St. Clair Hospital HouseCall Volume XI Issue 2

VOLUME XI ISSUE 2

HouseCall TCAR PROCEDURE

New surgical advancement for stroke prevention See Page 2

PREVENTING STROKE

2 I HouseCall I Volume XI Issue 2

In their midlife and senior years, many Americans become concerned about being diagnosed with cancer or having a heart attack, and engage in preventive measures and screenings to minimize their risk. Avoiding a stroke should be an equivalent concern, as stroke is the fifth leading cause of death in the U.S., and the number one cause of permanent, life-altering disability. In the U.S., 800,000 strokes occur every year, with 75 percent affecting those age 65 or older. ublic awareness of stroke arguably lags cancer

treatment, for selected patients.“TCAR is the latest technology

and heart attacks, and as a result, stroke’s risk

and a powerful adjunct to the conventional approaches to

factors and warning signs often go unrecognized,

CAD,” says Dr. Tom Simone. “We’re excited to be able to offer

with potentially catastrophic results. Surviving a

this new surgical procedure at St. Clair Hospital.”

stroke, and more importantly, surviving one with

The carotid arteries are like two parallel superhighways

the central nervous system undamaged, is contingent upon

on each side of the neck, transporting fresh, oxygen-rich

many factors, including timely recognition of symptoms and

blood straight from the heart to the brain, the body’s command

immediate, appropriate medical intervention at a hospital

center. Their patency, or openness, is vitally important,

like St. Clair, a Stroke Gold Plus Award recipient from

but as we age, they may become narrow as a substance

the American Heart Association and a certified Primary

known as plaque accumulates along the vessel walls.

Gradually, the space narrows (stenosis) and the artery

Stroke Center by The Joint Commission.

For all these reasons, stroke prevention is paramount, and at St. Clair Hospital, a team of vascular surgeons is

becomes stiff; eventually the stenosis may lead to complete occlusion or closing. The plaque that lines the

working to further reduce stroke risk in persons with

carotid arteries is composed of mostly fat and cholesterol,

carotid artery disease (CAD), a leading cause of stroke, with

and is exactly the same as the plaque that coats the walls

an innovative procedure known as transcarotid arterial

of the coronary arteries. This process, atherosclerosis, is

revascularization, or TCAR (pronounced tee-car). For Tom

actually a systemic condition, and when left untreated, can

Simone, M.D., and his partner Samuel T. Simone, Jr., M.D.

be equally lethal in the brain or the heart, producing stroke

(Tom’s father), TCAR is proving to be a patient-friendly

or heart attack.

Continued on Page 4

and highly effective alternative to traditional CAD

STROKE FACTS 800,000

140,000

PEOPLE SUFFER A STROKE IN THE U.S. EVERY YEAR

PEOPLE DIE FROM STROKE EVERY YEAR IN THE U.S.

5

STROKE IS THE # CAUSE OF DEATH AND A LEADING CAUSE OF DISABILITY

CAROTID ARTERY DISEASE IS THE CAUSE OF

ONE THIRD

OF ALL STROKES

Sources: CDC.gov and National Stroke Association.

Volume XI Issue 2 I HouseCall I 3

PREVENTING STROKE Continued from Page 3

“As plaque builds up, the artery can become completely blocked, resulting in embolization (fragments of plaque breaking off and traveling to the brain), transient ischemic attack, (TIA, or mini-stroke), or a major (ischemic) stroke,” explains Dr. Simone. “Carotid artery disease develops

WHAT IS CAROTID ARTERY DISEASE?

with aging and is second only to atrial fibrillation as a cause of stroke.

Risk rises with age and is associated with high blood pressure, high cholesterol, smoking, diabetes and heart disease. It is a silent condition, meaning that it typically has no symptoms, and it doesn’t cause pain.

Carotid artery disease can be

It is sometimes diagnosed during a routine physical exam, when the

caused by cholesterol build-up in the

doctor places a stethoscope on the neck and listens to the blood flow.

blood vessels (atherosclerosis). Blood

He or she is listening for a sound known as a bruit — a whistling sound

clots can form in this area and travel up to the brain. This condition may be present for a long time before symptoms appear. When symptoms do occur, stroke or brief stroke-like events are common.

CAROTID ARTERY

that indicates narrowing. Carotid artery disease can also be discovered during an eye examination, when an ophthalmologist may detect plaque

PLAQUE BUILD UP

in the retinal artery. But the first symptom of carotid artery disease can be a TIA or a stroke.”

The goal of treatment in carotid artery disease is to reduce the risk of stroke. If the physician hears a bruit, the patient will likely undergo a diagnostic carotid artery ultrasound to look for stenosis. Often, carotid artery disease can be medically managed to slow its progression.

“Medical treatment is the first line of defense in treating carotid artery disease,” says Dr. Sam Simone. “Low dose aspirin, medications to lower cholesterol (statins) and blood pressure, and smoking cessation are part of treatment. Statins are very effective and the newer ones are even better, with fewer side effects.”

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TH E TCA R P R OC ED UR E

To begin the procedure, a small incision is made just above the collar bone to expose the carotid artery.

A soft, flexible sheath is placed directly into the carotid artery and connected to a system that will reverse the flow of blood away from the brain.

However, for patients who are symptomatic and have had a

Blood flow in the cartoid artery is temporarily reversed to prevent emboli from traveling to the brain during the procedure. The patient's blood then flows through a filter outside the body where the filtered blood is then returned through a tube in the patient's upper leg.

A stent is placed in the artery reducing the risk of stroke due to narrowing of the artery (stenosis). After the stent is placed successfully, flow reversal is turned off and blood flow resumes in its normal direction. The incision is then sewed up with minimal to no visible scarring.

reaching the brain, and then a stent, a hollow mesh metal tube,

TIA or a minor stroke, there is a significantly higher risk of stroke

is inserted and left in place. Both the CEA and the CAS procedures are

and therefore a more urgent situation that demands intervention.

safe and have different benefits to the patient, Dr. Tom Simone says.

Surgical approaches to carotid artery stenosis are all designed to

“The CEA procedure is very effective and it is the traditional approach,

improve blood flow to the brain. The gold standard for surgical treatment

but it has risks, especially the risk of cranial nerve injury. CAS is a

is the carotid endarterectomy procedure, or CEA, during which a

less invasive way to treat carotid artery disease, but in the CREST

surgeon “cleans out” the blocked arteries through an incision in the

(Carotid Revascularization and Endarterectomy vs. Stenting Trial)

neck at the level of the blocked artery. It is an open surgical procedure,

study, a major stroke prevention study, it was found to carry a

performed with the patient under general anesthesia. A second

slightly higher risk of stroke in certain types of patients and is

procedure, carotid artery stenting (CAS), is a minimally invasive

only recommended in selective situations.”

procedure, much like a cardiac catheterization, that involves introducing

The TCAR procedure is a powerful adjunct to those traditional

a guidewire percutaneously (through the skin) through the femoral

approaches, says Dr. Simone, who began offering it at St. Clair earlier

artery in the groin and advancing it up through the blood vessels until

this year. “TCAR is hybrid between surgery and stenting; it includes

it reaches the carotid artery. A protection device is placed to prevent

elements of both. We make a small incision at the base of the neck,

escaping emboli (blood clot, air bubble, piece of fatty deposit) from

above the collarbone, and expose a small portion of the carotid artery.

