West Virginia University

West Virginia University Robert C. Byrd Health Sciences Center

National Center of Excellence In Women’s Health

Quarterly Progress Report

April 1, 2006 – June 30, 2006

National Centers of Excellence in Women’s Health

U.S. Department of West Virginia University Health and Human Services Contract

Contract Period 10/1/2004-9/30/2008

DHHS Contract # HHSP23320042207TC

Submitted by

Barbara Ducatman, MD, Director CoEWH

Professor and Chair Pathology

Elizabeth Critch Parsons, MBA, Project Director, CoEWH

Table of Contents

Executive Summary ………………………………….……………………………....3

Clinic Component..……………………………………………………………………4

Research West Virginia University Component………………………………..……………………………...11

Education Component ……………………………………………………………...25

Community Outreach Component………………………………………………...39

Academic Leadership Component ……………………………………………….55

Evaluation Committee……………………………………………………………….61

Information Technology Committee.……………………………………………..61

Attachments. …………………………………………………………………………63

^ West Virginia University Robert C. Byrd Health Sciences Center National Center of Excellence in Women’s Health Executive West Virginia University Summary
June 30, 2006

West Virginia University Robert C. Byrd Health Sciences Center National Center of Excellence in Women’s Health has just completed the third quarter of the third year as a West Virginia University National Center of Excellence in Women’s Health. Institutional commitment to our National Center of Excellence program is strong as demonstrated through financial support and the contributed efforts of a large cohort of West Virginia University faculty and staff members from the Health Sciences and the University at large. Institutional and State support has been further demonstrated by the fact that the Vice President of Health West Virginia University Sciences Center championed the Senate Resolution no 4, adopted by the Senate March 6, 2006, directed Norma L. Tennant, Special Assistant to the Vice President of the Health Sciences Center at WVU to coordinate the OWH West Virginia University Site Visit scheduled for March 30, 2006; as well as as the Changing The Face of Medicine: Celebrating America’s Women Physicians project. Dr. Ruth Kershner, Community Medicine, WVU HSC and CoEWH agreed to teach the West Virginia University Healthy lifestyles class for college-age women which would include a physical exercise component, in the fall 2006 semester, with women’s studies paying her salary. This class is offered through the West Virginia University WVU Women’s Studies Program, has a cap of 20 students, and it filled as soon as registration opened.

The accomplishments of the Center of Excellence during this quarter have been significant West Virginia University. Our clinic continues to work toward improving the patient-centered environment, and a provision of care to women with an outcome of an improved process of care. Our clinic was featured in the West Virginia University Dominion Post Sunday Lifestyles sectiona and one of our patients wrote a letter to the editorb discussing her satisfaction with the quality of care she received in our clinic. Our patients West Virginia University are provided with a comfortable, friendly environment, state-of- the-art equipment, conveniently located subspecialty clinics as well as a wide variety of reference material and support services. The number of patients we see West Virginia University continues to increase as our clinic becomes known in the community and across the state. Our CoEWH Stroke Clinic continues to increase their patient base. We expect our third West Virginia University subspecialty clinic to open in the future. It will be a CoEWH Urology Clinic. This clinic will serve for the diagnosis and treatment of various urogynecologic conditions that affect many women, such West Virginia University as stress incontinence, etc. We plan to complete a strategic plan for satellite clinics in the Robert C. Byrd Health Sciences Charleston and Eastern Divisions within the next year.

Dr. Michael Vernon, In-Vitro West Virginia University Fertility Center (IVF), professor, SOM has accepted the position of Interim Chair of Obstetrics and Gynecology. The leadership of the CoEWH looks forward to working with Dr. Vernon as we move women’s West Virginia University health forward in West Virginia. We celebrated Dr. Vernon’s new position with a filmed presentation at our site visit March 30th, as Dr. Vernon was of town.

