Health Connect - Summer2016 by Mary Greeley Medical Center

SUMMER 2016

CONNECT

Take an exclusive tour of Mary Greeley’s new Emergency Department! Patient care and safety is primary focus.

Learn the beneﬁts of 3D mammography  Remember a life at Hospice  Get the stats: Our Annual Report ALSO IN THIS ISSUE:

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CONNECT

COVER PHOTO: PAUL GATES

Contents SUMMER 2016

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About this publication Health Connect is published three times a year for residents of central Iowa by Mary Greeley Medical Center. For more information about Health Connect, please contact the Mary Greeley Medical Center Community Relations Department at 515-239-2038. Visit us on the internet Learn more about Mary Greeley Medical Center’s programs and services at www.mgmc.org. Contact us Individuals are encouraged to contact Mary

Q&A Discover how Mary Greeley is making sure antibiotics are working for patients.

Blue Skies A granted wish at Hospice creates a special memory for a Boone family.

A Better Look Learn how 3D mammography contributes to women’s health at Mary Greeley.

Inside the ED Take a look at the place you hope you’ll never see: Mary Greeley’s new, expanded Emergency Department.

Greeley Medical Center if they have any concerns about patient care and safety in the hospital that have not been addressed. If the concern continues, individuals may contact The Joint Commission at One Renaissance Boulevard, Oakbrook Terrace, IL 60181. You may also call 800-994-6610 or e-mail complaint@jointcommission.org. Opportunity for support Your contributions can help us care for those who come to us at every stage of life. Charitable giving to support Marty Greeley Medical Center has played a significant role in shaping your medical center. To learn

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Devoted to Emergency Care Meet the award-winning physician who is driven by the challenge of emergency medicine. Plus: Our other Innovation & Excellence award winners.

Emotional Rescue Find out how Iowa State psychology students can help patients with diabetes manage their disease.

Annual Report Get a picture of how we’re doing. Plus: Nursing Annual Report.

Prime Time Alive & Gift Shop Clinics & Classes

more, contact the Mary Greeley Medical Center Foundation at 515-239-2147 or visit www.mgmc.org/foundation.

Medical Advisor Steven Hallberg, MD

President and CEO Brian Dieter

Design Scott Thornton, www.designgrid.com

Director of Marketing and Community Relations Steve Sullivan

Photography Paul Gates Tim Hoekstra

Editors Steve Sullivan Stephanie Marsau

HEALTH CONNECT | Summer 2016 | www.mgmc.org

PRESIDENT’S LETTER

By Brian Dieter, Mary Greeley President and CEO

OR Ready

Dereck Hilsabeck, an RN with Manning Regional Healthcare Center, confers with Margaret Liston, director of Surgical Services.

“We are just as committed to building strong relationships with our neighboring hospitals and contributing what we can to ensuring central Iowans get the best care possible. It’s simply the right thing to do.” The partnership between Mary Greeley and MRHC “allows for our staff to be trained by experienced nurses who can share their wealth of knowledge which in turn they can bring back to their jobs. All of this will positively impact the patient and their surgical experience,” says

PAUL GATES

ealthcare is a competitive arena. Various hospitals and clinics are always vying to be your first choice for care. Sometimes, though, there is an opportunity for one facility to help another improve its care. In these incidents, competition gives way to cooperation. Case in point: Mary Greeley Medical Center is providing surgical tech training, at no cost, for nurses from Manning Regional Healthcare Center (MRHC). Working with our experienced OR nurses, several MRHC nurses are spending a few weeks at Mary Greeley enhancing their skills in surgical scrubbing and circulating. Scrubbing involves the proper washing of hands and forearms, and donning surgical scrubs and gloves. An OR nurse who is circulating serves as sort of the stage manager during surgery – taking care of any patient needs, making sure everything is documented, pointing out any breaks in process. MRHC is a small critical access hospital and has fewer surgery cases than a larger facility, which limits the opportunities for staff to get accustomed to various types of surgery. Training at Mary Greeley gives Manning nurses a chance to do a specific role in the OR for numerous surgeries over a span of a few weeks as opposed to several months.

Michelle Anderson, director of Inpatient Services at MRHC. This opportunity came about when Michelle asked Betty Baker, RN, for advice on how to get operating room training for Manning nurses. Betty knew exactly the place. A former Mary Greeley nurse who now teaches surgical tech at Des Moines Area Community College, Betty referred Michelle to Margaret Liston, RN, director of Surgical Services at Mary Greeley. “I love seeing people learn and helping young nurses gain the experience they need to provide better care to their patients,” says Liston. Dereck Hilsabeck, RN, was the first MRHC nurse to participate in the program. He says his experience at Mary Greeley has enhanced his skills and built his confidence as an OR nurse. Mary Greeley works hard to be your first choice for care. We are just as committed to building strong relationships with our neighboring hospitals and contributing what we can to ensuring central Iowans get the best care possible. It’s simply the right thing to do.

Thank you to our sponsors Presenting Sponsor McFarland Clinic PC Sustaining Sponsor Ames Tribune Lifesaver Sponsors Ames National Corporation and affiliates Boone Bank & Trust Co., First National Bank, Reliance State Bank, State Bank & Trust Co.

Pacemaker Sponsors Ag Leader Technology JE Dunn Construction Kinzler Companies

Caretaker Sponsors Ames Ford Lincoln Great Western Bank Jester Insurance Services NOW 1051 – An iHeart Radio Station Wells Fargo Sponsors Adams Funeral Home Alfred's Carpet and Decorating, Inc. Alpha Copies & Print Centers Bankers Trust Bill and Sue Ellen Burke Celebrations Party & Rental Store Dentistry at Somerset, Jason Niegsch, DDS, FAGD Deb and Bill Fennelly

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FASTSIGNS Gateway Insurance Services George White Chevrolet Green Hills Retirement Community Hanger Clinic Knapp Tedesco Insurance Agency Kreg Tool Company MB Financial Bank Nyemaster Goode, PC Robert and Karen Shirk Sign Pro Storey Kenworthy US Bank George and Mary Wandling

Mary Greeley Mileage Club Renewable Energy Group – Sustaining Sponsor 3M – Lifesaver Sponsor Danfoss – Pacemaker Sponsor Fareway – Pacemaker Sponsor HyVee – Caretaker Sponsor Grand Rounds First American Bank – Lifesaver Sponsor Green Hills Health Care Center – Pacemaker Sponsor

HEALTH CONNECT | Summer 2016 | www.mgmc.org

Q&A:

Antibiotic Stewardship Antibiotics are one of the most commonly prescribed drugs for hospitalized patients. Unlike other medications, antibiotics are drugs that impact not only the patient who gets them, but the society as a whole. When a patient gets an antibiotic, the bacteria in the patient’s intestines are exposed to it. Over repeated exposures, bacteria may learn and become resistant to the antibiotic. This resistant bacteria may pass on to other people in a number of ways. To get ahead of this phenomenon, hospitals nationwide and worldwide, including Mary Greeley, have launched antibiotic stewardship programs.

What is antibiotic stewardship?

Why is Mary Greeley so concerned about this now?

It’s the process of improving the use of antibiotics by making sure patients are being prescribed the most appropriate antibiotics and that these drugs are being administered in the most effective way. In other words, it is an extra layer of safety or review that the medical center provides when physicians prescribe antibiotics.

This is really a national healthcare issue and for many reasons. First, while the pharmaceutical industry continues to enhance existing antibiotics, new antibiotics aren’t being produced at a significant rate. This is a concern because existing antibiotics can’t keep up with the development of new bugs or infections that are resistant to antibiotics. This situation has led to a new emphasis on antibiotic stewardship. “The pipeline of new antibiotics is drying up and bacteria are becoming resistant to what we have,” says Dr. Ricardo Arbulu, infectious disease specialist with McFarland Clinic. “We have to be better stewards of the antibiotics we have available. It has never been as important and pressing as it is today.” Secondly, the CDC suggests that antibiotics prescribed are often inappropriate

or unnecessary. Thirdly, antibiotics are an important and effective treatment for many conditions. Antibiotics target bad bacteria but in doing so, can also attack good bacteria. This can lead to Clostridium difficile infection, or C. diff, which can cause life-threatening diarrhea. According to the CDC, C. diff causes at least 250,000 infections and 14,000 deaths each year in hospitalized patients. “Prescribing antibiotics that aren’t necessary to treat a patient’s condition can lead to C. diff,” says Arbulu. “This is the biggest motivator for antibiotic stewardship.”

Does Mary Greeley monitor the use of antibiotics?

Under Arbulu’s guidance, Mary Greeley launched an antibiotic stewardship program in 2015. A key component of the program involves a pharmacist reviewing all prescribed antibiotics to determine if it is the most appropriate course of treatment for a given patient. “We are asking important questions,” says Arbulu. “Does the antibiotic address too broad a spectrum of bacteria and infection? Is it too narrow for a particular patient’s condition? Are we giving it in the correct amount? Should we de-escalate the dose? Should we not even prescribe an antibiotic?”

www.mgmc.org | Summer 2016 | HEALTH CONNECT

What does the review process involve?

Do patients have a role in this effort?