Continued on Page 6

Volume XI Issue 2 I HouseCall I 5

PREVENTING STROKE Continued from Page 5

A stent is placed directly into the carotid artery

TCAR is not indicated for every patient

procedure is indicated. These patients, too,

and connected to a system that temporarily

who needs CAD surgery, but is for those with an

are good candidates for TCAR, as are those

reverses blood flow away from the brain, to

increased risk of stroke or other complications.

who have had previous neck surgery, such as

protect it from emboli — fragments of plaque

“TCAR is for patients who are high risk,” says

a radical neck procedure for cancer, or have

that may be loosened during the procedure;

Dr. Sam Simone. “The procedure makes it

had radiation to the neck. Smokers are high

the brain still receives adequate perfusion

possible for persons previously considered

risk for conventional surgery, because they

(blood flow) from the other cerebral arteries.

too high-risk for carotid artery surgery to

have poor wound healing and a higher risk of

All stents require some form of neuro-

undergo this brain-preserving treatment.

infection. It’s great to be able to offer this to

protection, and with TCAR that protection is

CAD patients tend to be older people, with

these patients.”

For the patient, TCAR has many advan-

provided by this unique blood flow reversal

co-morbid conditions (other medical issues)

technology. This flow reversal allows balloon

such as hypertension and heart disease;

tages, says Dr. Tom Simone. “TCAR has little

angioplasty and stenting to take place. After,

surgery is risky for them. Patients who have

to no risk of cranial nerve injury, which is a

the flow reversal is turned off, and normal

had previous CAD surgery may experience a

possible complication of the CEA procedure,

blood flow resumes.”

recurrence of the narrowing, so that a second

and very little stroke risk. We don’t have to

Dr. Sam Simone performs vascular surgery in an operating room at St. Clair.

SAMUEL T. SIMONE, JR., M.D. Dr. Simone specializes in vascular surgery. He earned his medical degree at Temple University School of Medicine, Philadelphia. He completed his internship and residency at Mercy Hospital of Pittsburgh, and a fellowship in vascular surgery at Presbyterian-University of Pennsylvania Medical Center, Philadelphia.

Dr. Simone is board-certified by the American Board of Vascular Surgery. He practices with General & Vascular Surgery Associates, Inc. To contact Dr. Simone, please call 412.207.2632.

6 I HouseCall I Volume XI Issue 2

KNOW THE SIGNS OF STROKE navigate the aorta and other blood vessels in the chest. There is no groin incision, only

B

E

F

A

S

T

a very small neck incision, so there is very little discomfort and minimal blood loss.

Patients are admitted to the Intensive Care Unit post-op in order for us to be able to closely monitor their neurological status; the admission is under two days. All of our TCAR patients at St. Clair have had excellent outcomes; in follow-up, I have seen no complications.

BALANCE

trouble walking, stumbling, falling, feeling dizzy or spinning sensation

EYES

vision loss, blurry vision, double vision

FACE

one side of the face is weak or numb, the face appears uneven or drooping

ARMS

weakness or numbness in the arm (or leg), especially if it is on one side of the body

SPEECH

slurred speech, trouble getting words out, speaking gibberish

TIME

call 911 immediately

“TCAR is safe and far less stressful for the patient. Outcomes are better than those for stenting and are as good as outcomes for CEA surgery. Every patient undergoing TCAR is enrolled in the Society for Vascular Surgery’s Vascular Quality Initiative, a database which tracks the patient’s outcome for safety and for research purposes. We believe that TCAR will have

“

WE’RE EXCITED TO BE ABLE TO OFFER THIS

a huge impact in stroke prevention; stroke

NEW SURGICAL PROCEDURE

is devastating, and 20 to 30 percent of

AT ST. CLAIR HOSPITAL.

strokes originate in the carotid arteries.

We hope to offer this at St. Clair to

many more patients who are at risk.” n

”

THOMAS A. SIMONE, M.D., VASCULAR SURGEON, ST. CLAIR HOSPITAL

Please see TCAR patient stories, pages 8-11.

Thomas A. Simone, M.D.

THOMAS A. SIMONE, M.D. Dr. Simone specializes in vascular surgery. He earned his medical degree at Jefferson Medical College, Philadelphia, and completed an Integrated Vascular Surgery Residency Program at Dartmouth-Hitchcock Medical Center, a tertiary care hospital affiliated with Dartmouth University in New Hampshire. Dr. Simone is board-certified by the American Board of Vascular Surgery. He practices with General & Vascular Surgery Associates, Inc. To contact Dr. Simone, please call 412.207.2632.

Volume XI Issue 2 I HouseCall I 7

PREVENTING STROKE Continued from Page 7

PATIENT PROFILE: ADENA “CAROLYN” BRUSCHI

Celebrating life

Adena “Carolyn” Bruschi believes that life is something

carotid artery was becoming re-occluded (blocked). “It had

to celebrate. Carolyn, 76, of Cecil Township, Washington

been two years since I had seen Dr. Simone and he wouldn’t

County, has an appreciation for the special occasions and

reorder my prescription unless I came in to see him. I am so

small moments that brighten everyday lives, and for her that

grateful to him for that. They did a Doppler test and he called

includes having her family over for dinner, playing bocce with

me personally and said, ‘Carolyn, you need an operation, but

her neighbors, and taking pleasure in the peonies and petunias

we have something new. It will be a lot easier.’ He didn’t need

that she nurtures in her garden. Carolyn and her friends find

to convince me; I trust him. I don’t think you can get a better

many reasons to celebrate with each other, honoring birthdays

doctor than him.”

and anniversaries, a new grandchild, a clear scan after cancer treatment or any kind of good news. Recently, they planned an

The TCAR procedure, performed by Dr. Simone’s son and partner Tom Simone, M.D., was successful and Carolyn spent

outing to the ice cream parlor at Sarris Candies in Canonsburg,

three days at St. Clair, where she says she had great care by

Washington County, where they celebrated the good news

the Intensive Care Unit nurses. She will see the Simones every

of Carolyn’s successful TCAR (transcarotid arterial revascular-

three months for monitoring her condition. “I tell everyone to

ization) surgery at St. Clair Hospital in early May.

make sure you see your PCP so they can listen to your heart

This was the second time that Carolyn has undergone

and carotid arteries. I had no symptoms, so I didn’t know my

treatment on her left carotid artery. Fourteen years ago, she

arteries were becoming blocked. I could have had a stroke,

had a carotid endarterectomy procedure (CEA) done at St. Clair

but I had excellent care and I’m fine.”

by surgeon Samuel T. Simone, Jr., M.D. That procedure went

Carolyn has even more to celebrate now. She is a world

well, but during her admission, she was found to have severe

traveler and has been to dozens of other countries with family

coronary artery disease. Carolyn underwent a triple bypass

members; she has seen most of Europe and the Middle East,

procedure at St. Clair. She recovered very well, with regular

and has even taken a cruise along the Amazon. She has been

follow up by her primary care physician (PCP) Nicolette E.

to Australia, New Zealand and Tasmania, and has visited

Chiesa, M.D. She went back to work at her job in finance,

Antarctica and the Falkland Islands. Here at home, Carolyn

and eventually retired and moved to a patio home

keeps busy with activities in her community clubhouse. She

community in Cecil.

