs.gov

Get With The Guidelines® Award

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Kittitas Valley Healthcare has been nationally recognized for its commitment to providing high-quality stroke care

The American Heart Association presents the Get With The Guidelines®-Stroke Gold Plus Award for proven dedication to ensuring all stroke patients have access to best practices and life-saving care

Kittitas Valley Healthcare has received the American Heart Association’s 2022 Get With The Guidelines®-Stroke Gold Plus Award for its commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, ultimately leading to more lives saved and reduced disability.

Stroke is the No. 5 cause of death and a leading cause of disability in the U.S. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so brain cells die. Early stroke detection and treatment are key to improving survival, minimizing disability and accelerating recovery times.

Get With The Guidelines puts the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping ensure patient care is aligned with the latest research- and evidence-based guidelines. Get With The Guidelines – Stroke is an in-hospital program for improving stroke care by promoting consistent adherence to these guidelines, which can minimize the long-term effects of a stroke and even prevent death.

The Mission: Lifeline and Get With The Guidelines programs make it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which helps us ensure more people in central Washington experience longer, healthier lives.

About Get With The Guidelines

Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Developed with the goal of saving lives and hastening recovery, Get With The Guidelines has touched the lives of more than 12 million patients since 2001. For more information, visit heart.org.

Donation by The Foundation at KVH

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The Foundation at KVH presents Kittitas Valley Healthcare with Donation

(Ellensburg) March 31, 2022 – The Foundation at Kittitas Valley Healthcare, which directly supports the programs and services of Kittitas Valley Healthcare, presented a check for $402,690.00 to Kittitas Valley Healthcare on Tuesday, March 29, 2022.  The release of funds is the largest in Foundation history thanks to generous donations from the community. 

“The Foundation is pleased to fund new state-of-the-art equipment for use in the surgical unit, CADD pumps for use by Home Health and Hospice and cardiac stress testing equipment from our FUND-A-Need campaigns of 2020-21,” said Bill Boyum, Foundation Board President.  “The new equipment uses the most advanced technology available and the Foundation is excited to be able to make this purchase for Kittitas Valley Healthcare.”

“Community support has always made us stronger and the need for charitable contributions is as great as it has ever been, said Foundation Board President, Bill Boyum. “The opportunity for meaningful impact is immense.”

The Foundation raises funds annually through an annual appeal to donors, Tough Enough to Wear Pink breast cancer awareness campaign and through fundraising events.

Foundation Board President, Bill Boyum, along with The Foundation Board of Directors, present KVH Commissioners Dr. Robert Davis and Jon Ward, KVH CFO, Scott Olander and KVH Chief of Facilities, Ron Urlacher with a check on Tuesday, March 29, 2022.

For Immediate Release (PDF)

For more information on The Foundation at KVH, or to make a donation, please visit kvhealthcare.org/foundation.

Racism is a Healthcare Crisis

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Kittitas Valley Healthcare joins other hospitals and healthcare systems across America in condemning racism, bigotry, discrimination, and violence. We have witnessed senseless acts of violence against people of color and we know that it must stop.

We are a place of healing and, as such, we have a special role to play in ensuring equality for all our neighbors. We must address racial, ethnic, and cultural disparities, including disparities in healthcare. Data is clear that there is implicit bias within the healthcare delivery system. People of color suffer more from preexisting conditions, and they have worse healthcare outcomes overall.

We the KVH Governing Board and Administration have a duty as an employer, community leader, and healthcare provider to do better.

  • As an employer, we will have the courage to listen to our employees and to recruit professionals with a diversity of perspectives.
  • As a community leader, we will listen to the experiences of the people we serve and collaborate with others who are on this same journey to do better.
  • As your healthcare provider, we will dedicate ourselves to closing the gaps in access and health outcomes so that we can all do better.

It is imperative that we work together to build and sustain an increasingly diverse community that values and cares for all of our co-workers, neighbors, and patients.

Sincerely,

Board of Commissioners
– Bob Davis, President
– Erica Libenow, Vice President
– Matt Altman, Secretary
– Terry Clark, Commissioner
– Jon Ward, Commissioner
Julie Petersen, CEO
Kevin Martin, MD, Chief Medical Officer

KVH awarded for practice transformation activities in Kittitas County

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Kittitas Valley Healthcare (KVH) came home from the Provider Recognition Awards with four awards from the Greater Columbia Accountable Community of Health on Wednesday evening, October 30.

KVH Hospital, KVH Family Medicine – Cle Elum and KVH Family Medicine – Ellensburg were each presented with the “Fighting for Change/War Room” Award by Jenna Shelton, GCACH’s Practice Transformation Navigator. This award recognizes the collaborative work being done by KVH and the other safety net organizations in our community towards practice transformation and the implementation of a Patient-Centered Medical Home. KVH also received the “Kittitas Beginner Opioid Resource Network (ORN) Award for work being done to reduce opioid abuse throughout the county.

“KVH has a team that brings nothing but excellence and dedication,” stated Jenner Shelton. “They have committed a space labeled as their ‘War Room’ where all of the practice transformation ideas and workflows have been built. They are a highly committed group.”

The GCACH’s mission is to advance the health of our population. The GCACH region includes nine counties and over 710,000 lives. Patient-Centered Medical Home (PCMH) is the strategic foundation for Greater Columbia’s work and puts the patient in the center of care. The result is better patient care, improved population health and lower healthcare costs. The PCMH acts as an “umbrella” that incorporates the majority of the work from the four project areas below:

  • Bi-Directional Integration of Physical & Behavioral Health – The focus is to address physical and behavioral health needs through an integrated network.
  • Addressing the Opioid Public Health Crisis – The focus is to reduce opioid related morbidity and mortality through prevention, treatment and recovery supports.
  • Chronic Disease Prevention & Control – The focus is implementation of the Chronic Care Model, a cornerstone of PCMH, with the goal being planned prevention and treatment strategies for individuals with chronic illnesses.
  • Transitional Care – The focus is to reduce avoidable admissions/readmissions to intensive care settings such as hospitals, psychiatric hospitals, skilled nursing facilities and prisons or jails. The goal of transitional care is getting the right care, at the right time, and the right place.