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W INTER 2018–20 19

healthwaves B AY H E A LT H

Getting back in the game starts with care on the field — PAGE 4


New hip gives hope


Special care for a special baby


New PVD stent treatment

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.

Bayhealth does not discriminate against any person on the basis of race, color, national origin, disability, or age in admission, treatment or participation in its programs, services and activities, or in employment. If you have any questions, please call JoAnn Davis at 302-744-7405. Bayhealth’s TDD or State Relay number is 1-866-237-0174.

TERRY M. MURPHY, FACHE President and CEO, Bayhealth

JENNIFER DAILEY Writer, Healthwaves

MICHAEL ASHTON, FACHE Vice President of Operations/ Administrator, Bayhealth Milford Memorial

Marketing Specialist II, Bayhealth AMANDA DOWNES Writer, Healthwaves Marketing Specialist, Bayhealth

PAMELA J. MARECKI Senior Editor, Healthwaves

GWEN GUERKE Writer, Healthwaves

Assistant Vice President Marketing Communications, Bayhealth

Marketing Specialist, Bayhealth BRANDON HOWIE Photographer, Healthwaves

AMANDA C. BOWIE Editor, Healthwaves

Marketing Videographer, Bayhealth

Marketing Operations Manager, Bayhealth

JENNIFER MYERS Writer, Healthwaves

DANIELLE PRO-HUDSON Editor, Healthwaves

Marketing Specialist, Bayhealth

Media Center Coordinator II, Bayhealth LEIGH ANN COLEMAN Photographer, Healthwaves Web & Digital Marketing Specialist II, Bayhealth

ALICE RAUSCH Contributor, Healthwaves Southern Region Strategy & Brand Program Manager, Bayhealth PAUL STECCA Designer, Healthwaves J&P Stecca LLC

IN THIS ISSUE feature story: 4 Getting back ●

in the game starts with care on the field PICTURED ON COVER Milford High School linebacker Mardis Powell turned to Bayhealth when he suffered an injury on the playing field.

6 ●

Spotlight on the Bayhealth Sussex Campus: Built to offer more to our patients

15 ●

Nurse leaders publish book on best practices in ethical decisions

8 ●

New hip gives hope of riding again

16 ●

10 ● 12 ●

2018 Winter Classes

An addition, an advocate, for colorectal cancer awareness

18 ●

Bayhealth residency programs to begin July 2021

14 ●

A distinguished certification for our patient focus

19 ●

Leading the way with new stent treatment for PVD

Special care for a special baby



640 South State Street Dover, DE 19901 302-674-4700

21 West Clarke Avenue Milford, DE 19963 302-422-3311



100 Wellness Way Milford, DE 19963 302-422-3311

Letter from the President DEAR NEIGHBORS, We’re well into the winter season. I hope that means you’re finding time to unwind after the hustle and bustle of the holidays and refocus on your health. For some of you, those aches and pains that you’ve been trying to ignore are growing harder to silence. For others, you may be welcoming a new child, recovering from an injury or just trying to keep in good health. Now is a good time to listen to your body and start giving it the care it needs. When Milford High School linebacker Mardis Powell was injured during a football game, a meniscus tear could have meant surgery. But with a team from Bayhealth rooting him on, Powell returned to the game after two weeks of physical therapy at Bayhealth Milford Memorial. Learn how the teamwork between Bayhealth staff and Powell meant a quicker return to play for the young athlete. See page 4 for the story. At Bayhealth, we continue to keep an eye on the future of healthcare for our community. That’s one of the driving factors behind our decision to build the new Bayhealth Hospital and Outpatient Center, Sussex Campus, set to open in February 2019. Get a glimpse of some of the features on pages 6 and 7. For Cecilia Ulhmann of Viola, Delaware, agonizing hip pain had her limping and kept her from horseback riding — a passion she’s had since childhood. The 74-year-old met with Bayhealth Orthopaedic Surgeon John R. Burger, DO, to learn about her options. A successful, muscle-sparing hip replacement surgery got Ulhmann one step closer to riding horseback again. Read her story beginning on page 8.

