SOUTHERN DELAWARE EDITION
healthwaves B AY H E A LT H
IN THIS ISSUE: 6
Stroke prevention and treatment
Women at the helm of your health
Building around patient benefit
SUM MER 2018
healthwaves Healthwaves is a quarterly publication of Bayhealth. The information is intended to inform and educate. It’s not a substitute for consultation with a physician. Always consult your physician for individualized care.
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TERRY M. MURPHY, FACHE President and CEO, Bayhealth
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MICHAEL ASHTON, FACHE Vice President of Operations/ Administrator, Bayhealth Milford Memorial
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IN THIS ISSUE feature story: 4 A new leash ●
PICTURED ON COVER Peggy Keleshian and her dedicated service dog Reaper enjoy lunch in downtown Milford. A special thank you to Georgia House restaurant for their assistance in capturing her story.
To view Healthwaves online visit: Bayhealth.org/HealthwavesSouth
Stroke prevention and treatment: Awareness and action are critical
Bayhealth Sussex Campus: Building around patient benefit
Women at the helm of your health
Expanding palliative care to Milford
The history of Milford Memorial Hospital: Evolution of nursing Passing on good cheer
10 ● 12 ●
2018 Summer Classes
18 ● 19 ●
The ins and outs of a colonoscopy
A discussion about concussions
Bayhealth receives Blue Distinction for Bariatric Surgery
Hertrich family grateful for lifesaving services
BAYHEALTH HOSPITAL, KENT CAMPUS
BAYHEALTH MILFORD MEMORIAL
640 South State Street Dover, Delaware 19901 302-674-4700
21 West Clarke Avenue Milford, Delaware 19963 302-422-3311
Letter from the President DEAR NEIGHBORS, The summer season has arrived. As the spring air grows warm and the sun stays out longer each day, it’s a time to enjoy the outdoors with family and friends. It’s also a great opportunity to reflect on all the exciting things that are happening. Peggy Keleshian looks forward to enjoying her first summer in southern Delaware. Peggy moved to the area to be closer to family. She was diagnosed with COPD years ago, but didn’t realize how quickly it was progressing. When she failed a breathing test she was in despair. That was until the pulmonary team at Bayhealth Milford Memorial helped Peggy breathe easier. Now with her COPD under control she has a new “leash” on life with her steady companion, service dog Reaper. Read her story on page 4. While the summer is often thought of as a time of fun in the sun, the warmer weather can be dangerous for some. While strokes can occur at any moment, the summer season can actually create an increased risk. Learn more about why this happens and ways to avoid the risk on page 6. The change of the season continues to bring exciting news regarding our projects in southern Delaware. The newly opened Quinn Medical Offices in Milford is now home to three primary care physicians to meet the needs of your family. The doctors explain what’s so special about their practice on page 8. We’re also expanding palliative care services to Bayhealth Milford Memorial for patients with serious illnesses. More on that on page 9.
And construction continues at the Bayhealth Sussex Campus. You may have seen the progress while traveling on Route 1 to the Delaware beaches. In addition to ensuring the Bayhealth Hospital, Sussex Campus provides increased access to care, it was designed to create the best physician-patient relationship and experience. You can learn more about those benefits for our patients on page 14. And make sure to visit BayhealthSussex.org to see all of the project updates and sign up for emails to stay informed. As the countdown begins to opening the Bayhealth Sussex Campus, we also want to take a moment to reflect on all we’ve accomplished at Bayhealth Milford Memorial. You can look back at the evolution of nursing since the opening of Milford Memorial Hospital on page 16. We hope you enjoy the summer season and all that southern Delaware has to offer. Sincerely,
Terry M. Murphy, FACHE President and CEO Bayhealth
A new leash on life Moving is stressful. Living in a new city isn’t easy. Learning your chronic obstructive pulmonary disease (COPD) is getting worse and you’ll need oxygen is downright overwhelming. That’s the situation Peggy Keleshian found herself in just a few short months ago. Keleshian was diagnosed with COPD years ago. While her initial diagnosis was scary, she was able to get through it in part thanks to her trusted service dog, Reaper.
