St. Clair Hospital HouseCall Vol VI Issue 3

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VOLUME VOLUMEVI V ISSUE 2 3

HouseCall ST. CLAIR HOSPITAL FAMILY BIRTH CENTER

Delivering Generations of Pittsburghers for 60 Years

QA & UPCOMING HEALTH INsUrANCE CHANGEs AT sT. CLAIr.

How You Might Be Affected.

Please see page 18.

Three generations of the Chiappetta family of Mt. Lebanon

inside

3D Mammography I Health Insurance Q & A I 60th Anniversary Celebration I Community Outreach Free Mammography And Women’s Wellness Day I Ask The Doctor I History Minute

Family birth center

2 I HouseCall I Volume VI Issue 3

Welcome

to theWorld!

The St. Clair Family Birth Center: delivering babies since 1954

At St. Clair Hospital’s Family Birth Center, no birth is routine, and no baby is ordinary.

Every delivery is a miracle, and every baby, a wonder to behold. In the Family Birth Center, the care is outstanding, and the environment matches the beauty of the work that takes place there. It is an exceptional, special place within the Hospital, artfully designed to blend the comforts of home with the clinical safety and quality of a first rate, award-winning medical facility. For families of newborns, the Family Birth Center at St. Clair Hospital is a place of welcome.

W

hen St. Clair Hospital opened its doors in 1954, those doors led

straight to the Maternity Department, right off the main lobby on the First Floor. The placement of the department in such a prime

spot reflected its significance to the brand new hospital, which was initially

developed to provide emergency care, medical-surgical care, and maternity care to the people of the South Hills. Women would no longer need to be driven long distances to have their babies; they could have them close to home, in their own neighborhood. It was the fulfillment of a dream for the people of the South Hills.

Sixty years later, St. Clair Hospital still places a high priority on offering the best quality obstetrical care to the women of the community. Over the decades, many things have changed in the care of mothers and babies, but St. Clair’s commitment to providing high quality obstetrical services stands stronger than ever. The maternity unit of 1954 has undergone relocations and transformations, evolving into the freshly renovated, sparkling, state-ofthe-art Family Birth Center that now welcomes more than 1,400 newborns a year into the world.

Continued on page 4

Volume VI Issue 3 I HouseCall I 3

Family birth center Continued from page 3

clinical excellence comes First At St. Clair’s Family Birth Center, clinical excellence and patient safety come first. A highly credentialed team of board-certified obstetricians and

Dr. Griffin takes pride in the high quality of pediatric services at St. Clair. “Our team of expert pediatric hospitalists provides round-the-clock

pediatricians, plus a team of expert nurses, provides the highest quality,

coverage, so families can feel confident that their baby is in good hands

advanced care to mothers and babies. The Family Birth Center staff prides

and that any problems that might arise will be skillfully managed,” she

itself on its outstanding record of safe deliveries and healthy newborns.

says. “We have 70 pediatricians on staff here who come to St. Clair to

For obstetrician Stephanie S. Brown, M.D., St. Clair is an ideal facility

provide care for their newborn patients; our hospitalists stay in contact

for childbirth. “St. Clair is a very safe place to have a baby,” she says.

with them to assure a smooth transition from the Hospital. It’s important

“We have excellent outcomes.”

to all of us that our mothers take home healthy babies. Our entire team of

St. Clair is distinctive among hospitals for the quality and range of pediatric services that complement the excellent obstetric department.

obstetricians, nurses, pediatric hospitalists, and community pediatricians works toward that goal.”

Since 1994, St. Clair has had 24-hour, in-house pediatric coverage, led by Dayle B. Griffin, M.D., a board-certified pediatric hospitalist, plus a team of pediatricians with advanced training. A pediatrician attends every

First rate Facilities and a Warm, safe environment The Family Birth Center features 11 LDRP (labor, delivery, recovery,

C-section, premature birth, and high-risk birth, such as the delivery of

postpartum) rooms, plus eight post-partum rooms that blend beauty and

multiples, and manages the care of the infants who require care in the

functionality. The rooms are ingeniously designed to camouflage the

Family Birth Center’s Level II Neonatal Intensive Care Unit (NICU). The

technology without sacrificing safety or efficiency, and are fully equipped

NICU has a nurse-baby ratio of 1:1 to 1:3, depending on acuity, and a

for emergencies. The transformation from labor room to delivery room

maximum of six babies, who may need antibiotics, oxygen, monitoring,

happens expeditiously, and most of the time, the new family stays together

or more time to grow. Every infant born at St. Clair receives a hearing

in the same room. According to Linda McIntyre, RN, MSN, director of

screening and CCHD screening, a simple yet extremely important test

Women and Children Services, the Family Birth Center environment is

that helps in the early identification of critical congenital heart defects.

“I think so highly of Dr. Griffin and her team,” says obstetrician Tera S. Conway, M.D. “Knowing that an excellent pediatrician is always here, immediately available, gives comfort to parents and enhances our quality of care.”

4 I HouseCall I Volume VI Issue 3

both aesthetically pleasing and therapeutic. “We have a beautiful environment with spacious rooms that are almost twice the size of the average hospital room. The décor is homelike and tranquil, with the amenities of a hotel and the clinical safety of a hospital. Our unit is private and secure.”

The Family Birth Center at St. Clair 14 obstetricians deliver babies • Reputation for overall excellence • Highly credentialed obstetricians and nurses • Level II Neonatal Intensive Care Unit • Leading-edge labor and delivery suites • 24-hour pediatrician coverage •

All of the Hospital’s LDRP rooms blend beauty and functionality.

