Author: Winneshiek Medical Center

Winneshiek Medical Center is pleased to share the new Wound Center is opening March 27.  The Wound Center is located in the North Building on the WMC campus in Decorah.

The Wound Center is a specialized outpatient service for patients with non-healing wounds due to common conditions such as: diabetes, burns, pressure ulcers, and other conditions.  Patients have access to the latest techniques and treatment modalities for the best chance for healing wounds, including hyperbaric oxygen therapy, coming this fall.

Bethany Stevens, ARNP, joined Winneshiek Medical Center in August 2021 to provide advanced wound care to patients. Bethany is a board certified wound specialist and has been providing wound care since 2015. She received her Bachelor of Science in Nursing, and Master of Science in Nursing – Family Nurse Practitioner from Allen College in Waterloo, IA.

Providing care alongside Bethany is Mayo Clinic Health System general surgeon Caroline Schwickerath, D.O., who is also a board certified wound specialist physician.  Dr. Schwickerath achieved this certification through the American Board of Wound Management.

Bethany shares, “I’m looking forward to expanding this specialty service to our region. I have seen first-hand the stress and burden carried by those living with a chronic wound. And I have also witnessed the impact that wound healing brings. That’s why I chose this specialty — to help patients heal and get back to living again.”

To learn more about the Wound Center at Winneshiek Medical Center, or to schedule an appointment, call 563-382-2911.

Access to mental health care is a top health concern of our community, according Winneshiek Medical Center’s Community Health Assessment (2022). To address this need, the Winneshiek Medical Center Behavioral Health team offers additional access to mental health care for patients through group therapy. Cognitive Behavioral Therapy for Insomnia is one of the groups that will be held again this spring.

Cognitive Behavioral Therapy for Insomnia

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a five-week session led by Claire Haedike, Psy.D., Mayo Clinic Health System psychologist at Winneshiek Medical Center. She says, “CBT-I is a drug-free, evidence-based treatment for insomnia. Lack of sleep is a common problem for many people. This group is for those who have difficulty sleeping and would like to be able to fall asleep, and stay asleep, through the night. Interventions are aimed at teaching behavior change skills that will create lasting improvement in sleep.”

CBT-I group therapy sessions will begin this spring. To be considered for group therapy, patients must first schedule a consult to ensure appropriateness for the group. Group therapy is a covered benefit under most insurance plans; check with your insurance carrier to find out your individual coverage options.

To schedule a group therapy consult, call 563-382-2911 and ask to speak with Behavioral Health.

At the March 1 meeting, the Board of Trustees approved a new name and brand for Winneshiek Medical Center.  Effective early summer 2023, the name will change from Winneshiek Medical Center to WinnMed.

Steve Slessor, chief administrative officer, says, “The new name closely connects to the current identity, but is shortened to be easy to see, say and remember.  The ‘Winn’ portion gives respect to Winneshiek County citizens to whom we are so deeply connected, and the ‘Med’ portion broadens our scope from a physical place or ‘center’ to a larger medical system that encompasses the entire region.”

A new tagline to support WinnMed was also adopted by the Board of Trustees: Excellence lives here. Slessor says, “The tagline speaks to the ideal that every patient receives the absolute best care here, and that care is inspired by the patients and health care providers who choose to live, work and care for each other locally.”

As under the legacy name and brand of Winneshiek Medical Center, clinic and many hospital physician services, as well as administrative services at WinnMed will be provided by Mayo Clinic Health System.  Thomas Marquardt, D.P.M., chief medical officer, says, “With the new brand there has been an ‘unlocking’ of the logos between WMC and Mayo Clinic Health System. This helps to protect brand identity of both organizations. The county-owned medical center will continue to have great service from our Mayo Clinic Health System physicians. The nearly 20-year partnership with Mayo Clinic Health System remains strong and continues to grow. The leadership and physician services we continue to receive from Mayo Clinic Health System will help keep WinnMed on the cutting edge of health care.”