In late winter of this year, a routine call to Dr. Simone’s office for a prescription led to the discovery that her left

8 I HouseCall I Volume XI Issue 2

serves on the social committee, which plans holiday parties, picnics and other events, including an occasional — but not

too frequent — outing to an ice cream parlor. n

“

I had no symptoms so I didn’t know my arteries were becoming blocked.

I could have had a stroke, but I had excellent care and I’m fine.

”

ADENA “CAROLYN” BRUSCHI, PATIENT

Volume XI Issue 2 I HouseCall I 9

PREVENTING STROKE Continued from Page 9

PATIENT PROFILE: DOMENICO PASQUARELLI

A new lease on life Domenico “Dom” Pasquarelli, 64, of Upper St. Clair, was

artery endarterectomy (CAE) surgery performed on his right

born in the rugged and mountainous Abruzzi region of central

carotid by vascular surgeons Tom Simone, M.D. and his father,

Italy, in a picturesque town called Pizzoferrato-Chieti (also

Samuel T. Simone, Jr., M.D. in November 2017.

the birthplace of another Italian-American Pittsburgher, the

The surgery was successful, and Dom’s recovery went well.

late Bruno Sammartino). In 1974, at the age of 18, Dom met

But at a follow-up visit earlier this year with his cardiologist,

Valentina, a young woman who had been born in that town,

James W. Marcucci, M.D., there was a red flag: Dr. Marcucci

but moved to the U.S. as a child in 1969. She had returned to

heard a bruit, or an abnormal sound, in Dom’s right carotid.

Pizzoferrato-Chieti with her brother Joe to visit relatives there,

“I don’t like the sound I’m hearing in your neck,” Dom

and one fateful day, Domenico met her in the town piazza.

recalls the doctor saying. Dr. Marcucci referred him back to

They fell in love and married. When he was 18, and she was

Dr. Tom Simone, who ordered an ultrasound and CAT scan.

17, Domenico followed Valentina to the U.S., to live in the

The tests revealed that Dom had a recurrence of carotid artery

Oakland section of Pittsburgh. They had three children:

stenosis, or blockage, and this necessitated a second procedure.

Patrizia, Piero and Domenico Jr.

Dom turned out to be a perfect candidate for the TCAR

Dom is retired, after having worked in heavy construction

(transcarotid arterial revascularization) procedure, and he

with different companies for 44 years, helping to build many

underwent TCAR at St. Clair. The procedure took place in

of western Pennsylvania’s major roads and bridges. In the fall

March, and Dr. Tom Simone says it went perfectly.

of 2017, he began having neurological symptoms: his fingers

“The second time that a patient is treated for carotid

fell asleep, on his left hand; he experienced numbness in his

artery disease, there is an increased risk of cranial nerve

left leg, and then in a portion of his mouth. He had previously

injury, because there is scar tissue at the site,” Dr. Simone

been diagnosed with high blood pressure by Anthony J.

says. “Domenico did very well with the TCAR procedure.”

Ciampa, M.D., his primary care physician, and Dom’s son,

Dom is pleased with his TCAR experience, and he is feeling

Domenico Jr., recognizing the possible signs of stroke, took

great post-op. “The second time, with the new procedure,

his father to the emergency room at St. Clair Hospital. He was

was a lot easier than the first time,” he says. “It was pain free

diagnosed with carotid artery disease and had a carotid

and I feel fine now. It helped that the doctors explained everything clearly, so we knew what to expect. I like the Simones, the father and son team; they kept me in St. Clair for a few days to make sure I was okay, because of my high blood pressure. They take good care of me.”

With the TCAR procedure successfully completed, Dom has a new lease on life, and he is enjoying his retirement. He and Valentina have traveled to Italy five times; but he is happy to spend time at home with family and often helps his children with projects and repairs at their homes. He enjoys gardening and taking care of his lawn and his house. “I worked in heavy construction for all those years, and that was very hard work,” he says. “I had enough of it, so now I take it easy and enjoy my life and my family, including daughter-in-law Dayna, Piero’s wife, and three grandchildren: Enzo, Matteo and Natalia.” n

Pizzoferrato is a town in the Province of Chieti in the Abruzzo region of Italy whose defining characteristic is the large cliff around which it is situated.

10 I HouseCall I Volume XI Issue 2

“

I like the Simones, the father and son team ... They take good care of me.

”

DOMENICO PASQUARELLI, PATIENT

Volume XI Issue 2 I HouseCall I 11

NURSING AT ST. CLAIR

Nursing Care at St. Clair Ranks Among the Nation’s Best Providing optimal patient care in a hospital setting requires a wealth of ingredients that, when combined, expertly merges the finest elements of high-tech and high-touch. At the core of this delicate amalgamation of intense training, technology, process engineering and the human art of caring, are nurses. What follows are insights into what has vaulted the nursing staff at St. Clair Hospital to the top echelon of “front-line” care givers in the United States.

Patients Always Come First St. Clair Hospital’s standing as a leader in nursing excellence is driven by an unrelenting focus on the patient: At St. Clair, patient-centered care defines the culture, and nursing is the center of that culture.

As the largest group of professionals within the health care workforce, nursing has an enormous impact on the quality of a patient’s experience, says Diane L. Puccetti, R.N., MS, Vice President and Chief Nursing Officer at St. Clair. Diane, along with her nursing leadership team, sets the strategic direction and vision for St. Clair’s approximately 600-member bedside nursing staff. “Nurses are the ’front line’ of health care,” she says. “A patient’s perception of quality care hinges largely on their interactions with nurses, and when they receive care that supports and protects their comfort, safety, dignity and individuality, they recognize that as excellence. Our nursing leadership goals are patient care, first and foremost; second, staff engagement, through mentoring programs for new staff, career pathways for existing staff, and keeping the front-line staff involved in moving initiatives forward and responding to their practical and professional needs; and, third, professional development through internal initiatives and career development through external means, such as Mayo Clinic and Robert Morris University.”

Keeping the patient at the center of care is not a simple matter in these days of high acuity (intensity of nursing care required by patients) and fast-paced, short admissions.

“Nursing maintains a focus on the patient by keeping them informed and involved in their care,” Diane explains. “That is best practice, and it is our practice.”

Amanda Russo, R.N. Coordinator, attends to patient Melanie McGinniss, of Upper St. Clair.

