Caring Connection Winter 2011
A publication of St. Joseph's Hospital Health Center.
Caring Connection S t . J o s e p h ’ s A Publication of St. Joseph’s Hospital Health Center | Winter 2011 | Vol. 8, No. 3 IN THIS ISSUE: St. Joseph’s Is Ranked No.1 for Vascular Surgery A Higher Level of Care t seems as if the work never ends, but for St. Joseph’s patients, their families, hospital staff and the Syracuse community that is great news! As the last tool is laid down upon completion of our new emergency department, chest pain center, mental health emergency department, data center and nutritional services area, we go right back to work on the final phase of our $265 million hospital expansion. A 110-bed patient tower will provide private rooms that are 35 percent larger than existing semi-private rooms. The size, and the fact that there is only one patient per room, will improve patient safety and also lower the risk of hospital-acquired infections. It also will make it easier for doctors, nurses, family members and patients to get around without bumping into furniture or each other. Family waiting areas also will be enlarged. Kathryn H. Ruscitto For the first time in its modern history, critical patient services such as the operating rooms, postanesthesia care unit, intensive care units and centralized sterile will be grouped in close proximity to each other to provide continuity of care instead of having surgery over here, radiology over there, and the intensive care units in another direction. Our current 12 operating rooms occupied 19,000 square feet when they were designed and built in 1992. The new surgical suite’s 14 operating rooms—along with expanded storage space and a larger, centralized presurgical area—will occupy 40,000 square feet. Space for an additional three operating rooms has been “roughed in” to be completed when the need arises, as it surely will. Each of the patient areas has been designed to provide more daylight, giving patients a proven boost in their ability to heal more quickly. Some have asked whether these new facilities will increase health care costs. Our calculations show that, in the long term, the design criteria, use of higher efficiency mechanical systems, and the ability to improve patient safety and lower infection rates through the use of private patient rooms will save money. There is another element of these improvements that is often overshadowed by our concentration on patient care and the latest in medical technology, and that is the economic power that a flourishing hospital injects into the Syracuse community. Consider the fact that these projects will have provided 600 construction jobs by the time they are finished. More than 80 percent of those jobs will go to local unionized labor. St. Joseph’s will have added 250 new, permanent health care jobs thanks to our expansion—100 jobs by the end of 2012, and an additional 150 jobs between 2013 and 2016. Look around the North Side and you’ll see new businesses coming into the area and others getting a facelift. We intend to improve the viability of these area businesses by providing tree- and shrubbery-lined greenways for better, more attractive access from the hospital. Anyone who has driven along Townsend and McBride streets near the hospital has witnessed the renewal of what was once a blighted residential neighborhood. St. Joseph’s has contributed by working with Housing Visions and Home HeadQuarters to provide new houses and rental properties. Let me put it this way: Where else can you buy a house, have the mortgage guaranteed by St. Joseph’s, gain access to as much as $15,000 in Syracuse Neighborhood Initiative grants, and have your kids go to a city high school, graduate and be able to go to college for free through the “Say Yes” program? And, if you walk to work at the hospital from a home in the neighborhood, you don’t even have to buy gas. There is no doubt we have a lot of work ahead of us, but it’s the kind of work we all can roll up our sleeves and relish. Sincerely, I Contents Ralph & Christina Nappi Emergency Services: Naming Gift to St. Joseph’s Honors Parents . . . . . . . . . . . . . . . . . 3 St. Joseph’s Is Ranked No. 1 for Vascular Surgery in New York State . . . . . . . . . . . . . . . . . 5 Up-to-Date . . . . . . . . . . . . . . . . . . . . . . 8 Taking the Road Less Traveled Has Made All the Difference in Her Life . . . . . . . . . . . . . . . . . . . . . 9 Our Foundation Report . . . . . . . . . . . 14 Franciscan Companies Franciscan Companies Aims to Improve Quality of Life for Patients, Reduce Health Care Costs and Help the Bottom Line . . . . . . . . . . . . . . . . . . 18 Tired of Being Tired . . . . . . . . . . . . . . 21 Quality Care That Provides Families a Break . . . . . . . . . . . . . . . 22 Embracing Age and Living Home Longer . . . . . . . . . . . . 23 Front Cover: The carotid endarterectomy that vascular surgeon Syed Zaman, MD, is performing reflects in his surgical glasses. St. Joseph’s vascular surgery program recently was named no. 1 in New York state by HealthGrades®. The story begins on page 5. Our Mission We are passionate healers dedicated to honoring the Sacred in our sisters and brothers. Our Vision To be world-renowned for passionate patient care and outstanding clinical outcomes. Our Core Values Kathryn H. Ruscitto President In the spirit of good Stewardship, we heal by practicing: Compassion through our kindness, concern and genuine caring; Reverence in honoring the dignity of the human spirit; Excellence by expecting the best of ourselves and others; Integrity by being and speaking the truth. 2 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org RALPH & CHRISTINA NAPPI EMERGENCY SERVICES Naming Gift to St. Joseph’s Honors Parents alph J. Nappi was never famous, nor is his wife, Christina. Yet their names appear for all to see on the St. Joseph’s Ralph & Christina Nappi Emergency Services building. Ralph was a public service employee for 30 years until his death in 1980. Christina describes herself (with some well-earned pride) as the equally hardworking mother of six—all of them, coincidentally, born at St. Joseph’s Hospital Health Center. Yet those are hardly ever the credentials needed to find your name above a sparkling new state-of-the-art emergency medicine facility primed to serve tens of thousands of Central New Yorkers when it opens in 2012. It was, however, more than enough for the couple’s son and daughter-in-law, Samuel and Carol Nappi, who made the gift to name the building—a gift they hope will recognize the lives and life lessons of Ralph and Christina Nappi. They also say the gift speaks about the care the elder Nappis received from St. Joseph’s physicians and nurses over the years. “Our parents taught us so much about helping others,” Samuel Nappi says. “We, as a family, are what we are because of what they taught us. They taught us by example the importance of helping others without expecting anything in return. They led by example: If you give back, you also get back. Giving is its own pleasure. R “My father was loved by his family and his commu nity,” Nappi continues. “In the 31 years since his passing, every time I meet someone who knew my dad, they say how much they loved him. He was a very giving person— a real gentleman and a fine example for us to follow. “This gift is about honoring my parents, but it’s also about honoring the care my parents have received over the years from St. Joseph’s nurses and doctors.” Nappi recalls playing football with friends as a teenager in 1972 when an out-of-breath friend ran to tell him that his father had been taken to St. Joseph’s. He arrived to find out his father had suffered a stroke and already had been given last rites. Over the next two or three weeks, Nappi remembers the care his father received from neurosurgeon (the late) Dominick C. Adornato Jr., MD, as his father was coaxed back from the brink. “Anyone,” he says, “who has been through that and comprehends what it’s like watching these nurses and doctors give back endlessly will understand. It’s in their nature.” Nappi praises other St. Joseph’s practitioners, as well. He recalls the efforts of Abdul-Ghaffar Musa, MD, who treated his mother for an aggressive cancer. Dr. Musa, Nappi says, “did an amazing job of saving her life. Dr. Musa really shines through for me today. He’s brilliant.” continued on page 4 St. Joseph’s Hospital Health Center’s new emergency services building was named by the Nappi family in honor of their parents, Ralph and Christina Nappi. Christina Nappi is photographed outside the facility with her sons John (left) and Nicholas (right). www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 3 continued from page 3 He also credits Joel Rosenberg, MD, as another member of the St. Joseph’s medical staff (and a longtime friend of his) with saving his mother-in-law’s life through coronary valve surgery. “St. Joseph’s has always been the choice for my family, as well,” Carol Nappi says. “Thanks to Dr. Rosenberg, my mother, Yoshi, is now 82 going on 65. “It was hard to get her out of cardiac rehabilitation she liked it and the staff so much. She has always liked to walk, and now she’s buzzing up and down the driveway.” Samuel and Carol Nappi hardly have time to slow down either. He is chairman and chief executive officer of a privately owned energy company with 12 power plants in the Northeast that supply electricity—a portion of it renewable like biofuel and hydroelectric— to more than a million households. The company also gathers natural gas in Alaska and operates natural gas pipelines in Western and Central New York. Nappi also is the founder of an entertainment company that produces plays, musicals and feature films. “I enjoy the business,” Nappi says. “The films and plays I’m involved with have a social consciousness. I’m working on a film now based on the life of Dr. Martin Luther King Jr. along with DreamWorks and Warner Brothers.” A play coproduced with Alicia Keys opened in New York in November. Carol Nappi is just as busy. She spent 11 years at the former Community General Hospital providing psychiatric day treatment. That was before son, Justin, and daughter, Leah, were born. “I stayed home and became a full-time mom,” she says. All Art © Peter Max 2011 This Peter Max portrait of Ralph and Christina Nappi, for whom St. Joseph’s emergency services building is named, was commissioned by the Nappi family and will be displayed in the new facility. (For more about the artist Peter Max, visit www.petermax.com.) Samuel Nappi says his parents taught by example the importance of giving to others. His mother, Christina Nappi, is surrounded by her sons (from left to right) John, Nicholas and Samuel. Her daughter-in-law, Carol, is seated next to her. Not photographed are Christina Nappi’s children