The spring 2013 issue of Caring Connection, 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 | Spring 2013 | Vol. 10, No. 1 IN THIS ISSUE: Lifesaving Procedure Is ‘Awesome’ A Higher Level of Care uality at St. Joseph’s wears so many hats that sometimes it’s nearly impossible to tell one from the other. One thing is for sure: However it’s defined, we do our best to measure and improve it daily. To patients, quality may be no more than the expectation of a good meal served warm and on time. To another patient, quality may mean no less than lifesaving surgery. At St. Joseph’s, we also measure quality in scores of clinical ways. You’ve probably all heard of the bacterium called Clostridium difficile or C. diff. It’s an organism that lives in our abdomen on a normal basis and is kept in check by other bacteria. But, if too many antibiotics are administered and kill the “good” bacteria, Kathryn H. Ruscitto C. diff. may multiply and make us very ill. That’s why we closely monitor how many antibiotics patients receive. As a result, C. diff. has been reduced dramatically among our inpatients. Be sure to read the article on page 14 of this issue to learn more about our efforts to reduce the incidence of C. diff. at St. Joseph’s. How seriously do we take quality? St. Joseph’s has appointed Sandra Sulik, MD, a family medicine physician, to oversee clinical quality matters. The hospital’s board of trustees oversees regular quality reports that measure more than 20 quality categories that focus on heart attack, heart failure and pneumonia care as well as surgical care/infection prevention. Quality is a subject in virtually every hospital meeting. We all scrutinize and follow-up on our monthly quality report cards because we know how important quality is to our patients, their families, our employees, and state and federal agencies. On our website (www.sjhsyr.org/quality-report-cards), you will find what quality categories we track as well as a link to the federal government’s Hospital Compare website where you may see how we are doing when compared to other hospitals. When it comes to quality, we invite you to ask us how we’re doing. Sincerely, Q Contents Up-to-Date . . . . . . . . . . . . . . . . . . . . . . . . 3 91-Year-Old Patient Describes TAVR Procedure as ‘Awesome’ . . . . . . . . . . . 6 The Center’s Inpatient Unit Is Renovated With Patients in Mind . . . . 8 Operation Walk Makes a Difference in the Lives of Central New York Residents . . . . . . . . . . . . . . . . . . . . . . . 10 Kathryn H. Ruscitto President It Took a Trio of Surgeons to Help Terry Morrison . . . . . . . . . . . . . . 11 Shadowing Adds Insight That Improves Patient Care . . . . . . . . . . . . . . . . . . . . 12 Antibiotics Save Lives, but They Aren’t Always the Right Treatment . . . . . . . . . . . . . . . . . . . . . . 14 Our Foundation Report . . . . . . . . . . . . . 16 Franciscan Companies Through the Eyes of a Caregiver . . . . . 28 A Life Made Easier . . . . . . . . . . . . . . . . . 29 Sleep Tips for a Lifetime: Help for Women . . . . . . . . . . . . . . . . . 30 Medical Alert for Cellular Customers . . 30 Our Mission We are passionate healers dedicated to honoring the Sacred in our sisters and brothers. Our Core Values Encore, Encore . . . . . . . . . . . . . . . . . . . . 31 Eyes and Ears at Home . . . . . . . . . . . . . 31 Our Vision To be world-renowned for passionate patient care and outstanding clinical outcomes. 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. Front Cover When other treatments were no longer an option, a new lifesaving procedure called transcatheter aortic valve replacement (TAVR) helped 91-year-old Constance Sgroi resume an active lifestyle. 2 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org up to date l l New Trustees Welcomed F our new members have joined St. Joseph’s Hospital Health Center’s board of trustees. They are John Marshall, CPA; Merriette Chance Pollard; Paul Tremont; and Richard Waldman, MD. Marshall is a partner at Testone, Marshall and Discenza, CPAs, where he specializes in business and individual taxation, acquisitions and mergers, as well as financial and estate planning. Pollard currently serves as a consultant, co-chairs the Medgar Evers College Social Work Program Advisory Board, and serves on the Links Incorporated National/International Trends Committee, among other endeavors. Tremont is president of SRC Inc., an independent, not-for-profit research and development company with more than 50 years of experience in defense, environment and intelligence. Dr. Waldman, a physician with Associates for Women’s Medicine, is a diplomat of the American Board of Obstetrics and Gynecology and a fellow of the American College of Obstetrics and Gynecology. A full list of trustees and biographical information is available at www.sjhsyr.org/ board-of-trustees. l Sweet Dreams in St. Joseph’s Newest Sleep Lab St. Joseph’s Hospital Health Center opened its third sleep lab, located on the North Medical campus, 7246 Janus Park Drive, Liverpool, in February. The 16-bed sleep lab features hotel-like amenities and is staffed by certified sleep technicians and registered respiratory therapists. Twentyfive to 35 percent of people suffer from obstructive sleep apnea in which the soft tissue in the back of the throat collapses during sleep and interrupts breathing. The prevalence of sleep apnea continues to increase as the population ages and becomes more overweight. Cutting the ribbon at the sleep lab’s ceremonial opening in March are (from left to right) Sherif El Bayadi, MD; Frank L. Smith Jr., St. Joseph’s vice president for corporate development and president of Franciscan Companies; Stephen Swierczek, RRT, RPSGT, director of respiratory care services; and Kathryn Ruscitto, president and CEO of St. Joseph’s Hospital Health Center. John Marshall, CPA Merriette Chance Pollard Paul Tremont Richard Waldman, MD Pharmacy Residency Program Achieves Accreditation S t. Joseph’s Hospital Health Center’s Pharmacy Residency program has received a six-year accreditation, the maximum allowed, from the American Society of Health-System Pharmacists. Established in July 2011, the residency, a collaboration with St. John Fisher College’s Wegmans School of Pharmacy, is a postgraduate, year-one (PGY-1) residency program for pharmacy school graduates. l Expansion Reaches New Heights The last beam was hoisted onto the new surgical suite at St. Joseph’s Hospital Health Center at a ceremony held at the construction site on Feb. 11. Before being raised, the beam was signed by representatives of St. Joseph’s staff and physicians, Sisters of St. Francis, construction workers as well as others present. The surgical suite is part of the last phase of St. Joseph’s $265 million expansion, which will also include a patient tower with private rooms, including those for medical-surgical and critical care patients. www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 3 up to date l l Community Service Plan Available S t. Joseph’s Hospital Health Center’s 2012 Community Service Plan is available on St. Joseph’s website or at http://issuu.com/ stjosephshealth/docs/sjh_commplan_2012. The plan is prepared as outlined in the New York State Health Care Reform Act of 1996. The information contained in the report is intended to update the community regarding St. Joseph’s performance in fulfilling its mission, gathering community views, meeting the community’s healthcare needs, improving access to healthcare services by those underserved, as well as providing charity care. l Electrophysiology Lab Celebrates 15th Anniversary St. Joseph’s Hospital Health Center celebrated the 15th anniversary of its electrophysiology (EP) lab recently. The lab has grown substantially during that time, due to increased demand for the diagnosis and treatment of cardiac arrhythmias. More than 500 electrophysiology procedures, 250 radiofrequency ablations and 350 implantable cardioverter defibrillators are performed annually. Original EP lab staff members photographed at the anniversary celebration are (from left to right) Annette Sheldon; Ali Al-Mudamgha, MD, director of electrophysiology services; Gina Cusworth, RN; and Paul Hudson, RN. Award-Winning Care St. Joseph’s recently was acknowledged with the following awards and recognitions: American Hospital Association et al (Hospitals & Health Networks magazine) • One of the nation’s Most Wired™ hospitals Healthgrades 2013 • One of America’s 100 Best Hospitals for Coronary Intervention™ • Recipient of Coronary Intervention Excellence Award™ • Five star recipient for valve surgery • One of America’s 100 Best Hospitals for Joint Replacement™ • Recipient of Joint Replacement Excellence Award™ • Ranked among top 5 percent in the nation for joint replacement • Recipient of Vascular Surgery Excellence Award™ • Ranked among top 5 percent in the nation for vascular surgery • Ranked no. 1 in New York state for vascular surgery National Research Corp. • 2012/2013 Consumer Choice Award Press Ganey Associates • Ambulatory surgery program named a 2012 Summit Award winner, one of only eight facilities in the country to receive the award Society of Cardiovascular Patient Care • Accredited Chest Pain Center with PCI • Heart Failure accreditation 4 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org St. Joseph’s Opens New Oncology Unit S t. Joseph’s Hospital Health Center opened a new oncology unit in October. The 16-bed unit consists of eight private and four semi-private rooms. “The unit includes the new medication cabinets and infection control closets that will be included in St. Joseph’s new patient tower when it is built,” says Gael Gilbert, RN, director of maternal-child, behavioral health (inpatient) and oncology services. “In addition, the technology the clinical staff is using is brand new.” The new technology includes a motion tablet nurses are using to record information about patients. Similar to an iPad, the tablets are easier to transport from room to room and smaller in size than the laptops formerly used. The unit also is using a new communication system in lieu of call bells as well as Welch Allyn Spot Vital Signs® LXi monitors, which allow clinical staff to take patient vital signs and have them automatically recorded in the medical record. St. Joseph’s cares for more than 1,000 patients with cancer each year. This new unit is entirely devoted to their care. l The Rev. Severine Yagaza, St. Joseph’s chaplain, blesses one of the new oncology rooms at the hospital. Echocardiography Laboratory Receives Accreditation S In living our mission St. Joseph’s Mission —We are passionate healers dedicated to honoring the Sacred in our sisters and brothers — calls us to care for the body, mind and spirit of our patients. Our new Therapeutic Music Program, featuring a certified music practitioner and harpist, helps provide patients with peace and distraction from their illness. Therapeutic music has been shown to reduce blood pressure, stabilize heart rate and aid in the healing process, resulting in a higher level of care. For more information about St. Joseph’s Therapeutic Music Program, visit www.sjhsyr.org/therapeutic-music-program. t. Joseph’s Hospital Health Center’s echocardiography labor atory was granted a three-year term of accreditation in echocardiography (adult transthoracic) by the Intersocietal Accreditation Commission (IAC). IAC accreditation is a “seal of approval” that patients can rely on as an indication that a facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of echocardiography. Echocardiography provides early detection of life-threatening heart disorders and other diseases. Echocardiograms are noninvasive tests that use sound waves to produce detailed images of the heart’s size, structure and motion. It also can measure blood volume and the speed and direction of blood flow through the heart. l www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 5 A Higher Level of Care C St. Joseph’s Hospital was the first in Central New York to give patients with aortic valve disease, such as 91-year-old Constance Sgroi, hope in the form of the new transcatheter aortic valve replacement (TAVR) procedure. 