12 I HouseCall I Volume XI Issue 2

Best Practices and Collaborative Care

St. Clair’s nursing department utilizes a Professional Practice Model (PPM) to unify nursing practice throughout the Hospital. A PPM The nursing culture at St. Clair empowers the staff to contribute is a conceptual framework that supports and informs nurses in their to decision-making, Diane says. “St. Clair has a Professional Practice daily practice; at St. Clair, this is a Collaborative Care Model that Council with a clinical focus and we’re always seeking best practices encompasses all the key components of nursing: the values, practices and the newest technology to improve our quality of care. The and processes that define nursing excellence at St. Clair. On every unit, Professional Practice Council is composed of front-line nursing staff, the Hospital’s nursing professionals implement “best practices” with a representative from each unit. The group has driven pivotal those processes or practices that have been proven through research — process improvements in a number of clinical areas: admission to produce superior outcomes. assessments, patient handoffs (the transfer of a patient The nursing profession has a strong education from one shift to another or from one department to ethic, and at St. Clair, nursing education is ongoing. another), patient mobility and others. Having the bedside Education programs enable nurses to provide best nurses involved makes a big difference; they know NURSES ARE practices, advance their skills, translate research into the issues directly. Nurse managers make bedside care and upgrade their knowledge of the newest THE ‘FRONT LINE’ rounds and see each patient at least once during technology, treatments and concepts. At St. Clair, admission. We have collaborative discharge planning OF HEALTH CARE. Clinical Nurse Specialists (dedicated nurse educators), rounds, with the nurse, charge nurse, social worker on the specialty units, and a Professional Development and case manager joining to identify barriers and Specialist offer classes and seminars to ensure that the arrange services needed beyond discharge.” staff is up-to-date; in addition, the nurses have access DIANE L. PUCCETTI, R.N., MS, The entire nursing staff at St. Clair continuously VICE PRESIDENT AND to the wealth of nursing resources provided through seeks ways to improve care and achieve excellence, CHIEF NURSING OFFICER, the Hospital’s relationship with Mayo Clinic. St. Clair’s she adds. “This year, they have lanched a remarkable ST. CLAIR HOSPITAL new relationship with Robert Morris University is further range of initiatives, including the Enhanced Recovery evidence of its commitment to the professional After Surgery (ERAS) program; alternative pain development of nurses: an enhanced RN-to-BSN management approaches; and a program to improve program is available to help St. Clair nurses earn the discharge process, which can be complex and their baccalaureate degrees. time-consuming. The staff is motivated to look for

“ ”

innovative approaches that solve problems, improve the patient experience and expedite processes.”

Continued on Page 14

Heather Tarbuk, R.N. Coordinator, and Chief Nursing Officer Diane L. Puccetti, R.N., MS, care for patient Virginia Oberschelp, of North Strabane.

Volume XI Issue 2 I HouseCall I 13

NURSING AT ST. CLAIR Continued from Page 13

Career Development and Advancement at St. Clair St. Clair has a Professional Development Program to recognize nurses who advance their careers through education, collaboration and service. It is a voluntary program, conducted annually; approximately 30 nurses enter the program every year. “Any staff nurse can participate and we encourage them to do so,” Diane says. “It’s recognition that has to be earned, via a point system, and it’s hard work. Each participant completes rigorous objectives that are meant to enhance their skills and develop their practice, including a process improvement project and community service. Completing the program entitles the nurse to additional financial support for her or his education—these funds can be used for tuition, conference attendance or obtaining certification in a clinical specialty.”

A nurse mentoring program gives newly hired nurses a solid foundation for their St. Clair career. “At St. Clair, we believe that nurses need mentors and we provide a highly effective mentoring program.

Nursing is a great profession, but it’s also very demanding and newly hired nurses and new graduates need support in order to succeed.

Mentoring helps them to acquire skills, gain confidence, learn hospital processes and become familiar with St. Clair’s standards of care.

Mentors offer both practical and emotional support. At St. Clair, we are so convinced of the value of mentoring that we even have mentors for our new nurse managers.”

St. Clair Nursing Among the Best in Nation in Patient Satisfaction PERCENTILE RANK NATIONALLY

Friendliness/courtesy of the nurses . . . . . . . . . . . 97

Prompt response to calls . . . . . . . . . . . . . . . . . . . . 99 Nurses’ attitude toward requests . . . . . . . . . . . . . 95 Attention to special/personal needs . . . . . . . . . . . 98 Nurses kept you informed . . . . . . . . . . . . . . . . . . 95

Making the Most of the Mayo Clinic Connection Nursing’s pursuit of excellence at St. Clair is energized by the Hospital’s relationship with Mayo Clinic. In the three years since St. Clair was invited to join the Mayo Clinic Care Network (MCCN), Diane has attended regular leadership symposiums with other chief nursing officers from MCCN member hospitals. She finds the meetings inspiring and validating. Interacting with her counterparts is, she says, an extraordinary opportunity to exchange ideas and learn from Mayo Clinic experts. “The MCCN CNO (Chief Nursing Officer) group is a wonderful resource,” she says.

“I come back from every meeting with new, important information to share with my team.”

Exposure to the opportunities afforded by the relationship with Mayo has invigorated St. Clair’s nursing staff. “When faced with a problem, we ask, ‘What is Mayo doing about this?’ We utilize Mayo resources for developing policies and clinical pathways, and have sent many of our nursing leaders to Mayo.”

A Calculated Mix of Science and Art Nursing is an expansive discipline that begins with science and encompasses technology, psychology, management and communication arts. Nurses must develop a broad range of sophisticated clinical skills, critical thinking and a deep understanding of disease processes, treatments and medical technology. Every day at St. Clair, nurses provide care, monitor patient status, interpret and communicate changes, keep patients safe, relieve pain and anxiety, educate patients and families, and collaborate with other disciplines. In addition, nurses offer genuine caring and compassion to their patients, providing comfort and respite from stress through authentic human connection.

“Nurses are valued at St. Clair, and the Hospital makes every effort to support our nursing staff and help them sustain their professionalism,” says Diane. “Nurses who have job satisfaction provide excellent care, and it’s imperative to keep the best nurses at the bedside, closest to the patient. High tenure and low vacancy are a St. Clair nursing tradition that we are upholding through all the initiatives and programs that we offer. Our nurses work hard, with commitment and passion, to care for patients with the highest level of quality. That’s patient-centered care, and that’s our mission.”

Skill of the nurses . . . . . . . . . . . . . . . . . . . . . . . . . 99 SOURCE: PRESS GANEY

.........................

Communication with nurses . . . . . . . . . . . . . . . . . 97

Nurses treat with courtesy/respect . . . . . . . . . . . 97 Nurses listen carefully to you . . . . . . . . . . . . . . . . 97

Nurses explain in way you understand . . . . . . . . . 96 SOURCE: CMS

14 I HouseCall I Volume XI Issue 2

UP NEXT: The following pages spotlight St. Clair’s partnership with a local university’s School of Nursing to mutually advance nursing expertise, and four examples of the cadre of nurses at St. Clair who have helped propel the Hospital’s patient care to being among the nation’s best.