Background

In 1992, the first of all Mayo Clinic Health System clinics opened in Decorah and worked in partnership with the local hospital, then Winneshiek County Memorial Hospital.  In 2005, Winneshiek County Memorial Hospital entered into a Professional Services Agreement and Management Services Agreement with Mayo Clinic Health System, and rebranded itself to Winneshiek Medical Center.  The medical center continued to grow and evolve, adding service lines and specialty services until the present time, and is now the largest and most specialized hospital in the region.  Currently, 565 staff and physicians work at Winneshiek Medical Center, and in addition to being a top economic engine for the region, Winneshiek Medical Center has significant plans to expand the facility over the next five to ten years.

Slessor says, “As expansion plans began to unfold, it was the perfect time to rebrand Winneshiek Medical Center to reflect our renewed commitment to the region and future growth.”  Winneshiek Medical Center engaged with Vendi Advertising from La Crosse, Wisconsin to support the rebranding efforts, which included a community perception study to inform WMC leadership what patients and non-patients alike expect from their local health care center.

Next Steps

Winneshiek Medical Center will continue to operate under the current name and brand until early summer, at which time there will be an official launch of WinnMed.  During the spring transition months, staff will prepare for the changes, including all print, signage and electronic uses of the name and logo. Clark Goltz, chair of the Board of Trustees, says, “We are a system that exists to care for the health and well-being of every person in the communities we serve. This includes our patients and their families, our professional colleagues and the community at large.  WinnMed reflects this broader level of commitment and our expanding presence and scope of care in the communities we serve.”

From the federal to the local level, taxes are a very real part of our world.  Typically, taxes support infrastructure like roadways, bridges, or law enforcement assistance; or social expenses like public education, Medicaid support and others. 

Iowa Code Chapter 347A allows for county or municipal hospitals to levy taxes to help cover unreimbursed expenses.  As a county-owned not-for-profit health care facility, Winneshiek Medical Center is legally able to set a tax levy and collect property taxes from the citizens of Winneshiek County.  Each March, the elected Winneshiek Medical Center Board of Trustees decides on a rate, or levy, of property tax dollars to go to the hospital.  For the Fiscal Year 2024 budget (July 1, 2023-June 30, 2024),  Winneshiek Medical Center leadership will propose a budget to the Board of Trustees that includes a tax levy of 1.08 per $1000 assessed valuation.   This is an increase from 0.77235 per $1000 assessed valuation from last fiscal year.  The proposed budget will be discussed at the March 1, 2023 board meeting at the medical center. 

Why is WMC considering a tax levy increase?

Most health care revenue comes from dollars reimbursed to the organization from insurance companies, including Medicare and Medicaid.  Organizations like WMC are unable to negotiate a reimbursement rate with most companies and accept the rate they provide.  For some services, the reimbursement rate is below the facility’s cost, especially for critical EMS services WMC provides Winneshiek County.  Steve Slessor, chief administrative officer, Winneshiek Medical Center says, “In an emergency situation, skilled, experienced paramedics arrive in a fully equipped ambulance to provide life-saving care.  However, the expense of purchasing, equipping and maintaining three ambulances, plus wages and benefits for 24/7 EMS staff, are only partially covered by the payments we receive for their services.”  In fiscal year 2022, WMC experienced a deficit of $682,000 in the EMS/Ambulance service line.  Slessor says, “We are proud to provide this service with our exceptional staff, and it does come at an expense to the organization.”

Slessor further explains, “The business of health care is a bit different than other industries. For example, a restaurant can increase their menu prices when food and labor costs go up.  In health care, most insurance companies only pay the set reimbursement rate, regardless of what we charge.  Expenses, including salaries, equipment and supplies and other infrastructure costs are increasing at a faster rate than they have in decades.”