Reaper is a four-year-old German Shephard that goes everywhere with Keleshian. “When I was first diagnosed with COPD, I thought it was a life sentence, I was just so overwhelmed,” she said. “Fortunately a very smart doctor back home in New Jersey suggested I consider a service dog, and thank goodness I did.” Reaper has been by Keleshian’s side ever since, including during her recent move to Milford. When she first moved to the area, she immediately began seeing pulmonologist Michel Samaha, MD. Dr. Samaha had Keleshian undergo breathing tests to ascertain the severity and progression of her COPD. Unfortunately, the tests didn’t go as Keleshian planned. “When Dr. Samaha ordered the breathing tests, and I ultimately failed them, I was heartbroken and just scared. I didn’t want to be on oxygen — I didn’t even understand all that it entailed,” Keleshian said. “But I know this was all a blessing in disguise. Everything that has happened since was meant to be.” Dr. Samaha says Keleshian was an ideal patient because of her determined attitude and strength during a difficult time. “My office staff and I love Peggy’s warmth and sweetness. She is a great patient who understands her disease and is compliant with her treatment, willing to do anything to improve her health and quality of life,” he said. “She keeps her mind strong and always has a smile on her face; she is a great example for others.” Keleshian immediately started pulmonary rehabilitation at Bayhealth Milford Memorial and began attending the Better Breathers support group for those with breathing disorders and their care partners. The group is aimed at helping people learn more about COPD and meet with others going through similar situations.
[PEGGY] KEEPS HER MIND STRONG AND ALWAYS HAS A SMILE ON HER FACE; SHE IS A GREAT EXAMPLE FOR OTHERS. — MICHEL SAMAHA, MD
Elizabeth Hurley is a Respiratory Therapy Navigator at Bayhealth and helped Keleshian navigate rehabilitation and the support group. “Despite her feelings of anxiety, she wanted to optimize her health and decided to take a leap of faith by attending our Better Breathers support group,” said Hurley. “She reached out to gain support and make a connection in hopes of finding resources that would help boost her confidence. I wish all of my patients shared Peggy’s zest for life.”
To learn more about Bayhealth’s Better Breathers support group, call Respiratory Therapy Navigator Elizabeth Hurley at 302-430-5902 or visit our website at Bayhealth.org/Breathe-Better.
Keleshian admits she was nervous at first. “I’m young at heart, but all I could think was, ‘I’m an old lady — I don’t need to join a club.’ But it was great, and I’m so glad I did,” she said. “I’ve learned so much through the support group. It’s so nice to be with other people who are going through the same thing. That’s such a great resource.” “Peggy takes the information she learns and incorporates it into her lifestyle,” said Hurley. “She is determined to maximize her quality of life and slow the progression of her disease by managing it well.” Keleshian says since moving to southern Delaware and going to the Better Breathers, she’s come out of her shell. “I do more on my own now than I ever did. I venture out; I go for walks with Reaper. I’ve seen a tremendous improvement in my quality of life,” she said. “Everyone I’ve worked with through the Better Breathers support group and the pulmonary rehab has been wonderful. They’ve been upfront with my diagnosis but so clear in the plan for treatment. I never felt alone in the process — I always felt that I had support.” ■
STROKE PREVENTION AND TREATMENT
Awareness and action are critical Stroke can occur to anyone, at any time and at any place. However, as Bayhealth Stroke Medical Director Sumeet S. Multani, MD, MBBS, and Nurse Practitioner Brandy Magee, MSN, APRN, FNP-C (pictured below), explain, some summertime habits and rituals can increase risk of stroke and also make you less likely to recognize stroke symptoms. Also, education and awareness are essential for effective stroke prevention and treatment. RECOGNIZE STROKE SYMPTOMS The first step is to learn the symptoms of stroke: • Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body • Sudden confusion; trouble speaking or understanding • Sudden trouble seeing out of one or both eyes • Sudden trouble walking, dizziness, and loss of balance or coordination • Sudden, severe headache with no known cause
“Unfortunately, some people shrug off stroke symptoms because they mistakenly think it’s a temporary problem, such as the typical numbness associated with your arm ‘falling asleep,’ or that the weakness or headache they have is caused by something else,” explains Magee. “This can have detrimental long-term effects, which is why it’s always best to seek immediate medical attention if you have any of these symptoms.” Other key factors in stroke prevention and treatment, especially during the summer months, are diet, medication compliance, and both immediate and follow-up care if you suffer a stroke. CONSIDER YOUR DIET Most people spend more time at barbecues and other outdoor events and activities during the summer — many of which can include increased alcohol consumption and sodium intake from foods such as hot dogs and potato chips. Alcohol consumption can make it difficult to recognize stroke symptoms since they mirror those associated with intoxication. Alcohol and increased sodium intake, along with the summer heat, can lead to dehydration, which increases risk of stroke. Dr. Multani says it’s also a good idea to keep a close eye on the amount of carbohydrates you eat since they drive up blood sugar, which can increase stroke risk. “As a reminder, diabetic patients need to be especially mindful of their carbohydrate intake since they’re twice as likely to have a stroke compared to someone without diabetes.” How to Lower Your Risk of Stroke: Consume alcohol and other carbohydrates and high-sodium foods in moderation. Increase your water intake, especially when spending time outside in the sun and higher temperatures.
