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Why

Quality Matters Reconstructive breast surgery Eudora practice moves forward The importance of preventive medicine

Winter 2011


Quality Matters

Why

Thanks to Quality Matters, patients can now view exactly where LMH ranks nationally in its success with many procedures and aspects of patient care. When you or your family is receiving medical care, you want to know that you are at the best hospital around. Quality matters at Lawrence Memorial Hospital (LMH), and it shows in LMH’s pledge to communicate data about hospital quality to you — all day, every day. After years of commitment to continuous assessment and improvement of patient care, LMH launched the Quality Matters program, recognizing that quality health care results in outstanding patient care. To ensure that everyone has access to LMH’s rankings and Quality Matters program, a special Quality Matters section was added to the LMH website in April 2010. Now anyone seeking information about patient care at LMH, from patient safety instructions to national hospital rankings, can find it at lmh.org. “LMH was one of the first hospitals in the region to voluntarily publish its national rankings,” explains Karen Shumate, chief operating officer, noting that patients can

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now make more informed decisions by comparing the quality of care provided at each hospital. Within the Quality Matters area of lmh.org, patients can link to national quality reports, including the following: • Hospital Compare, a national data “warehouse” sponsored by the Centers for Medicare & Medicaid Services, details how hospitals nationwide manage patient care, providing reports on treatment of heart attacks, heart failure, pneumonia and surgery-related measures. Hospital Compare also provides a comparison of each hospital’s process of care with those of hospitals nationally and statewide. • Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reports on patient satisfaction, allowing the public to see how hospitals compare to each other with regard to patient satisfaction. Anyone facing a hospital visit can also use the information found at lmh.org to see how LMH compares nationally

Want to check how LMH compares with other hospitals? See www.lmh.org/quality matters.


in the area of patient safety. When people do their research, Karen knows what they will find: “We have an outstanding hospital right here in Lawrence.” As part of LMH’s commitment to providing the best care possible, physicians and the LMH administration have devoted years of hard work and research to become leaders in technology. Significant strides were made in 2010 with the implementation of the Computerized Physician Order Entry (CPOE) system. This innovative achievement has set LMH above other area hospitals. “Right now, only 3 percent of hospitals in the country have achieved this level of electronic integration,” Karen says, “and Lawrence Memorial is one of them.” CPOE allows physicians to submit patient orders electronically and provides them immediate access to information about national standards of care and recommended treatments. This cutting-edge system has resulted in patient care outcomes that are both standardized and predictable, as the opportunity for human error in medication administration has been virtually eliminated by automated communication and bar-coded administration check steps. Karen is quick to credit the leadership of LMH physicians as well as the Board of Trustees with their consistent focus on and support for quality patient care and safety, adding, “We are fortunate to have physicians and a board who all take personal interest in quality care at LMH.” “The Board of Trustees is very involved in maintaining the high quality of care provided at LMH,” Karen points out. “They thoroughly review quality reports, setting goals for each area of care and then holding medical and hospital leadership accountable for attaining those goals. As members of the community, they voluntarily dedicate their time and attention to all matters at LMH, helping make Lawrence Memorial a true community hospital.” This emphasis on quality care can be found throughout LMH. Large bulletin boards have been placed throughout the hospital that display information, data and quality care goals. Visitors and employees can track LMH’s progress in providing excellence at every point of health care. To learn more about LMH and valuable patient safety tips, visit lmh.org and click on “Quality Matters” along the lower left side of the home page.

www.lmh.org

Pharmacy residency program benefits LMH patients In its second year of existence, the Lawrence Memorial Hospital pharmacy residency program is already proving to be successful. Surveyors from the American Society of Health-System Pharmacists recently granted accreditation to the post-graduate program, says Karen Shumate, LMH chief operating officer. “We were very proud of how we did in the first year of this program, and the surveyors really made a point to tell me how exemplary the program is,” Karen says. “We were accredited on the spot, which is very atypical. It normally takes about eight to 12 months.”

Current LMH pharmacy residents Tyler Dieker and Amanda Dugal

Two pharmacists were selected from more than 30 applicants to enter the program, which consists of one year of intense clinical and didactic experiences. For this “privilege,” the residents are paid at a reduced salary that is partially subsidized through the Centers for Medicare & Medicaid Services.