91-Year-Old Patient Describes TAVR Procedure as ‘Awesome’ to replace the diseased aortic valve in her heart. The process is called TAVR— transcatheter aortic valve replacement— and its reputation for saving lives is spreading. The aortic valve is the gate through which oxygenrich blood is distributed to the brain and the rest of the body to keep us alive. With age, the valve may become clogged and stiffened—a malady called aortic stenosis that gradually restricts the flow of blood to the rest of the body. Often, the aortic valve can be replaced surgically with an artificial valve. This traditional open-heart valve replacement is considered the best path to follow. However, in about a third of these cases, the valve may be so stiffened, clogged and hard to reach because of scar tissue from earlier surgeries that traditional surgery isn’t possible or, at best, is extremely risky. When that stage is reached, according to Dr. Zhou, about half of patients like Sgroi will survive for no more than two years. The symptoms are frightening, according to those who have survived them. “I was very, very tired all the time,” Sgroi remembers. “When I got out of my favorite chair, I could not walk to the next room without sitting down. I felt like I couldn’t breathe. I couldn’t even lie down to sleep at night. I had to sit up in bed. It was a frightening feeling.” As Sgroi’s illness continued unabated, she also became acquainted with Ronald Caputo, MD, an interventional cardiologist. To slow down Sgroi’s deterioration and descent into congestive heart failure, Dr. Caputo performed a pair of valvuloplasties during which he inserted a tube through an opening in the top of her leg and advanced it upward through an artery to the aortic valve in her heart. When it reached the valve, Dr. Caputo inflated a balloon in the tip of the tube that forced the diseased aortic valve open. Unfortunately, her valve closed again within a matter of weeks and another valvuloplasty was required to prevent the symptoms of congestive heart failure from occurring again. “The first time it helped for awhile, but it didn’t last,” Sgroi recalls. “The second one lasted for awhile, too, but eventually the same feeling of weakness and exhaustion returned.” Drs. Caputo and Zhou both felt Sgroi would be a good candidate for the TAVR procedure. She could no longer tolerate traditional open-heart valve replacement surgery because of previous cardiac surgery. Additional valvuloplasties were no longer feasible either. But the process is not that simple. To determine if she might be a candidate, Sgroi would have to undergo a month’s worth of various tests, and the results of those tests would have to be scrutinized by a team of two cardiac surgeons and an interventional cardiologist. This team would determine which of three treatments should be used to help her: Would she gain from the TAVR procedure? Could she still be considered for traditional aortic valve replacement? Was more traditional medical management a choice? onstance Sgroi may be 91, but she has every right to toss around some teenage slang in describing a relatively new cardiac treatment that she credits with saving her life. “I’m telling you, it was awesome!” she says with an animated smile. Without even looking, she wields a couple of crochet hooks as she fashions a warm coverlet for her husband of 66 years, John Sgroi. “What a blessing.” Sgroi is no stranger to St. Joseph’s Hospital Health Center nor its cardiology services. With a memory sharper than those crochet hooks, she recalls the coronary bypass surgery that cleared two of her blocked arteries back in 1993. More recently, she thanks Zhandong Zhou, MD, for implanting the pacemaker two years ago that helps keep her heart in rhythm. At the time, neither she nor Dr. Zhou had any indication that a large team of St. Joseph’s doctors, nurses and technicians would later work against the clock, using a last-hope technique 6 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org St. Joseph’s Cardiac Surgery Team Receives Highest Rating t. Joseph’s Hospital Health Center’s cardiac surgeons earned the highest rating, three out of three stars, in the Society for Thoracic Surgeons (STS) National Database. Established in 1989 as an initiative for quality improvement and patient safety, the STS Database ratings are published annually in Consumer Reports. “Patient safety and quality of care are of utmost importance to our cardiac surgery team,” says G. Randall Green, MD, cardiac surgeon and medical director for the cardiac surgery service line at St. Joseph’s. “We strive to be the best we can be for our patients and we’re proud to earn the highest ranking from this prestigious organization.” The surgeons also have been five-star rated by Healthgrades for valve surgery for the last two years. For more information about St. Joseph’s cardiac surgery program, visit www.sjhsyr.org/cardiac. S The evidence supporting those three outcomes would be gathered during the month of testing. “Mrs. Sgroi had received cardiac care through our group in the distant past,” Dr. Caputo says. “Then earlier this year she came into the hospital with heart failure, and I took care of her. It was apparent that she had severe aortic stenosis and continued trouble with heart failure. Considering her for the TAVR process started there.” The rigorous regimen of pre-TAVR testing (known as the Valve Clinic) is in the hands of Joy Cope, RN, BSN. She is the glue that holds everything together as physicians wait for the evidence to be gathered so they can consult among each other to assess their findings. The month-long, information-gathering ordeal is a very rigorous process. CT scans give the TAVR team a precise snapshot of the structures and organs in the chest and pelvis. A “Organizationally, it’s been an incredible challenge. There are so many moving parts, so much information to gather on each patient. But this is a very patient-centered approach and the collaboration works.” —Joy Cope, RN, BSN carotid Doppler ultrasound shows whether or not there is reduced blood flow to the brain through the carotid arteries that might increase the threat of stroke. The tongue-twisting transesophageal echocardiogram (TEE) gives a higher resolution view of the heart. Those are just a few. By the time the tests are done, the team has a clear “roadmap” from the groin all the way up to the patient’s neck. “Organizationally,” says Cope, “it’s been an incredible challenge. There are so many moving parts, so much information to gather on each patient. But this is a very patient-centered approach and the collaboration works.” One important metric confirmed during the battery of tests on Sgroi was the diameter of the arteries leading through her legs to her aortic valve. Had they been too large—or too small—the procedure wouldn’t have worked, since there are only two valve sizes available in the United States. It was clear, Dr. Zhou and the others said after examining the evidence, that Sgroi stood to gain the most through the TAVR approach. While the interventional cardiologist and the cardiac surgeon are the lead medical providers during TAVR, the cast is far larger than two, says Cope, who is one of the several registered nurses in the operating room. “There is a vascular surgeon, someone from anesthesiology, a perfusionist who operates the heart/ lung bypass machine in emergencies, registered nurses from the cardiac catheterization (cath) lab and operating room (OR), surgical technologists from the OR and cath lab, a monitoring team and a radiation technologist to run the X-ray machine.” The initial opening into the femoral artery was made by Dr. Zhou, providing a clear opening for Dr. Caputo to insert the catheter carrying the new aortic valve. He eased it smoothly upward toward the iliac artery and then into the aorta, arriving on the doorstep of the diseased artery that was causing Sgroi so much suffering. The catheter’s steady progress had been charted all along by X-ray. The valve itself had been compressed into a package at the end of the catheter about the diameter of a pencil. Dr. Caputo carefully inflated the new valve with sterile water forcing the walls of the new valve against the walls of the aorta. Then, Dr. Caputo deflated the catheter and withdrew it from the opening in Sgroi’s thigh. Like many cardiac surgeons, Dr. Zhou had implanted traditional artificial valves before during open-heart surgery, but he had always stitched them to the aorta’s wall. These new valves are held in place by nothing more than pressure. “Leaking isn’t a problem with these valves,” he recalls. “It’s a pressure fit with no sutures at all. It’s impressive.” Once the TAVR team began operating on Sgroi, the process took about 90 minutes. Typically, it can be accomplished from start to finish in less than an hour. Sgroi isn’t all that interested in the procedure’s details; however, it’s the results that she cares about. Sgroi continues to improve, and she is eager for spring weather. In the meantime, her strength is improving and she no longer is left breathless as she walks around the house. “I still have a lot to live for, and my son and daughter were all for this, too,” she says as she looks up from crocheting. “In comparison to my open-heart surgery in 1993, this was a breeze! And what a staff! You couldn’t ask for any more attentive and compassionate nurses, both men and women.” l Editor’s Note: A detailed article about the TAVR procedure appeared in the Summer 2012 (vol. 9, no. 2) issue of Caring Connection. If you would like a copy, call Community Relations at 315-703-2140, email community.relations@ sjhysyr.org, or visit www.sjhsyr.org/publications. www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 7 A Higher Level of Care P The Center’s Inpatient Unit Is Renovated With Patients in Mind atients undergoing total hip or knee surgery may spend two or three days on St. Joseph’s Hospital Health Center’s fourth floor, the inpatient unit of The Center for Orthopedic + Spine Care. If former patients were to return to the fourth floor now, they would be astounded by the changes that have occurred over the last year and a half. The number of beds delegated for orthopedics and spinal surgery has blossomed from 36 to 81 beds, for example. Family lounges have been enlarged, so relatives conveniently may visit patients and patients may leave their room and walk to the lounges, which is usually just the exercise the doctor orders. These new lounges are stocked with food and drinks, as well. The ways in which patients are cared for have changed, too. “At this point,” says Jennifer Johnstone, RN, director of orthopedic/spine services, “the hospital has a separate area in which all patients slated for surgery are ‘prepped,’ regardless of what the surgery is. “In the very near future our patients will be prepped in their own room by the fourth floor staff, taken to the operating room by our people, brought back to the fourth floor by the same staff after the surgery is finished, and admitted to their original bed. This serves as the foundation to relationship-based care. It builds and strengthens the relationship among patients, relatives and staff members.” The addition of single patient rooms also has encouraged relatives to spend the night with their loved ones. Single rooms are more comfortable for the patient and appear to further lower already low infection rates. The hospital also has increased the number of staff members on the fourth floor and expanded its own orientation and training. Talking about The Center’s new fourth floor could go on and on for pages. Suffice it to say, that friends and former guests will be astounded by what they see now. … Sinks in hallways make it convenient for staff to wash their hands before entering and when exiting patient rooms. Handwashing is the primary way to prevent infection. Above: Melinda Barry, RN (left), Alexa Bellucci, LPN (center), and Anna Reinsmith, unit secretary, take a breather at one of the central stations that serves as a resource for patients, visitors and staff members. Opposite page: Jamie Walts RN, clinical coordinator (right), teaches a patient the ins and outs of using an incentive spirometer to improve breathing after surgery. Single patient rooms on the fourth floor are larger, with roomier restrooms and wider doors granting easier access for beds, walkers and other equipment. Single patient rooms also afford patients privacy, reduce infection rates and encourage family members to stay with their loved ones. 8 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org Alexa Bellucci, LPN, uses a computer and her ID card to dispense medications from locked cabinets conveniently built into the unit’s walls. Emily Maston, PT, brews a cup of coffee for one of her patients in the newly renovated family lounge on the fourth floor near the physical therapy center. Placing the physical therapy center on the same floor as the total joint replacement patients reduces a great deal of shuffling back and forth among patients and staff. Above: Bhumika Patel, RN, has all the privacy and quiet she needs when adding information to her patient’s electronic chart. Nurses have their own pods with information management technology that accesses electronic records systems. Doctors also have separate, private pods to chart their patients. Left: Amy Szczesniak, RN, CNS, and Jamie Walts, RN, model T-shirts that mark the day when St. Joseph’s orthopedics floor switched to completely electronic order entry. The “Taking care of patients one click at a time” shirts had a purpose. If a doctor had a question about the electronic records system, any nurse wearing the shirt could assist them. www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 9 A Higher Level of Care O Operation Walk Makes a Difference in the Lives of Central New York Residents rthopedic surgeons, nurses and the other hospital staff who work with them side by side seldom perform routine surgery on weekends. Their regular work days, after all, may be 12-hours long and are often tense as they repair broken bones, replace joints and fuse vertebrae. But one Saturday