VOLUME 14 ISSUE 6, NOVEMBER/DECEMBER 2018
The war on polio
Burge Hospital led the community health charge in the Ozarks with the Polio Cottage.
CoxHealth Legacy
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As World War II wrapped up in the mid-1940s, people in the Ozarks – and across the country – turned to fight another battle. This time, they waged war against an enemy they couldn’t see, although they could see its results. It was a war on polio. According to one newspaper account, more than 57,000 cases of polio were diagnosed in the United States in 1952. The virus left thousands paralyzed, or with varying degrees of disability. Others simply didn’t survive. The Ozarks was not immune to these epidemics. Springfield newspapers recount locals affected by the dreaded disease, and that rural areas were unequipped to offer the care required. Burge Hospital – today’s CoxHealth – stepped up. In the late 1940s and ’50s, administrators at the small hospital decided to do whatever it took to ensure patients were cared for in an appropriate manner – whether it be through a former nurses’ dormitory, a relocated cottage or new wing of the hospital. Ultimately, Burge utilized all three of those oppor-
Our new CoxHealth Legacy series focuses on the ways our employees have made a community impact through their care and compassion during our 112-year history. This month, we look at how caregivers at Burge Hospital’s Polio Cottage provided care and rehabilitation at the height of the polio epidemic.
Photo courtesy of CoxHealth Libraries
tunities to care for polio patients. Even though the efforts occurred nearly 70 years ago, they tie to a mission that still fuels CoxHealth today: To be the best for those who need us.
Looking back
Today, polio has nearly been eradicated. Thanks to worldwide vaccination efforts, there are only three countries left in the world that actively see cases: Pakistan,
Afghanistan and Nigeria. “We’ve eliminated it from the United States and Europe,” says Becky Sigrest, system director of Infection Prevention at See ‘OUR FAITH,’ Page 2
‘Our faith in the people of the Ozarks has soared’ Springfield newspaper printed in June 1950. The designation meant that the unit would be open year-round (instead of closing after the periods of active disease) and that it would keep patients for the duration of their polio-related care, as opposed to sending them to another hospital elsewhere to convalesce. As the designation was made, hospital leaders were already working on a better place to
a building obtainable from O’Reilly Hospital,” printed a writer for the KWTO Dial, the radio station’s publication, after the cottage’s dedication. “That was a lot of money. But nickels, dimes, dollars and checks for twenty-five, fifty and one hundred dollars and more started rolling in.” Lester E. Cox, then chairman of the Burge Board of Directors, shared his thoughts at the
old woman died in St. care for their patients. There were those iron lungs, Louis. At the time, it That came in the and they made a lot of noise, seems that there wasn’t form of a little white and they had mirrors up so the a place in Springfield to building, relocated treat her. people inside them could see. from the former Her death was O’Reilly General reported on the front Army Hospital, which page of the Springfield Leader and Press. The was located in Springfield and served soldiers same issue announced something else: Despite during World War II. recent financial hardship, Burge’s leaders decided Dubbed the Polio Cottage, the building to establish an emergency polio isolation unit, was a home for individuals battling polio – and which was housed in a former nurses’ dormitory. represented a great deal of community effort. Less than a year later, the hospital’s role in Around $15,000 was raised, much of it by the fight against polio expanded. Ralph Foster (the namesake for Foster Audito“Burge Hospital in Springfield has been rium at Cox South, and a longtime Burge and designated by the State Board of Health as a CoxHealth board member) who used local radio ‘primary polio unit’ and St. John’s hospital has station KWTO as a way to solicit donations. promised to ‘stand by’ as an extra bulwark against “We told you that a minimum of ten thoupolio, officials of the two hospitals said today,” a sand dollars was needed to move and recondition
cottage’s dedication ceremony. “Our faith in the people of the Ozarks has soared to new heights,” he said back then. “Their generosity has been overwhelming. We, the members of Burge’s official family, assure you we shall never forget this magnanimous response to an imminent need.” Part of the cottage’s novelty was that it offered space for a variety of needs, and could be quickly converted back to patient space if the need arose. Some of those needs were for physical therapy – where patients could learn to walk again – or examination. They even had classrooms, since Springfield Public Schools helped organize classes at the cottage, so recuperating students could keep up with their studies. Some days were especially special at the cottage, like when movie star and future U.S. President Ronald Reagan came to visit in 1952.