TAKE PRESCRIBED MEDICATION Taking prescribed medication is critical for stroke prevention and treatment, but some people don’t stick with it, especially in the summer. They either don’t fill their prescriptions before they go on vacation or they forget to bring the medication along with them. “You need to make sure you take enough medication with you on vacation and that you get your prescriptions filled ahead of time,” says Magee. This is particularly important if you’re taking antiplatelet medications, blood pressure and cholesterol medications, and/or blood thinners such as Coumadin. “Missing even a single dose of Coumadin significantly increases the likelihood of stroke,” adds Dr. Multani. How to Lower Your Risk of Stroke: Make sure you always have your medications available and take them as prescribed.
MAINTAIN FOLLOW-UP CARE In addition to seeking immediate emergency medical attention, Dr. Multani and Magee say it’s equally important that stroke patients go to their follow-up appointments with their primary care physicians, cardiologists, neurologists, etc., because they can help prevent additional strokes from happening. ■ Bayhealth Milford Memorial and Bayhealth Hospital, Kent Campus earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Centers. This means both hospitals have met and seek to maintain The Joint Commission’s high standards in providing stroke care. Visit Bayhealth.org/Stroke to learn more.
ACT FAST If you have a stroke, time is of the essence. Every second of delay in receiving stroke care and treatment destroys one billion brain cells, which increases the risk of not only death but also of permanent damage and disability. Clot-busting medications also have to be administered within a short timeframe after the onset of a stroke. If you think you or someone else is having a stroke, you need to act F.A.S.T. Face: Does one side of the face droop? Arms: Does one arm drift downward? Speech: Does the person slur words or say things incorrectly? Time: If any of these or the other symptoms outlined earlier are present, don’t delay! Dial 911 immediately! Important reminder: It’s always better to call 911 than to have a friend or family member drive you to the hospital because EMS can start treatment while en route to the hospital.
Women at the helm of your health Finding a doctor in Sussex County just got easier, thanks to the newly opened Quinn Medical Offices. The new medical office building is located at 800 North DuPont Blvd. and is home to Bayhealth Primary Care, Milford. “Primary care is where healthcare really begins,” said Preeti Gupta, MD. “We take care of the whole person, and follow them throughout their life. If we want to focus on prevention over cure, we need patients to come see us regularly. This new building improves access for patients, which is important.” Dr. Gupta (pictured on left) has been practicing with Bayhealth in Milford for years, but is now joined by by Ambreen Raza, MD (center), and Anita Bapat, MD (right). “Increased access to care is so vital for patients, especially in rural areas,” said Dr. Raza. “It’s important for community members to have strong connections and relationships with their family providers. Bayhealth has such a tremendous footprint in central and southern Delaware. We have so many specialties and providers; it’s great for the area.” Patients can stay connected using Bayhealth’s patient portal, MyChart. This electronic health
record allows patients to view lab results and schedule appointments. All Bayhealth Primary Care locations use the Epic electronic health record. Dr. Bapat also sees patients at Bayhealth Primary Care, Harrington several days a week. “Primary care physicians connect the dots,” said Dr. Bapat. “We maintain the continuity between all the specialties and can see the whole picture with patients.” The practice is unique in that it’s currently all female physicians. “It’s fun and special to be working in an office with all female providers,” said Dr. Bapat. “Women are great listeners, which is such a benefit for patients.” Patient satisfaction is always top-of-mind for all the providers. “These folks have such a strong trust in us as providers, which is wonderful,” said Dr. Gupta. “The patients mean the world to me, and taking care of them is a real honor.” “I’m so happy to be here,” said Dr. Raza. “The patients are so nice and welcoming. And they are truly interested in improving their health. It’s wonderful to be part of that process.” ■ Visit Bayhealth.org/Primary-Care-Sussex for more information about primary care providers in Sussex County. You can also call 1-866-BAY-DOCS (229-3627) to find a physician to meet your needs.
Expanding palliative care to Milford Battling a serious disease can be overwhelming, but you don’t have to do it alone. Bayhealth can help you through this time with the Palliative Care program now offered at both Bayhealth Hospital, Kent Campus and Bayhealth Milford Memorial. Palliative care improves the lives of patients and their families when facing a serious illness.