“We try to tailor each resident pharmacist’s experience to what they need. That’s our goal, to get them to where they need to be career-wise,” Michael Bennett, LMH residency program director, says. The resident pharmacists get many opportunities to experience first-hand pharmacy practice in various patient settings at the hospital, Health Care Access and even globally through pharmacy practice teaching at Khon Kaen University in Thailand and a medical mission to Kenya, Africa. Not only is the program enriching for the resident pharmacists, but LMH and our patients also benefit from having two additional pharmacists. Michael says that allows time for more in-depth personalized care, and the research projects typically focus on improving quality or reducing cost. Karen says she agrees that having high-level post-graduate pharmacy residents raises the level of care that LMH provides. “Since the pharmacists in residency are just out of college, they really bring a fresh, new perspective and challenge our staff,” she says. “The program is a huge recruiting tool that helps us keep our quality of care high.” The new program also compares very favorably to those of other hospitals in the nation, Michael says. “We’re groundbreakers among regional care centers for our size,” he says. “Four other hospitals in Kansas use our model as a template to help develop their first residencies.”

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An

ounceof

prevention

The rising cost of health care has been a hot topic recently. Many people feel the price of health care is spiraling out of control. Unfortunately, the solution to the crisis is not an easy one. But many experts believe that prevention is one piece of the puzzle. Measures like screenings and regular preventive visits with a health care provider can save millions of dollars in medical costs, according to some. Others doubt the savings can be so significant. Still, it is easy to see that preventive measures can offer something even more important than monetary savings — improving the quality of life, helping ward off disease and, in some cases, even extending a person’s life. As a not-for-profit health care provider, Lawrence Memorial Hospital is actively involved in community wellness and disease prevention. The hospital has even gone so far as to outline this commitment in its strategic plan, which lays the foundation for the future plans of the hospital. In the plan LMH vows to lead wellness initiatives in collaboration with community partners. The hospital strives to meet this goal in a variety of ways — including prevention in the workplace, and education and preventive services for everyone.

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Prevention in the workplace The LMH Business Health Center offers a variety of health care services for local businesses. The center provides screenings, physicals and health education for employers of all sizes. The center also now supplies advanced registered nurse practitioners (ARNPs) in the workplace. This program encourages employee health and helps business owners reduce their insurance costs through a few easy steps: Step 1: Employers encourage employees to enroll in the wellness program, and may offer workers a reduced cost insurance premium. Step 2: Once enrolled in the program, the employee meets with a health care provider, generally a mid-level provider such as an ARNP or physician assistant to talk about the management of current health conditions, health screenings and making healthy lifestyle choices. The provider and the employee then devise a plan to maintain a healthy lifestyle or outline ways to improve the employee’s health.

Step 3: Periodically the employee and the provider meet to discuss the health plan and talk about the employee’s progress. The benefits of this program have proved to be outstanding for employees and employers alike: • Employee use of health screenings often increases by up to 150 percent; • Employees may receive a reduced health care premium; • Lost work time declines by up to 31 percent; • 81 percent of high-risk health conditions improve. For information about screenings, health care education or the LMH WellCare program, contact the Business Health Center at 785-505-3120.

Health education and preventive services LMH encourages community health and disease prevention by offering a wide variety of health education classes, seminars and support groups. The LMH community education department coordinates these free or low-cost services. Classes are held at LMH. Additionally, many of them may be offered on-site at service clubs, churches and businesses. Some of the most frequent offerings include the following: • Health seminars Presentations by physicians and/or LMH health care experts (topics vary) • Health screenings Bone density, cholesterol, blood pressure, blood glucose (sugar), body mass index and waist measurement • Safety classes and programs Child safety seat inspections, newborn safety, CPR • Prenatal and parenting classes Breastfeeding, prenatal care, babycare workshop, Tyke Hyke (sibling preparation) • Fitness programs Fit for 2 (a fitness program for expectant mothers), Fit for You (a postpartum exercise program), aquatics programs, Fit for Life, Get Your Joints Moving • Support groups Bereavement support group, breastfeeding and new parent support groups, Build Your Village (perinatal support group), diabetes education group, CLIMB® (Children’s Lives Include Moments of Bravery, for children who have family members with cancer), stroke support group For a full list of current education offerings, call ConnectCare at 785-749-5800, or click the Your Health and Education tab at lmh.org. For a listing of health education offerings available to church groups and parenting or service organizations, call 785-505-3066, e-mail Aynsley Anderson at aynsley.anderson@lmh.org or visit the News and Events area at lmh.org.