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CoxHealth. “Vaccines have saved hundreds of thousands of lives.” That vaccine, however, didn’t exist until the 1950s. Outbreaks occurred over the years, and by the late ’40s, outbreaks of the potentially fatal virus were causing great alarm. In Springfield, one of the first deaths to the disease came in July 1949, when a 30-year-
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Expanding services build on our mission Just as Burge Hospital staff cared for polio patients years ago, CoxHealth still strives to provide cutting-edge services and technology to the community. Recent examples include the expansion of the electrophysiology labs at Cox South, which allows even more space for patients to receive treatment for conditions related to irregular Adstamongkonkul K. Hefner heart rhythm. The labs also offer greater access to high-risk ablation J. Hefner – something CoxHealth is the sole provider in the area to offer. The health system is also in the process of growing its pediatric specialties clinic, which recently added three new specialties. The physicians include Dr. Jody Hefner, pediatric gastroenterology; Dr. Katherine Hefner, pediatric endocrinology; and Dr. Dusit Adstamongkonkul, pediatric neurology. Those efforts tie to a mission that is now more than 110 years old at CoxHealth – as well as passion and purpose that most assuredly go back just as far. “Children show you the way they see the world,” says Dr. Adstamongkonkul. “We want to push them to be better. Who knows, maybe a kid you treat will change the world. I want to be part of that.”
Battling polio was a community effort in Springfield in the 1950s. A citywide fundraiser helped finance the polio cottage. Staff worked to raise morale with parties and events for young patients, while local children raised money with lemonade stands and fundraisers for patients in the unit.
A patient’s memories
One of the patients at the cottage was Springfield resident Gary Ellison. Today known for his work in advertising and as an accomplished ragtime pianist, Ellison was a frightened 10-year-old when he came down with a severe fever in 1953. Initially, a flu-like diagnosis was made – a common mistake back then, since the symptoms were similar. It wasn’t long, however, before it was obvious this was something much more severe than the flu. “They took me in to Burge, and they did some sort of a spinal. I knew it really, really hurt,” says Ellison of the spinal tap used to diagnose polio. “The next thing that I knew, they had moved me to a small room in the polio cottage.” Back then, it wasn’t understood just how
polio was spread, so strict isolation was enforced. “My parents would come into the door and talk to me, but they were not allowed to go in the room with me,” says Ellison. “The only human contact I had was with the nurses and my physician, Dr. Clayton.” While Ellison was in isolation, he underwent Kenny Treatments, pioneered by Sister Elizabeth Kenny of Australia, which involved laying “hot packs” on limbs to help keep them from becoming stiff. “They would take Army surplus wool blankets, and steam them and get them very, very hot,” says Ellison, who still recalls the stench of the boiling wool. He also remembers something else: The room of “iron lungs” just down the hall from where he was. “There were those iron lungs, and they
For more than a century, CoxHealth CoxHealth has invested Legacy time, resources and passion into the health and development of the Ozarks. It’s indisputable that moments and milestones from throughout the health system’s history – first as Burge, and as CoxHealth – will forever be intertwined with this community. Our employees have made an indelible impact through their care and compassion. That’s why we are going to be sharing some of those stories through a series called CoxHealth Legacy. Every few weeks, a story focusing on our history will be published on CoxHealth.com, and shared on our social media pages. The stories will remind us of where we came from – and the impact CoxHealth continues to have today.