IN A PALLIATIVE CARE PROGRAM, PATIENTS CAN EXPECT: • Specialized care for new, advanced, or chronic illness • Integration of life-prolonging therapy • Focus on early identification and ongoing assessment of healthcare preferences • Better understanding of medical condition and treatment choices
WE WANT TO HELP PATIENTS LIVE COMFORTABLY, AND TO OPTIMIZE THE QUALITY OF LIFE FOR OUR PATIENTS AND THEIR FAMILIES. —T HERESA LATORRE-TEGTMEIER, MSN, APRN, FNP-C
Through the Palliative Care Program at Bayhealth, team members help patients suffering from the pain and symptoms of a serious illness. “We want to help patients live comfortably, and to optimize the quality of life for our patients and their families,” said Palliative Care Nurse Practitioner Theresa Latorre-Tegtmeier, MSN, APRN, FNP-C, who is based at Bayhealth Hospital, Kent Campus. Initially, the service was only offered at Bayhealth Hospital, Kent Campus, but in response to a rising need in the southern region, palliative care is now offered at Bayhealth Milford Memorial.
• Relief from symptoms such as pain, shortness of breath, loss of appetite, difficulty sleeping, and fatigue • A team approach to provide an extra layer of support Palliative Care Nurse Practitioner Suzette Flores, DNP, MSN, BSN, BSW, is leading the program in Milford. “I love being there for patients and families to provide education and options,” Flores said. “What I find is patients really appreciate the time we take to talk to them about what is important regarding their health.” ■ Referral into the program comes from a hospital-based physician. Visit Bayhealth.org/Palliative-Care for more information.
What’s important to remember about palliative care is that it’s more than end-of-life planning and isn’t hospice care. In fact, it’s appropriate for all stages of an illness and is for any illnesses, including cancer, cardiac disease, and lung disease. The Palliative Care team works with patients to make sure medical plans are based on the goals of the patient. 9
VISIT BAYHEALTH.ORG/CLASSES FOR A COMPLETE LIST OF CLASSES AND EVENTS.
STEPS EDUCATION LECTURES Led by expert speakers, these lectures cover a wide variety of health topics targeting the 50+ age group. For more information, visit Bayhealth.org/STEPS or call 302-744-7135.
Maternity BIRTH INN AND BEYOND TOURS AT MILFORD MEMORIAL Come for a tour of our unique facility, where we offer the convenience of birth and recovery in the same private room. For more information, call 302-430-5739. BREASTFEEDING 101 Come learn the basics about breastfeeding. Support persons are encouraged to attend. This class is offered the first Tuesday of every month at Milford Memorial and the third Tuesday of each month at Bayhealth Hospital, Kent Campus. Visit Bayhealth.org/Classes to register. BREASTFEEDING SUPPORT GROUP While breastfeeding is natural, it’s not always easy for new moms. Our Breastfeeding Support Group offers an encouraging environment. For more information, call 302-744-7233.
Healthy Aging STEPS CARDIOVASCULAR CLINICS Your personal numbers — blood pressure, heart rate, pulse oximetry, and weight — can tell you a great deal about your health. Bayhealth nurses take careful readings when you come to one of our STEPS clinics. And it’s free! For more information, call 302-744-7135.
A MATTER OF BALANCE A Matter of Balance is an award-winning program designed to manage falls and increase activity levels in older adults. The program is free, but registration is required! To register, visit Bayhealth.org/Classes or call 302-744-7135 or 1-877-453-7107.
Weight Loss SURGICAL WEIGHT LOSS INFORMATION SEMINAR Learn more about the Bayhealth Bariatric Program including the Laparoscopic Roux-en-Y Gastric Bypass and the Laparoscopic Sleeve Gastrectomy. Find out about the risks, benefits, and outcomes. Meet the surgeons and staff of the bariatric program, ask them questions, and see if you meet the criteria for bariatric surgery. These seminars are free of charge and all are welcome. To register, call the Bayhealth Bariatric Office at 302-430-5454.
2018 SUMMER CLASSES Because giving hope is always in fashion.
SAVE THE DATE:
AUGUST 3, 2018 11 A.M.–3 P.M. AT THE REHOBOTH BEACH COUNTRY CLUB
Join us for an afternoon of friends, fashion, fun, and fundraising! The Runway of Hope is a fundraiser supporting the Bayhealth Cancer Survivorship Program, which helps cancer survivors enjoy full and productive lives after treatment.
Screenings MAMMOGRAMS Each month, Bayhealth hosts regular mammogram screenings at multiple locations at no cost to those who are uninsured or underinsured. To register, call 302-430-5143 or 302-744-6528. CLINICAL BREAST EXAMS A clinical breast exam is a physical examination done by a healthcare practitioner trained to notice abnormalities in the breast tissue. Bayhealth
For more information, call 302-744-7015 or visit BayhealthFoundation.org.
offers free clinical breast exams to the community. Registration is required! To register, call Harriet Pinkston at 302-744-6528.
