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Sentara Marthamagazıne Jefferson SUMMER 2021

Celebrating

a Decade of Growth Team Members Share Milestones and Memories Cover Story: 10 Years on Pantops

Back in the Saddle After a Herniated Disk | Fighting Food Insecurity | Grilling for Good Health

LETTER FROM THE PRESIDENT

SENTARA MARTHA JEFFERSON BOARD Carol Hurt | Chair

Bill Achenbach Lillian BeVier John Ligush, MD Lawrence Martin E. Ray Murphy Bernie Boone Michael Gentry Douglas Moyer

SENTARA MARTHA JEFFERSON ADMINISTRATORS

Paul Gaden Interim President

Johnsa Morris, MHA, MBA, RN, NEA-BC Vice President, Chief Nurse Executive

Paul Tesoriere, MD Vice President of Medical Affairs

SENTARA MARTHA JEFFERSON MAGAZINE EDITORS

Jenn Downs Debra Thompson CONTRIBUTORS

Luanne Austin Karen Doss Bowman Lisa Smith Jennifer L. Stover

A Time for Hope and Celebration

ummer has arrived in Central Virginia, and with it a heightened sense of optimism. For the first time since early last year, there is a buzz around town, a pep in our step and many unmasked faces. People are out enjoying public spaces, restaurants and other community events. It sure feels like we have come around the bend to a brighter future. COVID-19 taking a back seat in our lives, however, is not the only change in the air. Since January, we have been searching for the next president to lead Sentara Martha Jefferson Hospital, and as of this writing, we have not yet found the right person. Chief Operating Officer Amy Black, who began serving as interim president in March, has accepted the opportunity to take her talents to Sentara Obici Hospital to be their interim president. Amy did a terrific job serving as interim president there for five months in 2019, and therefore was the logical choice once again. While Amy is fulfilling her new interim role, I will be serving as interim president at Sentara Martha Jefferson to help ensure a seamless transition. In my short time at the hospital, I have already had the opportunity to meet many of you, and I look forward to meeting many more over the next few months. I appreciate the warm welcome I’ve received and have enjoyed learning about Sentara Martha Jefferson and viewing firsthand the exceptional care we provide to the community we are privileged to serve. Additionally, the time I am spending in Charlottesville provides me better insight into ensuring that we select the right person to lead this special hospital. I grew up in Charlottesville, left for 10 years, and returned professionally to work for five years before leaving the area again. Although some things have changed in this area over the years, many things remain much the same. My wife and I still have lots of family in the area, and it is good to be home again, even if only for a little while. One of the main things I am excited to be a part of in my interim role is the celebration of two 10-year anniversaries. In June, Sentara Martha Jefferson celebrated 10 years as part of Sentara. Since joining the larger Sentara family, the hospital has been able to add office locations and practices through Central Virginia, offer new clinical services like neurointerventional radiology and advanced GI, and continue to improve upon the legacy of providing strong quality outcomes and the Caring Tradition to those we serve. Additionally, in August, we will celebrate the 10-year anniversary of our move from Locust Avenue to our present location on Pantops. On page 19, you can read more about the advancements and successes we’ve seen over this past decade. We have so many positive events and milestones to celebrate. As we enter these warm summer months and responsibly return to a new sense of normalcy, I hope you will find time to spend with your loved ones and reflect on the past 14 months. There are many reasons to be proud, thankful, hopeful, appreciative and optimistic as we take a peek back—and focus onward to our bright future together.

PHOTOGRAPHY

Luca DiCecco Sara Morris Andrew Shurtleff DESIGN

Picante Creative

Paul Gaden Interim President, Sentara Martha Jefferson Corporate Vice President, Western Region of Sentara

Contents S U M M E R 2 0 21

Getting Back in the Saddle After a Herniated Disk

10 Years on Pantops

Coming Together

Celebrating a Decade of Growth

Getting COVID Vaccines to Communities of Color

Contents

SUMMER 2021

14 D E P A R T M E N T S President’s Letter Inside front cover The Best Medicine

New & Noteworthy

Physician’s Perspective On-Call Advice

Improve Health Every Day Eat Well, Live Well

Grilling for Good Health

Calendar

Active Living

Sports Medicine Gets Athletes Back in the Game

Health Matters

Take Care of Anemia

La Salud Importa

Cuidarse de la Anemia

Sentara in the Community

Fighting Food Insecurity

Caring Tradition

Calendar

THE BEST MEDICINE BY MICHAEL CORDELL

More Than Just a Walk in the Park

hey say everyone has a special talent. Some people are great at building things, while others can cook amazing culinary dishes. Some individuals sing like a bird, and others can sit at a piano and play any song by ear. At first, I had trouble identifying my special talent. For example, to say that I’m not a particularly handy person is as accurate as saying that I’m not nine feet tall, and when it comes to cooking skills, I can’t even make microwave popcorn. On the musical side, the one person who’s ever told me that I sing like a bird was referring to a turkey buzzard—and if I tried playing a piano by ear, it would sound the same as if I tried playing it using my ear. Then I remembered something I’ve always done extraordinarily well: I am amazing at coming up with excuses not to exercise. That’s not a small feat. If I could strengthen my heart, lower my blood pressure, sleep better, think better, move better, focus better, live longer and experience less pain simply by exercising 30-45 minutes, three to four times a week, then obviously I had to be creative to come up with reasons not to do so. And creative I was. I didn’t run because my knees sometimes hurt. I didn’t swim because I didn’t want to get wet, and I didn’t lift weights because they were heavy. I didn’t know how half of the machines in the fitness center worked, and the other half looked scary. I was afraid my resistance band might snap me like a wet bath towel. Now I’m not saying my special talent was a positive one, just as people who irritate everyone around them at work by constantly humming or whistling shouldn’t brag about their special talent. I’m just saying it’s what I was good at. Then I learned about the health benefits of walking, which shares many of the same benefits

as other types of exercising, such as maintaining a healthy weight; preventing or controlling health conditions like heart disease, high blood pressure and type 2 diabetes; strengthening bones and muscles; improving balance; and a host of others. Try as I might, I couldn’t come up with a truly good excuse not to walk. I couldn’t even come up with a meager excuse. I didn’t need special clothing or equipment to take a walk, and it was something I had learned how to do many years ago. In fact, it was something I was already doing every day. Not only that, but if I wasn’t able to walk 30-45 minutes at a time, I could still achieve some health benefits by walking in smaller chunks throughout the day. So I started walking, and it turned out to be as easy as it sounds. And not only am I improving my overall health, but walking also can yield some unexpected benefits. I use my walking time as an opportunity to listen to podcasts, so I’m learning new things in the process. Granted, I only listen to podcasts that focus exclusively on knock-knock jokes, but you might choose something different (although, why?). I also reconnect with neighbors on my walks, explore new parts of town and find myself relaxing as I spend more time in nature. I used to see nature simply as that space that existed outside my house or car windows, but it turns out there’s more to it. Who knew? So now I’m back to trying to figure out what my special talent is—since, again, they say everybody has one. Maybe mine is proving that there are exceptions to every rule.

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new& noteworthy Sentara Martha Jefferson is pleased to welcome the following new providers into the hospital community. To get connected with one of our providers, or for more information on any caregiver at Sentara Martha Jefferson Hospital, please call 1-800-SENTARA. More information can also be found at Sentara.com.

Jimi O. Akingbade, MD Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580

Linnea Goodman, MD Reproductive Medicine & Surgery Virginia Fertility & IVF 434-654-8520

N. Shane Allen, CRNA Anesthesiology Sentara Anesthesiology Specialists

Amy Lansing, PA Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580

Sentara Martha Jefferson Joins Community Effort to Reduce Greenhouse Gas Emissions Sentara Martha Jefferson is pleased to be working with other community partners, through the Community Climate Collaborative’s Green Business Alliance, to reduce greenhouse gas emissions. This group of businesses has committed to reducing its collective emissions by 45 percent by 2025. A kickoff event for the hospital’s efforts took place at Sentara Martha Jefferson in May, with Gov. Ralph Northam in attendance. Sentara Martha Jefferson is pleased to be a part of this local community group, which is taking a leading role in addressing climate change and helping to ready our economy for a future that is more reliant on clean energy sources.

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Sentara Martha Jefferson Hospital Receives “A” Safety Grade from The Leapfrog Group

Sentara MJH has been awarded an “A” grade in safety in the spring 2021 Leapfrog Hospital Safety Grades. This national distinction recognizes Sentara MJH’s achievements in protecting patients from errors, injuries, accidents, and infections. The Leapfrog Group is an independent national watchdog organization committed to health care quality and safety. The Leapfrog Hospital Safety Grade assigns an “A,” “B,” “C,” “D,” or “F” grade to all general hospitals across the country and is updated every six months. It is the only hospital ratings program based exclusively on hospitals’ prevention of medical errors and other harms to patients in their care. “An ‘A’ safety grade is an elite designation that your community should be proud of,” said Leah Binder, president and CEO of The Leapfrog Group. “The past year has been extraordinarily difficult for hospitals, but Sentara Martha Jefferson Hospital shows us it is possible to keep a laser focus on patients and their safety, no matter what it takes.” Developed under the guidance of a national Expert Panel, the Leapfrog Hospital Safety Grade uses up to 27 measures of publicly available hospital safety data to assign grades to more than 2,700 U.S. acute-care hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public. For more information, visit hospitalsafetygrade.org.

Introducing Sentara Martha Jefferson’s New Breast Health Navigator Whenever a woman goes in for a mammogram, there is at least a minor undercurrent of anxiety as she wonders, “Will they find something?” About 12 percent of women will develop breast cancer in their lifetime, and for most of those women, that undercurrent of anxiety becomes a flood as they begin the journey through cancer treatment. Enter Jessica Cooper, BSN, RN, OCN, Breast Health Navigator at Sentara Martha Jefferson Hospital. Cooper’s full-time job is to support these women, from the moment they receive a callback for additional diagnostic testing, through their treatments and beyond. Nurse navigators have been available at Sentara Martha Jefferson and Jessica Cooper, BSN, RN, OCN other facilities for many years. In recent years, these caregivers have become increasingly vital in helping to guide patients facing a cancer diagnosis through the myriad steps, services and options available. Nurse navigators also educate and advocate for patients and their caregivers. Toward that end, Cooper’s many daily tasks include: •

Educating patients about their disease and treatment options

•

Offering emotional support

•

Helping to manage side effects

•

Assisting in communication with doctors and acting as a liaison

•

Offering aid in setting up appointments, getting rides to treatments, etc.

•

Ensuring translation services are available to non-native speakers

“As the breast health navigator, I’m here to connect my patients to all the resources they may need, including physical therapy, clinical social workers, financial counselors, dietitians—anyone who can help the whole patient throughout their journey,” says Cooper. “The one thing I want my patients to know is that there is always someone there for them. They are never going to be alone in their journey, and I will be there to help support them.” sentara.com

PHYS ICIAN’S PER SPEC TIVE

Providing Exceptional Cancer Care

in the Face of a Pandemic

ven during “normal” times, a cancer diagnosis can turn a patient’s entire world upside-down. And over the past year, with the added difficulties and uncertainties of receiving medical treatment during a global pandemic, patients often have been left to navigate clinic visits, treatments and recovery on their own, or with limited in-person support. Without question, 2020 was one of the most challenging years for patients and their care providers. With that challenge, however, came opportunity—a chance for the Sentara Martha Jefferson team to find creative ways to provide a care experience that is second to none. During the pandemic, nearly every aspect of health care had to be adjusted to protect patients and caregivers alike. Elective procedures and surgeries were postponed, and routine follow-ups were pushed back or transitioned to telehealth visits. While some specialties were a better fit for virtual care, oncology went through a more challenging transition. Due to the potential seriousness of any oncology visit, significant delays in diagnosis or treatment were likely to have negative impacts on patients. Since our patients often require inperson evaluation and then receive their

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By Erin McLoughlin, MD, Medical Oncologist/ Hematologist

treatment at our infusion treatment center, the pandemic presented unique challenges, in terms of ensuring that our patients were treated in a safe and timely manner. Thankfully, the Sentara Martha Jefferson team proved to be adept at devising solutions to many such obstacles.

