HEALTHLETTER COV ER S TO RY
Health Care Is a Family Affair PLUS
The Menopause Effect GRMC Recognized for High Quality in Bariatric Surgery
M AY 2018
Lisa Sears (left) discusses her next steps with Dr. Jennifer Paisley. Sears successfully changed her lifestyle and diet to avoid taking insulin for diabetes.
HEALTH CARE IS A
FAMILY AFFAIR MANAGING A CHRONIC ILLNESS CAN BE A CHALLENGE, and when Lisa Sears needed help managing her diabetes, her primary care provider wanted her to see, as he put it, “a tremendous resource, one of the internists right here at GRMC.” Her provider wanted Sears to have more individualized care to reduce Sears’ weight and her need for
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insulin, so Sears began seeing Jennifer Paisley, MD, FAAP, Dipl. of ABOM, an internal medicine specialist at GRMC. “Diabetes and obesity are two closely linked conditions,” says Dr. Paisley. “Chronic obesity is a disease, like diabetes or high blood pressure. Weight-loss management and nutritional adjustment provide an
Sears has found the right caring staff to help her on the health care journey at Grinnell Regional Internal Medicine. Over the past 18 months and under the watchful eye of Dr. Paisley, Sears no longer needs insulin, and she’s lost 48 pounds. Sears typically met with Dr. Paisley on a monthly basis to evaluate her progress and discuss any challenges she faced. “What I’ve realized since I started seeing Dr. Paisley is how important it is to communicate with my health care providers,” Sears says. “She really helps me feel like we’re in this together.” Having expert, personalized care so close to home has been a huge benefit for Sears.
option for patients to help manage diabetes, or other chronic conditions when they aren’t comfortable with surgery or candidates for surgery, but want to do more to take charge of their health.” “When Lisa came to see me, her first goal was to regulate her A1C levels and she wanted to reduce the amount of insulin she needed to take to zero,” says Dr. Paisley. “Her second goal was to lose weight. In managing chronic conditions, internal medicine is all about meeting the patient where they currently are in their health care journey and developing an individualized plan to help the patient succeed,” Dr. Paisley explains.
“In 20 to 25 minutes, I’m in my doctor’s office for my appointment. It’s much more convenient than having to travel,” she says. The easy access to specialized care not only helped Sears manage her own diabetes, but it helped her assist her mother, Judy. Lauren Graham, MD, MPH, also at Grinnell Regional Internal Medicine, follows Sears’ mother. A big challenge Lisa Sears had faced was scheduling around her work hours. The Grinnell front office staff works diligently to schedule Sears and her mother around Sears’ hours.
“The staff is so great with scheduling both of our appointments,” Sears says. “They know I am mom’s primary care giver and I want to be with her when she sees the doctor. They schedule our appointments so I can go to mine and then go to my mom’s.” One instance in particular stood out to Sears. Sears was afraid she would have to miss her mother’s appointment to attend her own. But then Drs. Paisley and Graham brought the appointment to them. “We were here one afternoon, and I started to worry about making both appointments. The nurse brought us back to an exam room. Dr. Paisley and Dr. Graham performed exams on both of us together, so I wouldn’t have to miss my mom’s appointment and we wouldn’t have to change rooms.” At Grinnell Regional Internal Medicine, a personalized approach is important to help patients manage common and complex conditions. In most instances, people stay with one primary care provider through all stages of their adult life. The impact of this team effort helps patients go from getting well to living well.
Internal medicine appointments typically need a physician referral. Talk to your primary care provider and then ask for Grinnell Regional Internal Medicine. For more information about internal medicine, please call (641) 236-2382. May 2018
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NEW EMERGENCY CARE IS STILL JUST THAT: AN EMERGENCY. When you have a need, you want the best people and services available, now. The new Brownell Emergency Center at GRMC is ready for you. Patients who have seen the 1984 and the 2018 versions of the GRMC emergency department appreciate the changes, and have this to say:
It’s bigger and more open. Much nicer.” “It was quieter and more private than the old trauma bays.” “I didn’t get anxious that staff had forgotten about me. The glass doors and curtains allowed me to see staff and know they were just outside the door looking at test results. I felt included.