a year, you can’t keep them away from St. Joseph’s operating rooms. It’s time for Operation Walk! Operation Walk is the day they bring long-term comfort to a few Central New York residents, who, often for years, have suffered from joint ailments that may have been debilitating. Operation Walk Syracuse was founded by St. Joseph’s orthopedic surgeons, Brett Greenky, MD, and Seth Greenky, MD. The organization and St. Joseph’s have partnered to provide free orthopedic surgery to qualifying Central New York residents who otherwise would have been unable to afford the procedures. During last December’s Operation Walk, three women received total knee replacements and one man received a hip replacement. Each is well on the path to recovery and the cessation of pain. Although all the surgeries happened on a single day, finding qualified candidates can be almost a year-long event, says Kim Murray, RN, MS, CNOR, St. Joseph’s service line administrator for orthopedic and spine services. “Throughout the year, we are in contact with different clinics and primary care providers who notify us about patients who might fall into a category that makes them eligible for Operation Walk,” Murray says. “In fact, we have one person on the team whose sole focus is working with the clinics and providers to screen possible patients.” The first step is to establish medical necessity. If a candidate does qualify for medical reasons, they then are screened from a financial standpoint. If a person is young or poor, they are frequently eligible for joint replacement surgery under the Medicaid program. A “senior citizen” covered by Medicare may also be covered. Those employed with a company that provides health insurance are usually covered, and some can pay for the surgery themselves. “That,” says Murray, “really filters out a lot of people. We are seeking to serve the working poor— those who may have a job but make too much to qualify for Medicaid and who aren’t covered by other insurance.” The search for next year’s Operation Walk candidates is already underway. l Operation Walk Syracuse co-founder Seth Greenky, MD, (seated) and Kim Murray, RN, screen a candidate for joint replacement surgery. 10 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org When faced with the daunting diagnosis of a rare form of kidney cancer, Terry Morrison turned to three St. Joseph’s surgeons, each from a different specialty, who collaborated to help ensure his surgery was a success. T It Took a Trio of Surgeons to Help Terry Morrison “It’s not uncommon to see the tumor extending from the kidney into the lower part of the vena cava,” Dr. Carlin says, “but it is uncommon to find a tumor encompassing the entire vein up to and including the chest.” As the heart surgeon on the team, Dr. Green would open up Morrison’s chest to remove the small portion of the tumor that was entering the heart’s right atrium. Dr. Green and a perfusionist would also place Morrison on the coronary bypass machine that allows the heart to be stopped during surgeries like these. The device also oxygenates the blood and detours it around the area in which the other two surgeons were working. All three surgeons worked at the same time, along with nurses, physician assistants, a perfusionist and an anesthesiologist. It was a complex scene, but one that had been worked out in advance over a two-week span before the day of surgery. “This was a back and forth process among the entire team,” Dr. Carlin says. “We each looked at scans and threw around ideas with each other in the two weeks leading up to the surgery. Did we think of this? Would this work? The stakes were high.” The collaborative effort did work, Dr. Salzhauer says, based on Terry Morrison’s recovery from his surgery last fall. “This was truly a collaborative effect,” Dr. Salzhauer says. “Not one individual in that room could take care of everything for Mr. Morrison. It comes down to everyone who is an expert in his own field coming together, checking their ego at the door, and working with each other as part of team.” Morrison describes it another way: “There aren’t enough adjectives in the English language to say how good these people are.” l erry Morrison needed a “threelegged stool,” and he needed one quickly. Fortunately, Elan Salzhauer, MD, knew just where to find one. Morrison had been referred to Dr. Salzhauer, a urologist at St. Joseph’s Hospital Health Center, by Richard Kronhaus, MD, Morrison’s regular urologist. It was Dr. Kronhaus who initially had diagnosed Morrison’s rare form of kidney cancer that could only be treated surgically—neither chemotherapy nor radiotherapy would help. Dr. Salzhauer, who has hundreds of kidney cancer surgeries to his credit, also knew he couldn’t perform the procedure by himself. “Of the 60,000 kidney cancers that occur nationwide each year, most of them are localized,” Dr. Salzhauer says. “I can remove part of the kidney and sew up the rest, so the patient still has the use of both. But this one was different. “Mr. Morrison’s tumor had engulfed most of his right kidney then spread to the small renal vein connecting with the inferior vena cava, the largest vein in the body. The cancer spread upward through the vena cava before making a turn toward the heart’s right atrium.” It is what Dr. Salzhauer and his colleagues call a tumor thrombus—a solid tumor that runs from the right kidney up to the heart’s entrance. Because it coated the walls of the vena cava and reduced the flow of blood returning to the heart to pick up vital oxygen, it had begun to affect Morrison’s ability to breathe. Morrison, a 72-year-old former telephone company “splicing manager,” is used to line dancing, golf and regular workouts. He said he never knew he had a problem, other than being “a little tired.” He credited Dr. Kronhaus with identifying the problem during a regular visit. “Without him, I don’t think I’d be talking to you today,” Morrison says. “He sent me to Dr. Salzhauer.” The tumor’s spread accelerated the need to take action. Dr. Salzhauer, however, realized he was but one leg of that three- legged stool. Because of their experience in their particular specialties, he contacted Robert Carlin, MD, a vascular surgeon, and G. Randall Green, MD, a cardiac surgeon. None of the three surgeons could take care of everything. It required experts in several fields coming together to concentrate on a bundle of unique problems. Dr. Salzhauer said it reminded him of some of the country’s largest hospital centers like Memorial Sloan-Kettering Cancer Center in New York City, or perhaps M.D. Anderson Cancer Center in Houston, Texas. In fact, Dr. Salzhauer had offered Morrison the option of a second opinion. “He asked if we could do it here at St. Joseph’s and I said ‘yes,’” Dr. Salzhauer recalls. “Given a choice, many of our patients just want to stay in the community with their family and their own support systems and get whatever needs to be done, done here.” “These doctors put my mind at rest,” Morrison says. “They said it would be complicated, but doable. It took me about 10 seconds to make up my mind.” Once Terry Morrison had made his decision, Dr. Salzhauer went to work gathering the team that would perform the surgery. Most of the contacts, Dr. Salzhauer says, were made by cellphone. “Because we have such good personal relationships among St. Joseph’s surgeons, it was a lot easier to schedule Mr. Morrison to have major, life-changing surgery with three surgeons from three separate disciplines than it was to get my snow tires changed,” recalls Dr. Salzhauer. He characterized each segment of the surgery as difficult. Most of the kidney tumors that urologists face are about an inch long. This one was much larger than that. It measured five or six inches and required the complete removal of the right kidney and the renal vein attached to it. The tumor in the vena cava that Dr. Carlin would be removing was about 10 inches long and attached to the vein’s interior walls. To make it more difficult, Dr. Carlin points out, three inches of it were hidden by the liver making it necessary to remove it by feel. l www.sjhsyr.org spring 2013 l St. Joseph’s hospital Health Center l caring Connection 11 A Higher Level of Care Shadowing Adds Insight That Improves Patient Care hen Irene Stackel was recovering last June from a total knee replacement at St. Joseph’s Hospital Health Center, she had many “visitors,” but those visitors were so quiet they all but disappeared into the walls. Stackel, who lives a few miles east of Watertown, NY, had agreed to be “shadowed” by a team of nurses from the time she underwent preadmission testing a couple of weeks before her surgery until she waved goodbye to the young transporter who helped her into her car on the way home three days after her surgery. The “visitors” were primarily nurses who spent two-hour shifts recording every “event” that happened to and around Stackel during her waking hours. 12:50, 5/11/12—Preadmission Testing: Sign in, photocopy ID, introduction from the receptionist, sorting out paperwork, patient identification. … While I.S. (Irene Stackel) and the receptionist were doing paperwork, another patient and her family entered from the waiting room. It was distracting to hear that interview/paperwork process so close to where I.S. was doing hers. W The patient-/family-focused approach to hospital care is the brainchild of Anthony M. DiGioia III, MD, an orthopedic surgeon at the Magee-Womens Hospital at the University of Pittsburgh Medical Center. Dr. DiGioia visited St. Joseph’s recently, and a group of nurses from St. Joseph’s musculoskeletal service spent a full day of observation at a nationally renowned joint replacement center in Pennsylvania to learn how PFCC is applied in a musculoskeletal setting and how it can be effective throughout a healthcare system. Such shadowing helps indicate where improvements are needed. 06:30, 5/29/12—Day of Surgery: Heath arrived to transport I.S. to the OR line room. Explained to daughter what was going to happen: Going into OR at 7:30 a.m. Surgery should be about an hour. Dr. Parker will call her when the surgery is over and explain how it went. Heath said goodbye to I.S. and how nice it was to meet her. Told her that she was in good hands with Dr. Parker. “The PFCC concept revolves around seeing and delivering care through the eyes of the patient and the family,” says Amy M.G. Szczesniak, RN, CNS. “To do that, you have to watch a patient and record the kind of care—from one healthcare professional to another— she is receiving.” After learning from the Pittsburgh experience, Szczesniak taught several nurses and student nurses the correct way to gather information that records the way patients and families actually experience their care at these important “touch points.” How many “touch points” are there? No one knows for sure, but there are scores of them. Szczesniak runs off half a dozen of them on her fingers in five seconds—phlebotomists drawing blood; physicians making rounds; residents and nurses checking on patients; staff members bringing in and removing food trays; housekeeping crews keeping everything clean. … Between the time Irene Stackel entered the hospital and left four days later, the shadowers had generated enough tersely written material to fill 17 single-spaced pages. The process will continue. “Through shadowing Irene and reviewing her story, we’ve formed four work groups to drive change in the musculoskeletal service line,” Szczesniak says. “They include preadmission testing, discharge from the hospital, physical therapy and nurse communication. The changes we’ll make will not only affect the musculoskeletal service line, but the entire hospital as a whole.” Seth Greenky, MD, section chair for orthopedics at St. Joseph’s and one of the “champions” of the PFCC effort hails the program’s potential. “Through shadowing Irene and reviewing her story, we’ve formed four work groups to drive change in the musculoskeletal service line.They include preadmission testing, discharge from the hospital, physical therapy and nurse communication.” —Amy M.G. Szczesniak, RN, CNS This shadowing is one element of a new effort to begin looking at hospital care through the eyes of the patient and family rather than from the hospital staff’s point of view. As with anything involved with health care, it has its own abbreviation—PFCC, an acronym for Patient- and Family-Centered Care. “My care overall was excellent,” Stackel says six months after her surgery, “and the shadowing was too. I had someone to share with, whereas normally no one knows what goes on between a patient, the nurses and other staff people. This way, you get a chance to share the positives and the not-so-positives with a non-partisan third party.” The non-partisan observers keep a minute-byminute chart of “touch points”—any interaction during the day between a patient or family member and any member of the hospital staff. In essence, the shadowers become the impartial eyes and ears of the patient and family. 