‘Phenomenal nurses’ The Family Birth Center offers a warm embrace to newborn families,

Women in labor receive one-to-one nursing care, and as often as

with the reassurance of a highly competent, experienced, and caring

possible, continuity is provided by having the same nurse provide

nursing staff. “If you have your baby at St. Clair Hospital, you will receive

postpartum care for the mother and her baby. Mothers receive thorough

care that is clinically excellent, personalized, and family centered. You’ll

education in infant care and feeding, and strong support for breastfeeding,

leave here feeling confident that you can take care of your baby. You’ll feel

according to Sharon. “We have lactation consultants on staff and we

supported every step of the way,” promises Sharon Johnson, RNC,

promote the benefits of breastfeeding. We also have breastfeeding

clinical supervisor of the Family Birth Center. Sharon knows of what she

classes and a support group. We encourage skin-to-skin contact at

speaks: she has 32 years of obstetric nursing experience and gave birth

delivery, and first-day pumping. Our lactation consultants are available

to all three of her own children at St. Clair. “Our professional team is our

to mothers after discharge, and our staff nurses are available 24/7 by

greatest asset. We have the best nursing staff and great obstetricians.

phone to answer parents’ questions.”

The nurses are all RNs and are cross-trained to care for both mothers

Sharon says that obstetric nursing is uniquely rewarding. “There’s

and babies. We have a sub-group of nurses who are Level II neonatal

a bond between the nurse and the parents. Helping a couple through

nurses, able to stabilize and care for babies with special needs. We have

childbirth is an intense and intimate experience; it means something

great depth of experience on our staff and nursing education is a constant.”

to the parents that you were there helping them at this incredibly important event. It can be emotional: when you see a father crying at

“

I have fIrst-hand experIence and I can say that the qualIty of the care, the qualIty of

delivery, when you place a baby in a mother’s arms for the first time.

You can’t help but be moved. Emotion is part of the job.”

Dr. Griffin says that the Family Birth Center’s “phenomenal nurses” are versatile, dedicated, and committed to excellence. “Our nurses take time with the mothers and give them personal care and individualized teaching. It makes a difference.” ■

the rooms, the personal attentIon, and the nurse-patIent ratIo

Continued on page 6

are second to none.

”

NEW MOM CATHERINE O’HARA, M.D., HOSPITALIST IN INTERNAL MEDICINE, ST. CLAIR HOSPITAL

New parents Catherine O'Hara, M.D. and Benjamin Susco, M.D. brought son Nathan back to the Family Birth Center to show him to staff, including Sharon Johnson, RNC, clinical supervisor of the FBC, and Linda McIntyre, RN, MSN, director of Women and Children Services.

Volume VI Issue 3 I HouseCall I 5

Family birth center Continued from page 5

Proud Parents HouseCall met with four young families who shared their respective experiences in the Family Birth Center — Mt. Lebanon brothers Tim and Tony Chiappetta, Moon Township’s Wiley family, and physicians Catherine O’Hara and Benjamin Susco of Ohio Township.

“

It was amazIng. It was everythIng they say It Is, and more. I wIll never forget Beau’s BIrth. and I wIll never forget the way that the doctors and

nurses at st. claIr took care of us.

”

ELIZABETH CHIAPPETTA

im Chiappetta is a first-time father, and

T

he, too, was born at St. Clair Hospital —

people and they were the best,” says Tim. Adds Elizabeth,

the same place where his son Beau

“The nurses went above and beyond. Our nurse was there

entered the world on Tuesday, July 8.

the whole time, for a full 12-hour shift. We had missed the

Beau arrived a bit early, at 37 weeks and

Labor and Delivery class because Beau came early, but it

six pounds, but he was strong, stable, and feeding well

enough to go home with his mother, Elizabeth, two days

parents feel as they anticipate childbirth — especially the first time. But their fear and anxiety were eased by the

needed to be closely monitored for early signs of problems.

environment and the caring competence of the staff. “I had

Every week, she came to the Family Birth Center for a

a strong sense of trust there,” says Tim. “We had a

non-stress test. When the time came, however, things

relationship with our obstetrician, Dr. Lenart; she had a

went like clockwork: her water broke at 7:45 a.m., and

calming presence. She’s awesome. She blended a nurturing

Beau was born at 7:45 p.m., with obstetrician Deborah

bedside manner with clinical skill. It made us feel safe.”

Lenart, M.D., attending the delivery.

Tim and Elizabeth, both attorneys, had elected to be surprised by their baby’s gender at delivery, and Tim recalls that the real surprise was

over to watch and be the first to see the gender — that was very cool.”

The Chiappettas are completely satisfied with their childbirth experience at St. Clair and would not consider anywhere else. “I’m the youngest of four and we

7/8/2014

The Chiappettas acknowledge the vulnerability that new

later. It had not been an easy pregnancy for Elizabeth;

was halfway out the doctor pulled me

CHIAPPETTA

didn’t matter because our nurse taught us everything.”

with gestational diabetes and high blood pressure, she

the way they found out. “When the baby

Beau

the security is excellent. But it really comes down to the

were all born at St. Clair. When Elizabeth and I toured the Family Birth Center, we were blown away. It’s a top-notch operation in every way. St. Clair is as sophisticated as the big hospitals and

One of the strong points for Tim and Elizabeth was the Family Birth Center environment. “It’s family centered, spacious, and welcoming. I have a large family, and everybody came. At one point we had a large group of visitors in the room. No one complained. And it was remarkably quiet! You expect noise, babies crying all day — but it was quiet and peaceful.” For Elizabeth, a highlight was the abundant natural light that streamed through the large windows. “I could watch the sunset with my baby in my arms.”