The Executive West Virginia University Team, Dr. Barbara Ducatman, Director WVU CoEWH, Dr. Ann Chester, Deputy Director and Betty Critch Parsons, MBA, Project Director continue to meet weekly. The CoEWH Directors meet monthly and the CoEWH hosts a University West Virginia University-wide informational session bi-monthly. The working groups of the Outreach Component met regularly through the quarter as did the Research, Education and Leadership Component committees. The Executive Team identified a West Virginia University team to work on a community partnership contract opportunity with Johnson and Johnson. The proposal is entitled: “Families First: Empowering Women to Lead Healthier Lives”. The team submitted a contract proposal to Johnson West Virginia University in Johnson at the end of March. We learned during this quarter that our proposal was not accepted. We will work with the Johnson and Johnson team to improve upon West Virginia University the proposal, as we strongly believe that this type of program is necessary to move women’s health forward in the rural state of West Virginia. The CoEWH leadership is a part of West Virginia University the steering committee for the traveling exhibit Changing the Face of Medicine: Celebrating America’s Women Physicians due to WVU in October 2006. We are developing a program that will encompass all the schools West Virginia University and celebrate women’s leadership roles in healthcare. We will soon have the Changing the Face of Medicine featured on our web page.

Ann Dacey, special project coordinator for the CoEWH West Virginia University, has been a leading force in the West Virginia Perinatal Wellness Study. The goal of this project is to understand the health of West Virginia children by studying and reporting key West Virginia University issue affecting the health and wellness of pregnant women and their infants. A Perinatal Summit was delivered during this quarter. The second phase of this project is now underway.

The Center of Excellence is West Virginia University partnering with Renate Pore, PhD, Director West Virginia Healthy Kids and Family Coalition to host a Luncheon called Community Conversations on Children’s Health. These luncheons will be held West Virginia University all over the state. The CoEWH will participate in these luncheons. The purpose of these luncheons is to present information on child health from a national and state perspective as discussed at the WV West Virginia University Child Health Conference, the Perinatal Wellness Study, and current child health initiatives to the people from each of the communities who have interest in children’s health. The goal is West Virginia University to build a statewide network of professionals and families interested in improving the health and well being of WV children.

The CoEWH hosted the Girl Scouts – Trillium Council delivery of the “New Normal” What West Virginia University Girls Say about Healthy Living.d Members of the CoEWH board participated in a panel discussion following the report.

Directors and members of West Virginia University Robert C. Byrd Health Sciences Center West Virginia University National Center of Excellence in Women’s Health presented or participated in at many seminars, conferences or exhibits during this quarter. Examples are as follows:

- Healthy West Virginia Summit

-- State Health Education Conference

-Parents Place, Preventative Health Care for Women

We continue to expand media use for women’s health messages such as

Dr. Kolar, Director of the Leadership component met with the executive team of the CoEWH and the West Virginia University Associate Dean, Medical School, Administration and Finance monthly during this quarter to work on the salary equity project. The preliminary data has been completed and was reported at our site West Virginia University visit. No gender-based inequities were found. Dr. Kolar is now working with the other schools to conduct the same type of study.

The education committee has мейд significant progress as women’s West Virginia University health is being identified, strengthened, and developed across the health professions. As evidenced by:

The research component welcomed a new director this quarter. Dr. Linda Vona-Davis agreed to co-direct the research component with Dr. Vernon. Linda celebrated her new position with the West Virginia University CoE by delivering the research component report at our site visit.

The Directors meet off campus to participate in our first annual strategic planning session held January 28, 2006.

The Outreach Component applied for West Virginia University and received a WVU Public Service Grant for $8,960 effective July 1, 2006. This grant was awarded to the Outreach Component to support CAB meetings and other outreach effort. This award is one West Virginia University more demonstration of the institutional support of West Virginia University and its commitment to women’s health.

The directors have started to plan our second retreat. It is our goal to increase West Virginia University our reach across the state this year and to develop the wellness maintenance retreat that is packaged so that it may be delivered across the state. Every woman will leave the retreat West Virginia University with her own personal wellness program. That is the goal. We will provide more detailed information in the technical report.

Members of the Board of Directors meet with Jim Wells of West Virginia University the Gallup Organization during this quarter. We hope that Mr. Wells came away with the an understanding the value we place on the designation of CoEWH importance of the CoEWH to the West Virginia University State of West Virginia.