ST. CLAIR’S ACADEMIC SERVICE PARTNERSHIP WITH ROBERT MORRIS UNIVERSITY PROVIDES MYRIAD BENEFITS

R

obert Morris University in Moon Township has joined with St. Clair Hospital in a new partnership that promises to bring myriad benefits to both institutions. Nadine Cozzo Englert, R.N., MSN, PhD., Associate Dean and Chief Nurse Administrator at the RMU School of Nursing, Education and Human Studies, says the new formal relationship is an academic service partnership, a collaboration between an educational institution and a health care organization. One component of the new partnership is a “Dedicated Educational Unit” (DEU) program, a peer education model that is transforming the way that nursing students gain clinical skills by employing hospital staff nurses as clinical instructors. At St. Clair, the program will pair staff nurses with nursing students to give them clinical experience and a realistic view of hospital-based nursing. The DEU concept departs from traditional nursing education in several important ways, explains Dr. Englert. “Most importantly, the nursing student has a one-to-one clinical experience with a registered nurse. The DEU provides an immersion experience; students are deeply engaged in patient care. The staff nurses get an opportunity to share their expertise and to make a difference for a future nurse.”

RMU’s School of Nursing is one of many regional nursing schools that have been bringing groups of nursing students to St. Clair for clinical rotations for years. This agreement takes that further and deeper. The students have the advantage of a prime clinical placement in one of the region’s most highly regarded hospitals, known nationally for its high quality of care and its clinical collaboration with Mayo Clinic. The staff nurse educators have prepared for this expansion of their role by undergoing special training at RMU. “St. Clair is a top-notch clinical learning environment and we are fortunate to have the Hospital as a devoted clinical partner,” Dr. Englert says. “Nursing schools compete for clinical sites and this partnership will prove beneficial as that competition continues to grow with the burgeoning demand for nurses.”

Another element of the RMU-St. Clair partnership is an enhanced RN (registered nurse)to-BSN (bachelor of science in nursing) program to help St. Clair nurses with associate degrees and nursing school diplomas earn a baccalaureate degree. This RN-to-BSN

program is part of an effort to align the Hospital with the 2010 Institute of Medicine Report on the Future of Nursing, which recommended that 80 percent of nurses have a BSN degree by 2020. With the new partnership, RMU is offering on-site support at St. Clair for nurses in the program by placing a member of the RMU faculty at the Hospital once a week, to facilitate their academic success. The first faculty member to fulfill that role is Dr. Englert, who offers technological support, help with scholarly writing and more.

In the third component of the new partnership, St. Clair will serve as a site for research for RMU students in the Doctor of Nursing Practice program. At RMU, nurse practitioners are prepared at the doctoral level.

There are mutual benefits to the academic service partnership, Dr. Englert says. “This partnership capitalizes on the strengths of both

institutions, and both institutions will gain advantages. RMU is getting a prime clinical placement; St. Clair is an amazing hospital, known for excellence in nursing. The registered nurses will have an opportunity to teach in the DEU program, and St. Clair will be in a position to recruit RMU nursing students to take a position at St. Clair after graduation.”

Diane L. Puccetti, R.N., MS, Vice President and Chief Nursing Officer at St. Clair, echoes Dr. Englert’s enthusiasm. “It’s a joy and a pleasure to have this relationship with RMU. They have a wonderful nursing program with many assets, including a high-tech simulation lab. Our nursing staff is very engaged in the new DEU program, and St. Clair nurses are signing on for the RN-to-BSN program as well. RMU and St. Clair are great partners and we are excited about all the possibilities as we move forward.”

“

St. Clair is a top-notch clinical learning environment and we are fortunate to have the Hospital as a devoted clinical partner.

”

NADINE ENGLERT, R.N., MSN, PhD., ASSOCIATE DEAN AND CHIEF NURSE ADMINISTRATOR, RMU SCHOOL OF NURSING, EDUCATION AND HUMAN STUDIES

Nursing students at RMU School of Nursing practice hands-on “patient” care on high-tech mannequins in the school’s simulation lab.

Volume XI Issue 2 I HouseCall I 15

NURSING AT ST. CLAIR Continued from Page 15

Nursing Spotlight Sharon

R.N., BSN

Caring is a core value of nursing, but the profession has sometimes struggled to define exactly what “caring” means. The best nurses, however, have no such struggle, and there is no better nurse than St. Clair Hospital’s Sharon Cropp, R.N., BSN. Sharon has graced the patient units and halls of St. Clair, contributing every day to St. Clair’s reputation for nursing excellence. Driven by a passion for her profession and a commitment to her patients, Sharon is involved in a remarkable range of initiatives, all aimed at improving quality of care and patient safety. For Sharon, nursing is caring in action.

As nurse manager of Nursing Unit 6E, Sharon supervises a staff of 26 registered nurses, 10 nurse aides, and four unit secretaries, and oversees the care of oftentimes 21 surgical patients. Many patients on her unit have undergone complex cancer surgeries.

Sharon is a member of multiple interdisciplinary patient care initiatives, including ERAS — Enhanced Recovery After Surgery. “ERAS is a Mayo Clinic-inspired way of thinking about surgery patients and we are using it for colorectal surgery patients. The ERAS program enables us to anticipate problems and avert them to facilitate recovery. We have seen dramatic improvements and patients are often able to go home in two days.”

Sharon, of Green Tree, is equally enthusiastic about St. Clair’s Collaborative Care Model, a best practice care delivery model. The model forms the basis for St. Clair’s patient-centered, proactive and team-oriented approach to nursing practice. Traditional patient reporting occurs at the nurses’ station and consists of nurse-to-nurse sharing of information and updates; in contrast, bedside reports, which take place on every shift at St. Clair, include the patient and are conducted in the

patient’s room. This practice keeps the patients informed and gives them substantial attention: during the report, IVs are checked, safety is assessed, incisions are examined and more — and all members of the team see these things at the same time. “Nothing gets missed this way,” Sharon says. “Patients appreciate it because the report informs them and lets them know what the plan is. It’s reassuring.”

Sharon is co-facilitator of the nursing department’s Professional Practice Committee, which is composed of front-line nurses from each unit. They meet regularly to discuss problems and find solutions.

“Nurses are problem solvers, and they are at their best when they are sharing ideas and information to improve care. They run their ideas for solutions past our Chief Nursing Officer Diane Puccetti, but they own the solutions.”

Sharon’s drive to enhance patient care has been boosted by St. Clair’s clinical relationship with Mayo Clinic. She says learning about Mayo’s implementation of best practices is informative and validating. “St. Clair is very similar to Mayo in this way. We’re very fortunate to have the unique resources of Mayo Clinic.”

Sharon, who has been a nurse manager since 1979, says she was inspired to become a nurse after seeing nurses care for a family member.

“I was amazed at what the nurses did, the way they cared for the patients, but also for the families. I knew then what I wanted to do.”

The best parts of the job, she says, are being with patients and nurses on daily rounds, and mentoring new nurses and nurse managers.

“Nursing is a complex, demanding job and nurses need mentors to succeed,” she says.

Sharon’s personal philosophy is that caring has to be extended to everyone. “I care deeply about the patients and families, but I care about the staff, too. I have learned as a manager that I have to model caring behavior toward them. You have to care, and care deeply, not only about the patients but also about the staff. If I care for them, they’ll care for the patients.”

“

Nurses are problem solvers, and they are at their best when they are sharing ideas and information to improve care.

”

SHARON CROPP, R.N., BSN, ST. CLAIR HOSPITAL

Sharon Cropp, R.N., BSN, with patient Jim Petrucci, of Mt. Lebanon.

16 I HouseCall I Volume XI Issue 2

Nursing Spotlight Denise

R.N.