Emergency department staff takes a moment to pose during the open house held on February 21. Three full-time physicians and 17 emergency-trained nurses and techs are on staff.
Common Questions about Emergency Care Why did another patient go into a room before me? Patients are seen in the order of severity, not in the order of arrival to the emergency department. Why do emergency department visits take so long? Blood tests, heart monitoring, x-rays and other tests require time to complete and time to interpret results. An MRI scan, for example, can take 20 to 30 minutes to complete and 30 to 60 minutes to interpret.
Lesa Peters, RN, GRMC emergency department nurse manager, explains how the technology has advanced. “Patient vitals are on the monitors in the nurses station. We can view heart rate, blood pressure and breathing pattern without interrupting constantly.”
Where will a patient be transferred if a higher level of care is needed? The emergency department physicians and the patient or family decide this together. For example, if you have relatives on the east side of the state, you may want to go to a hospital in Cedar Rapids or Iowa City.
“Advancements in security, monitoring, equipment, beds and facilities make this a more appealing place during what could be one of the worst days in someone’s life,” Peters says. “I’m proud of our team and this space.”
Patients always have a choice in care. Patients are not automatically transferred to a UnityPoint Health® hospital just because GRMC is part of the UnityPoint Health system. As the integration continues, patient experience will be even better: Communication and sharing of medical information are more easily accessible because we work within the UnityPoint Health system.
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Copyright ® 2018 UnityPoint Health. All Rights Reserved. ® SM trademarks of UnityPoint Health.
OPPORTUNITIES AWAIT AT GRINNELL REGIONAL MEDICAL CENTER
THE INTEGRATION OF GRMC AND UNITYPOINT HEALTH has people talking. In a good way.
I’m very excited about the opportunities coming with the UnityPoint Health affiliation. The big addition will be the transition to Epic [new electronic medical records system] and technology. With the affiliation we can gain more best practice policies and procedures to implement.
ICU NURSE TECHNICIAN
Sallie in the laboratory agrees. “I’m excited, but I like change. It could be the start to something great.” In the surgery area, nurses and techs agree. Lori, RN, says, “We feel this is a positive change and look forward to service changes, especially with the addition of orthopedics and ENT full time.” Tammy, a clinic supervisor, adds, “I’m anxious to see the changes and the influx of resources such as equipment, providers and services that will come to GRMC.”
She added that everything is going smoothly with the integration. Staff who were asked to comment agreed the affiliation is not changing their work environment. Marie, ICU, says she looks forward to changes with the Epic system in 2019 to increase focus on patient care. “We currently can monitor vitals at the nurses station and can react quickly. And with the EHR, the vital details will be in the record, which is more efficient. It allows more time to be present with the patient.”
PLANNING FOR A SMOOTH TRANSITION THE SHORT-TERM CHANGES ARE MINIMAL for GRMC’s clinical staff after five months into the affiliation process. Leadership teams have been meeting to assess UnityPoint Health departments and services. Zach Weiderspon, director of integration for UnityPoint Health and a member of the integration team, explains that the assessment process allows both facilities to share best practices and improve patient care. “Our nursing leadership team has met with members of the UnityPoint Health — Des Moines nursing leadership team to enhance
upcoming clinical education,” Weiderspon says. He explains, “Behind the scenes, our contracting and information services teams have been updating information to begin the initial infrastructure phase of the Epic implementation.” One noticeable initiative is the unveiling of the new UnityPoint Health — Grinnell Regional Medical Center brand and logo. Watch for new exterior signs this summer. One major activity that had been taking a large amount of time was
the search for the new GRMC chief executive officer. The decision to hire Jennifer Havens, RN, MHA, as the new CEO was announced in May. “GRMC welcomes feedback from the community as well as employees as the integration continues,” Weiderspon says.