Perhaps you’re expecting a newborn in the New Year — at Bayhealth Hospital, Kent Campus, a Level II Special Care Nursery provides intensive, specialized care for babies. The team in the nursery cared for the Zubrick family not once, but twice. It was the care their two babies received, two years apart, that has the family of six all smiles. Read their story on page 12. When it comes to cancer treatment, time is often of the essence. In Delaware, there’s a high rate of colorectal cancer, but some people put off screenings and treatment because of lack of funds or lack of insurance. Bayhealth Cancer Institute recently hired Nurse Navigator Trina Turner to help patients schedule screenings and get the care they need even if they are uninsured or underinsured. According to Bayhealth Colorectal and General Surgeon Assar Rather, MD, colorectal cancer is completely treatable and preventable in most cases. Read more about our advocates in the fight against colorectal cancer beginning on page 16. I hope you enjoy this issue of Healthwaves and are inspired to focus on your health. Sincerely,

Terry M. Murphy, FACHE President and CEO Bayhealth


Getting back in the game starts with care on the field Whether on the playing field or in a healthcare setting, teamwork is essential to success. As head athletic trainer at Milford High School, Taylor Hatfield, ATC, sees this play out daily with the school’s various athletic teams. As a Bayhealth employee, she and her colleagues are also a part of a network of professionals that live by this philosophy, working together to provide timely and beneficial care to area athletes. This teamwork was evident during an evening football game at Milford High School. Injury struck on the field for linebacker Mardis Powell. Hatfield was there for first-level care. Surgery looked to be a possibility to treat his meniscus tear, a common knee injury, but physical therapy was recommended as a first step. Communication with Department Manager for Outpatient Rehabilitation Josh Smith quickly ensued, and Powell was seen on the next day’s schedule for physical therapy at Milford Memorial. Upon first meeting Powell, Smith already had background information to expedite a plan that would best help him. Bayhealth providers and staff all use the same Epic electronic health record system, allowing for immediate access to patient health history, notes from practitioners and test results, such as X-ray and MRI images. The open flow of information and communication between everyone working with a patient streamlines recovery because everyone can make decisions about care knowledgeably and efficiently.


joined Bayhealth earlier this year and has been impressed by the strong collaboration he has seen among departments. Hatfield can attest to that. “There’s a great rapport between Bayhealth’s orthopaedics, sports medicine and outpatient physical therapy teams. With a quick text or phone call, an injured student athlete can be referred and seen as soon as possible for treatment. With everyone on the same page at each step, together we can provide a seamless process.”


As a senior starter on the team, Powell benefited from the swift action and his own motivation to work hard in physical therapy. Within two weeks, he passed the “Return to Play” examination required of all athletes, in time for the remainder of the season. “While a smooth and fast recovery from an injury is ideal, it’s critical to ensure that an athlete is 100 percent ready to reduce the likelihood of having the injury again,” explained Smith.

While sports medicine is just one of the areas that Bayhealth’s Outpatient Rehabilitation covers, Smith pointed out that at the heart of all treatments is a detailed one-on-one approach to care. Bayhealth provides physical, occupational and speech therapy services that are individually tailored to meet a multitude of diagnoses. “We have the system and resources in place to invest in helping each person recover. The dedicated and highly qualified team of therapists here works towards reducing the toll of injury and helping patients return to their best life. It’s great to see the future of healthcare at work through Bayhealth.” ■

Even with the protocols and tools in place, the human element should not be overlooked. Smith

Visit Bayhealth.org/Outpatient-Therapy to learn more about the outpatient rehabilitative services we offer.



Built to offer more to our patients When the Bayhealth Hospital and Outpatient Center, Sussex Campus opens in early 2019, it will be with a variety of enhancements in tow. Patients can expect a larger cancer center and emergency center, individual patient rooms, and several other expanded services. Here are some ways the Bayhealth Hospital and Outpatient Center, Sussex Campus was built around you: ROBOTIC SURGERIES The Robotic-Assisted Surgery Program at Bayhealth offers patients minimally invasive surgeries with the da Vinci surgical system. Patients who undergo a minimally invasive surgery are expected to experience a shorter hospital stay, fewer complications, a faster recovery, and minimal scarring associated with smaller incisions. “Providing robotic surgery at the Bayhealth Sussex Campus expands upon the surgical service line there. Patients will no longer have to drive to a different facility to have this done,” says Senior Vice President and Chief Nurse Executive Brenda Blain, DNP, RN-BC, FACHE, NEA-BC. RETAIL PHARMACY AND GIFT SHOP While Milford Memorial has a retail pharmacy near the hospital in the Medical Arts Building, the new Retail Pharmacy and Gift Shop will be housed within the new hospital. The Pharmacy, which will also be the new home for some of the items featured in the previous gift shop, will fill prescriptions and offer a wide variety of over-the-counter drugs


and other products. Items carried typically include glucometers, vaporizers, compression stockings, insulin products, heating pads, and braces. Ambulatory Pharmacy Manager Madeline (Lynn) Byrne, RPh, CCP, says having the retail pharmacy in the hospital will provide convenient, easier access for patients and staff. It’ll also increase efficiency for the Meds to Beds program, which provides medications to patients when they are leaving the hospital to make their transition to home easier. ALL PRIVATE PATIENT ROOMS In order to enhance quality, safety and the patient experience, the new Bayhealth Hospital, Sussex Campus will have three 24-bed Acute Care Units. Whether patients need an intermediate or medical-surgical level of care, they’ll receive it on an acuity-adaptable unit, where care can be adjusted to meet the patient’s needs. This translates into less moving around in the hospital for patients once they’re admitted. All of the patient rooms in the new Bayhealth Hospital, Sussex Campus will also be private and include many amenities that will further boost patient comfort and safety.