Photos courtesy of The Springfield News-Leader
made a lot of noise, and they had mirrors up so the people inside them could see,” says Ellison. Today, iron lungs are virtually a thing of the past. Also known as tank respirators, iron lungs were human-sized tubes that encased patients, helping them breathe. For some people, it’s where they remained for the rest of their lives. Thankfully, Ellison’s condition didn’t require him to be treated inside an iron lung. As he recovered, he transferred to a convalescence ward inside the cottage for several weeks before his release to go home.
The disease’s decline
A monumental moment in the history of polio came in the mid-1950s, when the nowfamous Dr. Jonas Salk discovered and developed a vaccine against the disease. See ‘POLIO,’ Page 7 3
‘We rocked it’ 3 West puts p A focus on teamwork and celebration has helped the unit make strides. Here’s how they did it.
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A great patient experience begins with a great employee experience. On a busy pulmonary floor like 300 West, providing an outstanding experience requires intentional effort. “I want the atmosphere on this floor to be positive no matter what,” says Nurse Manager Eric Milton. “Yes, we have difficult days, and we have complicated patients. You can still be positive about your job and enjoy the work you do.” Since he took over the role in April, Milton has made positivity the driving force behind the unit’s work. His straightforward tactics are paying off in staff satisfaction and patient satisfaction. Milton is well aware that change can be difficult. Rather than making incremental improvements, he wanted to make a splash. “I wanted a lot of sudden change, to refresh everyone’s mind and do a reset,” he says. He hired a new assistant manager as well as an assistant manager for overnights. He and the team rearranged the stockroom and patient care areas, changing the look of the floor and setting the stage for a new environment. If a staff member had questions, he took the time to explain his end goal: “I want 300 West to be the example for other floors, so people will come to us and ask how we did it.”
The reset
Milton began by simply working to be present with his staff. Milton says he makes a conscious effort to see as 4
What I’ve learned: Eric Milton No matter what you have to say, say it positively. A lot of people speak negatively -- they don’t mean it that way, but they sound negative. “I’ve had a busy, rough day. It’s been crazy.” You could say: “My patients were all very complicated, but I rocked it all day.” It was busy, but you did it. Don’t wait. Leaders need to be good at prioritizing what they should do for the good of the floor. If someone has a question, I try to get them an answer the same day. If I can’t get an answer, I will tell them what I’ve done. Those little things go a long way. Explain the why. Everyone is seeking understanding. When changes happen, people need to know why before they can be OK with it. Finding those whys and supplying them is important. many staff members as he can throughout the day. “When I get here each day, I go straight out to the floor and talk to charge nurses. And from there, I see who is around and ask them how their day is going,” he says. If there are new hires, he goes out of his way to check in and see how their day is going. “People want to know they have been seen.” Milton has also been intentional about how important teamwork is. He lets potential staffers know up front that there will be challenging days, but that chal-
lenge drives excellence. “I tell them: You will work hard. You will leave tired at the end of the day, but you will leave knowing that you have done a good job.” Beyond connecting with
staffers and updating the environment, Milton says one key to a fresh start is setting the right expectations. He and nursing leaders laid out black and white guidelines for what is expected on the job –
positivity first
Service secrets
Not a magic bullet, but close: Rethinking the hourly round Once a month, Marie Orchard of the Office of Patient Experience meets one-on-one with Nurse Manager Eric Milton to review what patients are telling us in surveys. They dig into the scores and look at areas where perceptions could be improved. They are looking closely at responsiveness, making sure call lights are answered quickly and that patients perceive that all of their needs are being met. The key to improving that perception? Purposeful hourly rounding. Like most units, 300 West is working to make sure that staff complete the “Five Ps”– potty, position, pain, personal items and check the IV pump. “So many things we see in patient feedback point back to the value of an hourly round,” Orchard says. Milton says staff are already doing a lot of the rounding tasks. Creating the perfect round is largely a change of mindset to make sure staff members hit each point, ask if patients need anything else and remind them that staff will return in an hour. Those steps improve perceptions of care and can save time for staff, since meeting patient needs during rounding can reduce the time spent responding to call lights. 300 West staffers like Allie Jackson (above) and Taylor Allman (top right) work to perfect their hourly rounding with feedback from Nurse Manager Eric Milton and Marie Orchard of the Office of Patient Experience. The unit combines service efforts with celebration. Nurse Tricia Holman (left) leads a program called Celebrate 3 West, which includes a large break room mural of staff photos.