Denise Teti, R.N. is not a nurse who draws attention to herself.

Soft spoken and gentle, she serves as a coordinator on Nursing Unit 5A, Orthopedics, where she and her nursing colleagues care for patients who have undergone complex joint replacement surgeries and repair of musculoskeletal injuries, followed by intense physical therapy. It’s a busy, fast-paced setting and Denise is a calm center who keeps her finger on the pulse of unit activities at all times. Although she is a coordinator, she also functions as a bedside nurse, always honing her clinical skills and staying close to the staff and the patients. Despite her quietude and calm demeanor, there are powerful forces driving Denise, whose focus is laser sharp and always directed toward excellence.

“At St. Clair, the environment of care is unique,” she says. “There is a St. Clair way of doing things, and it’s the right way, the safest way, and always the best way possible. We have a structure in place here that facilitates this and enables us to maintain excellence and pass it on to new members of the staff.”

Mentoring is one of the most effective ways to achieve this, Denise believes. “We have a mentorship program for new nurses that eases them into the culture and practices here. Our mentors are experienced nurses who have patience and empathy, in addition to strong clinical skills. The new nurses have to feel comfortable asking questions and talking about how to deal with job stress.

On our unit, mentoring works well to help new nurses become familiar with nursing practices, standards and policies and the use of the electronic health record.”

Denise, of Scott Township, is co-chair of the nursing department’s Professional Practice Council, a committee composed of front-line nurses from each nursing unit who identify, discuss and solve problems on the patient care units. It’s a committed and empowered group, says Denise, which searches for best practices and the newest technology to improve care.

An important resource for the Professional Practice Council is the Mayo Clinic; St. Clair’s membership in the Mayo Clinic Care Network provides the staff with nearly limitless materials and educational videos, which are electronically accessible right on the nursing units.

“We can call on Mayo at any time for order sets, patient education materials and everyday information to help us solve problems and care for patients,” she says.

A former phlebotomist, Denise became a registered nurse in 2007, after earning an associate degree from Community College of Allegheny County. This year she became one of the first St. Clair nurses to take advantage of the new academic service partnership between St. Clair and Robert Morris University, which includes a RN-to-BSN (registered-nurse to bachelor-of-sciencein-nursing) program. “St. Clair made this as simple as

possible,” Denise says. “Dr. Nadine Englert, RMU’s associate dean and chief nurse administrator, comes to St. Clair to meet with us.”

St. Clair’s professional advancement ladder, she says, is outstanding, offering incentives and accommodations to help nurses accelerate their career development.

With so many roles and activities, Denise is a nursing leader at St. Clair, and there is nowhere else she wants to be. “This Hospital has high expectations for nurses, and we support the nurses to meet and exceed those expectations. Physicians at St. Clair respect and rely on the nurses. There are many people at St. Clair, in all departments, who have been here a long time; we all know each other and work together with a single goal — good patient outcomes. All the things I do — supervising, teaching, mentoring, working on my BSN, working with the Professional Practice Council — converge into that one ultimate goal. At St. Clair, excellent patient outcomes are what it’s all about.”

Denise Teti, R.N., assists patient Paul Srsic, of Scott Township.

Volume XI Issue 2 I HouseCall I 17

NURSING AT ST. CLAIR Continued from Page 17

Nursing Spotlight Jake

R.N., BSN

Jake Meitzler, R.N., BSN did not originally set out to become a nurse.

He was working weekends as an emergency medical technician while completing a degree in biobehavioral health, and was considering becoming a paramedic. His mother, a registered nurse, suggested that he think about nursing instead. Jake enrolled in Penn State University’s second degree nursing program and found it was a perfect fit.

Jake, of South Park Township, started working as an emergency room staff nurse at St. Clair Hospital in 2015. He was promoted to a charge nurse and unit coordinator in 2018, and in April, was named Manager of the Emergency Department.

Emergency nursing was clearly the right specialty for Jake, and he loved the work environment that he found as a staff nurse in St. Clair’s ER. “St. Clair has a culture of collegiality and a philosophy of patient-centered care that lend themselves to extraordinary teamwork,” he says. “In the ER, we care for patients like a NASCAR pit crew — we descend all at once and get everything done very quickly. The faster you initiate care and put the patient into the system the better it is for the patient. We get them stabilized and treated faster.”

At one point in his career, Jake accepted a full-time opportunity to work in informatics at another hospital, but he continued to work at St. Clair on the weekends before returning full-time. When St. Clair added a new management position in the ER, Jake applied for the job.

“I knew that I eventually wanted to move into management and this came along at exactly the right moment. I view this position as an opportunity to improve the work environment for the benefit of my peers. I’m an advocate for the staff and I’m excited about what can be improved. There is a solid foundation for growth here and an administration that listens well and wants to help us solve problems.”

Jake says the transition to management has been inspiring at every level. “I’m building new relationships, with the ER staff and with other departments. I’m being exposed to things that one doesn’t know about at the staff level. It’s a never ending education, every day, but then that is true for nursing in general.”

One of Jake’s plans for the ER staff is to increase the number of nurses who have certification. That credential, “CEN” or Certified Emergency Nurse, gives the entire staff a deeper pool of knowledge, he believes. “An ER nurse sees everything and is required to be a jackof-all trades. A nurse with certification is a resource to the rest of the team and improves everyone’s delivery of care.”

Jake has high praise for the ER’s physician leaders. “Our physician group is fantastic. They buy into the interdisciplinary, collegial culture completely. They are true team members and it’s not at all unusual to see our doctors asking the nurses for their input and ideas. We also have excellent registration staff, respiratory therapists, and patient escorts on the ER staff, and we have excellent relationships with community emergency providers. This is an exceptional ER— we get nearly 63,000 visits per year, which makes us one of the busiest ERs in the region.

It’s a complex place that can be stressful, but there is also an adrenalin rush in working here. ER nurses have to have experience and a mindset that enables them to deal with trauma on a daily basis. We are each other’s support system; we share a commitment to each other and a commitment to the patient.”

Jake admits concern that the public can sometimes misunderstand what nurses do, but he wants everyone to know: Patients always come first with nurses. “As an ER nurse, I want to give the best care and for me, that includes ‘reading the room’— getting a sense of the patient so I can tailor my care to the individual. Some patients need me to be warm and personal; others want a more clinical approach. My assessment of the patient’s unique needs leads to a positive patient experience. That’s what quality is — safe, effective care, on an individual patient level.”

“

My assessment of the patient’s unique needs leads to a positive patient experience.

That’s what quality is — safe, effective care, on an individual patient level.

”

JAKE MEITZLER, R.N., BSN, ST. CLAIR HOSPITAL

18 I HouseCall I Volume XI Issue 2

Jake Meitzler, R.N., BSN, listens intently to Albert Wendland, of Scott Township.

Nursing Spotlight Katherine

R.N., BSN, CMSRN

Katherine Gillihan, R.N., BSN, CMSRN (Certified Medical-Surgical Registered Nurse), who has worked on Nursing Unit 6E for three years, has navigated an unusual career path to get to her present position.

