SURGERY at Carlsbad Medical Center Top Notch Facility, Equipment and Surgeons
Modern Womenâ€™s Health Surgery, New Options, New Staff Express Care and the ER Meet the Hospitalists and much more!
Sponsored in part by
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4/19/11 12:34 PM
Welcome to a very special edition of Focus
Magazine — Focus on Healthcare! The mission of Focus Magazine has always been to spotlight some of the many people, places and organizations which make Carlsbad such an interesting town. Healthcare is so important to everyone — from the newest newborn to the newest retiree, that we felt healthcare developments in Carlsbad deserved a special trip under the spotlight. The stories that follow are just a glimpse of a truly dynamic industry.
Carlsbad Medical Center An Overview.................................................
04 Modern Women’s Health............................... 06 Surgery, New Options, New Staff.................. 08 Express Care and the Emergency Room..........................................
10 Meet the Auxiliary......................................... 13 Here Come the Hospitalists.......................... 14 Technology Today......................................... 16 Nursing in Carlsbad...................................... 16 The Future of Assisted Living....................... 17 Editorial Content by Kyle Marksteiner Photographs courtesy of Carlsbad Medical Center Hospital & Kyle Marksteiner Special Contributors: Michelle Fox Focus on Carlsbad is published quarterly by Ad Venture Marketing. Ad Venture Marketing, Ltd. Co. toll free: 866.207.0821 www.ad-venturemarketing.com All rights reserved. Reproduction in whole or part without permission of the publisher is prohibited. Every effort was made to ensure accuracy of the information provided. The publisher assumes no responsibility or liability for errors, changes or omissions.
Carlsbad Medical Center – a Leader in Healthcare The Carlsbad Medical Center really believes that there is no place like home. That’s why the Center recently completed a $15 million renovation — to assure the community that the facilities and staff are in place to have most medical procedures handled locally. The recent renovation, completed in February, focused on three key areas inside of the hospital: the Women’s Services Unit, the front lobby and the surgical services. “One of our new surgeons recently remarked ‘I’ve never dreamed that Carlsbad Medical Center would have this type of facility,’” noted Dr. Michael Sims, Carlsbad Medical Center’s chief medical officer. “Another one of our technicians has commented several times that the operating suites here are equivalent to those in any care center in larger cities.”
“One of our new surgeons recently remarked ‘I’ve never dreamed that Carlsbad Medical Center would have this type of facility.’” - Dr. Michael Sims In 2007, Carlsbad Medical Center underwent another major renovation that remodeled the outpatient diagnostic center, added the state’s second 64-slice CT scanner and completed a 12bed, improved Intensive Care Unit.
Focus on Carlsbad | HEALTHCARE EDITION
Members of the community watch a presentation by Carlsbad Medical Center staff during a recent open house.
The first phase of the recent renovation involved a complete makeover in the front lobby. “I’m sure you remember the old lobby we had,” Sims said. “The new lobby really just dramatically improves the appearance of this hospital. It’s much more visitor friendly.” “It’s just much more inviting,” added Melissa Suggs, Carlsbad Medical Center’s marketing director. The new redesign of the front lobby also makes entering and leaving the facility safer, Sims added. The next phase of the construction involved a complete remodel of the Women’s Services Unit, including the addition of two modern LDR (Labor, Delivery, Recovery) rooms.
“The way it used to work is we had to move patients down the hall to a room where they had their baby,” Sims said. “Now, we have rooms where the whole labor, delivery and recovery process, most of the time, can occur in the same room. Sometimes, we may still have to use one of the two post-partum rooms, which were also recently updated.” “You are spending most of your time in the labor rooms, and before there was barely enough room for a bed,” Suggs said. “This whole setup is just much, much better for our patients, their families and our physicians and staff.” Sims noted that one of the center’s new pediatricians is a trained neo-natologist. “She’s given us the ability to take care of sicker newborns than before,” he said. The final and most detailed phase of the construction project was the Surgical Services expansion
“Currently, we have four general surgery rooms that are all bigger than any we had before.” - Dr. Michael Sims “Currently, we have four general surgery rooms that are all bigger than any we had before,” Sims said. “Plus, we have two huge operating room suites.” To supplement the new services, CMC has also recently recruited three new surgeons, for a total of five general surgeons. Other surgeons provide orthopedic surgery and other specialty procedures. Sims said the medical center’s goal now is to get the word out about its upgraded facilities and services, as many local residents are not aware they are available.
Lois Calderon and Mike Leach show some of the new equipment in Carlsbad Medical Center’s Surgical Services expansion.