everything from the attendance policy to the professional respect and courtesy required. “It took the ambiguity out of it, by saying ‘these are the policies and we will adhere to them,’” he says. “We make it clear: Everyone here came to CoxHealth looking for a job and there are requirements for that, including a high level of teamwork.”
Celebration keys
Milton says he noticed something else about the unit: Everyone knew they were doing a good job individually, but no one was praising anyone for it.
“There always needs to be a celebration going on, especially when we hit rough days,” Milton says. “We can’t stop on a bad day to make that happen, you have to have recognition in place before you need it.” To make celebration a part of the unit’s culture, the team launched a program called “Celebrate 3 West.” Nurse Tricia Holman took the lead in finding ways, large and small, to celebrate the work that is done on the unit. They started with the obvious: celebrating birthdays, anniversaries and graduations. Holman then branched out into monthly events.
One month, they asked staff members to draw names of their colleagues. Then, they were asked to write an anonymous note about that person on a whiteboard. Almost immediately, the entire 6x9-foot board in the break room was covered with positive notes. “People enjoyed coming in and reading what others said about them,” Holman says. “It is hectic when we’re out there working. This is our sanctuary. It’s good in those moments to come in here and get grounded back in good things.” Milton says the celebration has made a huge difference in how colleagues view teamwork. More celebration and recognition has shifted peer-to-peer attitudes from “this is what I need you to
do for me” to “how can we help each other with our jobs today?” The team has also launched other efforts, including: An Employee of the Month recognition, themed food bars for meetings and outside social events. Back in the break room, you can see one of Holman’s most visible ideas: A huge 3W mural, made up of team member photos. “It’s not always rainbows; people have bad days,” Holman says. “(The mural) reminds everyone we had these wonderful times. When we face adversity, we feed off of that. “We excel at teamwork on this unit. We genuinely care about our patients and we genuinely care about each other. We are watching out for each other every day.” 5
Benefits changes: Photo: Randy Berger
Electrophysiologist Dr. John Garner, CoxHealth Cardiology, leads a tour of the new electrophysiology labs at Cox Medical Center South.
New EP labs are meeting growing heart care needs Cardiovascular Services is in the middle of a growth spurt. According to Becky Watts, administrative director of Cardiovascular Services, cath lab procedures at Cox Medical Center South have grown by more than 25 percent compared with last year. Procedures in one sub-specialty, electrophysiology (EP) have grown by more than 70 percent year over year. “With the aging population in the region and higher risk of heart disease, we are seeing many more cases of AFib and other arrhythmias in our patients, and many of the treatments for those conditions are performed in the EP lab, including pacemakers and other implantable devices, as well as ablation,” says Watts. “Our program is unique in southwest Missouri. We do high-risk ablation, which no other provider in southwest Missouri does, so we get referrals from a wide area.” Because of the tremendous growth in electrophysiology cases, Cardiovascular Services needed to expand. The department recently unveiled a new Electrophysiology Lab in the fourth floor of the West Tower at Cox South. The EP Lab is the first occupant of the shell space in the West Tower. Watts says the new EP suite has four pre- and post-procedure bays for patients and three labs – two of the labs will be operational initially. Watts says the project will increase our ability to serve more patients. As electrophysiologist Dr. John Garner, CoxHealth Cardiology, is working with one patient, a second patient can be prepared in the next room, reducing wait times between cases. In addition, the existing EP lab in the Cath Lab will be converted to general cardiology for more cath procedures. 6
2019 changes will keep us competitive, with increases in compensation and benefits, and new health plan choices.