Lung Care BETTER BREATHERS This support group is for people with chronic obstructive lung disease and their family members. For more information, please call Respiratory Therapy Navigators Crystal Hiser, RRT, at 302-744-7661 or Elizabeth Hurley, RRT, at 302-430-5902.
RIVERWALK “FREEDOM” FESTIVAL Join Bayhealth at the 18th Annual Riverwalk “Freedom” Festival on Saturday, Sept. 8, from 9 a.m. to 4 p.m. The event will feature a car show, a special area for kids, and live entertainment. Be sure to stop by Bayhealth’s tables to learn more about the new health campus projects and our services.
The ins and outs of a colonoscopy “Colon cancer is preventable,” says Raghu D. Kottam, MD, Bayhealth Gastroenterology, Milford. A test called a colonoscopy is a screening method to detect potential problems including precancerous polyps. The colonoscopy itself allows the physician to examine the inside of the colon with a colonoscope, or a tube with a tiny camera on the end. The doctor is able to look at images of the colon walls on a screen. “The patient is in and out in a couple of hours,” he said. The actual procedure takes 20–30 minutes in endoscopy suites at Bayhealth Milford Memorial. “If the patient does a good preparation, this test once every 10 years can save their life. It is well worth it,” Dr. Kottam said. Misconceptions about the preparation for a colonoscopy can cause people to avoid the procedure. Dr. Kottam notes that the at-home preparation has improved. “It used to be a gallon of liquid, but now there are several options,” he said. One option is a lower volume of liquid in split doses so the patient doesn’t have to drink a gallon. There is also a pill preparation with the patient taking 32 pills. “It is not a single pill,” he said. “A good clean-out provides more accuracy. Flat polyps — an aggressive precursor to cancer — may not be visible if the clean-out is not good,” he said. Patients with chronic constipation may be advised to do a two-day preparation. Before the test, Dr. Kottam also advises patients to avoid foods linked to constipation for two days: red meat, cheese, and foods with lots of seeds. Patients who take iron supplements and certain blood thinners may also have to stop those medications before the procedure. The colonoscopy itself is not unpleasant, Dr. Kottam says. “The patients are comfortable, monitored, and in the care of a great anesthesia team. Some people say it is the best sleep they ever had.”
Once the patient is sedated, carbon dioxide gas is used to inflate the colon so the gastroenterologist can visualize every fold. “We use carbon dioxide for 100 percent of these procedures. It is absorbed immediately to eliminate discomfort. There is no post-procedure sense of bloating,” Dr. Kottam said. “We discuss the results immediately afterwards with the family member,” he explained.
IF THE PATIENT DOES A GOOD PREPARATION, THIS TEST ONCE EVERY 10 YEARS CAN SAVE THEIR LIFE. — RAGHU D. KOTTAM, MD
If no abnormalities are found, the American Cancer Society guidelines suggest a colonoscopy every 10 years until age 75. Dr. Kottam says most people need a baseline colonoscopy at age 50, unless they have a family history of colon cancer. In this case, they should have their first one at age 40. In addition, African Americans and Hispanics should have their first colonoscopy at age 45. Dr. Kottam said obesity and consumption of processed and red meat contribute to more frequent diagnoses of colon cancer in people under age 50. ■ Talk to your doctor today about scheduling a colonoscopy. Visit Bayhealth.org/Find-A-Doc or call 1-866-BAY-DOCS (229-3627) to be matched with a physician who meets your needs.
A discussion about concussions Young athletes are bound to get bumps and bruises when playing sports. But when a child sustains a concussion, it changes the game. A hit on the head that is accompanied by confusion, forgetfulness, glassy eyes, disorientation, clumsiness, slowed speech, and changes in mood needs quick attention. A concussion diagnosis can be frightening, but Bayhealth has a team that offers support. UNDERSTANDING A CONCUSSION’S IMPACT Once your child has been diagnosed with a concussion, testing is available through Bayhealth to determine the effect a concussion has had on them. Immediate Post-Concussion Assessment and Cognitive Testing, known as ImPACT, is a computerized test used to measure verbal and visual memory, attention span, reaction time, and brain processing speed.
can retrain their brain to do these activities and learn strategies to compensate for persistent deficits. “The goal is to help the patient return to the functional abilities they had before the concussion. This could be class, work, sports, or everyday life,” said Bayhealth Advanced Speech Pathologist Ashley Jones, MS, CCC-SLP. To receive cognitive therapy, a pediatrician, primary care physician, neurosurgeon, or neurologist must refer you. This form of treatment is available at Bayhealth Outpatient Rehabilitation, Kent Campus and Bayhealth Milford Memorial. ■ Visit Bayhealth.org/Outpatient-Therapy for more information on the services provided at Bayhealth. If you’re in need of a physician, call 1-866-BAY-DOCS (229-3627) or visit Bayhealth.org/Find-A-Doc.