© iStockphoto.com/zonecreative

For current education offerings, call 785-749-5800 or click the Your Health and Education tab at lmh.org.


How LMH promotes employee health Employee health is close to home at LMH! In addition to providing a wide array of traditional benefits for its employees, LMH takes extra steps to encourage their health and wellness. For employees, the hospital offers the following: • Health club discounts • Free massages from massage therapy training schools • A respite (relaxation) room • New Directions (employee assistance program) • Health screenings • Flu shots • Health risk assessments

Preventive services: In the news The new Affordable Care Act that was signed into law in March 2010 requires many insurance providers to cover some very important preventive screenings. The Act includes a long list of services. Some of the preventive services covered for adults include cholesterol screenings, pregnancy-related services, immunizations and sexually transmitted infection prevention and education. The preventive measures parents can expect for their children vary by age. Some of these measures include autism screening, hearing, height and weight and body mass index evaluation. There are some important details you should know, according to Healthcare.gov: • The Act applies to people enrolled in job-related health plans or individual health insurance policies created after March 23, 2010. If you are enrolled in such a health plan, this provision will affect you as soon as your plan begins its first new “plan year” or “policy year” on or after September 23, 2010. • If your health plan uses a network of providers, be aware that health plans are required to provide these preventive services only through an in-network provider. Your health plan may allow you to receive these services from an out-of-network provider, but may charge you a fee. • Your doctor may provide a preventive service, such as a cholesterol screening test, as part of an office visit. Be aware that your plan can require you to pay some costs of the office visit if the preventive service is not the primary purpose of the visit, or if your doctor bills you for the preventive services separately from the office visit. • If you have questions about whether these new provisions apply to your plan, contact your insurer or plan administrator. For more information visit the News and Events section at lmh.org.

www.lmh.org

Eudora Medical Park to open this spring “This is great! I can see myself working right here,” exclaims Becky Earl, CMA, while standing in the middle of what will be the nurses station — amidst concrete and framework — during a recent tour of the new LMH Eudora Medical Park. After several years of development and anticipation and many months of construction, Eudora Family Care is moving from downtown Eudora to a brand-new, state-of-the art facility southeast of Kansas Highway 10 and Church Street this spring. Becky is not alone in her enthusiasm as the rest of the Eudora Family Care staff take in their future home. Daniel Dickerson, MD, who joined Eudora Family Care in 2002 and had a hand in the planning and design of the building, eagerly awaits its completion. “We are excited to move forward with the new building,” Dr. Dickerson says, strolling brighteyed from room to room as he checks out the progress construction crews have made. “It is such a strong addition to the city and to surrounding communities.” The 10,000-square-foot, multifaceted building will be home to Eudora Family Care and onsite outpatient physical therapy with LMH Eudora Therapy Services. Eudora Medical Park will also lease space to Byrne’s Pharmacy, currently located in downtown Eudora next to Eudora Family Care. Eudora Family Care will continue to offer the same services, including laboratory services currently available at the 10th Street location, and maintain the same electronic medical records system and Monday-through-Friday hours. But the new facility, with approximately 6,000 more square feet of medical office space, will allow for an increased number of exam and procedure rooms, more clinical space and new radiological services. Dr. Dickerson, who has been the sole physician at Eudora Family Care ever since Kenneth Holladay, MD, retired in 2004, not only looks forward to working in a new building in 2011, but with a new partner too. Elizabeth Stamper, DO, joined the practice in December 2010 after completing her family practice residency in Augusta, Ga. A native of Lenexa, Dr. Stamper is happy to be back in the Midwest in a new facility designed specifically for a growing family practice. This increase in both physical space and medical staff reflects the significant growth Eudora has seen in the last decade. The city’s population swelled from 4,300 in 2000 to just over 6,200 in 2009, a growth rate of 45%. It is with this trend in mind that LMH designed the facility with enough room for up to two more physicians to join Dr. Dickerson and Dr. Stamper as Eudora continues to grow. Eudora Medical Park will open 50 years after Dr. Holladay first started his practice in Eudora. It’s a fitting golden anniversary tribute to a legacy of compassionate care, as Dr. Dickerson and his staff look forward to treating families in a facility that can match the high quality of medical care that has been provided in Eudora for the past five decades.