At 18, fresh out of high school, she looked to St. Clair Hospital, close to her Mt. Lebanon home, for gainful employment. She accepted a position in the Housekeeping Department on the night shift—a job that suited her well, as she soon enrolled in day classes to become a phlebotomist. The new job in the lab was ideal for “Katie” — it took her all over the Hospital and provided her with opportunities to watch and learn about health care career options. It didn’t take long for her to focus on nursing, and her flexible schedule in the lab enabled her to take the next step: acquiring an associate degree in nursing from Community College of Allegheny County. By then, Katie was a familiar face throughout the Hospital, known for her strong work ethic and upbeat personality.

Katie, now has three years of bedside nursing experience on a unit where she cares for patients who have undergone major surgeries.

She loves her work: “Every day is different; every patient is unique.

On a surgical unit, things get fixed — the patient is most likely going to feel better, go home and go on to a better quality of life. It’s satisfying, but also challenging. People come to the Hospital for surgery, but they bring their comorbidities (two or more chronic diseases or conditions) with them and are often high-acuity (require intense nursing care) patients.

They might have heart disease, diabetes or another chronic disease and have to be monitored for any signs of complications.”

Katie is one of the senior nurses on the night shift; she has achieved certification in medical-surgical nursing; and she has completed a baccalaureate degree program at California University of Pennsylvania.

She is a strong proponent of nurses acquiring a BSN degree and she is appreciative of St. Clair’s exceptionally supportive policies to help nurses at the Hospital do so. “The more education nurses have, the better it is

for the patient. And a BSN gives nurses even greater career choices.

St. Clair encouraged me to get my degree and certification by offering incentives; my bosses here have made every step of my career ladder possible. St. Clair also offers excellent on-the-job education. Things change constantly — new technology, surgical procedures and concepts — and we have to stay abreast.”

Katie personifies some of the best qualities of nurses. Her personal nursing philosophy is a simple one: take care of your patient, first, and the rest will fall into place. Her colleagues have recognized her for the achievements she has reached in just a few short years as a nurse: she has been chosen by them as St. Clair’s recipient of the 2019 Cameos of Caring nomination. Cameos is a prestigious regional award that was created to honor exceptional bedside nurses.

For Katie, it is made more meaningful by the fact that her co-workers chose her unanimously. “It was a complete surprise! Any one of the nurses I work with deserves this honor,” she insists. “My co-workers are amazing.”

Katie says her future might involve nursing informatics, a blend of nursing science and information management and analytical sciences. “I have a broad mindset because of my experience throughout the Hospital; that taught me that every job is important and every department matters.

The interdisciplinary nature of nursing and the interdepartmental interaction at St. Clair unite us in a common mission — the care of the patient. That is the shining light that directs me every day.” n

Katherine Gillihan, R.N., BSN, CMSRN,

Katherine Gillihan, R.N., BSN, CMSRN, center, checks a patient’s status with Samniang Promlee-Happe, R.N., left, and Mara Wetzel, CNA.

Volume XI Issue 2 I HouseCall I 19

ASK THE DOCTOR

Ask the Doctor GERSON B. FLOREZ, M.D.

Q A A

What is involved in shoulder replacement surgery?

Shoulder arthroplasty is the medical term for shoulder replacement surgery. To understand this surgery, it’s

There are three main types of shoulder replacement surgery:

important to gain basic knowledge of the shoulder’s

A hemiarthroplasty addresses arthritis that only involves

anatomy. The shoulder joint is the part of the body that

the cartilage on the humeral head (ball). A total shoulder

connects the upper arm to the torso. It’s composed of the

arthroplasty is commonly known as a shoulder replacement

humeral head (ball) and the glenoid (socket) of the scapula

and addresses the arthritis on both the humeral head (ball)

(shoulder blade). When the shoulder joint is damaged, it

and glenoid (socket). Lastly, the reverse total shoulder

results in pain and poor function. In shoulder replacement

arthroplasty is a specialized implant used for arthritis with

surgery, the damaged ball and socket are removed and

bony deformity or arthritis caused by rotator cuff tendons

replaced with prosthetic components to relieve pain and

that are not working properly. An orthopedic surgeon will

improve function of everyday activities.

help a patient select the appropriate prosthesis to maximize

Shoulder replacement surgery is not as common as hip

his or her functional improvement.

and knee replacements. Approximately 50,000 shoulder replacements are performed yearly in the United States.

Since being introduced in 1974, shoulder replacement surgery has demonstrated a strong track record in treating arthritic shoulder pain and restoring function.

The decision to undergo a shoulder replacement is a cooperative process between the patient, his or her family, and an orthopedic surgeon. The procedure requires a thoughtfully devised plan that incorporates preparing for surgery, care after surgery, and family support during the

Hemiarthroplasty

Total Shoulder Arthroplasty

Reverse Shoulder Arthroplasty

recovery period. Reasons to consider shoulder replacement Many patients have concerns about pain following

surgery include: 1. Severe shoulder pain caused by arthritis that limits daily

surgery. Every patient manages pain differently. If a

activities and caring for oneself;

patient’s pain before surgery is severe and limits his or her

2. Moderate to severe pain from the damaged, arthritic

ability to perform daily tasks, and the pain prevents one

shoulder that prevents one from sleeping;

from sleeping, then a patient will find pain after surgery

3. Loss of motion and weakness of the shoulder;

improved. An orthopedic surgeon, with the help of an

4. Failure of rotator cuff surgery, resulting in lost motion,

anesthesiologist, will manage a patient’s pain pre-

development of shoulder arthritis and increased pain; and

operatively with anesthetic medicine known as a regional

5. Failure to improve function and pain control with

block, which can last for 12 to 24 hours. After surgery, an

therapy,

orthopedic surgeon will prescribe a combination of oral

corticosteroid injections, activity modification, or anti-

anti-inflammatory and pain medication, as well as ice

inflammatory medications.

therapy, to help manage acute pain.

conservative

20 I HouseCall I Volume XI Issue 2

treatments

such

as

physical

Opioid medications are initially used to help reduce pain

alternatives. Making simple changes in the patient’s home,

after surgery, and a patient might have a concern about

such as moving necessary objects to a waist-high level, will

taking them. Most patients will have a need for opioid

allow for a faster transition back home. If a patient resides in

medication; however, they are not required to use them.

a multi-level residence, his or her family should prepare a

When opioids are used for short periods of time, in

temporary sleeping area on the main floor, with easy access

conjunction with other non-opioid pain medications and ice,

to a bathroom. Family members should also prepare to stay

the risk of dependency is minimized. For patients who have

with the post-surgical patient for a few days until he or she is

used opioid pain medication prior to surgery, it’s important

comfortable doing things independently. Occasionally, a

to set a clear plan to discontinue the medication after surgery

short stay in a rehabilitation facility or assisted living facility

and establish appropriate expectations.

Surgical blood loss is also a concern for patients,

may be required if the patient’s health warrants closer

attention or if family support is limited. n

especially for those with rare blood types or personal beliefs.

Due to advanced surgical techniques, blood loss is minimal in shoulder replacement surgery, making the need for blood transfusions rare.