Each day, Gary Bailey, a Mary Greeley pharmacist, looks over a list of patients receiving antibiotics. Bailey is certified as an infectious disease pharmacist, which is recommended for antibiotic stewardship programs. The list he reviews may have anywhere from 40 to 60 patients on it. He typically finds five or six patients who may benefit from a change in their antibiotic treatment. “We are trying to optimize patient care in terms of antibiotics they may be receiving,” Bailey says. “We’re looking for duplication of antibiotics with similar spectrums of activity. We’re looking at culture results to make sure we are using the right antibiotic. We’re looking for opportunities to switch from injectable to oral antibiotics, which can be less expensive.” For example, Bailey reviewed a patient whose wound culture had shown the presence of MRSA, an antibiotic resistant infection. The patient was on a broad spectrum antibiotic called Levaquin, which Bailey knew was not the best option for MRSA. He recommended that narrowspectrum antibiotic Vancomycin be added, which the patient’s physician accepted. “We have an 80 percent rate of acceptance for the pharmacist recommendations,” says Arbulu. “It isn’t that patients are getting the wrong antibiotic, it is more an issue of whether there is a better antibiotic.”

Absolutely. It is important that that hospital patients know that Mary Greeley has this program in place to help ensure they are receiving the most effective antibiotic treatment. Patients should be comfortable about asking questions regarding antibiotics they are taking, including why a specific antibiotic has been prescribed and any potential side effects. Finally, regular and thorough handwashing is one of the best infection fighters there is. A patient should make sure everyone who enters their hospital room – whether a visitor or hospital staff – washes their hands or uses the hand gel. 3

BLUE SKIES AN OUTDOOR LOVER’S REQUEST ADDS ANOTHER MEMORY TO A LIFE WELL-LIVED. B Y S T E V E S U L L I VA N

During their more than 50 years together, Liz Schabel and her husband, Frank, visited every state in the country, and camped out in most of them. So it’s no surprise that after a few days as a patient at Mary Greeley’s Israel Family Hospice House, Liz wanted to go outside.

What Liz asked shortly after nurses wheeled her hospital bed through the doors of the hospice house was a surprise, though: “Can I sleep out here?” The answer was “yes.” In the Garden

With members of her family nearby on cots, Liz spent two nights sleeping in her hospital bed under the pergola of the hospice house’s garden area. This, as far as hospice staff can remember, was a first.

“She always loved the outdoors and found fresh air enlightening. Her favorite places were on the beach or in the mountains,” says Frank. “Being outside gave her a chance to see some green and the trees and hear the birds. She woke up smiling.” At hospice house, special requests from patients and families are common. It may be a desire to see a family pet one more time, enjoy a dish from a favorite restaurant or a chance to check one last item off the proverbial bucket list. Every

attempt is made to honor them. “Hospice care, whether provided at Israel Family Hospice House or in a patient’s home, focuses on the dignity and quality of life,” says Valerie Bohlen, manager of hospice at Mary Greeley. “While we are providing end-of-life care, we are celebrating life. Helping Liz do something she loved, something that connected to so many experiences she’s had with her family, reflects what we try to do for all our patients.”

HEALTH CONNECT | Summer 2016 | www.mgmc.org

(Left) Liz Schabel with her husband Frank at Israel Family Hospice House. (Below) The pergola where Liz spent the night, accompanied by members of her family.

Liz, who died at hospice house in June, was known by her family and friends for her wit, writing talent, love of books, commitment to social justice, and impeccable sense of fashion. Her bright red fingernail polish, which provided an eye-catching contrast to the white sheets of her hospice bed, served as a reminder of her ever-present style. She was an award-winning English instructor at Iowa State University, and taught honors seminars on such topics as the

Holocaust. She also volunteered at an Iowa men’s prison, teaching theater to inmates. One young man who she had taught visited her at the hospice house. “She inspired men who had been inside for years to get up and recite scenes of plays, like her favorite, ‘A Raisin in the Sun,’” says Frank. “She touched so many lives.” Liz came to hospice house after being in and out of Mary Greeley due to chronic illness. During her stay at the hospice, she was surrounded by family, including her three adult sons, and

www.mgmc.org | Summer 2016 | HEALTH CONNECT

friends, sharing cherished memories and making some new ones. During the first several days at the house, Liz and her family took an epic trip down memory lane, viewing 1,500 pictures from vacations, family gatherings and parties since the 1960s. “She would narrate everything and laugh,” says Frank. “It was a wonderful transition. She was so happy all the time she was here. Being outside, looking up at the blue sky, made her extremely happy.”

PHOTOS COURTESY OF THE SCHABEL FAMILY

Memories

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A BETTER LOOK

New 3D mammography strengthens women’s health services at Mary Greeley.

BY STEPHANIE MARSAU

heri Severseike knew that every time she had a mammogram, she faced a strong possibility of having to undergo additional imaging. A new development in how mammograms are done at Mary Greeley Medical Center has changed that. Seversike, who works as a dosimetrist in the William R. Bliss Cancer Center, has dense breast tissue. That tissue, combined with some existing cysts and calcifications, makes her mammograms harder to read. “In the past, I’ve been called back to have additional imaging done to magnify the suspicious areas,” she says. Mary Greeley is now offering patients 3D mammography, which is sometimes referred to as tomosynthesis. When a mammogram is done this way, it allows radiologists to look at the breast in slices compared to a two-

dimensional picture. This new service helped the Bliss Cancer Center, a service of Mary Greeley and McFarland Clinic, recently receive designation as a Breast Cancer Center. (See back page for more detail.) “There’s a huge benefit to 3D mammography for everyone, but especially those with dense breast tissue,” said Scott Cue, director of Radiology at Mary Greeley Medical Center. “Masses can hide within that dense breast tissue. With 3D mammography we can look at the images of the breast layer by layer and get a much better look at things that may have been obstructed in a standard 2D mammogram.” No Call Back

Seversike was due for a mammogram, but purposely waited until the end of June until Mary Greeley was 3D capable. She then offered to be a test subject

of sorts to help train the department on how to use the new machine. “The definition and the detail on the images are incredible,” she recalls. “The positioning is still the same, but because of the ability to digitally enhance one area, people may not need to return for follow up MRIs or ultrasounds.” Dr. Grant Goldsberry, McFarland Clinic radiologist, echoed Severseike. “3D mammography is a significant technological advance for breast imaging. This technology allows us to reduce the number of women returning for additional imaging and greatly improves our ability to detect cancer earlier. This is especially true for those with dense breast tissue.” Not all insurance companies currently cover 3D mammograms, but Cue made the decision that everyone who comes in to have a mammogram will have the 3D procedure, despite the

HEALTH CONNECT | Summer 2016 | www.mgmc.org

PHOTOS BY PAUL GATES

Mammograms at Mary Greeley are scheduled for 45 minutes. The first part of the appointment takes place in a spacious sitting area where a certified tech‑ nologist takes the time to talk to you and go through your history. Radiologists at Mary Greeley (pictured here is Dr. David Larson) spend hours looking at images in the Reading Room. 3D mammography provides them a much better picture of the breast tissue and has made the likelihood of a woman needing additional imaging much less.

fact the new technology is also 2D capable. “We believe that everyone should be provided the best possible care and this machine does that,” he says. “We don’t want there to be a difference in the care you receive based on if you choose to have your mammogram done at Mary Greeley or at McFarland Clinic. We’re able to do this because our mammography machines are the same brand so the radiologists can read the images the same way, regardless of where the mammogram is done.” Enough Time

There’s more to a mammography appointment though than the physical act of having the mammogram done. “At Mary Greeley, we schedule 45-minute time slots with a certified technologist because we want to make sure we spend plenty of time with you,” explains Cue. “We sit down with

you and go through a breast cancer risk assessment. We go over a detailed history because while it’s great to have technology, it’s even better to have a detailed history. We take what we do very seriously and now we can give our patients the best imaging available.” The certified technologists in the department, Laurie Geis, RT(R) M, Shelby Ades RT(R) M and Kara Walstrom, RT(R) M went through additional training for the new device, but it’s their bedside manner that resounds with patients. “They are so very conscientious when it comes to your comfort and caring for you,” says Severseike. “Shelby particularly has been doing this for many, many years and you just know that with her, you’re in great hands. “At the end of the day, it truly is all about the patient,” remarks Cue. “The hospital’s tagline is ‘doing what’s right,’

www.mgmc.org | Summer 2016 | HEALTH CONNECT

Save the Date for the 2nd Annual Ladies Night Out on Main Thursday, October 6, 5:30 p.m.

Join us at the Ames City Auditorium for our speaker, get your goodie bags and then visit Main Street for exclusive deals at participating businesses! Register online, get more details and watch for the revealing of our keynote speaker at www.mgmc. org/ladiesnightout. The event is supported by gifts to the Mary Greeley Medical Center Foundation.

so we felt like we need to be doing 3D mammography because it’s the right thing to do.” For more information on 3D mammography and the many other imaging services Mary Greeley provides, please call 515-239-2131.