The new hospital features same-sided rooms, meaning each patient room looks exactly the same. The design was developed based in part on a lot of research and user groups doing workflow mock-ups. Registered Nurse Morgan McKenzie said they went step-by-step to see what changes could be made to improve workflows. “Through doing this, we’ve found ways to cut back on time. We’re making changes that will stop us from wasting time walking up and down the unit, which means we have more time with the patients,” McKenzie said. EXPANDED IMAGING AND TREATMENT SERVICES The state-of-the-art technology coming to the Sussex Campus includes an 1,150-squarefoot interventional radiology and interventional cardiology suite (much larger than a standard operating room) outfitted with the latest equipment, which will facilitate improved coordination among specialties for procedures. Our Imaging department (historically known as Diagnostic Imaging or Radiology) will be equipped with advanced equipment that emits the lowest possible radiation exposure while helping to detect and diagnose medical conditions in the earliest stages. The 3T MRI has a wider opening to provide more room and comfort for the patient and twice the strength for highest-quality images. The Digital C-arms in the Operating Room enhance surgical imaging. Nuclear medicine equipment with CT component can do two types of imaging at once for precise internal scans and better accuracy in diagnoses.

We’re improving your care and adding convenience by having more equipment that will prevent scheduling delays and allow for same-day or next-day appointments (barring any insurance limitations), faster check-in due to centralized scheduling and new pre-registration processes, an additional CT scanner in Emergency and Trauma Center that will decrease patient wait time, the ability to schedule mammograms through the MyChart patient portal, and new service offerings to allow patients a greater choice without the driving distance. These new services include cardiac catheterizations, peripheral vascular diagnostic and interventional procedures, electrophysiology studies, and device implants (pacemakers and defibrillators). The many enhancements keep patient needs at the forefront by streamlining processes, expanding access and providing the latest advances for diagnosis and treatment. IMPROVING THE SUPPLY DISTRIBUTION SYSTEM Another reason staff will be able to spend more time with patients is the two-bin system. Nurses will spend less time retrieving supplies and more time with the patients. With the two-bin system, supplies will be placed in two bins that are placed front to back. Nurses pick supplies from the first bin, and when it’s empty, it’s placed on the top shelf to be refilled by Warehouse staff. The second bin is then pulled forward to be used. With this new inventory system, the bins are rotated in a way that nurses never run out of supplies and are easily alerted when a refill is necessary. ■ Visit BayhealthSussex.org to see all the ways the Bayhealth Sussex Campus was built around you.


New hip gives hope of riding again The painful effects of arthritis were preventing Cecilia Ulhmann from enjoying her outdoor lifestyle. At age 74, Ulhmann was determined to get back to riding her horse, Vince — something she’s been doing since she was 3 years old. She turned to Bayhealth Orthopaedic Surgeon John R. Burger, DO, to find relief from debilitating left hip pain that left her with a limp. No stranger to orthopaedic surgery, Ulhmann had both her right hip and left knee replaced in recent years. She ignored the pain in her left hip because she was dealing with emotional hardships — the passing of her husband in 2015 and selling her six-acre farm that had become too much for her to manage on her own. It was during that time Ulhmann decided she couldn’t put her health on the back burner any longer. “I liked Dr. Burger right away,” recalled Ulhmann of her first visit to Bayhealth Orthopaedics, Dover. “He listened and answered all of my questions. I had a lot of confidence in him after one visit, just from our conversation.” Dr. Burger explained that the osteoarthritis in Ulhmann’s left hip altered her gait or stride. “With advanced osteoarthritis like Cecilia had, it’s not uncommon for a hip problem to cause the inner knee to hurt because of the nerve that runs between the two areas,” explained Dr. Burger. “This made Cecilia feel like one leg was shorter than the other. She was walking on her toes to compensate for her hip deformity.” X-rays confirmed that joint degeneration had left Ulhmann’s hip in a bone-on-bone state. Dr. Burger typically considers all conservative treatments like physical therapy and injections to remedy a patient’s joint pain before surgery is considered. In Ulhmann’s case, however, hip surgery was inevitable.