“I talked to a lady who was traveling to Lubbock for cardiology service, and she said, ‘I wish I could see someone here.’ Well, we have a board-certified cardiologist two doors down. For a small, somewhat isolated community of 26,000 people, the types of services we offer are really quite extraordinary, he said.” The medical center is still recruiting to fill a few recent specialty vacancies, such as a dermatologist and an ear, nose and throat specialist. However, as far as facilities go, Sims says everything is in place. “I think we’re where we need to be,” said Sims. “Our goal is to get people to realize what we have here. You don’t always have to go to Lubbock.”
A Community Magazine
Staying healthy has become an important trend in recent years, especially for women, but where can a woman who wants to live a healthy lifestyle begin? In Carlsbad, she can start at Carlsbad Medical Center. From advanced screening equipment to a community group focused on women’s health, Carlsbad Medical Center may just have it all for women’s health needs. Healthy Woman Healthy Woman is a national program provided through Carlsbad Medical Center. In August 2008, Melissa Suggs, CMC marketing director, kicked off the CMC chapter of Healthy Woman. According to Suggs, the program was started with this mission: “To empower women with the knowledge and confidence to make informed healthcare and well-being decisions for themselves and their loved ones.” Along with the interactive web site where members can keep a profile and check in with the happenings of the Carlsbad chapter, Healthy Woman provides seminars on a variety of health topics. “We provide monthly seminars to help educate women on the need for a healthy body, mind and spirit,” Suggs said. Some seminars available to the 700 members of Healthy Woman have included stress management, digestive health and the need for sleep. In the coming months, Healthy Woman will host courses on varicose veins and alternative medicine. The group is also planning a fitness boot camp for the summer.
To celebrate the women in the program, Healthy Woman hosts an anniversary dinner featuring health and fitness speakers. The ticketed event is described by Suggs as an “elegant dinner event featuring top rated speakers.” In the three years of the program’s existence in Carlsbad, Ali Vincent, the first female winner of “The Biggest Loser,” has Ali Vincent, the first female winner been one of the featured of “The Biggest Loser,” has been one of the featured speakers at the local speakers. Healthy Woman banquet. Joining Healthy Woman is free and can be done by visiting www.CarlsbadMedicalCenter.com or www.healthywomanonline.com. Bone Density
As we age, our bones begin to deteriorate. A healthy skeleton with plenty of solid bone per square inch works its way to being brittle and easily broken. Osteoporosis, a condition caused by extensive bone loss, occurs in four times as many women as men. The trend toward elderly women having experienced significant bone loss and osteoporosis is so great that more and more pharmaceutical companies are creating medications to help slow down or stop bone loss in women. There are also several tests that can give women an idea of how much bone loss they have experienced and how severe that is. One of the tests used by Carlsbad Medical Center is the bone densitometry screening. Bone density levels are measured using a dual-energy X-ray asbsoptiometry (DEXA). While lying fully clothed on a padded table, a patient’s bone density is measured using a low level of radioactive material. “”DEXA is the gold standard of measuring bone density,” said radiologist Marissa Galindo of Carlsbad Medical Center. The DEXA machine measures bone density of the Hundreds of local residents are now participants in CMC’s “Healthy hip, spine and wrist. These three areas of the body, Woman” program. Here, several members smile during the according to Galindo, are the most susceptible to bone program’s annual banquet. loss and fractures. In fact, Galindo said statistically, half
Focus on Carlsbad | HEALTHCARE EDITION
of everyone over the age of 50 will suffer fractures due to osteoporosis. There are several factors that put women at risk for osteoporosis; some are avoidable, others are not. The following are risk factors for osteoporosis according to the Mayo Clinic: Low calcium intake Tobacco use Eating disorders Sedentary lifestyle Excessive alcohol consumption Corticosteroid medication use Being a woman Getting older Race – Caucasian and people of Asian descent are at greater risk • Family history • Frame size – people with exceptionally thin frames are at greater risk. • Excess thyroid hormone The progression of your bones starts from birth. Until you reach age 30, your bones grow and rapidly replace old bone. After age 30, your body cannot produce new bone as fast as old bone is removed. “It’s known as the silent disease because individuals may not show signs or symptoms of bone loss until they fracture a bone,” Galindo said. • • • • • • • • •
Mammography Another important, albeit uncomfortable, test important to women’s health is the mammogram. And while Carlsbad Medical Center cannot promise a discomfortfree mammogram, there is technology that speeds up the process. “The image is computerized, “said mammographer Debbie Caughron. “The doctor can manipulate the image and that cuts down on time.” According to Caughron, a mammogram now takes around 20 minutes to complete. Since the images of the breast are broadcast directly to a computer, there is no worry of scratched film or otherwise damaged film images requiring the patient to have a second mammogram. The new digital mammogram machine also has a cushy add-on for patients. The MammoPad provides a breast cushion for the patient, helping make the mammogram warmer and softer. This is a plus considering the American Cancer Society recommends women over 40 have a mammogram every year. The other bit of new technology at CMC for breast cancer detection and prevention is the stereotactic biopsy machine. While laying face down on an elevated table, the patient’s breast that is to be biopsied goes through a
CMC celebrated completion of the Women’s Services Unit renovation with an Open House on October 12. The public was invited to tour the new LDR (Labor, Deliver, Recovery) Suites, meet physicians and staff, and learn about CMC’s new Tiny Toes program. Pictured left to right are: Charity Bock, Nancy Rios; Misty Sonner; Reagan Leyva, Director of Women’s Services; Avelino Garcia, MD; Anjana Nair, MD.