The revenue generated from the proposed tax levy increase will bring in an anticipated additional $437,000 (estimated) to the medical center. Slessor says these dollars will help cover increasing labor costs.  “It is vital for WMC to maintain a strong workforce, and as everyone knows, salary expenses are increasing across all markets and industries.  The additional tax dollars will cover far less than half of the expected salary adjustments we must make to retain and recruit skilled health care workers as we grow in services and specialties for our region.”

What will the increase mean for families?

At the proposed rate of 1.08 per $1000 assessed valuation, a resident within Decorah city limits with a $200,000 assessed land/building/dwelling would see an increase in annual taxes of $77.  A resident living in rural Winneshiek County would see an annual increase of $56.  The new rate will move Winneshiek Medical Center from the sixth lowest tax levy to the eleventh lowest out of the 43 county-owned hospitals in Iowa.* 

Slessor says, “WMC has a deep respect for the communities we serve, and the Board thoughtfully considers the tax levy rate each year.  We do not assess taxes we do not need and every dollar that comes into the medical center, including tax dollars, is reinvested in the medical care that we provide to Winneshiek County citizens and the broader region.”   He adds, “If the Board of Trustees approves the FY 24 budget to include a tax levy increase, we will use those dollars to continue to ensure the needs of our patients come first.”

*Iowa Department of Management – County Hospital Property Tax Rates FY2023https://dom.iowa.gov/document/county-hospital-property-tax-rates-fy2023

Winneshiek Medical Center in Decorah is launching a new telephone system in the New Year. Referred to as a unified communication system, the new cloud-based system replaces an aged system and provides improvements to the caller and staff experience.

Features

Most notably, the caller will be offered a short menu to better direct calls to departments of their choosing, such as Decorah Clinic, Billing and Insurance, Laboratory Service and Radiology.  The menu is expected to reduce time on hold, especially in the busier times early in the week and in the morning hours.

Dave Rooney, operations administrator, Winneshiek Medical Center says, “The new communication system has been a work-in-progress for some time and connects our 500+ staff through traditional phones, ‘soft’ computer-based phones, video calls and instant messaging.  We were able to address call flow preferences and past barriers to efficient communication.  Our staff will quickly notice the benefits internally, and we look forward to callers having an improved experience as well.”  He adds, “Patients have shared they appreciate talking to an actual person when calling us when so many call centers are now automated. Callers can be reassured that our staff is still just a step away. Once a menu option is chosen, a live person will be ready to assist them.”

Timeline

The transition to the new system is scheduled to take place the morning of Thursday, February 9. There may be a brief interruption in service at the time of transition.  All current phone numbers will remain intact.

Jim Schwan, lead infrastructure analyst in the WMC Information Technology department and lead for the communication project says, “We have been working in a ‘dual’ environment for some time as we have planned and built the new system.  As new phones have been deployed across the organization, our teams have also been involved in staff training and education. We are excited for the new system, the benefits it will bring, and are looking forward to the ‘live’ date in our near future.”  To contact Winneshiek Medical Center for an appointment or for other needs, please call 563-382-2911.  To send secure, electronic communication to your health care provider, please use MyChart, available through the WMC website at www.winmedical.org.

Winneshiek Medical Center is growing in many ways to meet the needs of the broader region. One of the ways that will be most visible is in their facilities with the Transforming Tomorrow project, which involves a major facility expansion and remodel.

Transforming Tomorrow is a long-term facility growth and improvement plan for Winneshiek Medical Center.  Expanding and remodeling the existing footprint, Transforming Tomorrow will provide:

• A new, fully renovated birthing unit that features all Labor, Delivery, Recovery, Postpartum (LDRP) suites, and direct access from Obstetrics to Surgery for patients needing a C-section.
• An expanded Surgery area to include larger rooms to accommodate new technology and an additional operating room to meet the growing volume of their surgical practice.
• A two-story addition to house expanded primary and specialty clinics to the north of the current clinic building, allowing for additional access, growth, a better patient experience, and promotion of team based care.  