Ulhmann was a candidate for anterior hip replacement — a less invasive surgical approach where the surgeon makes an incision through the front of the leg, sparing muscles in the process. The most important muscles for hip function and walking are left undisturbed, which makes for a shorter hospital stay, smaller incision, fewer restrictions during recovery, and shorter recovery time.


“She lives an active lifestyle and was motivated to get back to doing everything she was doing before her surgery — and more,” said Dr. Burger. He prefers the anterior approach to hip replacement because, while research shows similar outcomes long-term for the anterior and posterior approaches, anterior hip replacement patients tend to do better the first six weeks after surgery with a faster recovery and less pain.

Ulhmann had a successful surgery at Bayhealth Hospital, Kent Campus. The Kent Campus is certified by the Joint Commission for total knee and total hip replacements, and recently announced that they had zero infections for total knee and total hip replacements in 2017. The national average for total joint infections is between 0.5 and 2 percent. “It left me feeling better than I had in years,” Ulhmann said of her successful surgery. Just two hours post-op, she walked two laps. “To wake up and not feel pain for the first time in a while was absolutely wonderful. It felt so good to get up and move around like I used to.” Remarkably, Ulhmann had very little pain, needing prescription-strength pain reliever for the first day only and Tylenol after that.

Excited to now be living pain-free without restriction, Ulhmann is ready to enjoy the simple things in life like riding her horse again. With physical therapy helping to build up her strength, Ulhmann can get back in the saddle again very soon. ■ Visit Bayhealth.org/Orthopaedics to learn more about Bayhealth’s Division of Orthopaedics. Visit Bayhealth.org/Find-A-Doc or call 1-866-BAY-DOCS to receive a full list of orthopaedic surgeons who perform the anterior hip replacement procedure.

Ulhmann spent two days at Bayhealth Hospital, Kent Campus and says it was a positive experience. “All the nurses and staff in the Orthopaedics department were so caring,” she said. “I think the world of Dr. Burger. He’s a terrific doctor and I’d go back to him in a heartbeat.”



Maternity BIRTH CENTER TOURS We invite you to tour the facility where you will meet your new baby for the first time. Visit Bayhealth.org/Classes to register for one of the quarterly tours at Bayhealth Hospital, Kent Campus. To arrange for a personal tour, call 302-744-7245 (Kent) or 302-430-5739 (Milford). INFANT CARE These classes focus on basic infant care to give parents confidence in their ability to care for their babies. Visit Bayhealth.org/Classes to register. HELLO BABY Adjusting to a new brother or sister can be difficult for the older sibling. Bayhealth’s “Hello Baby” program is designed to help children accept their new role. Visit Bayhealth.org/Classes to register. This class has a fee. 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 Bayhealth Hospital, Sussex Campus and the third Tuesday of each month at Bayhealth Hospital, Kent Campus. Visit Bayhealth.org/Classes to register. LABOR AND CHILDBIRTH Classes are offered both in-person and online for expectant mothers and their partners. Mothers-to-be are encouraged to register early in their pregnancy. Visit Bayhealth.org/Classes to register. This class has a fee.


PUMPING MILK AND MORE Expectant mothers will learn the ins and outs of what kind of pump works best, based on personal circumstances and preferences. 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, visit Bayhealth.org/Breastfeeding-Support.

Healthy Aging PACE PROGRAM The PACE (Promoting Active Community Engagement) Program, previously the STEPS to Healthy Aging Program, is for anyone in Bayhealth’s service area who is interested in healthier living. PACE Clinics are held monthly in Dover, Lincoln and Milford and give you an opportunity to receive individualized counseling from a registered nurse (RN) based on your health problems, medications and blood pressure. Quarterly lectures will also be provided. For more information, visit Bayhealth. org/PACE or 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, call 302-744-7135.

Weight Loss BARIATRIC INFORMATION SEMINAR Learn more about Bayhealth’s Surgical Weight Loss Program. 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 Surgical Weight Loss Office at 302-430-5454. SURGICAL WEIGHT LOSS SUPPORT GROUP These meetings offer a secure and comfortable forum both for patients who have already had bariatric surgery and for people who are considering weight loss procedures. Participants learn valuable information from guest speakers and open discussion. The group is free to join. For more information, call the Bayhealth Surgical Weight Loss Office at 302-430-5454.

CPR & First Aid SAFE SITTER Safe Sitter® teaches boys and girls ages 12 to 15 how to handle emergencies when caring for children. Certified instructors teach safe and nurturing childcare techniques, behavior management skills and appropriate responses to medical emergencies. Students will also learn CPR. Visit Bayhealth.org/Classes to register. This course has a fee.