Pamela, Rita and Ralph. Even though she was raising two children, she continued to teach at the family’s church and volunteer for several agencies. Carol is an active board member on several national charities in Central New York, New York City and Los Angeles. She was honored with a local Jefferson Award in 2000 for her community involvement. But when there are calm moments, moments for reflection on the most important elements of life, their thoughts turn away from work and back to families and the communities in which they grow up—including those in poverty who need, but who can’t afford, health care. “The people who often need it the most, the impoverished, will use the emergency center for their primary care needs as they have in the past,” Nappi continues. “It’s not always good for the hospital, and yet one thing continues to ring true—St. Joseph’s is building a world-class facility for all comers, including for those who have nowhere else to turn. “We live in both New York City and Los Angeles, and have seen the facilities at New York’s Cornell Medical and Cedars-Sinai Medical Center in Los Angeles. We are so happy to see that St. Joseph’s is coming up to such wonderful standards in terms of technology and infrastructure. They have always had great doctors and nurses, and the fact that they are making such a huge capital investment in a community of this size is remarkable.” So how does Christina Nappi feel about having her and her late husband’s names connected with the new emergency services building? “You know,” she ponders, “I have seen the goodness in our children from a young age. I’m humbled by this honor; my husband would be proud. We are blessed that our children can give back to such an important cause and community.” l 4 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org t. Joseph’s Hospital Health Center has been named the top hospital for vascular surgery in New York state and among the top 5 percent in the nation by HealthGrades®, a nationally recognized, independent source of physician and hospital quality ratings. HealthGrades released its findings in October as part of its 2011 Healthcare Consumerism and Hospital Quality in America report. That is reassuring news for Central New York residents who may face the life-threatening consequences of blocked carotid arteries or bulging aortic aneurysms that, if they were to burst, are fatal more than 80 percent of the time. Surgical expertise is an important variable in survivability, so having a top-rated facility in the backyard is a big plus, but the biggest advantage is having seven vascular surgeons on St. Joseph’s staff with decades of experience in treating these high-risk conditions. You can understand the importance of experience as you watch Syed Zaman, MD, repair the severely blocked right carotid artery of Gloria Didas. The surgery is filled with risk and the possibility of catastrophic endings, unless the surgical team knows exactly what it’s doing and has learned to manage the dangers involved in nearly every vascular surgery. S St. Joseph’s Is Ranked No. 1 for Vascular Surgery in New York State Despite the risk, there seems to be very little tension. When Dr. Zaman, who is also chief of surgery at St. Joseph’s, reaches calmly to his right for a clamp, surgical technician Carene Lozito already has anticipated his move and places it in his gloved hand without being asked. Dr. Zaman hasn’t even looked up from the three-inch-long incision in Didas’s right carotid that gives him access to the artery that is 90 percent blocked by a lifetime’s accumulation of a gristle-like material called plaque. Dr. Zaman must now carefully peel the plaque away from the inside surface of Didas’ artery. If any of the plaque is loosened, it can travel to the brain and cause a debilitating or fatal stroke. Dr. Zaman is aided by physician assistant Larry Scimone, and Gerard Falotico, certified registered nurse anesthetist, who has sedated Didas and keeps track of her vital signs throughout the procedure. Meghan Harrison, RN, is the circulating nurse who seldom stops moving as she scurries around the operating room gathering whatever disposable supplies are needed. To keep blood flowing to the right side of Didas’ brain, Dr. Zaman and Scimone install a plastic tube that continued on page 6 Vascular surgeon Syed Zaman, MD, (left) performs a carotid endarterectomy at St. Joseph’s Hospital Health Center. St. Joseph’s vascular surgery program has been rated among the top 5 percent in the nation by HealthGrades, an independent hospital and physician quality rating organization. www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 5 A Higher Level of Care Plaque in the carotid artery, if not removed, may have devastating consequences, including stroke. The surgical team has opened the patient’s carotid artery and prepares to remove plaque that has blocked 90 percent of blood flow. continued from page 5 temporarily detours the blood around the blockage. With the tube—or shunt—in place, Dr. Zaman carefully slices into the artery and removes the plaque in one piece making sure that he doesn’t take any of the artery’s lining with it. It is, Dr. Zaman says, a delicate procedure. Once the plaque is removed and the interior of the now shiny artery is methodically rinsed with a mixture of sterile salt water and a blood thinner, Dr. Zaman closes the incision with 30 or so stitches before removing the shunt and restoring blood flow through the artery. What has taken less than a minute to read about has taken more than an hour to safely perform. It has also contributed yet more experience and knowledge to the entire team. “It is nice to have other people say good things about us, but we still continually evaluate ourselves to do even better for our patients.” —Lawrence Semel, MD Such experience is partly the reason St. Joseph’s and its vascular surgeons are rated so highly by HealthGrades®. “In every case, you see small differences,” Dr. Zaman says. “Everyone is slightly different. Even after doing thousands of such surgeries, you still may be surprised —something looks worse than you thought it would or there are abnormalities you’ve never seen. But, because we’ve been through these procedures so many times, we can tackle and overcome such challenges.” As an example, Didas’ carotid artery was larger in diameter than most—something seen in only one or two out of 100 patients. Dr. Zaman normally stitches a polyester fabric patch to help close smaller incisions, but didn’t need to this time. Lawrence Semel, MD, whose volume of carotid and aortic aneurysm surgeries is similar to Dr. Zaman’s, says that experience is the driving force behind patients’ successful surgeries at St. Joseph’s or any other hospital. “If you look at this from a numerical point of view, the seven vascular surgeons at St. Joseph’s have the largest volume of carotid operations in New York and the second highest volume of aortic aneurysm repairs,” Dr. Semel says. “There are a lot of data that says the outcomes on high-risk procedures are better at highvolume centers. That’s usually true because the fact is you can’t have a large volume unless your results are good because the physicians who send these patients to you wouldn’t send them otherwise.” Part of the reason the number of procedures is increasing is the overall aging of patients. Dr. Semel says that 10 years ago, a 70-year-old patient may have been considered “old.” Today it isn’t rare to have 80- and even 90-year-old patients. Nor is it odd to find patients in their 50s with carotid blockages. Dr. Zaman adds, “You’re only as old as your arteries.” Being ranked no. 1 in the state is a responsibility St. Joseph’s vascular surgeons take seriously, according to Dr. Zaman. “It is nice to have other people say good things about us,” Dr. Semel adds, “but we still continually evaluate ourselves to do even better for our patients.” “This is a team effort,” explains Dr. Zaman. “The partners I work with are the most professional, experienced and dedicated doctors I know. You can’t do this without support. St. Joseph’s anesthesia staff and nurses provide excellent care, and administration gives us what we need to do our work.” 6 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org You get the impression from talking with Dr. Zaman that he and the other vascular surgeons at St. Joseph’s view their work more as a calling than a job. He remembers the time he found himself humming as he got ready to leave home for an early morning surgery. His daughter asked him why he was so happy. “I don’t know,” he told her, “I just feel good when I go to work.” Turning momentarily serious, he reflects on the honor that St. Joseph’s vascular surgeons have earned and what it means for them and also for Central New York. “As a vascular surgeon, you don’t get too many second chances—you need to do things right the first time. The consequences of failure—a stroke, losing a limb or losing a life—are just too great. So being recognized like this for offering something in Syracuse that is safe, good and can’t be done better anywhere else in the state is quite an honor. “Being able to have a positive impact on the life of another person is a great privilege for us as physicians, but it’s also an obligation to make sure we are doing what we do the best we can.” l St. Joseph’s Receives HealthGrades Vascular Surgery Excellence Award A n n n n n n leading hospital and physician quality rating organization, HealthGrades® has recognized St. Joseph’s vascular surgery program as: Recipient of HealthGrades Vascular Surgery Excellence Award™ for two years in a row (2011-2012) Among the top 5 percent in the nation for vascular surgery (2012) No. 1 in New York state for vascular surgery (2012) Rated five stars for vascular surgery (2012) Rated five stars for carotid surgery (2010-2012) Rated five stars for peripheral vascular bypass (2012) HealthGrades’ five-star rating means clinical performance is better than expected. HealthGrades 2011 Healthcare Consumerism and Hospital Quality in America report stated that patients had, on average, a 73 percent lower risk of dying in a five-star rated hospital compared to a one-star rated hospital, and a 54 percent lower risk of dying in a five-star rated hospital compared to the national average. Patients, on average, were 63 percent less likely to experience in-hospital complications than patients at one-star rated hospitals and had a 43 percent lower likelihood of developing an in-hospital complication than the national average. More information about HealthGrades may be found at www.healthgrades.com. l St. Joseph’s vascular surgery program was rated no. 1 in New York state by HealthGrades in its 2011 Healthcare Consumerism and Hospital Quality in America report, released in October. St. Joseph’s vascular surgeons