We are pleased to submit the following detailed report on the activities on West Virginia University Robert C Byrd Health Sciences National Center of Excellence in Women’s Health. We believe West Virginia University the third quarter of our second year demonstrates progress toward our mission to improve the health of West Virginia women across their life span. We are working hard to West Virginia University identify, participate and deliver activities for Women’s Health across the State of West Virginia. We look forward to your comments.

^ Clinical Services Component

West Virginia University National Center of Excellence in Women West Virginia University’s Health is conveniently located in on the fourth floor of the Physician’s office Center. It is a patient friendly place where women of all ages will receive clinical care and up-to West Virginia University-date, easy to understand educational materials. The Clinic integrates multi-disciplinary research and training activities with clinical services in women’s health, spanning both academic and clinical department.

The clinic operates Monday through Friday from 7:30a.m. To 5:00 p.m. Physicians are available on-call 24 hours per day, 7 days a West Virginia University week. Urgent patient issues are addressed within the same day by one of the physicians or by the licensed nurse practitioner after a registered nurse triages patient symptoms via The West Virginia University WVU Health Line. Clinical practice standards are frequently reviewed to ensure adherence to internal guidelines or accepted national guidelines. Quality monitoring and patient satisfaction are foremost concerns of the practice. A West Virginia University computerized medical record provides documentation of patient encounters and information to assist in collecting practice data.

The Internal Medicine and Family Medicine practices provide comprehensive primary care to patients. The physicians stress West Virginia University preventive medicine and risk assessment in the care of all their patients. The stroke clinic works with women who are high risk for stroke and with those who have recently had a stroke West Virginia University to aid in the prevention of future problems. The clinic addresses risk factors for stroke such as hypertension.

The Gynecology practice provides general and specialty care, and minor, routine, ambulatory procedures West Virginia University for patients. The scope of care is appropriate to ambulatory practice standards. The board certified gynecologists have expertise in benign gynecologic surgery, management of abnormal PAP smears, the evaluation and treatment of West Virginia University abnormal uterine bleeding, treatment of uterine fibroids and ovarian cysts, contraceptive techniques, and menopause management. In addition, subspecialty expertise is provided for evaluation and management of urinary incontinence and pelvic floor support West Virginia University defects (uterine/vaginal prolapse, cystocele, and rectocele). Urodynamic testing is available.

The services defined as “one-stop shopping” includes primary care, gynecology, mental health, nutrition, and imaging including mammography, bone density, and ultrasound West Virginia University, and are available within the practice or in close geographic proximity in the same building.

The Robert C. Byrd Health Sciences Center encompasses the Schools of Medicine, Dentistry, Nursing and Pharmacy, West Virginia University West Virginia University Hospitals, and the West Virginia University Medical Corporation (UHA). As a whole and individually, the institution is committed to promoting and developing the CoEWH. This service model is one of West Virginia University multidisciplinary one-stop shopping that required breaking down barriers between OB/GYN, Internal Medicine, and Family Medicine. This required significant commitment from the School of Medicine, UHA, and the Departments of OB/GYN West Virginia University, IM and FM. The Schools of Pharmacy and Nursing have contributed to staffing in the CCC. In addition, there are substantial commitments from other departments to provide on-site consultation West Virginia University or preferential scheduling, such as Behavioral Medicine and Surgery and referrals to mammography. The Center of Excellence practices at the West Virginia University Robert C. Byrd Health Sciences Center.