Residents may call GRMC administration at (641) 236-2300 to discuss questions and plans as UnityPoint Health — Des Moines and GRMC become fully integrated over the next year. May 2018
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WOMEN AND WEIGHT GAIN:
YOU’VE SURVIVED THE HOT FLASHES — or maybe
Holly Pettlon, CPT Wellness Specialist Lead
you’re living with them now. And weight gain is a common, almost inevitable, additional side effect of menopause. Weight is often gained around the abdomen, which can lead to an increased risk of heart disease and diabetes according to the American Heart Association. Don’t let this news weigh you down! Lily Swedenhjelm, RDN, LD, a clinical dietitian at GRMC, has some great tips to lose unwanted menopausal pounds — and ways to not get them in the first place.
Lily Swedenhjelm, RDN, LD
It’s common to be less active as we age.
“Challenges with weight maintenance are associated with decreased physical activity, loss of lean muscle mass and lower resting energy needs. This means women experiencing menopause and post-menopause probably now need fewer calories to maintain a healthy weight.” Maintaining weight loss requires a lifestyle adjustment. Swedenhjelm references Today’s Dietitian research that recommends focusing on three goals: eating, sleeping and moving.
It doesn’t have to be the case.
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Watch your calories. Being mindful of calorie intake is a starting point. Focus on high quality sources of fiber, potassium and lean proteins. Make fish, fruits, nuts, vegetables, whole grains, beans and yogurt a main part of your diet. When fresh fruits or vegetables are out of season, take advantage of canned or drained products with minimal sodium. Plan to control portion size. Use a smaller plate, bowl or glass and plan your meals and snacks in advance. Prepare food at home so you have complete control. Limit refined grains, starches, sugars, high-sodium foods and trans fats. When eating out, order dishes with vegetables and fruits. Consider taking half of your meal home for leftovers. Try to get enough quality sleep. With the sweltering night sweats you’ve likely experienced, this can be a tough task. But it’s an important one. Lack of sleep can increase levels of the hormone affecting your feelings of hunger (grehlin) and simultaneously decrease the hormone that helps you feel full (leptin). This one-two punch can cause a serious setback in your healthy lifestyle journey. Additionally, people who sleep 7-8 hours a night are more likely to successfully maintain weight loss.
the slowing of your metabolism. Try to increase your movement throughout the day. Try taking two or three 10-minute walks each day or two 15-minute walks per day. Keep in mind that joints take more kindly to lower impact activities. If your schedule or the weather is more restrictive, try these quick tips to add some positive strides to your daily routine:
Tips for quality sleep during and beyond menopause: Get adequate exposure to natural light during the day. Fight daytime fatigue with exercise, not a nap. Establish a regular, relaxing bedtime routine. Limit bright lights from electronics right before bedtime. Avoid stimulants (caffeine and nicotine) 4-6 hours prior to bedtime. Consider avoiding alcohol before bedtime. It can disrupt your normal sleep patterns. Eat a lighter evening meal.
Stay active Although it’s common to be less active as we age, it doesn’t have to be the case. GRMC Wellness Specialist Lead Holly Pettlon, CPT, suggests setting yourself up for success as you embark on a new fitness goal. “Join a fitness class or hire a personal trainer to shake up your current exercise routine. Classes provide guidance and a support system to encourage and structure workouts, and a personal trainer is able to customize workouts that are especially suited to the individual while also making sure form and function are on point,” Pettlon says. Pettlon also references Mayo Clinic research that highlights the benefit of incorporating strength training into your weekly routine. It will help combat the decrease in lean muscle mass; therefore, it will help prevent
Park in the farthest available parking spot.
Take the stairs.
Use a smaller glass/cup so you need to go for more frequent refills.
Do an at-home workout video or walk indoors.
Consider adding weight or resistance training.
Although the metabolism shift associated with menopause can create quite the drag, you don’t have to fall victim to it. Use the tips here to positively adjust your lifestyle and help you eat, sleep and move better today!
