Knoxwise Spring 2015

Spring 2015

delivering comprehensive

care PARTNERSHIP OFFERS KCH PATIENTS DIAGNOSTIC IMAGING

hospital-based physicians benefit the community

KCH ANNOUNCES ANNUAL CAMPAIGN

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welcome!

After the harsh realities of one of the coldest winters on record, I’m happy to report

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that spring is just around the corner. Before we know it the flowers will be blooming and the birds will be chirping. I look forward to seeing neighbors who I haven’t seen in months as we all start to Bruce D. White, CEO

emerge from our homes to enjoy the outdoors.

The changing seasons bring fresh and exciting things and

Knox Community Hospital is proud to enhance our partnership with Riverside Radiology and Interventional Associates, the largest independent radiology practice

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in Ohio. This partnership offers unparalleled access to 90 subspecialists who can read images both onsite and from digital workstations outside the hospital. Read more about this collaboration on page 3.

For women who have been recently diagnosed with breast disease, navigating their way through the maze of specialist appointments and hospital services can be

2015 BOARD OF TRUSTEES

daunting. To help our patients through this challenging time, we are happy to offer

Joan Jones PRESIDENT

the services of a breast health navigator. Becky Dangelo, WHNP, CNOR, MSN, RN,

Ian Watson VICE PRESIDENT Joe Street SECRETARY Thomas R. Fosnaught TREASURER Jeffrey L. Boucher Charles R. Brenneman Juan De Pascuale Inge Krajenski Thom McKinley, MD Patrick McLarnan Amy D. Murnen, MD Kim M. Rose Ann Schnormeier Michael Sullivan, MD Gordon E. Yance

CHIEF EXECUTIVE OFFICER

BHN, provides our female patients with emotional support, helps to create a care plan from diagnosis through recovery, and educates them about support groups and self-care. On page 7 hear about Becky’s unique and important role as she answers some frequently asked questions from our readers.

Do you know who your doctor would be in the event you are hospitalized? The answer might surprise you. At KCH, hospital-based physicians, also known as hospitalists, provide care for all patients admitted to the hospital. This type of medicine is quickly becoming more common across the U.S. and this team provides an important role in the continuum of patient care. Read more about our team of Hospitalists and their role in your care on page 4.

Happy Spring!

Bruce D. White CHIEF OPERATING OFFICER

Bruce Behner CHIEF FINANCIAL OFFICER

Bruce D. White, CEO

Mike Ambrosiani CHIEF NURSING OFFICER

James Middleton, RN, MSN, MBA

A publication of the Community Relations Department at Knox Community Hospital.

knoxwise | spring 2015

partnership offers KCH patients unparalleled care in Knox Community Hospital is pleased to announce a unique partnership with Riverside Radiology and Interventional Associates (RRIA), Ohio’s largest independent radiology practice.

According to Ann Styer, director of Diagnostic Imaging at KCH, “The addition of the radiologists from Riverside provides our patients with access to specialists both onand offsite who interpret all of the hospital’s diagnostic imaging.”

Working with patients and referring physicians, the doctors from RRIA provide a wide range of innovative and leading edge diagnostic radiology services.

Board-certified radiologist Dr. Robert Konstan, one of RRIA’s physicians who specializes in breast imaging, spends between two to three days a week onsite at Knox.

Dr. Konstan, who came to KCH in September 2014, has more than 20 years of experience reading both screening and diagnostic mammograms as well as CTs, MRIs and ultrasounds.

“I was excited to come to Knox because I like the personal feel of the smaller, community hospital.

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diagnostic imaging We can provide quality patient care with excellence and compassion close to home,” he said. “Most recently I spent the last 20 years in private practice at a similar size hospital in Cleveland.”

With over 90 subspecialized radiologists at RRIA, the patients at KCH have unparalleled access to highly experienced and qualified boardcertified radiologists who can consult with each other on complex cases.

“Via digital workstations any of the breast specialists at RRIA can interpret our patients’ mammograms,” said Styer.

With over 550 mammograms performed monthly, the doctors are busy.

“Screening mammograms are done annually with the goal to identify breast cancer at the earliest stage,” Dr. Konstan said. “Diagnostic mammograms are performed when there is an abnormal screening examination or clinical finding requiring further evaluation. We also use ultrasound as a tool to help us further characterize findings and determine appropriate treatment planning.”

Dr. Konstan says his love of anatomy and the exposure to a wide range of pathologic processes inspired him to pursue radiology as a career.