2018 WINTER CLASSES HEARTSAVER CPR/AED/ FIRST AID This course reviews the steps of cardiopulmonary resuscitation (CPR) for adults children, and infants. Participants will learn how to use an automatic external defibrillator (AED). It includes four core modules: first aid basics, injuries and illnesses, life-threatening emergencies, and the chain of survival. It is offered as a two-part program. Part 1 is online and Part 2 is in the classroom. Visit Bayhealth.org/Classes to register. This course has a fee and requires the purchase of a textbook. HEARTSAVER CPR/AED This course reviews the steps of cardiopulmonary resuscitation (CPR) for adults, children and infants. Participants will learn how to use an automatic external defibrillator (AED). It is offered as a two-part program. Part 1 is online and Part 2 is in the classroom. Visit Bayhealth.org/Classes to register. This course has a fee and requires the purchase of a textbook. HEARTSAVER FRIENDS AND FAMILY CPR This course is designed for people who want to learn cardiopulmonary resuscitation (CPR) but do not need a CPR course completion card. It is ideal for community groups, new parents, grandparents, babysitters, and others age 14 and over. Visit Bayhealth.org/Classes to register. This course has a fee and requires the purchase of a textbook.

HEARTSAVER PEDIATRIC CPR/FIRST AID This course reviews the steps of cardiopulmonary resuscitation (CPR) for children and infants. It also provides information on how to manage a child’s injury during the first few minutes of an emergency until professional help arrives. It includes four core modules: first aid basics, injuries and illnesses, life-threatening emergencies, and the chain of survival. It is offered as a two-part program. Part 1 is online and Part 2 is in the classroom. Visit Bayhealth.org/Classes to register. This course has a fee and requires the purchase of a textbook.

Chronic Lung Disease BETTER BREATHERS This support group is for people with chronic lung disease and their family members. Visit Bayhealth.org/Classes for more information.

Diabetes DIABETES SUPPORT GROUP This support group provides a nonjudgmental atmosphere where persons with diabetes can gain management insight from one another. For more information, call 302-744-6307.

Prostate PROSTATE CANCER SUPPORT GROUP This support group brings together prostate cancer survivors and those who are close to them in an open forum so they can share their experiences and learn from one another. For more information, call 302-744-7990.

Stroke STROKE SUPPORT GROUP This group is for stroke patients and their caregivers. Guest speakers present information on educational topics such as dealing with depression, nutrition and the promotion of overall wellness. For more information, call 302-744-6638.

Screenings MAMMOGRAMS Each month, Bayhealth hosts regular mammogram screenings at multiple locations at no cost to those who are uninsured or underinsured. Registration is required. To register, call 302-744-6719. 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 offers free clinical breast exams to the community. Registration is required. To register, call 302-744-6719.


Special care for a special baby Welcoming a new life into the world is a joyous time. But not every birth goes as planned and not every baby gets to stay with mom after delivery. Newborns needing extra care are often brought to the Special Care Nursery at Bayhealth Hospital, Kent Campus. That’s the situation Katy Zubrick found herself in earlier this year. Katy and her husband Chris welcomed their fourth child, Lane, in late September. Lane came at 36 weeks. He was having issues breathing after delivery and was immediately brought to the Special Care Nursery at Bayhealth, a place Katy and Chris were already very familiar

with. Two years prior when the Zubricks welcomed their third child, Amily, she also needed care in the Special Care Nursery. Amily was also born at 36 weeks and weighed just four pounds. The 15-bed Level II Special Care Nursery at Bayhealth Hospital, Kent Campus was designed for infants needing more intensive, specialized care. The Special Care Nursery has a trained neonatology team, including board-certified neonatologists, neonatal nurse practitioners, staff nurses, and respiratory therapists, who provide expert care to premature and newborn babies with more complex medical conditions. The Special Care Nursery serves many surrounding hospitals in southern Delaware. “I never thought I would have two babies in the Special Care Nursery,” said Katy. “When Amily was there, I remember I was just so scared. It wasn’t anything I’d ever experienced before. But as soon as we met the staff I was immediately at ease.” While the Zubricks were in shock that they needed to return to the Special Care Nursery with their fourth child, both said they were better prepared for their second experience. “I was okay with Lane being in the Special Care Nursery,” said Katy. “I knew he was in great hands, and what is even more special about the experience was that Lane and Amily actually had the same nurse. That was huge for us to know we already had such a good experience, and we were going to have the same nurse again.”