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INSIDE THE ED Take a look at the place you hope you’ll never be: Mary Greeley Medical Center’s new Emergency Department. B Y S T E V E S U L L I VA N

In April, more than 400 people attended an open house at Mary Greeley Medical Center’s new Emergency Department (ED). During the event the most frequently heard comment went something like this: “I want to see it before I needed it.” Exactly. The ED is a place nobody wants to be, but everybody wants it to be there… because you never know when you might need it. Mary Greeley’s new ED was designed with patient care and safety top-of-mind. The new department has 23 rooms, and is 70 percent larger than Mary Greeley’s previous unit. There is a uniformity to the design of each room and to the way each room is supplied. This ensures that doctors, nurses and others can efficiently treat

patients, no matter which room they are using. “It’s beautiful,” says Dr. Sherry Flugrad, medical director for the emergency department. Mary Greeley’s ED sees approximately 28,000 patients each year. This demand drove the need for a new emergency unit. “Emergency room visits are up nationwide, and we are definitely part of the trend,” says Flugrad. “There are more insured people now, but mostly people want instant attention. No matter how good your primary care access is, people don’t always want to wait to see their regular doctor. As a result, we’re managing more chronic illnesses, as well as the usual emergency situations, like broken bones.”

T U R N T H E PA G E T O V I E W S O M E K E Y F E AT U R E S O F O U R N E W E D .

HEALTH CONNECT | Summer 2016 | www.mgmc.org

www.mgmc.org | Summer 2016 | HEALTH CONNECT

PAUL GATES

Rooms in the new Emergency Department have a standardized design, which contributes to patient care and patient safety. No matter the room they are in, caregivers always know where everything is.

INSIDE THE ED Behavioral Health Rooms: Mental health patients often come to the ED first for an evaluation to determine the need for inpatient care. Those who need inpatient care stay in the unit until they are transferred to Mary Greeley’s Behavioral Health unit or another facility. Several times a week a bed may not be readily available and patients may stay in the ED until one is located. There are two designated behavioral health rooms, each designed with the safety of the patient in mind. Each is equipped with furniture designed for safety and a TV encased in Plexiglas. A bathroom is provided for patients in this area. The rooms can be monitored by a crisis nurse, who is stationed nearby. A treatment room next to the rooms is used for medical-psych patients, such as those who have overdosed. “Our ED may board a behavioral health patient for a few hours or more than a day,” says Christy Krause, director of Behavioral Health Services. “We need safe, secure spaces for patients, some of whom have significant mental health and behavioral disorders, which is why these new rooms in our ED are so beneficial.”

BH RM.

EQUIPMENT

BEHAVIORAL HEALTH SUITE

Procedure Room: The ED has several treatment and exam rooms. The procedure room is slightly bigger and is used for the patients who have fractures, dislocations and similar injuries. The space can be used as a third trauma room if necessary.

REST RM.

TRAUMA

TREATMENT

PROCEDURE

NURSE STATION

PHYSICIAN DICTATION

NURSE STATION

TREATMENT

Eye Treatment and ENT rooms: These two specialty rooms are designed for eye emergencies and ear, nose and throat (ENT) emergencies. The chair in each room is designed for of the treatment of eye and ENT emergencies.

Pediatrics Room: The brightly colored patient room (the wall color is called papaya, by the way) is supplied with children in mind. A nearby cabinet is stocked with diapers and other materials a parent might need for their young child. There are also books and toys to keep patients occupied. “Being in the emergency department can be stressful, especially if you are a young patient or that patient’s parent,” says Dr. Laura Hufford, pediatric hospitalist. “Having room created especially for these patients helps put everyone at ease. It conveys a message of thoughtful, coordinated care.”

EXAM: EYE

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SUPPLIES

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NURSE STATION TREATMENT: PEDIATRIC

EXAM: ENT

TREATMENT

EXAM

WAITING AREA

TREATMENT

EXAM

WAITING AREA

EXAM

Nurse stations: These areas are decentralized to ensure nurses are close to patient rooms. Four stations form a centrally located square, with each assigned to section of the ED.

 TO MAIN ENTRANCE

HEALTH CONNECT | Summer 2016 | www.mgmc.org

What’s the Wait? Heading to the Emergency Department and curious what the wait time is? Just go to www.mgmc.org to find out. The wait time from arrival to room assignment is listed on the medical center’s home page. It is updated every 15 minutes.

FAMILY WAITING

EXAM

TREATMENT

Take a Video Tour

Trauma Rooms: Because traumas often involve more than one patient – think vehicular accidents, for example – there are two trauma rooms. The rooms are connected by a sliding door, which allows the medical team to move back and forth as needed. The rooms have the same supplies, as well, which contributes to the efficiency of care. Exam & Treatment Rooms: Each room is furnished and stocked in the same way to ensure efficient delivery of care. One exam room is a negative airflow room, which is an important patient safety feature. This means that room air is constantly being drawn out and filtered and ventilated outside. This minimizes anything airborne being drafted into other areas of the ED from the room that has a patient who may be contagious. The entire ED can also go into a negative air flow mode. This could be used during an epidemic, such as pandemic flu, when the ED is treating multiple patients suffering from a contagious illness.

TREATMENT

Steve Gelder, RN, CEN, director of Emergency Services, takes you on a video tour of the new Emergency Department. See it at: www.mgmc.org/ insidetheed.

LINEN DECONTAMINATION

Decontamination Room: Someone exposed to hazardous materials, such as farm chemicals, will immediately need to be thoroughly rinsed off. This room has exterior access so contaminant does not enter the ED or other areas of the hospital. It also has a tank which can catch any water that needs to be analyzed or disposed of in a way that will not adversely impact the city water supply.

TREATMENT

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TRIAGE

STAIRS

Triage: This is where a patient’s situation is assessed to determine the next steps in treatment. The new ED has two triage rooms. Youngster Braidan Tinta is shown here being treated by Karissa Shindelar, RN.

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VENDING RECEPTION

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Waiting Area: A comfortable waiting area greets people entering the Emergency Department. There is also a family waiting room near the ED’s trauma rooms.

PHOTOS BY PAUL GATES

ENTRANCE

WAITING AREA

 NORTH

www.mgmc.org | Summer 2016 | HEALTH CONNECT

DEVOTED TO EMERGENCY CARE

Dr. Sherri Flugrad earns Mary Greeley’s top physician honor. Here’s why. B Y S T E V E S U L L I VA N

PAUL GATES

r. Sherri Flugrad comes to the end of a nine-hour shift in Mary Greeley’s Emergency Department. Her day started at 6 a.m. with two separate cases of patients complaining of belly pain. Those were followed by patients who were treated for: • Minor injuries suffered in a car accident • Chronic neck pain • A badly smashed foot due to a construction accident (“Sewed a toe nail back on and sent him home.”) • A finger laceration • A skin infection • Complications due to cancer (“An elderly man who lives alone and can’t take care of himself. Not as unusual as you might think.”) • Stomach pain while pregnant (“Nothing serious, fortunately.”) • Complications due to pneumonia • An elbow injury • A case of neck pain (“We see a lot of chronic pain. People lose employment and insurance and can’t afford their meds or epidural shots. They come here when it gets really bad. We’re a safety net for them.”) • A chain saw injury to the leg (“A big, deep laceration. Sewed him up and sent him home. Super nice kid.”) • A complaint of abdominal pain • Complications related to colon cancer That’s fifteen patients, varying in age, gender and condition. “A slow day, a low volume day,”

says Flugard. “The average is 2.5 to 3 patients an hour, so around 25 to 30 patients a shift. It’s when you hit 3.5 or 4 patients an hour that it gets really interesting.” Those are the kind of days that Flugrad may prefer. Her personal and professional lives have been fueled by adrenaline and controlled chaos. Her skill at managing it all, and consistently delivering quality care when people need it the most, is why she was chosen

“Deep down I love what I get to do. I can’t imagine doing any other specialty. There’s a great balance of pediatrics and geriatric medicine, trauma and general medical any given day. Not many specialties allow you to do all those things.” – DR. SHERRI FLUGRAD

as the 2016 recipient of Mary Greeley’s Innovation & Excellence Award for Medical Practice. The first woman to receive the honor, Flugrad was nominated by her peers, including one who praised her as an “excellent physician leader and caring physician filling many roles in the ER and hospital that

www.mgmc.org | Summer 2016 | HEALTH CONNECT

often go unnoticed.” “Hopefully this means I’ve gained the respect and trust of my colleagues and the nursing staff. Those who have been honored before me, like Dr. Mark Taylor and Dr. Ricardo Arbulu, are people I look up to as very ethical, hardworking, patient-centered physicians,” she says. “It’s an honor to be in this group.” Ready for Action

Flugrad has long had an appetite for stuff that gets the adrenaline pumping. As a student in Colfax, she was all-conference in softball, baseball, track and volleyball. She did her pre-med studies at Wartburg College and earned her medical degree at Des Moines University. She played sports at Wartburg and satisfied her taste for action by working as an emergency medical technician (EMT), which provided some intense exposure to that style of medical care. “It was a way into medicine that I could do while continuing to do sports and my premed studies,” says Flugrad, who joined McFarland Clinic’s Emergency Medicine team in 2006. “I know what happens out it the field so it gives me a different perspective on what I do in the emergency department. I know the situations the paramedics bring to us, I know what they go through out there. It’s a tough job, with a lot of lifting, a lot of sweating or freezing on the side of the road.” Flugrad is married to Mary Greeley 13