“Radiology is a very challenging field,” he said. “Radiologists play a pivotal role in the diagnosis of disease processes. We work closely with clinicians and surgeons providing important information necessary for treatment plans.”

The American Cancer Society recommends: • Women age 40 have a clinical breast exam and mammogram annually.

• Women in their 20s and 30s have a clinical breast exam every three years.

• Beginning in their 20s, all women should perform monthly breast self-exams.

Women with a strong family history of breast cancer should consult with their doctor about an appropriate screening protocol.

To schedule a mammogram, call 740.392.8378.

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hospital-based

physicians care for acutely ill patients It’s been almost 20 years since the term “hospitalist” was first introduced to our vocabulary and it’s been almost as long Dr. Nancy Andreano has been practicing hospital-based medicine.

Dr. Andreano’s colleague, Dr. Magdalena Gasiorova, originally wanted to be a gastroenterologist but instead chose to become a hospitalist six years ago.

“I decided to pursue inpatient medicine because it offered lots of opportunities to deal with higher intensity, acutely ill patients,” said Dr. Gasiorova.

As part of the team of hospitalists who provide care at Knox Community Hospital, Drs. Andreano and Gasiorova, along with their physician counterparts, each have a set shift rounding on hospitalized patients.

The days of primary care physicians having the time to run an outpatient practice and round on their patients in the hospital are all but gone.

“It’s no longer cost effective or efficient for family physicians to do both,” said Dr. Andreano.

With an average length of stay around three days, the hospitalists base their schedules around the idea of providing continuity of care for patients.

“Each one of our schedules vary,” Dr. Andreano explained. “Some doctors prefer to work seven days on and seven days off. Others, known as nocturnists, choose to work nights only.”

Dr. Gasiorova, one of KCH’s nocturnists, wouldn’t have it any other way.

“I prefer the night shift,” she said.

“The hospital at night is much different and requires a specific type of person. I enjoy the collegiality of the night team.”

Although the physicians have no control over how many people will be ill on any given day or night, a typical patient load is between 13 and 16 patients.

Patients are admitted from the ER, wound clinic, primary care provider offices and other institutions and run the spectrum of diagnoses – heart attacks, congestive heart failure, uncontrolled diabetes, COPD, flu, infections and surgical patients with medical complications.

“

I need to look at the big picture, know what to anticipate, design the plan of care and know what my resources are both in and out of the hospital.”

– Nancy Andreano, DO

knoxwise | spring 2015

Hospitalists play the role of both admitting and attending physician and also consult with subspecialists when the need arises.

Continuity of care and maintaining a good rapport with a patient’s primary care provider is also part of their job.

During the evenings Dr. Gasiorova relies on the ER team to contact a patient’s PCP in order to facilitate communication and continuity of care.

“If necessary I can talk with my daytime colleagues about contacting the PCP for any required information,” she said.

The hospitalists use a number of communication tools depending on the case. Most often, a notice of the patient’s admission is faxed within 24 hours of hospitalization and includes a working diagnosis.

“The PCP will also receive a copy of the discharge summary which includes a description of the course of the patient’s care in the hospital as well as the plan of care for the initial period after the hospital stay,” said Dr. Andreano. “If something requires urgent attention or a detailed explanation I may call the PCP to discuss.”

Having a knowledge of support services and resources out in the community and helping families find solutions is another part of the hospitalist’s job.

“There is no guidebook. I am a problem solver throughout the day,” said Dr. Andreano. “I see a great deal of diversity from the routine to the very complex and challenging cases. This job is never boring.”

meet the KCH hospitalists Fraol Adugna, MD medical school: Addis Ababa University School of Medicine, Ethiopia residency: Howard University, Washington, D.C. board certifications: Internal Medicine Nancy Andreano, DO medical school: Philadelphia College of Osteopathic Medicine residency: Riverside Methodist Hospital, Columbus board certifications: Internal Medicine David de Lorenzo, DO medical school: Ohio University College of Osteopathic Medicine residency: Johns Hopkins University/Sinai Hospital, Baltimore, MD board certifications: Internal Medicine Magdalena Gasiorova, MD medical school: Medical University of Silesia, Poland residency: Mount Carmel Health System board certifications: Internal Medicine Kombian Gbaruk, MD medical school: University of Science and Technology, Kumasi, Ghana residency: Medical University of Ohio, Toledo board certifications: Internal Medicine David Kittoe, MD medical school: University of Ghana Medical School, Accra, Ghana residency: Huron Hospital, Cleveland Clinic Health System board certifications: Internal Medicine Laura Murnane, MD medical school: Ross University School of Medicine, Portsmouth, Dominica residency: Akron General Medical Center

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new campaign for the Foundation for Knox Community Hospital Following another successful annual campaign in 2014, The Foundation for Knox Community Hospital has set its sights on a bigger goal in the days ahead.