hole and is placed into a compression area so pre-biopsy pictures can be taken. These pictures will help the doctor isolate the tissue that needs to be removed. Once the pictures have been taken and the area to be biopsied isolated, the breast is numbed with lidocaine. Using one point of entry, the doctor will use the stereotactic needle to take several tissue samples from the area. After the biopsy is complete, a clip is placed in the area so doctors know that area has been biopsied in the past. The entire outpatient procedure takes approximately 40 minutes. “The woman is able to lie down and relax,” Caughron said, “and there is only one stick instead of multiple sticks.” Much like osteoporosis, there are risk factors associated with breast cancer that can be controlled and some, like gender and aging, that cannot be changed. Some risk factors for breast cancer include: • Alcohol use • Aging • Family history of breast cancer • Large amounts of menstrual cycles – women who began menstruating at a young age or went through menopause at an older age are more at risk for breast cancer • Dense breast tissue • Obesity • Oral contraceptive use (continued page 12)
A Community Magazine
Top Notch Facility, Equipment and Surgeons
Dr. Robert Pendrak
Dr. Cheickna Diarra
Dr. Murugan Athigaman
Dr. Salim Amrani
Dr. Abdul Qureshi
If there is a heart to the Carlsbad Medical Center, it may just be in the surgery unit. After all, that’s where many of the center’s most significant procedures are taking place on a day-to-day basis—which is why CMC officials are extremely proud of their recently completed multimillion dollar Surgical Services expansion. The new Surgical Services unit includes four general surgery rooms that are all larger than the previous rooms, two large operating rooms and a greatly-improved overall layout. All told, the Surgical Services unit was expanded from 10,000 square feet to 23,000 square feet, and from four to eight rooms. “We’re increasing the property value,” said Mike Leach, Carlsbad Medical Center’s director of surgical services, about the expansion. Additionally, in 2010, Carlsbad Medical Center added three surgeons to its staff. The surgeons each bring areas of expertise that allow the center to expand its scope of services offered. “Our services have broadened,” Leach said. “Right now we can do just about any surgery besides heads and hearts.” Other additions outside of the surgery unit also collaborate well with the goal of broadening CMC’s scope.
Focus on Carlsbad | HEALTHCARE EDITION
“With Dr. Alan Orellana as a pulmonary specialist—he’s the director of our ICU—we’re able to keep more critically ill patients than before due to his expertise,” said Dr. Michael Sims, Carlsbad Medical Center’s chief medical officer. To make extra room, the hospital’s inpatient laboratory was moved to the front of the hospital and the materials management department was moved to a new building behind the Medical Administrative Services building. While the square footage of operating space was increased, Leach said, it is just important that the redesign resulted in an improved layout. “It’s just more user friendly,” he explained. “Where the patient starts, they go down the hall and then they go left or right into the OR rooms, then they come out the other way. It’s a complete circle.” Also, about $1 million in new equipment was added to the surgery area at the same time as the renovation, Leach said. “And they really did a good job with buying us the right equipment,” he noted. “We’ve got all new everything.” “The equipment we have now rivals anywhere in the southwest,” agreed Sims. In fact, Leach said the medical center is now able to provide surgery for any process imaginable.