Elizabeth says that Beau, at four months, is a great baby. “At one month, Beau weighed eight pounds, five ounces and was sleeping through the night — almost. He would get up once.” That nighttime wake-up was Daddy’s special time with Beau: “We would rock and listen to a Beatles lullaby CD,” Tim recalls. “Our favorite song was Across the Universe.” ■ Continued on page 8

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Over

100,000 babies have been born at St. Clair Hospital since 1954.

Tim and Elizabeth Chiappetta with baby Beau.

Volume VI Issue 3 I HouseCall I 7

Family birth center Continued from page 6

Tony and Emily Chiappetta with baby Mary Virginia and her big sister Caroline.

8 I HouseCall I Volume VI Issue 3

6/9/2014

MaryVirginia CHIAPPETTA

“

the entIre hospItal made us feel lIke they were

there for us. we were not just passIng through — It Became ‘our’ hospItal; we felt lIke we Belonged there. the secluded locatIon of the famIly BIrth

center makes you feel lIke you aren’t In a hospItal. you feel physIcally and emotIonally secure.

”

TONY CHIAPPETTA

ony Chiappetta and his brother Tim were born

of mind in knowing that we could get to the Hospital quickly and

just 15 months apart, so they grew up doing

easily. Since we both grew up here, St. Clair is familiar to us.

T

nearly everything together. Today, they live near

I originally chose St. Clair because my doctor, Stephanie Brown (M.D.),

each other and still do things together — they

delivers there. I’ve been with her for a long time. Her partner,

even became fathers just one month apart. “On

Dr. McGranahan, actually delivered both of my babies. I have

June 9, our daughter was born, and on July 8, Tim’s son was born;

both were born at St. Clair Hospital, like us, and they were baptized

complete trust, love and respect for these doctors.”

Tony, an engineer, refers to the LDRP room where Mary was born as “the corner office.” It was the last room along the hallway,

together at St. Bernard’s Church in Mt. Lebanon.”

Tony and his wife Emily welcomed Mary into the world five months ago. She was delivered by C-section, performed by obstetrician

quiet and private, enabling Emily to sleep when she needed to.

“I could rest and recover there,” Emily says. “The LDRP room was

Shannon H. McGranahan, M.D. “Our first baby, Caroline, now 4,

beautiful, and it was great to remain in one place the entire time.

was also born by C-section at St. Clair. That time, it was

No shuffling around from place to place. The whole FBC is incredibly

unexpected, but the doctors and nurses helped us through it.

clean; everything is spotless and brand new. I urge people to check

Dr. McGranahan delivered both girls and she

out St. Clair. We received care that was high

was spectacular! She saved Caroline, and we

quality and very personal. Sometimes hospitals

owe her a debt of gratitude.”

have that revolving door feeling. St. Clair never felt that way. Every single nurse was

The Chiappettas say they had great

highly competent and the communication

experiences at St. Clair, both times. “The proximity to home and the accessibility are

among the staff was seamless. Nothing ever

great — no long drive, no parking worries,”

fell through the cracks. And there’s a great

says Tony. “Just a quick jump from home instead of a long commute and traffic.” For Emily, the convenience put her mind at rest.

“We live in Mt. Lebanon and there was peace

St. Clair’s OB Department is ranked in the top

ten percent nationally in patient satisfaction.

coffee shop (Café 4) — Caroline loved it; the cookie selection met her needs. St. Clair offered everything possible to make our experience as nice as it could be.” ■ Continued on page 10

Based on independent research conducted by Press Ganey.

Volume VI Issue 3 I HouseCall I 9

Family birth center Continued from page 9

5/23/2014

Josie WILEY

“

the famIly

BIrth center met every sIngle need we had. I could not have asked for a Better oBstetrIcIan, Better nurses, or a Better hospItal. It was really perfect.

”

LISA WILEY

L

isa Wiley

It just felt right and I knew

was in the third trimester of her second preg-

nancy when she made a

courageous decision: she decided that she wanted

I was in good hands. I had trust in my doctors and they are all wonderful, but I was happy when Dr. Duncan showed up.”

Lisa gave birth on May 23 to a girl named

a new obstetrician and a new hospital — St. Clair

Josephine, nicknamed “Josie”; she weighed six

Hospital — in which to deliver her baby. She now

pounds, eight ounces and got off to a great start,

says it was the best decision she could have made.

breastfeeding well right away. The Wileys loved

“I was planning to deliver at another hospital, and it

their experience at the Family Birth Center. “I liked

was late in my pregnancy. You have a relationship

the size — it was just right,” Lisa says. “When my

with your doctor by then and it’s almost time for the

older daughter was born, it was at a university

birth. But I attended the women’s group at our church

medical center in Indiana, and it was busy and

and the women raved about St. Clair Hospital’s

crowded. When I delivered, there was a group of

Family Birth Center and their obstetricians. They

medical students watching and nobody even asked

encouraged me to consider St. Clair and take a

me if that was okay. On the postpartum floor, no

tour. I liked it immediately. I met all the doctors in

one ever checked on me. My experience at St. Clair

the Paul Zubritzky (M.D.) group and loved them all.

was the opposite. The nurses were attentive and

I chose Paula Duncan (M.D.) for my doctor, and

competent. I loved having such personal care.

she’s amazing. She makes me feel like I can tell

When I delivered, it was just my doctor, two

her anything.”

nurses, my husband and me. Private.”

Lisa and her husband, Adam, a commercial

The Wileys live in Moon Township and Lisa

airline pilot, moved to Pittsburgh from the state of

works in Human Resources for a national firm.