are (from left to right) Robert Carlin, MD, J. Timothy Riley, MD, Lawrence Semel, MD, Syed Zaman, MD, and Mark McGurrin, MD. www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 7 up to date l l A Higher Level of Care Vice Presidents Named t. Joseph’s Hospital Health Center has named Mark Murphy, RN, NP, senior vice president for system development and ambulatory care. Murphy works closely with St. Joseph’s President Kathryn Ruscitto on system development, and with Frank Smith Jr., vice president for corporate development and president of Franciscan Companies, to further develop home care, wound care, the sleep labs, as well as dialysis and cardiac rehabilitation services at St. Joseph’s. In addition, he focuses on developing primary care center based mental health services and medical homes. Murphy will continue to concentrate on care coordination and readmission prevention. Murphy, who has worked for St. Joseph’s since 1989, most recently served as vice president for care management and ambulatory services. He is pursuing a master’s degree in business administration from Le Moyne College and currently holds a master of science in nursing degree from Boston College and a bachelor’s degree in nursing from SUNY Plattsburgh. He is a member of several community boards, including PACE of Central New York, the New York State Home Care Association, Rosewood Heights Skilled Nursing Facility and the Liverpool Little League. Fred Letourneau has been named vice president for physician enterprise. He is responsible for working with employed and private practice physicians affiliated with St. Joseph’s to form an integrated system to improve quality and coordination of patient care. This new position is part of St. Joseph’s recognition that physicians and health care organizations working together provide the best care for patients throughout the care continuum, from wellness visits in the primary care provider’s office to advanced procedures offered in the hospital. With 16 years of experience in physician practice management, Letourneau is returning to St. Joseph’s S Mark Murphy Fred Letourneau Deborah Welch where he previously ran a physician hospital organization in the mid-1990s. Most recently, Letourneau served as chief executive officer/administrator for three medical groups in Syracuse: CNY Family Care, LLP, a family medicine group with 11 physicians and seven mid-level providers; Upstate Surgical Group, a general surgery practice with nine physicians; and Vascular Surgeons of Central New York, a vascular surgery group with five physicians. Letourneau also has worked for Aetna Health Plans. He holds a bachelor’s degree in management from Syracuse University. In January 2012, Deborah Welch will assume the position of vice president for people (mission integration and organizational development). A 32-year employee of St. Joseph’s, Welch has been responsible for the overall operation, administration and management of mental health services for 22 years. Under her leadership, St. Joseph’s mental health services has grown exponentially and has led the way in providing mental health services to those most in need in the Central New York community. Recently, Welch assumed additional responsibilities as director of organizational development. Applying her knowledge of Baldrige principles, quality and employee development, she has helped advance the organization’s readiness to meet the challenges of tomorrow. As vice president, Welch will continue to focus on organizational and leadership development, as well as mission integration at St. Joseph’s. She holds a bachelor’s degree in psychology from Le Moyne College and is an alumna of Leadership Greater Syracuse, Class of 2003. She also is a member of the boards of directors of the New York State Council for Community Behavioral Health and Catholic Charities of Onondaga County. l New Kitchen Cooks Up Made-to-Order Meals t. Joseph’s new $6 million kitchen, which opened in October with a ribbon-cutting and open house, will allow the hospital to provide on-demand room service for patients. The first hospital in Syracuse to provide room service, St. Joseph’s expects to kick off the program in early December. Patients, who may choose from a selection of menus featuring regular and modified diets, will receive their freshly prepared meals within 45 minutes. “No one wants to stay in a hospital, but if they need to be here, we want to be sure they are well-nourished with high-quality hot meals made to order to their specifications and needs,” says Jamie Nicolosi, director of nutritional services. Nutritional services aide Carlos Lind cuts the ribbon unveiling St. Joseph’s new kitchen while (from left to right) Jeffrey Mitchell, executive chef who recently became a certified culinary administrator™; Joseph Scicchitano, vice president for support services; Jamie Nicolosi, director of nutritional services; and St. Joseph’s President Kathryn Ruscitto look on. l S 8 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org Photographed at the Fayetteville Free Library, Andrea Grant embarked on “the road less traveled” when she decided to change her life with bariatric surgery performed at St. Joseph’s Hospital Health Center. Taking the Road Less Traveled Has Made All the Difference in Her Life . . . Two roads diverged in a wood, and I— I took the one less traveled by, And that has made all the difference. — Robert Frost ndrea Grant, like millions of others, is familiar with Robert Frost’s four-stanza poem, The Road Not Taken, but for her it has special meaning as she reflects on the choice she made eight months ago to change her life with the help of St. Joseph’s Hospital Heath Center and Dmitri Baranov, MD, PhD, FACS. Frost’s protagonist, like Grant, encounters two roads that divide in a forest. She must choose one over the other, knowing that the consequences of her choice will almost certainly be irreversible. Grant is fortunate in that she, unlike Frost’s wanderer, already had some hints of the burdens that one road was likely to bring. Even knowing that, however, didn’t make her choice any easier. With a deep breath, Grant took her first step down the other path on April 12. When Grant (whom almost everyone calls Drea) first visits Dr. Baranov in May for a consultation on bariatric surgery, she weighs 321 pounds, is 29 years old, in love, and, she admits, not all that happy with the road she has allowed herself to take. Her shopping options, she says, are limited and “not the same fashion that you long to enjoy.” The available colors and prints remind her of living room drapes. There are good shops, she admits, but they are too expensive, even though she works two jobs. A “When I ride in an airplane, a train or go to a sporting event, I tend to spill over onto the person next to me,” she admits. “That’s alright if it’s your fiancé sitting there, but with a stranger it’s embarrassing. “You don’t want to be that way. You don’t want people to look at you. And sometimes you look at yourself in disgust that you’ve allowed yourself to get so big.” That’s exactly the way she feels when she makes a routine visit to her family physician and the nurse asks her to step up on the scale to be weighed. Grant hadn’t weighed herself recently and remembers looking down at the scale as it settled at 321 pounds. She was devastated, having told herself that she’d never let herself get over 300 pounds. She entered a “biggest loser” competition at work, feasting on a protein shake for breakfast, a simple lunch, and then what she called a more elaborate, but healthy, dinner. Extra exercise was still difficult because when she finished one job, she’d change clothes and be off to the next leaving scant spare time in her day. It was a chance conversation with a friend who had undergone gastric bypass surgery that convinced Grant there were ways to lose weight other than traditional dieting. “My friend characterized the gastric bypass surgery with Dr. William Graber’s group as ‘amazing,’ and said she had no complaints,” Grant recalls. “I also had done some of my own research and learned that, if I met certain criteria, the surgery could be covered by my employer’s health insurance. I was determined to attend the next information session hosted by St. Joseph’s Hospital Health Center.” That session would point the way to “the road less traveled,” and it was on Grant’s day off—April 12. continued on page 10 www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 9 A Higher Level of Care Andrea Grant meets bariatric surgeon Dmitri Baranov, MD, for the first time on May 27 in his office. After attending an informational session about bariatric surgery hosted by St. Joseph’s Hospital Health Center in April, Grant decided she wanted to learn more and see if she would be a candidate for the procedure. continued from page 9 Obesity—weighing more than you should for your height and gender—is a killer. It is estimated to be responsible for 300,000 premature deaths each year in the United States. About 34 percent of Americans are obese, according to the Centers for Disease Control and Prevention, and more than 5 percent are considered to be morbidly obese with a body mass index of 40 or more. That’s the category into which Andrea Grant falls when she seeks information and help at that April 12 seminar. “It was an eye-opening session and they gave us so many facts,” Grant says. Among those facts are these: Obesity contributes to diabetes, high blood pressure and an increased risk of heart attacks and strokes, liver and kidney disease, and several kinds of cancer, including breast and colon. But the fact that struck Grant the hardest was this: Women who have gastric bypass surgery are 50 percent less likely to have children who struggle with childhood obesity. “If I could prevent my child from having to suffer any of the heartache that I went through as a chubby child, I would go through any kind of pain and any kind of food restrictions that gastric bypass surgery requires,” Grant says. Gastric bypass surgery can’t be taken lightly, William Graber, MD, FACS, says. It is major surgery and its success, in the end, depends on how serious the patient is about changing his or her eating habits following surgery. Bariatric surgery, he says, remains the only way to help the morbidly obese successfully lose weight, keep it off and improve overall health. Drs. Graber and Baranov won’t perform it on everyone. Surgical candidates, they say, must have a body mass index of 40 or more—or 35 or more with other significant medical conditions such as diabetes, hypertension and obstructive sleep apnea. Grant met those surgical prerequisites, but she also has two other personal goals driving her: She is engaged to Daquan Thomas and she looks forward to a long healthy marriage along with healthy children. She