Laura Wedel, MSN, RNC-OB, cared for Amily and Lane during their time in the Special Care Nursery. “We try to be very sensitive and understanding of our families,” she said. “You don’t typically plan for a baby in the Special Care Nursery, but it’s our job to make sure our babies and their families are well taken care of. The Zubricks were such a wonderful family. I wanted to make their experience as meaningful as possible.” Chris noted another comfort he felt during his children’s time in the Special Care Nursery was that his wife was also being taken care of. “It was nice to know that Katy’s needs were addressed too — that helped the experience,” said Chris. After six days in the Special Care Nursery, Lane was able to go home to adjust to life with his three older siblings. Lane is beginning to stay awake longer and is showing his first signs of smiling. “It definitely wasn’t part of our plan to have two of our babies in the Special Care Nursery, but it was also comforting knowing our babies were in good hands,” said Katy. “The whole experience was so positive, and we can’t say enough about the nurses. It’s like there’s a family member watching your baby for you. There’s no peace of mind better than that.” ■ Visit Bayhealth.org/Maternity-Obstetrics for more information on Bayhealth services for expectant mothers, including information about Bayhealth’s Special Care Nursery.

EDUCATING PATIENTS ABOUT POSTPARTUM DEPRESSION The National Institute for Healthcare Management estimates between 10 and 20 percent of women experience postpartum depression during pregnancy or in the first 12 months postpartum. Symptoms include sadness, anxiety, poor bonding with baby, and loss of interest in one’s self. Bayhealth is now screening new mothers for symptoms of postpartum depression to ensure patients receive information about resources available to them. Community providers are also taking action. Some OB-GYNs now see patients two weeks after birth instead of six.


A distinguished certification for our patient focus Bayhealth Hospital, Kent Campus and Bayhealth Milford Memorial have been awarded Silver Certification for Excellence in Person-Centered Care by Planetree International. Bayhealth is one of only seven healthcare organizations internationally with the Silver-level certification since Planetree first introduced the recognition level in 2012, and one of only three healthcare organizations in the U.S. designated Silver Certification. Planetree is a nonprofit organization that helps patients, families and staff members deliver care from the patient’s perspective. Since 2005, Bayhealth has been incorporating Planetree’s patient-focused model of care, centered on a holistic approach to healing in all dimensions — the mind, body and spirit. “This achievement demonstrates our commitment to our patients, their families and the communities we serve,” said Senior Vice President and Chief Nurse Executive Brenda Blain. “Achieving Silver Certification for Excellence in Person-Centered

Care demonstrates the compassionate, high-quality service provided by everyone at Bayhealth.” Bayhealth achieved this recognition after submitting a comprehensive document that captures more than 25 specific criteria, which was followed by a threeday site visit conducted by Planetree. There were several areas where Bayhealth excelled, including patient-directed visitation, opportunities for patient and family input through patient partners, community access to health and wellness programs, family involvement in care through the Care Partner Program, and sensitivity around the cultural norms and preferences of patients. “We are driven to understand what is most important to all those we serve,” said Director of Patient Advocacy, Professional Recruitment, and Service Excellence Marianne Foard, MS, RN, NE-BC. “This recognition not only demonstrates that we have the structures in place to provide individualized care, but that we have also removed barriers to understanding what really matters to each person who walks through our doors.” ■ Visit Bayhealth.org/Planetree to learn more about person-centered care at Bayhealth.


Nurse leaders publish book on best practices in ethical decisions Bayhealth nurses are driven to achieve nursing excellence, and are passionate about the work they do and the care they provide patients. This drive is evident in everything they do. An example of this is the collaboration between two Bayhealth nurse leaders, who authored a book on nursing’s role in healthcare ethics. Senior Director of Patient Care Services Andrea Holecek, EdD, MSN, MBA, RN, NE-BC, FACHE (pictured left), and Director of Education Angel Dewey, MSN, RN, APRN, ACNS-BC, CCRN, CNRN (pictured right), are celebrating the release of their book, The Nurse’s Healthcare Ethics Committee Handbook. The book came about after the duo presented at a national nursing conference in 2016, where they were approached by an acquiring editor from the Sigma Theta Tau International Honor Society of Nursing about writing the book. The book was released in August. “The care of patients in a hospital setting is complex, and there are often situations where difficult healthcare decisions need to be made,” Dewey said. This is where an ethics committee comes in. A consultant from Bayhealth’s Ethics Committee is available 24 hours a day, 7 days a week to guide patients, families and the healthcare team in making decisions about medical treatment. Bayhealth’s Ethics Committee is an interdisciplinary team that determines the best path forward when ethics issues arise in the patient care process. The committee works closely with legal professionals to ensure that decisions are aligned with Delaware law.