Indiana just a year ago, with their two-year-old

She says things are going well; Josie is a good baby

daughter, Jainy. It was important to Lisa to have

and Jainy loves being a big sister. She encourages

that level of comfort with her doctor. “I was in a

other mothers-to-be to visit St. Clair just as she did,

new city; I didn’t know anybody. Dr. Duncan and her

so they can see for themselves all the resources and

partners made me feel welcome and cared about.

amenities there. “The Family Birth Center is a beautiful environment. I felt relaxed and catered to.

I was never hungry; the food was good and came in

All Family Birth Center rooms are private, offering sleeping

large portions! I loved the bright, spacious room. The

accommodations for fathers

I was comfortable with her going there. More people

or other family members.

nurse took Josie to the nursery so I could sleep and should experience childbirth at St. Clair Hospital.

It’s clean and beautiful and the doctors and nurses are amazing.” ■ Continued on page 12

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Lisa and Adam Wiley with baby Josie and her big sister Jainy.

Volume VI Issue 3 I HouseCall I 11

Family birth center Continued from page 10

Benjamin Susco, M.D. and Catherine O'Hara, M.D. with son Nathan.

12 I HouseCall I Volume VI Issue 3

5/16/2014

Nathan SUSCO

“

the rooms are spotless, homelIke and prIvate. I was

amazed at how they are aBle to transform the room, to convert It to a delIvery room and then a recovery room — the process Is amazIng!

”

CATHERINE O’HARA, M.D.

ull-term and weighing in at a healthy, robust eight

F

integral part of the day. All of the nurses are on the ball, and are

pounds, three ounces, Nathan Thomas Susco

nice, warm people who made my family comfortable. Everyone

entered the world at St. Clair Hospital’s Family

was kind to my husband and always included him; there was even

Birth Center on May 16. His parents, Catherine

a bed for him in my room.”

and physicians, and their experience on the “other side” of the

celebrate Nathan turning 24 hours old, with family and friends

O’Hara and Benjamin Susco, are first-time parents

The family had a “birthday party” in their hospital room to

hospital bed was entirely positive. “Working at St. Clair, I knew that

in attendance. “The rooms are so spacious that we were able

the Family Birth Center was highly regarded, with a record of

to have a group of people in there without it feeling crowded,”

excellence,” Dr. O’Hara said. “I heard good things about it from

Dr. O’Hara recalls. “The rooms are spotless, homelike and private.

friends and colleagues, and I felt reassured by knowing that

I was shocked at how they are able to transform the room, to

pediatrician Dayle Griffin, (M.D.) would be there; she has a superb skill

convert it to a delivery room and then a recovery room — the

set and I knew the right steps would be taken if there was a problem.”

As a hospitalist in internal medicine at St. Clair, Dr. O’Hara

process is amazing! And they do it quickly and efficiently. But everything was done that way. I had an epidural and the timing

recognizes high quality healthcare. She and her husband, a

was just right, the anesthesiologist came right away. The lactation

cardiologist in Pittsburgh, were expecting excellence, but their

counselor held a very informative breastfeeding class; she made

experience surpassed their expectations. “My obstetricians are

my husband a part of it, too.”

with Advanced Women’s Care of Pittsburgh, and I like all of

Nathan, known as “Nate” to his family, is thriving at six

them,” says Dr. O’Hara, who hailed Advanced Women’s Stephanie

months, and Mom is back to work now at the Hospital. She is

S. Brown, M.D. for averting what could have been a serious

happy to tell others of her experience. “Things are very well done

medical emergency during Nathan’s delivery when the baby’s

in the Family Birth Center. The nurses are the best of the best —

heart rate slowed and his oxygen levels were dipping. “You realize

the entire team. They make you feel like you are the only patient,

in times like those how much you truly trust your obstetrician in

and they do everything they can for you. They work long hours

caring for both your baby and you,” she says. “And I can’t say

and things can change quickly; they have to be ready for anything.

enough good things about the Family Birth Center nurses. My

They do it all with such grace. They were so good to Nate. I felt

nurses were phenomenal. They gave me skilled hands-on care,

that I received nothing but the best from everyone in the Family

and were so responsive to my and Nathan’s needs. They were an

Birth Center.” ■ Continued on page 14

Nathan, Josie, Beau and Mary — four beautiful healthy babies, all growing and thriving at home, thanks in no small part to the excellence of the care that they and their mothers received at St. Clair’s Family Birth Center. The best beginnings happen at St. Clair Hospital’s Family Birth Center, an ideal setting where the most advanced technology and medical capabilities are balanced by an environment that is safe, comfortable, and nurturing.

Parents-to-be are invited to

tour the Family Birth Center.

Please call

412.942.5877.

Volume VI Issue 3 I HouseCall I 13

Family birth center Continued from page 13

leading Physicians oFFer advanced care at st. clair hosPital Family birth center The Hospital’s obstetrics and pediatrics services are fully prepared with the appropriate equipment, resources, and expertise.

“ Q

uality of care. It matters immensely in every specialty, and the drive to improve quality is a priority for physicians and the healthcare industry. In obstetrics,

our team of expert pedIatrIc hospItalIsts provIdes round-the-clock coverage, so famIlIes can feel confIdent that theIr BaBy Is In good hands and that any proBlems that mIght arIse wIll Be skIllfully managed.

”

DAYLE B. GRIFFIN, M.D., MEDICAL DIRECTOR OF PEDIATRIC AND NEWBORN SERVICES, ST. CLAIR HOSPITAL

quality of care is of profound importance; both mother and baby are highly

vulnerable throughout the perinatal period. Quality obstetric care means safe, healthy

passage through pregnancy, labor, delivery, and the post-partum period for the mother, and the safe, uncomplicated arrival of a healthy newborn.