12 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org Information gathered during the “shadowing” of Irene Stackel (left), who had total knee replacement surgery at St. Joseph’s, will assist Amy Szczesniak, RN, CNS, (right) and four work groups in enhancing the patient care experience. The groups are driving change that will deliver care through the eyes of the patient and family rather than from the hospital staff’s point of view. “PFCC basically flip-flops the way things have usually been done up through now,” he says. “In the past, healthcare providers—nurses, doctors, physical therapists, pharmacists, all of us—have set the standard for what we have perceived as being best for patients. PFCC changes the system to be a lot more patient and family oriented. “Sometimes, changes toward a more patientfriendly atmosphere have come from doctors or nurses who have found themselves in the hospital. There is, we say, no better way for a nurse or doctor to understand what’s best for patients than to be one themselves—or at least listen to what people like Mrs. Stackel and their families are saying.” 10:35, 6/25/12— Follow-up Phone Call: Irene reports that she is doing well. She has outpatient therapy twice a week and her family is taking good care of her. She can bend her knee all the way back, but she still experiences some stiffness which she understands is “to be expected.” She appreciates St. Joe’s and the shadowing program. She thinks that this “captures what happens in the room between the nurse and the patient. …” She was pleased with her hospital stay, and thinks very highly of this shadowing program. l www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 13 A Higher Level of Care Clostridium difficile Antibiotics Save Lives, but They Aren’t Always the Right Treatment t St. Joseph’s Hospital Health Center, a group of health care professionals has begun a program to address the problems caused by the overuse and misuse of antibiotics. The Antibiotic Stewardship Program (ASP) was established a year and a half ago partly in response to statistics provided by the Centers of Disease Control and Prevention (CDC). According to the CDC, 14,000 deaths annually in the United States alone are linked to Clostridium difficile, also known as C. diff., which can infect patients receiving antibiotics. The ASP’s goal is to reduce healthcare-associated infections through decreased use of antibiotics as well as promoting the appropriate use of these powerful medicines. “Antibiotics are, of course, lifesaving drugs, but we should be careful to use them only when they are really indicated,” says Helen Jacoby, MD, an infectious disease specialist who leads the ASP with Lisa Avery, PharmD, a pharmacy professor at St. John Fisher College Wegmans School of Pharmacy, and Bernie Delello, RPh, St. Joseph’s pharmacy director. “Antibiotics can have risks,” says Dr. Jacoby. “Those risks and benefits need to be balanced, so that we will continue to get the benefits of antibiotics over the long term.” A The pharmacists and physicians who comprise the ASP are targeting their study on fluoroquinolones, broad-spectrum antibiotics that kill a wide range of bacteria. Recognizable medicines such as Cipro, Levaquin and Avelox fit into this category. “These drugs seem to be associated with more people getting C. diff. than a lot of other antibiotics, but it’s not like it can’t happen with other antibiotics,” Dr. Jacoby says. “The risk may be much less for penicillin, but even that’s not zero risk.” Dr. Jacoby says that studies done at other institutions indicate that up to 50 percent of antibiotic use is unnecessary. “We know that antibiotics contribute to C. diff. We know they contribute to bacteria getting more and more resistant,” she adds. “Another problem we, and all hospitals, have is very resistant bacteria developing, especially in patients who’ve been in the hospital for a very long time. The fewer antibiotics you use, the less likely that is to happen.” The risk of getting C. diff. is elevated in a hospital or nursing home setting due to the high rate of exposure to germs. Patients who are already on an antibiotic and are exposed to C. diff. bacteria or C. diff. spores are also more likely to contract the infection. The elderly or 14 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org people who have just had bowel surgery may be at high risk, too. There’s also an increased risk in the spring. ASP members regularly analyze sundry reports to determine percentage variations of antibiotic use among inpatients, and to record any increase or decrease in secondary infections. A full-time pharmacist follows patients taking fluoroquinolones to confirm appropriate use. “If it looks like a patient could be switched to another drug or maybe an antibiotic isn’t needed, we contact the person’s doctor and make suggestions,” Dr. Jacoby says. “The patient’s doctor always has the final word, however, no matter what. We never make anybody change, but we do reach out and make suggestions.” Dr. Jacoby notes that both physicians and care providers have been very receptive to recommendations, and reports support the progress made so far. During the program’s six-month trial, the group intentionally tried to decrease the number of patients prescribed Cipro. The baseline gradually decreased. “Cipro use really came down,” says Dr. Jacoby. “Total antibiotic use tends to be seasonal. For example, in winter 2011-2012, it was up, but this past summer compared to summer 2011, total antibiotic use was down. And if you look at our C. diff. rates, there is a great impact.” St. Joseph’s has made other improvements to reduce C. diff. infection: “It’s not just antibiotic stewardship. We’ve also been really careful about bleach cleaning rooms to kill off C. diff. spores. We’ve made big strides in getting everybody to clean their hands regularly. All these things add up to reduce the incidence of infections like C. diff.,” says Dr. Jacoby. When it was first invented, Cipro worked for 100 percent of E. coli bladder infections. Now, in the hospital, it works for only 70 percent. “That’s due to a lot of Cipro being used for whatever reasons,” says Dr. Jacoby. “Even if you’re taking it for another problem, the nonresistant bacteria in your body get killed off, so any resistant E. coli start growing. Gradually, these resistant bacteria start to replace the sensitive ones, both in the hospital and in the community at large.” Every quarter, ASP educates St. Joseph’s medical staff on the best ways to use antibiotics through a program developed primarily by Dr. Avery. The same presentation, featuring current research, is given to residents, hospitalists, nurse practitioners and physician assistants. “St. Joseph’s is working really hard on using antibiotics in a smart way,” Dr. Jacoby says. “We’re doing this to prevent some of these secondary infections. Antibiotics have good and bad sides to them. They are not always the right thing. They definitely save lives, but we have to use them in an intelligent way.” If seeking medical attention outside a hospital environment, Dr. Jacoby recommends asking your doctor what is the best treatment for your condition. “For viral illnesses, standard antibiotics don’t do anything because they don’t kill viruses,” Dr. Jacoby says, noting sinusitis and bronchitis as two common Robot Helps in War on Germs T he Jetsons had Rosie the robot to assist with household chores and cleaning. St. Joseph’s also employs robots, and they successfully kill germs in patients’ rooms using ultraviolet light. St. Joseph’s is the first hospital in Central New York to use the robot, which is manufactured by Xenex Healthcare Services. About 100 hospitals nationwide use the device. The robot eradicates all types of viruses, bacterial spores and bacteria, including Clostridium difficile (C. diff.). C. diff. is a highly contagious bacterium that can make patients who are weakened by illness extremely ill. Sometimes, C. diff. kills them. In fact, in the United States, infections acquired while hospitalized are the fourth leading cause of death—behind heart disease, stroke and cancer. After trying out the robot last summer, St. Joseph’s saw its rate of C. diff. infections drop by 50 percent. “The robot has surpassed our expectations,” says Dorothy Haag, director of quality. Right now, St. Joseph’s has two robots. They primarily are used to clean isolation rooms, the operating rooms, acute kidney unit, and other high-risk areas and equipment. St. Joseph’s uses the Xenex robot, which blasts powerful flashes of ultraviolet light to eliminate viruses, bacteria and bacterial spores that are a danger to patients. Patient rooms and bathrooms initially are cleaned by the housekeeping staff and then the robot is used for an additional 10 minutes to disinfect all surfaces and the air. infections that are primarily caused by viruses. Patients oftentimes tell their doctors that they need an antibiotic. “I think a more appropriate question for the doctor is, ‘Is this something that should be treated with an antibiotic?’ If it’s not, there are still other things you can do to make yourself more comfortable in terms of decongestants, pain medications and rest.” That’s the discussion patients should have with their own doctor. Dr. Jacoby and the ASP are working to keep patients infection-free while in the hospital. l www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 15 A Higher Level of Care Our Foundation Report Dear Friend of St. Joseph’s, n line with health care in our nation, hospitals are changing the fundamental trajectory of medicine to include more efficient management of patient populations and increasing access to primary care. In 2013, St. Joseph’s Hospital Health Center and its Foundation will be transforming in ways that take both patient care and the development efforts that support it to the next level. For example, as the facility infrastructure continues to evolve to better meet community healthcare needs, the hospital will also be moving to the award-winning EpicCare Electronic Health Record— a fully integrated system that will improve patient safety, operational Kathryn H. Ruscitto efficiency and overall quality of services. Simultaneously, St. Joseph’s Foundation will be making changes of its own. After 11 years as vice president for marketing, communications and development, Margaret Martin is moving to a new and exciting chapter in her life. Margaret’s contributions to St. Joseph’s were many, and we wish her well in this next stage of life. Accepting the Foundation’s leadership position is Douglas G. Smith, FAHP. Sharing his vast development experience with us since Feb. 1, 2013, Doug is a senior-level fundraising executive with more than three decades of experience in positions of leadership, both in health care and higher education. At this time, I am pleased to introduce him as St. Joseph’s new vice president for development. A native of Northern New Jersey, Doug served as vice president of development and foundation president at Greater Baltimore Medical Center in Towson, Md. He held similar positions at Douglas G. Smith Pittsburgh Mercy Health System (Pittsburgh, Pa.) and Vail Valley Medical Center (Vail, Colo.). An active member of the Association for Healthcare Philanthropy for more than 25 years, Doug holds the association’s highest level of achievement—Fellow (FAHP)—in the field of health care resource development. St. Joseph’s is pleased to have him on board. We are equally excited by Doug’s extensive experience and recognize that it will play a key part in creating new development opportunities and strengthening donor relations as the hospital continues its mission of serving our Central New York community, including many who are among the underserved. I 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 Heath Center Foundation has to fit your giving interests and capabilities, please call Douglas Smith, vice president, at 315-703-2137; email Douglas. Smith@sjhsyr.org; or visit the Foundation’s website at www.sjhsyr.org/foundation. Gifts at any level are appreciated. Kathryn H. Ruscitto President 16 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org Alfred Falcone, MD: Many Stories in an Abundant Life lfred Falcone, MD, admits to having what he calls “many stories in an abundant life” and most of them, in one way or another, are firmly intertwined with St. Joseph’s Hospital Health Center. Even as a 13-year-old boy, he remembers walking daily alongside St. Joseph’s as he delivered the Herald Journal to his 40 customers. He admits to crossing himself and uttering a quiet prayer for those in the hospital each time he passed. Young Alfred’s father operated a fruit store on lower James Street three blocks from St. Joseph’s where he spoke Italian with J. Ernest Delmonico, MD. Dr. Delmonico was chief of surgery at St. Joseph’s in those days, and he made frequent fruit “rounds” at the store, starting with a banana, grapes, and then a peach or pear. “I wanted to be just like him,” Dr. Falcone admits. “He was my idol.” Although he didn’t know it then, Dr. Falcone would follow in the footsteps of his Alfred Falcone, MD, and his wife, Francoise, recently made a contribution to St. Joseph’s capital campaign. idol as a surgeon on St. Joseph’s medical Their gift will