NW Regional WISCPHR Meeting Minutes

NW Regional WISCPHR Meeting Minutes Sacred Heart Hospital, Eau Claire WI ______Date: July 12, 2016 1100-1400 Attended in person: Sarah Bourget, Stephanie Fleming, Dawn Hoff, Ashley Kren, Heidi Grafft, Heidi Saddoris, Samantha Sweeney, Mary Wiley, Edward Stenger, Shannon Riley Via teleconference: 10 callers

Northwest Region Representatives: 3rd year term: Dawn Hoff—Vernon Memorial Hospital ([email protected]) 2nd year term: Heidi Grafft—Mayo Clinic Health System, La Crosse ([email protected]) 1st year term: Shannon Riley—Gundersen Health System, La Crosse ([email protected])

Call to order and brief introductions ______Welcome to new members and attendees! Guest Speaker: Sara Polzin, St. Jude Medical – Pacemakers: Basic Modes, Codes & Indications  Focal points from the talk: o Indications for Pacemaker Therapy – requires both symptoms and arrhythmias o SA Node and AV Node anatomy - Pacemaker needs usually b/c problem with one or both nodes. o Junctional Rhythm – “notch in t wave think p wave” o Right and Left Bundle Branches – look in V1 of 12 Lead EKG: . “rabbit ears” – 2 spikes above baseline = RBBB (problem on left side of heart) . “carrot” below baseline = LBBB (something going on in the right side of heart) o Rhythm strip review – possible talk of presenting 12 Lead EKG review at future meeting if group is interested. o Guidelines for pacemaker, physician makes decision based on: Guidelines, patient symptoms, patient’s condition (overall health, prognosis, wishes). o Pacing system reviewed – examples of pacemakers provided o Pacing Modes and Codes The NBG Code, Positions I-V reviewed, USA does not use position V, currently utilized in Europe. o Generalized guidelines discussed – pertinent to Cardiac Rehab patient’s questions: . 4 week restriction on lifting arm above shoulder height . <10lbs (pushing, pulling, lifting) for 4 weeks . Driving restrictions – up to doctor discretion . Refer to physician for MRI questions, work environment near magnets, cell phone usage (most likely not an issue), using microwaves (only an issue if microwave is from 1950’s/1960’s) . Patient’s provided temporary ID card for travel for 4-6 weeks, then provided with permanent card regarding pacemaker placement. o Speaker offered her services to present on the following topics if group shows interest in the future – 12 Lead EKG, Sensing, Heart Failure, Lifevest, ICD. Old Business:  Review of regional meeting minutes from 5/3/16  Review of WISCPHR BOD meeting minutes from 5/17/16

New Business:  AACVPR, Certification and CCRP updates  Bonnie Anderson shared some updates:

o New tools (surveys) for outcomes assessment will be available by the national conference time.

o Reminder to reference the Q and A’s on the AACVPR website for clarification on many issues

o Applications for 2016 have all been reviewed 1-2 times, notice about remediation’s should be coming out soon – Reminder to review/read ALL requirements in detail and submit required information.

o Encourage everyone to attend National AACVPR Conference this year – look forward to updates on Health Care Reform, alternative delivery models, if not able to attend in person remember the updates/resources/information from meeting available online through AACVPR website.

o CEP Licensure – on hold until after November elections, most likely another strong push will occur spring, 2017, Jennifer Schilling still strong advocate, please continue to spread the word of the importance of licensure and the positive impact it will make on our patients.

o CCRP exam closer to going to on-line testing format, most likely online after National Conference

. Stay tuned for Pulmonary rehab credentialing process (not necessarily an Exam like CCRP) – process underway with AARC and AACVPR looking at proper credentialing process for Pulmonary rehab staff.

 Joint Affiliation Review:  Discussed benefits provided through WISCPHR/AACVPR affiliation which include – Education Advantage, CEU’s (AACVPR 10 webinars yearly, 2 WISCPHR webinars yearly), up-to-date resources for the field, WISCPHR conference fee possibly less for members in the future.  Discussed concerns/questions with affiliation – AACVPR member plans to attend next BOD meeting to address questions with support, website, and membership dues, possibly provide letter for staff to give to hospital administration seeking support of this cost, etc…  WISCPHR Website Updates – please send any suggestions for changes to make and/or features to add to regional reps.  WISCPHR Newsletter will be released 09/30/16NW region responsible for articles.

 Anyone wanting to write a short article on an area of interest, or maybe something that your program is doing that is interesting or innovative; please consider writing an article for the newsletter! Articles need to be submitted to Heidi Grafft by August 15th, one article submitted thus far, Gundersen Health System may have article to submit.

 Round table discussion  Topics for Future meetings – Heart Failure, Pulmonary related topics, lifestyle change coaching tactics, 12 lead EKG.

 Pulmonary Rehab Patient Scenarios discussed

o Skills to helping patients with tobacco cessation

o Providing the science behind “why” certain behavior change may be important to patient

o Strategies for non-compliant patients – need to see progression for program continuation

 AACVPR Recertification process, questions addressed on Staff Competencies

o Need to list objectives for teaching

o What tool was used, how did you know competency was met

o Reminder if staff has CCRP, programs do not need to submit competencies for the individual staff that hold the CCRP.

 InsuranceDifferent methods of verifying insurance

o Patient responsibility

o EP/nurse calls

o Hospital insurance staff

 Encouraged members to consider options for getting involved with WISCPHR – check out committees on WISCPHR website.

 Heart Failure / Stable Angina – addressing readmission referrals into program for patients who have been non-compliant – discussed different ways of communicating the need to see progression with the patients.  Depression screening – processes for referring patients for additional emotional support:

o Refer to primary doctor

o Refer to Behavioral Health department of organization

o Hopefully each program has process in place of who/when to refer patient for additional support

Dates to Remember:  Next BOD Meeting: o 9/27/16  Upcoming Regional Meetings: o October 4th, 2016  2017 Regional Meetings Confirmed: o January 10th, 2017 o May 2nd, 2017 o July 11th, 2017 o October 3rd, 2017

 AACVPR Annual Meeting: o September 7th-10th, 2016: New Orleans, LA o 2017: Charleston, SC