Preparing to play a new role
The Business Journal of Milwaukee - by Julie Sneider
At first glance, the recent opening of a health care center at Waukesha County Technical College (WCTC) might not seem all that extraordinary. Many technical schools, colleges and universities run some sort of health center or clinic for students who need urgent care but don't have regular doctors or health care coverage.
What's distinctive about the new Community Nursing Center at WCTC is the partnership that established it. Although the center is on WCTC's Pewaukee campus, it is run by Memorial Hospital at Oconomowoc, which pays the salaries of the center's three nurse practitioners.
The partnership stemmed from the hospital's interest in promoting wellness and WCTC's interest in providing health care to its students and faculty. The center also serves as a training ground for the students enrolled in WCTC's two-year associate degree nursing program.
The idea of hospitals operating health clinics in colleges is not new in other parts of the country, but is unusual in Wisconsin, said Marvin Neely, president of the Hospital Council of Greater Milwaukee.
With its emphasis on wellness and health promotion, the center is a reflection of bigger changes occurring in health care delivery. Hospitals now are known for taking care of sick people. In the future, hospitals also will be paid to keep people healthy so that they don't develop serious and costly illnesses that require hospitalization.
Memorial Hospital saw its partnership with WCTC as one way to prepare for a health care world in which the hospital is no longer center stage.
"As health care has changed over the years, the hospital's vision was to become more involved in health and wellness," said Sharon Wolf, director of ambulatory care at Memorial Hospital. "With all the reimbursement changes (under managed care), hospitals will be better off (financially) keeping people healthy."
Not only is the center open to students and faculty six days a week, it also is open to the public.
From its opening day Aug. 19 through Sept. 30, the center recorded 759 patient visits. Of that total, 160 visits were made by WCTC faculty or staff; 694 visits were by students; and five visits were by members in the community. The nonprofit center charges for some services, but accepts patients whether or not they have insurance coverage.
The visits were higher than the center expected for its first month of operation, according to WCTC nursing instructor Bobbi Jurishica, whose nursing students now help out with health promotion activities at the center as part of their educational program.
Many of the patients who have visited the center do not have a primary care doctor and aren't necessarily sure how to access the health care system, said Carol Millman, the center's only full-time nurse practitioner.
Millman and the other nurse practitioners will refer patients, who need more extensive medical care, to doctors and hospitals closest to the patients' homes. Although the center is affiliated with Memorial Hospital, which is part of the Wauwatosa-based Horizon Healthcare network, the referrals are not necessarily made to Horizon-affiliated providers, Millman said.
For WCTC, the center fills a role in the school's nursing curriculum by showing students that their future careers won't necessarily be made in the traditional hospital setting. As more medical care is provided in outpatient settings, those students will be more likely to get jobs at primary care clinics, community health centers and home health agencies.
"At one point in time, 70 to 80 percent of all nurses worked in hospitals and 20 to 30 percent worked in community settings," said Kitty Gotham, WCTC's associate dean of nursing. "It's been predicted those percentages will flip-flop by the year 2005, and only 20 to 30 percent of nurses will work in hospitals."
WCTC, which graduates about 30 students in nursing per semester, changed its nursing curriculum in 1995 to put more emphasis on illness prevention. The nursing center fits in well with the new curriculum, Gotham said. Under the old curriculum, nursing students met their work experience requirements solely at local hospitals and nursing homes.
"Our philosophy now is health promotion and wellness, and the new clinic gives our students community-based clinic experience," Gotham said.
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