also looks forward to her June 9 surgery, but not without some trepidation. On June 9, a Thursday morning, Andrea Grant is nervous, but not too nervous. She knows that what she’s doing is the right thing for her health and her future. She also has some help from a friend, Sarah Paschuk, an RN in St. Joseph’s postanesthesia care unit, who calms her until she goes into the operating room. “Sarah was there for me and that was great,” Grant recalls. “Any normal person has to be a little nervous before going under anesthesia, but I was ready. I remember them moving me over to the operating table and the next thing I knew. . ..” Grant has no recollection of the hour or so it took for Dr. Baranov and the surgical team to complete the procedure that would significantly change her life. But, she knew what to expect. Dr. Baranov earned his medical degree and a doctorate in his native Russia. Upon completion of his surgical training, he worked as a staff surgeon in one of the city hospitals in Moscow. After coming to the Weight Loss Surgery Office Opens on St. Joseph’s Hospital Campus he weight loss surgery practice of William Graber, MD, FACS, and Dmitri Baranov, MD, PhD, FACS, has opened an office in St. Joseph’s Hospital Health Center’s Medical Office Centre, located at 104 Union Ave., Syracuse. On the St. Joseph’s campus, the office is located in suites 809-810 on the eighth floor of St. Joseph’s Medical Office Centre. The practice, which specializes in weight loss surgery, has treated nearly 4,000 patients. Board-certified surgeons specialize in laparoscopic bariatric surgery, and use the most advanced techniques. Drs. Graber and Baranov have earned the American Society for Metabolic and Bariatric Surgery Center of Excellence designation. St. Joseph’s Hospital also is designated as a Bariatric Surgery Center of Excellence. To learn more about bariatric surgery at St. Joseph’s, see the list of upcoming informational sessions on page 13 or call St. Joseph’s Resource Line at 315-703-2138 or 1-888-7856371 (toll free). l T 10 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org United States, he completed a general surgery residency at the Brooklyn Hospital in New York City, and then a fellowship in minimally invasive surgery at the Boston University Medical Center. Drs. Graber and Baranov have performed hundreds of these procedures, but they are never routine. Long before the surgery, Dr. Baranov explained to Grant that he would perform what is known as a “Roux-en-Y gastric bypass” procedure named decades ago for a Swiss surgeon, Dr. Cesar Roux. He also would perform the surgery laparoscopically. Instead of making one long incision opening up much of her abdomen, Dr. Baranov would make several small halfinch incisions through which he would insert small surgical tools. He will be guided by a high-resolution videocamera with his progress shown greatly enlarged on an overhead videoscreen. “The laparoscopic approach makes it much easier to see what we are doing,” Dr. Baranov says, “and it’s also much easier on patients because they have less pain, it reduces their hospital stay and it gives much better cosmetic results. It also reduces some complications associated with open procedures.” Just because the laparoscopic approach reduces complications, it doesn’t reduce the procedure’s complexity. Following the surgery’s progress on the screen takes a well-trained eye, since virtually all of the structures in the abdomen tend to look about the same color and texture to the novice. continued on page 12 In the most commonly performed gastric bypass procedure, Roux-en-Y, a small pouch is created, excluding a large portion of the stomach. A section of the small intestine is attached to this pouch. Food that is now eaten bypasses the stomach and goes directly to the small intestine. Filling this pouch with just a few bites of food creates the same sensation as a large meal would prior to surgery. Patients who have gastric bypass surgery need to commit to a new style of eating (including smaller portions, foods low in sugar and fat, and appropriate fluid intake) as well as regular physical activity in order to promote overall good health. Weight loss surgery often alleviates obesity-related illnesses such as diabetes, sleep apnea and hypertension. Dr. Baranov looks at one of several videoscreens in the operating room as he conducts Grant’s gastric bypass surgery laparoscopically, using a number of small incisions through which he inserts the surgical tools, instead of making one large incision. Laparoscopic surgery typically benefits patients by reducing the length of hospital stay and likelihood of postoperative complications. www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 11 A Higher Level of Care continued from page 11 Under normal circumstances, chewed food is swallowed and enters the upper end of the stomach from the esophagus. The food is partially digested in the stomach and then passes through the other end of the stomach into the small intestine, a wrinkly tube about an inch in diameter and about 25-feet long, where it continues the digestion process. From the small intestine, waste passes into the large intestine and is eventually expelled from the body. In the Roux-en-Y procedure, Dr. Baranov shortcircuits the digestion process. He cuts a small portion of the top of the stomach, creating a pouch about the size of a jumbo chicken egg. The remainder of the stomach is stapled closed at the top cutting off the flow of food to the remaining bypassed “big stomach.” In the second part of the operation, Dr. Baranov cuts the lower part of the small intestine, pulls it upward, and fastens it to the newly created pouch creating a direct and much shorter path for the food to follow. What happens to the portion of the small intestine still attached to the lower end of the “big stomach” but disconnected from the remainder of the small intestine that was pulled up and attached to the “pouch?” It is reconnected to what’s left of the small intestine further down the line. When the two portions of the small intestine are reconnected, they form a “Y” giving the procedure the rest of its name. It’s not necessary for Andrea Grant to grasp the technical aspects of the Roux-en-Y procedure, but it is necessary for her to grasp its consequences, Dr. Baranov says. The surgery dramatically reduces the amount of food Grant can consume, and, importantly, it decreases the craving for food. To be successful, however, she must eat three meals a day of regular food At her first postoperative appointment with Dr. Baranov’s office on June 30, Grant has lost 38 pounds to date. Grant attends a St. Joseph’s bariatric support group meeting in August. The group is held monthly for those who have had bariatric surgery at St. Joseph’s or elsewhere. Barb Wagoner, RN, (center), facilitates the group. knowing that she’ll feel “full” much sooner than she used to, and when that happens, she must stop. She will learn that the most important thing is to “protect the pouch” by following the post-surgical diet to the letter, and also drinking and eating slowly. Dr. Baranov tells his patients that the newly created “pouch” is delicate and, for the next several weeks while it is healing, is not strong enough to withstand overfilling. The single most important instruction after surgery is to follow the diet exactly as it is written. Grant continues to lose weight—86 pounds by mid-October. Reflecting on the changes the surgery has had on her eating habits and diet, she explains: “All I ‘ate’ my first two weeks after the surgery were fluids,” Grant says, “juices, broth, some protein shakes. Then I started some mushy foods like diluted mashed potatoes or humus. I love humus. At four to six weeks, I was eating soft foods with more texture—soft fruits, soft vegetables, a little macaroni, even some mashed tuna. Finally, at seven weeks, I could start eating some meat. It was meat, but it was like shaved deli meat— not a fork full of steak.” The pace of eating and drinking slows, as well. Grant has been counseled to drink about eight cups of water or other calorie-free liquids a day—slowly, always slowly, and not directly before or after meals, and in tiny sips, never gulps. Over those first few weeks, Grant’s new stomach “pouch” would slowly begin to stretch as the swelling from recent surgery decreases, but never would it hold more than a cup of food. “Being hungry all the time was one thing I worried about before the surgery,” Grant says candidly. “But when you slow down your eating and get food in that little pouch you feel as if you’ve just eaten a Thanksgiving dinner. It seems impossible, but you are satisfied.” Throughout both the pre-operative and postoperative periods patients like Grant have full access to the practice’s staff of physician assistants, nurse practitioners, registered nurses and dietitians. Grant admits that there have been some changes in her food choices. She tries to avoid pasta and some l 12 caring Connection l St. Joseph’s hospital Health Center l winter 2011 www.sjhsyr.org varieties of rice because they seem to expand in her stomach pouch and cause mild pain. She also has decided that if she can’t eat very much, she will make the most of what she does eat by using fresh ingredients and packing each meal with flavor. Never, she says, have fresh zucchini, beans and other vegetables tasted so good. Her fiancé, Daquan Thomas (she calls him a gentle giant), continues to lose weight, as well. “He’s been amazing throughout this whole process,” Grant says. “He took a week off work without pay to stay home and look after me. He stayed both nights at St. Joseph’s sleeping in a chair. If I needed anything, he was just there. That speaks volumes about his character.” It’s now mid-November—nearly six months since Andrea Grant awoke from the June surgery that, as she suspected, would change her life. When she was rolled into one of St. Joseph’s operating rooms for the hour-long gastric bypass surgery with Dr. Baranov, she weighed more than 300 pounds. Today, she weighs 225 pounds—well on the way to her goal of 180 pounds. She has settled into her regimen of metered eating and has become used to a stomach that is threequarters smaller than it used to be. She’s exercising regularly, too. But right now, there’s something else on her mind besides her weight and her two jobs— her April 14 wedding to Thomas—a year and two days after her first information-packed meeting with Dr. Graber’s practice. Enough has changed now, Grant says, that her friends—both close and casual—have witnessed what a difference gastric bypass surgery can make in a person’s life. She was facing collateral health problems before the surgery, but those are gradually waning. A new set of “problems” now face her, but they bring smiles to her face. With