Addressing Numerous Challenges Our infusion treatment center is a perfect example of this

struggle. As a physician, while I may see a patient for 20 minutes or so on a particular day, a treatment session may actually last five or six hours. This extended time in the infusion center was never intended to be an experience that patients had to face alone—to help keep patients at ease and engaged, interactions during treatments with nurses, volunteers, support services and loved ones are typically frequent. Limiting the infusion center experience to only the patient and nurse, due to COVID restrictions, fundamentally altered our fullspectrum approach to care. The importance of a patient’s personal support system has long been known, so pandemic-related patient isolation and loneliness have been very real concerns for caregivers. Limited patient interactions with friends and loved ones—including not being able to physically be together for appointments and treatments—has taken a toll on patient well-being. As well, when loved ones are forced to receive updates secondhand, largely unable to provide direct assistance, they can experience stress and anxiety. Access to care during the pandemic also has been a troubling issue. Although many of us take for granted the easy access to and reliance on technology for everyday tasks, not all our patients have smartphones or reliable internet access. As a result, the pandemic has placed many of those without reliable access to virtual care in an even more precarious situation. Another difficulty experienced by caregivers during the past year has involved our ability to connect with and comfort our patients. As oncologists we are frequently in the position of having to deliver difficult news. While we all have our own approach and style for doing so, the foundation of such conversations relies on developing interpersonal connections with our patients and their families. Having to deliver challenging news while socially distanced— behind a mask and refraining from offering a comforting touch or hug—has felt very unnatural to me. In fact, in such instances, I often had to remind myself to take a few sentara.com

steps back or put my hands at my sides in order to maintain proper COVID protocols.

provider, during visits I also personally made a concerted effort to identify specific stressors brought on by the pandemic—often unrelated to a patient’s diagnosis or treatment—and Finding Solutions ensure that those issues were being addressed The delivery of cancer care has long focused as well. on creating a culture of support and empathy. Increased collaboration among caregivSentara Martha Jefferson team members coners also emerged as a valuable caregiving tool stantly strive to support all aspects of a patient’s during the pandemic. Although oncology care health—physical, mental and emotional. The has always been a multispecialty field requirpandemic, however, created a situation in ing a high level of interaction and shared which our healthcare providers not only had to management of patients among the subspeadjust to the inconveniences cialties, the pandemic called of physical separation, but for even more coordination also had to find new ways, and shared decision-making The Sentara Martha Jefferson even amidst those circumthan before. Complex deciCancer Center offers the stances, to deliver the same sions about whether to omit following support services to level of all-encompassing supspecific treatments, options our patients and their families: port to our patients and their for shorter courses of cheloved ones. motherapy or radiation, and Overcoming such chal• Certified cancer genetic discussions about the actual lenges to care has been counselor benefit of a particular therapy daunting, but in countless • Cancer nurse navigators were much more common instances, I have seen our over the past year than before • Case management, team rise to the occasion the arrival of COVID. social worker and to care for our patients in While we have now largely financial counseling keeping with Sentara Martha adapted to our “new normal,” Jefferson’s Caring Tradi• Palliative care one in which fist and elbow tion. Whether patients were • Cancer survivorship clinic bumps have replaced handnew to our practice or with and a “Living with Cancer: shakes and hugs, the longing us long term, we wanted to Facing Forward” class for closer human interactions provide the same services persists. While I am heartened • High-risk breast clinic they had come to expect by the creative solutions develand rely on in years past. For • Support groups oped by our entire care team example, we pivoted many to adapt to the pandemic, I • Clinical trials of our support services and am still concerned for those support groups to be offered • The Something Special whose access to care has been virtually. For clinic visits, we Shop—certified mastectomy reduced by COVID restricregularly made efforts to bra and prothesis fitter tions. Certainly, my perspecinclude support persons via • Marianne’s Room—wigs, tive on the delivery of care has phone or video chat during hats and cooling cap fittings been forever changed. clinic visits, to ensure that And while the pandemic’s • Cancer rehab and renewal patients and their families global toll around the world exercise support program could take in information has been staggering, the care and ask questions as needed. • Smoking-cessation team at Sentara Martha JefferAs well, our clinic and infuspecialists son is stronger than ever, and sion center nurses have done we now have more tools at our For more information on an outstanding job stepping fingertips to continue providCancer Support Services, into the void created by the ing the high-quality care that call our Cancer Resource Center lack of visitor access, making our patients and their loved at 434-654-8401. extra efforts to engage and ones have come to expect. connect with patients. As a

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SUMMER 2021

ON-CALL ADVICE

Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions

What is lupus? Lupus, also known as systemic lupus erythematosus, is a type of chronic autoimmune disorder in which the body’s immune system attacks its own healthy tissues or organs. The resulting inflammation may damage the joints, skin, blood cells, kidneys or other organs. No one fully understands why lupus and other autoimmune responses occur. Symptoms of the condition vary from person to person, and often come and go. Most people with lupus experience joint pain, often with stiffness, swelling or arthritis; mild to severe fatigue; and a skin rash that may get worse in sunlight. About half of

those with such a rash develop a characteristic “butterfly rash” across the nose and both cheeks. Fever that cannot be traced to another cause also may be present. Other symptoms may occur as well, depending on which organs are affected. Diagnosis typically is based on the presence of several characteristic symptoms and may be confirmed by tests to check for inflammation in the body, including blood or antibody tests, urinalysis, X-rays and biopsy. No cure for lupus currently exists, so the goal of treatment is to control symptoms and minimize organ damage. Treatment varies by person and depends on the organs affected and how severely symptoms are interfering with the individual’s daily activities. In milder

SYMPTOMS

cases, doctors may prescribe anti-inflammatory and pain medications to treat muscular or joint pain or swelling, antimalarial medications to treat pain and fatigue, and corticosteroid creams for skin rash. More severe cases may require medications to suppress the immune system. Most people with lupus have the mild form, with occasional symptom flare-ups. If left untreated, lupus can lead to complications such as blood clots, destruction of red blood cells, low blood platelets, inflammation of blood vessels, and fluid around the heart or in the lungs. Having lupus also raises a person’s risk of having a heart attack or stroke. People living with lupus should see their doctor regularly, avoid getting too much exposure to sunlight, stay current with immunizations, engage regularly in heart-healthy physical activity, and eat a balanced, healthy diet. sentara.com

ON- C ALL A DVICE

Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions

What are blood clots, and why are they dangerous? A clot is a clump of blood cells and other blood components that forms in the blood. In response to an injured artery or vein, clot formation is normal, helping to stop bleeding and promote healing. After such a wound heals and the clot is no longer needed, the body releases chemicals to dissolve the clot. Sometimes inappropriate clotting can take place, however, obstructing normal blood flow. In some cases, clots form in one part of the body and then migrate to another area, where they can cause harm. These dangerous clots may form for a variety of reasons, including due to surgery or trauma; in response to plaque, a fatty substance that builds up gradually inside arteries; or due to health problems like heart disease or high blood pressure. Factors that increase a person’s risk of forming dangerous clots include smoking, obesity, prolonged lack of physical activity, advanced age, some forms of hormone therapy and certain genetic factors. Common symptoms of blood clots include pain and swelling, with other varying

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SUMMER 2021

effects throughout the body. For instance, clots in the legs often make it painful to walk, while clots in the lungs may produce chest pain and shortness of breath. In some cases, a potentially life-threatening condition known as pulmonary embolism occurs when a blood clot travels to a lung and blocks the flow of blood. When a clot blocks a coronary artery, the result may be angina (chest pain) or a heart attack. When a clot blocks a carotid artery, which supplies blood to the brain, or blocks a vessel inside the brain, it may cause a stroke. Clots in the kidney may lead to high blood pressure or kidney failure.

Medications for preventing the formation of blood clots include anticoagulants (“blood thinners”) such as warfarin, heparin, apixaban (Eliquis®) and rivaroxaban (Xarelto®). In addition, so-called “clot buster” medications can be used to dissolve clots. In serious cases, doctors may perform a minimally invasive catheter-based procedure that involves inserting a long, thin tube into an affected blood vessel to remove a clot. Occasionally, a more extensive procedure known as a thrombectomy may be performed to remove a clot. People can lower their risk of developing blood clots by eating a healthy diet, maintaining a healthy weight, staying physically active and not smoking.

IMPROVE HEALTH EVERY DAY

i l o C . E t s n i a g A Be on Guard One of the most common sources of foodborne illness is a bacteria named Escherichia coli, or E. coli for short. Certain types of E. coli make a toxin that can cause diarrhea, urinary tract infections, respiratory problems and other serious illnesses. Some people, including children, pregnant women, older adults and individuals with weakened immune systems, are at higher risk for contracting a foodborne illness. The best way to protect yourself from E. coli infection is to follow strict hygiene recommendations and observe safe practices when preparing food.

When preparing food, follow these guidelines:

• •

Wash fruits and vegetables under running water before use Cook meats thoroughly, using a food thermometer to ensure the meat reaches an internal temperature suitable for killing E. coli and other bacteria (most meat packaging will list the appropriate internal temperature)

The most important hygiene practice is to wash your hands thoroughly in the following situations:

• • • •

Before and after handling food— especially raw meats, vegetables and fruits After using the bathroom or changing diapers After touching animals or objects that animals use, such as food bowls, pet toys and beds Before preparing and feeding bottles or foods to an infant or toddler, or touching anything that goes into a child’s mouth

If soap and water are not available, use an alcohol-based hand sanitizer.

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I M PROVE HEA LTH EVE RY DAY

SUNSCREEN SMARTS If you’re going out in the sun for any length of time, be sure to apply sunscreen to all exposed areas of your body to protect your skin from the sun’s damaging ultraviolet UVA and UVB rays. Not all sunscreens are created equal, so be sure to choose your sunscreen based upon factors other than its fragrance or degree of greasiness. Using any sunscreen is better than using no sunscreen at all, but for the best protection, experts recommend using a sunscreen with the following characteristics: •

Broad-spectrum coverage, protecting you from both UVA and UVB rays

•

Resistance to water and perspiration, if you will be going in the water or will be exposed to high temperatures that promote perspiration

•

A sun protection factor (SPF) of 30 or higher

Put on your sunscreen about 15 minutes before going out in the sun. Reapply sunscreen according to the label’s directions or at least every two hours—and more frequently if you go in the water or are sweating. Even water-resistant sunscreens can begin to break down when exposed to water or perspiration, and in such cases should be reapplied after about 40 minutes.

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COVID Vaccine and

Mammograms Since the initial rollout of the COVID-19 vaccines in late 2020, the public has been advised that the vaccines may cause certain mild symptoms that mimic some of the symptoms of full-scale virus infection, such as slight fever, headache and fatigue. These symptoms are a sign that the vaccine is “working,” and they typically go away on their own within a few days. Recently, breast health experts have noted an additional symptom of COVID-19 vaccination: swollen lymph nodes under the same arm in which patients received their injection. This is an additional normal response by the immune system, and similar swelling often occurs in women who get the flu shot. Like the other postvaccination symptoms, swollen lymph nodes are an indication that the immune system is preparing itself to fend off any future COVID-19 infection. According to the Centers for Disease Control and Prevention, swollen lymph nodes that occur following COVID-19 vaccination typically go away on their own within a few days to a few weeks. However, breast health experts point out that swollen lymph nodes under the arm also can be a sign of breast cancer.