“We’ve got everything we need,” he said, noting that the addition of new surgeons allows CMC to perform more general surgeries and add their specialties. “The only thing that holds us back is to have the right surgeon (for any given procedure).” New Surgeons In 2010, three new surgeons joined Carlsbad’s professional surgical staff — Cheickna Diarra, Salim Amrani and Abdul Qureshi. Diarra joined Dr. Robert Pendrak at Pendrak Surgical while Amrani and Qureshi joined Dr. Murugan Athigaman with the Surgery Group of Carlsbad. Both groups are affiliated with Carlsbad Medical Center and the Pecos Valley Physician Group. Dr. Diarra, a graduate of the Wake Forest School of Medicine, recently completed his general surgery residency at Cooper University Hospital in Camden, New Jersey, where he was named Chief Resident. Diarra has extensive experience in complex colon and rectal surgical management. Diarra became a member of the medical staff at Carlsbad Medical Center in September 2010. Pendrak Surgical is located at 2402 W. Pierce, Suite 6C, and can be reached at 8875321. Dr. Amrani also joined CMC’s staff in the fall of
“The equipment we have now rivals anywhere in the southwest.” Mike Leach Director of Surgical Services 2010. He specializes in general and colorectal surgery. Amrani earned his medical degree at I.N.E.S.S.M. in Algiers, Algeria, and completed his Fellowship in Colorectal Surgery at Stony Brook University in New York. The Surgery Group of Carlsbad, located at 2410 W. Pierce Street, can be reached at 885-0766. Dr. Qureshi joined CMC’s Medical Staff in June 2010. He earned his medical degree and completed his internship and residency at the Aga Khan University Medical School and Hospital in Karachi, Pakistan. He completed a Fellowship in Cardiovascular Surgery at the Texas Heart Institute in Houston as well as a Fellowship in Thoracic Surgery at Harvard Medical School, Brigham and Women’s Hospital. Practicing with the Surgery Group of Carlsbad, Dr. Qureshi is a Member of the Medical Staff at Carlsbad Medical Center.
instruments he manipulates with his other hand. A TV screen overhead is used to view the procedure while the surgery is in progress. With both a hand and laparoscopic instruments doing the work through two or three additional, small, half-inch incisions, the surgeon has excellent control over the operation, as the sensations of touch and depth are preserved. Organs such as the colon, small bowel, stomach, pancreas, and spleen can be removed using the same procedure. This makes it possible to evaluate and remove any evidence of cancer or benign conditions in a less invasive way. “This type of minimally invasive surgical approach has revolutionized the way we perform surgery,” says Dr. Diarra. “The old-fashioned way depended on making large abdominal incisions, which were painful and kept the patient in the hospital for several days with longer recovery times. The advantages of A Better Kind of Surgery laparoscopic hand-assisted surgeries Due to the new expertise, a include shorter hospital stays, less minimally invasive surgical procedure postoperative pain, faster return to a solid food diet, accelerated return for patients needing colon resection surgery is now available at Carlsbad of bowel function, quicker return to Medical Center. Laparoscopic, hand- normal activity and better cosmetic assisted colon resection surgery was appearance.” performed for the first time at CMC Although there are many in late 2010 by Cheickna Diarra, advantages of this type of surgery, Dr. M.D. Diarra cautions that not everyone is Laparoscopic hand-assisted a perfect candidate for the procedure. “Patients who have severe abdominal colon resection surgery is a surgical procedure in which the surgeon adhesions or scar tissue from inserts a hand through a small previous surgeries, unclear anatomy, incision in the abdomen using a or extensive cancer obstructing the specialized gel-like sleeve. view and preventing a safe surgery The hand is used for sensory may not be candidates for this type of perception and to guide the surgical procedure.”
A thorough evaluation in the clinic is mandatory before deciding which patients are candidates for this type of surgery. Most patients stay in the hospital for three to five days and are able to return to light-duty work after two weeks.
A Community Magazine
Certified Nurse Practitioner Karen Farias, at right, helps provide important express care services.
What is the Pecos Valley Physician Group? It’s a term not everyone is familiar with, and it sometimes shows up on paperwork. “We are a hospitalowned clinic group,” explained William Hopson, executive director. “What that means is we have employee physicians.” Essentially, the physician employer has to be a separate business than Carlsbad Medical Center though the two entities work closely together. Having a physician’s group, instead of individual doctors, also provides benefits for the local community. “For a market like Carlsbad, it allows us to get more specialties,” Hopson explained. “It helps you to have the infrastructure and support in place.” The Pecos Valley Physician Group manages 15 physician practices in Carlsbad.
It’s 10 a.m. on a Saturday and your child is sick. The doctor’s office isn’t open for another two days and you are understandably concerned. What’s the best option? Every parent knows about the emergency room, but emergency room visits can also get pricey. A visit to the Pecos Valley Express Care, located at 2330 W. Pierce St. next to the movie theater, may be a better alternative. Pecos Valley Express Care shares the same space as the Pecos Valley Family Clinic. What are some of the differences between visiting the ER and utilizing urgent care? ER Carlsbad Medical Center’s ER, located at the south end of the hospital, handles an abundance of injuries and accidents each day, running from teething toddlers to heart attacks and strokes. All together, the ER saw 22,000 total patients last year for an average of 68 per day. That’s up from 14,000 visits a year for CMC’s ER eight years ago. The average length of visit though Carlsbad Medical Center’s emergency room, from the moment you enter the door, is 2 hours and 40 minutes, which is much better than the national average. Many visits are much faster. ER Director Connie Willis stressed that she isn’t discouraging anyone with concerns from visiting
the emergency room, but she did suggest that there are instances where it might be better to use urgent care or another service. “Obviously, come see us with any chest or abdominal pain, or if something is broken. If you are in doubt, come and see us and we’ll take a look,” she noted. But the process can be misused. “We’ll get folks coming in for medication refills because the primary care physician is out of town,” she said.”Awareness of how much medication you have left is important so you do not run out. You should start calling for refills a week or two before getting close to running out, not the day of.” Other individuals who don’t have primary care physicians use the ER for all of their health care needs, which can get expensive. The difficulty is that insurance companies are increasingly denying coverage for visits to the ER that are not classified or defined as an emergency condition. “We do understand that urgent care hours aren’t all night long, and let’s face it, everybody who comes in truly believes that it is an emergency,” Willis said. “I just think the more we educate, the better off we are in the long run. However, if you are scared, the best thing is to come here.” Visitors to the ER are classified using a five-level triage system.