her weight dwindling steadily, it’s difficult to predict what size wedding dress she’ll need next April. She has finally found a bridal salon willing to wait until very close to the service before settling on a size. There will still be some alterations needed here and there, but those are the problems that any young woman doesn’t mind facing. “My friends tell me that in a few years that final wedding gown won’t even fit,” Grant smiles. “I tell them I’ll wear it when I’m pregnant.” Her mother will be making the wedding cake, but Andrea has no problem with that, either. She just plans on eating the tiny morsel that her new husband will feed her for the photographers. These wedding plans bring smiles to Grant’s face, but when she discusses the surgery, she takes on a serious mien, again considering, perhaps, Robert Frost’s figurative “Y” in the road that she faced only months ago. “I could have taken the other road just as easily,” Grant says. “I already had clues where it would lead—guaranteed health issues the rest of my life. So do you stay with the road you know even though it will probably have dire consequences, or do you take the unknown path? I knew there were risks along the road less traveled, but I chose to imagine a bright, serene meadow at its end.” And that has made all the difference. l Shopping for gowns on Sept. 23 for her April 2012 wedding, Grant is more interested in the style of dress than the size as she continues toward her goal of losing 140 pounds overall. ONE FREE HOUR WITH A ST. JOSEPH’S PHYSICIAN Weight Loss Surgery: When Is It the Best Option? Presented by William Graber, MD, FACS Board-certified surgeon specializing in weight loss surgery (most insurance plans accepted) n Learn what qualifies as obesity n Review how obesity affects health n Find out when surgery is the best option n Review what can be expected after surgery Monday, Feb. 27, 2012 at 6 p.m. St. Joseph’s Medical Office Centre Suite 809-810 104 Union Ave., Syracuse, NY Free parking Monday, March 26, 2012 at 6 p.m. Northeast Medical Center 5th floor conference room Medical Center Drive, Fayetteville, NY Free parking Space is limited. Register at 315-744-1244 or email email@example.com. www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 13 A Higher Level of Care Our Foundation Report “I keep my friends as misers do their treasure, because, of all the things granted us by wisdom, none is greater or better than friendship.” —Pietro Aretino, 1537 Dear Friend of St. Joseph’s, ach holiday season I take time to think about the treasures in my life—family, friends, work and good health. This year, as I do so, it comes to me that I would like to share with you why I begin each of my letters to you with the words “Dear Friend.” To some, this phrase might feel impersonal. However, to me, these words were carefully selected out of the emphasis I place on the friendships in my life. Whether at home or at work, I believe it is important to hold my friends tightly “as misers do their treasure” because they are irreplaceable. Likewise, here at St. Joseph’s, Margaret Martin friends and their ongoing support—whether provided through time, material gifts, financial support, or thoughts and prayers— are equally valued. All of us at St. Joseph’s are so appreciative of the many donors from throughout our community who have played such an important role in the Foundation’s success and the hospital’s ability to continue to provide the highest quality health care. With your help, this has been a great year! In 2011, the hospital and Foundation have worked together to raise more than $7.5 million through grants and donations from foundations, individuals and businesses. And, thanks to the community’s generosity, the annual gala and the golf tournament together netted nearly $580,000. Much of our focus this year has been on the Generations Campaign for the hospital’s major facility expansion. As of this writing, the campaign has reached more than $12.5 million in gifts and pledges! This is a thrilling testament to the value that Central New Yorkers place on excellent health care—and most especially on keeping this care accessible to all, regardless of their station in life. There is still time for you to be a part of this exciting project. Naming opportunities are available at many levels. Every gift is crucial and every gift is appreciated. For more information, call the Foundation or visit the Generations website at www.generationscampaign.org. As you see, my friend, without you, we would not be able to accomplish what we do. For this, on behalf of St. Joseph’s Hospital Health Center and St. Joseph’s Hospital Foundation, I extend my most sincere, “Thank you!” Best wishes for a happy and healthy holiday season, E 973 James St., Suite 250 Syracuse, NY 13203 Phone: 315-703-2137 Fax: 315-703-2139 Email: Foundation@sjhsyr.org Donate Online: www.sjhsyr.org/foundation For more information about the many opportunities St. Joseph’s Hospital Health Center Foundation has to fit your giving interests, please contact Margaret Martin, vice president, by calling 315-703-2137; emailing Margaret.Martin@sjhsyr.org; or visiting the Foundation’s website at www.sjhsyr.org/foundation. Gifts are appreciated at any level. Margaret Martin Vice President 14 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org Fund raising on the Greens Helps to Keep Health Care in Central New York Out of the Rough uch fun was had by a total of 380 golfers in a relaxed and happy atmosphere as they participated in St. Joseph’s Annual Golf Classic held at the Turning Stone Resort & Casino on Sept. 9, 2011. Greatly anticipated in the community, the tournament is one of St. Joseph’s Hospital Foundation’s primary fundraising events each year. With a goal of enhancing health care for the residents of this community, and in support of St. Joseph’s, many local businesses support the Golf Classic as golfers, hole sponsors, through donated prizes or by advertising purchased in the event’s program booklet. Netting more than $227,200, this year’s Golf Classic was described by Margaret Martin, St. Joseph’s vice president for marketing, communications and development, as “a tremendous success!” During the evening’s wrap-up, amidst heavy hors d’oeuvres, cocktails and raffles, Martin thanked all of the tournament’s generous supporters and said, “We are pleased to see friendly faces from past years and new partners for the future.” Proceeds from this year’s tournament will benefit the comprehensive range of services at St. Joseph’s Hospital, including mission services that provide compassionate care and state-of-the-art technology to address our community’s health care needs. Taking a swing is Hank Fust, president of Fust Charles Chambers LLP. The company was a master level and luncheon sponsor of the tournament. 19th Annual St. Joseph’s Golf Classic a Success! M John O’Connor (far left), with wife, Kathleen, and Patrick O’Connor (far right) and wife, Ellen, put their best wood forward as they enjoy Turning Stone’s award-winning golf course, Shenendoah. Kopp Billing supported the tournament as a master level sponsor and by donating three TVs for closest to the pin prizes. Franciscan Companies, a member of the St. Joseph’s Hospital Health Center network, was the presenting sponsor of the tournament. “We believe it’s important to give back to the community,” Franciscan President and CEO Frank Smith Jr. says. “We’ve been an important part of it for nearly 30 years and this is our home. Just as our home health care services contribute to the continuum of care at St. Joseph’s Hospital Health Center, we are pleased to contribute to a worthwhile event and benefit a great cause.” Next year’s tournament, to be held on Friday, Sept. 7, 2012, at Turning Stone Resort & Casino, will mark the event’s 20th anniversary! l Immersed in shopping bags generously donated by Wegmans is Pamela Kennedy, event coordinator for St. Joseph’s Hospital Foundation. Don’t Miss Out in 2012 e sure to mark your calendars for St. Joseph’s Hospital Health Center Foundation’s 2012 events! Highly anticipated and always fun, next year’s Annual Gala and Golf Classic will both offer participants the opportunity to benefit the hospital’s many award-winning programs and services: n St. B Top: Mark McConn, MD, chief medical officer of St. Joseph’s Medical, PC, shows a higher level of skill as he prepares to swing out of the rough at St. Joseph’s 2011 Golf Classic. Above: Franciscan Companies President Frank Smith Jr. and Margaret Martin, vice president of St. Joseph’s Hospital Foundation, share in the post-tournament “follow-through” during the awards portion of the evening. Franciscan Companies was a presenting sponsor of St. Joseph’s Golf Classic and donated a number of raffle prizes. n Joseph’s Annual Gala Dinner Dance Friday, June 1, 2012 20th Annual St. Joseph’s Golf Classic Friday, Sept. 7, 2012 www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 15 A Higher Level of Care St. Joseph’s Hospital Health Center’s new patient tower will feature team communication centers on its medical-surgical floors and critical care units. Communication among health care professionals is a critical component to quality care, and the centers will foster a high level of interaction—especially during critical times such as shift changes—to enhance workflow and patient care. Patient rooms will be in clear sight of the team communication centers, and the centers will be within easy access to medication/ supply rooms and private dictation centers. This specialized workspace also will support the latest technology needed to maintain electronic medical records. Construction of St. Joseph’s new patient tower will begin in 2012. Recent Grant Awards We thank the following foundations and agencies for their support of St. Joseph’s mission and services: The Pfizer Medical Education Group awarded a grant of $26,850 to enhance care for patients of St. Joseph’s Family Medicine Center. Faculty and resident physicians will utilize disease registry software to conduct evidence-based research to establish quality of care benchmarks for chronic diseases such as diabetes. New York State Department of Health awarded $40,000 to St. Joseph’s Hospital for bioterrorism preparedness. This funding will be used to continue to strengthen the hospital’s ability to respond to the threats of bioterrorism through the purchase of equipment, supplies and training. St. Joseph’s LINK (Leading, Integrating and Networking for Kids) program received a $10,000 grant from Citizens Bank Foundation. Serving school-age children and their families from the East SyracuseMinoa Central School District and the North Syracuse Central School District, LINK offers highly innovative programming that will be enhanced through this funding. The pediatric office at St. Joseph’s