View from the northeast of our Surgery area expansion. This addition which will include larger operating rooms to accommodate new technology and an additional room to meet the growing volume of surgical practice.

The project costs are near $50 million and are financed in large part by low-interest USDA loans.  The remaining balance will be funded by WMC dollars and loans from local banks.

“We have recently received approval of the project from the Decorah City Council, who followed the recommendation of the Planning and Zoning Commission.  Currently, we are completing final architectural documents, identifying our interim construction financing and then we will put the project out to bid in early summer,” says Steve Slessor, chief administrative officer, Winneshiek Medical Center.  “As always, final approval is needed from our Board of Trustees to proceed with all or even part of the project.”

As blueprints and plans are refined by architects and WMC staff, leaders continue to review costs of the project to ensure good stewardship of the invested dollars.  Slessor says, “It is our goal to identify opportunities to continue to reduce project costs in an era when construction costs are increasing dramatically.”

Once Transforming Tomorrow work begins, Slessor believes the work will take approximately 2.5 years. He says, “The architects are outlining a plan that will allow for work to progress with minimal disruption to patient care activities.  Patients will notice the construction, but we will ‘choreograph’ changes so services can continue at or near capacity.”

Winneshiek Medical Center believes the Transforming Tomorrow project demonstrates their commitment to their patients, staff, communities and to progress in general. Slessor says, “Our goal is to be the regional hub of health care services for an eight-county area.  We are investing in facilities, staff and technology, and are actively recruiting physicians to join the Mayo Clinic Health System primary and specialty care practice here at Winneshiek Medical Center.  These are exciting times to be part of Winneshiek Medical Center as it grows into the future.” 

Winter is in full swing this week! Low temperatures with extreme wind chills calls for all the winter essentials. If you haven’t already you’re likely digging out your gloves, hats and scarves for the season. It’s common to see many runny noses, hear coughs and sneezes and be experiencing a sore throat this time of year.

Be honest, have you ever used your glove or scarf to wipe your nose and/or cover a sneeze or cough when a tissue isn’t available? Then you continue to touch your steering wheel, door knob, seat or shopping cart all while spreading those germs to others. This is called cross contamination.

“People use gloves to protect themselves from the elements,” says Maggie Busta, WMC infection preventionist. “However, winter gloves do not shield us from germs. Our winter gloves may carry e-coli, cold and flu viruses, such as influenza, and can potentially contribute to the spread of these. “If you are worried about touching public surfaces (ATM’s, cross walk buttons, shopping carts, etc.) it is best to remove your gloves first because it is easier to sanitize your bare hands,” adds Busta.

Winter gear picks up everything bare hands do, so it is best to wash these items weekly. Most germs will survive two or three days on winter gear, possibly longer. We don’t think to wear our clothes over and over without washing them, yet in colder weather we regularly wear our coats, gloves, hats and scarves when they haven’t been washed in months. Something to think about: when was the last time you washed your winter gear, or your child’s winter gear?

“Washing your hands is the most important way to prevent the spread of infection. It’s also important to eat healthy and have a good sleep routine. Carrying tissues and hand sanitizer with you can help keep you and your community healthy,” shares Busta.

Winneshiek Medical Center is taking registrations for a spring session of DBT Essentials.  DBT Essentials is group therapy to help people change their thoughts, emotions and behaviors to improve their quality of life.

The 12-week group is led by Kara Crain, who is a licensed mental health counselor with 16 years’ of experience in the field and 10 years’ experience providing individual and/or group DBT services. It will be co-facilitated by Hannah Schroeher, a licensed independent social worker.  Crain answers some frequently asked questions about DBT Essentials.

What does DBT stand for?

DBT stands for Dialectical Behavior Therapy. Dialectical means that two opposite ideas can be true at the same time: there is more than one way to look at any situation, there are lots of different ideas and opinions out there, and we can feel different emotions in the same situation. Behavioral highlights how we have to learn to change old behaviors, habits, and thoughts if we want our lives to improve. Therapy, in this case, is group.