Speak with your primary care provider for menopause management tools. For more information on nutrition, contact a GRMC dietitian at (641) 236-2488. For more information about fitness and exercise, contact the Paul W. Ahrens Fitness Center at (641) 236-2999.
| HEALTHLETTER 6
VITAL SIGNS GRMC Recognized for High Quality in Bariatric Surgery
Neleman Named a 100 Great Iowa Nurse
Wellmark Blue Cross® and Blue Shield® has recognized GRMC with a Blue Distinction® Center+ for Bariatric Surgery designation as part of the Blue Distinction Specialty Care program. These centers are nationally designated health care facilities that show expertise in delivering improved patient safety and better health outcomes, based on objective measures that were developed with input from the medical community.
GRMC Surgical Coordinator Katie Neleman, RN, received the 100 Great Iowa Nurses award from the Iowa Nurses Foundation. The foundation recognizes 100 outstanding nurses every year in Iowa for courage, competence and commitment to patients and the nursing profession.
To receive the designation, a facility must demonstrate success in meeting patient safety measures and bariatric-specific quality measures. A facility must also be nationally accredited at both the facility and bariatric program-specific levels, as well as demonstrate cost-efficiency compared to its peers. In 2017, the Blue Distinction Centers for Bariatric Surgery program expanded to include the site of care. Health care facilities were evaluated as either a comprehensive care center or as an ambulatory surgery center. “Grinnell Regional Medical Center has been committed to providing high quality bariatric surgical care for many years. The designation as a Blue Distinction Center+ for Bariatric Surgery demonstrates the continued focus on quality surgical care that we provide here,” says Natalie Cline, RN, GRMC care coordination director.
For more information about the program, please visit myweightlosssurgery.org or call (641) 236-2423 or (855) 567-7123.
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“Katie is a leader, both by nature and by appointment,” said GRMC Director of Surgical Services, Paul Topliff, RN, BSN, CNOR. “Her actions promote a climate of cohesion through enthusiasm for teamwork. She is the gold standard for how to interact, collaborate and cooperate with others.” Neleman’s most significant contribution to the nursing profession is her leadership role in the installation, development and improvement of robotic surgery over the last five years. This has made GRMC a leader in the most effective and least invasive surgical treatment options available today. Neleman is also an active volunteer in the Grinnell community. She coaches youth through community sporting programs and mentors the Boy Scouts of America. It is for these reasons and more that one of the finest nurses at GRMC is receiving the recognition she deserves!
New Helping “Hands” in an Emergency Montezuma and East Poweshiek Ambulance Services each obtained two new LUCAS® 3 systems through the Poweshiek County Board of Health’s Public Health Grant. These portable units will be on ambulances to provide continuous chest compressions to save cardiac arrest patients. They will free up emergency personnel to focus on additional critical emergency care such as defibrillation, intubation and transport to a hospital. The units will also allow for quality compressions to be administered in situations where manual CPR may be dangerous or challenging such as in a moving ambulance or when patients are hypothermic.
TOWN Proceeds this year from Shults & Co. and the Grinnell Rotary show went to the GRMC Paul W. Ahrens Fitness Center. “The fitness center is important to the long-term health of our community,” says Frank Shults, co-director of the show, along with Sherry Shults. “We, along with the Grinnell Rotary, want to do our part to support local health care projects.”
THANK YOU TO THE SHULTS & CO. MUSICAL TROUPE for their continued support of Grinnell Regional Medical Center. The “As Time Goes By and Other Great Movie Songs,” performances rang
out to community members in April. But the troupe’s intention is not to just entertain. Shults & Co. regularly uses its biennial performances as a fundraising platform for local nonprofit organizations.
With the money received from the Shults & Co. performances, the PWA Fitness Center hopes to acquire new fitness equipment. The events raised approximately $13,000 toward that goal.
INNOVATION WE NEED YOU. In May, GRMC launched its annual drive to ensure GRMC has the best equipment and services. This campaign will focus on a new ultrasound unit for the diagnostic radiology center, new transport carts and a new EKG heart monitoring unit. The goal is to raise $225,000 for these items as well as for ongoing services such as the community care clinic, babies room, nursing scholarship program, bike helmet distribution to third graders and the Senior Education Program.