Dr. Sherri Flugrad (far right) led the effort to get hypothermia therapy in 2012 at Mary Greeley. Three days after it was approved, the therapy was put into use to help save Julie Schwery (forefront), a member of medical center staff, after she experienced a heart attack. (To read the story about Julie in the Winter 2012 issue of Health Connect, please visit www.mgmc.org/aboutMaryGreeley.)

paramedic Steve Flugrad and the two are raising six children in their blended family. Being in emergency medicine can’t help but shape one’s approach to parenting. “You remember the worst cases. The horrible fatalities. The motor vehicle crashes. Bad pediatric cases. Drownings,” she says. “It makes you jaded. You compartmentalize things because you have to. You also become a neurotic parent. I don’t own a trampoline or an in-ground pool. My kids have knee guards and always wear their bike helmets.” In-demand Expertise

In addition to serving as medical director of Mary Greeley Emergency Department, Flugrad also provides numerous hours of medical training for paramedics. She does quality reviews of the medical aspects of Ames and Story County dispatch responsibilities. She serves as medical director for Ames Fire Department, Huxley paramedics and ambulance service, and first responders in Slater, Kelly, Story City, Gilbert and Roland. She also works shifts in the emergency department at Central Iowa Healthcare in Marshalltown. She’s been a force in emergency care at Mary Greeley and has spearheaded efforts to introduce new equipment and procedures that can benefit patients. The most significant is hypothermia therapy, which lowers a person’s temperature, slowing body function and essentially giving the brain time to rest after cardiac arrest. “This is helping us improve survival 14

rates for cardiac patients. They leave with intact neurological functions and can go back to a normal life after cardiac arrest,” says Flugrad. “We need to try to do anything like this that is evidence-based and improves outcomes.” Immediacy

“Deep down I love what I get to do,” says Flugrad. “I can’t imagine doing any other specialty. There’s a great balance of pediatrics and geriatric medicine, trauma and general medical any given day. Not many specialties allow you to do all those things.” Emergency care might be best described as variety paired with immediacy. You have to constantly be “on,” ready for whatever potential life and death situation might come through the door. There are always multiple patients needing attention at the same time – patients you know more by room number than name. While it’s adrenaline that drew Flugrad to emergency medicine, the job has taken on deeper significance for her. “After more than a decade doing

this, it's the more intellectually challenging cases that get me – the patients whose problem isn’t immediately clear and that I need to figure out,” she says. “My husband says he can tell when I’ve had a case that I really enjoyed because he can see my wheels spinning.” Of course, part of the job is often never knowing what happens to that patient you just stitched up, sent to the operating room or transferred to another facility. Unlike a surgeon or a primary care physician, you don’t always get to know the patient. “That is the sad part,” says Flugrad. “You don’t always know what happens to the person, especially if they are transferred to another facility. We’ll get nice notes from those other facilities, thanking us for the great emergency care we provided. Sometimes I bump into people I treated. I may not remember them, but they remember me. Someone will approach me at the grocery store, for example, and say, ‘Hey you sewed up my forehead six years ago. The scar looks great,’” she says.

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HEALTH CONNECT | Summer 2016 | www.mgmc.org

2016 Innovation & Excellence Award Winners Each year, Mary Greeley Medical Center employees nominate their colleagues for the Innovation & Excellence Awards in the areas of leadership, nursing and service. The recipients of these awards make significant contributions to high quality patient care at Mary Greeley. Here, the honorees share thoughts about their work at the medical center. Videos of each winner can be viewed at www.youtube.com/marygreeleymedctr.

Shelia Keisel

Angie Carswell

John Rodilosso

Senior System Administrator, Information Systems

Registered Nurse,Birthways

Director, Facilities Management

Service Delivery Award

Nursing Practice Award

Leadership Award

have been at Mary Greeley for 20 years and in Information Systems for all of those years. One of my favorite things about Mary Greeley is the teamwork. I enjoy the fact that if we run into difficulty or have a problem we can go to anyone in our department and ask for help. It is really a team effort all of the time. Mary Greeley seems like more of a family than just a place of work. Winning the award was so unexpected and I was really taken aback when I learned that I had won. I am very humbled by the award. I just think there are so many people out there that deserve a service award. It is hard to think that in a hospital someone who is not a clinical person can achieve this, because usually you are behind the scenes and not thought of as the service people in a hospital.

love coming to work every day. Having worked here for 19 years you would think it would be the same thing over and over again, but it is not. Every day I learn something new. I Iove to teach too, so it is nice to be a part of welcoming those new little ones into the world and helping the families get to know their babies. I didn’t know about the nomination process beforehand. I just learned that I was chosen as the recipient and was flabbergasted. I feel like there are so many good things that happen every day at Mary Greeley and so many other staff members that do wonderful things every day, that it was amazing that I would be picked for something like this. I am just completely honored that I was chosen as this recipient. Mary Greeley is a wonderful place to work. I am proud to work here and represent our department. It is an honor that I can share with our entire department and staff because many of the things that were talked about in my nomination are things that our entire department and so many other people worked on. There were countless hours and a tremendous amount of work that went into everything that we did, so ‘thank you.’

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here are a lot of things that are rewarding about my job. I like to see my staff learning, so that they can educate other hospital staff in what needs to be

done. I like to see them ask good questions – the right questions – and be able to answer them. I love showing them what needs to be done and how to do it. At Mary Greeley, you get to work with everyone in the organization. You get to work side by side. You get to work to help those departments that provide patient care. We focus on taking care of our patients and if the patient care staff is worrying about other things, that’s a distraction for them. So in our department we try to relieve some of that pressure so that they can do what they need to do for the patient. It’s a great privilege to be able to do that and help in that way. When I first found out I’d won I thought it was a mistake. At first I thought there’s no way, there are so many good leaders in our organization, there are so many good people and it’s a healthcare facility. There’s a lot of focus on patient care so I was shocked being that I oversee a non-clinical department. I was just dumbfounded, it was not even imaginable to me. It’s just amazing that Mary Greeley does this. It really is. 15

EMOTIONAL RESCUE Iowa State psychology students help Mary Greeley diabetes patients cope with impact of chronic disease.

Rachel Bitman-Heinrichs, an Iowa State University graduate student in psychology, (left) helped Susanne Shaffner cope with tragedy and manage her diabetes.

early a decade ago, diabetes crept onto Susanne Shaffner’s medical records. Those documents already bulged with diagnoses of fibromyalgia, high blood pressure, osteoarthritis and migraines for the Ames woman. But with the help of Mary Greeley Medical Center diabetes educators, Shaffner was able to manage her glucose levels. Until May 8, 2014. That was the day Shaffner’s 17-yearold son, Bowman Mills, was killed in a car accident. Aside from the obvious grief and emotional stress Shaffner faced, the trauma unleashed rampant glucose spikes that caused serious issues exactly two months later. “I had just taken my younger son to church camp, and while sitting on the grounds, I was fighting blurry vision,

a queasy stomach and I didn’t feel right in the head,” she recalls. “I happened to see a boy there I knew was a diabetic. I asked him if he had his meter on him, and when he tested my blood, my glucose count was 539. I ended up in the ER that night, and by that time, my blood sugar didn’t even register on the meters.” Back in Control

Not long after that incident, Shaffner began using a new tool offered through Mary Greeley’s Diabetes and Nutrition Education program. Partnered with Iowa State University doctoral student Rachel Bitman-Heinrichs, Shaffner pursued psychological counseling as a means to regulate her insulin levels. “Meetings with Rachel were always a highlight for me,” Shaffner says. “She was so sweet and pleasant, and she was the first counselor I’d ever met who

made me feel human, and not just a textbook case. I knew she was really listening, understanding and empathizing with me. She truly wanted to know how I felt.” In addition to a year of grief counseling, Bitman-Heinrichs assisted Shaffner in setting lifestyle goals like healthier eating and trying new foods. As Shaffner’s emotional equilibrium righted itself, so did her glucose levels. Free counseling services for Mary Greeley diabetes patients has been available since 2013. Under the academic guidance of ISU professor Norman Scott and supervision of psychologist Ken Dodge, ISU students pursuing psychology PhDs gain onthe-job training while working with patients. Bitman-Heinrichs, the daughter of a Florida physician, found her interest in health care further piqued when she

HEALTH CONNECT | Summer 2016 | www.mgmc.org

worked with college students struggling with both emotional and medical issues. Keen to continue practicing in a multidisciplinary environment, Bitman-Heinrichs quickly immersed herself in the challenge of aiding Mary Greeley’s diabetes patients. “There have been so many rewards, especially when I can help people come to a place where they can identify their values, talk about their emotions and come to a better self-acceptance,” she says. “That’s empowering to them. And to me, to know that I’ve helped see someone through a really difficult time in their lives.” Service Grows

Wisconsin native Dakota Kaiser credits his shadowing of dietitians and nurses for aiding his understanding of diabetes prior to counseling patients. “The staff made sure I had the same experiences the patients were having,” the ISU doctoral student explains. “They put me through the type 2

“Meetings with Rachel were always a highlight for me. She was so sweet and pleasant, and she was the first counselor I’d ever met who made me feel human, and not just a textbook case. I knew she was really listening, understanding and empathizing with me. She truly wanted to know how I felt.” – SUSANNE SHAFFNER

diabetes classes and loaded me up with stacks of books. They helped me to understand the illness, and how it can influence mental health and social functioning.” That training assisted Kaiser when counseling patients. Take, for example, the frustrated patient with Type 1 diabetes who felt the disease was unmanageable. Kaiser guided the patient through memories of an anxious, angry parent who made the patient feel guilty