“When the test is used in conjunction with a thorough clinical assessment, it can help with determining what areas of the brain may need additional treatment,” said Physical Therapist Angela R. Mollohan, PT, MPT. Bayhealth conducts ImPACT testing every two years at local schools so a set of baseline test results are on hand for clinicians to compare a post-concussion test to. Bayhealth has provided this service free to the community since 2011. Testing is offered at Bayhealth Outpatient Rehabilitation, Kent Campus and with the athletic trainers at the following high schools: Polytech, Dover, Lake Forest, Milford, Smyrna, Woodbridge, and MOT Charter School. TREATING A CONCUSSION Quite often, a person who has suffered a concussion looks and feels fine. It isn’t until they go back to their daily activities that they may experience difficulty completing the tasks they once did with ease. Through cognitive therapy, patients
BAYHEALTH SUSSEX CAMPUS
Building around patient benefit Project leaders, architects, construction managers, and user group members have been meeting for more than two years to work on the new Bayhealth Hospital, Sussex Campus. Most meetings begin the same way, with a review of the guiding principles that help ensure a successful completion of the project. One of the guiding principles is to “utilize the lean-led design process to continuously optimize processes and technologies throughout the organization to improve quality of care and strive to preserve only those processes used today that are highly effective and/or efficient.” The guiding principles also emphasize broad involvement of the end users, which include physicians, nurses, and allied health professionals and other care team members. This, in turn, has played a significant role in how the new Bayhealth Hospital, Sussex Campus will affect the physician-patient relationship in terms of access, care, and overall experience. For example, lean-led design and end-user involvement are the driving forces behind the implementation of same-sided rooms — meaning each room is set up the same way, regardless of where it’s located — along with the same layout on each floor and the construction of team stations. The rooms are also private and designed with three primary zones: one for the patient, one for the providers and other caregivers, and one for family and other visitors. Here’s a closer look at how these important components will enhance patient experience, care, and safety at the new Bayhealth Hospital, Sussex Campus.
BENEFITS OF SAME-SIDED ROOMS/ SAME FLOOR LAYOUTS The lean-led design elements of same-sided rooms and the same layout on each floor provide multiple benefits for physicians and patients alike, such as easier wayfinding and familiarity. “The same layout in each room and on each floor will help patients because they won’t lose their orientation,” said Muhammad R. Syed, MD, director of the Hospitalist program at Bayhealth Milford Memorial. Dr. Syed is one of the physicians who participated in the user groups that were created as part of the guiding principles. “For example, the bathroom will always be located in the same place, no matter where the patient is in the hospital.” The fact that each patient room has its own private bath will also benefit infection control, adds Dr. Syed. “Private bathrooms will greatly improve isolation standards across the board for conditions such as Clostridium difficile. Another plus for infection prevention is having the sinks in the same spot in each room, which will help ensure nurses and doctors wash their hands and will allow patients to watch them do that.” Having everything from the computers and standard medical equipment to the supplies and trash cans in the same location in every room is also beneficial. “The uniformity of the rooms and layout will greatly enhance physician workflow and efficiency, and in turn, patient care and experience,” said Julianne Wysocki, DO, medical director, Bayhealth Milford Memorial Emergency Department. “Physicians will be able to spend more time with patients because they’re not going to have to worry about so many logistics.”
BENEFITS OF PRIVACY AND ZONES
BENEFITS OF TEAM STATIONS
All of the patient rooms at the new Bayhealth Hospital, Sussex Campus will be private and also contain three primary zones to maximize care, safety, and comfort. For example, in the Family Zone, family and visitors will have access to a sleeper sofa, lighting, a table, and outlets for charging their phones and other portable devices.
The team stations provide space for physicians and other care team members on each floor of the new Bayhealth Hospital, Sussex Campus. They will allow for easier and greater collaboration between these allied health partners. They will also allow for more efficient workflow and help ensure there’s no delay in patient care.
“Certain patients greatly benefit from seeing family members close by,” said Dr. Syed. “Seeing familiar faces frequently helps recovery, and having a special zone for family members to allow them to be comfortable while with their loved ones is a win-win for everyone.”
In summary, the lean-led design process and other guiding principles that were used to build the new Bayhealth Hospital, Sussex Campus will allow for more efficient physician workflow and ultimately the best possible patient care, safety, and experience. ■ Visit BayhealthSussex.org for more information about the new Bayhealth Sussex Campus.