The majority of shoulder arthroplasties are performed as inpatient procedures. Most patients stay less than 23 hours in the Hospital. There has been recent evidence that outpatient shoulder replacement surgery is safe when appropriate patient education and patient selection are incorporated with effective pain management and intraoperative techniques. Discussions during treatment will help a patient understand if inpatient or outpatient surgery is best.

Preparation for a shoulder replacement is a cooperative effort between an orthopedic surgeon, a patient’s primary

Gerson B. Florez, M.D.

care physician (PCP), the patient, and family members who will support the patient during recovery. The patient’s PCP will review all medically relevant issues to confirm safety in proceeding with surgery. The orthopedic surgeon and patient will discuss which type of shoulder arthroplasty will provide the potential for the best outcomes, as well as the risks and

GERSON B. FLOREZ, M.D. Dr. Florez specializes in orthopedic surgery. His expertise includes shoulder, elbow, wrist and hand surgery. He performs shoulder replacements, arthroscopic rotator cuff repairs, bicep tendon repairs, wrist arthroscopy, thumb arthritis surgery, carpal tunnel and trigger finger surgery. He also supports Emergency Room patients and community sports teams by treating pediatric and adult injuries and fractures. He earned his medical degree at Georgetown University School of Medicine, completed a residency at Albert Einstein Medical Center, Philadelphia, and a fellowship at the University of Pittsburgh Medical Center. Dr. Florez is board-certified by the American Academy of Orthopaedic Surgeons and holds a distinguished subspecialty certificate in hand surgery from the American Society for Surgery of the Hand. He practices with St. Clair Orthopedic Associates, part of St. Clair Medical Services.

To contact Dr. Florez, please call 412.942.7262.

Volume XI Issue 2 I HouseCall I 21

PHILANTHROPY

Richard King Mellon Foundation Awards Generous Grant for New Outpatient Center

The Richard King Mellon Foundation has granted $1 million to the St. Clair Hospital Foundation to help St. Clair Hospital construct its new, state-of-the-art Dunlap Family Outpatient Center, adjacent to the Hospital.

The Richard King Mellon Foundation, based in Pittsburgh, with assets of $2.5 billion, is the largest grant-making philanthropy in the region and the 36th largest in the United States. For the past 72 years, the Foundation has invested in the competitive future of and quality of life in southwestern Pennsylvania.

The Richard King Mellon Foundation has built on the vision of its founder. It was created in 1947

by Richard King Mellon, president and chairman of Mellon Bank, a conservationist and leading figure in the financial and civic life of Pennsylvania.

Mr. Mellon inspired and led the rebirth of Pittsburgh as a great American city; his creative energies forged the Pittsburgh Renaissance, a nationally recognized architectural, civic, social, and educational venture.

In 2018, the Richard King Mellon Foundation awarded 180 grants totaling more than $127 million.

Fifty-seven of those grants — more than $26 million —were made to human services initiatives, including the $1 million, three-year support toward the

22 I HouseCall I Volume XI Issue 2

Outpatient Center, which is designed to meet growing patient demand and address national trends in health care.

“The Richard King Mellon Foundation has a long and storied history of philanthropy that enhances the health and welfare of men, women and children throughout the region,” says G. Alan Yeasted, M.D., senior vice president and chief medical officer emeritus at St. Clair Hospital. “St. Clair is honored and humbled to be recognized with a grant from such an august organization and we are committed to creating an Outpatient Center that will uphold the Foundation’s mission and legacy of improving quality of life and standards of health care throughout southwestern Pennsylvania.”

The total projected cost of the 280,000-squarefoot, six-story Outpatient Center, including infrastructure, is $142 million. To date, over $28 million in grants and private support, including the $1 million Richard King Mellon Foundation grant, has been raised to assist in financing the project. n Individuals interested in donating to the Groundbreaking Growth campaign, which supports construction of the Outpatient Center, may do so online at stclair.org/giving or by calling 412.942.2465.

ETC.

Saving Lives

St. Clair Hospital is partnering with the Dormont Fire Department

to provide smoke detectors and

carbon monoxide detectors for the residents of Dormont. Pictured left to right are Marianne Olschesky,

Community Outreach and Marketing Specialist at St. Clair Hospital, and

firefighters Chief Mathew Davis,

Jim Barca and Max Schoppen. n

Online tool takes the mystery out of health care costs At St. Clair Hospital, patients enjoy the peace of mind that comes from knowing the high quality health care services they are receiving are in-network with every major insurer in almost every product. St. Clair is also frequently the lowest cost provider, so patients who have deductibles and co-pays can save money while accessing the region’s most awarded health care services. For a complete listing of participating insurers and products, or to use St. Clair’s nationally recognized cost transparency tool, Patient Estimates, please visit www.stclair.org. n

Volume XI Issue 2 I HouseCall I 23

1000 Bower Hill Road Pittsburgh, PA 15243 stclair.org

General & Patient Information: 412.942.4000 | Physician Referral Service: 412.942.6560 | Medical Imaging Scheduling: 412.942.8150 Outpatient Center–Village Square: 412.942.7100 | Urgent Care–Village Square: 412.942.8800 | Outpatient Center–Peters Township: 412.942.8400

Patient safety is key when choosing a hospital “ Every day we make choices about where we shop, who we bank with, what cars we drive, and on and on. Yet despite our consumer culture, some people aren’t even aware they can choose what hospital they go to.

Your choice of hospital could be a life or death decision. Hospitals vary greatly on things like infection rates, surgical errors, and patient injuries — not to mention ER wait times, patient satisfaction, and other things.”

REPRINTED FROM THE LEAPFROG GROUP: “CHOOSING THE BEST HOSPITAL”

In May, The Leapfrog Group, an independent, national, not-for-profit, patient safety watchdog, awarded St. Clair an “A” hospital safety grade for the 14th consecutive period. That makes St. Clair one of only 56 hospitals in the country (i.e., the top 2%), and the only hospital in the region, to receive an “A” hospital safety grade for more than seven years running.

Hospital safety grades score every hospital in the nation on how well they keep patients safe, assigning letter grades of A to F, with A being the highest rating. The scores are calculated using 28 safety performance measures.

THE REGION’S IN HOSPITAL PATIENT

SAFETY

“A” rated hospitals evidence a lower risk of avoidable death. “ ” St. Clair recently received an A hospital safety grade, making it the only hospital in the region to achieve the highest grade for seven years running.

87.7%

34.9%

HouseCall

• Patients at “D” and “F” hospitals face a 92% greater risk of avoidable death • Patients at “C” hospitals face an 88% greater risk of avoidable death • Patients at “B” hospitals face a 35% greater risk of avoidable death 91.8%

According to a new study, patients at hospitals rated lower than “A” have higher risk of avoidable death.

In a recent study by Johns Hopkins University’s Armstrong Institute for Patient Safety and Quality, researchers determined that, on average, when compared to “A” hospitals:

According to the same study, if all hospitals with grades of “B” through “F” had the same safety performance as hospitals graded “A”, more than 50,000 lives would be saved annually.

For more about patient safety, or to see the hospital safety grades of all hospitals in the region, go to www.hospitalsafetygrade.org.

is a publication of St. Clair Hospital. Articles are for informational purposes and are not intended to serve as medical advice. Please consult your personal physician.

@StClairHospital