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Each week at orientation, President and CEO Steve Edwards makes it clear how we should approach our work: We are here to relentlessly take care of our patients. In turn, it is leadership’s job to relentlessly take care of our staff. To see how CoxHealth is doing that, look no further than the rollout of the 2019 benefits changes. From health plan options to growing our investments in wages and benefits, we are investing in our team. The numbers, shared by HR’s Eric Maxwell and Sarah Wyman, tell the tale:
Wages and benefits
In fiscal year 2018, CoxHealth spent 78 cents of every dollar earned investing in employee compensation and benefits. For 2019, leaders are planning to invest the entire margin in our staff. Next year, CoxHealth is increasing investment to $682.5 million overall, with $125 million in benefits. That’s a 5.2 percent increase overall and an 8 percent increase in benefits. Meanwhile, CoxHealth is working to raise wages to remain competitive in our market. CoxHealth’s average pay increase is budgeted at 4 percent, compared with the average of 2.4 percent across the Missouri Hospital Association members. That includes a budgeted $7.3 million for market adjustments. CoxHealth is budgeting for employees to receive an average 2.5 percent merit increase, up from 2.2. Maxwell points out that we are going above the Missouri average of 2.3 percent. “We’re spending more than a million dollars to make the change and it’s a great benefit,” Maxwell says. “People deserve merit increases – and we would love to see our entry wage continue to increase, we are actively working on a plan.”
New dental options
This year’s changes also include a dental option with a higher maximum. Based on
employee feedback, we have added a higher maximum option. Staff can now choose from plans with maximums of $500, $1,000 or $1,500.
Affordable health plan options
CoxHealth will offer an Exclusive Provider Organization (EPO) plan, in addition to our current Preferred Provider Organization (PPO). The EPO offers a narrower network of providers, but it is a lower cost option. The PPO will remain as it is currently, with three tiers of coverage: CoxHealth network; participating network; and out of network The EPO offers two tiers: CoxHealth network and an exclusive participating network (which includes Barnes and Washington University in St. Louis). The EPO is set up just like the PPO, offering the same deductibles. The EPO will not have all the same providers that the PPO has in tier 2 and it will not have an out-ofnetwork option. “For most people, the EPO is the better option,” Maxwell says. “You will have care for everything you would need. Anything CoxHealth wouldn’t offer, we will have in the tier 2 providers.” The EPO also includes out-of-network coverage for emergencies, such as a vacation ER visit. Maxwell says one example where the PPO would be a better choice: If an employee has a dependent on their health plan and they are living in another state – at college for instance – and they are receiving primary care in that state.
Healthy Living offsets deductibles
In keeping with market trends, CoxHealth’s member ER copay goes from $225 to $300. Wyman points out that services like Save My Spot are offering easy access to urgent cares, which we are planning to expand. In the coming months, the Turner Center urgent care will be open 24/7, with plans to extend hours at other urgent cares in the future. Some deductibles will be changing, but the employee-only deductible will remain at $2,000. Deductibles for two covered members will be $3,000, while deductibles for three or
Investing in you
Polio From Page 3
The vaccine’s effect was quickly felt: One newspaper noted that polio cases plummeted from 39,000 cases nationwide in 1954 to around 15,000 in 1956. “This is less than half the total for 1954 and the average of the past five years,” a Springfield newspaper printed. According to the World Health Organization, the number of reported cases in 2017 was only 22.
Looking forward
Nurse Bailey Young says preparing to be a first-time mom next spring is both exciting and stressful. A new benefit offering two weeks off is reducing some of that stress.