Express Care While some patients with less urgent triage classifications may have to wait, a nurse is supposed to check up on all patients in the lobby to see if their condition has changed. Some patients to the ER are admitted, some are transferred and some are treated and released. The ER contracts through a company called Schumacher, which supplies a core group of physicians throughout the week. A team of nurse practitioners also staff the ER. Willis said it used to be that visits to the ER picked up after 5 p.m. and slowed down at around 1 or 2 a.m. “Not lately. Lately we’ve been going pretty much all of the time,” she noted. Her advice to anyone paying a visit to the ER is to bring any information related to medication, allergies and recent surgeries possible. Parents concerned about their children, or about themselves, also have the option of getting information through a 24-hour hotline based in Albuquerque. The number is 1-877725-2552. Express Care For almost two years now, the Carlsbad Medical Center has operated Pecos Valley Express Care as an express care facility. The clinic is located next to the mall cinema, and patients can visit without making an appointment. “I think first and foremost, the concept of express care is that it’s
intermediary,” said William Hopson, executive director of the Pecos Valley Physician Group. “With transitions in health care, you are starting to have an environment where some ER visits are being denied by insurance
companies as non urgent, and the average emergency visit is $500 minimum.” That’s where express care steps in. It’s an alternative if a primary care physician is unavailable, and it is covered by most insurance plans. “It offers an opportunity for people to receive intermediary care, and we can still refer you to the ER,” Hopson said. “We have a balance of both a doctor and a nurse practitioner, and when you start talking the insurance side, it’s a little bit cheaper (than ER).”
“We’re appropriate for most of the same things that family doctors handle, but primary care physicians are sometimes booked and can’t see you on short notice,” said Certified Nurse Practitioner Karen Farias. “The thing to remember is that we bill the same as the doctor, so for most insurances, their co-pay will be the same.” While the clinic does not offer 24-hour service, it does offer more extended hours than most physicians do. The clinic is open from 8 a.m. to 8 p.m. Monday and Thursday, 8 a.m. to 5 p.m. on Tuesday, Wednesday and Friday and 9 a.m. to 1 p.m. Saturday, dependant on provider availability. The express care clinic is more limited in what services it can offer than the ER. “If your weekend warrior breaks something, we can’t fix that,” Hopson noted. “But if you are in doubt, I definitely think this is a good first place to start and get a medical opinion. We’re going to send them to ER if we need to. If nothing else, you’re going to have the providers that can make that determination.” The Pecos Valley Clinic saw about 7,000 patients last year, Hopson said, and has the capabilities to see more. “What I’d like to contribute is that there really is an option,” he said. “The clinic is an intermediary step where you can get the care you need for something that is urgent but not emergent.” A Community Magazine
Obstetrics Need a place to have your baby? Carlsbad Medical Center may well have the most advanced OB/GYN area in southeastern New Mexico. “We have the nicest rooms I have seen,” said Chief Nursing Officer Carol Welch, who retired in the spring of 2011. Not only are the rooms nice, they are also secure. Mom, significant other and baby are equipped with security devices that will lock the doors and sound an alarm when the baby gets within three feet of any exit from the wing. The entrances into the wing are also locked coming into the OB/GYN portion. In 2010, CMC began a major renovation on the OB/GYN wing. One of the major changes was to convert the standard
delivery rooms into labor, deliver, recovery rooms. These LDR rooms allow the mother to go through labor, delivery and her recovery all in the same room. Women do not have to be moved to another room after delivery and the baby can stay with the mother longer. “The LDR rooms all have bathrooms and showers,” said Reagan Leyva, director of women’s services. “They have everything—continual fetal monitoring, a sofa bed, scales for the baby and a storage room with supplies.” The updated wing can also handle high-risk pregnancies and premature births as early as 32 weeks. According to Welch, the LDR’s were constructed using existing square footage on the floor. The renovations also added new exam rooms and a doctor sleep area. “We hope the new unit will make people not think they have to go out of town,” Welch said.