If such swelling doesn’t go away within a few weeks, or if it continues to get bigger, see your healthcare provider. Should women who have received the COVID-19 vaccine delay getting a mammogram? Many breast-screening experts suggest that women may delay having a regular annual screening mammogram for four to six weeks following COVID-19 vaccination (after the second shot, if the vaccine requires two doses). However, women who have other symptoms of breast cancer, who have a known breast cancer or who have been previously treated for breast cancer should not delay having a mammogram—even if it is scheduled for right after a COVID-19 vaccination. If you have questions about mammograms and the COVID-19 vaccines, be sure to speak with your physician.

Does Acid Reflux Cause Cancer? Acid reflux occurs when stomach acid enters the lower esophagus, where it does not belong, and where it may cause indigestion, heartburn or other feelings of discomfort that seem to come from the chest or upper abdomen. While nearly everyone has occasional episodes of acid reflux, symptoms also can be long-term or chronic—a condition known as gastroesophageal reflux disease (GERD). People with GERD have a somewhat increased risk of developing cancer of the esophagus; however, GERD is very common, and the vast majority of people who have it will not develop esophageal cancer. GERD can lead to esophageal cancer by causing what is known as Barrett’s esophagus, a condition in which the squamous cells that line the interior of the esophagus are transformed into gland cells. Gland cells, which are more resistant to stomach acid, are similar to the cells that line the inside of the stomach. People with Barrett’s esophagus typically have had GERD for a long time, and they are at significantly higher risk of developing esophageal cancer (about 1 in 400). Still, the majority of people with Barrett’s esophagus do not develop cancer from the condition. If you suffer from persistent acid reflux, talk to your doctor. Effective treatments are available. sentara.com

Gforrilling Good Health EAT WELL , LIVE WELL

By Robin Atwood, MS, RDN, CSO Sentara RMH Medical Center

It’s that time of year again when the weather is good for grilling outside. You may already know that choosing grilled foods over fried foods generally reduces the calorie density of food—but to make your grilled food choices healthy, you will want to look at how you are grilling as well as what you are grilling.

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Grilled Chicken Fajitas Ingredients

How to Grill Healthfully One major tip for healthy grilling is simple: Don’t burn the meat, poultry (chicken and turkey), and seafood. Although there isn’t clear evidence that grilling animal products directly increases cancer risk, experts at the American Institute of Cancer Research (AICR) warn that charring meat, poultry and seafood while cooking at high temperatures in the presence of smoke forms substances called polycyclic aromatic hydrocarbons (PAHs) and heterocyclic amines (HCAs), which can cause changes in our DNA that may lead to cancer. To avoid formation of PAHs and HCAs: • Marinate meat, poultry and fish in an acidic marinade (containing vinegar, lemon juice, orange juice or wine, along with herbs and spices). Studies show that marinating in this type of marinade for at least 30 minutes prior to grilling can decrease the formation of HCAs by as much as 90%. • Choose lean cuts of meat and trim excess fat before grilling. Potentially cancer-causing PAHs form in the smoke when fat from meat, poultry or fish drips onto the heat source. That PAH-filled smoke then coats your food. • Cook at a lower temperature and flip meat frequently to reduce charring. • Avoid flare-ups and keep juice from dripping into the fire. Cover the grill with aluminum foil and puncture the foil with tiny holes. • Trim off any charred flesh before eating. • Precook food. Cook meat, poultry or fish in the oven or microwave for 2-5 minutes, then finish cooking on the grill. Less grill time means less exposure to potentially cancer-causing substances. • Choose gas over wood or charcoal. You will have more flame and flare-ups with wood and charcoal, which can increase charring and smoke contact with meat, creating both PAHs and HCAs.

6 boneless, skinless chicken breasts (about 6 ounces each) ½ cup canola oil ¼ cup red wine vinegar 1/3 cup lime juice ¼ cup finely chopped onion 2 cloves garlic, minced 1 teaspoon sugar 1 teaspoon dried oregano leaves ½ teaspoon salt ½ teaspoon pepper ¼ teaspoon ground cumin 12 flour tortillas (8-inch) 6 cups shredded lettuce 2 cups chopped tomato 3 ripe avocados, peeled, seeded and sliced 2 cups of your favorite salsa

Directions 1.

For the marinade, whisk together oil, vinegar, lime juice, onion, garlic, sugar, oregano, salt, pepper and cumin in a shallow, nonmetal container.

One at a time, place each chicken breast on a cutting board, place a sheet of plastic wrap over chicken and pound to an even ½-inch thickness.

Add chicken to the marinade, turning to coat each side, then cover and refrigerate for 4 hours, turning occasionally.

Prepare grill for direct cooking over medium heat (350-450 degrees F).

Wrap 6 tortillas each in 2 foil packets.

Remove chicken from marinade, discard marinade and place chicken on the grill. Grill with lid closed until chicken is no longer pink and a meat thermometer reads 165 degrees F. This should take 6-8 minutes, turning once. At the same time, warm the tortilla packets over direct heat for 2-4 minutes, turning once.

Place chicken on a clean cutting board and slice crosswise into ¼-inch strips. Transfer to a clean bowl or plate and serve with the warmed tortillas, lettuce, tomato, avocado and salsa.

What to Grill for Good Health Limit processed meats such as hot dogs, sausages, bratwurst and bacon. According to the AICR, even small amounts of processed meats, if eaten regularly, can increase your risk for colorectal and stomach cancer. sentara.com

E AT WE LL , LIVE WEL L

Grilled Summer Vegetables Serves 4 Ingredients 4 ounces baby bella mushrooms 1 eggplant 1 zucchini 1 yellow squash 1 onion 1 bunch thick asparagus 1 red bell pepper 2 tablespoons extra-virgin olive oil 1 tablespoon kosher salt 1 tablespoon freshly ground black pepper 2 tablespoons fresh basil, chopped ¼ cup balsamic vinegar reduction or your favorite salad dressing

Directions 1.

Preheat the grill to medium heat (350-450 degrees F).

Chop the mushrooms in half. Trim the ends of the eggplant, zucchini, yellow squash and onion, and cut into slices of 1/3-inch to ½-inch. Seed the red bell pepper and cut into quarters. Trim the asparagus ends.

Drizzle the vegetables with olive oil and sprinkle evenly with salt and pepper. Place the vegetables in a grill basket or grill pan and grill with the lid closed until tender and lightly charred all over—about 8-10 minutes for the bell peppers, onion and mushroom, and 5-7 minutes for the yellow squash, zucchini, eggplant and asparagus.

Sprinkle with fresh basil and drizzle with balsamic vinegar reduction or a dressing of your choice. Serve warm, cold or at room temperature.

Limit red meat. Diets high in red meat increase your risk of colorectal cancer. The AICR recommends limiting red meat to 12-18 ounces of cooked red meat (beef, pork, lamb or venison) per week. Choose to grill poultry and seafood more often. Fish such as salmon and tuna contain omega-3 fatty acids, which have been shown to decrease inflammation in the body, promote heart health and possibly benefit brain health as well. Grill plant-based foods such as veggie burgers, fruits and marinated vegetables. Grilling fruits and vegetables produces no HCAs or PAHs and poses no potential cancer risks. In fact, diets high in plant foods are associated with reduced risk of several cancers.

Safe Grilling According to the Centers for Disease Control and Prevention (CDC), food poisoning cases rise in the summer months, when warm temperatures increase the growth rate of bacteria in our foods. Be mindful of the following CDC food safety principles when planning to grill: When shopping for meat, poultry or seafood, add them to your cart last, keep them separated from other foods and keep them chilled/refrigerated below 40 degrees Fahrenheit until ready to grill. Wash your hands before and after handling raw meat, poultry and seafood. It is also important to wash your work surfaces, grill and utensils before and after cooking meat, poultry and seafood. Use a food thermometer to check that your grilled foods reach an internal temperature that will kill any foodborne pathogens: •

Beef, pork, lamb, veal, fish: 145 degrees F

•

Hamburger and other ground meats: 160 degrees F

•

Poultry: 165 degrees F

After grilling, discard any marinades or sauces that have touched raw juices of meat, fish or poultry. Use a clean plate to serve the grilled food. Refrigerate or freeze any leftover grilled meats, fish or poultry within 2 hours of cooking—or within 1 hour of cooking, if the air temperature is above 90 degrees F.

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calendar

Sentara Martha Jefferson Hospital is pleased to provide a variety of health education opportunities to community members. Highlights of the summer/fall 2021 offerings are listed below. A full list of classes, support groups and seminars can be found by visiting Sentara.com or calling 1-800-SENTARA (1-800-736-8272). About Bariatric Surgery: An Information Session for Those Seeking Lifelong Weight Management Sept. 23, Nov. 18, 1-3 p.m. This free seminar discusses specific types of bariatric surgery and whether those options might be right for you. Monthly in-person seminars will be held on the dates above in the Kessler Conference Room, Sentara Martha Jefferson Outpatient Care Center. COVID-19 safety precautions will be observed. A free online seminar is also available at Sentara.com/weightlosssurgery.

Joint Camp: A Complete Guide to Preparing for Knee and Hip Surgery Details on Sentara.com. Call Tiffany Townsend, BSN, RN, at 434-654-8338 to obtain the Sentara Martha Jefferson Joint Camp video link.

VIRTUAL CLASS: Preparation for Childbirth * Call 1-800-SENTARA or visit SentaraMJHMaternity.com for dates and times. Classes are conducted by a certified childbirth instructor, and topics include understanding and managing the different stages of labor through relaxation, labor positions and breathing techniques; medication options; and Caesarean birth. Early registration is encouraged!

Advance Care Planning Assistance If you desire assistance completing your advance care plan, please call 434-654-8407. We can answer your questions and assist you via telephone or Zoom. In-person classes will resume when it is safe to gather.

VIRTUAL SUPPORT GROUP: Out of the Blues—Postpartum Support Meets the second and fourth Thursdays of each month, 10:30 a.m.-noon. Even if this is not your first baby, sometimes the work of caring for your family can be overwhelming and bring unexpected stress, worry and sadness. If you need a place to talk, we are here for you. Feel free to bring your baby and connect with others who may be experiencing similar challenges. For more information or to be added to the email list to receive a link to join, call 434-654-4415.

VIRTUAL SUPPORT GROUP: Empty Arms, Full Hearts Held the third Thursday of each month, 7-8:30 p.m. For parents of deceased infants; find space and time to share with other parents who are going through the same experiences. Currently meeting by Zoom. To request the meeting link, please contact Tammy James at 434-654-5597.

Registration for all classes is required unless otherwise noted. To register, call 1-800-SENTARA.

calendar

VIRTUAL Cancer Support Groups Various cancer support groups are offered: • Coping with Breast Cancer • Living with Cancer (for new patients) • Establishing a New Normal (cancer survivorship)

Sentara Martha Jefferson offers a variety of other classes and seminars, including the following:

Please contact Tammy James at 434-654-5597 to explore which group best fits your needs.

Basics in Baby Care

Sentara Star Hill Health Center

Breastfeeding

A Free Wellness Center Focused on Chronic Disease Prevention and Management located at the Jefferson School City Center, 233 4th St. NW, second floor, Charlottesville

Welcome to Motherhood Support Group (virtual)

Currently, because of the COVID-19 pandemic, we are not holding our drop-in sessions, but we are seeing patients and offering the community the opportunity to schedule appointments to have their blood pressure, blood sugar and weight checked. Also conducting virtual group sessions and virtual cooking classes, and connecting community members to resources and services that provide mental and physical wellness. All services are free and open to the public. For information or to schedule an appointment, call 434-984-6220.

Sunsets with Sentara August 28, 5:00 p.m.

Parenting Support Group for Survival (virtual) Most classes are free. For a complete list of classes, support groups and seminars at Sentara Martha Jefferson Hospital, please visit www.sentara.com.

With

sentara

Sentara Martha Jefferson is pleased to present a special 10-year anniversary Sunsets with Sentara on Saturday, August 28. Gates open at 5:00 p.m. and music starts at 5:30 p.m. Relax on the lawn at Sentara Martha Jefferson Hospital with your family while you enjoy the sunset and music provided by a local band. Refreshments will be available for purchase from local food trucks, wineries, cideries and breweries.

Registration for all classes is required unless otherwise noted. To register, call 1-800-SENTARA (1-800-736-8272).

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10 Years on Pantops Mountain

Sentara Martha Jefferson Hospital Celebrates a Decade of Growth A photograph displayed on the desk of Amy Black, DNP, RN, NEA-BC, captures a historic moment: a small circle of people watching as a pink ambulance departs from Sentara Martha Jefferson Hospital’s former location at 459 Locust Ave. The squad was transporting a breast cancer patient to the hospital’s brand-new building on Pantops Mountain—the last of 59 patients moved from the old facility to the new one. » sentara.com

10 Years

The image, taken on Aug. 28, 2011, depicts a celebratory mood and features broad smiles. Black is shown embracing Becky Owen, MSN, RN, a former hospital nursing director who has since retired. “Just seeing the smiles on people’s faces, I remember it was so gratifying to have a safe moving day and be off to the new hospital,” recalls Black, vice president and chief operating officer at Sentara Martha Jefferson. “Many people had put in more than three years of work planning the new facility, and we knew it was going to be beautiful. It was such a thoughtful design and collaborative process. We knew we would enjoy the fruits of our labor, and it was truly a labor of love.” This August, the first 10 years on Pantops will come to a close, and one thing is certain: Sentara Martha Jefferson has thrived in its 520,000-square-foot, 176-bed facility, which comes complete with spectacular views. In June 2011, Martha Jefferson merged with Sentara Healthcare, an innovative, community-focused, not-for-profit organization founded in Norfolk in 1888. Martha Jefferson became the 10th hospital to join the Sentara

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system, following the addition of RMH Medical Center in Harrisonburg, and together the two facilities became the Blue Ridge Region of Sentara. This partnership with a larger system has enhanced the hospital’s ability to offer safe, high-quality medical care. “One of the strengths we’ve acquired through integration with Sentara has really come from being able to tap into the knowledge and experience of our peers across the system,” says Allison Crawford, MSN, RN, director of the Surgical Interventional Procedural Center. “That allows us to leverage our strengths as groups of clinicians and healthcare leaders, bouncing ideas off of one another and supporting each other.” Over the past decade, although Sentara Martha Jefferson has added new healthcare services, new partnerships and new programs, patients remain at the center of every decision.

A Focus on Patients and Community Since the hospital’s founding in 1903, patients have been at the heart of Sentara Martha Jefferson’s mission, and the move from downtown Charlottesville to Pantops hasn’t changed that focus. In fact, the new facility and its picturesque setting provide a soothing, healing environment that embraces Central Virginia’s natural beauty and helps foster a safe and comfortable patient

A Strong Caring Tradition Since Sentara Martha Jefferson Hospital moved to Pantops Mountain 10 years ago, individuals from Charlottesville and beyond have demonstrated love and enthusiasm for the hospital’s vision of providing world-class care in Central Virginia. Philanthropy has been the backbone of Sentara Martha Jefferson’s efforts to go beyond what is expected from health care in the 21st century. The generosity of time and resources offered by the community has been vital in strengthening the hospital’s Caring Tradition. Gifts to the Martha Jefferson Hospital Foundation have made possible or enhanced numerous programs and initiatives, including: • Palliative Care • Haden Institute for Nursing Excellence And Innovation • Clinical Education Center • Caregiver Center • Cancer Resource Center (Includes Marianne’s Room, the Something Special Shop, Caring Embrace, Look Better Feel Better, the High-Risk Breast Program and Free Breast Cancer Screening Clinics) • Cancer Survivorship Program • Sentara Starr Hill Health Center Please see page 41 to learn more about how philanthropy supports the mission of Sentara Martha Jefferson.

experience. For example, private patient rooms in the new hospital reduce the risk of infection, while giving patients and families the privacy they need during anxious times. Sentara Martha Jefferson is committed to caring for the whole person. The Cancer Center Tumor Board, for example, provides a multidisciplinary focus on each cancer patient’s medical and nonmedical needs. The hospital also offers little touches to enhance the patient experience, such as the Acts of Kindness program and the Caring Always Cart for inpatients, as well as new-parent celebratory meals and massage therapy for cancer patients. Patients aren’t the only ones who need and deserve special attention, however. Caregivers—usually spouses, parents, children or siblings—also have physical, emotional and spiritual concerns. Sentara Martha Jefferson’s new Caregiver Center, which opened in 2020, provides a quiet place to rest and recharge, with counseling and coaching available to caregivers who may need some extra assistance and encouragement. Sentara Martha Jefferson has always been a communityfocused hospital, and that tradition continues strong today. The Sentara Starr Hill Health Center, for instance, has helped maintain the hospital’s connection to neighborhoods in downtown Charlottesville by offering programs to help prevent and manage chronic diseases like heart disease, diabetes and obesity. During the pandemic, the center was instrumental in addressing vaccine hesitancy and expanding sentara.com

10 Years

immunization access to communities of color. And to strengthen relationships across the Charlottesville community and beyond, the hospital established the Patient and Family Advisory Council to facilitate prompt and effective responses to patient and family needs and priorities. Robert Chambers, a supply chain associate who was working in Dining Services at the time of the move, says that having a larger building not only provided staff members more space to do their jobs, it also provided more comfort and privacy to visitors. “It was just so much more comfortable once patients and their families got the extra space they needed while waiting to get news—or just to take a break,” Chambers says. “Patients’ loved ones often experience anxiety in hospital settings, so to be able to help them relax a bit was a huge plus—and the new hospital provides that benefit for our community.”

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Access to Sophisticated, Compassionate Care Over the past decade, Sentara Martha Jefferson has established or expanded several service lines and programs to provide patients with advanced therapies. In 2015, the hospital also began offering neurointerventional surgery services for treatment of advanced stroke and aneurysm. As a vital piece of that program, the hospital’s helipad opened in 2016. Both of these accomplishments laid the groundwork for Sentara Martha Jefferson to become, in 2018, the first hospital in the

nation to receive certification from DNV GL Healthcare as a Primary Plus Stroke Center. The stroke program also has received the Stroke Gold Plus Quality Achievement Award from the American Heart Association/American Stroke Association’s Get with the Guidelines. Other enhancements include the opening of a free-standing Emergency Department in northern Albemarle County in 2012; the addition of advanced gastrointestinal specialists for treating digestive disorders, as well as bariatric surgery specialists; the hiring of new cancer specialists, including colorectal and hepatobiliary surgeons; and the development of the Fast Track Lung Cancer program. On the nursing side, Sentara Martha Jefferson received Magnet® recognition from the American Nurses Credentialing Center—the highest national honor for nursing excellence—in 2006, 2011 and 2016. Currently, only 7% of all U.S. hospitals have achieved Magnet recognition.

“I am left with a sense of joy and pride, recognizing that less than 2% of hospitals in the nation attain four consecutive Magnet designations,” says Johnsa Morris, MBA, MHA, BSN, RN, chief nurse executive for Sentara Martha Jefferson. “This year, Sentara Martha Jefferson participated in its fourth Magnet survey, and we are eagerly awaiting the news of this fourth designation in mid- to late June. All members of the team—including our providers, ancillary support and community members—are encouraged to take time to reflect on how nursing at Sentara Martha Jefferson has maintained the foundational principles, purpose and outcomes required to seek this redesignation.”

Improving Workflow While the aesthetics of the new Sentara Martha Jefferson certainly boast a “wow factor,” the hospital’s design and layout— the planning of which involved team members from all areas of Sentara Martha Jefferson— were primarily intended to support and enhance the efficient delivery of patient care. For example, considerations were made for improving nurse workflows, and with that in mind, each patient room was equipped with a bedside computer, enabling nurses and other clinicians to document cases in real time and keep electronic medical records as accurate as possible. Nikki Eppard, BSN, RN, especially appreciates the “nurse servers” located just outside of each patient room. These cabinets are equipped with medical devices, linens, gowns and other supplies nurses need to care for their patients. “Most everything we need is right there within arm’s reach,” Eppard says. “And the technology has come so far over the past 10 years. We have machines that dispense medications, fall alarms that make it easier to

monitor our patients and single-click sign-on capabilities to access patients’ electronic medical records.”

Supporting the Martha Team Evidence shows a correlation of advanced nursing education with both improved patient outcomes and reduced patient mortality. The Haden Institute for Nursing Excellence and Innovation, which was established in 2013 to support the hospital’s commitment to promoting nursing leadership, superior clinical outcomes and exemplary patient care, offers scholarships to Sentara Martha Jefferson nurses who want to pursue higher-education opportunities. The Institute also offers other types of support, such as loan forgiveness. In 2017, the Martha Jefferson Hospital Foundation launched the Center for Clinical Education, thereby extending educational scholarship opportunities to non-nursing Over the past decade, Sentara Martha professionals on staff as well. Jefferson Hospital has continued its To help look out for the commitment to providing exceptional well-being of staff members, care for the Charlottesville community the leadership team at and beyond. In recent years, Sentara Sentara Martha Jefferson Martha Jefferson has received has expanded the hospital’s numerous honors, including: Caring Tradition to address • DNV Primary Plus Stroke (PSC+) more than just patient needs. Certification from DNV GLResiliency programs, such as the Healthcare (the first hospital Intentional Caring Committee in the nation to receive this and Schwartz Rounds, help designation) staff cope with daily stress and • Blue Distinction® Center+ for reduce feelings of burnout by Bariatric Surgery designation as providing opportunities for part of Anthem Blue Cross Blue open discussion of social and Shield’s Blue Distinction Specialty emotional issues that arise in Care program caring for patients and families. • 5-Star Rating from the Centers for Ultimately, when staff take care Medicare & Medicaid Services of themselves, they can take better care of patients. • Hospitals & Health Networks’ Most Wired Award for 2016 For her part, Crawford feels inspired every day to come to • Soliant Health’s 2012 Most work in the beautiful natural Beautiful Hospital in America surroundings on Pantops. • LEED® certification by the U.S. “We are fortunate to have Green Building Council the landscape and the beauty • Magnet® Recognition for Nursing both inside and outside of this Excellence from the American building,” she says. “It certainly Nurses Credentialing Center does not feel like I’m coming to (2006, 2011, 2016) work at a hospital. I can’t brag enough about this building.”

Awards and Accolades

sentara.com

Coming Together to

Get COVID Vaccines to

Communities of Color 24 |

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The COVID-19 crisis took hospitals and communities largely by surprise in 2020, forcing planners to react quickly and develop ways to keep healthcare teams— and the patients they serve— safe from the virus. Those early challenges helped form new ties and strengthen established bonds among Sentara Healthcare and other healthcare organizations, as well as with community groups, churches, volunteers and government entities. During the early months of 2021, those vital relationships have played a key role in reaching out to communities of color—the groups most affected by COVID-19—to share vital information about vaccines and,

We’re proud to collaborate with our many partners to serve communities of color, to ensure access to the COVID vaccine and provide assistance with other hardships created by the pandemic.”

ultimately, to create a more direct and welcoming path for people in communities of color to get vaccinated against the disease. “We’re proud to collaborate with our many partners to serve communities of color, to ensure access to the COVID vaccine and provide assistance with other hardships created by the pandemic,” says Jackie Martin, director of community benefit for Sentara Martha Jefferson Hospital. “It was important to us to make sure the vaccine events felt approachable and that we were removing some of the barriers to getting vaccinated.” COVID-19 has disproportionately affected many racial and ethnic minority groups, putting them at greater risk of hospitalization and death from the virus, according to the Centers for Disease Control and Prevention. With Martin’s leadership, in collaboration with the African American Pastors Council of Charlottesville & Vicinity (AAPC), Sentara Martha Jefferson set out to reach these vulnerable populations.