healthcare ethics because they are intricately involved in all aspects of patient care, including care coordination, recommendations for plans of care, provision of life-sustaining interventions, and patient education,” Holecek said. The handbook provides tools that nursing students, professionals, administrators, and other members of the healthcare team need to develop processes that support nurses in an ethics committee leadership role. The handbook is filled with real-life scenarios and outlines a step-by-step process for nurses to evaluate ethical cases and the risks involved. “As nurse leaders, we have a responsibility to share best practices,” Holecek said. “At the end of the day, everything we do is for the betterment of our patients, including helping families make ethical decisions.” ■ Visit Bayhealth.org/Nurses to learn more about nursing at Bayhealth.

Holecek and Dewey wrote the book because of the role of nursing in ethical decision making. “Nurses are uniquely positioned to serve as leaders in


An addition, an advocate, for colorectal cancer awareness According to colorectal cancer incidence and mortality rates in Delaware, there’s much work to be done in terms of increasing awareness, early detection, screening rates, and community education for this third-most common type of cancer. To help facilitate this, the Bayhealth Cancer Institute recently added a nurse navigator specific to colorectal cancer.

Turner says too many people skip doctor’s visits or their regular screenings because they’re uninsured or underinsured. “Screening for Life is a program designed to help these patients get the care and treatment they need,” she said. “It provides assistance in finding a primary care provider, if needed, and provides payment for cancer screening tests to qualified Delaware adults.”

Trina Turner, MSN, RN-BC, LNC, is Bayhealth’s new nurse navigator specific to colorectal as well as lung cancer. “Screening plays an essential role in the early detection of all cancers, especially colorectal cancer. Early screening and detection can produce better patient outcomes for the treatment of colorectal cancer. An important part of my role as a nurse navigator is to help schedule cancer screenings for patients and provide follow-up help — whether they have health insurance or not,” she explained.

Bayhealth Colorectal and General Surgeon Assar Rather, MD, FACS, FASCRS, adds that although colorectal cancer is the second-leading cause of cancer death, it’s completely treatable and preventable in most cases. According to Dr. Rather, risk factors for colorectal cancer include a Western-style diet or one low in fiber, obesity, lack of exercise, smoking, inflammatory bowel diseases such as Crohn’s or ulcerative colitis, and a family history.



Dr. Rather recommends people start regular screening at age 50. “Newer research suggests that African Americans should begin regular screening at age 45. Patients with family history of colorectal cancer may need earlier screening. Screening can be done by a gastroenterologist or a colorectal surgeon,” he said. The common colorectal screening methods are a fecal occult blood test; Cologuard®, which also detects blood in the stool and looks for DNA cell changes; a flexible sigmoidoscopy; and a colonoscopy. If blood or an abnormality is found as a result of the other methods, a colonoscopy will be required. Also, the American Society of Colon and Rectal Surgeons considers a colonoscopy to be the “gold standard” when it comes to colorectal screening and says it’s the preferred method unless medical conditions don’t allow for it. TREATING COLORECTAL CANCER ONE STEP AT A TIME For those diagnosed with colorectal cancer, at Bayhealth, patients receive a specific treatment course based on their individual needs. During a multidisciplinary Tumor Conference, surgeons, oncologists, radiologists, pathologists, and other medical providers come together for a multimodality review of the patient’s case history and make recommendations for treatment and follow-up care based on national guidelines.

As Dr. Rather also explained, a few steps typically apply to all Bayhealth colorectal cancer patients as outlined below. Step One: See a specialist. This may include a surgeon, a medical oncologist and/or a radiation oncologist. If the patient requires surgery, it’s usually performed using minimally invasive techniques — either laparoscopic or robotic. Step Two: Attend Colon Camp. This is an educational opportunity for patients before they undergo surgery. It’s an hour-long appointment with a nurse who explains how the surgery works, how to prepare for surgery and what to expect after surgery. Step Three: Undergo colorectal surgery followed by the ERAS protocol. ERAS (enhanced recovery after surgery) is a set of perioperative procedures and practices that are applied to all patients undergoing colorectal surgery to improve patient outcomes and satisfaction. Positive outcomes include freedom from nausea, freedom from pain at rest, early mobilization, early return of bowel function, improved wound healing, and early hospital discharge. ■ For more information about the Screening for Life program, visit HealthyDelaware.org or call 302-744-1040. Visit Bayhealth.org to learn more about colorectal cancer treatment and prevention.