Who is a good referral for this group?

This group is for people age 18 or older, who want improve their quality of life by changing their thoughts, emotions, and behaviors.  The group works to improve communication skills, reduce impulsive behaviors, and have more balanced thinking.

What will group be like? 

Group is held one time a week for 12 weeks at Winneshiek Medical Center.  It is a classroom type setting all about learning new skills. It will have a maximum of 10 members and is an educational group. Sessions are over the lunch hour.

What cost is there for group?

Group is covered by most insurance companies, including Medicare. There is a $20 workbook to purchase at the first day of class. Financial assistance is available for those unable to cover the cost of the book.

Someone has suggested that I do DBT in the past. Is this DBT group the same thing?

No. A Full DBT program involves DBT skills group, DBT individual therapy, and phone coaching. Skills group in a full DBT program lasts around a year and covers more skills than this DBT Essentials Group. This DBT Essentials group is meant to be a snapshot of core skills over the course of 12 weeks. It’s a good introduction to DBT skills.

This sounds like a group I am interested in.  What do I do next?  

Call Winneshiek Medical Center at 563-382-2911, and ask to speak with Behavioral Health.  We will schedule an individual DBT group consult with you to make sure group is a good fit, discuss your skill goals, review group rules, and talk more about the basics of DBT.

During mid-winter, you may hear people talk about the “winter blues.” In fact, they may be suffering from seasonal affective disorder (SAD).

“Seasonal affective disorder is a specific type of depression and is more common in winter months in our area,” says Claire Haedike, Psy.D., Mayo Clinic Health System psychologist at Winneshiek Medical Center. She adds, “The second most common type is summer depression.”

Many people experience some change in mood and functioning (i.e. fatigue, energy level, appetite) at the change of a season but generally people acclimate.  Seasonal Affective Disorder is different because it is a subtype of depression.  Symptoms of SAD are consistent with symptoms of depression and can last anywhere from several weeks to several months: feeling depressed most of the day, nearly every day, having low energy, feeling hopeless or worthless, losing interest in activities you once enjoy, having problems sleeping, experiencing changes in appetite (especially craving foods high in carbohydrates) or weight, having difficulty concentrating, feeling agitated or sluggish, experiencing a heaviness in arms and legs, and having thoughts of death or suicide. 

According to mayoclinic.org, the specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:

• Your biological clock (circadian rhythm). Reduced levels of sunlight may disrupt your body’s internal clock and lead to feelings of depression.
• Serotonin levels. Reduced sunlight can cause a drop in serotonin, a brain chemical that affects mood.
• Melatonin levels. Changes in seasons may disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.

Treatment for SAD is important to avoid chronic or re-occurring depression.  Treatment may include light therapy, medications and psychotherapy.  These self-help tips can also be useful in treating SAD:

• Make your environment sunnier and brighter. Open blinds and trim trees that block sunlight. Sit closer to bright windows while at home or in the office.
• Get outside. Take a walk or just sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
• Exercise regularly. Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms.
• Normalize sleep patterns: Schedule reliable times to wake up and go to bed each day.
• Ensure you are spending time interacting with family and friends (increasing social support)
• Make sure you are doing things you find enjoyable (hobbies, learning something new, etc.)

“It’s normal to have days when you may feel down,” says Dr. Haedike. “But if this feeling lasts more than a few days and you just can’t seem to get motivated to do things you enjoy, you should see your doctor.”

In addition, if you turn to alcohol for comfort or discover that sleep patterns and appetite have changed or you have feelings of hopelessness, these are all signs to seek help by making an appointment with your local doctor. If you have thoughts of suicide, please seek help now by calling the Suicide & Crisis Lifeline by dialing 988 or by reporting to your local emergency room.