To support the 2018 GRMC annual fund drive, call (641) 236-2961 or visit grmc.us/donate/annual-fund-drive. May 2018
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CALENDAR OF EVENTS Adult Foot Care Clinic LIGHT CENTER FOR COMMUNITY HEALTH, GRMC 2nd and 4th Thursday of the month, 9 a.m. to noon Call Grinnell Regional Home Care: (641) 236-2385.
Babies Room Parenting Classes LIGHT CENTER FOR COMMUNITY HEALTH, GRMC 3rd Tuesday and 3rd Thursday of the month, 4:30 to 5:30 p.m. Call (641) 236-2385.
Grinnell Regional Community Care Clinic LIGHT CENTER FOR COMMUNITY HEALTH, GRMC 1st and 3rd Thursday of the month, 2 to 4 p.m. Clinic for those with no insurance. Call (641) 236-2385.
Infant Massage Class POSTELS COMMUNITY HEALTH PARK 807 Broad St., Grinnell June 6, 1 p.m. September 5, 1 p.m. December 5, 1 p.m.
Prevent T2 Diabetes
Cost is $5 per baby.
LIGHT CENTER FOR COMMUNITY HEALTH, GRMC Thursdays, 1 to 2 p.m. Free, no appointment needed.
Contact Kim Creps at (641) 236-2953 or email firstname.lastname@example.org.
Breastfeeding Education LIGHT CENTER FOR COMMUNITY HEALTH, GRMC July 24, 6:30 to 8 p.m. September 25, 6:30 to 8 p.m. November 27, 6:30 to 8 p.m. Call Kintzinger Women’s Health Center: (641) 236-2324 or email email@example.com.
Eating with Diabetes and Pre-Diabetes EAST TOMASEK ROOM, GRMC June 20, 4 to 6 p.m. Pre-registration is required by noon on the Friday prior to the class; class will be cancelled if not enough have pre-registered. Call (641) 236-2421 to pre-register.
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12-month program for those at risk of developing prediabetes. Call (641) 236-2079.
Immunization Clinics LIGHT CENTER FOR COMMUNITY HEALTH, GRMC (By Appointment Only) 1st Monday of the month, 1 to 4 p.m. 1st Tuesday of the month, 9 to 11 a.m. 2nd Tuesday of the month, 2 to 6:30 p.m. 3rd Tuesday of the month, 8:30 to 11:30 a.m. Every Wednesday, 1 to 4 p.m. 3rd Friday of the month, 9 to 11 p.m. Call (641) 236-2385.
SATURDAY ALL-DAY SESSIONS June 9, 8:30 a.m. to 3 p.m. September 8, 8:30 a.m. to 3 p.m. December 8, 8:30 a.m. to 3 p.m. Call Kintzinger Women’s Health Center: (641) 236-2324 or email firstname.lastname@example.org.
Blood Pressure Clinic
Call (641) 236-2385.
TOMASEK CONFERENCE CENTER, GRMC July 3, 10 and 17, 6:30 to 8:30 p.m. October 2, 9 and 16, 6:30 to 8:30 p.m. (Must attend all three evening sessions during that month.)
WIC Clinics (or Well Child) BROOKLYN, BROOKLYN UNITED METHODIST CHURCH 3rd Monday of the month, 9 a.m. to 2 p.m. LIGHT CENTER FOR COMMUNITY HEALTH, GRMC 3rd Tuesday of the month, 6:30 a.m. to 4 p.m. 4th Tuesday of the month, 8:30 a.m. to 5:30 p.m. Call Mid-Iowa Community Action (MICA): (641) 752-7162 or (800) 390-5293.
Clothing, Cupcakes and Cocktails THE GLASS GIFT BOX Our auxiliary-run gift shop at GRMC
Host a Thursday night shopping party at The Glass Gift Box! When you bring five or more friends, everyone will receive 20 percent off their entire purchase. You’ll enjoy free wine and dessert cupcakes, plus a free stemless wine glass with a purchase over $10, and you may receive an additional discount on your items, dependent on total party sales. Call (641) 236-2522 to schedule your shopping party!
All classes are free unless noted otherwise.
SUPPORT GROUPS Bariatric Support Group
Caregivers Support Group
TOMASEK CONFERENCE CENTER, GRMC August 4, November 3, 9 to 11 a.m.