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Auxiliary They are the first people that you meet when you also often thanks walk into the Carlsbad Medical Center — they are the Auxiliary members men and women of the Auxiliary. with gift certificates The Auxiliary has been assisting the Carlsbad during holidays. Medical Center since 1977 and currently consists of 65 Langlinais said members, including six men. she volunteers about Auxiliary President Ann Langlinais said she became 10 hours a week. involved in the auxiliary in 2001, after she lost her “I’ll work at the husband. front desk one day, one day in the gift “I needed something to do, and I wanted to do shop and one day in something I felt was beneficial and helpful to people in the surgical waiting the community,” she said. room,” she said. The role of the Auxiliary is to provide Carlsbad “It’s like the front Medical Center with volunteer assistance with a variety desk, but for families Auxiliary President Ann Langlinais of activities around the center. of people in surgery. prepares to answer the phone at “We have people who work the information desk Carlsbad Medical Center. I also work in the when you first come into the lobby,” Langlinais said. “We’ll let them know what room pharmacy.” people come in and we’ll answer The Auxiliary volunteers often “I needed something the phone.” have to help with family members to do, and I wanted to Because of privacy laws, all who are nervous about a sick or Auxiliary members receive extra do something I felt was injured patient. training in making sure they “They’ll ask if we’ve heard beneficial and helpful to know what information they can anything or can we call back to the people in the community.” operating room,” Langlinais said. and cannot give out. Ann Langlinais “We’ll try to get them information “We’re told several times Auxiliary President ‘what you see here stays here,’” or make them more comfortable.” she said. The Auxiliary has also assisted in Other Auxiliary volunteers the community with other projects. For example, a few deliver newspapers and flowers to patients and escort years ago the organization purchased defibrillators and visitors to patient rooms. The Auxiliary also runs the put them in local police cars. Money was raised from the hospital’s gift shop, with proceeds going to support local gift shop. students interested in medical fields. Carlsbad’s Auxiliary belongs to the state organization “We’ve offered five scholarships for the semester to as well. While the majority of volunteers are retired, the students and this year they are all in nursing,” Langlinais organization also includes several younger volunteers said. who are interested in pursuing medical careers. In return, volunteers receive a meal for every two “I just enjoy the feeling that I am helping people, and hour shift worked at the hospital. The medical center it also helps me,” Langlinais said.
A Community Magazine
Greatly Improving Medical Efficiency “The continuity of care is really quite remarkable.” – Michael Sims, CMC Chief Medical Officer It has been four years now since Carlsbad Medical Center began a hospitalist program and CMC Chief Medical Officer Michael Sims says members of the community are starting to embrace the change. The hospitalist program, in which a staff of full time physicians handles day-to-day needs at the hospital, has certainly been a major plus for area physicians. Prior to the use of hospitalists, doctors would spend the day rotating between working in their practice and working on patients at the hospital. “So on a Monday, we’d come in and see hospital patients at maybe 7:30 a.m., but then by the time we got to the office there would be maybe 10 patients waiting to see you,” Sims said. “While you were seeing those 10 patients, you might get two calls back to the hospital.” The problem is that it became almost impossible for physicians to stay caught up with and meet the needs of both their practice patients and their hospital patients. “Then you might get called back at 2 a.m. and 4 a.m. on night duty,” Sims said. “The next day, that’s when it really catches up to you.” Then a physicians’ group in Northern California began a program where doctors would rotate every six months. Half of the doctors would work in the hospital, while the other half would work in the doctor’s office.
Focus on Carlsbad | HEALTHCARE EDITION
physician they are most familiar with available at all times. “But the efficiency on both sides of the fence is so much better,” he said. Carlsbad Medical Center has four full-time hospitalists in its program, along with two nurse practitioners who work with the hospitalists. “They rotate where there are two people on duty every day,” Sims said. “They essentially handle all of the medical sorts of admissions, such as pneumonia, diabetes and asthma.” The hospitalists are all boardeligible or board-certified. “Just like every other specialty, things change,” Sims said. “Hospital medicine is becoming more and more specialized to where there are new drugs primarily applicable to a hospital patient.” Sims did want to clarify a misconception that office doctors are not allowed to see patients in the hospital. Doctors such as S. Salahuddin, M.D., one “That is absolutely not the case,” of the hospitalists who contracts with he said. “We still have the same Carlsbad Medical Center, free up other privileges and we can come back to physicians. do what we used to.” Currently, more than 80 percent He also wanted to make it of hospitals have some form of clear that when one his patients is hospitalist program, Sims said. admitted to the hospital, he remains CMC began its program in 2007 and involved in the decision making contracted with a hospitalist service process. program called Apogee Physicians. “When one of my patients is Sims admitted that it has taken admitted, I’ll be faxed an additional some patients time to become used to notice and have a chance to put in the change. Many patients want the my input. Hospitalists are by and “What they found was that, at the end of time, it was really a much better way of doing things,” Sims said. “Some of the doctors liked being in the hospital all the time and the other half really liked to be in the office. That was kind of the genesis of the hospitalist program.”