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Reconstructive surgery A next step for breast cancer survivors Patients, staff and physicians tend to agree that Lawrence is home to some of the region’s best breast cancer specialists. Outstanding chemotherapy, radiation therapy and surgery options are available right here in our community. Breast cancer patients also have access to another important group of experts in the treatment and recovery process: plastic surgeons. Many women choose to have some form of breast reconstruction done during or after treatment, and many of them choose to have their surgery done by the physicians at Lawrence Plastic Surgery. In addition to traditional cosmetic surgery work, Scott Thellman, MD, and his partner John Keller, MD, have served breast cancer survivors in Lawrence and the region for 16 years. They treat women ranging in age from their 20s to 70-plus, and average about 100 breast reconstruction surgeries in a year. Nearly half of the women travel from outside Lawrence to receive care.

Why have reconstructive surgery? For most women, the answer is simple. “They just want to feel whole again,” says Dr. Thellman. Jan Pratt, a Lawrence Plastic Surgery patient who lives in Topeka, agrees with his assessment. Breast reconstruction for her wasn’t about vanity. “For me, it wasn’t about looking pretty,” she commented. “It was about empowering myself and choosing to travel a positive path to wholeness again.”

Breast reconstruction options Lawrence Plastic Surgery offers three types of plastic surgery for women who have suffered from breast cancer. Implant procedures | With this option, the plastic surgeon implants a tissue expander into the breast cavity to stretch the skin slowly and make room for a breast implant. Once the skin has adequately expanded, a breast

implant is put in place of the expander. This option is popular for many women and often involves a shorter surgery and expedited recovery time, compared with the other types of surgery. Tissue flap procedures | The second type of surgery involves harvesting skin and muscle from the belly or the back to replace the breast tissue. This option usually involves a longer recovery time but can produce a more natural feel. It also tends to stand up to the test of time because the repositioned tissue is able to expand and shrink naturally with the woman’s body. Corrective surgery | The third option is corrective surgery, most often on the unaffected breast. This procedure is popular for women who have undergone lumpectomy, the partial removal of a breast to remove cancerous tissue, or mastectomy, the complete removal of a breast. In some cases this option can completely eliminate the need for

One woman’s story

Even though cancer treatment and an infection left a concave area in her breast, Jan Pratt never considered breast reconstruction. “I was so grateful to have been a candidate for cancer treatment that it wasn’t difficult for me to accept the physical defect that it created,” she says. But after her oncologist and general surgeon commented on her breast appearance and told her about the options for plastic surgery, she decided to visit Dr. Keller at Lawrence Plastic Surgery. “I immediately felt a warm, safe place to land,” Jan remembers. “I left that appointment feeling enthusiastic and excited knowing they would help me get myself back.”

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www.lmh.org


a prosthetic by reducing the size of the other breast to match that of the affected breast. Reducing the size of the unaffected side allows many of these women to wear a much smaller and more comfortable prosthetic. Determining the best option is based on a variety of medical factors and on individual preference. In some cases breast reconstruction surgery is done while the patient is undergoing a mastectomy. Other patients opt to wait until cancer treatment is complete to undergo reconstruction. Dr. Keller and Dr. Thellman say they find breast reconstruction after breast cancer to be some of the most rewarding work they do. The physicians credit their outstanding staff and the phenomenal medical community with their success. “We are a product of our environment,” says Dr. Keller. “We are very blessed to work with great nurses and staff and an exceptional medical community.”

About the tumor conference For new breast cancer diagnoses, a team of radiologists, surgeons, plastic surgeons, medical and radiation oncologists, pathologists, primary care physicians and nurses meet to discuss the best treatment options for the patient. This benefits patients in a variety of ways. When breast reconstruction is concerned, for example, the tumor conference allows the plastic surgeon to be aware of the whole process and to offer input. For example, if a woman knows she is going to have reconstructive breast surgery, the physicians are able to discuss the best way to incorporate this into her treatment. The general surgeon and the plastic surgeon can then discuss the placement of incisions during the mastectomy or lumpectomy. Collaborating helps improve the outcome of breast reconstruction.