Dakota Kaiser and Rachel Bitman‑Heinrichs, both Iowa State graduate students in psychology, conduct a support group in Mary Greeley’s Cancer Resource Center.

for the diagnosis. Kaiser helped the patient reframe the disease and its treatment in a more positive light. As the patient worked on personal growth and an acceptance of medical responsibilities, the patient’s glucose numbers began to stabilize for the first time in years. “Living with diabetes is hard,” Kaiser said. “It’s a chronic illness that requires you to give up things you like, and you have to be meticulous about pricking your fingers. It’s a lot to manage, and physical and emotional stresses come with that.” “Anytime there’s a chronic disease, you see depression,” said Lynn Maves, a Mary Greeley certified diabetes educator. “Learning about the disease and accepting it is a big part of the experience for patients. We often have patients who come through who might benefit from counseling services. Now we can make simple referrals to our ISU students.” Grief Support

The Mary Greeley Medical Center Foundation recently began funding the cost of the clinical psychologist who supervises the ISU students. Thanks to the success of the diabetes counseling program, the therapy services now are available in the oncology department as well. In fact, Bitman-Heinrichs recently completed a year working in that program, a service for which Janae Ver Helst remains grateful. Ver Helst watched her mother, Sheryl Miller, battle cancer for nearly eight years. In January, Miller was diagnosed with an inoperable brain tumor. Ver Helst struggled to wrap up her final semester as a student at Iowa State while assisting her debilitated mom, helping her younger brother prepare for his upcoming Ames High

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graduation, working at the Iowa State Center and maintaining leadership roles in several ISU organizations. “My friends recommended I talk to someone, because they thought I would explode with all my emotions,” Ver Helst says. “The first meeting with Rachel was weird, telling her my story, but now she’s become like a good friend to me. I could tell she actually cared when she asked me questions.” Bitman-Heinrichs guided Ver Helst through several tumultuous months, and continued to work with her after her mom passed away. “She taught me to do more for myself, to help me release my stress. For me, that means exercising every day, and now I’m trying yoga,” Ver Helst says. “Plus, it helped so much that I didn’t have to come up with money for counseling – that would have just added to the stress.” As Bitman-Heinrichs notes, “there is real power in therapeutic relationships.” “Through these programs, I now feel more confident to help advocate for my profession and its usefulness in a health care setting,” she says.



Donations to the Mary Greeley Foundation support many programs and services that enhance the quality of care our patients receive. To learn more about how you can help, please contact the Foundation at 515-239-2147 or visit www.mgmc.org/foundation.

By the numbers

Mary Greeley Medical Center FY 2015 (July 1, 2014 – June 30, 2015)

In this section, we provide a snapshot of Mary Greeley Medical Center’s ﬁnancial status, patient satisfaction, and quality data.

Payor Mix This measure indicates the sources from which Mary Greeley Medical Center receives payment for services provided. The largest source of payment for patients served at Mary Greeley Medical Center is Medicare.

Other – 3.3% Medicare – 44.5%

Medicaid – 9.4%

Managed Care/ Commercial – 10.8%

Wellmark/Blue Cross – 32.0%

Board of Trustees Sarah Buck Chair

Ken McCuskey Louis Banitt, M.D. Secretary/Treasurer

Brad Heemstra

Mary Kitchell

HEALTH CONNECT | Summer 2016 | www.mgmc.org

ANNUAL REPORT

››

Financial Assistance and Charity Care Mary Greeley Medical Center continued to provide financial assistance during fiscal year 2015. At Mary Greeley Medical Center, all patients, regardless of their ability to pay, receive the same high‑quality care. Each year, the medical center Board of Trustees sets aside a special assistance fund to help those who need assistance in paying their health care bills. Additionally, those who are afﬂicted by a catastrophic health

event may be eligible for assistance based on the amount of their medical center bills and their income level. The Mary Greeley Medical Center Financial Assistance Program offers financial assistance on a sliding fee scale for those earning up to 350 percent of poverty guidelines. We care about the communities we serve, and do what’s right in regards to providing them with affordable healthcare.

Financial Assistance Program Payouts FY 2012

$5,958,985

FY 2013

$6,895,933

FY 2014

$6,788,434

FY 2015

$3,633,233*

* Please note that between Medicaid expansion in Iowa and the Affordable Care Act, more people are now insured than ever before. Due to that, financial assistance isn’t being requested as often so the number for FY 2015 decreased.

Mary Greeley continues to be recognized nationally for the quality of care patient receive. The medical center has received Gold recognition from the Iowa Recognition of Performance Excellence and nine consecutive ‘A’ grades for patient safety from the Leapfrog Group – the only hospital in Iowa to achieve this.

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By the numbers

Statements of Net Position FY 15*

FY 14* (not restated)

Current & other assets

51,371

56,049

Assets limited as to use

212,579

203,576

Capital assets

195,719

183,058

6,232

N /A

Total assets

465,901

442,683

Long-term debt outstanding, including current

84,201

87,511

Other liabilities

30,550

31,351

Net pension liability

34,772

N /A

Total liabilities

149,523

118,862

Deferred inflows related to Pension

13,696

N /A

Total net position

302,682

323,821

Total net position and liabilities

465,901

442,683

FY 15*

FY 14* (not restated)

Deferred outflows related to pension

Condensed Statements of Activities Revenues 177,080

166,167

Other operating revenue

7,130

8,128

Total operating revenue

184,210

174,295

Net patient revenue

Expenses

Our patients continued to enjoy the superior healing environment of our new patient tower. Oncology patients are able to enjoy the benefits of the Burke Family Suites, which allow a patientâ&#x20AC;&#x2122;s family to remain with them throughout treatment.

Salaries, wages & benefits

77,560

82,212

Supplies & other expenses

69,590

63,755

Depreciation & amortization

18,487

14,921

Interest

3,255

904

Total operating expenses

168,892

161,792

Operating income

15,318

12,503

Non-operating income

7,651

25,863

Excess revenue over expenses before contributions

22,969

38,366

965

1,185

Changes in net position

23,934

39,551

Total net position, beginning of year**

278,748

255,132

Total net position, end of year**

302,682

294,683

Contributions

*In thousands of dollars **The Medical Center adopted GASB Statement No. 68 during the year ended June 30, 2015, which resulted in the restatement of net position as of June 30, 2014.

HEALTH CONNECT | Summer 2016 | www.mgmc.org

ANNUAL REPORT

››

Patient Satisfaction To learn more about how our patients feel about their experiences with Mary Greeley Medical Center, we use the National Research Corporation (NRC) rating system – ‑ a national benchmarking tool for measuring all aspects of patients’ experiences. Percent of ‘9’ or ‘10’ Ratings

Percentile Rank

Inpatient (adult)

82.4%

Laboratory

88.2%

Cardiac Cath Lab

92.4%

Radiation Oncology

92.8%

HCAHPS Patient Satisfaction Ratings Hospital Consumer Assessment of Health Providers (HCAHPS) represents patients’ opinions about the care they received while in the hospital. These opinions were obtained through surveys sent to patients after they left the hospital during the calendar year 2015. How do patients rate the hospital overall? (Percentage of patients who gave their hospital a rating of 9 or higher on a scale from 0 (lowest) to 10 (highest). Mary Greeley – 83% Iowa Hospitals – 76% U.S. Hospitals – 72%

Many amazing patient stories unfolded at Mary Greeley, including one that involved a wedding on the rooftop garden. The bride’s father, suffering from lung cancer, was not able to leave the hospital. So Mary Greeley nurses and staff helped the couple plan their wedding at the hospital, where the bride’s father was able to walk his daughter down the aisle.

Would patients recommend the hospital to friends and family? (Percentage of patients who reported that they would definitely or probably recommend the hospital). Mary Greeley – 83% Iowa Hospitals – 76% U.S. Hospitals – 72%

National Quality Measures At Mary Greeley Medical Center, we stress the importance of quality through the care we deliver every day. Our mission, vision and values guide us to strive for improvement continually. No matter how far we come, or how successful we have been in the past, our dedicated staff are always seeking innovative ways to improve the quality of care and the overall patient experience at Mary Greeley Medical Center. Mary Greeley Medical Center participates in the National Quality Initiative developed by the U.S. Department of Health and Human Services through the collection and reporting of information regarding the quality of care at Mary Greeley Medical Center. Quality reporting upholds the integrity of our organiz-

ation by providing the communities and people we serve with the tools they need to make a wise health care choice. The information about quality measures has been gathered as part of the Center for Medicare and Medicaid Services (CMS) project called the Hospital Quality Alliance. As a participating hospital, Mary Greeley Medical Center volunteers this information to CMS and offers additional quality information for public reporting. A website called Hospital Compare has been developed by CMS to publicly report valid, credible and user-friendly information about the quality of care delivered in the nation’s hospitals. You can find it at www.hospitalcompare.hhs.gov and www.medicare.gov. For the 29th year in a row, Mary Greeley provided medical support for the Iowa Games. More than 140 employees logged nearly 700 hours.

