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Carondelet Health Network A New Vision of Healthcare

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We have to take up the charge of the health and well-being of our community if we are to have an impact on the national cost of care. Jim Beckmann President & CEO Carondelet Health Network –

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-Being A New Vision for Healthcare

Carondelet Health Network, a pioneer in Southern Arizona healthcare, is building an innovative system of wellbeing designed to create a healthier community while reducing skyrocketing medical costs. At the heart of this evolution is a new health management philosophy – launched with the “Be Well” brand last year – that sets aside the traditional way of doing things and integrates a holistic approach to community care. Defined as “population health management,” the new approach provides the ability to keep healthy people well, identify and “course correct” those who may be at risk, better manage those who are chronically ill and work to eliminate gaps in care. As Jim Beckmann, president and CEO of Carondelet Health Network put it, even as the Affordable Care Act

has been driving dialogue about the need to address healthcare reform, Carondelet leadership believes that real change needs to begin within the industry. “We’re excited to be participating in one of the greatest opportunities of our time,” Beckmann said of the new philosophy. The history of Carondelet in Tucson dates back to the 19th century, when the Catholic Sisters of St. Joseph of Carondelet opened St. Mary’s Hospital in 1880. Today, with nearly 30 facilities and medical offices throughout Southern Arizona, Carondelet is the leading provider of healthcare services, serving a community of more than 1 million residents and employing more than 4,000. From Tucson to Nogales, the region’s 12th largest employer is investing millions of dollars in resources, technology

and innovative medical procedures – all designed to provide for the health and well-being of Southern Arizonans while raising the standard of care. Carondelet St. Mary’s Hospital has been revitalized as part of the investment, and is now home to the Carondelet Heart & Vascular Institute. Carondelet St. Joseph’s Hospital has been the focus of growth and expansion, and ground has been broken on the new Carondelet Health & Wellness Pavilion in Sahuarita. To develop its population health management approach, Carondelet is currently partnering with Healthways, a global leader in providing well-being improvement solutions that focus on this comprehensive model of care. It begins with an assessment of what’s needed to meet Carondelet’s goals and continued on page 122 >>>

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By Mary Minor Davis

Carondelet St. Joseph’s Hospital



Carondelet St. Mary’s Hospital

Carondelet Holy Cross Hospital

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Changing the paradigm happens one person at a time – with the right social networks around them – with a strong base of primary care physicians to lead the effort.

– Chris Castellano Executive VP & Chief Strategy Officer, Carondelet Health Network

continued from page 121 ends with primary care physicians working in tandem with their patients, other physicians, specialists and the patients’ extended community to ensure comprehensive care and well-being that will transition care from “volume” to “value.” Traditionally, healthcare has been delivered in a kind of silo system, with the primary care physician identifying medical conditions and then referring the patient to specialists. Carondelet is removing those silos with this holistic approach, which takes into consideration all aspects of a person’s well-being – including financial, mental and physical – combined with the biometrics of the individual. “With this information, we can then stratify individuals within the population into three main groups,” explained Dr. Donald Denmark, Carondelet’s senior VP and chief medical officer. “The ‘at-risk’ group will, over time, drive costs, but studies have proven that intervention can help,” he added. “For individuals with chronic disease you employ intervention tactics focused on aggressive care management.” Chris Castellano, executive VP and chief strategy officer for Carondelet, added, “For example, patients most often come to the St. Mary’s emergency room with stomach pain or dental pain. These issues can often be prevented or managed if people build trusting, valued relationships with a primary care provider or specialist. Without that opportunity for intervention and management, those with chronic disease turn to ERs once their condition has worsened continued on page 124 >>>

Tuberculosis Sanatorium, 1900s

St. Mary’s Hospital, 1887

Seven Sisters of St. Joseph of Carondelet

St. Mary’s School of Nursing, 1914

St. Mary’s Hospital, 1955


By Gabrielle Fimbres In 1870, a group of seven Catholic Sisters from Missouri bravely set out on a mission to the untamed West to care for the people of Tucson. The Sisters of St. Joseph of Carondelet – a congregation established in France in 1650 – were asked by the bishop of Tucson to leave their home in Carondelet, Missouri to teach in the barrios of Tucson and at Mission San Xavier del Bac. The journey lasted a month as the Sisters traveled by train, ship and covered wagon. They were greeted at Picacho Peak by soldiers, who provided them safe passage into town. On May 26, 1870, the Sisters arrived in Tucson, a town of a little over 3,000 souls. They were welcomed with celebrations and a fireworks display, and soon set up schools. A decade later, responding to the

needs of the injured workers of the Southern Pacific railroad’s westward expansion, they were asked by the bishop to open Arizona’s first continuously operating hospital – St. Mary’s. The 12-bed hospital was built in collaboration with the Tohono O’odham tribe, who helped the Sisters build the little hospital from rocks and boulders. St. Mary’s cared for its first patients on May 1, 1880. Today, 143 years after their journey to Tucson, the Sisters of St. Joseph of Carondelet continue to care for the people of Southern Arizona. Sister Irma Odabashian, a patient advocate at St. Mary’s, said the mission of the Sisters remains strong. “Our existence continues to be driven by the needs of the people we serve, which is our way of responding to the mission of Jesus – he taught, he healed,

he counseled, he loved,” said Sister Odabashian, one of eight Sisters of St. Joseph of Carondelet living in Tucson. The Sisters have led the transformation from a small hospital on Tucson’s west side to the modern day Carondelet Health Network. They have overseen the growth of St. Mary’s, the addition of St. Joseph’s Hospital in 1961, Holy Cross Hospital in Nogales in 1981 and the many areas of specialization that thrive today. “We are still growing, and it’s very exciting,” Sister Odabashian said. “We are deeply immersed in the community of Southern Arizona. The needs of the people of Southern Arizona will continue to direct our future growth. We continue to embrace courageously and with a strong faith the direction that current changes require of us in order to have a strong future.”

For a complete history of the Sisters of St. Joseph of Carondelet in Tucson, go to

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BizHEALTHCARE Evaluating Our Well-Being Carondelet Health Network is partnering with Healthways in building an innovative system of well-being, based on information garnered about Southern Arizona residents in the Gallup-Healthways Well-Being Index. We turned to Healthways’ CEO Mike Farris for details.

is the Gallup-Healthways Q: What Well-Being Index?

The Gallup-Healthways Well-Being Index was developed to establish official statistics on the state of wellbeing in the United States and globally. It is the first-ever daily assessment of U.S. residents’ well-being, and was developed by scientists at Gallup and Healthways. By interviewing at least 500 U.S. adults every day, the Well-Being Index provides real-time measurement and insights needed to improve well-being, increase performance and productivity, and lower healthcare costs. There are more than 1.8 million completed surveys since inception in 2008, making this the world’s largest data set on well-being.

does it work? Q: How The survey covers topics such as emotional health, life evaluation, physical health, healthy behavior, work environment and basic access. The methodology relies on live interviewers conducting telephone interviews with randomly sampled respondents ages 18 and older. Location data allows researchers to map the responses.

does information collected Q: How benefit communities?

The information can be used to inform leaders about the well-being of their communities. Leaders can compare their community and population to other communities and populations across the country. They can use this information to identify opportunities for well-being improvement, which has a direct impact on increasing performance and lowering healthcare costs.

can Tucson take away? Q: What The Well-Being Index provides government officials,

business leaders and residents of Tucson with the opportunity to measure their current level of well-being relative to other cities. Carondelet’s partnership with Healthways enables leaders to create an action plan for improving well-being and execute programs to improve Tucson’s well-being.

is the value of increasing a Q: What population’s well-being?

Our research shows that a 1 point difference in wellbeing equates to a 1 percent difference in healthcare costs, a 2.2 percent difference in likelihood of hospital admission and a 1.7 percent difference in the likelihood of being admitted to the emergency room. Research also indicates that well-being change is a statistically significant predictor of change in many valuable areas including individual productivity, unscheduled absences and retention/turnover rates.

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I’ve been a physician on staff at Carondelet for over 20 years. We’re all very proud of this new direction we’re taking. –

Dr. Amy Beiter, President & CEO, St. Mary’s Hospital

continued from page 122 to a point where a higher level of care feels like their only option.” A trip to the ER is far more costly than preventive care. Under the new Carondelet/Healthways model, the value of care will be improved, reducing the number of treatable conditions entering the ER by boosting care before conditions become emergencies. Healthcare costs today are $2.5 trillion – making up 18 percent of the gross domestic product, Beckmann said. “As professionals, we have to take up the charge of the health and well-being of our community if we are to have an impact on the national cost of care,” he said. A key element of community health management is that it is built around a team concept. Physicians, specialists, clinicians, social service organizations, family members, employers and patients themselves all play a role in making the model successful. The Healthways model promotes engagement at all levels, providing individuals with simple, fun tools that encourage active participation in and personal accountability for the management of one’s health and well-being. “Engagement is the result of motivation, inspiration,” Castellano said. “Changing the paradigm happens one person at a time – with the right social networks around them – with a strong base of primary care physicians to lead the effort.” Beckmann and his team recognize that it will take time to implement this change, both from the patient and the physician standpoint. Many Carondelet stakeholders and community members across Southern Arizona have already participated in the assessment, and Carondelet is implementing the program first within its own internal community of more than 4,000 employees. The organization has set a goal of a 5 percent improvement in the overall health condition within its own organization in 12 months – primarily among employees with chronic illnesses – as well as a decrease in employee absenteeism due to sick leave. Healthways claims increasing the well-being of a population – like a company’s employee base – can increase productivity, reduce absenteeism and improve job performance. “In the end it will require each individual and family to take action for their health,” Beckmann added. “That’s why this is going to take time, and the investment is significant – but the results will be also.” The energy that the program has generated is palpable when talking to physicians about the new approach. “I’ve been a physician on staff at Carondelet for over 20 years,” said Dr. Amy Beiter, president and CEO of St. Mary’s Hospital. “We’re all very proud of this new direction we’re taking.” Beckmann said the new philosophy is in line with the mission of the Sisters of St. Joseph of Carondelet to serve “every dear neighbor with dignity and respect.” “We are fortunate in that we are grounded in the history of the Sisters,” he said. “This gives us a sense of purpose, greater than just being part of the medical community. We are able to maintain the legacy and mission of the Sisters, not only for today, but well into our community’s future.” Biz

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Faces of Carondelet

Since 1880, Carondelet has provided compassionate healthcare to Southern Arizonans. Today, the Carondelet Health Network team of more than 5,000 employees and physician partners carries on the mission of improving the well-being of the community and providing the latest in technology in nearly 30 locations throughout


Southern Arizona.

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From left – Dr. Amy Beiter, President & CEO, Carondelet St. Mary’s Hospital; Debbie Knapheide, VP, COO & Chief Nursing Officer, Carondelet Holy Cross Hospital; Chris Castellano, Executive VP & Chief Strategy Officer and Tawnya Tretschok, VP, Physician Practices.

Driving Force in Four women are driving the growth of Carondelet Health Network along the Interstate 19 corridor, from Tucson’s west side to the U.S.-Mexico border in Nogales. From the growing and reinvigorated Carondelet St. Mary’s Hospital in Tucson to Carondelet Holy Cross Hospital in Nogales, Ariz. – and everything in between – Carondelet is providing a broad scope of healthcare specialties to address a wide range of needs among a diverse population. Guiding the strategic roadmap between Tucson and Nogales is Chris Castellano, Carondelet’s executive VP and chief strategy officer.

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Joining her are:

Amy Beiter, president and CEO • Dr. of St. Mary’s Knapheide, VP, COO and • Debbie chief nursing officer at Holy Cross Tretschok, VP of physician • Tawnya practices

They carry on the work of the seven Sisters of St. Joseph of Carondelet, who arrived in Tucson in 1870 with the mission of educating and caring for our residents. Castellano joined Carondelet in 2012, bringing with her 25 years in healthcare leadership in Tucson. She is inspired by the new vision of care developed by

Carondelet leaders working closely with her. “The current complexities in the healthcare ecosystem create bold and exciting new opportunities for all of us,” Castellano said. “If you look at growth patterns in Tucson and along the path of I-19 and combine that with St. Mary’s location, we see a synergy that creates the opportunity to view things differently.” St. Mary’s, which has undergone $20 million in recent improvements – inside and out – is now home to Carondelet’s Heart & Vascular Institute. Among the Tucson companies behind the growth are Chestnut Construction and Diversified Design & Construction.

Never have I been more excited about our direction than I am today. – <<<

Fall 2013

Dr. Amy Beiter, President & CEO, St. Mary’s Hospital


Healthcare By Mary Minor Davis

Of the 73 primary care physicians in the Carondelet network, 23 work along the I-19 corridor. Additionally, Carondelet specialists make “house calls” – in a way. They often drive to the system’s medical practices in Green Valley and Nogales – and soon to Sahuarita – to see patients close to home. Tretschok, one of the newer mem­ bers of the Carondelet team, said the concept of bringing specialists into local communities provides convenience for residents who can’t make the drive to Tucson regularly. That synergy is tied to the growth

and expansion that exists in the neighborhoods as you drive south. Carondelet Medical Mall at Green Valley, Holy Cross in Nogales and the network’s newest facility, soon to be constructed in Sahuarita, provide a connection that extends from Tucson to the border. The $6.5 million Carondelet Health & Wellness Pavilion in Sahuarita is scheduled to open in late 2014. The 14,000-square-foot, state-of-the-art facility will celebrate the region and its heritage with a nod to the 17th century Spanish Colonial architecture that once dotted the landscape.

Carondelet contracted with FreemanWhite and Diversified Design and Construction to build the facility. Construction is set to begin in January 2014, with completion in November 2014. Features of the pavilion include:

• A

lobby with a glass-enclosed children’s playroom, family waiting room and a separate waiting area for individuals looking for a quieter environment.

• 27 exam rooms • Nine physicians specializing in internal and family medicine and pediatrics

• Visiting specialists • Mobile imaging onsite

continued on page 130 >>>

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BizHEALTHCARE continued from page 129 The expansion provides access to the newest advancements in medical technology. “Collectively, we can incorporate this technology into the healthcare delivery system,” which in turn provides quality care with lower risk and shorter hospital stays, fewer emergency room visits and reduction in healthcare costs, Tretschok said.

Carondelet also partners with organizations along I-19 in collaborative opportunities to educate and raise awareness of health issues with residents. Clinicians hold educational health seminars in Rancho Sahuarita. The network will be collaborating with Sahuarita Unified School District to provide students with hands-on career shadowing opportunities. Carondelet sponsors summer camps for kids, kindness initiatives and programs including Walk with

a Doc. These programs are all aimed at increasing the community’s well-being holistically – body, mind and spirit. Knapheide manages the “very, very busy” Holy Cross Hospital. With St. Mary’s being the closest hospital to Nogales – 66 miles to the north – Knapheide said providing community care in Santa Cruz County is crucial. Diabetes education and management, obstetrics and gynecology, plus continued on page 132 >>>

Heart & Soul of St. Mary’s By Mary Minor Davis As part of Carondelet Health Network’s approach to holistic community care, the Carondelet Heart & Vascular Institute has moved into the network’s legacy facility, St. Mary’s Hospital. About $17 million in renovations to the interior of the hospital have resulted in the creation of the institute known as CHVI – 96,000 square feet dedicated to patients seeking the latest in cardiac and vascular care. The new facility features some of the latest in technology and tools, including resources to enhance minimally invasive cardiac and vascular surgical procedures and support scientific research undertaken by many of Carondelet’s nationally recognized heart and vascular specialists. A dedicated cardiovascular intensive care unit, a specially appointed hospital wing with all private rooms, outpatient cardiac rehabilitative services, new operating suites, catheterization labs for electrophysiology procedures and a noninvasive cardiac testing area are some of the amenities that offer comprehensive support, ensuring the highest quality in care, according to Carondelet administrators and physician leaders. In addition to providing the newest technologies, CHVI’s location within St. Mary’s Hospital provides greater access from Interstates 10 and 19, helicopter access for emergencies and room to grow. One of the most advanced features is the addition of a 1,000-square-foot hybrid operating room, supporting the ability of surgeons and cardiologists to perform the latest in minimally invasive cardiovascular procedures. Dr. Derek von Haag, medical director of cardiothoracic surgery at CHVI, 130 BizTucson


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is a leader in minimally invasive cardiac surgery. He notes that there are many unique aspects of the new hybrid OR, particularly live audio/video streaming capability, which allow other physicians to remotely observe surgeries and learn more about these advanced procedures from CHVI specialists. According to von Haag, this makes the institute a “major destination for cardiac care,” not only for patients, but also physicians. “Our goal is to teach other physicians around the country what is possible,” von Haag said.

Did you know? The Carondelet Heart & Vascular Institute, while far more sophisticated, is a return to Carondelet’s cardiovascular and cardiothoracic pioneering roots. In 1959, St. Mary’s was the first hospital in Arizona to perform open heart surgery, and the first hospital in the state to use a heart-lung machine. St. Mary’s implanted Tucson’s first pacemaker in 1960. Dr. Scott Berman is medical director of vascular surgery at CHVI. He has been at the forefront of vascular surgery in Southern Arizona since the mid-1990s. He began the first minimally invasive endovascular program in the area, and his commitment has resulted in new procedures for patients with vascular disease. In 2000, Berman’s practice – Tucson Vascular Surgery – and St. Mary’s Hospital performed Southern Arizona’s first endovascular stent graft for abdominal aortic aneurysm repair. In 2006, he placed the first endovascular stent graft

for the treatment of thoracic aneurysm disease. While more minimally invasive vascular procedures are being conducted in the United States, fewer than 10 percent of vascular surgeons perform them, and not all of the time. “There is nothing more satisfying than seeing a patient walking, eating a regular diet and being discharged home on the first day after a procedure,” Berman said. “This is in stark contrast to traditional open surgery that would require days in the intensive care unit, a week in the hospital and months for full recovery.” Today, Berman and von Haag are part of Carondelet Heart & Vascular Institute Physicians, a local medical practice that employs cardiologists, cardiothoracic surgeons and vascular surgeons. A practice that employs an array of specialists working side by side and consulting with one another about cases is unique in Tucson. The goal is to provide patients with a comprehensive “team approach” to their care. Stanley Curd was the first patient at the new CHVI. Curd lived with a prolapsed mitral valve for years until his cardiologist, Dr. Kirk Gavlick, highly recommended that Curd see von Haag for a valve repair. In November 2012, Curd underwent a minimally invasive procedure that required only a 3-inch incision. He experienced a shorter length of stay and three weeks later, he was walking two miles. Within a month, the 72-year-old was back at the gym, working up to his regular two-hour workout regimen. “I was really impressed with both of my doctors,” Curd said of his experience.


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The Breast Center at St. Mary’s

The Breast Center at Carondelet St. Mary’s helps set the revitalized hospital apart by providing comprehensive breast care to Southern Arizonans. The center is a multi-disciplinary, integrated group of independent radiologists, pathologists, medical and radiation oncologists and breast surgeons whose focus is the prevention, early detection and prompt treatment of breast disease. A patient navigator, experienced in breast health education, helps guide patients who have been diagnosed with breast cancer. “We encompass the whole scope of breast disease and – more specifically – breast cancer,” said Dr. Gerlinde Tynan, medical director of The Breast Center and the Breast Health Program at St. Mary’s. “Everything from the screening mammogram through biopsy, surgery to chemotherapy and radiation treatment, support groups and educational resources is handled under our auspices,” Tynan added. The Breast Center opened in 2012, the same year that the National Cancer Institute estimated there were 229,060 new cases of breast cancer diagnosed in the United States, with 3,400 in Arizona. Imaging services are offered onsite, including digital mammography, breast ultrasound, bone densitometry, breast MRI and interventional breast procedures – stereotactic, ultrasound and MRI-guided breast biopsy. The Breast Center is unique in Southern Arizona in its use of high-tech imaging software, said Radiologist said Dr. Christopher Reed, radiologist. Physicians also offer patients the latest technology in treatment options including 5-day brachytherapy radiation, genetic testing, immediate breast reconstruction, cryoablation of fibroadenomas and participation in clinical trials. Also setting The Breast Center apart is the speed with which patients proceed from initial screening to follow-up treatment – usually 2 to 3 days between screening, diagnostic workup and surgical consult appointments. Each new cancer case is presented during a weekly conference and a custom treatment plan is created by the team of doctors. “Like any other area in medicine, we have patients asking, ‘Are you going to tell this to my doctor?’ The thing about The Breast Center is all your doctors are already there. The radiologist, the pathologist, the oncologist – we’re all familiar with your records,” said Dr. Robert Gin, a radiation oncologist. “It’s a team approach. Everything is integrated.”


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Adapting and creating our new future is one way to honor our 133year legacy in this community. – Chris Castellano Executive VP & Chief Strategy Officer Carondelet Health Network

continued from page 130 emergency services make up the bulk of patient care. Under the proactive team approach, Knapheide said the full continuum of care – primary care, acute care and chronic care management – will keep the community healthier. “It’s amazing how we’ve already turned a lot of the business (at Holy Cross) from inpatient to outpatient treatment,” Knapheide said. Outpatient care is less expensive and more appealing for patients who can recuperate in their own homes. “We have a patient-centric vision of identifying what our patients need and then defining what we need to do as a team to provide for those needs,” she said. As the longest serving executive leader with Carondelet, Beiter, with 20 years of service at St. Mary’s, has seen tremendous change in local healthcare. “Never have I been more excited about our direction than I am today,” she said. Watching a traditional healthcare practice move from operating in “silos” to the holistic, community-wide approach is “the right thing to do,” Beiter added. “The focus is now on the value of the care provided, as opposed to the volume a hospital produces – from volume to value,” she said. “Patient-centric care will bring tremendous benefits.” She cites the multi-disciplinary team approach that will provide one-stop service. She gave the example of The Breast Center at Carondelet St. Mary’s – a physician-led program in which doctors from across the breast cancer continuum are working in tandem to support the needs of each patient. There’s no disconnect from screening to survivorship for breast cancer patients, she said. Similar approaches are also in place at Carondelet Heart & Vascular Institute and Carondelet Neurological Institute at St. Joseph’s Hospital. If passion and excitement are prescriptions for success, these women who stand at the forefront of Carondelet’s approach to community care will ensure that success is reached. They each said Carondelet’s innovation has reinvigorated their personal commitment to healthcare and renewed their dedication to the patients and the communities they serve. Beiter said the approach “reflects the heart and the quality of care on the part of everyone at Carondelet. It’s an outward demonstration of what we’ve always known. We are all proud of the direction we’re taking.” Said Castellano, “Our values, vision and mission set the context and provide fertile ground for innovation. Adapting and creating our new future is one way to honor our 133-year legacy in this community.”


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Dr. Robert P. Goldfarb, Consulting Neurosurgeon & Chairman, Carondelet Neurological Institute

Dr. Eric P. Sipos Neurosurgeon & Medical Director Carondelet Neurological Institute

From left – St. Joseph’s President & CEO Tony Fonze and Dr. Donald M. Denmark, Chief Medical Officer at St. Joseph’s Hospital & VP for Carondelet Health Network

Rehabilitation Pool at St. Joseph’s Hospital

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Labor & Delivery and Couple Care offered at St. Joseph’s Hospital Women’s


Patient-first Philosophy at St. Joseph’s By Dan Sorenson


We’ve all heard that healthcare is going to change dramatically in the next few years. At Carondelet St. Joseph’s Hospital, it already has. Patients are seen as customers, consumers with a choice. Hospital administration and staff want to keep these paying patrons happy – as happy as one can be when in need of a hospital. To pull that off, St. Joseph’s President and CEO Tony Fonze says that patientfirst philosophy has to run deep throughout the culture of the hospital. “A hospital is really like a little city, and you have many of the same services, problems and issues that a city would have,” Fonze said. “We have facilities that we have to manage, environmental services, very extensive food and restaurant services, security – except the population of our city consists of people who are often in a very vulnerable, frightened and sometimes dangerous part in their lives.” Besides this patient-as-consumer philosophy, Fonze reels off a list of “products and services” to back up this new version of St. Joseph’s – dedicated

state-of-the-art units, including the new Joint Replacement Center, Carondelet Neurological Institute and the Women’s Care Pavilion – with a neonatal intensive care unit, as well as robotic surgery suites. Also included are a regional eye center and the O’Reilly Care Center for behavioral health. Fonze has what could only be called an interesting resume, with career stops as a Grand Canyon helicopter pilot and a software business executive before landing in healthcare. Along the way, Fonze said he picked up a style that recognizes service as a product and the customer as a consumer with a choice. He and Dr. Donald M. Denmark, chief medical officer at St. Joseph’s and a senior VP for Carondelet Health Network, present this approach as a natural evolution, something that just makes sense both in terms of the quality of healthcare and as a way to do business. “Doctors understand that this is more of a competitive market than it has ever been and that we have to accommodate our customer base,” Fonze added. continued on page 136 >>>

A hospital is really like a little city… except the population of our city consists of people who are often in a very vulnerable, frightened and sometimes dangerous part in their lives.

– Tony Fonze, President & CEO Carondelet St. Joseph’s Hospital

New Chapel

Place of Healing At the heart of Carondelet St. Joseph’s Hospital is a serene spot where families and patients can go to find peace and give thanks. After years of fundraising and months of construction, the Fred & Olga Pace Spiritual Center at St. Joseph’s Hospital opened in April 2013, featuring a healing garden, spaces for quiet reflection and the centerpiece – the hospital chapel. “The chapel and the spiritual center offer us all a very special place where we can rejoice and be thankful for the wonderful things that happen in our lives – but also we can find consolation and peace during times of confusion and loss,” said Tony Fonze, president and CEO of St. Joseph’s. The spiritual center and chapel, built by W.E. O’Neil Construction Company and designed by Swaim Associates Architects, were made possible by private donations from the community and fundraising efforts by Carondelet Foundation. Most of the windows were salvaged from the hospital’s last chapel – which was built in 1984 – and restored by the original artist, Mary Myers. Only the meditation room window is new, and was designed and fabricated by Myers along with stained glass artist Teresa Karjalainen. Biz Fall 2013 > > > BizTucson 135


Program Coordinator Jamie Wagoner holds Joint Camp for patients at the Joint Replacement Center.

Sometimes solving simple problems keeps patients healthier and out of the hospital.


– Dr. Donald M. Denmark Chief Medical Officer & Senior VP, Carondelet St. Joseph’s Hospital

Carondelet’s Joint Replacement Center is One New, Hip Place By Dan Sorenson Among the specialized units at Carondelet St. Joseph’s Hospital is the new Joint Replacement Center, with an expert staff of joint specialists – a dedicated unit with 20 private rooms and pre- and postoperative programs credited with greatly improving patient outcomes. “What most people want from a hospital is to know what they’re getting into,” said Dr. Edward Berghausen, a fellowship-trained joint replacement surgeon. St. Joseph’s Joint Replacement Center provides that information about every stage of the upcoming procedure – from two weeks before admission to discharge and through physical therapy. In addition to the overview, patients are screened for other medical problems that could affect the success of a joint replacement. “We set expectations and educate patients. It not only engages them, it empowers them because now they are a more active part of their care,” said Kyle Bennion, St. Joseph’s senior director of product management. A week or two before surgery, Berghausen said, a nurse practitioner assesses “that you’re fully prepared for surgery. If there is a deficiency, she’ll make sure you receive the right treatment before surgery. We believe that this has had a great impact on our outcomes – patients are prepared for surgery.” Berghausen said patients are overwhelmingly positive about the thoroughness of the program and being involved in their own outcomes. He said the 136 BizTucson


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health evaluation and repeated meetings with the surgeon and staff improve their comfort level on the day of surgery. “What I’ve frequently heard from patients who have gone through this process is that they have never been more thoroughly evaluated,” Berghausen said. “Our patients experience a 30 percent improvement in mobility after joint replacement – walking, standing for lengths of time, maneuvering through a store – that type of everyday activity,” Bennion said. Berghausen attributes success rates to the big-picture approach to joint replacement, not just the expertise of the center’s surgeons. “The surgical procedure involves so many other people than the surgeon – it involves the nurses, the physical therapists, the operating room staff,” he said. “The one thing I can provide for my patients is safety. That’s the part I think the surgeon should take charge of.” Bennion credits the collaboration of surgeons from several orthopedic practices who all participated in the design of the Joint Replacement Center for the program’s success and the many positive responses from patients. “Why is our program unique? For several reasons,” Bennion said. “Our surgeons represent five or more different practices. And they have come together to help in the design. That is unique to our region. And it makes our program stronger.”


continued from page 135 “Our other customer is your primary care physician, the person who is going to take care of you once you are discharged,” Fonze continued. “Or, if you’re not quite ready to go home and are going to be discharged to a skilled nursing facility, it could be the doctor there. “So what we’re working toward now is customizing the care that we give to the other doctor,” he said. “We have an automatic mechanism to notify them if their patient has been admitted or discharged. But what we’re adding to that is follow-up on how the patient is doing.” Bringing the primary care physician and the patient’s family or significant other into the communication loop can improve outcomes for patients, Denmark said. And after discharge, the communication continues with the primary care physician. Denmark and Fonze said this post-discharge care began as an effort to reduce re-admissions of recently discharged Medicare patients. “We’ve put a program in place and we’ve actually had very positive results,” Denmark said. “One of the things it focuses on is making sure there is an effective handoff to either another provider or set of providers. Sometimes, these people have simple yet complicating issues – they don’t have transportation so they can’t get to another caregiver or another service. Sometimes solving simple problems keeps patients healthier and out of the hospital.” Denmark said a crucial part of this post-discharge care involves a partnership with the Pima Council on Aging. continued on page 138 >>>

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BizHEALTHCARE continued from page 136 “We have a team that assesses and evaluates these patients and does the transition and handoff. The communitybased team then looks after the patient’s needs,” Denmark said. “As a result of this collaboration with the Pima Council on Aging, we have significantly reduced re-admission rates. The re-admission rate for this population of Medicare patients has gone from about 22 percent to approximately 7 percent,” Denmark said. Registered nurse Amy Salgado is the clinical coordinator for St. Joseph’s Carondelet/Pima Council on Aging Transitional Care Navigation Program. Salgado knows St. Joseph’s, having

worked her way from volunteer in 1995 to head of this program. She’s a believer in getting everyone who can help involved, inside and outside of the hospital. “We’re out there for (patients), for the home health agencies, for the nursing homes and for the families,” she added. Sometimes the job means using her clinical experience. Sometimes it involves going to a patient’s home or finding a way to help them afford the medications they need. “When a patient leaves and they can’t get their prescription because it’s too expensive, who do they call? So, I call the doctor in the hospital and say, ‘You just discharged this patient yesterday. Their

medicine is going to cost them $80. Can you find something different that they can afford?’ ” she said. Associates like Salgado recognize they play multiple roles at St. Joseph’s – as champions for their patients’ needs, torchbearers of the healthcare system’s commitment to serve with quality and compassion and representatives of a service-oriented industry. “Our product here is everything we do – it’s not just surgery, it’s not just inpatient care,” Fonze said. “If you come in here you’re likely to have a whole range of services. Your impression when you leave is every aspect of that. We all own the whole product.”


When Time Matters Most By Dan Sorenson

Just over five years ago, if you needed emergency neurosurgery in Tucson on some nights, you might have been out of luck – or racing time in a helicopter or airplane headed for Phoenix, Flagstaff or San Diego. Tucson didn’t have sufficient on-call neurosurgeons and hospital neurosurgical operating facilities that were staffed 24/7. “It turned out to be a little bit of a lottery. If you got injured on Monday, there might be a neurosurgeon available. But if you got injured on Tuesday, there might not,” said Dr. Robert P. Goldfarb, consulting neurosurgeon and chairman of the Carondelet Neurological Institute. “You’ve heard of the Golden Hour – the hour following the onset of a neurological illness or injury, when care may change the outcome significantly. That hour was often passed while an emergency room doctor tried to find both a neurosurgeon and a hospital that were available to treat an emergency neurosurgical condition,” he added. Neurosurgeons are scarce, Goldfarb added, because training for neurosurgery is intense, requiring seven to nine years after medical school. “But in a city of 1 million, we had to do better.” That’s when Carondelet Health Network and Western Neurosurgery col-