Dr. Kamishele Maila examines some paperwork at Carlsbad Medical Center. Maila and CMC’s other hospitalists work for Apogee.
large so thorough, that it’s very seldom that I have to add additional information,” he said.
Sims is able to track the condition of his patients every day, he said, and he receives a discharge notice when the patient leaves. “The continuity of care is really quite remarkable,” he said. CMC’s hospitalists are top notch, Sims said, and patients are starting to warm up to them. “I think it has taken a while to get used to the new system,” he said. “But I’m starting to see patients who refer to hospitalists as ‘my hospital doctor,’ which shows they are developing a relationship similar to the relationship they (the patients) have with me.” Survey results have also shown that the quality of care provided by hospitalists is exceptional, Sims said, and the center’s hospitalists are also receiving training to improve patient satisfaction. “It’s sometimes a simple thing like sitting down in a chair and talking with the patient,” he said. “You don’t stand in the doorway and talk, you cross into the room.”
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NMSU-C’s Nursing Program
Carlsbad’s medical community is bolstered by a healthy nursing program at New Mexico State UniversityCarlsbad. There, students receive training for entrance into a career that is habitually one of the nation’s most indemand professions. NMSU Carlsbad’s nursing program began in 1973, with the first class graduating in 1975. The program received its first National League for Nursing accreditation in 1990 and has maintained full accreditation since then. The university offers two nursing programs. The primary program is an associate’s degree program designed toward taking the NCLEX-RN test and licensure as a registered nurse. The program also offers a path for a Licensed Practical Nurse certificate. “The majority of our nurses complete the RN program,” said Faith Goad, the program’s interim director. “Also, many students will complete the PN program in the summer and then continue the RN program.” Additionally, there is also a fouryear Bachelor’s of Science in Nursing program that can be completed online or through NMSU’s main campus in Las Cruces. A BSN nurse would obtain the same RN licensure. NMSU Carlsbad maintains 55 slots for incoming freshmen interested in its RN program. “We currently do not have a waiting list,” Goad said, “which makes us one of the nation’s best kept secrets, as most programs do.” Goad said there were 77 total students admitted in the nursing program in the fall of 2010. Most NMSU Carlsbad students go on the pass the NCLEX. “Our pass rate is well above the national average,” she noted. “We have consistently maintained pass rates above 90 percent.” (continued page 18)
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A licensed Radiologic Technologist performs diagnostic imaging examination. All technologists have been educated in anatomy, patient positioning, examination techniques, equipment protocols, radiation safety, radiation protection and basic patient care. They also specialize in specific imaging techniques, such as bone densitometry, cardiovascularinterventional radiography, computed tomography, mammography, magnetic resonance imaging, nuclear medicine, sonography and general radiography. Diagnostic imaging performs outpatient examinations from 7:30 a.m. to 5 p.m. Monday – Friday. The Outpatient Diagnostic Center registration office can be reached at 575-887-4289. Inpatient and Emergency Department exams are performed 24 hours a day by staff on-site or on-call. You can contact the Diagnostic Imaging Department at 575-887-4493.
Medical technology has evolved significantly over the past ten years, especially in fields related to diagnostic imaging. Before any surgery begins, physicians now have an extensive array of tools available to help them best know what’s developing inside a patient. Here are a few of the “hightech” elements of Carlsbad Medical Center. The Diagnostic Imaging Department is dynamic and innovative, with a commitment to stay at the forefront of technology and clinical applications in today’s changing field of medical imaging. The latest technology advances include a Toshiba 64-slice CT scanner and installation of a fully digital imaging system, known in the healthcare industry as PACS. Services at CMC also include Magnetic Resonance Imaging (MRI). Digital mammography is also now available. Carlsbad Medical Center has opened a one-stop, full-service Outpatient Diagnostic Center on the hospital campus. Diagnostic testing and women’s services are now under one roof. The center includes a sleep studies lab. Other procedures offered at the center include mammography, bone density, cardiopulmonary stress screening, outpatient laboratory services, and new diagnostic Dr. Otoniel R. Sullesta demonstrates technology for spine and hip some of Carlsbad Medical Center’s radiology equipment. imaging.