FIRST PRESBYTERIAN CHURCH 1025 5th Ave., Grinnell 4th Tuesday of the month, 10 to 11 a.m.
Call (641) 236-2069.
Diabetes Living Support Group EAST TOMASEK ROOM, GRMC July 9, 7 to 8 p.m. September 10, 7 to 8 p.m. November 12, 7 to 8 p.m.
For anyone caring for an adult loved one. Call (641) 236-2418 or email email@example.com.
Grief Support Group
Call (641) 236-2488.
DRAKE COMMUNITY LIBRARY 930 Park St., Grinnell 2nd Wednesday of the month, 10 to 11 a.m. (for adults)
Perinatal Loss Support Group
Call (641) 236-2418 or email firstname.lastname@example.org.
EAST TOMASEK ROOM, GRMC July 26, 6:30 to 8 p.m. October 25, 6:30 to 8 p.m.
Meet and Eat Bereavement Support
Call Kintzinger Women’s Health Center: (641) 236-2324 or email email@example.com.
TOMASEK CONFERENCE CENTER, GRMC 1st Sunday of the month, 5:30 p.m.
Includes a visit with the dietitian and diabetes educator. Speakers and topics vary.
Cancer Support Group ROOM 204, GRMC Every Tuesday, 9:30 to 10:30 a.m. For those with a cancer diagnosis. Call (641) 236-2568 or email firstname.lastname@example.org.
Breastfeeding Support Group LIGHT CENTER FOR COMMUNITY HEALTH, GRMC 1st Tuesday of the month, 4:30 p.m.
Cost of meal: $6 This is not your typical bereavement support group. Meet and Eat is a monthly dinner gathering for those who have lost a loved one. It is a time to remember that even though you may have lost a loved one, you can still be social and enjoy a meal out with others who share similar experiences.
Grip It and Rip It: Forever 29 It’s not too late to join the 29th Annual GRMC Golf Outing Friday, July 13, at the Grinnell College Golf Course (933 13th Avenue). Don’t miss this fun best shot, auto two putt format with shotgun starts at 7:30 a.m. and 12:45 p.m. There will also be multiple pin event prizes including longest putt and longest drive. All dollars raised locally will benefit the hospital in Grinnell and its services. TO REGISTER as a player or sponsor, go to grmc.us/donate/ways-to-give. You may also contact Heidi Ramaeker Pearson at (641) 236-2961 or email@example.com or Jan Veach at (641) 236-2946 or firstname.lastname@example.org.
Call (641) 236-2418 or email email@example.com.
Infant weight checks are done following the class open to anyone. Call (641) 236-2385.
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HealthLetter is published as a service for the residents of the UnityPoint Health® — Grinnell Regional Medical Center service area. Chair, Board of Directors Wendy Kadner President, Medical Staff Laura Ferguson, MD Interim CEO Doris J. Rindels Editorial and Design Staff Jeanette Budding Heidi Ramaeker Pearson Leah Van Rees
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210 4th Avenue | Grinnell, Iowa 50112
Cedar Rapids, IA Permit No. 174
Contact us 210 4th Avenue | Grinnell, Iowa 50112 (641) 236-7511 | www.grmc.us The health information in this newsletter is not intended to provide diagnosis. If you have questions about your health, please consult your primary care provider. 2018 GRMC Event Headline Sponsors
Poweshiek Mutual Insurance Association
Fremont Farms Discrimination Is Against the Law Grinnell Regional Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. GRMC does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. If you need accommodations, contact Janet Lacey, RN, Director of Patient Experience or the Nursing Supervisor outside of regular business hours. Contact: Janet Lacey, 210 4th Ave | Grinnell, Iowa 50112 (641) 236-2524 | firstname.lastname@example.org
You’re the love of their life. We know you mean the world to your world. To us, you’re family too. That’s why we want to make it easier for you to live well — so you can be there for the everyday moments that matter.
People are amazing. We’re here to help keep them that way.
Health Care is a Family Affair The Menopause Effect Nice and New Emergency Department Love Living in Our Town