THE HISTORY OF MILFORD MEMORIAL HOSPITAL
Evolution of nursing When Milford Memorial Hospital opened in 1938, it was well prepared to provide quality nursing care to all who entered its doors. After all, its predecessor, Milford Emergency Hospital, began serving the community 17 years earlier with the first nurse training program, which entailed 18 months of courses and floor duty. Then in 1925, the Milford Memorial Emergency School of Nursing opened, with a three-year training program consisting of classes after a full day of work in the hospital. By 1938, other changes to the school and its program had been implemented — including its name: Milford Memorial School of Nursing. Although the school officially closed in 1976, nursing education continued to play a critical role. NURSING SHORTAGES DRIVE CHANGES IN EDUCATION Several nursing shortages have occurred since 1938, not only at Milford Memorial but across the nation, and many have been a catalyst
for significant changes in educational programs and requirements. For instance, Milford Memorial records indicate that in 1948, “the nursing program needed to be training 27 nurses but housing was only sufficient for 19.” By 1965, the nursing school “began to change its educational direction, and was moving gradually from the service-oriented program of education for the student nurse into a program where all experiences were in relation to specific goals in education. Also, the program was becoming more autonomous.” The first male nurse also graduated from the school in 1965. Bayhealth Milford Memorial Nursing Supervisor Vicki Pini, MSN, MEdu, MHCA, BSN, RN, who came on board as a nurse in 1974, also notes how nursing education has evolved. “I was the first graduate of a two-year program to be hired,” she recalled. Pini says nursing titles, programs, and degrees have continued to grow since then — from a simple diploma to an associate’s degree to bachelor’s (BSN), master’s (MSN), and doctorate (DNP) degrees.
Bayhealth Milford Memorial Operating Room Nurse Gail Geesaman, BSN, RN, CNOR, CRNFA, started working at the hospital in 1973. She’s one of the nursing school’s last graduates. She says another notable change is the skill set. “Being a nurse now requires technical knowledge,” she said. “The philosophy of teaching new nurses has changed in a positive direction. Knowledge is power and it prevents mistakes.” IMPROVED TECHNOLOGY BRINGS BETTER PATIENT CARE Changes in technology have also affected how the nurses do their jobs and greatly improved the experience and care they deliver to patients. For example, decades ago, the nurses took pulse and blood pressure readings and counted IV drops by wristwatch, and they charted everything on paper before the implementation of electronic medical records. Other beneficial changes include greater access to telephones and the addition of ASCOMs, which are the wireless handsets nurses use today. “When I worked on the fourth floor, there was one telephone located at the front desk,” recalled Geesaman. Pini also says ASCOMs and other technology have provided more transparency and a greater link with the rest of the staff. “Communication is more important than ever since we have less time to get things done right, as the average admission is three to five days versus the ten-plus days of the past,” said Pini. “Fortunately, documentation is better, we have greater access to lab reports, and there are built-in reminders that help ensure all steps are done.” PATIENT CARE BECOMES MORE COLLABORATIVE Bayhealth Milford Memorial Intensive Care Unit Nurse Manager Jill Tatman, MSN, RN, CCRN, who’s been working at the hospital for more than four decades, has also witnessed major changes. For example, she remembers when private duty and team nursing were the models. “This included LPNs at the bedside, RNs at the desk, a medical nurse, and a team leader,” she explained.
HISTORY OF NURSING AT BAYHEALTH MILFORD MEMORIAL
Affiliation established with Delaware State Hospital as a training site for student nurses.
Dr. Grier’s house on Lakeview Avenue becomes the place for students to live and learn; Director of Nursing is hired at $250/month.
First graduating class to take the National State Board Exams for nursing.
Major change in nursing salaries occurs.
1951 First Capping Ceremony held.
Grier Building opens and becomes new home for nurses.
First male nurse graduates from the nursing school.
School of Nursing closes, one year after celebrating its 50th anniversary.
Pini noted how social changes have brought modifications to nurses’ involvement in patient care. “Back then [in the ’70s] we focused more on care inside the hospital. Now we make sure patients have someone at home to continue to care for them if necessary and even pick them up when they’re discharged. The nurse also has become more of a patient advocate in recent years.”
Mid- to late 1980s
All agree that nursing has become more professional and more respected over time, and there’s much more collaboration with the physicians and other medical staff. These changes have helped Bayhealth nurses better care for the community. ■
Milford Memorial Hospital merges with Kent General Hospital to become Bayhealth.
Visit BayhealthSussex.org for information about the new Bayhealth Hospital, Sussex Campus. Some of the milestones and historical facts cited, including the quoted pieces, come from the book, Origin & History: Milford Memorial Hospital, Seventy-Five Years of Caring.
Patients were far sicker than in the past, putting additional and different responsibilities on the nurses.