ROBOTIC-ASSISTED SURGERY Bayhealth’s Robotic Surgery Program began in 2010. Today, more than 30 types of robotic surgeries are performed at Bayhealth by nine surgeons who are specially trained and credentialed to use the da Vinci robotic-assisted surgical system. Thanks in part to generous monetary gifts from members of our local communities given through the Bayhealth Foundation, Bayhealth recently purchased a second da Vinci surgical system. As a result, the highly trained and experienced surgical teams at both Bayhealth Hospital, Kent Campus and the new Bayhealth Hospital, Sussex Campus will use this minimally invasive surgical system to perform a wide range of delicate and complex operations. This includes those related to bariatric, colorectal, general, gynecologic, thoracic, and urologic surgeries. The robotic-assisted surgical system has been shown to provide a faster recovery, less pain, fewer complications, and better clinical outcomes. 17

Are cheat meals the best choice? To cheat or not to cheat on your eating plan? Is a “cheat meal” a treat meal or does it derail efforts? Amanda Buehler, MDA, RD/LDN, a bariatric and clinical dietitian with Bayhealth’s Surgical Weight Loss program, says there are no one-size-fits-all answers. “It depends on the person. For some people, a cheat meal works, but for others this treat can easily snowball into a cheat day,” she said. Buehler describes a cheat meal as something indulgent, something that doesn’t fit into your typical eating plan. She warns that fad diets — eating plans that are rigid and focus on self-deprivation — may lead you to cheat, because strict diets are difficult to maintain. Eating cheat foods — foods typically rich in sugar or dairy — can backfire. It can create digestive issues if you’re not used to eating that type of food regularly. So, what’s the alternative, and how do you stay on track? “We go for lifestyle changes,” explained Buehler, who consults with bariatric patients both pre- and post-surgery, depending on the patient’s insurance plan.


“We emphasize whole grains, fruits and vegetables, and encourage patients to remove high-fat and fried foods,” she said. “We don’t want patients to feel like they are depriving themselves.” Buehler advises patients who have had weight-loss surgery to avoid cheat meals for the first three to six months immediately after that surgery. “To avoid backsliding, they need to heal and to understand the plan,” she explained. The meal plan, for example, includes healthy snacks that are rich in protein, such as almonds, low-fat string cheese or plain Greek yogurt. “Protein takes longer to digest,” Buehler said. A healthy meal plan is safe not only for the patient, but also for the patient’s family. “It’s not restrictive, and the family can provide support by sharing the same meals,” she said. In addition, Buehler notes that preparing healthy meals has become less labor-intensive, with options like cauliflower rice, zoodles (zucchini noodles) and spaghetti squash readily available in the frozen food section of most supermarkets. ■ Visit Bayhealth.org/Nutrition to learn more about healthy eating.

Leading the way with new stent treatment for PVD If you’re among the more than 8 million nationwide who suffer from peripheral vascular disease (PVD) and need treatment close to home, there’s good news. Bayhealth Hospital, Kent Campus received early access to a new FDA-approved stent treatment that’s been shown to relieve pain, ulceration and decreased mobility that are often associated with PVD. When left untreated, it increases a person’s risk for heart attack and stroke, and can lead to leg amputation in the most severe cases, so early intervention is key.

by a buildup of fatty deposits in the arteries that restricts blood flow. Many experience the discomfort and difficulty walking caused by this common circulatory condition and don’t even know they have it. The first signs, including aches, cramps and fatigue when walking that typically go away with rest, and weakness or discoloration in the legs or feet, should be a trigger to see a doctor. People age 50 and older and those with high cholesterol, hypertension, heart disease, diabetes, and obesity are at greater risk of developing PVD.

The Eluvia stent system, produced by Boston Scientific, gradually releases a medication to the main arteries supplying blood to the legs and other extremities. Its clinical trials revealed superior results in treating leg blockages compared to similar products on the market. The Kent Campus is among only 50 hospitals in the U.S. and just five along the East Coast to have access to this cutting-edge device.

“Because of the muscles and bones in the legs, blockages there are traditionally harder to treat with stenting than are those in the heart. The improved technology of the Eluvia stent has a proven track record of providing relief from PVD symptoms and preventing further complications,” said Cardiovascular and Electrophysiology Lab Medical Director John Shuck, MD, of Bayhealth Cardiology Consultants. “We’re thrilled to have access to it to help countless patients with this condition.” ■

One in 20 Americans is estimated to have PVD, also known as peripheral artery disease (PAD), caused

Visit Bayhealth.org/Cardiovascular to learn more about Bayhealth’s heart and vascular services.


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Healthwaves Southern Edition Winter 2018  

Healthwaves Southern Edition Winter 2018  

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