New, extended parental leave ‘truly a blessing’ for parents Soon-to-be parents like nurse Bailey Young got some great news in the 2019 benefits rollout. Beginning Jan. 1, CoxHealth is offering two weeks of paid maternity and paternity leave. “As a first-time mom, there is so much that is exciting and stressful,” Young says. “Figuring out how much time I will have with the baby and how to budget for it was a major stressor.” Young calls herself “very much a planner,” and she had already been calculating how much Earned Time Off she would need to carry her through the holidays and on to her due date in May. “This has taken a lot of stress off my plate and my husband’s plate,” she says. “It is an extra two weeks with more members will be set at $4,000. Maxwell says the goal was to limit the increases to areas where we’re not seeing as much utilization. “We want to minimize the impact: less than 5 percent of the 15,000 people in our plan hit these deductibles,” he says. CoxHealth’s efforts to control rising benefit costs are working and Maxwell and Wyman say there is one key benefit we all
my baby without having to worry about bills.” The new benefit will offer two weeks of paid time for moms, dads and parents who are adopting children. The two weeks is in addition to accumulated disability benefit coverage and ETO that have traditionally been used for maternity leave. Young says she would have had about two and a half weeks of ETO banked by May, so the new benefit will nearly double that. “It’s truly a blessing for us. I’m super excited about getting as much bonding time -- and getting all the cuddles and the love -- as I can,” she says. “From our working environment to our benefits, it just shows that CoxHealth cares about us as people. It’s a wonderful place to be a nurse.” should be taking advantage of: the Healthy Living program. The best way to offset our plan’s deductible is by participating in the Healthy Living Wellness program and earning the HRA funds it offers. Healthy Living allows participants to earn up to $1,000, and retain a $250 rollover year to year. Last year, only 21 percent of participants earned the full $1,000, with employees earning an average credit of $571.
Despite the vaccine’s discovery, Burge wasn’t done serving patients battling polio. In 1956, the cottage closed with the unveiling of the new Crippled Children’s Wing. Another community initiative, the wing featured clinic space, an area for physical therapy, operating rooms, a new laboratory and rooms for about 50 patients. Near the new wing, another part of CoxHealth history was made: Artist George Kieffer installed his now-famous Helping Hands mural during the same period, which depicts medical professionals serving children seemingly battling polio. The Crippled Children’s Wing saw decades of helping young patients. As polio decreased, the clinic instead served children with orthopedic issues, continuing at least through the mid-1980s. The wing’s legacy is still obvious on the east side of Cox North, where the concrete is engraved with its original purpose. Though Burge’s efforts to care for polio patients are decades past, they represent the same efforts CoxHealth makes today when it comes to care. The health system routinely expands its offerings and abilities, giving people of the Ozarks cutting-edge treatments, high-qualified specialists and award-winning care close to home. 7
3850 S. National Ave. Springfield, MO 65807
Photo: Russell Weller
Meeting the new da Vinci surgery robots CoxHealth’s robotics team is growing: Three of the most up-to-date da Vinci robots arrived at Cox South in October. The robots allow teams to increase capacity and technique in areas including gynecology, urology and bariatrics. Staff were invited to see these new robots in the surgery classroom as representatives were on hand for a hands-on demonstration of the technology.
Magic Word
Find the magic word and you could win your choice of a shirt or coffee mug from 1906, The Employee Store. Call 269-4154 and leave a message with the magic word and the page on which it can be found. Include your name,
department and phone number. The 44th correct answer will win. Clue 1: A place of refuge and safety. Clue 2: A nature preserve: “A bird __________.”
Connection is a regular publication for the employees of CoxHealth 3801 S. National Ave. Springfield, MO 65807
Email us any time at CorporateCommunications@coxhealth.com Editor: Randy Berger 269-3171
Contributors: Kaitlyn McConnell Russell Weller
Yvette Williams
November / December 2018
CoxHealth’s community impact: Reflecting on our past
CoxHealth Legacy
The new CoxHealth Legacy series of historical stories in Connection and on CoxHealth.com will remind us of where we came from – and the impact CoxHealth continues to have today.
Investing in you More options, new perks: Check out the 2019 benefits changes. Pages 6-7
The war on polio
See how Burge Hospital cared for our kids across the region during the 1950s epidemic. Page 1
Inside 300 West One unit is making strides in service with a positive approach. Pages 4-5