COEWH staff, COEWH clinic physicians West Virginia University, and clinic physicians meet on a regular basis to discuss clinic operations and improve patient care coordination. The clinic intake form has been updated to accommodate the wishes of the West Virginia University physicians and to include more COEWH standard requirements. The clinic team has written a job description for a nurse CoEWH clinic coordinator to be hired to assure continuity of patient care, triage new West Virginia University and established patients, and to make the goal of “one stop shopping” more established in short to improve the customer service we provide our patients. The job description is in the review West Virginia University process by the Human Resources. Multiple copies of the magazine “EveryWoman” in Spanish and English have been added to the clinic waiting room. Every Woman magazine is a comprehensive, evidence-based, quarterly, patient-education West Virginia University resource with a readership of over 6 million. The recipient of four national consumer health information awards, Every Woman is a full-color, annual women's health guide distributed to West Virginia University more than 1 million women a year through their nurses. The magazine is written by leading nurse experts entirely for the female consumers they serve -- women who are providing care for themselves, their West Virginia University families, and perhaps their aging parents and relatives. Considered the leading women's health education guide published by a recognized health authority, Every Woman covers the most compelling women's health issues West Virginia University across the life span. Topics covered include: heart health, menopause and midlife changes, breast health and breast cancer, diabetes prevention and treatment, sexual health, nutrition and exercise, dieting and preventing obesity, pelvic health, asthma West Virginia University, and allergies.

The goal of Every Woman is to equip women, via their nurses, with the latest in evidence-based women's health information in order to promote optimal health and well West Virginia University-being for themselves and for their families.

Dr. Laura Davisson developed a curriculum on Women’s Health Rotation as a part of the WVU Internal Medicine Residency Program. Dr. Davisson is working West Virginia University with Dr. Anne Cather, Associate Dean for Student Services and Professional Development, clinical faculty, SOM to fully integrate the rotation in the SOM.

During this quarter, the Health Sciences Center West Virginia University institutional commitment has provided public relations and marketing support. This group continues to provide press and media coverage of the contract award as an introduction to CoEWH concept. The CoEWH was featured in the West Virginia University Dominion Post Living Section1. A patient in our clinic wrote an editorial about the care she received as a patient in the CoEWH clinic.2

During the following years, financial analysis West Virginia University of the progress мейд in marketing initiatives on behalf of the CoEWH and CCC will be conducted. This will be reflected in increases in new patient visits and billable encounters. We are currently West Virginia University discussing with the hospital system, the expansion of clinical care sites to the eastern panhandle of West Virginia, where the Health Sciences Center has a clinical campus (City Hospital in Martinsburg, WV), and Charleston West Virginia University, WV, at the Charleston Area Medical Center, and possibly at Cheat Lake Physicians office in Morgantown and in Clarksburg, WV.

For the third quarter of fiscal year 2005-06 the CoEWH had 3487 billable West Virginia University hours excluding well OB visits. (Attachment J)

a. Physically Identifiable Clinical Care Center

The CCC utilizes clinic space on the fourth floor of the Physicians Office Center, consisting of multiple (13) consultation West Virginia University rooms and a waiting area, and a resource area.

The CoEWH Clinical Care space is wheelchair accessible and has Americans with Disabilities Act compliant examination rooms and exam tables.

Executive Leadership engaged a local West Virginia University WV artist to chair a committee to develop an area in the CoEWH clinic waiting area to celebrate The National Center of Excellence in Women’s Health, “Body, Mind and Soul West Virginia University” of WV Female Artists. This committee was charged with identifying and exhibiting the work of a Female WV artist every quarter.

b. Patient Centeredness- Integration of Care

The Clinic Component Working Team has changed it West Virginia University meeting time to bi-monthly on the 2nd and 4th Monday of the month at noon.

The inclusion of the Call Center helps us identify areas of improvement that are required at West Virginia University the inception of the CoEWH visit (initial impression by the patient). By including the call center in the clinic care working team, we have expressed the value the Call West Virginia University Center adds to the CoEWH. As a result the Call Center has changed the way the phone is answered, thus improving a point of origin. By attending these meetings the Call Center is West Virginia University able to hear firsthand from a health care provider problems identified with patients initial impression of the CoEWH that may be Call Center oriented. The issue is then addressed and we West Virginia University become more patient centered from the point of origin. Dr. Michael Vernon, Chair of OB-GYN is working closely with the call center to ensure that the call center understands the Center West Virginia University of Excellence in Women’s health, its mission and providers.

Working towards providing a seamless one-stop shop concept of clinical care, the clinic provides the following:

Services that are available include intervention for patients in the clinic for West Virginia University the following: