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Whenever we talk to a Veteran, the phrase, “thank you for your service to our country” always works its way into the conversation. Veterans and active servicemen and women appreciate hearing those words. I do too, having served in the U.S. Air Force as a member of the Munitions Maintenance Squadron at Edwards Air Force Base in California. It was a privilege to serve and I was eager to transition to the civilian workforce. Fortunately, I landed at HCA. HCA recruited me to be a recruiter; to be part of a team committed to attracting, hiring and retaining Veterans. One of the things I love about my job is working with the men and women of the armed forces. They are disciplined, trained in teamwork and perseverance, and have great attention to detail, skills that are valuable to our company to help us deliver quality patient care in the communities we serve. I have always been amazed at the level of community involvement to which HCA is committed. Companies often state their values, but it is another thing entirely to put those words into action. HCA’s commitment to our community is one of our major differences from other organizations. We have taken that desire to help our community and country and morphed it into a program called the HCA Military Veteran Hiring Initiative. Hiring Veterans is something we do because it aligns with our values, is the right thing to do and ultimately helps our company serve our patients. Likewise, supporting spouses and families of military warriors is also part of our mission. You will read how HCA facilities everywhere embrace our military families and lend support in a number of unique ways. Veterans today are returning home to high unemployment rates. Seeing their needs, HCA stepped up and joined the U.S. Chamber of Commerce’s Veteran Employment Advisory Council. Ideas and best practices that come from the Council are shared with other major companies, helping over time to make a greater positive impact. HCA’s Veteran Hiring Initiative has several components, and two main areas of focus: First, we make sure Veterans know that we have multiple opportunities within HCA that don’t require healthcare experience. Second, as hiring managers look for the best talent to fill open positions, we need to have a paradigm shift in our selection process. Veterans may lack technical certifications or industry knowledge; however, they do have exceptional skills that shouldn’t be overlooked. These include commitment, diversity, the ability to perform under pressure, leadership, and the proven ability to learn new skills quickly. In short, they know how to get the job done. One of my favorite Proverbs states, “… as iron sharpens iron, so one man sharpens another.” This is evident of what takes place at HCA. As we hire Veterans into HCA, it can only make both of us stronger.
HCA Mission Statement Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high-quality, costeffective healthcare in the communities we serve.
HCA Values In pursuit of our mission, we believe the following value statements are essential and timeless. We recognize and affirm the unique and intrinsic worth of each individual. We treat all those we serve with compassion and kindness. We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live our lives. We trust our colleagues as valuable members of our healthcare team and pledge to treat one another with loyalty, respect and dignity. We foster a culture of inclusion and diversity across all areas of our company that embraces and enriches our workforce, physicians, patients, partners and communities.
HCA Chairman and CEO Richard M. Bracken President and CFO R. Milton Johnson Senior Vice President, Corporate Affairs Jana J. Davis Director, Corporate Communications Richard Jonardi Send comments to YOU.Magazine@hcahealthcare.com
Designed and Published by Parthenon Publishing www.parthenonpub.com President Bobby Stark Vice President Nicole Bates Provonchee Chief Operating Officer Carlton Davis Managing Editor Joe Morris Creative Director Michael Ray Nott Cover Image: Apple Photographics, St. Petersburg, Fla. Back Cover Image: John Ho
Avery King is Lead Military Veteran Recruiter for HCA www.VeteransAtHCA.com 2 you spring | 2013
INSIDE F E AT U R E S
5 Innovators Award
From better customer service to smarter workflows, this year’s Innovators Award winners show why HCA leads in healthcare.
8 Life-Changing Surgeries
When physicians and staff at LewisGale Health System saw the chance to make a difference in the lives of two children, they jumped at it.
9 Aquatic Therapy
As more rehabilitation programs expand their aquatic therapy programs, HCA hospitals learn the benefits of spending time in the water.
10 HCA Supports Military Staff & Families
Rocky Mountain Hospital for Children’s Ronald McDonald Room has room for many families.
From training the Armed Forces’ next group of physicians to helping ease the difficulties of deployment, HCA is there for our staff and their families.
HealthONE/Ronald McDonald House services the entire region Denver, Colo.
16 MRSA Study Improves Care
Strong community ties are hall-
HCA hospitals led the way in a recent study of MRSA prevention, which moved from clinical data-gathering to implementation in record time. D E PA RT M E N T S
3 Regional Roundup
News from around the divisions.
15 Real-Time Recovery
Bigger, better and faster back up systems keeps HCA’s key information secure.
Hitting The Gym Southern Hills Hospital becomes one of the nation’s first to offer a YMCA facility on site.
18 Active Shooter Guidelines for Survival
What to do in the event of an on-site shooting emergency.
19 Assessing Your Health
HCA employees are getting more fit, but there’s still room for improvement.
marks of HCA hospitals, and that’s certainly evident in Denver, where HealthONE Rocky Mountain Hospital for Children continues to deepen its relationship with Ronald McDonald House Charities of Denver. Bright, open spaces for The hospital and family-respite charity families’ comfort. first began working together eight years ago, when the children’s hospital was being envisioned, said Mimi Roberson, CEO of Rocky Mountain and Presbyterian/St. Luke’s Medical Center. A Ronald McDonald House was two blocks away, and would service the new hospital along with an existing children’s facility. The Rocky Mountain Hospital for Children has an 84-bed NICU. Thirty-five percent of its patients are from outside the Metro Denver area, so a Ronald McDonald Room was incorporated in the facility plans so families could relax on-site as well as at the nearby house.
Helping make a second house happen “But as we were developing that plan, the other children’s hospital announced it was leaving its downtown site and moving out to the Aurora community,” Roberson said. “We also have a hospital out there, and so there was a lot of interest in a Ronald McDonald House in Aurora. But that meant that they would have to close the existing house, and that was the last thing we wanted to see happen.” For two houses to be up and running, the charity would need some help. They got it in the form of a land lease from HealthONE’s Aurora site to the spring | 2013 you 3
REGIONAL ROUNDUP The Ronald McDonald rooms provide a quiet respite for families.
tune of $1 a year for 90 years. In return for the property, the Ronald McDonald House operators would agree to maintain and fully staff the downtown house near the new Rocky Mountain Hospital for Children, and it would also house one of their first Ronald McDonald Rooms. Today, the room is staffed from 9 a.m. to 9 p.m. and has become a haven for families. It had more than 7,000 families visit in 2012, said Pam Whitaker, executive director of Ronald McDonald Charities of Denver, and is a valuable component of the two Ronald McDonald houses, both of which are running at capacity and servicing the entire Metro Denver area. “We have been able to keep two houses going and serve families throughout the Metro Denver area,” Whitaker said. “Now we are looking at a second family room in Rocky Mountain’s next phase of growth, so that we can provide services to even more families. It’s been an amazing partnership. We recently had a family who was here with a baby for four months. We are here to make sure they know they have a clean place to stay, to do laundry, all the burdens they would otherwise have to deal with.”
Hospital-charity partnership keeps growing
“With a bright, lively painting from survivors, doctors, current patients, staff and well-wishers, the job got done,” said Tes Sawyer, Director of Marketing at St. David’s Medical Center. “People were very excited and involved in the event, and we wanted to do something that would capitalize on that,” Sawyer said. “The idea of a painting came from wanting an activity where everyone could get involved. We had surgeons, ultrasound techs, directors and patients participate — everyone was able to pick up a brush if they wanted.” Creating a tangible piece of art meant a lot to many of the women who attended, added Brenda Baumann, RN, MSN, Director of The Breast Center.
Art as history and therapy “It was meaningful to the breast cancer survivors,” Baumann said. “It provided a visual means of expression, but also an outlet for some. I think a few left with plans to continue artistic expression as a form of therapy on their journey towards healing and wellness. It was a positive experience for staff and the public.” Some people chose to write out a message, while others painted symbols or just abstract squiggles. There were a few “girl power” notations, as well as dates of employment, or how long someone has been cancer-free. Since its opening in 1992, the center has diagnosed and treated nearly 5,000 women for breast cancer. At the center’s 20th anniversary celebration, the blank canvas held a place of pride near a dessert buffet located at the end of a facility tour. The idea was to represent a celebration at the end of a patient’s journey, but even with all the good feelings it still took a little ice-breaking to get the crowd’s inner artist released. “We had this big, blank canvas, and a sign encouraging people to put on an apron, get some paint and a brush, and paint away,” Sawyer said. “But everyone was a little bit shy, so I painted a big pink ribbon in the middle. After that, people were eager to join in.”
The two rooms at Rocky Mountain will serve the pediatric intensive care and NICU areas, Roberson said, noting that HealthONE continues to work closely with the charity to make sure everyone involved is allocating their resources most effectively. “We have always had someone on their board, and it’s a partnership that continues to evolve,” she said. “We’ve really been able to think outside the box in terms of accomplishing both their goals and ours, which are about patient and family service.” “They are very comfortable here, and they really are a part of our family,” adds Kathy DeMarco, Vice President of Women’s and Children’s Services. “I can’t imagine our hospital without them; really, I can’t imagine Denver without them.” Wesley Medical Center in Wichita, Kan., also has a Ronald McDonald Family Room, located near its PICU.
Artwork commemorates Breast Center’s anniversary Austin, Texas When it marked 20 years of service to women in Central Texas last fall, The Breast Center at St. David’s Medical Center wanted to do something that looked back at its successful past and gave hope to those who would be coming through its doors in the future. 4 you 2013 | Spring
Maria Ledesma, a former patient of The Breast Center and breast cancer survivor, was eager to take part.
HEALTHY WORK ENVIRONMENT
Idea Bank Innovators Award celebrates employees’ creativity National-level Innovators Award winners receive a $10,000 prize.
When HCA launched the Innovators Award in 2010, no one really had any idea what to expect. More than 2,000 entries later, it was clear that not only was there a great deal of interest throughout the company, but there were a lot of very creative people out there. “It was a robust group of ideas, and it was hard for winners to be chosen at the facilities, at the division level and then the finalists here at corporate,” said Jeff Prescott, Vice President of Communications Operations. “Everyone really rose to the challenge.” After a year off to retool the categories and work on the overall structure, the Innovators Award came back strong, with more than 1,500 submissions in 2012. “We went out and sought feedback from people on how we could improve the program, and got good input from the local level,” Prescott said. “Everything begins at the facilities, so that’s who we wanted to hear from. Their suggestions were incorporated all along the way.” One of the program’s strengths is that every idea gets a review, so every applicant is heard. Many times a suggestion that doesn’t win at the local or division level is still used, so the organization benefits from employees’ creative thinking. “Because every idea gets a set of eyes on it, a lot of them get tried even if it’s just a small pilot program,” Prescott said. “And we’ve seen those efforts spark another idea, and then another, and eventually something is built that is of value to the entire company, all from that single idea.” Facility winners receive $1,000, division winners get $2,500 and the national winners receive $10,000, so competition is fierce. “It’s a significant award, because we wanted it to be a tangible Spring | 2013 you 5
HEALTHY WORK ENVIRONMENT recognition of the value the company places on innovation,” Prescott explains. “The national winners also get a crystal statue of Dr. Thomas Frist, Jr., which signifies his role as a great innovator.” Prescott said he believes the Innovators Award will only continue to grow in both scope and popularity. “People feel really good about the fact that we want their ideas,”
he said. “One of the foundational elements of the Innovators Award, and really of HCA, is that we value the ideas and creative thinking of people throughout the company. They are doing the work, and they are the ones who come up with creative new ways to solve problems and make our services and quality better. The fact that we gather these ideas, and have a way that makes people excited about offering them, is a win-win all the way around.”
2012 NATIONAL WINNERS Todd Wilder knows the value of good customer service.
SERVICE EXCELLENCE WINNER: Todd Wilder, Nuclear Medicine Technologist, TriStar Greenview Hospital, Bowling Green, Ky. IDEA: “The Closer” For fans of television’s “The Closer,” Todd Wilder’s idea may come as a bit of a surprise. Rather than getting bad guys to confess, Wilder’s idea of closing the deal means making sure patients are fully satisfied with their hospital stay. How does he do it? Simple. He asks patients about their stay. By listening to the voice of the patient, Greenview’s patient satisfaction scores have soared. “I have worked in healthcare since 2000, but before that I was in the service industry,” Wilder said. “I began thinking that we could use some of the same service principles in healthcare, because we too are 6 you 2013 | spring
very dependent on customer satisfaction. I made the suggestion to our radiology director, who recommended I submit it to our CNO, and shortly after that we implemented our program.” In 2012, The Closer program began. Department directors were issued a pager, and when a patient was being prepped for discharge, the director would be alerted. He or she would sit down with the patient to find out how their stay had gone, and address any problems or concerns. “Before it was just the discharging nurse, and they have a lot of other things to do at the same time,” Wilder said. “By having someone focused just on the experience, it gave us a chance for a service recovery if there had been a problem.” Scores began to go up. When there was a brief lull in the program during the summer, scores dipped. That kind of evidence got everyone’s attention, so The Closer has been fully operational ever since. “There are so many things in an HCAHPS [Hospital Consumer Assessment of Healthcare Providers and Systems] survey score that are out of our control,” Wilder said. “But if someone has a bad experience, and then sees that we care and want to make it better, that goes a long way. And when those directors introduce themselves as being a part of the management team, that makes a difference as well.” Now, the conversations are happening in the second day of a patient’s stay, so that management can get any negative feedback earlier. The timing is secondary to the dialogue, Wilder said, noting that the program can easily be replicated elsewhere. “If someone has cold food, or if there’s loud noises at night, that’s universal,” he said. “If they have someone to talk to about it, the problem can be fixed, the scores will go up, and everyone is happier.”