During Jan’s procedure at Lawrence Memorial Hospital, Dr. Keller removed tissue from her abdomen and used it to reconstruct the affected breast, giving her a flatter tummy and a new breast. When she woke from surgery, she was overwhelmed by the positive outcome. Jan remembers this as a beautiful, tearful moment. “I was completely speechless as I looked up from the hospital bed and saw my two angels, Dr. Keller and his nurse, Vonda,” she says. “Not only did I have a beautifully reconstructed breast, I had a flat stomach and I felt healthy again. It was the first time since the cancer diagnosis that I felt like I was regaining myself.”

Lawrence Plastic Surgery 1112 W. 6th Street, Suite 210 (785) 843-7677 lawrenceplasticsurgery.com John Keller, MD, and Scott Thellman, MD of Lawrence Plastic Surgery

Jan raves about the physicians and staff at Lawrence Plastic Surgery and says her experience at LMH was also wonderful. Jan, who lives in Topeka, says she felt so comfortable receiving care in Lawrence that she chooses to schedule her cancer follow-up appointments at the LMH Oncology Center. Jan encourages all women who have had breast cancer to explore the option of reconstructive surgery. She believes that women should embrace their womanhood and take the opportunity to restore what cancer has taken away. “They don’t have to accept what breast cancer has handed them. It isn’t selfish or just about looking good,” Jan says. “It is about looking healthy and whole, and feeling healthier generally means you are healthier.”

Reach Lawrence Plastic Surgery at 785-843-7677 or see lawrenceplasticsurgery.com.

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325 Maine Street Lawrence, KS 66044

Healthy Hearts Fair

LMHEA Annual Meeting

Saturday, February 12 | 8-10:30 a.m. (blood work available 7:30-10 a.m.) February is heart month! Join us for screenings and information about cardiovascular disease prevention and treatment. Full cholesterol panels will be offered for $25 ($20 if registered by February 4); overnight fast required. Free screenings include BMI, waist measurement, blood pressure, and heart attack and stroke risk appraisals. For more information or to register for blood work, see lmh.org or call 785-505-6179 to request a form be mailed to you.

DocTalk Michelle Affield, MD Michelle Affield, MD, has joined the LMH Oncology/Hematology Center. She graduated with distinction from Benedictine College in Atchison with a degree in biology and completed medical school at the University of Kansas. Dr. Affield completed an internship in internal medicine at the University of Wisconsin and an internal medicine residency at the University of Kansas. She is a member of the American Society of Hematology, American Society of Clinical Oncology and the American Association of Hospice and Palliative Medicine. She is board certified in hospice and palliative medicine. Dr. Affield and her husband, Kerry, have two children. She enjoys reading, camping, listening to music and spending time with family and friends.

Thursday, January 27 4:30-6:30 p.m. at Maceli’s

Register to attend at the newly redesigned lmhendowment.org.

Elizabeth Stamper, DO Elizabeth Stamper, DO, is joining Eudora Family Care. She graduated from Kansas State University with a bachelor’s degree in biology and completed her medical degree at Des Moines University College of Osteopathic Medicine. She is certified in Advanced Cardiac Life Support and Pediatric Advanced Life Support and is a member of the American Osteopathic Association. Dr. Stamper enjoys spending time with her family, reading, watching movies and listening to music. She and her husband, Erik, have a 2-year-old son and are expecting a baby in March.

Ervin Eaker, MD Ervin Eaker, MD, has joined Lawrence GI Consultants and is seeing patients at Lawrence Specialty Care in Ottawa. He graduated with a bachelor’s degree in chemistry from Emory University and earned his medical degree from the University of Miami. He completed a fellowship in motility disorders at the University of Florida. He is a member of the American College of Gastroenterology and has served as a professor of medicine at the University of Kansas School of Medicine. Dr. Eaker and his wife, Mary Elizabeth, have three children.

connect is published by Lawrence Memorial Hospital. The information in this newsletter is intended to educate readers about subjects pertinent to their health and is not a substitute for consultation with a personal physician. To have your name added to or removed from this mailing list, please call 785-505-3315.

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Gene Meyer | President and CEO, Lawrence Memorial Hospital Editorial Board | Kathy Clausing Willis, Sherri Vaughn, MD, Janice Early, Heather Ackerly

Lawrence Memorial Hospital • 325 Maine Street • Lawrence, KS 66044 • 785-505-5000 • www.lmh.org


Connect Winter 2011