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By the numbers

In fiscal year 2015, Mary Greeley Medical Center compared favorably with U.S. and Iowa hospitals. Following are some of the results: Emergency Department - Timely and effective care in hospital emergency departments is essential for good patient outcomes. Delays before receiving care in the emergency department can reduce the quality of care and increase risks and discomfort for patients with serious illnesses or injuries. Average time patients spent in the emergency department, before they were admitted to the hospital as an inpatient* Mary Greeley – 187 minutes Iowa Hospitals – 212 minutes U.S. Hospitals – 262 minutes

Average time patients spent in the emergency department before they were seen by a healthcare professional* Mary Greeley – 18 minutes Iowa Hospitals – 22.5 minutes U.S. Hospitals – 25 minutes

*Data collected during a 12 month period from July 2014 to June 2015

Preventive Care - Hospitals and healthcare providers play a crucial role in promoting, providing and educating patients about preventive services and screenings and maintaining the health of their communities. Many diseases are preventable through immunizations, screenings, treatment and lifestyle changes. The information below shows how well the hospitals you selected are providing preventive services. Percentage of patients assessed and given influenza vaccine* Mary Greeley – 97% Iowa Hospitals – 93% U.S. Hospitals – 94%

Surgical Care - Surgical wound infections can be prevented. Medical research shows that surgery patients who get antibiotics within the hour before their surgery are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, is not as effective. Hospital staff should make sure surgery patients get antibiotics at the right time. This measure shows the percentage of Mary Greeley patients who received an antibiotic in the appropriate time period. Percentage of surgery patients given an antibiotic at the right time to help prevent infection* Mary Greeley – 100% Iowa Hospitals – 96% U.S. Hospitals – 99% *Data collected during a 12 month period from July 2014 to June 2015

Special events included the 15th Annual Hope Run for Hospice, which had its largest turnout ever with more than 750 participants.

ANNUAL REPORT

Mary Greeley Medical Center Statistics 2012

2013

2014

2015

% of Inpatients from Story County

55.6

56.8

56.5

54.9

% of Inpatients from 6 County Primary Market ^

88.1

88.3

87.9

% of Inpatients from 14 County Service Area #

95.9

97.9

95.3

2012

2013

2014

2015

9,617

8,768

8,289

8,298

163,479

165,418

167,791

167,466

Births

1,030

1,086

1,143

1,113

Operating Room Visits

8,831

9,214

8,967

9,586

Emergency Room Visits

25,313

25,439

25,742

27,885

4.2

4.4

4.5

4.41

59.1%

57.5%

53.1%

52.2%

2012

2013

2014

2015

CT Scans

10,284

9,182

9,015

10,316

Mammograms

1,752

1,669

1,542

1,566

Radiation Oncology Procedures

26,012

20,338

18,220

17,469

749

685

693

660

MRIs

1,941

1,798

1,684

1,910

GI Services Visits

5,632

5,888

6,403

6,004

Radiology Procedures

25,700

25,459

25,224

26,138

Additional Information**

2012

2013

2014

2015

Emergency Ambulance Runs

2,870

3,057

2,918

2,610

158,664

183,285

173,505

165,478

1,030,015

1,056,472

990,865

1,100,944

Service Area Origins*

Patient Information** Inpatient Admissions (excluding births) Outpatient Visits

Average Length of Stay (Adult & Pediatrics) Average Occupancy Rate

Procedures**

Sleep Lab Procedures

Patient Meals Served Pounds of Laundry Serviced

*Calendar Year **Fiscal Year ^6 County Primary Market includes Story, Marshall, Boone, Hamilton, Hardin and Greene #14 County Service Area includes those counties above as well as Polk, Carroll, Jasper, Dallas, Grundy, Tama and Poweshiek

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Nursing Annual Report

One significant way to measure the quality of a hospital is to measure the quality of its nursing. From training statistics to patient satisfaction surveys, there are many ways to measure the quality of nursing. In this nursing annual report, we share some key measurements of our nursing quality. “At Mary Greeley, our nurses have a huge impact on patient care, whether providing care at the bedside or in a clinical department, or working to improve the way we do things,” says Neal Loes, vice president and chief nursing executive. “We applaud our outstanding nurses for everything they do for our patients, every single day. They have set a standard of care at Mary Greeley that continues to inﬂuence generations of nurses.”

Professional Nursing Specialty Certifications

Nurses with Advanced Nursing Education

Certiﬁed Nurses % of Nursing Staff

BSN / MSN Nurses % of all Nursing Staff

30%

50%

27%

37.5% 24.5 %

24% 22.7 %

21%

22.2 %

13/14

14/15

25%

0% 12/13

13/14

14/15

15/16 YTD May

Mary Greeley has increased the percentage of nurses who have achieved professional nursing specialty certiﬁcation. These nurses have demonstrated that they have mastered a body of knowledge and acquired skills in their respective nursing specialities.

40.5 %

12.5%

19.9 %

18% FY

38.4 %

44.9 %

40.8 %

12/13

15/16 YTD May

Mary Greeley has increased the percentage of nurses who have achieved their baccalaureate or master’s degree in nursing, demonstrating our commitment to nursing professional development.

HEALTH CONNECT | Summer 2016 | www.mgmc.org

ANNUAL REPORT

Falls with Injury

Hospital-Acquired Pressure Ulcers (HAPU)

Number of Patient Falls Resulting in Injury

Number of Patients with HAPU

21 22

0 12/13

13/14

14/15

15/16

13/14

14/15

YTD May

15/16 YTD May

Decreasing the number of inpatient falls each year demonstrates our commitment to patient safety. We are learning and improving our fall prevention program year after year.

Decreasing the number of patients who develop a pressure ulcer is also a demonstration of our commitment to patient safety.

Communication with Nurses

Nurse Autonomy

Percent of Patients Report Always

Average (based on 5-point scale) of All Units

82%

4.48 81.5 %

81.25% 80.5%

3.36

79.9 %

1.12

79%

0 13/14

14/15

4.39

2.24

80.4 %

79.75%

4.48

15/16 YTD May

Our patient engagement scores indicate that nurses are improving how they communicate with our patients in hourly rounding and bedside shift report.

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14/15

15/16 YTD May

Nurse satisfaction surveys reveal that Mary Greeley nurses have a high level of autonomy. Our shared decision-making councils at the organizational level and shared decision-making teams at the unit level give nurses the autonomy to make decisions that impact nursing practice, professional development, and quality, and professional image.

Prime Time Alive & Gift Shop

PRIME TIME ALIVE

Created specifically for those age 50 and older, Prime Time Alive is a membership program (just $15 a year) that helps people live and age well. Members have access to: • Educational Programs: A selection of educational programs on physical, social, intellectual, emotional, financial, and spiritual wellness are available. • Mallwalkers: Monthly programs are held at North Grand Mall in Ames the first Tuesday of every month (except July) at 8 a.m. • Trips: Join your Prime Time Alive friends on day and overnight trips throughout the year. • Social Events: Our holiday gathering and other social events provide great opportunities to meet people. • Fitness Discounts: A variety of fitness discounts are available to Prime Time Alive members through Mary Greeley Rehab & Wellness and the Story City Lifetime Fitness Center. • Massage Therapy: Enjoy a 15% discount on all massage therapy services at Mary Greeley. • Cafeteria Discount: A 10 percent discount on meals served in the cafeteria is given to all Prime Time Alive members. Simply show your Prime Time Alive membership card to the cashier. • Burgie’s Coffee & Tea Company: Receive a 10% discount on any purchase at Burgie's located at Mary Greeley. All you need to do is show your Prime Time Alive card to receive the discount. Learn more at http://www.mgmc. org/medical-services/older-adult.

Prime Time Alive programs are designed to help you achieve a vital balance of the physical, financial, emotional and spiritual components in your life. Don’t miss all the fun and learning! You can become a member and register for events online at www.mgmc.org/pta or by calling 515-239-2423 or 800-303-9574. Preregistration is required for all Prime Time Alive programs.  Life Reimagined Checkup Wednesday, Aug. 24, 2 p.m. Quality Inn & Suites Center, 2601 E. 13th St., Ames Presented by Nancy Hemphill and Julie Huisman, AARP Life Reimagined guides. Sometimes life takes you in a different direction than where you thought you’d go. But it’s never too late to make a change – and we can help guide you. Now is the time for you to dust off a few dreams. At a Life Reimagined Checkup you can reflect on your goals and aspirations, harness your underlying personal strengths, and get tools and inspiration to take the next step. Group discussion is encouraged – please participate at whatever level you feel comfortable.  Anesthesiologists Role in Your Health Care Tuesday, Sept. 13, 2 p.m. Quality Inn & Suites Center, 2601 E. 13th St., Ames Presented by Allen Stoye, MD, McFarland Clinic Anesthesiology. When preparing for surgery, many patients think of the physician anesthesiologist as just the person behind the mask who puts them to sleep and wakes them when it’s over. They may not realize the comprehensive medical care the physician anesthesiologist provides between those two points and beyond. Join McFarland Clinic anesthesiologist Allen Stoye, MD, to learn more about his role in patient care.