Maternal Child Health Center (MCHC) promotes childhood literacy through the national Reach Out and Read program. At checkups, pediatricians give each child a new book of their own to take home. Also in support of child and family literacy, MCHC and St. Joseph’s Family Medicine Center receive generous donations of children’s books from the Ella Fitzgerald Charitable Foundation. l St. Francis Garden • Walk of Valor • Caritas Park he three Walkways of Caring, located throughout St. Joseph’s Hospital Health Center’s grounds, are beautiful courtyard settings that offer patients and visitors a peaceful oasis during what may be a stressful time. Visitors to St. Francis Garden, the Walk of Valor and the College of Nursing’s Caritas Park take comfort in the names and messages on the parks’ bricks and benches. These inscriptions carry messages of hope, love, dignity and caring with words that honor heroes, support the hospital’s mission or express gratitude for a special nurse. They become a part of the healing atmosphere that permeates St. Joseph’s, and their words are read by thousands of people who visit the hospital each year. To purchase a brick or bench in honor of a loved one, as a memorial to someone special, to express gratitude to a caregiver or to leave a message for future generations, please contact the Foundation office at 315-703-2137. Additional information is also available online at the Foundation website: www.sjhsyr.org/foundation. l T 16 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org College Corner St. Joseph’s College of Nursing Joins Say Yes to Education Higher Education Compact S t. Joseph’s College of Nursing is the latest college to join the Say Yes to Education Higher Education Compact, by agreeing to offer free college tuition to Syracuse City School District graduates who meet residency and college entry requirements beginning in 2012. St. Joseph’s College of Nursing joins nearly 100 colleges and universities currently in the Say Yes to Education Higher Education Compact. St. Joseph’s offers several options for nursing students to reach their career goals, including weekday and weekend options that allow them to graduate with an associate degree in applied science with a major in nursing (RN) in just two years. The college also offers a dual degree partnership with Le Moyne College, another Say Yes to Education Higher Education Compact member. The dual degree partnership allows students to satisfy both the associate degree and bachelor’s degree requirements within four years. Say Yes to Education is a non-profit foundation that began offering K-12 supports in the Syracuse City School District four years ago to assist the district in increasing graduation rates. Students who attend their sophomore, junior and senior years and then graduate from a Syracuse City School District high school are eligible to receive college tuition grants at one of the Say Yes partner colleges once accepted into that college. More information is available at www.sayyessyracuse.org and www.sjhcon.org. l St. Joseph’s Nurse Visits Capital of Country She Faithfully Served F rances Steve Gibbons, St. Joseph’s College of Nursing Class of 1942, proves that there’s no stopping a St. Joseph’s nurse. Now 91 years old, Gibbons served in the Navy Nurse Corps during World War II and later provided care to the wounded aboard ships during the Korean War. Still able to fit into her 1943 issued Navy dress uniform, Gibbons visited Arlington National Cemetery in June and visited the gravesite of her husband, Joseph Aloysius Gibbons, who served as a lieutenant colonel in the Army Air Force (later the U.S. Air Force) during World War II, Korea and Vietnam—a military career that spanned 55 years. Although she graduated from St. Joseph’s more than 60 years ago, Gibbons still commends the nursing program for her educational preparation and remains a devoted alumnus. l Has Your Life Been Touched by a Nurse? T St. Joseph’s College of Nursing Students Make a Commitment to Nursing Profession St. Joseph’s College of Nursing Commitment to Nursing Ceremony was held in August at Immaculate Conception Church, Fayetteville, NY. Students celebrated their chosen profession at the ceremony by lighting candles, reciting the Nightingale Pledge and receiving crosses or lamp pins from representatives of the previous year’s class. The Nightingale Pledge is a testimony of students’ commitment to the nursing profession. The cross is a reminder of the spirit of St. Francis and symbolizes the unity and dedication of the students to their chosen profession. Representing the Class of 2012, Alison Houck (left) and Nicole Tartaglia (right) lit candles from the Nightingale lamps. Because Florence Nightingale was known as the “lady with the lamp,” the lamp became representative of nursing. It is an icon that signifies the light that shines brightly as a symbol of the care and devotion a nurse provides to the ill and injured. After the candles were lit, the flames were passed to all members of the Class of 2012. o learn how you can help dreams come true by contributing to the nursing programs and infrastructure needs at St. Joseph’s College of Nursing, contact Connie Semel, BS, RN ’74, Director of Development, St. Joseph’s College of Nursing, at 315-448-5303 or Connie.Semel@ sjhsyr.org. You may also use the enclosed business reply envelope; just write College of Nursing on your check. Thank you! l www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 17 A Higher Level of Care Franciscan Companies Aims to Improve Quality of Life for Patients, Reduce Health Care Costs and Help the Bottom Line he story begins in 1985 with an idea, a two-bay garage on North State Street, Syracuse, and one employee. Over time, it weaves through Central New York, ultimately stretching from Watertown to Pennsylvania, Utica to Auburn. Today, the idea has prospered, and that first office employee remains, but she is joined by hundreds of others. Thousands of patients are receiving services daily to improve their lives. Millions of dollars are funneled back into local hospitals for patient care. The story is that of Franciscan Companies. “There probably isn’t a week that goes by that a patient or family member doesn’t phone or send a note thanking us for something Franciscan Companies has done,” President and CEO Frank Smith Jr., MS, RRT, says. Smith was the director of St. Joseph Hospital’s Health Center’s respiratory therapy department in 1984. Under his leadership, the state-of-the-art department was rendering an advanced level of care. “As a respiratory therapist and associate professor of respiratory therapy, I was acutely aware of the adversities experienced by those “Our role has always been to be flexible visionof all ages with pulmonary disorders,” Smith says. “I have asthma aries who establish programs that complement and I know what it feels like to not be able to breathe. Over the years, I saw people suffer because they couldn’t breathe.” the mission of the hospital, reduce costs and It became apparent to Smith and Thomas Aiello, MD, a pulmonologist, that patients with chronic obstructive pulmonary disease generate a new source of revenue for the (COPD) were making repeated visits to the emergency department. hospital system.” “You knew the patients by heart,” says Tim Scanlon, executive vice president of Franciscan Companies. “They’d come in for —Frank Smith Jr., MS, RRT tune-ups, if you will, only to go home to the same environment and lifestyle; their disease was not being well managed. It wasn’t unusual to see patients readmitted three, four, five or six times a year.” “There was a very high mortality rate as patients’ conditions spiraled downward,” Dr. Aiello recalls. “We wanted to improve their quality of life and extend their lives.” Then in 1985, Smith and Dr. Aiello brainstormed Franciscan Health Support—a program in which a respiratory therapist would care for patients at home after discharge. Whatever they did for them in the emergency department, the respiratory therapists were able to do at home. “We wanted them not to have to change their life drastically,” Dr. Aiello says. “The program had to be very, very patient directed, increase patient comfort, maintain quality of life, and reduce morbidity and hospitalizations. We had all the pieces and had to put them together.” “So, we set up a home medical equipment program with a clinical component,” Smith says. “It was the only one with a full-time medical director. We employed only registered respiratory therapists (RRTs) while other companies utilized technicians. We were interested in more than just selling equipment. We did home visits and follow-ups.” “Immediately, almost overnight, those ‘frequent fliers’—the people who used to come in all the time—they weren’t coming in,” recalls Scanlon. “You didn’t see them anymore. We reduced readmissions into the hospital.” That is one of the main goals of Franciscan: to prevent unnecessary readmissions to St. Joseph’s Hospital Health Center. “Our role has always been to be flexible visionaries who establish programs that complement the mission of the hospital, reduce costs and generate a new source of revenue for the hospital system,” Smith says. Franciscan aims to reduce patient length of stay, Member of the St. Joseph’s promote good physician relations and good community relations, too. Hospital Health Center Network The key is to get people engaged in their care. “Nobody wants to go to a hospital. 