name a family consultation room in the new surgical suite. staff for exactly 40 years, beginning July 1, 1957 until July 1, 1997. When St. Joseph’s new surgical suite is opened this year, Dr. Falcone’s name will grace a private section “I was thrilled,” Dr. Falcone says. “Here was my idol and I was of the new surgical waiting room for going to work with him! I’d never been in an operating room before, families. His gift, he says, is the least he could do for an institution but I knew what the routine was—you scrubbed for 10 minutes all that had done so much for him—the least of which was supplying the way up to your elbows.” the fodder for 40 years of stories (some hilarious, some poignant Preparing for the surgery, Dr. Falcone grabbed a cloth gown and and moving). was immediately addressed by a nun. It was her duty to dispense Interestingly, he began as a dentist. the surgical gowns, so they wouldn’t be contaminated. After attending Syracuse University, Dr. Falcone was looking “I was saved when Dr. Delmonico gave her a long, stern look. forward to medical school, but the demand for dentists was higher He was happy to have me. The operation was a simple one and all I during World War II, so he earned his dental degree in three years at did was hold the retractors, but it was a thrill because I was able to the top of his class at the University of Buffalo. As it turned out, the work with my boyhood hero.” top three dental school graduates were granted the opportunity of Dr. Falcone went on to earn his medical degree and spent his attending medical school. Dr. Falcone snapped up the offer. To gain internship in Florida before returning to St. Joseph’s. In the early more experience he’d take the train back to Syracuse on Fridays 1950s, Dr. Falcone joined the U.S. Air Force reserve. (The Army, he and Saturdays to work at the hospital as an “extern” appointed says, was too rigorous, and the Navy was out because he couldn’t by St. Joseph’s Sister Wilhelmina Fitzgerald. swim.) He was deferred from active duty for at least 18 months “Sister Wilhelmina assigned me to do some minor laboratory during which time he became a surgical resident at St. Joseph’s for work over the weekend—blood counts, urine exams and patient $45 a week. That’s when Sister Wilhelmina stepped in again. health histories,” Dr. Falcone recalls. “She also gave me a white “She knew what my salary was,” Dr. Falcone says, “and she jacket and a stethoscope! Then, I would go back to Buffalo on offered me $15 a week more if I’d become the hospital librarian. It Sunday afternoons.” was very generous of her, I thought. Dr. Falcone recalls the Friday night he got to work with his idol. “When I saw her in the hallway about a month later, I Dr. Delmonico was called to perform an emergency appendectomy, mentioned that I hadn’t seen the library yet. Sister Wilhelmina and the interns who outranked Dr. Falcone were playing a hot game admitted that the hospital didn’t have a library, and all I really had to of poker. They looked at the newcomer and suggested that he go in do was to straighten out the magazines in the doctors’ lounge.” their place. continued on next page A www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 17 A Higher Level of Care continued from page 17 Dr. Falcone learned a lot as a surgical resident at St. Joseph’s. He spent his mornings assisting in surgeries, visited patients until about 2 p.m. and then usually took a lunch break. “One lunch break changed my life,” Dr. Falcone says with a gifted story-teller’s gait. “I was having a sandwich and this guy in military uniform sat down opposite me. I almost told him the table was reserved for hospital staff. He said he worked in Washington as director of medical procurement for the Air Force. I almost jumped out of my skin. I then learned I was being stationed in France. “I thanked him later for doing that because I met my wife-to-be in England while on temporary duty. She was French and worked as a nanny. When I came home we continued a correspondence courtship. We were married in Paris on April 18, 1956—the same day as Grace Kelly and Monaco’s Prince Rainier.” When Dr. Falcone joined the St. Joseph’s staff in 1957 he came aboard as a plastic surgeon healing cleft lips and palates, as well as head and neck injuries. The practice grew, and then branched out one afternoon when Dr. Falcone stumbled over a newsletter in the hospital. On the front page was a teenage girl with an open cleft lip. The first question Dr. Falcone asked himself was why the girl had not been treated. “Why had she been missed? In this country, her lip should have been repaired when she was three months old,” he recalls. The newsletter turned out to be from a U.S.-based agency seeking plastic surgeons willing to work at no charge far up the Amazon River. Not knowing what he was getting into, he recruited a pair of volunteer St. Joseph’s nurses and an anesthesiologist. The hospital provided most of the surgical equipment he would need. “We worked for almost a month and the patients kept coming and coming and coming,” Dr. Falcone remembers. “Still, St. Joseph’s offered everything we needed.” Dr. Falcone eventually made six journeys to the Amazon helping scores of young patients. “St. Joseph’s kept donating surgical equipment. How can I not be thankful to St. Joseph’s for all they have given us, and for all they have given the community?” In the process, he and his wife adopted two Brazilian infants who joined two more adoptees from the United States as well as four biological children—a total of eight. One of them, Philip Falcone, MD, is a plastic surgeon at St. Joseph’s. There seems no end to Dr. Falcone’s stories. Just ask him about St. Millie’s, a dance emporium outside of London. That’s where he met his wife, Francoise. … l Music to Our Ears ecently donated to St. Joseph’s by Associates for Women’s Medicine, a new Yamaha hybrid piano is on display in the main hospital lobby. A favorite during the holidays, James Brown Jr., MD, was seen tickling the ivories as he played a variety of musical selections near the visitor registration desk. Music holds the power to affect people in profound ways. A single song can tell a thousand different stories that are born from the experiences of the listener. For many, music offers a sense of peace and promotes relaxation during a stressful time. Each melody played will help transform both the environment and the individual experience while also complementing our holistic approach to health care. R St. Joseph’s Honors Supporters t. Joseph’s Hospital Health Center Foundation paid tribute to supporters at the 23rd annual St. Joseph’s Day Appreciation Breakfast held at The Genesee Grand Hotel, Syracuse, in March. The breakfast is held annually to recognize major supporters and advocates of St. Joseph’s. St. Joseph the Worker Awards were presented to Housing Visions, A. John Merola, MD, and Pulmonary Health Physicians, PC. Kathryn Ruscitto, president and chief executive officer of St. Joseph’s, is photographed at the event with (from left to right) Thomas Aiello, DO, medical director of Pulmonary Health Physicians, PC; Kenyon Craig, executive director, Housing Visions; and A. John Merola, MD. S 18 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org Connecting the Community to Health Care T he pedestrian bridge connecting St. Joseph’s Medical Office Center to the main hospital was formally named in honor of A. John Merola, MD, on Nov. 26, 2012. A family medicine physician who founded North Medical, PC, as well as developed North Medical and Northeast Medical centers, Dr. Merola has a 50-year legacy with the St. Joseph’s family. In support of the hospital, Dr. Merola gave a $1 million gift. A profile of Dr. Merola appeared in a previous issue of the Caring Connection (Spring 2012; vol. 9, no. 1). It is available at www.sjhsyr.org/publications. St. Joseph’s Hospital Health Center Foundation Cherry Blossom Gala Black tie optional. l Giving strength to hope. Please join us Friday, May 31st, 2013 for an evening of dinner and dancing to the live music of Atlas. Presenting sponsor: CNY Infusion Services, LLC F o r i n F o r m at i o n a b o u t t i c k e t s , a d v e r t i s i n g o p p o r t u n i t i e s a n d s p o n s o r s h i p s , c a l l 3 1 5 - 7 0 3 - 2 1 2 8 o r e m a i l Pa m e l a . K e n n e d y @ s j h s y r . o r g . www.sjhsyr.org spring 2013 l St. Joseph’s hospital Health Center l caring Connection 19 A Higher Level of Care College Corner College of Nursing Granted Accreditation by Middle States Commission on Higher Education t. Joseph’s College of Nursing at St. Joseph’s Hospital Health Center has been granted accreditation by the Middle States Commission on Higher Education, 3624 Market St., Philadelphia, Pa. 19104. The Commission is recognized by the U.S. Secretary of Education as an accreditor of degree-granting colleges and universities in the Middle States region, which includes Delaware, the District of Marianne Columbia, Maryland, New Jersey, New York, Markowitz, MS, RN Dean, St. Joseph’s Pennsylvania, Puerto Rico, the U.S. Virgin College of Nursing Islands and several locations internationally. The Commission is a voluntary, non-governmental, membership association that defines, maintains and promotes educational excellence across institutions with diverse missions, student populations and resources. It examines each institution as a whole, rather than specific programs within institutions. Accreditation by Middle States is evidence of the quality and excellence of the nursing education program offered at St. Joseph’s College of Nursing. St. Joseph’s College of Nursing also is accredited by the National League for Nursing Accrediting Commission (NLNAC). NLNAC is responsible for the specialized accreditation of nursing education programs (clinical doctorate, master’s, baccalaureate, associate, diploma and practical programs). NLNAC is nationally recognized as a specialized accrediting agency for both postsecondary and higher degree programs in nursing education. S May 2012 Graduates Achieve 98.1 Percent Pass Rate on NCLEX S t. Joseph’s College of Nursing held its 112th annual graduation ceremony on May 23, 2012, at the John H. Mulroy Civic Center in Syracuse. The associate degree in applied science with a major in nursing was conferred on 114 students. Sixty-eight had completed the school’s Weekday Option and 46 had completed the Weekend Option. May 2012 graduates achieved a 98.1 percent pass rate on the NCLEX-RN (National Council Licensure Examination for Registered Nurses). This pass rate far exceeds the state mean of 87.59 percent and the national mean of 90.88 percent. $300,000 Grant Will Replicate DDPN Program Across New York State A Has Your Life Been Touched by a Nurse? he quality of nursing at St. Joseph’s has been recognized as among the best in the nation. You can help ensure that it stays that way by contributing to the nursing programs and infrastructure needs at St. Joseph’s College of Nursing. For more information, contact Connie Semel, BS, RN ’74, director of development, St. Joseph’s College of Nursing. Email Connie.Semel@ sjhsyr.org or call 315-448-5303. Gifts may also be made online at www.sjhcon.org/giving-options. If you prefer to use the giving envelope enclosed in this issue of Caring Connection, simply write College of Nursing on your check. Thank you! T two-year, $300,000 grant from the Robert Wood Johnson Foundation (RWJF) will promote replication throughout New York state of the Dual Degree Partnership in Nursing (DDPN) program, a successful collaboration between St. Joseph’s College of Nursing and Le Moyne College. The Foundation of New York State Nurses will target funds from the RWJF grant to support the New York State Future of Nursing Action Coalition’s efforts to help current and future registered nurses (RNs) to advance their academic nursing preparation in order to improve patient care and help fill faculty and advanced practice nursing roles. New York is one of only nine states in the nation to receive grants through the RWJF Academic Progression in Nursing (APIN) program. APIN, which is run by the American Organization of Nurse Executives (AONE), advances state and regional strategies aimed at creating a more highly educated, diverse workforce. The Institute of Medicine’s 2010 report, “The Future of Nursing: Leading Change, Advancing Health,” established a goal of having 80 percent of RNs prepared with a bachelor’s degree by 2020. Known as the Dual Degree Partnership in Nursing (DDPN), the associate degree program at St. Joseph’s College of Nursing and the upper-division bachelor of science (BS) degree program in the Department of Nursing at Le Moyne College enroll qualified high school graduates to earn both associate and bachelor’s degrees in nursing in four years and to sit for the national nursing licensing exam after just three years to become RNs. “Little did we know when we began the implementation of the Dual Degree Partnership in 2005 that it would not only be successful, but that it would be so timely in contributing to the IOM’s recommendation of 80 percent of nurses being BS prepared by 2020,” says