Churches Working Together for the Greater Good In the early days of COVID, the African American Pastors Council took a lead role in gathering personal protective equipment (PPE) and supplies for communities of color.

“Houses of worship began meeting to determine how we could best serve our community,” explains the Rev. Dr. Lehman Bates, president of the AAPC and pastor of Ebenezer Baptist Church in Charlottesville. “To help address some of the community’s pandemic-related needs, we distributed face masks, hand sanitizer, cleaning supplies and other PPE.” Throughout 2020, the AAPC held events at churches to distribute these critical supplies and equipment. COVID testing events to reach the Black community also took place at Mt. Zion First African Baptist Church in Charlottesville, led by the Rev. Dr. Alvin Edwards. Martin, whose office is located at the Starr Hill Health Clinic in Charlottesville, sentara.com

and Dr. Jeanita Richardson, professor and director of educational program enhancement at the University of Virginia School of Medicine, worked with community groups to coordinate the testing events, which were initially provided by Sentara, and later by UVA.

Getting the Word Out As vaccines became available to the general public this year, Dr. Richardson, Martin and the AAPC developed a culturally responsive program to reach communities of color. “Vaccine hesitancy aside, when vaccines began to roll out, it was painfully clear that the national trends were being mirrored locally,” Dr. Richardson notes. “Black and brown people weren’t being vaccinated quickly enough, given their proportion of the population and the prevailing risk factors.” In response, the team developed an information campaign to encourage more people to get vaccinated by tapping into the Your Life Matters Cville initiative, which was designed to get health information out in the Black community. Besides working with churches, the team also reached out to African American fraternities, sororities and other community organizations.

Crafting the Message To answer questions and provide information that particularly concerned people of color, the team organized virtual town hall meetings that were staffed with wellknown and respected community leaders, including Black physicians. “When it comes to messaging, it’s important for people of color to do the talking,” says Edwards. “That really helped with the webinars and Zoom calls we set up. We felt that

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Providing Vaccines to Cancer Patients Sentara Martha Jefferson also recognized the need to make vaccines readily available to those with compromised immune systems, such as cancer patients, who are also more vulnerable to the far-reaching effects of the virus. “We recognized the importance of vaccinating those diagnosed with and receiving treatment for cancer because of impacts of cancer on the immune system,” says Crystal Chu PhD(c), BSN, RN, manager of Cancer Programs and Support Services. “Patients with a weakened immune system are at risk for severe COVID-19 disease, so it was really important to provide them any extra protection.” Chu notes that between 330 and 350 patients were vaccinated at clinics held at the Sentara Martha Jefferson Hospital Outpatient Care Center in April. “We offered two clinics so that patients could return for their second shot,” Chu explains. “So many patients were thankful for the opportunity. Despite being eligible for the vaccine and in the priority group, vaccines were not readily available to them elsewhere due to supply.” While the clinics were staffed mainly with cancer center employees, those from various departments, such as surgery, supportive care services, and other patient care services also signed up to help, Chu says. “The team effort that came together to offer these clinics to our community and patients with cancer demonstrated our commitment to the Caring Tradition,” Chu notes. “Everyone was willing to work extra hours and come in on Saturdays to do this important work. Staff commented that they felt as if they were a part of history administering the vaccine, and they felt a sense of purpose in vaccinating a lot of the patients they care for daily in the cancer center.”

having Black people speak would send out a very positive message.” To ease registration concerns, those without computer access or who were uncomfortable with online forms could call their churches directly, and a volunteer would fill out paperwork for them over the phone. Vaccine applications were available in Spanish and English, to help remove language barriers.

Vaccine Opportunities The first vaccine event aimed at serving people of color took place in February 2021. Martin and her task force had a week to line

up people to receive the Moderna vaccine at the Carver Recreation Center clinic in Charlottesville. More than 600 people filed vaccine applications, and during the first event, more than 65 clinicians, staff and volunteers helped vaccinate approximately 450 Black and 130 Latino community members. Outreach to the Latino community was led by Dr. Max Luna at the UVA Health Initiative. Since demand for the vaccine exceeded the doses available at the first clinic, two other vaccine clinics were held at Carver over the next couple of months, attended mostly by persons of color. sentara.com

The Diversity and Inclusion Council at Sentara Martha Jefferson To help build a diverse workforce and foster community partnerships, Sentara Healthcare hospitals recently have formed a number of diversity and inclusion councils. The primary areas of focus are promoting: •

A diverse and talented workforce that is reflected in our frontline workers and leadership team

•

An inclusive and supportive workplace by creating a climate of respect, trust, belonging and collaboration, where all team members feel valued and can thrive, innovate and serve

•

Strategically formed community partnerships to advance diversity and inclusion issues within our corporate social responsibility, health equity programs and supplier diversity In December 2020, the Sentara Martha Jefferson executive team began defining the membership structure for the 22-member diversity council. Members were selected to help ensure that each “dimension of diversity,” as noted by Korn Ferry International, a global organizational consulting firm, was covered. The council’s first meeting took place in February 2021 with 100% participation from its members. “The members of this team are engaged and passionate about pushing forward our ultimate vision: to create a culture where we recognize our differences as our strengths by intentionally fostering a culture of inclusion and belonging, in recognition of our employees and the diverse communities we serve,” says Johnsa Greene-Morris, who is a council member, as well as vice president of patient care and chief nurse executive at Sentara Martha Jefferson. “This focus on our current state, both in-house and in the community,” Greene-Morris continues, “will enable us to align with the priorities of Sentara Healthcare and with our system mission to ‘Improve Health Every Day’ for everyone we serve.”

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A Friendly Vibe Organizers wanted to be sure vaccine clinics were inviting, rather than sterile or intimidating. “We wanted to create something that had more of the feeling of a community gathering when people came to get vaccinated, as opposed to a clinical intervention,” Dr. Richardson says. Martin’s team arranged for food boxes to be available for attendees to take home from vaccine events at Carver and Southwood. The 20-pound boxes, organized by Sentara Martha Jefferson, the Blue Ridge Area Food Bank and other partners through the We Care program (see article on page 38), contained heart-healthy staples like oatmeal, canned vegetables, unsweetened applesauce and Cheerios. The Martha Jefferson Hospital Foundation also staffed a table at the Southwood event to distribute hand sanitizer and face masks. Altogether, the Your Life Matters Cville campaign was instrumental in getting more than 1,500 people of color vaccinated within four months. “We all brought different gifts, specialties and skills to the effort,” Dr. Richardson notes. “None of this would have been possible without Jackie Martin. Her leadership, her ability to pull together a lot of volunteers and talk through logistics, and the relationships she has built—all of them contributed to our success in getting people vaccinated.”

Tina Ryner

Getting Back IN THE

SADDLE After a Herniated Disc

A herniated disc occurs when one or more of the cushions that sit between the bones (vertebrae) of the spine slip out of place, or herniate, resulting in compression of a nerve. Typical symptoms include pain that radiates down the leg, with or without numbness or tingling. Some people also may experience muscle weakness. » sentara.com

Such an injury can make it hard to perform even the most basic tasks. Thankfully, however, a number of treatments are available that can alleviate symptoms and get you back to doing the things you love to do.

Nonsurgical Versus Surgical Approaches The first approaches for treatment are typically nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen and naproxen sodium, as well as epidural steroid injections and physical therapy. When those treatments aren’t effective enough, however, surgery might be an option for some patients, and can be especially helpful for those with: • Pain or numbness and tingling that doesn’t improve after nonsurgical treatments • Muscle weakness • Symptoms that affect quality of life

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Back to an Active Life Tina Ryner moves a lot. Previously, she served as a firefighter and police officer, and now she lives on a farm in Albemarle County, where she enjoys riding horses. “I’m constantly lifting heavy stuff,” explains Ryner, 63. Over the years, she’d had several minor back injuries, but nothing she couldn’t treat on her own. Then one day, as she was walking at her home, she was hit suddenly with severe back pain. Ryner thought a few days of her usual combination of ice and NSAIDs would help, but the pain didn’t improve. “I knew something was wrong when the pain went all the way down my leg and into my toes,”

she explains. “I was just miserable. I couldn’t even sit on the edge of the bed to take my socks off. I couldn’t sit down to eat.” She also couldn’t go to her part-time job, work on her farm or ride her horses, so her quality of life was severely impacted. Ryner tried medication, steroid injections and physical therapy, with no success. Then in April 2020, she saw Sentara Martha Jefferson neurosurgeon Osmond C. Wu, MD, who scheduled her for a surgical procedure the next day. “In the right patient with certain symptoms, surgery can

be an excellent option—but it should be the last option considered,” says Dr. Wu. “Tina tried the appropriate nonoperative options before we performed surgery.” The procedure involved two steps. First, Dr. Wu performed a hemilaminotomy, during which he removed a small portion of the lamina, which is a part of the vertebra. Then he performed a microdiscectomy to remove the protruding, or herniated, portions of Ryner’s disc.“The goal of this surgery is to remove the herniated portion of the disc that is compressing the nerve root, helping to relieve pain,” explains Dr. Wu. Although the procedure can be performed with a traditional “open” incision, Dr. Wu used a minimally invasive approach, which allows for a smaller incision and can result in less pain. Ryner returned home the same day. Most people feel relief immediately after surgery for a herniated disc, and recovery time is typically short. Prior to surgery, Ryner’s pain was so severe that she had to ride to the hospital lying down in her boyfriend’s pickup truck—sitting was just too painful. “When I came out of surgery, I could sit in a wheelchair,” Ryner says. Although she didn’t need any physical therapy after her procedure, she did have to limit her movements and any heavy lifting—limitations she found to be challenging. “The hardest part was remembering I was at a higher risk for injury. I had to remember not to go ahead and do something I would normally do without thinking,” she says. “I took it very seriously because I didn’t want to reinjure myself.” Ryner knew she wanted her surgery at Sentara Martha Jefferson, where she’d previously had cancer treatments. “I retired to this area for the good health care. Dr. Wu and his staff were absolutely awesome. They got me in the next day and made sure my insurance covered my surgery. I was absolutely so impressed. I have sent some of my friends to Dr. Wu, and they’ve been really pleased with him, too.”

Jesse Kelly

Back TO BIKING Jesse Kelly had dealt with lower back issues for several years, but when his entire right leg went numb in the summer of 2020, he knew he needed help. The 35-year-old Charlottesville resident enjoys riding his bike. Although he was still able to ride despite the numbness, his physical therapist noticed that his right calf wasn’t functioning at all. “I was really concerned about losing motor function,” Kelly recalls. Physical therapy, medication and injections didn’t help his condition, and an MRI showed that Kelly had a herniated disc that was causing radiculopathy, or a pinched nerve along the spine. Sentara Martha Jefferson neurosurgeon David F. Slottje, MD, performed a minimally invasive microdiscectomy to remove the disc fragment pushing on Kelly’s spine. “Dr. Slottje got me in quickly,” Kelly says. “He spent a lot of time reviewing my MRI and going over my options.” The professionalism and safety protocols at Sentara Martha Jefferson during the COVID-19 pandemic also impressed Kelly. “It was my first time there as a patient,” he says. “I was really happy with the hospital. They took all the right precautions, and I felt really comfortable.” Kelly returned home the day of his procedure. “It went really well,” he says. “Dr. Slottje’s team was really sentara.com

CONTACT US Sentara Martha Jefferson’s neurosurgeons can treat back pain associated with a number of conditions, including: • Degenerative disc disease • Herniated discs • Osteoarthritis • Spinal stenosis Contact Sentara Martha Jefferson Neurosciences at 434-654-8960.

great, and I felt almost immediate pain relief after the surgery.” One day after the procedure, Kelly was up and walking. After three months of physical therapy, Kelly’s calf function returned fully, and he was back on his bike. “It was a little bit like starting over,” he says. “It took a couple months, but now I’m back to where I was before things started acting up.” Dr. Slottje monitored Kelly’s progress through in-person and telehealth appointments. “He answered a lot of questions and talked me through things,” Kelly adds. According to Dr. Slottje, it’s important to take the time to educate patients, so they know what to expect before and after surgery. “They need to know what should prompt a call to the office and what is normal during recovery from surgery,” he says. For instance, after surgery some patients may experience nerve pain flare-ups or muscle spasms, which can be treated

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with medications like muscle relaxers or steroids. “There can be a lot of worry about surgery. Providing reassurance and clear expectations can help relieve some of that anxiety,” he adds. For Kelly, that clear communication from Dr. Slottje made all the difference. “He created good feedback between the two of us and made me feel

comfortable,” Kelly says. “I’ve had surgeries in the past after which my doctors just had me report back to my primary care doctor, but Dr. Slottje and I had several follow-up visits. He talked to me about returning to full activities like biking and how to ease into those without concerns about reinjury. He was very encouraging.”

AC TIVE LIVING

Getting Back in the Game

Sports Medicine Physicians Tailor Treatments to Athletes’ Goals Sports medicine specialists have an in-depth understanding of athletic injuries, as well as the associated treatment and recovery process. The professionals at Sentara RMH Medical Center and Sentara Martha Jefferson Hospital work with individual athletes to understand their unique goals and needs and guide them to the best treatment path for their situation. “Our primary focus is to restore function and get the athlete moving again,” says orthopedics and sports medicine specialist Thomas S. Weber, MD, of Sentara Orthopedic & Sports Medicine Specialists. “Depending on the situation, we are able to use either surgical or nonsurgical techniques— or a combination of the two—to get athletes back in the game.”

Successful Surgery and a Newfound Career Path

Luke Bailey

Surgery, combined with a year of rehabilitation, helped Luke Bailey get back on the football field—and gave him a focus for his future. During a football scrimmage at Wilson Memorial High School in Fishersville in August 2018, Bailey tore his anterior cruciate ligament (ACL). “I went in to make a tackle,” says the 18-year-old. “I was hit from an awkward angle and went down and twisted my knee.” A sophomore at the time, Bailey didn’t immediately realize the severity of his injury. To assess the situation, he first went to South River Rehabilitation & Performance in Stuarts Draft, sentara.com

AC TI VE LIVIN G

and was then referred to Clark Baumbusch, MD, an orthopedic surgeon at the Sentara Sports Medicine Center. “Dr. Baumbusch knew it was an ACL tear right away,” Bailey recalls. “He scheduled me for surgery before he even had the MRI scan done.” Dr. Baumbusch built a new ACL using a portion of Bailey’s patella (kneecap) tendon. “It’s probably the most common approach for someone who is a contact athlete, and it’s a wellestablished surgical technique,” he explains, noting that each person’s situation is different, and that ACL surgery should be tailored to a patient’s specific injury, goals and expectations. For Bailey, the surgery itself was a breeze. “The whole process was really easy,” he recalls. “I was very comfortable. Everyone I encountered made me comfortable and helped me relax.” His recovery was a long process, however, which is typical with ACL surgery. He started physical therapy the day after surgery, but otherwise spent the first week resting in bed. He then saw Dr. Baumbusch regularly for follow-up care. For the first month, Bailey went to physical therapy five days a week and then tapered to three or four days a week for the next year. Rehab following ACL surgery has evolved in recent years, with an emphasis now on getting people moving and bearing weight immediately after surgery. But rehab also focuses on tailoring a program to the needs and healing

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level of each patient. “Luke was a pleasure to work with,” says Dr. Baumbusch. “I tell my patients that recovery is dependent on several variables: the ability of your surgeon to fix your problem, the ability of your therapist to understand and manage rehab, and the dedication the patient has to get better. When those stars align, the sky’s the limit.” The length of a rehab program depends on each patient’s goals. Bailey transitioned to athletic performance training in the final months of rehab to ensure that he was fully ready for a new season of football. “His goals were to get back to competition and contact sports at a high level,” notes Dr. Baumbusch. “That’s a pretty lofty goal, and in those situations the rehab can last a year.” Rehab and sports conditioning helped prepare Bailey for a return to the competition he loved. “I was in a better place than before the ACL tear,” Bailey says. “I would recommend Dr. Baumbusch 100%. He was awesome and very personable. Every time we went to the clinic, it was always upbeat and cheerful, even though the reason we were there wasn’t fun.” Bailey continued playing at tackle and middle linebacker during his junior and senior years, and also wrestled for Wilson Memorial. “I’ve had zero problems with my ACL,” he says. He’s also a competitive powerlifter and plans to continue lifting while he attends James Madison University in the fall. Somewhat unexpectedly, his injury and rehabilitation process also led him to explore a new career: He now plans to major in kinesiology, with a focus in exercise science.

“My injury is what made me want to go into this career,” he explains. “I was able to see the different aspects of physical therapy and athletic performance training. Ever since then, I’ve wanted to be a strength and conditioning coach.”

A Wrist Break and a Return to the Court Ben Bellamy’s sophomore basket-

ball season at Eastern Mennonite High School in Harrisonburg was cut short in February 2021 by an injury during a state playoff game on his home court. “I went in for a layup near the end of the fourth quarter,” says the sophomore shooting guard. “I jumped up, and a kid went under me and took out my legs.” Bellamy, 17, tried to catch himself on the way down, but all of his body weight landed on his left wrist. “I had never had a broken bone before, but it really hurt, so I figured something bad had happened. I remember thinking how I wouldn’t be able to finish the year and how it would affect my travel basketball season. I was hoping it was just a small sprain.” The athletic trainer covering the game that night, who happened to work at Sentara Orthopedic & Sports Medicine Specialists at Sentara RMH, contacted Dr. Weber to get Bellamy an appointment the following morning. “One great thing about our department is we have employees throughout the region serving as athletic trainers at games,” says Dr. Weber. “This allows us to get people prompt and accurate care, and also save the time and cost of a trip to the emergency room or urgent care.” The next day, X-rays showed that Bellamy had fractured his

Ben Bellamy

wrist. “Dr. Weber was really straight up and didn’t sugarcoat anything,” says Bellamy. “He told me it was going to be six to eight weeks before I’d be back. He was really cool. He knew I was sad, but he was trying to make everything better. He made the process a lot smoother.” Bellamy needed a cast for four weeks and a wrist brace for two weeks after that, but he didn’t require physical therapy. According to Dr. Weber, younger athletes typically don’t need surgery or physical therapy for a wrist break. “These younger patients with wrist fractures tend to bounce back very well,” he says. Dr. Weber did give Bellamy some exercises to perform to strengthen his wrist and get him ready for travel basketball. The exercises included squeezing a stress ball throughout the day to improve Bellamy’s hand strength while he wore the brace. “Once his bone was ready to go, he wanted to play,” Dr. Weber says. “We had him do aggressive therapy, which younger athletes can handle because their bones tolerate it well. We had him back on the court as soon as that cast came off.” Bellamy returned to play most of his travel basketball season in the spring and plans to play Injured? See a Sentara with another travel Sports Medicine Doctor! team this summer. In Harrisonburg: Then, he hopes, it’s Sentara Orthopedic & back to high school Sports Medicine Specialists competition. (East Market Street and Elkton locations) “I thought I was 540-689-5500 going to be out for two months, but it In Charlottesville: was thankfully only Sentara Sports Medicine Center at Sentara about six weeks,” he Martha Jefferson says. “I feel better (Pantops and than ever. I feel Proffit Road locations) really good.” 434-654-5575 sentara.com

HEALTH MATTERS

Take Care of

Anemia

nemia is a common blood disorder in which a person’s red blood cell count is lower than normal, which means less oxygen than normal is being transported through the circulatory system to the body’s tissues and organs. Anemia can occur either because the body makes too few red blood cells, or because the body loses or destroys them faster than it makes new red blood cells. There are many types of anemia, some of which are mild, and others that can be serious or even life-threatening. In addition, anemia can be a temporary or long-term condition.

Symptoms Initially, a person with anemia may not notice that anything is wrong. As the condition worsens, however, so do symptoms. Fatigue is the primary symptom of most types of anemia, but the condition also can cause other symptoms like: • Shortness of breath • Irregular heartbeat • Weakness or dizziness • Cognitive problems • Numbness or coldness in the arms and legs • Pale skin

Types of Anemia The most common types include the following: • Iron-deficiency anemia affects one in five women, nearly half of all pregnant women and about 3% of men in the United States. • Vitamin-deficiency anemia can result from a diet that is deficient in key nutrients—especially folate and vitamin B12, which are needed to produce an adequate amount of red blood cells. • Blood loss anemia can be caused by gastrointestinal conditions like ulcers or gastritis (inflammation of the stomach), or by overusing certain over-the-counter oral pain medications or certain anticoagulant medications that can cause or aggravate ulcers or gastritis. Very frequent and heavy periods also can sometimes cause anemia.

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•

Aplastic anemia: This life-threatening type of anemia results from a decline in the bone marrow’s ability to produce red blood cells. The condition is typically caused by radiation therapy, chemotherapy, pregnancy or lupus. • Anemia resulting from chronic disease: Certain diseases like cancer, bone marrow disease, Crohn’s disease, rheumatoid arthritis and other chronic inflammatory diseases can reduce red blood cell production.

Risk Factors Your chances of developing anemia are greater if you have any of the following conditions: • Alcohol abuse: Excessive alcohol consumption can interfere with red blood cell production. • Diabetes: This chronic condition also can reduce blood cell production. • Family history: If anemia runs in your family, you are at greater risk. • Pregnancy increases a woman’s risk for developing iron-deficiency anemia. • Vegetarian/vegan diet: If you follow a vegetarian or vegan diet, make sure you get sufficient iron to support red blood cell production. If you have symptoms of anemia or suspect you may have the condition, see your physician. Even if your anemia is not severe, you can improve your quality of life by treating this common blood disorder.

LA SALUD IMPORTA

Cuidarse de la

anemia

a anemia es un trastorno sanguíneo común en el cual el recuento de glóbulos rojos de una persona es inferior al normal, lo que significa que se está transportando menos oxígeno de lo normal a los tejidos y órganos del cuerpo a través del sistema circulatorio. Síntomas Inicialmente, una persona con anemia puede que no note que algo anda mal. Sin embargo, a medida que la afección empeora, también lo hacen los síntomas. La fatiga es el síntoma principal de la mayoría de los tipos de anemia, pero la afección también puede causar otros síntomas como: • dificultad para respirar • ritmo cardíaco irregular • debilidad o mareos • problemas cognitivos • entumecimiento o frialdad en los brazos y las piernas • piel pálida

• Anemia aplásica: Este tipo de anemia, potencialmente mortal, es el resultado de una disminución en la capacidad de la médula ósea para producir glóbulos rojos. La afección suele deberse a la radioterapia, la quimioterapia, el embarazo o el lupus. • Anemia resultante de una enfermedad crónica: Algunas enfermedades como el cáncer, la enfermedad de la médula ósea, la enfermedad de Crohn, la artritis reumatoide y otras enfermedades inflamatorias crónicas pueden reducir la producción de glóbulos rojos.