“We are excited to announce a new two-year campaign for 2015 and 2016, with the goal of raising $1,000,000,” said Jeffrey Scott, Director of Marketing and Development at Knox Community Hospital, who serves as the liaison between KCH and The Foundation.

“Through this campaign, Knox Community Hospital will solidify its position as a regional leader in detecting, diagnosing and treating breast cancer.”

With this campaign, The Foundation will underwrite the purchase of two new pieces of breast imaging equipment for KCH’s Center for Cancer Care: a second digital mammography unit

ingredients

with 3D capabilities, and a whole breast ultrasound unit. In 2008, The Foundation raised $360,000 to purchase the hospital’s existing digital mammography unit. Nearly seven years later, patient volume indicates a real need for a second unit, and the additional purchase of a whole breast ultrasound unit will only enhance the diagnostic experience for KCH patients.

One such patient is Leslie Croft. Leslie doesn’t live in Knox County, but when she was diagnosed with stage three breast cancer, she chose the medical team at Knox Community Hospital for her surgery and oncology care. She could have chosen to go to Columbus or Cleveland, but she believes nowhere has better quality care than Knox.

“You could never meet a better group of people than the staff at Knox Community Hospital,” says Leslie.

Numerous women throughout our community are battling breast cancer, just like Leslie, with the help of Knox

Community Hospital. The Foundation is proud to lead the effort to ensure that our friends, family and neighbors have access to the best possible equipment right here at home.

“If you’ve never considered making a donation to The Foundation for Knox Community Hospital, I would encourage you to do so this year,” says Scott. “Every new donation made in 2015 and 2016—whether by a new donor or an increased donation from a regular donor—will be matched, dollar for dollar, by The Ariel Foundation, up to $200,000. We’re extremely grateful to The Ariel Foundation for this generous pledge to help maximize the impact of this campaign.”

For more information about becoming involved in the work of The Foundation for Knox Community Hospital, please contact us at Foundation@KnoxCommHosp.org or 740.393.9602.

quinoa enchilada bake

1 cup uncooked quinoa, rinsed 2 cups water 1 tablespoon olive oil 1 small onion, diced 3 cloves garlic, minced 1 jalapeño, seeds and ribs removed, diced 1 red pepper, seeds removed, diced 1 orange pepper, seeds removed, diced 1 cup corn frozen kernels Juice of 1 small lime 1 teaspoon ground cumin 1 tablespoon chili powder 1/3 cup chopped cilantro Salt and pepper, to taste 2 (15 oz) cans black beans, drained and rinsed 2 cups red enchilada sauce 1 cup shredded Mexican cheese Toppings: Sliced green onions, avocado slices, sour cream, optional

preparation

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Preheat the oven to 350 degrees F. Grease a 9x13 baking dish with cooking spray and set aside. dd quinoa and water to a medium saucepan and bring to a boil over A medium heat. Boil for 5 minutes. Turn the heat to low and simmer for about 15 minutes, or until water is absorbed. Remove from heat and fluff with a fork. Cover quinoa and set aside.

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I n a large skillet, heat the tablespoon of olive oil over medium-high heat. Add the onion, garlic, and jalapeño. Sauté until softened, about 5 minutes. Add in the peppers and corn. Cook for about 3-4 minutes.

Add the lime juice, cumin, chili powder, and cilantro. Stir to combine.

Season with salt and pepper, to taste.

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I n a large bowl, add the cooked quinoa and black beans. Add the sautéed vegetable mixture and stir to combine. Pour in the enchilada sauce and stir. Add 1/2 cup shredded cheese.

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our the black bean and quinoa mixture into the prepared baking P dish. Top with remaining shredded cheese. Cover the pan with foil.

Bake for 20 minutes, then remove foil. Bake an additional 10 minutes, or until the cheese is melted and edges are bubbling. Remove from the oven, and let cool for 10 minutes. Garnish with toppings, if desired.