Marianne Markowitz, MS, RN, dean of St. Joseph’s College of Nursing. Since its inception, other nursing programs across the state have begun or are interested in replicating the St. Joseph’s and Le Moyne College model. The RWJF grant will increase the number of RNs pursuing bachelor’s degrees in currently established partnerships as well as expand the number of partnerships across New York state. l 20 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org Awarded the Sister Antonia/Angel of Mercy Award at the St. Joseph’s College of Nursing Class of 2012 Convocation ceremony held in January 2013 was Weekend Option graduate Kristen Milburn (right). She was presented the award by Michael Verostek, brother of the late Ann Marie Verostek, a graduate of the class of 1987. The award is presented on behalf of the Verostek family in memory of Sister M. Antonia, a former St. Joseph’s administrator, and Ann Marie Verostek, who had won the award herself. The award is bestowed by members of the graduating class to someone they judge to meet the high personal ideals of nursing. Weekend Option graduates attend the January Convocation ceremony where they receive their pins and diplomas. They may also attend the college’s May Commencement ceremony. Donations Fund Surgical Waiting Room and Veranda atient care areas within St. Joseph’s new surgical suite, including 14 state-of-the-art operating rooms and a hi-tech perianesthesia care unit (PACU), is scheduled to open in summer 2013. Supporting the new surgical suite and slated to open in 2014 will be a twostory surgical waiting room, complete with a family waiting area and family consultation rooms. Helping to create a warm, welcoming atmosphere which promotes respect and privacy for families, the waiting room itself will have large windows looking out on newly planted green spaces and parks. In addition, families will be able to step out onto a veranda overlooking West Laurel Street and get a breath of fresh air to help ease the anxiety of waiting for a loved one in surgery. St. Joseph’s is grateful to Costello, Cooney & Fearon, PLLC, for their gift to name the veranda, which is slated for completion in 2014. Also contributing toward the surgical suite are HUEN and Dr. and Mrs. Alfred E. Falcone. They have generously provided naming gifts for family consultation rooms to be located off of the surgical waiting room. St. Joseph’s employees and their family members also are helping to meet the needs of those whose loved ones are undergoing surgery. Employees contributed nearly $1 million—the most of any employee fundraising campaign to date—toward the surgical waiting room. Employee gifts were given in honor of Sister Mary Obrist, a former vice president of support services at St. Joseph’s. P www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 21 A Higher Level of Care Thank You to the Panasci Family A n n lways appreciative to the corporations, foundations and individuals who help enhance patient care through their support of St. Joseph’s Hospital, the Foundation would like to thank the Panasci family for their support of the Generations of Compassion u Healing u Innovation Capital Campaign. In honor of the Family of Henry A. Panasci Jr., Faye Panasci has generously provided a naming gift for a family waiting area in the new North Patient Tower. St. Joseph’s Hospital Foundation board member, David Panasci, and his wife, Jan, also have contributed to the capital campaign through their naming of a patient exam room, located in the emergency services building, which opened in February 2012. Naming opportunities currently available include: Parks, green spaces and trees Lobbies and corridors n Murals along the “Main Street” corridor n Patient rooms n Serenity room (for meditation and reflection; located by critical care) n Operating rooms and surgical lights n Physician and staff work areas n Intuitive patient beds and other patient care equipment n Children’s play tables and wall mazes for waiting areas The Largest Project of Our Generation We invite you to Be a Part To learn more about the Generations Capital Campaign or to discuss naming opportunities, we invite you to call 315-703-2137. To make a pledge or credit card donation, call 315-703-2137 or give online at www.generationscampaign.org. Thank you. Opportunities to Inspire S t. F r a n c i s G a r d e n , Wa l k o f Va l o r , C a r i ta s Pa r k Opportunities start at $500 and pledges may be paid as multi-year gifts. Giving opportunities are available at all levels. For more information on how you can be a part of this exciting project, contact St. Joseph’s Hospital Foundation at 315-703-2137 or visit www.generationscampaign.org. l T 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 healthcare provider or to leave a message for future generations, please contact the Foundation at 315-703-2137. Additional information is also available online at the Foundation website: www.sjhsyr.org/foundation. l 22 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org Announcing the net amount raised at the 2012 St. Joseph’s Foundation annual golf tournament are St. Joseph’s Hospital President Kathryn Ruscitto (left) and former President Theodore Pasinski (right). Chip In for Charity! C ome out “fore” a day on the green Friday, Sept. 6, 2013, and help St. Joseph’s Hospital Foundation score a hole-in-one in its efforts to benefit the hospital’s patients—many of whom are among the poor and underserved. To be held at one of the nation’s premier golf destinations, St. Joseph’s 21st Annual Golf Classic will be at Turning Stone Resort & Casino. Highly anticipated, last year’s 2012 Golf Classic netted nearly $227,000 that benefitted the hospital’s many award-winning programs and services. The event’s tremendous success is, in no small way, directly related to the backing it receives from Central New York’s corporate, physician, golfing and philanthropic communities. To show your support to St. Joseph’s as it continues its healing mission in our com munity, take aim and follow through by making your reservations now with Pam Kennedy, event coordinator, at 315-703-2128 or email Pamela.Kennedy@sjhsyr.org. www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 23 A Higher Level of Care Recent Grant Awards We thank the following foundations and agencies for their support of St. Joseph’s mission and services: New York State Department of Health and the Centers for Medicare and Medicaid Services awarded a three-year, $1.9 million grant to St. Joseph’s Hospital under the Hospital-Medical Home Demonstration Program. The purpose of the program is to support teaching hospitals as they work to improve coordination, continuity and quality of care for Medicaid beneficiaries by transforming their outpatient primary care training sites into high-quality patient-centered medical homes (PCMH). Providing a framework for the delivery of primary care that emphasizes team-based, evidenceand data-informed, continuous care, a PCMH aims to deliver high-quality preventive and chronic care consistent with improving health, health care and reducing costs. Funding will be used for a variety of activities, including practice redesign; curriculum development/residency training in medical home protocols; resident integration into existing infection prevention initiatives; workforce development, retraining and retooling; personnel; and other expenses associated with program implementation. New York State Department of Health awarded a grant of $40,000 to St. Joseph’s 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. NYSERDA has approved a $2 million incentive to St. Joseph’s combined heat and power (CHP) plant project which is scheduled to begin later this year. Providing an efficient way to keep energy costs down by generating power, reducing demand from the electric grid and recapturing waste heat for other uses, the $15 million plant will provide a majority of St. Joseph’s electricity needs, as well as steam and hot water. National Grid and onsite boilers will continue to provide for the hospital’s supplemental needs. The adoption of CHP can provide energy supply reliability, environmental benefits and predictable energy costs. St. Joseph’s Lymphedema Program has been awarded $30,199 from Susan G. Komen for the Cure Central New York Affiliate for the LEAP from Stage 0 program. LEAP from Stage 0 works to prevent, delay and reduce the progression of lymphedema that may occur as a result of breast cancer treatment. “Komen Central New York is so pleased to be able to fund LEAP from Stage 0 once again. Many of our supporters have gone through this program and have found that, with proper care and treatment, their lymphedema was treated and controlled so as not to progress further. Breast cancer survivors often tell us that education from the very beginning prevented anxiety and was invaluable.” — Livvy Kronhaus, Director of Education, Susan G. Komen for the Cure Central New York Affiliate A $10,000 grant award from the Bank of America Charitable Foundation is helping to fund the recently launched Health Train, a collaboration between St. Joseph’s Hospital and the Northside Urban Partnership (Northside UP). Health Train is a workforce development program designed to prepare un- and underemployed community members from the city’s North Side for entrylevel positions at St. Joseph’s Hospital Health Center and, eventually, other healthcare employers. Many participants are recent immigrants and refugees who face a variety of barriers to overcoming the already difficult challenges of poverty. Delivered in five stages— recruitment, screening, healthcare readiness, internship and career support, Health Train has been designed to help program participants get into a stable, full-time, livable wage situation with the hospital. This will allow them to take advantage of St. Joseph’s tuition reimbursement program to obtain additional schooling, advance their healthcare careers and enhance their quality of life. “Helping individuals obtain the education and training that they need for 21st century jobs, as well as access to job opportunities, is critical to our national economic recovery. That’s why Bank of America is proud to partner with St. Joseph’s Hospital Health Center to extend vital services to those who need them most.” — Michael Brunner, Bank of America Syracuse/Utica Market President One in five children and adolescents in the U.S. experiences mental health problems and up to half of all lifetime cases of mental illness begin by the age of 14. Through a $2,000 grant award from RBC Foundation–USA, the KIDS Prevention Series at St. Joseph’s will engage families through education on significant “hot topics” such as bullying, school anxiety, the impact of texting, social media, and drug and alcohol use and experimentation, thereby promoting prevention 24 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org and positive mental health in children served through St. Joseph’s primary care centers. KIDS stands for: “Know it” (know the signs and symptoms of bullying, anxiety, depression, etc. and learn how to identify areas of concern); “Improve it” (improve understanding of kids’ issues, what to look for, ways to help and how to foster better parent-child relationships); “Discuss it” (discuss concerns and improve communication with your kids to help encourage them); and “Support it” (support your child in coping with issues and stressors). “At RBC Wealth Management, our culture is deeply rooted in supporting the communities where we live and work.” — Erik Hartmann, Complex Director, RBC Wealth Management St. Joseph’s Nurses to Benefit From Grant St. Joseph’s Hospital has been awarded a $221,242 grant from the New York State Department of Labor’s H-1B Registered Nurse Upgrade Project. Funding for the H-1B Registered Nurse Upgrade Project comes from fees paid by employers seeking highly skilled foreign workers under the H-1B visa program. The goal of this training grant is to prepare U.S. citizens for these same highskill jobs, reducing our nation’s dependence on foreign labor. This grant funding, which is to be provided over three years, will be used for tuition reimbursement for registered nurses who pursue a Bachelor of Science in Nursing (BSN) degree. Key findings in the Institute of Medicine’s landmark 2010 report, “The Future of Nursing,” recommend that 80 percent of our nation’s nurses achieve a BSN degree by 2020, a priority also identified by the New York State Regional Action Coalition. Pending legislation in New York state, “BSN in 10,” recommends that all RNs in New York state hold a bachelor’s degree within 10 years of graduation from an associate or diploma program. Taking a proactive stance toward enhancing care for its patients, St. Joseph’s has required all nurse managers to have a BSN since March 2010. Further, St. Joseph’s also has established an organizational goal requiring that all new RNs hired beginning Jan. 1, 2013, hold a BSN or obtain a BSN within five years. To help make this happen, St. Joseph’s is incentivizing current RNs to obtain BSN degrees, through enhanced tuition reimbursement benefits made available to employees. Among other enhancements to St. Joseph’s tuition benefits, employees can now access reimbursement money up front rather than having to pay it out-of-pocket and then wait several months until after the course to receive reimbursement. The area’s fourth largest employer, St. Joseph’s employs 415 BSN-prepared nurses, which represents just more than 30 percent of the nursing workforce. These nurses care for thousands of patients every year; the combination of an aging population base plus the Central New York region’s higher rates of acute and chronic conditions means that St. Joseph’s nurses will continue to treat patients who have more serious and more complex conditions than prior generations. The American Association of Colleges of Nursing reports that education has a significant impact on the knowledge and competencies of all healthcare providers, including nurse clinicians.