 A Most Magnificent Gift: Celebrating Mary Greeley’s Centennial Thursday, September 15, 2 p.m. Quality Inn & Suites Center, 2601 E. 13th St., Ames Presented by Steve Sullivan, director, Marketing and Community Relations, Mary Greeley Medical Center. In 1916, Capt. Wallace Greeley gave the city of Ames the gift of a hospital named in honor of his late wife, Mary. A century later, Mary Greeley Medical Center is still here, providing quality medical care for the people of Ames, Story County and surrounding communities. We will take a look at how Mary Greeley has grown from its beginnings 100 years ago to what it is today, continually improving its services, technology and facilities.  Balance Your Life with Tai Chi Wednesday, Oct. 5, 2 p.m. Quality Inn & Suites Center, 2601 E. 13th St., Ames Presented by Virginia Dowling, certified tai chi instructor and senior trainer with the Tai Chi for Health Institute. This program is an introduction to tai chi and how it can enhance your life. It has been shown that tai chi is one of the best exercises for improving balance and reducing the risk of falls. It also has many other health benefits, from reducing stress to improving the immune system. It is also fun to do. Once you learn it, you can practice on your own in your own home, though many people love to also do it as a group.  To Fall or Not to Fall... That is the Question Tuesday, Oct. 18, 2 p.m. Quality Inn & Suites Center, 2601 E. 13th St., Ames Presented by Dana Barnard, PT, neurology clinical specialist, Mary Greeley Medical Center Rehab and Wellness. Fall reduction is one of the key health and wellness initiatives throughout the country, and central Iowa is no exception. This short program will discuss the recommendations from the CDC, as well as local initiatives and options for people in our community to decrease their fall risk.

HEALTH CONNECT | Summer 2016 | www.mgmc.org

 Tips to Keep Your Back Healthy Thursday, Nov. 10, 2 p.m. Quality Inn & Suites Center, 2601 E. 13th St., Ames Presented by Anne Hilleman, PT, DPT, Mary Greeley Rehab & Wellness.

 Update on Flu and Pneumonia Tuesday, Nov. 1, 8 a.m. North Grand Mall Presented by Terri Olinger, RN, BSN, Story County Public Health Nurse, Mary Greeley Home Health Services.

This program will provide general information to help you keep your back healthy; including strength exercises, flexibility exercises and general tips.

Learn the current information on flu and vaccinations for flu and pneumonia. Flu and pneumonia shots will be available. Bring your Medicare B card. Flu shots available from 7:30 to 9 a.m.

 AARP Smart Driving Tuesday, Nov. 15, 8:30 a.m. to 12:30 p.m. Mary Greeley Medical Center North Addition Room C Presented by Stuart Huntington, AARP Smart Driving instructor. This one-day presentation covers driver’s safety. Learn about the normal changes of aging and the effects it may have on driving. Cost is $15 for AARP members and $20 for all others (make checks payable to AARP) and may entitle participants to an insurance premium discount.

Prime Time Alive Mallwalkers  The Low-Down on Blood Pressure Medications Tuesday, Sept. 6, 8 a.m. North Grand Mall Presented by Cheri Schmitt, pharmacist, Medicap Pharmacy. This presentation will discuss the basics of hypertension and the different classes of medications to treat hypertension.  Your Spirit, Your Body, Your Health Tuesday, Oct. 4, 8 a.m. North Grand Mall Presented by Katherine Werner, M.Div., chaplain, Mary Greeley Medical Center. How does the state of your personal spirit affect your body’s overall health and vice versa? Come explore together how holistic health is more than just a set of physical vitals even as these numbers indicate some of what is going on inside of us.

Auxiliary Gift Shop

Proceeds from the Gift Shop support Auxiliary scholarships, programs and services of Mary Greeley Medical Center. For more information call the Gift Shop at 515-239-2190.  Fall Open House Thursday, Sept. 15, 8:30 a.m. to 7:30 p.m. Friday, Sept. 16, 8:30 a.m. to 4:30 p.m. The Gift Shop will be decorated for the colorful fall season. Come see our new location in the main lobby area and shop our Fall Open House featuring home décor, candles, diffusers, floral stems, unique Halloween and Thanksgiving decorations, seasonal greeting cards, special occasion napkins, and other items. Receive 20% off your purchases during the event.  Linens Fair Fundraiser Monday, Sept. 26, 8:30 a.m. to 5 p.m. Tuesday, Sept. 27, 8:30 a.m. to 1 p.m. Snuggle-up this fall and winter with soft, luxury bedding, blankets and throws. Geneva Distributing will be at The Gift Shop for their Linens Fair Fundraiser, selling 800-1,200 thread-count sheet sets for all bed sizes (twin, twin-XL, full, queen, king, and California king). Sherpa blankets and throws, and Memory Foam pillows will also be for sale in various sizes.

www.mgmc.org | Summer 2016 | HEALTH CONNECT

 HCI Fundraising $6 Sale Atrium Conference Rooms A & B Tuesday, Oct. 3, 7:30 a.m. to 5 p.m. Wednesday, Oct. 4, 7:30 a.m. to 1 p.m. Start your holiday shopping early at the HCI Fundraising $6 Sale. Perfect stocking stuffer items for every family member including LED flashlights, watches, reading glasses, scarves, gloves, wallets, ISU and UI collegiate items, CDs and much, much more – all for $6, along with some show specials!  Scrubs & Beyond Atrium Conference Rooms A & B Wednesday, Nov. 2, 7 a.m. to 7 p.m. The nation’s largest medical uniform retailer, Scrubs & Beyond, is coming to Mary Greeley for one day only! Choose from a wide selection of brand name scrubs, accessories and shoes in an array of sizes, styles and colors for both men and women. Brands include Grey’s Anatomy, Landau, Urbane, Carhartt, Jockey, Cherokee, Dansko, and many more! Monogram with the Mary Greeley logo for an additional charge.  Holiday Cut-Out Cookie Fundraiser Thursday, Nov. 10, 10 a.m. to 4 p.m. Make your holiday baking a breeze by purchasing frozen sugar cookies at the annual Holiday Cut-out Cookie Fund-raiser. The Gift Shop will sell boxes containing 3 dozen frozen cut-out sugar cookies in shapes of trees, stars and snowmen for just $15. Frozen Gingerbread Men cookies, will also be available to purchase for just $15. Enjoy a sample while shopping during the Gift Shop Holiday Open House that same day!  Holiday Open House Thursday, Nov. 10, 8:30 a.m. to 7:30 p.m. Friday, Nov. 11, 8:30 a.m. to 4:30 p.m. Join us at the Gift Shop for our Holiday Open House and receive 20% off your gift purchase. Featuring home décor, candles, diffusers, ornaments, jewelry and other accessories, holiday greeting cards, napkins, and much more! Get in the spirit, enjoying holiday music as you shop.

Clinics & Classes Clinics  Childhood Immunization Clinics Mary Greeley Medical Center offers childhood immunization clinics for Story County residents on the second and fourth Tuesday of every month from 4:30 to 6:30 p.m. at the Mary Greeley’s Home Health Care office located at 1114 Duff Ave. Upcoming dates include: Aug. 9, Aug. 23, Sept. 13, Sept. 27, Oct. 11, Oct. 25, Nov. 8, Nov. 22. Parents of children receiving immunizations are asked to bring previous immunization records with them. Even if a child has never received an immunization, he or she may start a program at any time. Call 515-539-6730 for more information.  Adult Immunization Clinics Mary Greeley Medical Center offers adult immunization clinics for Story County residents every week at Mary Greeley’s Home Health Care office located at 1114 Duff Ave. The clinics are held Monday and Wednesday from 8 a.m. to 12:30 p.m. and Friday from 10 a.m. to 2 p.m.  Blood Pressures at Mall with Prime Time Alive Free blood pressure checks will be providedby Mary Greeley Medical Center from 7 to 9 a.m., on the first Tuesday of every month at North Grand Mall.  Pre-diabetes Class Mary Greeley's Diabetes and Nutrition Education Center offers this class to help people at-risk for diabetes. Taught by a diabetes educator, the class focuses on nutrition, weight management, diet, exercise and behavioral changes. A $10 donation is requested for this class. Register online at www.mgmc.org or call the Diabetes and Nutrition Education Center at 515-956-2880.

Senior Health Clinics

Mary Greeley Medical Center Senior Health Clinics offer foot care, blood pressure screening, blood sugar testing and health education for Story County older adults. Call 515-239-6730 for more information. Mary Greeley will offer clinics at the following locations, dates and times: 28

Ames Bickford Senior Living Thursday, Aug. 18, Sept. 15, Oct. 20, Nov. 17; 1 to 3:30 p.m. Green Hills Health Care Center Tuesday, Aug. 2, Sept. 6, Oct. 4, Nov. 1 1 to 3:30 p.m. Heartland Senior Services Thursday Aug. 4, 11, 18, 25 Sept. 1, 8, 15, 22, 29 Oct. 6, 13, 20, 27 Nov. 3, 10, 17 9:30 a.m. to noon

The Meadows Apartments Tuesday, Aug. 16, Sept. 20, Oct. 18, Nov. 15; 1 to 3 p.m. Story City Story City Community Health Center Wednesday, Aug. 24, Sept. 28, Oct. 26, Nov. 23; 1 to 4 p.m. Cedar Place Thursday, Aug. 11, Sept. 8, Oct. 13, Nov. 10; 1 to 4 p.m.