Choosing an obstetrician and the highest quality hospital in which to give birth is the first “parenting” decision that mothers- and fathers-to-be must make. Prospective parents may want a homelike, comfortable environment, but they also want — and need — the reassurance of clinical excellence. A high quality obstetric service has to be fully prepared for maternal and neonatal emergencies, with the appropriate equipment, resources, and expertise to address every medical issue.

st. Clair Hospital OB/GYNs ADVANCED WOMEN’S CARE OF PITTSBURGH, P.C. Shannon H. McGranahan, M.D., FACOG Stephanie S. Brown, M.D. Patricia J. Bulseco, M.D. Deborah A. Lenart, M.D. Douglas H. MacKay, M.D. Kristen E. M. Peske, D.O. MT. LEBANON St. Clair Hospital 1000 Bower Hill Road, Suite 213 Mt. Lebanon, PA 15243 412.561.5666 PETERS TOWNSHIP St. Clair Hospital Outpatient Center–Peters 3928 Washington Road, Suite 230 McMurray, PA 15317 724.941.1866

14 I HouseCall I Volume VI Issue 3

At St. Clair Hospital, says Dayle B. Griffin, M.D.,

st. Clair Hospital OB/GYNs

medical director of Pediatric and Newborn Services at St. Clair, quality has many dimensions. “The first step in finding high quality obstetric care is choosing a good obstetrician and trusting that obstetrician.

Your doctor wants the best for you and your baby.

It’s essential that the hospital you choose has highly skilled nurses to help you through labor and delivery, and pediatric coverage, with full capabilities to manage emergencies.”

Linda McIntyre, RN, MSN, director of Women and Children Services for St. Clair, says that the decision about where to deliver is highly individualized.

“Prospective parents should explore their options,

ZUBRITZKY & CHRISTY OB/GYN

talk with their obstetricians, take tours, and ask

Paul M. Zubritzky, M.D. • Tera S. Conway, M.D. • Patrick T. Christy, M.D. • Paula A. Duncan, M.D.

questions. Get recommendations from friends, but make the decision based on personal needs and preferences. The ideal setting is one that provides high quality of care through advanced technology and an experienced staff, capable of dealing with

MT. LEBANON St. Clair Hospital Professional Office Building 1050 Bower Hill Road, Suite 205 Mt. Lebanon, PA 15243 412.942.1066

ROBINSON TOWNSHIP 6000 Steubenville Pike Suite 105 McKees Rocks, PA 15136 412.788.1330

KENNEDY TOWNSHIP 1767 Pine Hollow Road McKees Rocks, PA 15136 412.331.1623

any kind of complication, and meets your need for comfort and safety.” ■

SOUTH HILLS OB/GYN ASSOCIATES, INC. Sandor Mecs, M.D. Robert C. Rankin, M.D. St. Clair Hospital Professional Office Building 1050 Bower Hill Road, Suite 206 Mt. Lebanon, PA 15243 412.572.6127

St. Clair maintains

24/7 in-house pediatric coverage staffed by specially trained pediatricians experienced in handling difficult deliveries as well as caring for newborns.

ARTHUR P. SIGNORELLA, M.D. Arthur P. Signorella, M.D. St. Clair Hospital 1000 Bower Hill Road, Suite 311 Mt. Lebanon, PA 15243 412.572.6595

st. Clair Hospital 24/7 In-House Pediatricians Pediatric hospitalists at st. clair hospital not pictured are:

Dayle B. Griffin, M.D.

Sheila Clarke, M.D.

Kendell R. German, M.D.

Meredith C.G. Broberg, M.D.

Melanie Austin, M.D. Donna Bosworth, M.D. Charles Brickner, M.D. Michael Fox, M.D. Satyanarayana Gedela, M.D. Shawn Kapoor, D.O. Ashley Loboda, M.D. Kultar Shergill, M.D. Damian Ternullo, M.D. Catherine Udekwu, M.D. Pushpa Viswanathan, M.D. Volume VI Issue 3 I HouseCall I 15

imProving care through advanced technology

NEW STUDY SHOWS THAT 3D MAMMOGRAMS GREATLY IMPROVE BREAST CANCER DETECTION comprehensive new study confirms that 3D mammography—

earlier and reduces false alarms that lead to “call-backs” — repeat

such as that used at the St. Clair Hospital Breast Care Center—

screening mammograms that can create unnecessary anxiety and fear.

A

is more effective in finding invasive cancer than traditional

two-dimensional mammography.

3D mammography offers women a remarkable new breast cancer screening technology that is enabling radiologists to detect small breast cancer lesions earlier and with much greater accuracy, especially in women with dense breast tissue.

Digital 3D breast tomosynthesis, more familiarly known as 3D mammography, is the most advanced diagnostic imaging technology available for the detection of breast cancer. It combines traditional digital mammography with tomosynthesis, which is similar to a CT scan. It’s a state-of-the-art imaging tool that provides far more accurate images that

According to Sherri H. Chafin, M.D., a board-certified diagnostic radiologist who specializes in breast imaging and directs St. Clair’s Breast

“

thIs technology far exceeds standard two-dImensIonal testIng and makes It much easIer to detect Breast cancer .

”

SHERRI H. CHAFIN, M.D., VICE CHAIR OF MEDICAL IMAGING, ST. CLAIR HOSPITAL

Imaging Center, 3D mammography represents a major breakthrough in breast cancer diagnosis and treatment. “This technology far exceeds standard two-dimensional testing and makes it much easier to detect breast cancer,” she says. “I am finding breast cancers which I would not have found without it. It is useful for women with dense or fatty breast tissue.