“Studies have shown that better-educated nurses save lives,” says AnneMarie Czyz, MS, RN, chief nursing officer for St. Joseph’s. “With every increase of 10 percent in the proportion of staff nurses with a BSN, there is a corresponding decrease of five percent in mortality rates.” Nurses with a BSN are better prepared to meet the demands placed on today’s nurse. St. Joseph’s has long been committed to nursing education, establishing a school of nursing, now a college, in 1898. It now offers a BSN option through partnerships with area universities, including Le Moyne College and SUNY Upstate Medical University in Syracuse, SUNY College of Technology in Utica, and Nazareth College and St. John Fisher College located in Rochester. “By supporting children’s behavioral health, this grant strengthens our commitment to the community through the great work being done by St. Joseph’s Hospital and their KIDS Prevention Series.” — Frank Arkinson, First Vice President, RBC Wealth Management Helping to increase access to St. Joseph’s Breast Cancer Services, the Saint Agatha Foundation has awarded $50,000 to enhance care for women and families who “cannot afford their disease” and have nowhere else to turn. Playing a vital role in the lives of the patients who access it, funding from the Saint Agatha Foundation is used as a “last resort” after all other potential funding sources have been exhausted. “I want to help those who can’t afford their illness.” — Laurie Mezzalingua, an outspoken advocate for breast cancer survivors and founder, Saint Agatha Foundation Mezzalingua felt that those affected by the often debilitating and expensive effects of breast cancer should always have someone in their corner so that they might “stay strong and keep fighting.” Her 12-year battle with breast cancer came to an end in 2009. “Laurie was a wonderful example of what it meant to be a giving person.” — Kathleen Mezzalingua, mother of Laurie Mezzalingua and President, Saint Agatha Foundation www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 25 A Higher Level of Care Members of The Rotary Club of Syracuse, Inc. have awarded $5,000 to purchase a children’s play island for the waiting room in St. Joseph’s surgical suite. This area has been designed to help reduce the anxiety associated with waiting for news of a loved one’s surgery by providing a warm and attractive family-friendly space. The children’s area of the waiting room will provide a place to play—complete with child-sized chairs, tables and play pods—where even the youngest visitors will feel more comfortable. “The Rotary Club of Syracuse admires the fabulous achievements of St. Joseph’s Hospital. Club members want to join in the deep community support of the hospital and its efforts to bond with and serve the people of Central New York. The club, involved in the education and socialization of children, realizes that sickness causes stress in a family. Therefore, we support the Children’s Play Island because it will provide diversion and comfort to children and their families.” — Allen Kosoff, Chairman of the Rotary club of syracuse Philanthropy Committee Providing State-of-the-Art Technology for St. Joseph’s College of Nursing The Auer Family Foundation has awarded $2,835 to purchase a SimPad that helps to optimize the use of simulation mannequins in the clinical simulation laboratory at St. Joseph’s College of Nursing. Simulation mannequins mimic real patients for the simulated clinical environment and, when coupled with the SimPad, can be used by college faculty as a “pick up and play” technology. Featuring an intuitive, interactive handheld touchscreen, the SimPad is a user-friendly device that enables training simulations to be run easily and efficiently. “The Auer Family Foundation was founded by Edmund R. Auer and Mary (Peg) M. Auer in 1993. An important component of the Foundation’s primary mission is to encourage charitable volunteerism by Peg and Ed’s 10 children, their spouses and 25 grandchildren. St. Joseph’s College Allen Kosoff (center), chairman of the Rotary Club of Syracuse Philanthropy Committee, presents a check to Kathryn Ruscitto, president and CEO of St. Joseph’s Hospital, and Douglas Smith, FAHP, vice president for development, St. Joseph’s Hospital Foundation. 26 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org of Nursing is Peg Auer’s alma mater. Supporting our mother’s nursing school is a way to honor our parents’ memory and a tribute to all they have done for their children, grandchildren and the lives of many they touched in their lifetimes. Our parents felt it was important to support causes that gave back to the community. Supporting St. Joseph’s College of Nursing helps students on the nursing path, existing nurses stay current with their skills and, most importantly, helps the people of the community that the graduates from the college will be caring for. Caring for others is the greatest way we can honor the memory of Peg and Ed Auer.” — Auer Family Foundation Photo by Sarah Averill Helping to take technology at the college’s clinical simulation laboratory to the next level, BristolMyers Squibb has awarded $4,813 to purchase a SimPad and other simulation accessories specific to cardiac care. SimPad Arrhythmia Trainers will work with the SimPad to allow heart sounds and functions, including variable heart rates, rhythms, abnormalities and durations of heart functions, of the SimMan to be adjusted. Projecting lifelike cardiac scenarios, this equipment can also be used for defibrillation and EKG training. “Bristol-Myers Squibb has a long history of supporting projects to promote health and wellness in the communities where our employees live and work. One way in which we fulfill our mission to help patients prevail over serious diseases is by supporting programs that help uninsured and underinsured patients obtain high-quality health care. Our support of St. Joseph’s Hospital Health Center’s SimPad project will help ensure that nursing students in St. Joseph’s College of Nursing are well-prepared to handle cardiac emergencies.” — John Mosack, Executive Director of Biotechnology Manufacturing and Operations, and General Manager of Bristol-Myers Squibb’s East Syracuse facility Residents of Syracuse’s North Side, Vishma (left), from Nepal, and Myint, from Burma, benefit from participation in the Yeshua Restoration Ministries Soccer Club. Playing With Purpose St. Joseph’s Hospital Health Center Foundation was the fiscal agent for a grant of $4,200 which was awarded to the Yeshua Restoration Ministries (YRM) Soccer Club through the “What If…” mini grant program. The “What If…” program was established by The Gifford Foundation to foster growth in neighborhoods, strengthen the capacity of community residents who are focused on making positive changes in their neighborhood, and increase community participation, awareness and partnerships. Serving children and youth living in an area significantly affected by economic decline—Syracuse’s North Side—the YRM Soccer Club places an emphasis on youth empowerment, community pride and cultural diversity toward creating a positive effect on the social, physical and psychological condition of the neighborhood and its residents. This funding has been used toward field cleanup, beautification and maintenance; fencing; soccer equipment; and summer day trips. As the St. Joseph’s College of Nursing prepares its students to meet the demands of nursing in the 21st century, the Flora Bernice Smith Foundation is helping to equip one of the college of nursing’s classrooms with new, up-to-date educational technology. Through a recent grant award of $15,000, St. Joseph’s College of Nursing will be able to put the most efficient teaching resources at the fingertips of faculty. Equipment such as a touch panel control, microphones, amplifier, tuner, conference phone and audio mixer will allow our faculty to spend more time instructing students and developing class content. www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 27 A Higher Level of Care Through the Eyes of a Caregiver ude Hughes describes her parents as the perfect couple: “She had the operations, and he had the mechanics.” It wasn’t until her mother passed away unexpectedly that Hughes and her siblings realized there were deficits. Her father, Matthew Pelletier, had always been spry and independent. But now, he was becoming quite forgetful. Hughes recalls a turning point when she was driving behind her father after church. “He went through a stop sign and a red light,” she says. “And, he didn’t even realize it.” On the advice of doctors, Hughes and her siblings had the very difficult task of addressing their concerns about his driving. Then they discovered he wasn’t eating the meals they delivered daily. He became weak and he fell. “It all went downhill fast,” Hughes says. “We didn’t know what to do. We didn’t know if we needed to place our dad somewhere.’’ Hughes had heard of Embracing Age, a membership program through Franciscan Companies that provides the support services needed to remain living independently for as long as possible. She met with Mary Gualtieri, MS, an elder life specialist with Embracing Age, who guided the family through the process of caring for their father. J Embracing Age member Matthew Pelletier spends time with his daughter, Jude Hughes, at the Inn at Menorah Park. Member of the St. Joseph’s Hospital Health Center System “You have no clue what you’re doing. The family was questioning, ‘Where do we go next?’ But, knowing Mary’s there, being a resource and a support system, is invaluable,” Hughes says. Pelletier couldn’t safely remain at home, so Gualtieri helped the family decide on the best option. They settled on The Inn at Menorah Park where Pelletier can receive care 24 hours a day. Hughes says the decision was stressful, but the correct one. “You don’t have to feel ashamed—like you’re putting your parents away some where,” she says. “There is that fear, though. You ask yourself, ‘Am I doing the right thing? What if he’s mad at me? How am I going to get through this?’ But, with the support from Embracing Age, I know that when it’s all said and done, we did the best job we could. Down the road, that will give us comfort.” Hughes only wishes she sought out Embracing Age a few months sooner, rather than waiting until a crisis occurred. She says the experts at Embracing Age can help prevent crises before family members end up in conflict. “When I think of Embracing Age, the one thing I think about is calm, rational and sane support,” she explains. “This is a real community resource and, whether you like it or not, you’re going to need it. People think they can handle it. But you can’t. And you have help right next door!” Embracing Age is located in DeWitt, NY, and offers companions, transportation, light housekeeping, home repairs, spiritual care, home health aides and more. For more information about Embracing Age, call (toll free) 1-855MYHELP2 (1-855-694-3572) or visit www.EmbracingAge.org. l Suite 100 333 Butternut Drive DeWitt, NY 13214 Phone: 315-458-3600 Fax: 315-458-2760 www.franciscancompanies.com 28 caring Connection l St. Joseph’s hospital Health Center l spring 2013 l www.sjhsyr.org D A Life Made Easier “It allows patients to have a life again,” says Tim Curtis, RRT. “Their breathing is easier. They absolutely love the fact that they can get out and do things they have to do. They are able to live a more normal life.” Franciscan has the most advanced ventilators on the market, and the company serves more ventilator patients than any other company or hospital in the region. “We take a lot of pride in our ventilator patients and the fact that we can take care of them away from the hospital,” says Curtis. “They can come home and live their life.” “The smaller ventilator is so much lighter and so much easier,” Therese Carroll says. “My husband and I are both 53 years old. We throw it over our shoulder and hold Vinnie’s hand. It’s much more convenient and smaller; it’s much easier to move around. If Vinnie still had the big, bulky unit, we wouldn’t be able to go out. His wheelchair can’t accommodate that unit.” The advanced technology, along with the support of Franciscan, has helped improve Carroll’s life and kept him the spitfire