Support Groups

Keystone Apartments Thursday, Aug. 25, Sept. 22, Oct. 27, Nov. office closed; 1 to 2:30 p.m. Regency V Apartments Tuesday, Aug. 2, Sept. 6, Oct. 4, Nov. 1 10 to 11:30 a.m. Stonehaven Apartments Tuesday, Aug. 23, Sept. 27, Oct. 25, Nov. 22 10 to 11:30 a.m. The Waterford at Ames (Assisted Living) 1200 Coconino Rd. Wednesday, Aug. 17, Sept. 21, Oct. 19, Nov. 16; 1 to 3:30 p.m. Windsor Oaks Apartments 1100 Adams St. Wednesday, Aug. 17, Sept. 21, Oct. 19, Nov. 16; 10 to 11:30 a.m. Collins City Hall Senior Meeting Room Tuesday, Aug. 16, Sept. 20, Oct. 18, Nov. 15; 9 to 10 a.m. Colo Community Center Tuesday, Aug. 16, Sept. 20, Oct. 18, Nov. 25 10:30 to 11:45 a.m. Huxley Nord-Kalsem Community Center Thursday, Aug. 4, Sept. 1, Oct. 6, Nov. 3 1 to 2:30 p.m. Nevada Senior Center Tuesday, Aug. 9, Sept. 13, Oct. 11, Nov. 8 12:30 to 2 p.m.

 Bereavement Support Groups; Six-Week Group For more information on grief support groups, contact, Bonnie Riphagen, Mary Greeley Hospice bereavement coordinator at 515-956-6038 or 877-469-0079.  BRCA Support Group This group meets the second Tuesday of every month at 7 p.m. in the William R. Bliss Cancer Resource Center. Call 515-956-6440 for more information.  Breastfeeding Support Group This group meets the third Thursday of each month from 1:30 to 3 p.m. in North Addition C. For more information, call Birthways at 515-239-2444.  Courage in Motion This fitness program for cancer survivors meets Thursday at 1 p.m. at Ames Racquet and Fitness Club North. Contact the William R. Bliss Cancer Resource Center for details. Call 515-956-6440 for more information.  Diabetes Support Group This group meets the first Tuesday of every month at 7 p.m. in classroom 1 of the Diabetes and Nutrition Education Center, Third floor, North Addition. Call 515-956-2880 for more information.  Living with Cancer Support Group Contact the William R. Bliss Cancer Resource Center for details. Call 515-956-6440 for more information.

HEALTH CONNECT | Summer 2016 | www.mgmc.org

Art Schedule

AUGUST Jackie Stoken Photography Entrance west hallway

SEPTEMBER Cindy Skeie Photography Entrance west hallway

OCTOBER Cindy Skeie Photography Entrance west hallway

NOVEMBER Joel Lueck Prints & pencil drawing Entrance west hallway

Delores Frederick Prints and Watercolors West extended hallway

Jenny Conrad Fiber West extended hallway

Emily McFarland Ceramics West Lobby display case

Beverly Westra Scarves and jewelry West Lobby display case

 Parkinson’s Support Group The group meets the third Thursday of each month. Call 515-239-2323 for more information or to be added to the mailing list.  Stroke Support Group The Stroke Support Group is free and open to the public. It meets the third Tuesday of each month. Call 515-9562774 for more information.

Family Birthing Classes

Register online at www.mgmc.org, or call 515-23 9-2444 or 800-951-9222 for specific information and to register. Preregistration is required.  Big Brother, Big Sister Class Classes are offered for ages 2 to 4, mixed ages, and ages 4 and up. Ages 2 to 4: Aug. 4, Sept. 8, Oct., Nov. 10, Dec. 8 Mixed ages: Aug. 25, Sept. 19, Oct. 17, Nov. 14, Dec. 12 Ages 4 and up: Aug. 29, Sept. 29, Oct. 27, Nov. 28, Dec. 19 5:30 to 6:30 p.m. Main Lobby  Childbirth Classes Birthways offers a one-day series (Saturday) and a two-day series (Tuesdays) childbirth class to help women in their seventh to eighth month of pregnancy and their support persons prepare for childbirth. Wear comfortable clothes. Bringing two pillows is suggested. A tour is included with the class. $30 donation per class.  One-Day Childbirth Class Saturday: Aug. 6, Aug. 13, Sept.10, Sept. 17, Oct. 1, Oct. 8, Nov. 5, Nov. 12, Dec. 3, Dec. 10; 8:30 a.m. to 3:30 p.m.; North A&B  Two-Day Childbirth Class Tuesday: Aug. 2 & 9 Sept. 6 & 20, Oct. 18 & 25, Nov. 15 & 22, Dec. 6 &13 6:30 to 9 p.m.; North A&B

 Birthways Tour Birthways offers tours of the hospital and unit for expectant women and their support persons. Aug. 31, Sept. 28, Oct. 26, Nov. 30, Dec. 28; 7 to 8 p.m.; North C  Breastfeeding Classes Aug. 1, Aug. 11, Sept. 12, Oct. 11, Oct. 20, Nov. 7, Nov.17, Dec. 5, Dec. 15 6:30 to 8:30 p.m.; North A&B $10 donation  Baby Basics Class Aug. 20, Sept. 24, Oct. 15, Nov. 19 North A&B (all dates) 8 a.m. to noon, $5 donation

Fitness Classes

Call for specific dates and times. Call 515-956-2731 for Ames classes or 515-733-4029 for Story City classes. Preregistration is required. Ames Classes  Moms in Motion Designed for prenatal women, this aqua class includes gentle stretching, strengthening and mild cardiovascular exercises. Following guidelines from the American College of Obstetrics and Gynecologists, Moms in Motion prepares women for the physiological changes associated with pregnancy, and develops stamina and strength for labor and delivery. Class participants enjoy a unique bond exercising with other moms-to-be.  Joints in Motion This 45-minute aqua class is designed for individuals with arthritis, fibromyalgia and other related conditions. Using a wide variety of gentle exercises, the focus is on improving flexibility and range of motion, plus enhancing cardiovascular and muscular endurance. Story City Classes  Yoga Combine traditional yoga postures with modern fitness moves for an excellent mind/body experience – perfect for

www.mgmc.org | Summer 2016 | HEALTH CONNECT

those seeking strength, flexibility, stress reduction and total relaxation. Bring your own yoga mat.  Power Hour Pump it up and join us for this total body strength training workout using free weights, bars, tubing and more. This workout is appropriate for all fitness levels.  SilverSneakers Have fun and move to the music through a variety of exercises designed to increase muscular strength, range of movement and activity for daily living skills. Weights, elastic tubing with handles and a ball are offered for resistance, and a chair is used for seated or standing support.  H.E.A.T. If you want to take your fitness and fat loss to the next level – without spending more time in the gym – then H.E.A.T. could be exactly what you’re looking for. Push yourself to your limit with athleticstyle cardiovascular exercises – both choreographed and drill-based. Get your metabolism fired up before most people are out of bed.  Zumba Ditch the workout and join the party! Zumba fuses hypnotic Latin rhythms and easy-to-follow moves to create a dynamic fitness program. Enjoy an exhilarating hour of calorie-burning, body-energizing, awe-inspiring movements meant to engage and captivate.  TBW (Total Body Workout) The TOTAL package – cardio, strength and interval training. Build metabolismboosting muscle and improve cardiovascular endurance in this fun, fast-paced, hour-long workout.  Boot Camp Our boot camps provide you with the latest tools and strategies to take your fitness to the next level. Join us for fun and games as you rev up your metabolism and greet the day energized, ready to burn calories all day long. 29

1111 Duff Avenue, Ames, Iowa 50010

Bliss Cancer Center is a Breast Cancer Center The William R. Bliss Cancer Center is designated as a Breast Center* by the National Accreditation Program for Breast Centers (NAPBC). The designation recognizes the Bliss Cancer Center’s commitment to offer patients every significant advantage in the fight against breast cancer. The Bliss Cancer Center is a service of Mary Greeley Medical Center and McFarland Clinic. The two organizations have combined skills and services that provide a full spectrum of advanced breast cancer services to patients from throughout central Iowa. Our comprehensive care includes: • Breast Cancer Risk Assessment • 3D Screening and Diagnostic • ABUS-Automated Breast Ultrasound • MRI Guided Breast Biopsy • Breast Ultrasound • Breast MRI • Ultrasound Guided Breast Biopsy • Stereotactic Breast Biopsy • Needle-Localized Biopsy • Lumpectomy, Reconstruction, Partial or Full Mastectomy

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External Beam Radiation Prone Breast Radiation MammoSite Brachytherapy Cancer Navigator Service Cancer Genetics Services Lymphedema Prevention and Management Therapy • Cancer Registry • Nutritional Consultation

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*To be recognized by the NAPBC, the Bliss Cancer Center had to demonstrate proﬁciency in leadership, clinical management, research, community outreach, education and quality improvement.

A multidisciplinary team coordinates the best treatment options. Team members come from a variety of services, including: • Medical Oncology • Radiology • Radiation Oncology • Surgery • Inpatient nursing • Infusion Center • Cancer Resource Center • Pathology • Palliative Care Team • Clinical Trials • Plastic Surgery • Oncology Pharmacy

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