7246 Janus Park Drive Patients always do better at home,” Scanlon says. Liverpool, NY 13088 Take Bernard Coyle who had a wake-up call of sorts about six years ago. “I went to the Phone: 315-458-3600 doctor for a colonoscopy and my doctor wouldn’t release me because my oxygen level was Fax: 315-458-2760 too low,” Coyle says. “I was diagnosed with COPD.” www.franciscan-services.com Coyle became engaged in his care. He took control, lost weight and got into better shape. T 18 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org “Your quality of life doesn’t have to decrease. It’s how your mental attitude is. You have to pull yourself together,” says Coyle. “Oxygen has improved my life. It has kept me from saying, ‘poor pitiful me.’” As the need evolved, Franciscan grew. It was apparent that people needed more than oxygen; they also needed bathroom safety products and mobility products to use at home. So, Franciscan established a full-service durable medical equipment supply company. “Today, Franciscan is the largest independent home medical equipment provider in this region,” Smith says. “We are leaders in the industry.” The concept helped St. Joseph’s by freeing up patient beds, and Smith knew it would be beneficial to other hospitals and health care providers. Franciscan set up joint ventures with Loretto in 1998, St. Elizabeth Hospital in Utica in 1998 and Lourdes Hospital in Binghamton in 2002. Oneida Health Support and Auburn Health Services followed in 2010 and 2011, respectively. Home intravenous (IV) therapy was added through a joint venture with A.J. Stone in 1999; CNY Infusion Services, as it is now known, is under the leadership of April Stone, CEO, and Frank Smith, general manager. In 1993, Franciscan set up a licensed home health care agency to provide patients with hands-on care services such as aides. It complements St. Joseph’s Hospital’s certified home care agency. Lifeline Medical Alert system, Philips medication dispenser, Take Shape weight loss program, and Among other services, Franciscan Health Support provides home health aides for companionCNY Medical Supply, an online retail medical ship and to assist with the activities of daily living, such as cooking, bathing and dressing. equipment company, round out the Franciscan Companies’ clinical services. Most recently, Franciscan Companies launched a membership service for senior citizens called Embracing Age. The first of its kind in the region, Embracing Age creates a comprehensive network of pre-screened professionals to assist senior citizens who want to remain in their homes. The program helps to improve their quality of life through arranging services such as yard and home maintenance, financial and legal assistance, medication management and home health aides. “We are proud to have a board with a patient-centered care mentality. They’re more interested in quality of care than profit,” Smith says. “Our goals, mission and values have never changed. The number of people we serve has changed. Our values have not. We provide compassionate care. We never turn anyone down, regardless of whether they can pay or not.” “Decisions are based on patient need, not on what we’ll get paid for the service,” Scanlon adds. “That’s my problem to figure out. We want our people to focus on improving quality of life.” “Our goals, mission and values have never With more than 5,000 patients being cared for each day, it is changed. The number of people we serve has no longer possible to have respiratory therapists visit every patient’s home monthly. However, with a staff of nurses and registered changed. Our values have not. We provide respiratory therapists, clinical services are available on demand. “I’ll have therapist there in an hour if we need to,” Scanlon says. compassionate care.” Coyle experienced that firsthand when the power went out —Frank Smith Jr., MS, RRT and he had a problem with his oxygen concentrator. “I called after hours. Within a few minutes, they called me back and we worked it out within 30 minutes. First thing in the morning they were out here to change the concentrator. The service tech gave me his personal cell and said, ‘If you run into any problems, call me…anytime.’ Those are the things that separate the companies. These men and women are fantastic to deal with.” continued on page 20 www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 19 A Higher Level of Care Top: Down the hill from St. Joseph’s Hospital Health Center, Franciscan Health Support began in this former garage at 400 N. State St., Syracuse. Franciscan aimed to help patients with respiratory illnesses avoid unnecessary readmissions to the hospital. Inset: Franciscan Companies, with services ranging from durable medical equipment to medical weight loss, now is located on Janus Park Drive, Liverpool. Satellite offices and warehouses are located throughout Central New York. continued from page 19 “That’s exactly the reaction we want to hear from our patients,” Smith says. The company tracks patient satisfaction through Press Ganey. It maintains averages near or above 90 percent. “We’ve always taken pride in our care,” Scanlon says. “The highest quality of care is always a given; it’s not even up for discussion.” As part of the community, Franciscan Companies prides itself on giving back through significant charitable sponsorships of St. Joseph’s Hospital Health Center network events and contributions to other organizations that provide services to this community. The company gives approximately $300,000 per year. “Part of our mission is being an active part of the community,” Scanlon says. “That’s extremely important to us. We live in the community we work in. We provide a lot of charitable care. We carry on the mission the Sisters of St. Francis brought here in 1869 when they founded St. Joseph’s Hospital, and we’re honored to be a part of that.” Franciscan Companies plans to be a part of the community, while continuing to grow, for years to come. “In the future, I see us being an integral part of the medical home model, specifically as it relates to chronic disease management, including everything from patient education programming, telemonitoring, chronic disease housing and working with storefront medical clinics,” Smith says. The baby boomer generation is expected to put an enormous demand on the health care system. That, coupled with the Healthcare Reform Act that may add another 50 million insured Americans to the medical system by 2014, and the economic climate, brings a lot of uncertainty. “But one thing I am certain of,” Scanlon says, “is that we’ll have to do more with less. We have to be able to evolve. As long as the decisions are centered on what’s good for the patient, we’ll make the right decision.” “We want patients to be able to do what they want to do,” Dr. Aiello says. “With medical support, you can. We have regular communication with patients, and we can achieve things.” Today, Franciscan is successfully caring for more and more complex patients. “There are patients we have, where if you walked into their homes, you’d think you were in intensive care,” Scanlon says. “With the care offered by Franciscan Companies, people are enjoying a higher quality of life and, given the support they need, may remain in their homes longer.” And what of that first office employee who is still employed at Franciscan Companies 26 years later? “When I first started out, I made birthday cakes for employees and it was easy at first: I had one small round cake pan,” says Diane Fluck. “Then I went up to a 13” x 9” pan and, before I knew it, I was up to sheet cakes just so everyone could have a piece. The growth has been phenomenal. I never thought back then that it would be as large as it is now.” It seems that a good idea—just like the size of birthday cakes —has just kept growing. l 20 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org Tired of Being Tired ossing and turning all night… getting elbowed to stop snoring… and waking up—startled. This is a typical night’s sleep for many people. Just ask John More of Syracuse. For more than a decade, he woke up more tired than he was the night before. He had no energy and wanted to crawl back in bed. He was keeping the house awake with his snoring. “I just figured, with a 14 and 12 year old, that you’re always going to be tired,” More says. “I will never have a good night sleep with kids. I was always listening for them and didn’t realize something else was going on.” That “something else” is obstructive sleep apnea. The National Sleep Foundation estimates more than 18 million American adults have sleep apnea. The condition occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. Obesity is the most common cause of sleep apnea. The condition is also related to high blood pressure and diabetes. When More began working for Pulmonary Health Physicians, he realized his nighttime angst wasn’t simply a result of aging or parenting. His family doctor sent him to get a sleep study. Once he was diagnosed with obstructive sleep apnea, More received CPAP supplies through Franciscan Health Support. Franciscan Health Support fit him with the correct size mask, which ensures successful treatment. The results, he says, were immediate. “I felt rejuvenated and refreshed. I hadn’t felt that way in years. It was instant.” More’s reaction is one shared with most people who seek treatment for sleep apnea. “People are simply amazed,” Neil Widrick, RRT, manager of St. Joseph’s sleep laboratory says. “They can’t believe they feel that way and are stunned.” Sleep problems start to arise in women who have a neck size greater than 16 inches and men with necks larger than 17 inches. It’s a good idea for both groups to undergo a sleep study. “If you take that step to see a doctor and get a sleep study, you can sleep well within a few weeks,” Widrick says. Every six months, a representative from Franciscan Health Support follows up with More to make certain he has the supplies and support he needs to continue home sleep therapy. More likens the CPAP mask to a catcher’s mask. “You put it over the back of your head and you’re good to go,” he says. It’s comfortable, he can sleep on his back or sides, and he stays put through the entire night, with no tossing or turning. “I feel great with it. My wife likes it because I don’t snore,” More says, “so she gets a good night sleep, too.” T Now that John More is being treated for sleep apnea, he has more energy for the things he enjoys such as a game of basketball. “I think a lot of people regret not seeking treatment sooner,” says Widrick. “They say, ‘If I had known I could do this 10 years ago, I wouldn’t have felt so awful for so long.’” More shares this sentiment. When he thinks back to all the restless nights and tired mornings, he wishes he gone for a sleep study years ago: “It’s like someone took the blinders off and everything was in high definition—instead of black and white TV.” l www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 21 A Higher Level of Care Quality Care That Provides Families a Break L Louis Polge enjoys working with wood at St. Francis Adult Day Care. et’s face it. We’re all getting older. Nearly 40 million Americans are now over the age of 65. And, according to the Administration on Aging, there will be 72 million senior citizens by 2030. That’s a huge jump. As baby boomers hit this milestone, families may be hit with the role of caregiver. Family members may be dealing with the onset of dementia or early Alzheimer’s Disease. Occasional visits may turn into the need for supervised care. St. Francis Social Adult Day Care in Syracuse offers caregivers a break. Program participants may attend Monday through Friday or on weekdays when family members have appointments and other commitments. Jean Polge brings her husband, Louis, to the day program for seniors. She heard about St. Francis Adult Day Care through Onondaga County and thought it would be great for her husband who suffers from some dementia. “They said nothing but high things about St. Francis,” Polge says. Taking advantage of a guest pass to try out the facility, Polge recalls, “I took my husband there for the visit