3D mammography is a wonderful technology and a great advancement.”

Dr. Chafin’s experience with 3D mammography is validated by the most current research findings.

An article in the June 25 issue of the Journal of the

facilitate the early diagnosis and treatment of breast

American Medical Association revealed the results

cancer. The 3D mammogram finds small cancers

of a 13-center study: the addition of tomosynthesis to digital mammography was associated with an increase in breast cancer detection rates and a decrease in recalls.

3D mammography works by taking a series of X-ray images in an arc around the breast. In a traditional mammogram, the machine is stationary and takes images from two angles only; with 3D, the X-ray tube moves in a circle around the breast while the pictures are taken, and a special computer combines the images into a three-dimensional picture, in a

Diagnostic radiologist Sherri H. Chafin, M.D. “reads” 3D mammograms at the St. Clair Hospital Breast Care Center.

16 I HouseCall I Volume VI Issue 3

“stack” of very thin, layered slices, almost like the pages of a book. It allows the radiologist to look at each slice, one thin layer at a time, and see clear, detailed, highly focused

regular screenIng Began In the u.s. In 1990. the mortalIty rate dropped By 30 percent almost ImmedIately. In 2014, early detectIon remaIns the key to survIval.

images. The thin layers

density as a risk factor for breast cancer. Women with dense breasts are likely to be diagnosed with breast cancer at later stages, when treatment is more difficult and a successful outcome less likely.

reduce the “overlapping” effect that can

Although 3D mammography is strongly

do you KnoW your density?

make interpretation of the images a

recommended for women with dense or fatty

challenge. The breast, explains Dr. Chafin,

breasts and other high risk factors, St. Clair

is a complex structure, consisting of breast

Hospital has taken the unique step of offering

tissue, fatty tissue, glandular tissue, milk

3D mammography to all patients. “At St. Clair,

Women who are concerned with their

ducts, blood vessels, and ligaments. In a two-

anyone who wants it can have it,” Dr. Chafin

heart health know how important it is to

dimensional image, all this tissue overlaps,

says. “3D mammograms are done at the

know their numbers: their blood pressure,

which can create distortions that may delay

Breast Care Center at our Outpatient Center

cholesterol level, and weight.

diagnosis. Small tumors can be overlooked

in Village Square in Bethel Park. Our patients

and go undiagnosed for another year or

can get same-day screening results. They can

longer, while they grow and spread.

wait right in the comfortable waiting area,

Furthermore, normal tissue can appear

post-mammogram, for their results.”

abnormal, and this leads to call-backs.

Breast density is a risk factor for breast

Every year in the U.S., 40 million screening mammograms are performed, and most of

Now there is another number that women need to know: their breast density.

This number indicates how dense the breast tissue is, and that’s important because it affects the accuracy of mammogram interpretation and is a

cancer. (Please see sidebar at right.) “Dense

these are traditional, two-dimensional digital

breast tissue and fatty breast tissue have

mammograms. More than 4 million women

nothing to do with weight or obesity; it also

will be called back for repeat screenings to

has nothing to do with the size of your

clarify the findings. The American Cancer

amount of fatty tissue and connective/

breasts,” says Dr. Chafin. “It’s like a fingerprint,

Society, American Congress of Obstetricians

glandular tissue in the breast. It is

it’s simply how you are made. Women

and Gynecologists, and the American College

determined by the radiologist who reads

of any age can have dense breasts; they

of Radiology agree that annual breast screening

the mammogram, and, in Pennsylvania,

should find out about the density of their

should begin at age 40, and earlier if a

the law now mandates that women be

breasts at their first mammogram. If no

woman is at greater risk for developing

informed of their number, on a scale

one tells you, ask. There is a Breast Density

breast cancer.

from one to four. The number is assigned

scale, mandated by the Breast Density Notification Law.”

Regular screening began in the U.S. in 1990. The mortality rate dropped by 30 percent

Pennsylvania is one of 19 states that currently have a Breast Density and Reporting

almost immediately. In 2014, early detection remains the key to survival. ■

Act. The law was enacted in January of this year in recognition of the significance of breast

To schedule a 3D mammogram at the Breast Care Center, please call 412.942.8150.

factor in breast cancer risk.

Breast density refers to the relative

according to the percentage of breast tissue that is composed of fatty versus dense tissue, with a rating of “one” indicating very fatty breast tissue and a “four” indicating very dense breasts with little fat.

Most women do not know their

SHERRI H. CHAFIN, M.D.

breast density number, but should ask

Dr. Chafin specializes in diagnostic radiology at St. Clair Hospital, where she is Vice Chair of Medical Imaging and directs St. Clair’s Breast Imaging Center. She earned her medical degree at the Penn State Hershey Medical Center and completed her residency at Allegheny General Hospital. Dr. Chafin is board-certified by the American Board of Radiology. She practices with South Hills Radiology Associates.

about it at their annual mammogram.

To contact Dr. Chafin, please call 412 .942.3101.

Dense breasts raise the risk of breast cancer in two ways: they make cancer harder to detect, and density is itself a risk factor for cancer.

Volume VI Issue 3 I HouseCall I 17

Q & a: health insurance

QA &

As you navigate the new health insurance landscape, make sure St. Clair is in your network.