2015 Bayhealth Milford Memorial achieves Magnet® designation. 17
Passing on good cheer The Harrington Sunshine 4-H Club has been spreading cheer at Bayhealth Milford Memorial for years. The group participates in a variety of service projects that benefit patients, their families, and visitors of the hospital. Annually, the group donates 500 care packages for patients of all ages. Each holiday, the group also creates a holiday favor that is placed on the patient trays to ensure that those who are in the hospital during the holiday still get to celebrate. “The Harrington Sunshine 4-H Club is a true partner of Bayhealth Volunteer Services,” said Bayhealth Volunteer Supervisor Katherine Matthews. “Their dedication and generosity has a tremendous impact on the patients and families at Milford Memorial. We are so grateful for all that they do.” In previous years, the group also wrote “get well” cards for those patients who weren’t doing well or not receiving any mail. The group participants have one goal: to help others.
“The group members take pride in their actions. Their commitment and sense of caring is well recognized in their community,” said group leader Heather Crouse. “The group is extremely proud of doing anything that can help make a difference in someone’s life.” Many of the group members are also student volunteers at Bayhealth Milford Memorial during the summer months. In addition to their work with the hospital, they also visit nursing homes, collect food and clothing for donation drives, and help with beach cleanup efforts. “The group members participate because they want to help others and they see what a meaningful benefit their actions can provide,” said Crouse. “Through this process, they are developing into strong leaders and better citizens for the future.” ■ Visit Bayhealth.org/Volunteer or call 302-430-5621 to learn about the many ways to give back at Bayhealth.
Hertrich family grateful for lifesaving services The day began like many others for the Hertrich family. Fred and Lyndie Hertrich made sure their three children, ages 8, 6, and 4, were ready for school, and Fred left for another day of work. But a severe pain put a stop to Fred’s busy schedule at The Hertrich Family of Dealerships.
“Every community needs lifesaving services with the newest and best technology and most comfortable surroundings possible,” said Lyndie. “We’re thankful Bayhealth is expanding and improving those services in the southern Delaware community with the new Bayhealth Hospital, Sussex Campus.”
“He described it as enough pain to go to the emergency department at Bayhealth Milford Memorial,” said Lyndie, who is not a stranger to the Milford community. With a doctorate in education, she worked as a teacher in the Milford School District at Banneker Elementary School for several years, and also as vice principal for Lula Ross Elementary School.
Fred and Lyndie are also thankful they can return to their regular daily routine and focus on their number-one passion in life, their children. ■ Visit BayhealthSussex.org for more information on the new Bayhealth Hospital, Sussex Campus. Call the Bayhealth Foundation at 302-744-7015 to learn how you can support the Bayhealth Sussex Campus.
According to Lyndie, the rest of the day moved very quickly. Fred was admitted to Bayhealth Milford Memorial with a life-threatening condition, and they learned he would need emergency surgery. “It was a frightening experience, but when I arrived in the emergency department I felt comforted by the family atmosphere,” said Lyndie. “I recognized the faces of many of the parents of students that I taught, and even some of the students. It felt like we were in the right place, and I trusted the nurses and physicians because I had built a relationship with them through working in the community. You don’t get that same treatment in a city hospital.” Fred and Lyndie Hertrich expressed great appreciation for the physicians and nurses responsible for saving Fred’s life. As a result of their positive experience, the Hertriches were compelled to make a generous contribution to the Campaign for Bayhealth Phase III in support of the Bayhealth Sussex Campus.
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Bayhealth receives Blue Distinction for Bariatric Surgery Highmark Blue Cross Blue Shield Delaware has recognized Bayhealth Hospital, Kent Campus with a Blue Distinction® Center for Bariatric Surgery designation and Bayhealth Milford Memorial with a Blue Distinction® Center+ for Bariatric Surgery designation as part of the Blue Distinction Specialty Care program. To receive a Blue Distinction for Bariatric Surgery designation, a healthcare facility must demonstrate success in meeting patient safety measures as well as bariatric-specific quality measures, including complication and readmission rate for laparoscopic procedures in sleeve
gastrectomy, gastric bypass, and adjustable gastric band. It must also be nationally accredited at both the facility and bariatric program–specific levels. Also, only those facilities that first meet Blue Distinction’s nationally established, objective quality measures will be considered for designation as a Blue Distinction Center+, which Milford Memorial received.
ABOUT BLUE DISTINCTION CENTERS Blue Distinction Centers (BDC) met overall quality measures for patient safety and outcomes, developed with input from the medical community. A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable health care. Each provider’s cost of care is evaluated using data from its Local Blue Plan. Providers in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on www.bcbs.com. Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers. 20