etirement needs are constantly shifting, through medical developments, economic changes and even generational shifts. Retirement communities can best prepare for these changes by offering a diversity of options, noted Marsha Drapala, development and marketing director for Carlsbad’s Landsun Homes. Landsun Homes, along with Lakeview, is one of Carlsbad’s two “large” retirement communities. Landsun’s range of retirement options includes townhouse living, independent living, assisted living, longterm care, private duty service, hospice and community deliver-a-meal. As an example of a change, a recent downturn in the economy meant that many retirees were staying at their original houses for a longer period of time and joining a retirement community at an older age. During that period, fewer people were entering Landsun’s program at the townhouse living stage. While Landsun recently saw vacancies in its townhouse village for the first time, that appears to be changing, Drapala said. “I think the economy is perking up and people are starting to look again,” she said. The typical Landsun resident will become a part of the community quite a while after retirement, Drapala said, but many retirees begin making preparations very early. “We are also having many people choose their retirement community (earlier in retirement) because they want to make those decisions and enjoy life,” Drapala said.
of continuing care
For example, a couple might retire in Michigan and move to Arizona for a decade. After ten years in Arizona, they may decide on a “second retirement” to a continuing care retirement community like the Parkhouse Village, townhouse living at Landsun. That way, they are still basically living on their own, but have access to additional health care, social services, and worry free maintenance.” “They’ll be a part of our community when the next level of care is needed.” Drapala said. As the retirees become more in need of direct services, they can move up into other residential opportunities that offer increased assistance, such as independent living, assisted living, long-term care, or memory care. Spouses who require different levels of care can stay together on the same campus. “Many of the potential residents coming to Landsun find it difficult to perform the maintenance or find someone to help with the daily chores in their home. She said. “If they want to go away for a month, we’ll be able to take care of their property, and they’ll have access to emergency healthcare 24 hours a day.” Landsun also offers hospice services for anyone on the Landsun campus as well as in the community. “There’s a time when someone makes the decision that they want to be comfortable,” Drapala said. “The focus of hospice is on comfort and quality of life.” (continued page 18)
What are nursing homes? Nursing homes are facilities licensed by the state to provide nursing care, personal care and medical services. Nursing homes offer roundthe-clock care if someone is too sick to live on his or her own, or if he or she needs to recover after an illness or operation. What is assisted living? Assisted living is a program with a philosophy focused on maximized independence of residents. Many consumers enjoy it because they get the help they need with everyday living tasks and receive help with health care in a residential setting. Assisted living communities are also regulated in all 50 states. What are Continuing Care Retirement Communities? Continuing Care Retirement Communities offer several services in an all-in-one location which give a person the opportunity to stay in one place even if his or her needs change. Services may include both nursing home and assisted living care. ~ Source: The American Association of Homes and Services for the Aging
face (continued) Hospice does not imply that there is a specific lifespan timeline, Drapala said; and in fact, patients have to be recertified to stay on hospice. Interdisciplinary teams, including doctors, therapists and clergymen, work together during hospice care to make sure the patient’s needs are met. One major change that is developing in the retirement field is related to the fact that many baby boomers will soon be joining retirement communities. “We’re going to need to change in the future,” Drapala admitted “I think baby boomers are going to be more demanding and want more amenities.” For example, while Landsun offers an internet connection, boomers who become affiliated with the community down the road are going to want high speed connections. Some items, such as level of care, will be the same for every generation. Landsun offers a certified nurse assistant on each of its assisted living floors 24 hours a day, Drapala noted. “We’re a continuing care community that does the whole thing,” she said. Drapala is also an active participant in the Carlsbad Chamber of Commerce’s retirement program. “I’m thrilled with how successful the program has been,” she said. “I think we can justify 190 people who have moved here (to retire) since we started the program.” Most of the people who have recently retired to Carlsbad have done so early in their retirement, Drapala said. Many work part time jobs here or volunteer heavily. They are typically members of the middle class. The newcomers, generally, haven’t immediately become residents of Landsun, Drapala noted, but instead have considered the fact that there are two thriving retirement communities in Carlsbad to be a bonus down the road.
For example, NMSU Carlsbad graduated 21 RN students last May. 100 percent of those graduates who took the NCLEX examination passed it, Goad said. NMSU (contnued) Most of the students can quickly find nursing jobs in Carlsbad and the immediate vicinity. “You will see lots of information about nursing shortage,” Goad said. “Nurses are always in high demand.” To better support its nursing program and other health-related programs, NMSU Carlsbad is currently undergoing the process of constructing a new 17,550 square foot allied health building. The estimated completion date for the $6 million project is June 2011. The project was funded through a General Obligation bond approved by the citizens of Carlsbad in 2008 and through State General Obligation Bonds. “The nursing program at NMSU Carlsbad is one of our strongest, most viable vocational programs,” said Russell Hardy, NMSU-C president. “In addition, we are proud of the quality nurse practitioners that the program produces and the degree to which our program is supported by the local community and by our local health care constituents. It is our vision that the new allied health programs that are currently in development will achieve the same reputation and overall level of quality.”
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