Serve warm.

knoxwise | spring 2015

Breast Health Navigator

offers guidance and support for women with breast disease physician Q&A

Knox Community Hospital is fortunate to offer the services of breast health navigator Becky Dangelo, WHNP, CNOR, MSN, RN, BHN, to women in our community trying to navigate through a breast health issue which can include anything from an abnormal mammogram to a breast cancer diagnosis. Her job is to assist and guide women starting from the screening process throughout a breast cancer journey to alleviate fear and anxiety and provide support and education. It’s reported that one in seven women will be diagnosed with breast cancer in their lifetime.

QWhat is a breast health navigator?

AAs the breast health navigator (BHN) at Knox

Community Hospital my role is a triage manager, consultant, collaborator, educator and researcher. I use my breast health expertise to provide personal, individualized attention, support, and education through all phases of care. A person’s physical, social and psychological needs are assessed to ensure they are being met. The other part of my job is to promote breast health education in the community and provide assistance for underserved community members to attain screenings and diagnostic procedures, as well as any identified treatment.

QAt what point in treatment does a breast health navigator become involved?

AMy involvement begins at the time of an abnormal

mammogram, or when someone presents with an identified breast change or mass (lump). From the onset throughout diagnosis, treatment and beyond I am a part of the journey.

QWhat if someone doesn’t have insurance to cover the cost of a mammogram?

Becky Dangelo, WHNP, CNOR, MSN, RN, BHN

AKCH was able to obtain grant funding for the

Mother, Daughter, Sister and Friends program through the Columbus affiliate of Susan G. Komen for the Cure. The grant provides access to screening mammograms and diagnostic services for those who are uninsured or underinsured. Survivorship assistance is also available via the project. Please contact me to discuss available assistance.

QWhat if someone was recently diagnosed and doesn’t know where to turn?

AAnyone may contact me for assistance and guidance, whether that is someone who has been diagnosed or a family member with concerns or questions.

Educational programs are also available for the community and organizations. Please contact Dangelo at 740.393.5579 or email: becky.dangelo@knoxcommhosp.org.

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AKRON, OH PERMIT NO. 286

1330 Coshocton Rd. Mt. Vernon, Ohio 43050 KnoxCommHosp.org

calendar of events Diabetes Education Events Pre-Diabetes 101 Thursday, April 16, 5:30-6:30 p.m.

KCH 3rd floor meeting room A light meal is provided, so pre-registration is required.

Please call 740.393.9970.

Hike for Health (indoor) Tuesday, May 5, 5:30-6:30 p.m.

First Church of the Nazarene 807 Coshocton Rd., Mount Vernon Bring tennis shoes!

Living with Diabetes Tuesdays, June 9, 16, 23 4:30-7:30 p.m.

KCH Childbirth Education Room Registration is required, call 740.393.9970 For more information or any questions, please call Jenny Parker, RN at 740.393.9970 or Rosemary Farren, RD, LD, Diabetes Coordinator at 740.393.9797.

Breast Cancer Support Group

New Men’s Cancer Support Group

First Monday each month, 7 p.m.

Knox Medical Pavilion Please call Becky Dangelo, WHNP, CNOR, MSN, RN, BHN, patient navigator, 740.393.5579

3rd Tuesday each month, 6:30 p.m.

Knox Medical Pavilion Organized by men, for men.

Please call Mandy Holt, RN, OCN, patient navigator, 740.393.5558.

Young Survivors Breast Cancer Support Group

Free Monthly Screenings

3rd Monday each month, 7 p.m.

Knox Medical Pavilion Please call Becky Dangelo, WHNP, CNOR, MSN, RN, BHN, patient navigator, 740.393.5579

Cancer Support Group 2nd Thursday each month, 6:30 p.m.

Knox Medical Pavilion Please call Mandy Holt, RN, OCN, patient navigator, 740.393.5558.

1st Wednesday of the month, 8-10 a.m., Urgent Care Classroom Screenings are available for blood pressure, glucose and cholesterol. 12-hour fasting is recommended for best results.

Look good‌Feel Better Please call 740.393.5579 for information.

Please visit our website at KnoxCommHosp.org for additional details about our programs and services.

Knox Community Hospital welcomes

Jaime Goodman, MD to the medical staff. Dr. Goodman, a board-certified endocrinologist is accepting new patients. For more information about Dr. Goodman, call 740.393.9621.

Knox Community Hospital welcomes

Elizabeth Klenk, MD

to the Department of Primary Care-Internal Medicine. Her office is located at 1661 Venture Drive, Suite A, with Dr. Frederick Carroll.

To schedule an appointment with Dr. Klenk, please call 740.397.2915.