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laborated on a vision to develop a neurological institute with the latest in technology and 24/7 coverage in neurosurgery and neurology. Carondelet has not stopped improving neurological services and coverage for Tucson – recently recruiting to the team Dr. Emun Abdu, the first vascular neurosurgeon in Southern Arizona. Soon after her arrival, a patient came to St. Joseph’s showing significant signs of an acute stroke, unable to move her left side or speak, and unresponsive to initial medical treatment. Abdu performed a clot extraction and within days, the patient was able to walk, talk and eat without impairment. “Our vision was nobody should have to leave Tucson under emergency conditions to seek help elsewhere,” Goldfarb said. Unique to the institute are state-of-theart operating rooms. “The technology we have at our disposal allows sub-millimeter precision during complex brain and spine surgery,” Goldfarb said. That kind of accuracy allows surgeons to minimize damage to other parts of the brain while reaching surgical targets that might have otherwise been considered inoperable. Included in the OR is a CT scanner. “We were the first in the U.S. to have

the most advanced Brain Suite technology,” Goldfarb said. “They had some of this technology in Singapore and Munich, and we were the first to have all of this technology together. Our operating rooms have become something of a showpiece, with neurosurgeons visiting us from other major neurological centers.” That has attracted neurosurgeons from all over the world wanting to see CNI’s operating rooms, Goldfarb said. And that technology helped with staff recruiting – including one of Goldfarb’s partners, Dr. Ryan Kretzer, formerly of Johns Hopkins Hospital in Baltimore. “My expertise is in minimally invasive and complex spine surgery, including adult degenerative deformity and spinal oncology,” said Kretzer. “Dr. Goldfarb’s goal in recruiting me to Tucson was to provide more complex spinal surgery techniques that weren’t previously provided.” With 14 neurologists and neurosurgeons, Carondelet Neurological Institute provides comprehensive neurological expertise and services with a focus on advanced technology and optimal outcomes, Goldfarb said. “The bottom line – the institute is a truly unique asset to Tucson,” he said.


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2 Photo: George Howard

Photo: Tom Spitz

1. Community members break ground for St. Joseph’s Chapel in the Fred and Olga Pace Spiritual Center 2. Southern Arizona’s first mobile CT scanner, donated to St. Joseph’s Hospital by the Armstrong-McDonald Foundation 3. From left – Toby Allen, 2013 event chair, Bill Hussey, president of The Centurions and June Hussey get gussied up for The Great Outlaw Brouhaha 4. From left – Norbert Jankowicz and  Fred Fruchthendler, Carondelet Foundation board chair, at the lighting of the new cross at St. Mary’s Hospital, donated by Jankowicz in memory of his wife 5. Sisters of St. Joseph of Carondelet volunteer for Habitat for Humanity



Photo: Tom Spitz


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Photo: Tom Spitz


Supporting the


of Carondelet

By Steve Rivera

Since 1993, Carondelet Foundation has supported the mission and vision of Carondelet Health Network, generating more than $50 million in private support. Governed by a 35-member board of trustees, the foundation builds and strengthens relationships in support of Carondelet Health Network, raises private funding to benefit Carondelet and helps tell the Carondelet story. “At Carondelet Foundation, we work to showcase the network and help people to better understand the depth of services Carondelet provides,” said Richard Imwalle, senior VP and CEO of Carondelet Foundation. Imwalle, who was a familiar face at the University of Arizona Foundation before joining Carondelet four years ago, calls Carondelet “a quiet jewel in the community.” The impact of private support is evident throughout the network. One of the more recent projects was a $1.3 million campaign to fund the St. Joseph’s Chapel in the Fred and Olga Pace Spiritual Center. The chapel was dedicated in April 2013. “This is a critical time for philanthropy in healthcare,” said Fred Fruchthendler, president of Jacob C. Fruchthendler & Co. and chair of the Carondelet Foundation Board of Trustees. “Carondelet Foundation is committed to doing its part – securing private funding and raising community awareness to help meet network needs.” Other donor-funded projects include major facility renovations and improvements, purchases of medical equipment and supplies, and programmatic support such as the Van of Hope – a 38-foot motor home that provides mobile medical services to Tucson’s homeless population. Carondelet has enlisted Arizona basketball coach Sean Miller as a network spokesperson. Miller also serves as honorary chairman of the Carondelet Neurological Institute Board of Advisors. “He has been really committed to learning about the people and programs

of Carondelet,” Imwalle said. “He is a dedicated member of our team.” Another key network partner in Carondelet philanthropy is a group of well-known and enthusiastic volunteers, The Centurions. From the early, feel-good fundraisers to gatherings of thousands of locals out for a major party for a good cause, The Centurions have come a long way in the group’s 45-year history of providing support to Carondelet. “Some of the members who are 90 years old and have been there from the beginning tell stories of starting out very simply,” said Bill Hussey, president of the board for The Centurions and national sales manager at Clear Channel Outdoor. “We now have so many great sponsors.” It’s turned into a labor of love for more than 100 active members of The Centurions, some of Tucson’s most prominent business and civic leaders.

Jim Click on Carondelet

“Carondelet Health Network was the first board of directors I ever served on. Our son, Chris, was born at St. Joseph’s Hospital near Christmas 1971. It was the most wonderful experience Vicki and I have ever had at a hospital. As a result of our pleasant and caring stay, we wrote a letter to St. Joseph’s stating that I hoped that we could treat each and every one of our customers as well as we were treated at St. Joe’s. A few days later, Judge Evo DeConcini contacted me stating that he had an award for me. My award was to join the Carondelet Annual Gifts Committee. I can’t tell you how easy it was to call people and ask them to donate to St. Joseph’s. Forty-two years later, Carondelet is still providing outstanding medical services – not only on the eastside and westside, but in Nogales, as well. Carondelet is one of the best hospital networks in the country.” Jim Click, Jr. President, Jim Click Automotive Team