Tipos de anemia

Las posibilidades de manifestar anemia son mayores si se dan alguna de las siguientes condiciones: • Abuso de alcohol: El consumo excesivo de alcohol puede interferir con la producción de glóbulos rojos. • Diabetes: Esta afección crónica también puede reducir la producción de células sanguíneas. • Antecedentes familiares: Si la anemia está presente en su familia, su riesgo es mayor. • El embarazo aumenta el riesgo de una mujer de manifestar anemia por deficiencia de hierro. • Dieta vegetariana/vegana: Si sigue una dieta vegetariana o vegana, asegúrese de consumir suficiente hierro para facilitar la producción de glóbulos rojos. Si tiene síntomas de anemia o sospecha que puede tenerla, consulte a su médico. Incluso si la anemia no es grave, puede mejorar su calidad de vida tratando este trastorno sanguíneo común.

Los tipos más comunes incluyen los siguientes: • La anemia por deficiencia de hierro afecta a una de cada cinco mujeres, casi la mitad de todas las mujeres embarazadas y alrededor del 3% de los hombres en los Estados Unidos. • La anemia por deficiencia de vitaminas puede ser el resultado de una dieta deficiente en nutrientes clave, especialmente el folato y la vitamina B12, que son necesarios para producir una cantidad adecuada de glóbulos rojos. • La anemia por pérdida de sangre puede deberse a afecciones gastrointestinales como las úlceras o la gastritis (inflamación del estómago), o por el uso excesivo de ciertos analgésicos orales de venta libre o algunas medicaciones anticoagulantes que pueden causar o agravar las úlceras o la gastritis. Los periodos menstruales muy frecuentes y abundantes también a veces pueden causar anemia.

Factores de riesgo

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SENTA R A IN THE COMMUNITY

Sentara Hospitals Create Innovative Programs to

Help Fight

Food Insecurity When the pandemic began to roll through Virginia in 2020, job loss, illness and quarantines limited the ability of many people to fill their refrigerators and pantries at home. To compound that situation, with school out, many children weren’t receiving the meals they normally would get in an in-person school setting. In fact, about 450,000 students in Virginia rely on free or reduced-price meals during the school day. As a result, the share of people experiencing hunger and food insecurity in Virginia rose from about 10% in February 2020 to 22% in June 2020, according to the Federation of Virginia Food Banks. The U.S. Department of Agriculture defines food insecurity as a lack of

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consistent access to enough food for an active, healthy life. “When COVID hit, we noticed quickly that a lot of people needed food,” recalls Jackie Martin, director of community benefit for Sentara Martha Jefferson Hospital. “The Local Food Hub worked quickly with us to help solve this problem.”

Fresh Produce, Healthy Options The Local Food Hub works with Virginia farmers to bring fresh food to the tables of Virginians. For the past five years, the organization has worked with Martin and her team—Seirra Winn, Diana Webb and Setour Dillard— at the Sentara Starr Hill Health Center to provide free, fresh produce to patients. During the growing season, the Local Food Hub usually delivers 100 fresh-produce bags to the clinic for distribution every Wednesday. Fifty of those bags would go to patients, while clients of other Jefferson School City Center tenants would receive the remaining 50 bags. During the early stages of the pandemic, the Starr Hill clinic team began running out of bags, so the Local Food Hub quickly increased distribution to 220 bags to help satisfy needs. “We are currently distributing bags every other week and have yet to see a decrease in need,” Martin explains.

five-day supply of heart-healthy, low-sodium, shelf-stable items, including cereal, rice, and canned vegetables and fruit. Sentara gave $500,000 to the $2.6 million We Care initiative— but the commitment didn’t stop with donating funds. “We engaged staff to help pack those boxes, since it was a Sentara partnership,” explains Patra Reed, Blue Ridge regional director of integrated care management and Sentara RMH Medical Center director of community health services. “Our senior leadership teams from Sentara RMH and Sentara Martha Jefferson, along with a group of staff nurses, helped pack boxes at the Blue Ridge Area Food Bank.” Both Sentara Martha Jefferson and Sentara RMH also received We Care boxes from the Blue Ridge Area Food Bank to distribute to patients in need. To see how they could assist hospital patients who needed help obtaining food, coordinators

at the Blue Ridge Area Food Bank contacted the RMH Foundation. Sentara RMH developed a program to provide identified patients with a box weighing up to 20 pounds and containing staple foods like peanut butter, kidney beans, long-grain rice, navy beans, dried fruit, shredded wheat and vegetable soup. To reach patients needing assistance, staff provided boxes at the Sentara RMH Emergency Department, Cancer Center and physician practices, as well as through the Continuum Case Management program, which visits patients at home. Case managers identified patients who would have difficulty purchasing food due to COVIDrelated circumstances, including: • Patients waiting for COVID test results • COVID-positive patients quarantining at home • Patients discharged from the hospital after being treated for COVID

Food Bank Partnership Last July, Sentara Healthcare, Optima Health, Truist, the commonwealth of Virginia and the Federation of Virginia Food Banks joined forces to provide free food boxes statewide. The 20-pound We Care boxes were filled with a

sentara.com

SE NTA R A IN T HE COMMU N IT Y

• Any patient discharged for whom food access was difficult, due to COVID-related reasons “Many of our elderly patients being discharged didn’t feel comfortable going to the grocery store or even going out in public, whether they were being treated for COVID or any other condition,” recalls Reed. “The boxes provided them with some muchneeded supplies to help get them through a tough time.”

Taking Boxes to the Community To reach out directly to the community, Martin and her team at Sentara Martha Jefferson decided to deliver We Care boxes to people in their neighborhoods. “We selected specific sites, and the Blue Ridge Food Bank worked with us to expand our food access program,” Martin says. “Beginning in February 2021, our team began distributing food boxes either directly to recipients

or by giving them to community leaders for distribution, recognizing that people might be more comfortable accessing the food from people they know.” Another strategy Sentara Martha Jefferson used to get We Care food boxes out to the community was to have them available at vaccine events. “What I liked about this program is that we didn’t have to ask people for a lot of personal information,” Martin explains. “The Food Bank only required the ages of people in their

households—no names. You shouldn’t have to give your life story to get a box of food.” In 2021, Sentara Martha Jefferson and Sentara RMH will continue to provide food boxes to patients and families, as needed, and will partner closely with local food pantries to assess ongoing needs. “We knew that a lot of people were food insecure before the pandemic, but COVID really made us see the need,” Martin says. “The food boxes have been so helpful.”

Sentara Cares: A Multifaceted Approach to Improving Community Health The overall health of a community requires more than access to health care. The Sentara Cares program is a comprehensive approach to addressing the key aspects that determine overall community health. The program focuses on five pillars: • Community engagement • Housing • Skilled careers • Food security • Behavioral health Sentara Healthcare has consistently recognized its role in corporate social responsibility, and the Sentara Cares program creates a formula that can be applied systemwide. “Sentara, historically, has been very philanthropic with multiple partners, but the goal here was to be more strategic about

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improving the health of the population at large, versus focusing on individual programs in each of our regions,” says Sherry Norquist, director of corporate social responsibility for Sentara. Every three years, Sentara hospitals are required to submit a community health needs assessment that identifies and suggests ways to improve health, including what’s known as the social determinants of health: the conditions in the environments where people are born, live, learn, work, play, worship and age. Sentara Cares builds on these assessments. “Beyond providing traditional health care, Sentara is addressing many of our communities’ needs, especially those needs that cannot necessarily be

treated inside the walls of the healthcare facility,” Norquist explains. “Creating healthier communities requires finding solutions that address health where it starts—at home.”

CA RING TR ADI TION

A Legacy of

Philanthropy Keeps Martha Jefferson’s Caring Tradition Alive

Care

“It is our aim to make this institution a blessing to this community.” —Dr. J. Hamilton Browning, a Martha Jefferson Hospital founder, 1906

For more than a century, the

Martha Jefferson Caring Tradition has been the hallmark of our commitment to patients and families: skillful, safe, compassionate care, defined by an abiding respect for the community we serve. Since our move to Pantops Mountain a decade ago, your generosity has expanded the margin of excellence at Sentara Martha Jefferson Hospital, enabling us to be even more responsive, innovative and flexible in providing care. With your help, we are creating an everstrengthening culture of excellence among our staff, while serving our community of patients, families, friends and neighbors. The following pages share a few examples of the lives touched by our community’s generosity through the Martha Jefferson Hospital Foundation over the past decade. Thank you!

Caregiver Center Coordinator Katy Kreienbaum (left) talks with Laura Marks.

Caring for the Caregiver For well over three months, Laura Marks attended the bedside of her daughter, Maria, at Sentara Martha Jefferson, waiting anxiously as Maria fought to recover from pancreatitis. Like many caregivers, Laura struggled to manage her own physical and emotional needs as she grappled with the impact of Maria’s illness.

A month or so after the family’s ordeal began in February 2021, a team member invited Laura to visit the hospital’s new Caregiver Center, which opened during the summer of 2020. Free of charge and fully funded by philanthropic support through the Martha Jefferson Hospital Foundation, the center provides a lifeline of emotional support, assistance and resources for caregivers, whether they be family members, medical staff or community members. mjhfoundation.org

of scenery and getting away from the beeping machines. The center was a peaceful place where I could close my eyes for a few minutes.” One of just 22 such programs in the United States, the Sentara Martha Jefferson Caregiver Center is a model for the entire Sentara Healthcare system.

Continuing Care After Cancer

Laura Marks (left) and her daughter, Maria (top), with Maria’s team of caregivers.

“Often, right next to the patient is a caregiver who is under a tremendous amount of stress,” says Katy Kreienbaum, Caregiver Center coordinator. “Our goal is to provide a place for people to come in, recharge and take time for themselves.” The Caregiver Center offers a welcoming and relaxing oasis, centrally located near the gift shop and Phillips Cancer Center, yet removed enough to provide a quiet place of rest. The space features a fireplace, expansive windows to let in abundant natural light, and beautiful artwork by local Vir-

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ginia artists. The center also includes a business hub equipped with a computer and phonecharging station, a snack station, and a private meeting space with a tranquil water feature for relaxation and meditation. For Laura, a favorite spot in the center was the small, quiet personal retreat room equipped with a massage chair. “I began to visit the Caregiver Center whenever Maria was taken out of her room for a procedure or test, because it was pretty depressing to sit in the hospital room all day, every day,” Laura recalls. “It was wonderful just having a change

Nearly four years after being diagnosed with breast cancer, Elizabeth “Betsy” Raich says she doesn’t have time to dwell on the disease. With multiple surgeries and radiation treatments behind her, Raich is now focused on two particular personal interests that bring her joy: applying her newly attained Master Gardener certification to revive the landscaping around her beloved Howardsville home, and training her English lab puppy, Kirby, to be a therapy dog who can comfort others. Cancer-free for three years, Raich recently “graduated” to the Sentara Martha Jefferson Cancer Survivorship Program, which focuses on patients’ needs after they complete treatment. At least once a year, she will see the Survivorship Clinic’s dedicated nurse practitioner, who provides follow-up visits and long-term monitoring. The program also assists patients with physical, emotional and nutritional rehabilitation needs to help manage the long-term effects of cancer treatments. “The Cancer Survivorship Clinic is such a nice bridge between the end of treatments and some needed ongoing medical support,” Raich says. “By using these services, I’m not taking up an appointment that someone just beginning the cancer journey might need immediately, but I’m also not completely out of the web of medical support,

should a need arise in the future. This program keeps me plugged into those resources.” Launched with philanthropic support in 2018, the multifaceted Cancer Survivorship Program offers a wide range of support services and resources, including chaplainled support groups for patients and family caregivers; access to mental health care, nutrition counseling and fitness training; and genetic testing and educa-

tion through a certified genetic counselor. Patients also may participate in the 12-week Cancer Rehab and Renewal Program to help them adopt or sustain a healthy quality of life during and after diagnosis. Raich feels blessed to have had a compassionate, capable medical team to help see her through her cancer journey. Thanks to the Cancer Survivorship Program, she can dedicate her energy toward Elizabeth Raich relaxes at her beloved family farm in Howardsville.

restoring her home and farmland, which have been in her family for five generations. “I can't say enough good things about the care I received at Sentara Martha Jefferson, and it feels good to know there's a team continuing to look out for me,” she says. “I have a lot of interests, and I don't want to spend my time thinking about cancer. Cancer isn’t my identity.”