Health insurance in our region is changing rapidly, from the Affordable Care Act to the scheduled end of the Highmark-UPMC agreement. Fortunately, St. Clair Hospital makes navigating these changes easier because St. Clair participates with every major insurer in almost every product.* THAT MEANS ST. ClAir iS AN iN-NeTwork Provider FOR THESE INSURERS AND PRODUCTS. And, if you choose a health insurance product (like a high deductible health plan) that requires you to share in the cost of paying for services, you’ll be pleased to know ST. ClAir iS ofTeN THe loweST CoST Provider.

So, when you choose a health plan, make sure you have one of the nation’s 100 Top Hospitals®, close to home, in your network.

* St. Clair Hospital does not participate in two new “ultra-narrow network” products:

(1) the Community Blue Medicare HMO Medicare Advantage product offered by Highmark; and (2) UPMC Advantage Select HMO/PPO/EPO products offered by UPMC Health Plan on the federal health insurance marketplace (www.healthcare.gov). St. Clair Hospital will be out-of-network for patients who select either of these products.

in advance of annual health insurance enrollment deadlines, housecall answers key questions below:

Q: WILL ST. CLAIR HOSPITAL PATIENTS BE AFFECTED WHEN THE CONTRACT BETWEEN HIGHMARK AND UPMC EXPIRES ON DECEMBER 31, 2014?

18 I HouseCall I Volume VI Issue 3

A:

No. Hospital and physician services provided at St. Clair Hospital will not be affected by the expiration of the contract between Highmark and UPMC.

QA & Q: WHAT ABOUT SERVICES PROVIDED AT ST. CLAIR’S EMERGENCY ROOM, ITS URGENT CARE CENTER, AND ITS OUTPATIENT CENTERS?

A:

Q: WHAT TYPES OF SERVICES DOES ST. CLAIR HOSPITAL OFFER?

A:

Again, nothing will change as a result of the expiration of the contract between Highmark and UPMC on december 31, 2014.

St. Clair Hospital and its medical staff provide a wide range of advanced clinical services, as well as women’s and children’s care. All of these services will remain in-network for every major health insurer in almost every product.*

Q: WHAT ABOUT CLINICAL SERVICES SUCH AS RADIATION ONCOLOGY AND MEDICAL ONCOLOGY IN WHICH ST. CLAIR PARTNERS WITH UPMC CANCER CENTERS? WILL THOSE SERVICES BE AFFECTED?

A:

No. St. Clair’s clinical service partnerships and joint ventures with UPMC will remain in-network.

Q: WHAT ABOUT OTHER HEALTH INSURERS? IS ST. CLAIR IN-NETWORK FOR THEM, AS WELL?

A:

Yes. with the exception of the two products listed below,* St. Clair is in-network for every major health insurer, including Highmark, UPMC Health Plan, Aetna, Cigna, Coventry Health America, and United Healthcare, as well as all major Medicare Advantage plans, and all major Medicaid managed care plans.

Q: WHO SHOULD A PATIENT CONTACT WITH ADDITIONAL QUESTIONS ABOUT HEALTH INSURANCE COVERAGE AT ST. CLAIR HOSPITAL?

A:

Please call the Customer Service line at 412.344.3408 to speak to a St. Clair representative.

Q: IF A PATIENT WANTS TO SWITCH TO A ST. CLAIR-AFFILIATED PHYSICIAN, HOW CAN HE OR SHE FIND A PHYSICIAN?

A:

Please use our physician finder at www.stclair.org/physicians/directory, or call 412.942.6560.

Volume VI Issue 3 I HouseCall I 19

annual Fundraiser

sT. CLAIr HOsPITAL CELEBrATEs ITs

60th Anniversary AT THE 17TH ANNUAL sUMMEr sWING EvENT

St. Clair Hospital’s annual Summer Swing event exuded a special vibe this year as the Hospital continued its year-long celebration of its 60th Anniversary. St. Clair, which opened its doors in February 1954, played host to a record-setting 550 guests in July at Summer Swing, the Hospital’s signature fundraiser.

To help set the tone for the 60th Anniversary, guests were greeted at the main entrance to St. Clair Country Club by a number of vintage automobiles of the era, and junior volunteers dressed in the fashionable styles of the mid-1950s.

Guests posed for photos with the classic cars before moving indoors to enjoy an evening of fine foods, live music, and a silent auction featuring an eclectic selection of items sure to make those

Posing with a proclamation from Congress recognizing St. Clair Hospital’s 60th Anniversary are: Chairman of St. Clair Hospital Foundation Board of Directors Gary J. Zentner; Thomas M. Medwig, Chairman of the Board, St. Clair Health Corporation; U.S. Rep. Tim Murphy; and Melvin D. Rex, Chairman of St. Clair Hospital Board of Directors.

who missed the party green with envy.

To receive an invitation, or to be involved in the Friday, July 17, 2015 version of Summer Swing, just drop us a request at schfoundation@stclair.org. ■

Jerry and Susan Dioguardi represented Summer Swing Gold Level Sponsor Aetna.

20 I HouseCall I Volume VI Issue 3

Orthopedic Surgeon Derrick J. Fluhme, M.D. (3rd from left), and Ophthalmologist Roger P. Zelt, M.D., pause with other Summer Swing guests for a quick snapshot.

St. Clair Hospital Chief Medical Officer G. Alan Yeasted, M.D. with Summer Swing Committee Chair Vicki McKenna and Hospital President and CEO James M. Collins in front of St. Clair Country Club.

Washington County Commissioner Diana Irey Vaughan and her husband, Robert, in front of one of several classic cars from the 1950s that greeted guests at Summer Swing.

St. Clair Hospital Junior Volunteers Johnny Sieber and Chloe Hoffman arriving in a 1955 Buick Special.