There are more than 200 members in all. “The Centurions are fabulous and not just because they put on those firstrate parties,” said Imwalle. “They want Carondelet to be the very best in what we do.” It’s those parties that make things happen for Carondelet and keep The Centurions loving what they do. This past May, its rodeo-themed event saw about 4,000 people gather to help raise more than $300,000. In all, The Centurions have raised more than $5 million for Carondelet, with more to come. “Anything to help” has been the unofficial catch phrase of The Centurions since the group formed in 1969 to raise money for what was the St. Mary’s Hospital Burn Center. “As the town grew and the needs grew, we decided to raise money for all of Carondelet,” Hussey said. Funding from The Centurions has benefitted a number of important projects, including Carondelet Hospice & Palliative Care. In 2012, the group helped St. Mary’s with a major renovation that Imwalle said gives the facility the “look of a new hospital” to match the state-of-the-art medicine and technology that is found inside. “A lot of what we raise goes to unfunded projects, some that otherwise would not be implemented, like immunization and diabetes programs,” Hussey said. “We are really happy to raise funds and sponsor those programs.” Hussey said The Centurions are embarking on a commitment that would push fundraising efforts to $6 million in total. The official news won’t come out for more than a year but he’s optimistic it will come to fruition. Until then, The Centurions and Carondelet Foundation will continue to work as they always have. And it is those people – and the hundreds of other network volunteers – that Imwalle appreciates. continued on page 142 >>> Fall 2013 > > > BizTucson 141



More than 2,200 people showed up for a free flu shot clinic offered by Carondelet.

Care for Those in Need By Gabrielle Fimbres

Carondelet Health Network’s mission embraces caring for Southern Arizona’s most vulnerable residents and providing preventive care for those at risk of developing chronic illness. In fiscal year 2013 (July 2012- June 2013), Carondelet provided more than $69 million in community benefit in Tucson and Southern Arizona – in the form of public programs, community services, educational outreach, charity care and uncompensated care. That amount increased from about $52 million just two years ago, speaking volumes about the growing need in Southern Arizona, said Donna Zazworsky, VP of community health and continuum care at Carondelet Health Network. Community benefit, which is a requirement of nonprofit hospitals, covers Carondelet’s unpaid costs to public programs, traditional charity care and other programs – all with the goal of improving the health of at-risk, uninsured, low income and homeless Southern Arizonans. “We want our community to be well,” Zazworsky said. “We are helping our community stay healthier.” Among the programs provided through community benefit are diabetes education, obesity awareness, telemedicine, healthcare for the homeless and other services. Carondelet recently teamed up with The University of Arizona Medical Center and Tucson Medical Center to conduct a community health needs assessment, helping to pinpoint the most critical areas of need. This effort engaged key stakeholders, demonstrating how the community can work together for a stronger future. Diabetes education has been an important mission of Carondelet’s for decades throughout Southern Arizona, providing education and medical care to children, seniors and adults. “Southern Arizona is an epicenter of diabetes,” Zazworsky said. “One in eight people in Pima County have diabetes.” For more than 20 years, nurse practitioner and certified diabetes educator Gwen Gallegos has helped maintain the 142 BizTucson


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health of people with diabetes – or at risk for diabetes – in Nogales. “She is teaching people how to eat right, how to manage their health,” Zazworsky said. “If you have diabetes in Nogales, you know Gwen.” Carondelet provides free information sessions for people with diabetes in Tucson as well, with the goal of providing basic lifestyle information and referrals into more extensive self-management programs that will help prevent lifethreatening – and costly – complications down the road. Carondelet has worked with more than 200 local houses of worship to provide obesity awareness and prevention in Pima County, helping 57 of these faith communities establish a health ministry, Zazworsky said. Carondelet also partners with El Rio Community Health Center, Primavera Foundation and others to provide services to homeless adults and children through the Southern Arizona Health Village for the Homeless. Through the Van of Hope, healthcare providers travel throughout Southern Arizona to provide primary care and behavioral health services to homeless people. Carondelet also offers a post-hospital program with a few shelters to provide follow-up care for people who were recently hospitalized and are not safe to be back on the streets. “They say it takes a village – and that is what we have helped to create,” Zazworsky said. Carondelet provides community health outreach workers to assist uninsured and homeless patients who come to their emergency rooms in obtaining primary care visits, assistance with Arizona Health Care Cost Containment System applications, food stamps and other programs. “It can be a very difficult system to navigate,” Zazworsky said. “That is the mission of Carondelet, to provide to the community and particularly the more vulnerable. We have seen more vulnerable people in the last two years – people who fell off the system and had nowhere to turn. We have really had to step up those efforts.”


Carondelet Foundation is committed to doing its part – securing private funding and raising community awareness to help meet network priorities.

– Fred Fruchthendler Board Chair, Carondelet Foundation

continued from page 141 “Our board members are successful, engaged representatives of Southern Arizona’s business and civic communities,” Imwalle said. “They recognize the highly dynamic nature of healthcare and want to make a difference.” Making a difference is a key. So is telling the story of Carondelet. Imwalle said without people – volunteers like Foundation trustees and The Centurions – telling the network’s story, Carondelet wouldn’t be what it is today. “Trustees and other volunteers are important ambassadors who carry the message of Carondelet’s commitment to excellence,” Imwalle said. “And their diligence and enthusiasm is matched by Carondelet leadership. Our President and CEO Jim Beckmann and his management team have a vision for this place that inspires even stronger community partnerships.” Fruchthendler agrees. “The community and Carondelet are in this changing world of healthcare together,” he said. “Carondelet Foundation is proud to help navigate the challenges and be a partner in creating better living through better health.” Biz

Carondelet Auxilians

Members of the St. Mary’s and St. Joseph’s Hospital Auxiliaries join foundation trustees and The Centurions in their volunteer service to Carondelet. A familiar sight to hospital patients, physicians, visitors and personnel, auxilians work at hospital information desks, manage gift shops and provide visitor escorts and clerical services. The auxilians have raised more than $7.5 million over the past 59 years and have donated nearly 6 million volunteer hours. Combined membership in the auxiliaries is nearly 400 volunteers.

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Fall 2013 carondelet  
Fall 2013 carondelet  

A Special Report from BizTucson magazine.