Holistic Care Planning for You and Your Loved Ones Soon after Joyce Massowd was admitted to Sentara Martha Jefferson Hospital with sepsis in March 2021, her condition deteriorated rapidly. As infection began to affect her lungs, doctors discussed performing a high-risk, but potentially lifesaving, procedure. In preparation for the procedure, they asked Massowd’s daughter, Deneen Bivona, if her mother had an advance directive in place. Although Massowd had never officially signed any documents, she and Bivona had already discussed how much medical intervention she desired in the event of life-threatening circumstances. Alex McGee, chaplain at Sentara Martha Jefferson and a member of the Palliative Care team, recommended putting Massowd’s wishes into an official, legal document, and helped the family complete the form. Bivona scanned the document and now keeps a digital copy on her smartphone. “I’m so grateful to the doctors and nurses at Sentara Martha Jefferson who guided us through these hard decisions,” says Bivona. “When you are the caregiver and have authority over someone’s medical care, it doesn't matter how you feel—it’s their wishes mjhfoundation.org

that matter. And when you know your loved one’s wishes, you don't have to feel guilty, because you know you’re doing what they would want.” Thankfully, Massowd recovered. Guiding patients and families through difficult discussions about issues such as end-of-life care is an essential function of the Sentara Martha Jefferson Hospital Palliative Care Program. Established in 2006 and significantly expanded with philanthropic support over the past decade, the program’s goal is to improve quality of life for patients adapting to chronic, progressive conditions. McGee and other members of the Palliative Care team collaborate with physicians, nurses and clinicians to provide holistic, person-centered, patient-directed care to more than a thousand patients each year. Palliative care services may range from managing symptoms

Joyce Massowd (left) and her daughter, Deneen Bivona, found peace of mind from creating an advance care directive with support from the Sentara Martha Jefferson Hospital team.

like pain, anxiety, depression and sleep problems to providing emotional and spiritual support, guidance in navigating the healthcare system, and help making tough decisions about treatment options. Sentara Martha Jefferson piloted Sentara Healthcare’s first outpatient palliative care program, and other Sentara hospitals have since replicated this model.

For McGee, facilitating difficult conversations among family members is extremely rewarding. “I was so touched and moved when I saw that Deneen and her mother were talking and laughing and eager to fill out the advance directive form together,” she says. “Like many other families, they found that doing so gave them peace of mind.”

Advance Care Directives Have you told your doctors and loved ones how you would want your medical care to be handled if you are unable to communicate due to a life-threatening injury or illness? These conversations can be difficult, but they are necessary to ensure that your health care is handled as you would wish. The Sentara Martha Jefferson Hospital chaplains can guide you and your family through these discussions. Available at Sentara Martha Jefferson, advance care plan information and directive forms may be picked up at the display table next to the concierge desk in the front lobby. You can also call our Palliative Care team at 434-654-5597 to request the forms, and you can find sample advance care directives and other related information at Sentara.com.

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CA RING TR ADI TION

Empowering

Nursing Professionals

Martha Jefferson Hospital Foundation Offers Scholarships to Help Nurses Achieve Career Goals Dana Graves, BSN, RN, PCCN,

joined Sentara Martha Jefferson’s nursing team in September 2001, just a few months after earning her associate’s degree in nursing and becoming a registered nurse (RN). At the time, she couldn’t imagine the world of opportunity an advanced education might open up for her. Her spark of ambition was ignited when a supervisor, recognizing Graves’ leadership potential, encouraged her to strive for a management role. To qualify for such a position, however, she would need a more advanced Bachelor of Science in Nursing (BSN) degree. “When I started working at Sentara Martha Jefferson, I did not intend to further my education,” Graves says. “I had no idea that leadership would be in my career path until my supervisor shared her belief that she saw strong leadership qualities within me.” In 2005, Graves was promoted to unit coordinator as she began an RN-to-BSN degree

Nurse leaders (from left) Johnsa Morris, vice president of patient care and chief nurse executive; Dana Graves, clinical nurse manager, and Courtney Lambert, director of Emergency Services.

program through Old Dominion University. A single mom at the time, she was grateful to receive a scholarship funded by the Martha Jefferson Hospital Foundation. “It was so nice not to have to worry about tuition,” says Graves, who completed her BSN in 2009 and was promoted to clinical nurse manager that same year. “Everything I learned set me up to qualify for management positions as they became available.”

When Sentara Martha Jefferson moved to Pantops Mountain 10 years ago, the Foundation accelerated investments in education and training for team members like Graves by founding the Haden Nursing Institute, a program that bolsters the hospital’s ongoing commitment to delivering a high level of care to each patient. Since then, nearly $15 million has been contributed to the Haden Nursing Institute to fund formal education and mjhfoundation.org

Over the past decade, an outpouring of community support for the Haden Nursing Institute has helped more than 200 nurses earn advanced degrees.

professional certifications. These awards, which have helped nearly 200 nurses earn advanced degrees, bring Sentara Martha Jefferson closer to achieving its goal of having 80 percent or more of its registered nurses obtain at least a baccalaureate-level education. In addition to their benefits for individual nurses, these scholarships are valuable for recruiting and retaining a highly qualified nursing staff in a competitive environment caused by a national shortage of nurses. Despite expected overall growth in the RN workforce, the Virginia Healthcare Workforce Advisory Council’s 2020 report indicates a projected deficit of more than 203,000 nurses per year through 2026, in terms of filling new positions and those vacated through retirement—and the challenges of fighting the COVID-19 pandemic have only intensified the problem. “We recognize our nurses as the primary contributors to our organization’s success,” says Johnsa Greene-Morris, MBA, BSN, NEA-BC, vice president of patient care and chief nurse executive. “Investing in our

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team is essential, and the community’s support makes all the difference in our ability to maintain a culture of continuous professional development for all our nursing staff.” Courtney Lambert, MSN, RN, NE-BC, who joined Sentara Martha Jefferson in 2006, received a Haden Institute scholarship to pursue her master’s degree in nursing, with a concentration in leadership and management, from Eastern Mennonite University. Six months after graduating in December 2018, she was promoted to her current post as director of Emergency Services. Last year, she took on an additional role as director of Critical Care Services/ICU. Lambert, whose past leadership roles include clinical nurse educator and nurse manager, says that advancing her education has given her the tools to help shape and sustain a culture of quality care within the departments she oversees—a focus that is in keeping with Sentara Martha Jefferson’s Caring Tradition. “Stepping away from bedside nursing required a change in perspective for me,” Lambert says. “Early in my career, I cared for a certain number of patients each shift. As I moved into management, however, I realized that I’m taking care of every patient in my department by leading a highly qualified, compassionate team. My impact starts with making good hiring choices, building relationships and retaining employees. When everyone on my team senses that I’m supporting and advocating for them, they are able focus on the patients and provide the best care possible.”

CA RING TR ADI TION

Promoting

Health Equity

FOR ALL

ecognizing the need to stay rooted in the community it serves, Sentara Martha Jefferson Hospital launched the Starr Hill Health Center in the Jefferson School City Center soon after the hospital made the move to Pantops. “We knew we couldn’t leave the downtown area completely,” says Community Benefit Director Jackie Martin, a longtime hospital administration veteran with a passion for partnership building. Martin was tapped to launch the Starr Hill Center to support the healthcare needs of underserved members of our community. Fast forward a decade, and the Starr Hill Center has evolved into a crucial linchpin in the network of programs and partnerships working to address healthcare inequities in the Blue Ridge Health District

Sentara Starr Hill Health Center Works to Improve Community Health and Wellness

Starr Hill created and distributed more than 400 educational and play kits during the pandemic.

Starr Hill Heath Center staff includes, from left, Integrated Care Manager Setour Dillard, RN; Community Health Worker Seirra Winn; Community Health Educator Diana Webb; and Community Benefit Director Jackie Martin.

(BRHD). Martin is a key player in the BRHD’s MAPP2Health effort, which has identified equity strategies around healthy living, access to care and mental health. “Community health doesn’t happen in a vacuum,” says Martin, who in May 2021 graduated with a Master of Public Health degree from the University of Virginia, and this summer will receive special certification in championing diversity in health care from the American Hospital Association. “You really have to listen and learn from the people who are living with inequities what kind of programming they need. They are the experts, not us.” Guided by this vision, every day Martin and her team provide personalized wellness support free of charge to all who enter their doors, thanks to philanthropic support from the community through the Martha Jefferson Hospital Foundation. mjhfoundation.org

From holding COVID testing events to providing play kits for children to distributing food bags, the Starr Hill team has served the community throughout the pandemic.

The Starr Hill Center’s focus is helping people prevent and manage chronic illnesses like heart disease, diabetes and obesity. Since 2012, the center has served hundreds of people, with Setour Dillard, resident nurse and integrated care manager, providing blood work and blood pressure checks, as well as food preparation and nutrition guidance, and connecting visitors with a range of local services. Center activities for children and teenagers include a seven-week volunteer experience for high school students who are interested in healthcare careers. Given their commitment to listening intently and meeting people where they are—literally and figuratively—it’s not unusual to see the Starr Hill team offering chronic disease learning sessions in public spaces such as barbershops, churches and hair salons. While the COVID-19 pandemic has temporarily paused most in-person classes, Martin takes great pride in the ways in which the Starr Hill team has stayed nimble, dug in with their partners and continued to serve the community. Working closely with the Blue Ridge Area Food Bank and the Local Food Hub, the Starr Hill Center team led a charge to distribute hundreds of food boxes and produce bags. They also joined forces with the

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African American Pastors Council to reach communities of color with vaccine information and access. In addition, the center launched virtual group sessions and cooking classes when social distancing became necessary, and developed five educational videos to serve as starting points for deeper health discussions. The Starr Hill team’s COVID-19 response efforts also included outreach to a nearby housing community, where many residents were at higher risk due to chronic illnesses and disabilities, and where social distancing protocols were difficult to maintain. Together with its partners, the team kept community residents supplied with a steady stream of cleaning supplies, hand sanitizer, face masks and face shields. They also assembled 400 “survival in small spaces” educational and play kits for children living in and around the housing community. “I’m grateful that we have never been alone in this,” says Martin, who wants friends and neighbors around the Jefferson School to know that Starr Hill is once again open (with masking and social distancing requirements in place) to serve those in need. To find out more about available services, visit the Sentara Starr Hill Health Center or call 434-984-6220 to schedule an appointment.

Community Is Our Greatest Strength Our 100 % Promise To You Our hometown healthcare heroes at Sentara Martha Jefferson Hospital will be here for you and your family when you need us. 100% of your generous gift to the Martha Jefferson Hospital Foundation will support local patients and their families, our doctors and nurses, and those most at risk in this community. Make a Gift Online at mjhfoundation.org or by phone at 434-654-8258.

“It is our aim to make this institution a blessing to this community.” —Dr. J. Hamilton Browning, a Martha Jeﬀerson Hospital founder, 1906

For information on including Martha Jefferson Hospital in your will and estate plans, email us at: mjh_foundation@sentara.com or call us at: 434-654-8258

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For more information visit sentara.com/mammogram.