Volume VI Issue 3 I HouseCall I 21

community outreach

ST. CLAIR OFFERS FREE SCREENINGS AT HEALTH FAIR a s part of its ongoing commitment to the communities

it serves, St. Clair Hospital recently conducted a free

health fair at Focus On Renewal (FOR) in McKees Rocks.

FOR was formed in 1969 to focus on the economic, social, and healthcare needs of the Sto-Rox community, and has been the place to turn for social services since.

At the health fair, numerous men and women from the area underwent free screenings — including glucose and cholesterol, respiratory, stroke, and bone density — by clinical personnel from the Hospital. Registered dietitians, cancer experts, and other health experts from the Hospital provided one-on-one counseling to participants at education tables. ■

free MAMMogrAPHY ANd woMeN’S wellNeSS dAY beNefiTS UNiNSUred woMeN s a kick off to Breast Cancer Awareness Month, St. Clair Hospital

The free mammograms were a response to a St. Clair Hospital

a

Community Health Needs Assessment, which showed a higher

Women’s Wellness Day for area women 40 and older who do not have

incidence of breast cancer in women residing in the South Hills

health insurance.

compared to much of the nation.

Breast Care Center recently hosted a free Mammography and

The women were provided free transportation to the Breast Care Center where, following their mammograms, they were treated to breakfast, hand massages and one-on-one meetings with clinicians specializing in nutrition, exercise, smoking cessation, and more.

An interpreter was on hand for Spanishspeaking participants.

All of the women left with a gift bag featuring, among other things, pink umbrellas and bandanas. ■

22 I HouseCall I Volume VI Issue 3

asK the doctor

Ask the Doctor Q A

JEFFREY R. WILSON, M.D.

i’ve just learned that i have kidney stones. what are my treatment options?

Rates of kidney stones are rising. Up to one in 11 Americans will be afflicted with kidney stones in their lifetime. Genetics, diet, hydration status, urinary tract infections, chronic medical problems, and certain medications can contribute to stone formation. Stones can occur in any part of the urinary system, including the kidneys, ureters, or bladder.

Treatment of kidney stones depends on several factors, including their location, size, and composition. Small stones in the kidneys often do not have to be treated through surgery, unless they are causing symptoms. Stones moving from the kidney into the ureter may cause the classic symptoms of flank pain, nausea, and sometimes blood in the urine. They may pass with hydration and medication; however, many require surgical treatment. In addition, any stone in the ureter causing fevers and flu-like symptoms requires immediate relief of the obstruction.

There have been drastic advances in urologists' ability to treat stone disease. Several decades ago, open surgical procedures were performed, with large incisions and long convalescence. Nowadays, open procedures are almost never required. Instead, minimally invasive techniques such as extracorporeal shock wave lithotripsy (aka "lithotripsy" or ESWL), ureteroscopic stone ablation using a laser (URS), and percutaneous nephrolithotomy (PCNL) are able to treat stones of nearly all sizes, shapes, and locations.

ESWL and URS are best used for smaller stones under 1.5cm, and both usually are done as outpatient surgery.

ESWL uses shockwaves to break up stones into passable fragments. URS uses lighted telescopes under direct vision to target stones, which are then fragmented using a laser.

Often, fragments are then removed using a specially designed basket. Both procedures are performed under a light anesthetic, and patients often are able to return to regular activity in a few days to a week.

Larger stones present a unique challenge. Previously, they were treated with open surgery, long hospital stays, significant recovery periods, and sizable incisions. Now, advanced PCNL techniques allow minimally invasive instruments to be used. Instead of a several day hospital stay, most patients are discharged home in 1-2 days, have about a 2-inch or less incision, and recover in about 2 weeks.

Sometimes very large stones require a second procedure to completely clear the kidney.

After your stone procedure, it is important to modify lifestyle factors to decrease the chance of future recurrences. These modifiable factors include increasing fluid consumption, limiting salt, reducing protein consumption, and making sure to get enough, but not too much, calcium. Also, your urologist may send your blood and urine for tests to determine if medications can help prevent future stone formation.

No two kidney stones, and the cause of their formation, are exactly alike. Treatment should be tailored to the individual patient for optimal management. Diet changes, medications, and minimally invasive surgery are all critical components of a treatment strategy. ■

JEFFREY R. WILSON, M.D. Dr. Wilson earned his medical degree at The Ohio State University College of Medicine.

He completed residencies in general surgery and urology at The Ohio State Universityaffiliated hospitals. He practices with St. Clair Medical Services Sholder and Bordeau Urologic Associates in Mt. Lebanon and Peters Township.

To contact Dr. Wilson, please call 412.572.6194.

Jeffrey R. Wilson, M.D.

Volume VI Issue 3 I HouseCall I 23

St.Clair Hospital 1000 Bower Hill Road Pittsburgh, PA 15243 www.stclair.org

General & Patient Information: 412.942.4000 Outpatient Center–Village Square: 412.942.7100

HouseCall

Physician Referral Service: 412.942.6560 Urgent Care–Village Square: 412.942.8800

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.

Make sure St.Clair is in your Health Insurance Network

Medical Imaging Scheduling: 412.942.8150 Outpatient Center–Peters Township: 412.942.8400 Follow us on twitter at: www.twitter.com/stclairhospital

history minute

See page 18 for answers to key questions regarding the region’s changing health insurance market.

QA & Ultra modern in every respect, St. Clair Memorial Hospital boasts many innovations and the latest in scientific equipment to provide the best in medical, surgical, and emergency service. It is the first hospital in this area to have oxygen piped directly to each patient’s room. Jets in the wall connect with the oxygen apparatus while the patient relaxes comfortably behind zippered plastic screens.