that he is. “Our respiratory therapist Tim Curtis comes in anytime there’s an issue. I call him if I need him and he’s here in 20 minutes,” Therese Carroll says. “If there’s an issue with Vinnie’s breathing, tweaks or changes to the settings might need to be made. Tim will get on the phone with the doctor to make the changes. Franciscan has been fabulous supporting us.” For information about Franciscan’s ventilator program, call 315-458-3200. l estiny USA is an attraction for most 23 year olds, and Vinnie Carroll III from Jamesville, NY, is no different. Sure, it takes more time and effort to get there—he uses a walker and wheelchair, and is connected to a tracheostomy tube and ventilator 24/7—but he gets there. And, he enjoys it. “He would come every day if he could,” says his father, Vinnie Carroll Jr. “As it is, someone brings him two to three times a week.” Carroll was born with prune belly syndrome, a condition that causes a buildup of fluid where internal organs should be. He underwent two kidney transplants. One was rejected when he developed lymphoma; the second time, medication caused him to develop pneumonia and lose most of his hearing. He also has severe scoliosis that required surgery. His family has been through a revolving door of doctors, therapists and treatments. “I want to give him as much normalcy and the best quality of life that I can help him have,” says his mother, Therese Carroll. That quality of life depends greatly on his ability to leave the house and have fun. “We go to the movies; we go to the mall,” Therese says. “He loves to go in the summer to the Nationals Car Show at the New York State Fairgrounds. He loves to go to the Fair itself and SU basketball and lacrosse.” None of these activities would be possible if Carroll still used what his mother calls the “big old monster” ventilator that made leaving home difficult. This past year, registered respiratory therapists from Franciscan Health Support set Carroll up with a Trilogy 100 ventilator made by Philips Respironics. It weighs 10 pounds, comes with a shoulder strap and has a six-hour internal battery life. A portable ventilator unit from Franciscan Health Support allows Vinnie Carroll III to enjoy Destiny USA with his father, Vinnie Carroll Jr. www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 29 A Higher Level of Care G Sleep Tips for a Lifetime: Help for Women etting enough sleep is impor tant—and sometimes challeng ing—for everyone. For women getting enough sleep can be especially difficult. But as women continue to tackle the multiple responsibilities of home, work and family, getting enough sleep is crucial as it positively impacts concentration, job performance, social interaction and overall well-being. Through the course of their lives, women experience various factors that can make it tough to get a good night’s sleep. Young women tend sleep the most soundly and are less prone to sleep disturbances. As women move further into adulthood, that can all change. Menstrual cycles, pregnancy and motherhood can all have a detrimental effect on sleep. As women continue to age, other factors such as physical ailments, breathing disorders and hormonal changes like menopause can negatively affect sleep. Women who experience bloating, cramping, headaches and emotional changes related to their menstrual cycle often have short-term sleep difficulties, which usually disappear a few days after their menstruation begins. Women who suffer more severe menstrual symptoms may experience lingering sleep problems and even chronic insomnia. Chronic insomnia can lead to depression, so it is beneficial for women with difficult menstrual cycles to seek professional help to reduce menstrual cycle symptom severity. Menopause also impacts sleep. As sex hormones fluctuate, they affect sleep hormones both directly and indirectly. Often, menopausal women experience a decrease in deep sleep and wake more throughout the night. Many women find hot flashes and night sweats cause repeated awakenings. In severe cases, women can awaken from hot flashes hourly. These awakenings can lead to daytime fatigue, irritability and depression. Here are some suggestions that may help alleviate sleep disturbances associated with hot flashes: In addition to menstruation, many women experience sleep changes with pregnancy. As the levels of the hormone progesterone increase, so does a pregnant woman’s need for longer nighttime sleep. Then, in the last trimester of pregnancy, slow-wave sleep decreases and the number of awakenings increases. Finally, after the baby is born the stresses of pregnancy on sleep are replaced by the demands of a new baby. Pregnant women should try the following to get a good night’s sleep: n avoid n keep n use your room cooler lightweight and comfortable bed linens, like cotton n eliminate caffeine, sugar and alcohol from your diet n increase vitamin E in your diet n have a light snack at bedtime n consider hormone replacement therapy n avoid hot showers or baths within one to two hours of bedtime n go to bed and get up at the same time everyday While we all face certain challenges that can negatively impact sleep throughout the course of our lives, taking these steps may result in more restful nights. However, if restless sleep or an inability to sleep is affecting your quality of life, seek the advice of your physician. l This story was written by Donna Metz, RRT, RPSGT, St. Joseph’s Sleep Laboratory. spicy food for two hours prior to bed n maintain a balanced diet n keep a regular bedtime and awakening time n avoid extra stresses n try muscle relaxation techniques, as medications to help sleep should be avoided eople without a home telephone line now have an option to safeguard themselves in case of a fall. Franciscan Lifeline is offering a cellular medical alarm, monitored by Doyle Medical Monitoring. The service provides users with a button wear that they can press if they need “It allows me to be active to help. The customer is put in immediate without worrying about contact with the response center, which will dispatch nearby friends, family or falling. I feel safe.” emergency services, if needed. —Linda Lewis Linda Lewis from Jordan signed up for the service after she fell for a second time. “I slipped and fell under my dining room table,” she says. “A chair fell on top of me and I panicked! Then a bookcase fell, too. I was really scared. I yelled but no one heard me; I must have been under there a good two hours!” Without a home phone line, Lewis’ options for a medical alert service were limited. Those she saw P Medical Alert for Cellular Customers advertised nationally were priced out of her budget. Then, Franciscan added a cellular service. A technician from the company installed and explained the unit, and Lewis has been wearing it ever since. “I love it; I feel very happy to have it,” she says. “I think everyone should have it, if they’re older. You never know if you’re going to fall. When I fell, I was only 63. It allows me to be active without worrying about falling. I feel safe.” More than 30 percent of homes had only a wireless phone in the latter half of 2010, according to the National Center for Health Statistics. Up until now, these people were at risk if a medical emergency, such as a fall, occurred because most medical alarm systems use landlines. Franciscan’s new cellular service alleviates that concern and connects customers to the help they need immediately. Call 315-492-8175 for more information. l 30 caring Connection l St. Joseph’s hospital Health Center l spring 2013 www.sjhsyr.org N Encore, Encore a homecare provider, downloading the information manually and printing it out and delivering the data to a physician. Instead, Encore Anywhere allows the homecare program (e.g., Franciscan Health Support), the ordering or consulting physician or provider, as well as other assigned entities such as insurance companies, to analyze and provide recommendations without transporting equipment and making a number of trips back and forth. “Real-time access to patient data enables providers to adjust therapy quickly, which improves the outcome of sleep apnea treatment,” Widrick says. For information on Encore Anywhere, contact Franciscan Health Support at 315-458-3200. ew technology is allowing sleep experts to better track the effectiveness of obstructive sleep apnea treatment. Franciscan Health Support is using a software program called Encore Anywhere to collect data from continuous positive airway pressure (CPAP) machines to ensure they are being used correctly in patients’ homes. The information provided is pertinent data that can be accessed by the physician, homecare provider and/or insurance provider. “One of the most important aspects of patient care is compliance. If patients don’t use their CPAP equipment correctly at home, they may not experience an improvement in their conditions,” says Neil Widrick, RRT, RPSGT, manager of the Sleep Laboratory at St. Joseph’s Hospital Health Center. The ability to track what is going on in the home from a remote location allows providers greater access to patient-driven data. Providers may download information from a secure website and make needed prescription changes with the push of a button, saving time and money for all involved. Encore Anywhere replaces the traditional method of delivering a card or the entire CPAP machine to F Eyes and Ears at Home The therapists relay concerns to the doctor early enough, so they can make changes in the patient’s care at home—including medication and activity level—to keep them out of the hospital. Rather than wait until a problem escalates, complications can be caught early. ranciscan Companies’ registered respiratory therapists are playing the role of physicians’ eyes and ears in patients’ homes. The respiratory therapy/medical equipment company’s new program called TLC (Teach, Learn, Comprehend) increases the education patients receive when discharged from the hospital. It helps them avoid readmission to the hospital because they are taking charge of their health. “It’s a fresh new program that no other companies are offering,” says Joseph Nicoletti, RN, RRT, executive director of clinical services. “It takes our care to another level. We are not a drop-ship type of organization. While we are equipment-oriented, we have a tremendous focus on patient education.” The process is simple. With a referral from a physician, a respiratory therapist goes into the home, does an assessment, and then admits the patient into the TLC program—all at no charge. Patients receive ongoing support, education and guidance to manage their condition at home. They learn how to breathe and exercise correctly, the importance of taking their medications, how to read food labels and track their weight. The respiratory therapists also teach patients what’s considered normal and what warrants a call to their doctor. “We find that patients respond much better to this type of education when it’s done in the comfort of their homes,” Nicoletti says. “They go to the doctor and emergency room less frequently and their quality of life improves.” “We find that patients respond much better to this type of education when it’s done in the comfort of their homes. They go to the doctor and emergency room less frequently and their quality of life improves.” — Joseph Nicoletti, RN, RRT, executive director of clinical services The TLC program has proven especially helpful for people with CHF (congestive heart failure) and COPD (chronic obstructive pulmonary disease) because both conditions have very high incidences of readmission. Franciscan is expanding the TLC program into the Oneida area. For more information or to refer a patient, call 315-458-3200. l www.sjhsyr.org l spring 2013 l St. Joseph’s hospital Health Center l caring Connection 31 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 St. Joseph’s Caring Connection is published by St. Joseph’s Hospital Health Center, 301 Prospect Ave., Syracuse, NY 13203. Copyright © 2013 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. Denise Jochem-Robertson Editor Contributors Eric Johnson Writer Lisa Laribee Writer, St. Joseph’s Foundation Kiefer Creative Design Chuck Wainwright Photography Kelly Quinn Writer, Franciscan Companies Eastwood Litho Inc. Printing Contact Us St. Joseph’s Hospital Health Center 301 Prospect Ave., Syracuse, NY 13203 www.sjhsyr.org Follow us on Facebook and Twitter: stjosephshealth 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. Butternut Café Opens; Culinary Services Receives Award t. Joseph’s Butternut Café, located in the Ralph & Christina Nappi Emergency Services Building, is open for visitors. The café features many healthful menu options and provides a comfortable, relaxing atmosphere. St. Joseph’s has been nationally recognized with the 2012 Achievement of Excellence Award from the American Culinary Federation. It is one of the first hospitals in the nation to receive the award. Photographed in the Butternut Café are Nicholas Trasolini, MD (standing), Cathy Coryell, John Andersen, LRT, and Carla Goettsch, RDMS. S Member of the St. Joseph’s Hospital Health Center System