and he seemed to get along with no problems.” One year later, her husband still attends. While he has good days and bad days, the caring staff members know how to talk with him and engage him. The program focuses on meaningful activities that stimulate participants’ minds and help ward off the progression of dementia. Instead of sleeping all day or watching television, participants are active, reminiscing with friends and learning new things. “If he’s at home, he usually falls asleep or if he takes a nap, it’s hard to get him up because he confuses days and nights,” Polge says of her husband. As a former television technician, Polge is good with his hands and enjoys the arts and crafts activities at St. Francis Adult Day Care. “He loves to color,” Polge says. “He never colored before. This is great. It keeps him active and keeps him thinking.” St. Francis Social Adult Day Care provides exercise, healthy meals and assistance with personal care needs. “I know he’s getting great care there,” Polge says. “They change from one room to the next, so they’re not doing the same thing in the same room. They do different projects to keep their minds stimulated. So, I love them for that.” Polge also loves that the day program gives her a break from around-the-clock care and time to accomplish her to-do list. “If I have an appointment or there are things that I need to do, and it takes longer than a couple hours, I don’t like to be away from him,” she says. “This gives me a chance to do things that I normally couldn’t do if he was home. “St. Francis Adult Day Care gives me peace of mind,” Polge continues. “I know he’s well taken care of.” St. Francis Social Adult Day Care is sponsored by the Sisters of St. Francis. It’s located at 1108 Court St., Syracuse. For more information, call 315-424-1003 or visit stfrancisadc.com for a free guest day pass. l 22 caring Connection l St. Joseph’s hospital Health Center l winter 2011 l www.sjhsyr.org Embracing Age and Living Home Longer enjoy the wisdom of seniors, their life experiences and the stories they share,” says Mary Downey Gualtieri, MS. Gualtieri is an eldercare specialist for Franciscan Companies’ Embracing Age Program, which was launched in September. “It’s an exciting new opportunity to assist seniors to be able to live in their homes and live independently,” she says. Embracing Age is a membership service that creates a comprehensive network of professionals on whom elders and their families know they can rely. “Embracing Age eliminates the stress associated with not knowing where to turn for services, assistance, companionship and guidance,” says Susan ClancyMagley, executive director of the program. Services include medication management, home health care, Lifeline Medical Alert system, legal assistance, landscaping, snow removal, personal care, pet care and a person who will drive a “snowbird’s” car to Florida so he or she may fly there instead. “The senior we serve is at the center of Embracing Age, and all of the services and activities we offer flow from there. The member is really the main event,” Clancy-Magley says. “Keeping in mind that everyone’s needs are different, we provide person-centered plans designed to meet the unique needs of each member.” Gualtieri guides members through the process, acting as their personal assistant on an ongoing basis. She coordinates the services members need at the time they need them. “What happens is that a lot of seniors don’t reach out until there is a crisis,” Gualtieri says. “Embracing Age is a proactive program. People can become members when they are active and healthy. The services will evolve with them over time, providing the support they need as they age. For now, they may need a snowplow service, but in the future they may need added supports such as a home health aide or respiratory care.” The first step is a comprehensive assessment. As the member and eldercare specialist get to know one other, individualized services will evolve. “My goal will be to build trust with them,” Gualtieri says. “Getting to know the clients is paramount. They will begin to trust me and trust the services they receive.” With Embracing Age, elders and their caregivers no longer need to spend time researching the right roofer, right contractor, pet care services and financial services. They don’t have to worry about being the victims of a scam artist. Embracing Age has done the research and formed the network, connecting elders with trusted, reliable assistance. Elders can maintain their independence and live more comfortably. Caregivers can have peace of mind and comfort, knowing that Embracing Age is listening to their concerns and ensuring their loved one’s well-being. ‘I Unveiling the Franciscan Companies’ Embracing Age program at a news conference held at the New York State Fairgrounds in September are (from left to right) Tim Carroll, director of mayoral initiatives for the city of Syracuse; Kathryn Ruscitto, president of St. Joseph’s Hospital Health Center; Frank Smith Jr., president of Franciscan Companies; and New York State Sen. John DeFrancisco. A membership service for senior citizens, Embracing Age creates a comprehensive network of prescreened professionals who help participants stay in their homes and enhance the quality of their lives. “At Embracing Age, we feel it is a privilege to serve our members in their homes. By providing a continuum of customized services, members can live life to the fullest right where they want to—at home,” Clancy-Magley says. Information on Embracing Age is available at 1 (855) MY HELP 2 or www.embracingage.org. l Medical Supply E-Commerce Site Hits Milestone ranciscan Companies, a member of the St. Joseph’s Hospital Health Center network, now offers 1,000 medical products through its website CNY Medical Supply (www.cnymedicalsupply.com). The available products include: n Diabetes management n Mobility, including canes and walkers n Sleep and breathing systems n Daily living aids, including power seats, benches and other comfort and safety devices Many of the products are priced well below suggested retail. In addition, the website’s new disease management section is designed to help educate those with diabetes or chronic lung disease. “By doing business online instead of in a brick-and-mortar building, we can keep prices down and get products to customers quickly and conveniently,” says Keith Cuttler, vice president for corporate development. The site does not accept Medicare, Medicaid or private insurance, but instead offers customers products they can buy on a self-pay basis. l F www.sjhsyr.org l winter 2011 l St. Joseph’s hospital Health Center l caring Connection 23 Non-Profit Organization US Postage Paid Community Relations Office 301 Prospect Ave. Syracuse, NY 13203 change Service Requested Permit No. 3560 Syracuse, NY St . Caring Connection Jo s e ph’ s HealthGrades® Rates St. Joseph’s Cardiac and Orthopedic Services Among the Best in Nation t. Joseph’s cardiac and orthopedic services recently were rated among the best in the nation by HealthGrades, receiving five-star ratings (clinical performance is better than expected) for joint replacement for six consecutive years (2007-2012) and treatment of heart attack for three years in a row (2010-2012). St. Joseph’s was named one of America’s 100 Best Hospitals for Specialty Care™ for joint replacement (2012). The hospital also received a five-star rating for valve surgery (2012). HealthGrades, a nationally known, independent source of physician and hospital quality ratings, released its findings in October as part of its 2011 Healthcare Consumerism and Hospital Quality in America report. HealthGrades research found that patients treated at a five-star rated hospital, on average, experienced a 73 percent lower risk of mortality and a 63 percent lower risk of complications compared to one-star rated hospitals. St. Joseph’s also received HealthGrades Vascular Surgery Excellence Award™ for the second year in a row (2011-2012). The program was ranked no. 1 in New York state and among the top 5 percent in the nation. (See article on page 5). A comparison of hospitals and physicians in the Syracuse area may be found online at www.healthgrades.com. l St. Joseph’s Caring Connection is published by St. Joseph’s Hospital Health Center, 301 Prospect Ave., Syracuse, NY 13203. Copyright © 2011 by St. Joseph’s Hospital Health Center. All rights reserved. No part of this publication may be reproduced without prior written consent of St. Joseph’s Hospital Health Center. If you know someone who would like to receive Caring Connection or be removed from our mailing list, contact the editor c/o St. Joseph’s Marketing/ Communications Office, 301 Prospect Ave., Syracuse, NY 13203, or call 315-703-2140. S Denise Jochem-Robertson Editor Margaret Martin Vice President, Marketing, Communications and Development Contributors Eric Johnson Writer Chuck Wainwright Photography Kelly Quinn Writer Eastwood Litho Inc. Printing Kiefer Creative Design Contact Us St. Joseph’s Hospital Health Center 301 Prospect Ave., Syracuse, NY 13203 www.sjhsyr.org General information ���������������� 448-5111 Patient information������������������ 448-5113 Resource line (physician and program information)���������� 703-2138 Foundation office (giving opportunities) ���������� 703-2137 Marketing/Communications office�������������������������������������� 703-2140 College of nursing�������������������� 448-5040 Volunteer office������������������������ 448-5186 All telephone numbers are in area code 315. St. Joseph’s Hospital Health Center is sponsored by the Sisters of St. Francis. St. Joseph’s Is the Consumers’ Choice t. Joseph’s Hospital Health Center has been named by the National Research Corp. (NRC) as a 2011/2012 Consumer Choice Award winner. This is the 11th time in 12 years the hospital has earned the award. The award identifies hospitals that health care consumers have chosen as having the highest quality and image in more than 250 markets throughout the United States. Winners are determined by consumer perceptions on multiple quality and image ratings collected in the company’s Healthcare Market Guide Ticker study, S the nation’s largest and most comprehensive study of its kind. Of the 3,200 hospitals named by consumers in the study, the winning facilities rank highest in their metropolitan statistical areas (MSAs), as defined by the U.S. Census Bureau. The Healthcare Market Guide Ticker study surveyed more than 200,000 households representing more than 400,000 consumers in the contiguous 48 states and the District of Columbia. The study has a margin of error of + or – 0.2 percent at a national level. Co-winners are named when scores fall within the statistical margin of error for a given market. l Member of the St. Joseph’s Hospital Health Center Network