WINNER: Michele Dissinger, Emergency Department Manager, West Houston Medical Center, Houston, Texas. IDEA: Bubble Gum Crash Carts In an emergency, the crash cart is vital. If doctors, nurses and techs don’t know where it is, or it’s not equipped properly, unfavorable outcomes can result. As an emergency-room veteran, Michele Dissinger knows this too well. And because she sees a lot of codes called for pediatric patients, she has long been aware of shortcomings most carts have when it comes to stocking them with a one size fits all approach. “We use a color-coded cart, and everything in it is prepackaged,” Dissinger said. “We were unfamiliar with it, so the nurses would grab something up, not know what it was and throw it on the floor. Then we’d go to the cabinet for our own equipment — IV catheters, tubing, all the things we need to get started treating the patient. The physicians were having trouble with the cart system too, so it wasn’t working well for us at all.” Dissinger had an idea and set out to change how carts look and work. She began with small improvements, redoing an airway box with the necessary equipment. The doctors liked it and began using it with adults, so she went bigger and retooled an adult crash cart that could be used for pediatric emergencies. “The carts we have are bright red, and so I took one and had it painted bubble-gum pink,” she said. “Then I did away with all the color-coded items, and built it out with
FINANCIAL IMPACT WINNER: Far West Division IDEA: Real Time Reports Patient data comes in reports of all Michele Dissinger wanted to improve care and cut waste.
our own equipment, and in the sizes that would be used on a child.” Everyone quickly became familiar with the new cart and it began to see heavy and successful use. Not only was it proving to be better for patient safety, waste was reduced by $10,000 a year which helped the hospital’s bottom line. “We saw an improvement in our pediatric code outcomes, because there wasn’t as much scrambling and fumbling,” Dissinger said. “It caught on, and so I was asked to create one for the operating room. Now we have three, and I am sure we’ll have more.” She has been approached by other hospitals that want to build their own carts, and so she thinks this could be something all HCA hospitals could develop soon. “I hope to get some recognition from the Emergency Nurses Association, and even The Joint Commission for this, because I think it really does raise patient safety standards, “ she said. “This has ‘national safety’ written all over it, and it’s a real honor to be a part of such a huge organization that really cares about taking care of its patients.”
shapes and sizes, and keeping up with it can be overwhelming. And that can lead to inefficiencies, something that a group in the HCA Far West Division wanted to address. So, after some brainstorming, the concept of Real Time Reports (RTRs) was born. Not long after, staff in several hospitals began tapping into real-time data that helped them improve their processes and patient care in a meaningful way. “To create a RTR, Dan [Neuman, Manager of Application Development at HCA Far West Division] accesses data from several sources, aggregates it into a central repository and then re-displays it as information, using color coding for quick analysis,” said Cae Swanger, Chief Information Officer at HCA Far West Division. “From there, summary data is displayed via color coded screens and can be drilled down to more specific data to identify problem areas immediately.” This tool helps multiple departments throughout the facility. By viewing real-time data that can be manipulated, users can efficiently discover the information they need while there is still time to affect the outcome. “Our facility directors and managers have countless responsibilities and often do not have time to sort through multiple paper reports,” said Lori Coleman, Vice President of Quality at HCA Far West Division. “With RTRs, they can obtain information that is constantly refreshed and sortable, allowing them to make better use of their time and pinpoint the critical needs of their departments quickly. For example, with Core Measures Reports, the data can now relay what needs to be done in real-time while the patient is being cared for in the hospital.” The primary beneficiaries of RTRs are facility executives and department directors, but a few of them are invaluable to caregivers, Swanger said, noting that of the 20 RTRs modules now in service, each may have as
many as 10 different segments with information for specific staff members. “It’s data in one central location, and depending on who you are and what you need, it’s accessible,” she said. “You click in one place on the central report and then drill down to get a different slice of the same information. And you can keep doing that until you find what you need.” This dynamic reporting is a far cry from the previous formatting, and it took a while to get built out, said Neuman. “We were able to import text files into a central server, and then display that data on the other side in different style sheets and colors so users see what is good, and what requires action,” he said. “Those text reports have been turned into real information, which is pulled from Meditech in a much more timely fashion. Now we are pulling data every minute, which gives the user a real-time perspective.” The first RTRs rolled out in 2010 and focused on ED wait times and Core Measures, such as vaccines. Now there are about 20, and more are being developed. As far as adaptation goes, RTRs have been a resound-
Left to right: Dan Neuman, Cae Swanger and Lori Coleman, knew there was a better way to update patient information.
ing success. ”It’s caught on fast,” Coleman said. “I certainly can apply it to my quality world, and Dan has a queue of people waiting for new ones to be developed. We have received very positive feedback, partially because we included the operators in the development process. “Whether it’s for immunization or sepsis, their input was taken into account to develop a program they can use to determine whether something is compliant or whether it needs attention in real-time.”
Have a Great Idea? Tell us your most innovative idea to improve our performance. Visit www.HCAInnovators.com for more information or to submit an idea.
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Helping Hands LewisGale Regional Health System’s Charitable Care Transforms Teens’ Lives Oftentimes, kids don’t want to appear too different from their peers for fear of being singled out as “uncool” or bringing unwanted attention to themselves. Two teenagers who arrived in the United States with conditions that severely afKethia after her procedures fected their physical capabilities returned home recently as changed teens, and looking a lot more like their friends, thanks to LewisGale Regional Health System and the charitable care it provided. Kethia Sirena is a 14-year-old from Haiti who was burned over 30 percent of her body after falling into a cooking fire at age three. Scar tissue caused her right arm to fuse to her torso making it unAnderson Mambwe and Dr. Charles Zelen.
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2013 EMPLOYEE ENGAGEMENT SURVEY May 1- 31
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usable. And 18-year-old Anderson Mambwe faced certain amputation of both feet if he remained untreated in his native Zambia. He had a congenital birth defect that made walking extremely painful.
With help from several community groups, both teens traveled to southwest Virginia to receive surgeries – provided at no cost by LewisGale Health System – to correct their conditions. Kethia underwent a special surgery at LewisGale Hospital Montgomery to repair her arm, torso and shoulder. Physicians participating in her care included Drs. David Berry, James Farmer, Philip Grubbs and Brian Torre. After intensive physical therapy, Kethia returned to Haiti a changed teen, both in terms of her physical appearance and her arm’s functionality, as well as her outlook on life. Anderson, meanwhile, underwent two surgeries at LewisGale Medical Center and stayed in the country for nine months. His surgeries were valued at $100,000. Foot and ankle surgeon Charles Zelen operated on Anderson. As a result of the surgeries and follow-up treatment his shoe size went from a size 17EEEEEE to 14E. For the first time in his life he fit into a pair of shoes, and received his first pair of sneakers from Dr. Zelen. Most importantly, he can now walk without the crippling pain he previously experienced. “Whether it’s in southwest Virginia or in special cases around the world, LewisGale Regional Health System is committed to delivering quality, compassionate care that results in positive patient outcomes,” said Victor Giovanetti, President. “Our committed, experienced medical staff has changed Kethia and Anderson’s lives for the better.”
Water, Water Everywhere
Kelly Sacky and one of her patients prepare for a watery workout.
Aquatic therapy is making a big splash As more people seek skilled rehabilitation following surgeries or medical events, aquatic therapy continues to rise in popularity. Many proponents say that’s because this type of therapy can work for a variety of patients. Age isn’t a factor, as water treatments are good for everyone from children to seniors, and physical limitations are aided by the water’s buoyancy. “We see a variety of patients with lower back pain to spinal cord injuries,” said Concetta Leach, MSPT, an outpatient physical therapist at Blake Medical Center in Bradenton, Fla. “The types of exercises are boundless and the results are phenomenal.”
Water works Leach and other therapists work one-onone in the water with patients and also set up specific exercises they can do on their own. They often team up with their local H2U affiliate to establish an aquatic exercise program to keep former patients in the loop, and in the pool, for continued health. “It has been proven that the buoyancy felt in the water decreases the stress and compression on the spine, discs and muscles therefore allowing for more movement,” Leach said. “We also see many other diagnoses, such as stroke, paraplegia, arthritis, orthopedic issues involving knee, foot and hips. In these cases it is the buoyancy that helps assist the patient in strengthening with decreasing joint compression. The soothing temperature in the water also can decrease muscle tension and hypersensitivity of the nerves. And in very low-tone individuals such as those with spinal cord or traumatic brain injuries, we can elicit motor control in the water that cannot be done on land.”
At Texas Orthopedic Hospital in Houston, aquatic therapy is a key element for many of their patients, said Kelly Sacky, PTA, ATRIC. “Patients recovering from total joint replacements and or surgical repair of the shoulder, hip, knee, and ankle, and patients diagnosed with neurological diseases, strokes, and spinal cord injuries also benefit from aquatic therapy as part of their rehabilitation process,” Sacky said, adding that patients who are undergoing limb reconstruction or lengthening also benefit from treatment in a lowgravity environment. “Patients may initially begin aquatic therapy and progress to land based therapy, or they may alternate land and aquatic based therapies to meet their goals,” she said.
Aqua equipment At St. David’s Medical Center in Austin, Texas, the 20-yard rehabilitation pool has three sets of parallel bars, two underwater treadmills, a ramp, lift and stairs. Like other aquatic facilities, it is designed for use by patients who have specific low-gravity needs and who may eventually transition to land based therapy, or a combination of the two. “Aquatic therapy strengthens patients who experience too much pain or are too weak to do land-based therapy, but it also instills motivation and confidence,” said Katherine Tanney, PTA. “The warmth of the water and the way that hydrostatic pressure assists and improves balance allows patients who are fall risks to move with less fear as they simul-
taneously strengthen their lower-extremity muscles.” Indeed, the underwater treadmills are the most popular feature in the pool, adds Natasha Johnson, Senior Physical Therapist. “We are seeing new programs develop, such as those for expectant and newly delivered mothers,” Johnson said. “As the popularity of aquatic therapy continues to grow, I believe more equipment will be designed as well as more treatment techniques.” All therapists agree that the next trend will be to find ways to take land based therapies as diverse as yoga and tai chi and adapt them properly to the water. “There are many options available when it comes to techniques and equipment,” Leach said. “We frequently use ankle/wrist weights, paddles, noodles and Styrofoam dumbbells in order to challenge patients. “There are more elements on the way all the time, we just have to be inventive in applying them to our patients’ needs.” spring | 2013 you 9
Duty Calls Veterans in our ranks In a Florida hospital, a young doctor will join the U.S. Air Force upon completing his residency. Nearby, a marketing manager hopes to transfer to a similar job if her husband receives redeployment orders to another part of the country. In California, a stroke coordinator is shuttling between coasts to help with her injured son’s rehabilitation in a military hospital. Throughout HCA, thousands of employees and their families serve in or are touched by the U.S. Armed Forces. Some are in the reserves and must take extended absences from work when they train or are deployed overseas. Others have spouses or children in the service, and so must pick up and move when new orders come. Whatever the case, HCA does all that it can to support its military staff and families.
The doctor is in … the Air Force
Dr. Scott Hewitt
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For Dr. Scott Hewitt, it’s hard to tell where the military training ends and the medical training begins. Hewitt, who is in the fourth of a five-year surgery residency at Largo Medical Center, is also a captain in the U.S. Air Force. He enlisted just before going to medical school and is considered a reservist while he completes his residency. After that, he’ll serve as an active-duty surgeon. “I did my commissioned-officer training before medical school, and I do two weeks of training every year while I’m deferred,” Hewitt said. “They have pretty much let me know that I won’t be deployed while I am completing my residency, so I haven’t had the struggles that some military staff have had, but I do know how important it is that HCA really understands what’s going on with military personnel and their families.” For doctors, he said, it’s not just about the time away, but what happens upon coming home. “If you’re employed by a hospital and are a reservist, you’re going to worry about having a practice to come back to,” he explains. “Physicians want to come back to what they left. It’s very hard for a doctor to walk away from a practice and from his or her patients. It’s certainly hard for the patients, even if they understand that the doctor has no choice. You want to
make sure that they’re taken care of while you’re gone, that they get great treatment, but also that you’re going to have a position waiting when you get back. HCA does a great job of making sure all that takes place.”
Seeing both sides For Christine Prouty, the military is a way of life. As Human Resources Manager for HCA’s IT&S Field Operations, she helps ensure that the company’s policies and procedures are properly followed. She’s been with HCA since 2005. Since marrying husband Shaun in 2007, she has seen him deployed three times, so she’s come to rely on the flexibility built into those policies. “The last two [deployments] were really hard, because both times we’d just had or were about to have a child,” Prouty said. “Last time, he left before our daughter was even born. Luckily I haven’t had to relocate, because after he did what was considered a permanent tour in Korea, we don’t have to move, so he’s been based out of MacDill [Air Force Base] the whole time.” As she has tended to a growing family, often on her own, “The company has been very supportive,” she said. “When he has been deployed, my managers have been very flexible with me in terms of taking time off when I have to, or making alternative arrangements for my schedule so I can manage my responsibilities. That’s been very helpful to me, because the first time he left our daughter was six weeks old, and in 2012 he left when I was 37 weeks pregnant with our second child. It’s nice to have a leadership
HCA Helps Active Duty Soldiers and Vets Transition into the Workforce By pairing active duty servicemen and women with hospital and healthcare leaders, HCA further supports our troops while raising awareness of healthcare as an occupation. The company is working with American Corporate Partners
(ACP), a national nonprofit organization that works to help Veterans transition to the private sector through one-on-one mentoring with business leaders, and Not Alone, a network of programs, resources and services to Veterans and families that have been affected by
USAF Tech Sgt. Shaun Prouty with daughter Isabella Faith
combat stress and PTSD. With ACP, HCA has committed to a program that will pair 50 of the company’s leaders with active duty soldiers preparing for the civilian work place. These include people who work in the corporate office, technologists, and clinicians in our hospitals. For more information visit Atlas keyword: Military Veteran.
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Cathi Senter’s son Josh counts President Obama among his well wishers.
team that understands the importance of that flexibility, and nice to work for a company that provides the tools for families like mine to use.”
Stroke coordinator aids in son’s rehab Cathi Senter’s medical training was summoned, not to mention her reserves of strength and faith, when her son, Josh,
Military Vet Hiring In 2012, HCA hired more than 1,600 Veterans. It has set a goal of 1,500 for both 2013 and 2014. This year, there were 272 Vets hired by Feb. 28, in the following areas: Clerical and Other Admin.: 20 Clinical Specialists/Professionals: 24 Clinical Technicians: 30 Environment/Food Service/Plan Operations: 16 Management and Supervision: 20 Patient Care Support: 47 Physicians: 4 Non-clinical Specialists/Professionals: 27 Non-physician Medical Practice: 2 Registered Nurses Direct Care: 82
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was severely injured in Afghanistan. The U. S. Army Sergeant’s injuries from an IED explosion required that both of his legs be amputated. He sustained other serious wounds as well. Recovery would be long and arduous. Senter was able to fly to Germany and assist in her son’s immediate postoperative care, and has since been heavily involved in his treatment. “I have been allowed to alter my schedule around all of the important events in Josh’s military career,” said Senter, an RN who is a Stroke Coordinator at Good Samaritan Hospital in San Jose, Calif. “When he was injured, the hospital was extremely supportive of me and my family, and offered to help with anything that I might need. I was with my son at Walter Reed Medical Center for three-and-a-half months, and then returned to work part-time. After my return, the hospital continued to allow me to alter my schedule so I could be available for Josh when he had further surgeries and treatments. For a few months, I flew back and forth every other week.” Senter received a grant from the HCA Hope Fund, which she said was extremely helpful, and has been keeping co-workers and others updated on Josh’s progress via a Facebook page, Prayers for Josh Wetzel. She applauds Good Samaritan’s willingness to make scheduling and other compromises so that its military-related employees can continue to meet the needs of both their families and employers.
“It’s nice to work for a company that provides tools for families like mine to use.”
“It definitely decreases the stress, knowing that the company you work for supports not only you, but your family as well,” Senter said. “Josh is my only child and I am a single mother. If I had been forced to worry about my job during this time, I wouldn’t have made it. I knew when the time came for me to come back to work, my job would be here waiting for me, along with my Good Sam family. That kind of security is priceless.”
Military spouse pitches in to aid other families Sometimes the best way to cope with a spouse’s deployment is to stay involved. Ranishley Larsen, Marketing Manager for Largo Medical Center in Largo, Fla., is married to an active-duty air traffic controller. Since working at HCA, she has had a baby and also experienced her husband’s deployment, two things that made her appreciate the company’s support of military families. “One of the biggest challenges that military spouses face is the constant moving and job change,” Larsen said. “I knew HCA supported military Vets, but wanted to know if they also could
Job Ready Vet recruitment efforts get results HCA recruiters are no strangers to job fairs where concentrated numbers of qualified people can be found. That’s proving true at military-oriented expositions, especially once Veterans realize that “healthcare” means a lot of different things. “We have conducted as many as three military job fairs a month,” said Avery King, Lead Military Veteran Recruiter and IT&S Technical Recruiter. “We experienced the most success once we started talking to Veterans and realized that they might not be looking at HCA because they don’t have direct healthcare experience. Once our Veterans realize HCA needs people in accounting, information technology, and logistics, we are able to match them to valued roles in the organization. We’ve also worked with military junior officers to recruit them into healthcare management. We’re working hard to ensure that active duty military personnel and Veterans know that HCA is an option for them.” “Our recruiting team works with other organizations to raise awareness of the HCA job roles that are out there for Veterans,” King added. “By partnering with multiple organizations, HCA can have a presence at several hundred job fairs scattered across the country. Not only do we attend these job fairs, but we also step outside the booth and talk to the Veterans who might
help spouses of active duty members relocate to another HCA hospital because I knew I might eventually have to move. I was so pleased when I found out how much support was available to me.” Her husband’s deployment was hard because she didn’t have any family in the area. He left just before Ranishley their son’s second birthday Larsen and was gone during the holidays that year. Larsen credits co-workers with keeping her spirits up, but she also dove into a task that helped other military spouses and families in the same circumstances. “One Largo Medical Center project that helped me through the
walk by our table without stopping. Once the discussion with Veterans begins, we find more and more people who are a great fit for HCA.”
Outreach for Vets King and the recruiting team changed the look of the company’s marketing materials aimed at Vets. Instead of using traditional photos of doctors and nurses, the materials show Veterans in healthcare settings. Advertising for non-clinical and service positions has gone up as well. These efforts have driven candidates to pick up materials and visit our recruiting and employment sites. To further its outreach, HCA joined the U.S. Chamber of Commerce, and is now seated on that organization’s Veterans Employment Advisory Council, a group of 25 of the national’s largest employers from a cross section of industries. Other ways the company is supporting Vets, military spouses and their families include: • HCA was selected by G.I. Jobs magazine as one of the nation’s most military friendly employers and is among the nation’s top 25 most friendly military spouse employers. • The company was nominated for the U.S. Chamber of Commerce’s Military Spouse Employment and Mentoring Award for demonstrated leadership supporting military spouses in their search for meaningful employment and professional licensing recertification when moving from one state to another.
• The company was acknowledged by the U.S. Dept. of Defense for participating in military job fairs. • HCA partnered with the Tennessee Department of Labor and the National Guard to conduct job fairs called “Paychecks for Patriots” across Tennessee. The same format has been adopted by Florida, Georgia, Pennsylvania and Arizona. • HCA placed a Veteran in our COO Development Program who has surpassed all expectations. • The company joined American Corporate Partners (ACP) to provide 50 mentors for active duty military members preparing for civilian life. • On Veterans Day 2012, HCA made a $10,000 donation to the Wounded Warriors Project. “We’ve got more than 9,000 openings across the organization, so we have lots of opportunities,” King said. “We are working to capture these individuals that would fit into the positions we have. In addition to the U.S. Chamber, we’re working with RecruitMilitary, an organization that puts on job expos across the country. “They go out and actively seek Veterans and military spouses, so we are attending their events as well,” he added. “Military Veterans and families are mobile, and they are looking for work. We make sure that HCA is known as a great company with a variety of opportunities for them.”
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received a package of holiday gifts. “That was more than 200 packages, which was by far our biggest collection yet,” Larsen said of what is now an annual undertaking. “We also were able to donate 60 boxes to the Tampa Bay USO to send around the world. A lot of our employees wanted to support the Military personnel pitched in when it was time to start the assembly lines. military but didn’t know how to execute a project like this. Now they do. Having an employer support your military lifestyle, and to be flexible, deployment was the annual holiday troop collection,” Larsen said. makes family life easier to handle. I couldn’t have kept as strong “It wasn’t an easy feeling knowing my husband couldn’t be home as I did without the love and support of my team.” for the holidays, and there was nothing I could do to help cheer him up. The troop collection gave me hope The Largo packing crew packed enough gift boxes to serve that I could cheer him and his co-workers up hundreds of service members locally and around the world. during the holiday season. My senior team and our Medical Executive Committee supported the collection of material and a lot of my coworkers got involved to help spread cheer to deployed military. I also felt useful packing up all those boxes!” Hospital staff collected and provided the bulk of the donations. Local vendors pitched in with holiday hats and other items, local schoolchildren wrote cards and, when all was said and done, every single deployed service member from nearby MacDill Air Force Base
Mind-Body Treatments Coexist With several hospitals located near military installations, HCA facilities are seeing larger numbers of active-duty and former military personnel who are suffering from Post Traumatic Stress Syndrome (PTSD) and other service-related mental conditions, which has meant a significant retooling of new and existing programs, said Terry Bridges, President of Behavioral Health Services. “Ideally, we would want to provide a distinct unit to care for our warriors in need of behavioral health treatment, as the common preference is to preserve the military culture on the unit with some Base Commanders wanting to maintain their warriors in uniform,” Bridges said. “It is optimal to have all programming [on these units] focused on the specific needs of those warriors suffering from Post-Traumatic Stress Disorder and substance abuse issues created by their combat experiences.” While most Behavioral Health units are small, less than 25 beds, and address a variety of
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patient needs, a unit has been dedicated to the active military at TriStar Skyline Madison Campus in Nashville, primarily serving nearby Fort Campbell. The unit has been very successful at maintaining the military culture and addressing the special needs of soldiers, which often include issues created by the stress of long deployments and separation, Bridges said. “Providing dedicated units or programs for our military has its challenges, as the demand for care rises and falls with the waves of deployment and returning troops. Our programs have developed close working relationships with our counterparts on base to ensure a smooth transition to treatment and return to service for our soldiers. “A major issue for our troops dealing with the stress of combat and separation becomes the dependency on drugs and alcohol to cope,” Bridges continues. “In the private sector, most chemical dependency treatment consists of
inpatient detox, if needed, and a long regimen of outpatient services to support their recovery while they reintegrate back into their careers. For our military, there is a different focus. Most bases want their soldiers back and ready for deployment as soon as possible. This usually means intensive inpatient treatment that may run three to four weeks, with access to intensive outpatient care, but they want their soldiers ready to serve.” Currently, HCA has 54 facilities with inpatient behavioral health services and a growing number of outpatient services being implemented to expand their continuum of care. Goals include assisting military bases where facilities are colocated to meet the rising demand for psychiatric and chemical dependency services. “Our challenge is to provide the specificity of services to best meet the needs of our soldiers within our settings and to be able to provide outpatient care proximate to their bases to allow greatest access to care,” Bridges said. “Wherever appropriate, we want to help make a difference in our warrior’s mental health.”
Get Real > As part of emergency readiness, HCA has vastly improved our information storage and recovery capabilities. HCA has long maintained the ability to recover IT services at remote facilities. In addition to protecting its Nashville Data Center, the company has facilities in Fort Worth and Orlando. It also maintains a small data center for Alaska Regional Hospital. Recovery capabilities for each of the data centers are located at a site in Philadelphia. Early recovery systems relied on tape backups, which could take days or even weeks if an entire data center had to be recovered due to a catastrophic event. New technologies have made for more effective and faster recovery operations, and the company wanted to take advantage of that, said Brian Blackburn, AVP of Performance Management within Information Technologies & Services.
Philly site is recovery hub “We historically had contracted with SunGard Recovery Services in Philadelphia to provide us with the equipment we need to recover our services in the event of a disaster,” Blackburn said. “We had been taking tape backups every night and sending them to off-site storage locations. If something happened in Nashville or the other data centers and we needed to restore all of our systems,
Protecting our critical systems
then we would have to send those tapes and people to Philadelphia and begin the process of recovering our servers.” There were a few problems with this setup. For one, the restoration could only be done up to the point of the last backup, so it would be possible to lose as much as a few hours to potentially a couple of days’ worth of information from key clinical and financial systems. Travel to Philadelphia for personnel and tape shipments would add to that time. So, a full recovery of a data center was typically measured in days, which doesn’t meet business requirements given the critical nature of many of HCA’s IT services. But now, with the investment in new technologies, data is synchronized between the centers and recovery site effectively in real-time, and full recoveries are measured in hours, instead of days, for critical services. “We have built out a recovery site, basically another data center, within SunGard’s facilities,” Blackburn explains. “We bought all the equipment we needed, so that the servers and storage we would need for recovery of our critical infrastructure would be in one place.” The new recovery method keeps data updated between sites, and will soon be enhanced even more by a move to an Atlanta recovery site from its current
home in Philadelphia. That move will be completed this summer, and will double the overall floor space to about 5,500 square feet. It also will have 550 kW of power, a significant power boost, and will operate at about 65 percent of current costs due to savings provided by the new location.
Efforts could expand “We’re refreshing some key pieces of equipment, such as the storage environment,” Blackburn said. “We’ll be building our storage networks, which already are designed to carry our full load of data, to be able to do even more to keep up with anticipated demand.” The recovery infrastructure primarily handles systems such as Meditech. However, with the increase in floor space and power capacity, other services could be considered such as those running within the divisions. “We are very interested in leveraging the capacity of the new recovery location to enhance the disaster recovery capabilities throughout the enterprise, where appropriate,” he said. “Additionally, I see us working over the next five years to create active-active data centers, where we aren’t just replicating data but also balancing workloads across multiple physical locations and avoiding downtime due to disasters, where possible.” spring | 2013 you 15
Reduce MRSA Study sets standard for responsible infection prevention Reducing healthcare-associated infections (HAIs) is an important national goal, established in 2008, when the U.S. Department of Health and Human Services (HHS) announced its National Action Plan to Prevent Healthcare Associated Infections. The goal is complex, but a recent study conducted in HCA facilities is advancing national progress toward eliminating HAIs and providing a safer hospital environment for patients. The ability to go from clinical study to practice relatively quickly was enhanced by the pragmatic nature of the trial, which was incorporated into the daily workflow of hospital clinicians and did not require on-site investigators or research staff. The comprehensive study, known as Randomized Evaluation of Decolonization versus Universal Clearance to Eliminate (REDUCE) MRSA (Methicillin-resistant Staphylococcus aureus), was conducted exclusively at 43 HCA-affiliated hospitals. It involved nearly 75,000 patients and more than 280,000 patient days in 74 adult Intensive Care Units (ICUs), located in 16 states. The study concluded that using antimicrobial soap and a nasal ointment on adult ICU patients reduces bloodstream infections, including MRSA, by 44 percent. The results convinced HCA to begin implementing this protocol, called universal decolonization, in its adult ICUs in 2013. “The REDUCE MRSA study proved convincingly that universal decolonization is the best practice to prevent infection from MRSA and other antibiotic-resistant bacteria in high-risk ICU patients,” said Dr. Jonathan B. Perlin, President, Clinical and Physician Services, and Chief Medical Officer. “By bathing patients daily with chlorhexidine antiseptic soap and swabbing their noses twice daily with mupirocin antibiotic ointment, central 16 you 2013 | spring
line bloodstream infections caused by MRSA and other antibiotic-resistant bacteria can be reduced.” Dr. Perlin also had praise for the collaborative effort, a national study with strong outcomes that may be easily replicated by other hospitals. “This unprecedented partnership has yielded information that not only makes preventing MRSA and other antibioticresistant bacteria simpler and more effective, it sets a new standard for responsible infection prevention,” he said. Multidrug-resistant organism (MDRO) is a general term used to describe a number of bacteria resistant to ordinary antibiotics, making them significantly harder to treat. Eradicating MRSA, an MDRO, is a goal that was being championed by Dr. Perlin even before the HHS launched its national initiative.
HCA’s prevention protocols Shortly after arriving at HCA, Dr. Perlin challenged clinicians to find new ways to effectively combat problems associated with MRSA by identifying high-risk patients and making sure their infection risk was being properly managed and treated at all facilities, said Jason Hickok, MBA, RN, Assistant Vice President of the Critical Care, Infection Prevention and Lab Programs for the Clinical and Physician Services Group. One resulting program was MRSA ABCs, which uses letters of the alphabet as reminders, to summarize HCA’s MRSAprevention steps: • Active surveillance. If admitted patients are high risk, a nasal swab is collected to determine if they are positive for MRSA. • Barrier precautions. If the nursing staff knows a patient is colonized or infected with MRSA, they take appropriate measures (gowns and gloves) to avoid transmitting the bacteria from
REDUCE MRSA Study Partners Centers for Disease Control CDC Prevention Epicenter Program, University of California, Irvine Harvard Pilgrim Health Care Institute Harvard Medical School Rush University Washington University, St. Louis Agency for Healthcare Research & Quality’s Healthcare Associated Infections Program AHRQ’s Developing Evidence to Inform Decisions about Effectiveness (DECIDE) Network
one patient to the next. • Compulsive hand hygiene. Proper hand washing and sanitization reduces transmission of organisms. • Disinfection. Once there’s a known colonization, the room is thoroughly cleaned once the patient has been removed. • Executive ownership. Every hospital CEO is responsible for implementation of the MRSA-elimination protocols. “Dr. Perlin’s vision of the MRSA ABCs was transformed into a clinical program for HCA hospitals,” Hickok said. “After seeing significant reduction in MRSA infections, we began sharing our results nationally at professional conferences.” Soon the CDC and Harvard approached HCA to partner on the REDUCE MRSA study, which benefited from datagathering efficiencies HCA brought to the partnership. “We were able to offer study planners the ability to use a common platform for collecting data due to the fact we have a standard documentation system in our all of our hospitals,” Hickok said. There are costs involved in the new protocol, but the improved patient care is well worth the added expense. “We are making a serious investment based on the clinical results of the trial and believe strongly in this protocol,” Hickok said.
From Work to Workout Some HCA employees just got a shorter commute from the job to the gym. In July 2012, the YMCA opened a branch at TriStar Southern Hills Medical Center in Nashville, one of the Y’s first on-site facilities at a hospital in the country. Housed in more than 4,900 square feet on the TriStar Southern Hills Medical Center campus, the new facility offers the holistic health and wellness services traditionally offered through a Y membership. In addition, TriStar Southern Hills staff will soon provide on-site cardiac and pulmonary rehabilitation services, for which a Y membership is not required. “We are so proud to be a part of bringing a real-life wellness solution to our staff, our physicians, our patients and our neighbors,” said Thomas Ozburn, chief executive officer of the hospital.
life,” Ozburn said. “At TriStar Southern Hills Medical Center, we want to be proactive with our patients and employees, and we think wellness is the answer.” YMCA leaders echo Ozburn’s excitement, citing the partnership as a key step in bridging the gap in access to health and wellness support in south Nashville. “People are spending more and more time at work, so it’s never been more important for employers to ensure they’re nurturing a healthy work environment,” said Journey Johnson, president and CEO of the YMCA of Middle Tennessee. “When Tom Ozburn approached us about a possible partnership, we knew it was a win-win. By partnering, we’re able to maximize our resources and expertise to increase access to wellness support not only for Southern Hills employees but also for residents in an underserved community. In doing so, we make prevention part of the prescription for more people.”
Partnering to improve health
Prevention and intervention
The partnership between the Y and TriStar Southern Hills is the result of two years of planning, and Ozburn said he’s glad to see all of the pieces finally come together. “My hope for the Southern Hills YMCA is to reach residents, community members, employees and patients who typically haven’t had the opportunity to involve wellness in their everyday
The hospital-Y partnership will also make it easier for physicians to make prevention and lifestyle intervention a part of their prescriptions. Doctors at TriStar Southern Hills will be able to refer patients to the center for free wellness consultations. A patient newly diagnosed with diabetes, for example, might meet with a nutritionist at the center to get help managing the disease through diet, or with a wellness expert who can help them safely incorporate more physical activity into their daily life. Cardiac and pulmonary rehabilitation services will be conducted in a designated area supervised by a hospital-appointed Medical Director and a licensed cardiac nurse. Y personnel will staff all other areas of the center, which will offer many of the typical services one might find at any YMCA: a fully equipped wellness floor, wellness consultations, personal training, group fitness classes, community outreach and education programs, among other offerings. Y members with associationwide memberships will be able to access the facility and anyone in the community will be able to join the Y using the same incomebased rate scale offered at all other area Y’s. To incorporate a little healthy competition early on, the “Y Lifestyle Challenge” was launched in early February. Nineteen participants completed a 12-week wellness program that included personal training sessions from the YMCA staff, a nutrition class from a Southern Hills dietitian and wellness tips from Dr. Daniel Hartman, who oversaw the program.
YMCA opens branch on hospital campus
Southern Hills staff are enjoying the proximity of the new YMCA.
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SAFETY & SECURITY
What Would You Do? Active shooter guidelines give answers Despite all that we have come to expect from living in a free and civilized society, tragedies in Newtown, Aurora and other U.S. cities remind us that we should never take safety for granted and must always be prepared to react to the unthinkable. Hospitals and healthcare facilities may not only receive the victims of shootings, they may be the scene of the event. The same is true of any office building or public venue. Based on guidelines issued by the U.S. Department of Homeland Security on how to respond to an “active shooter” incident, HCA created two model policies: one specific to hospitals and one to clinics and offices. “We need to be prepared to deal with someone in a facility, with a gun, who is intent on hurting people,” said Scott Cormier, Director of Emergency Preparedness and Management. “As part of our 18 you 2013 | spring
overall program of preparedness, we’ve created a model plan to respond to these types of events. We are requiring every HCA facility, clinical and non-clinical, to have an active shooter policy in place by this summer.”
Preparation is key Teaching us about steps to take if an armed person threatens can help us be prepared. And because of the unique considerations under which hospitals operate, plans must be carefully customized, Cormier said. “Much of their template focuses on responding to an active shooter in a business center. There are a lot of differences between an office building and a hospital or healthcare center. We are working with the Federal Emergency Management Agency to fashion guidance so that first responders are aware of issues such as
infectious disease, locked units, hazardous materials and the different types of patients they would encounter in a hospital setting.” Cormier is also serving on a committee put together by the U.S. Dept. of Health and Human Services to standardize guidelines for healthcare facilities. “HCA has worked to develop its own policy, which was done with input from all our facilities,” he said. “Not a lot of hospitals have a policy in place. We think that our policy could serve as a baseline for many of the national guidelines that HHS is looking to put together.” In addition to learning how to react to an active shooter scenario, each of us can do small things to help to make our workplace safe. Basic rules include properly displaying your ID badge, reporting any suspicious activity and keeping locked areas secure.
In The Know Being Aware of Your Health Risks is Key to Lowering Them If you are like me, whenever anything happens in the world, your smartphone vibrates and alerts pop on the screen. Mostly, we just note them in passing. But, once in a while, we grab our flashlights and weather radios and head for our safe rooms. Immediate action is necessary. Like severe weather alerts, HCA’s Employee Wellness Program is aimed at calling our attention to potential health risks that should trigger immediate action on our part. Unlike a tornado or hurricane, health risks have no color radar tracking and may not cause symptoms for months or years. However, taking action now is important in order to prevent serious damage.
Health risks affect us all If we fail to modify our health risks, there may be dangers for us personally and for all of us collectively. For example, if we don’t lower our blood pressure, we are at risk of suffering a stroke. If we don’t get immunized, all of us, especially the most
vulnerable members of our communities, may be at increased risk for a preventable disease — as happened recently with whooping cough. Each risk profile must be customized for the individual. In our HCA employee population, the most common modifiable risks are related to blood pressure, diabetes and Dr. Thomas obesity. Garthwaite How are we doing at listening for the signals and taking action? From 2009 to 2012, the percentage of eligible employees completing a Personal Health Assessment (PHA) and applicable screening measurements increased from 3 percent to about 80 percent. We are definitely listening. Just as important, 84 percent of the 60,000 employees judged to be at low risk have created Health Action Plans as of mid-March 2013, to develop and maintain good health and work on lowering their potential risks. For the other 49,500 individuals who are rated as high risk and therefore qualify for coaching, 60 percent have scheduled at least one coaching session and 74 percent of those sessions have been completed.
Coaching spurs progress There are now record numbers of employees working with a coach: We had close to 22,000 by mid-March. And there are another 8,000 eligible employees waiting in the queue for their first coaching session. The feedback on the value of the coaching is uniformly positive, and many employees are improving their various screening results, a strong indicator that their health risks are going down. What risks are HCA employees lowering? In the preventive-health arena we have improved our risk by using less tobacco, exercising more often and doing less ‘binge’ drinking. Participants with conditions such as diabetes or high blood pressure are improving their risk by working with their coaches to lose weight, modify their diets and/or improve their medication adherence and dosages. As a group, we are making progress. If you are already participating in the wellness program, keep up the good work. If not, stay tuned for opportunities to participate in the future. You, your loved ones and your community will be better for it. Dr. Thomas L. Garthwaite is the Vice President and Chief Operating Officer for the Clinical Services Group of HCA. spring | 2013 you 19
ONE PARK PLAZA NASHVILLE, TN 37203
PRSRT STD US POSTAGE
THE HCA WAY
Kitty Lan helps the healing process with her music.
Hitting the right note Music offers many benefits It might seem odd to have a piano in the lobby, or a strolling violinist on a post-op ward, but for the staff and patients of Good Samaritan Hospital, it’s the perfect counter to what can be a stressful environment. Good Sam uses music at both its main and Mission Oaks campuses. Pianists play background music in the lobby, while others visit the Behavioral Health area and encourage patient participation. All musicians are auditioned and coached to play soothing selections, so there are no surprises, said Mary McCall, Director of Volunteer Services. “Music reduces stress and anxiety, and we think it works as a positive diversion,” McCall said. “It’s not going to take the place of pain
medication, but it certainly means that sometimes a patient might use less.”
Healing opportunity For violinist Kitty Lan, a highschool student who plays in the ICU and the NICU, the chance to use music for healing was not one to be missed. “When I saw the genuine smiles of patients, caretakers and doctors, I felt an overwhelming sense of joy and fulfillment,” Lan said. “I limit my music to the more low tones of the violin, to avoid any possibly irritating sounds. I love to play lullaby-like pieces from some famous composers, such as Mozart or Bach.” Other NICU musicians include a harpist, whose music “is very
soothing and a gentle reminder to lower our voices while caring for our babies so they, as well as we, can hear the music,” said Maris Whitney, RNC, MSN, Manager of Children’s Services. “Our parents enjoy hearing it as well. Our unit has so many sounds and alarms which usually signal something is wrong; it’s nice to have a sound that signals something good.”
Music melts stress
Steve Austin enjoys helping patients recall happy times.
Guitarist Steve Austin visits the Behavioral Health Inpatient Unit, where individuals are being treated for mental health issues and chemical dependency. It can be a difficult group to work with but he said the rewards are worth the extra effort. “I participate because it is a very humbling experience,” Austin said. “I like to play songs from the 1950s
through the 1970s, stuff I grew up with. I like these songs because people can sing along. It makes them feel good.” Staff members agree. “For a short time, patients’ personal struggles seem lessened,” said Rose Furlong, RN, MN, Director of Behavioral Health at the Mission Oaks campus. “Music and mental health appear to be good partners.” More than anything, the music serves as an antidote for everything that’s happening to patients and families alike. “There can be a lot of stress here,” McCall said. “I work here; it’s comfortable for me. But for many people, their blood pressure goes up as soon as they arrive. They don’t know what to expect or what’s going to happen, and hearing some music helps them to calm down and relax, even if it’s just a little bit.”