Keep up on healthcare

Getting healthcare is important – now, more than ever. Whether you have an emergent need or a chronic condition that requires routine care from a provider, patients can feel confident in receiving care at Skagit Regional Health during this COVID-19 pandemic.

Staff and providers at the hospitals and clinics are keeping facilities clean and safe following the highest standards. Patients, visitors and staff are all required to wear masks. The number of visitors are limited and a portion of the Emergency Department is sectioned off to help isolate potential COVID-19 patients from non-COVID-19 patients. Staff and providers have access to the appropriate Personal Protective Equipment (PPE) and are following the latest guidance from Public Health and the Centers for Disease Control.

BELOW: Chief Medical Officer Connie Davis, MD, chats with a staff member in the Family Birth Center at Skagit Valley Hospital.

Still, physicians are aware that some patients are concerned about coming in to receive care.

Emergency Department Medical Director Krishnaraj “Raj” Jayarama, DO recalls quite a few patients in recent months who delayed care and arrived at the Skagit Valley Hospital ER with much more serious symptoms. “When these patients finally do come in, they are sicker than they would have been had they taken action with the onset of symptoms,” he said. “Please don’t let COVID scare you from the hospital and the ER. It’s a safe place to come for care.”

Skagit County offers drive-through testing for people who live and work in Skagit County from 8:30 a.m. to 4 p.m. Monday, Wednesday and Friday and from 11 a.m. to 7 p.m. on Tuesday and Thursday.

To find out about testing in nearby counties, consult the following: Whatcom County Health Department: 360-778-6000 or health@co.whatcom.wa.us

Snohomish Health District: 425-339-5234 or cdquestions@snohd.org Island County Health Department: 360-678-2301 or pubhealth@islandcountywa.gov San Juan County Health Department: 360-370-7500

Patients with potential symptoms may receive testing for COVID-19 at Skagit Regional Health’s Riverbend and Smokey Point Urgent Care locations. Check the Skagit Regional Health website for more information at www. SkagitRegionalHealth.org/the-new-normal

Examples include a person who had chest pain for several days and had suffered a heart attack that now creates lifelong health issues; a patient who presented so sick with an infection they needed to be treated in the ICU after waiting to come to the hospital; and a person who had “belly pain” for a period of days who arrived with a ruptured appendix.

“We are seeing a lot of very sick patients and the acuity has gone way up,” Dr. Jayarama said. “We are taking all the right precautions. We are wearing the appropriate PPE. We ask all patients and visitors to wear masks. We can care for you safely.”

As a system, as of September 1, Skagit Regional Health staff and providers have treated dozens of inpatients with COVID-19, however, the number of positive inpatients at any given time has averaged in the single digits at Skagit Valley Hospital, licensed for 137 beds, and averaged one or less at Cascade Valley Hospital, licensed for 48 beds. Patients who test positive are cared for by staff with expertise in respiratory illness in rooms within specific areas of the hospitals with all appropriate precautions in place.

“We are continually monitoring the medical science and our community infection status. We are in close contact with Public Health. Skagit Regional Health is staying ahead of the curve on our safety supplies and processes,” said Connie L. Davis, MD, MHA, Regional Vice President and Chief Medical Officer. “Other than the protection of your own home, we are one of the safest places to be in our community. We are here for you. Come see us with your health concerns. Keep yourself on track for the best health.”

Family Medicine provider David Escobar, DO, who sees patients at Skagit Regional Clinics – Stanwood, notes that it is especially important for patients to receive care during times of stress.

“One’s health care needs shift frequently, especially during times of stress. We are all feeling the global stress of the current pandemic, and it is important to stay in touch with your primary care provider, especially during these uncertain times,” Dr. Escobar said. “We are offering video visits on a regular basis now and it is rewarding to continue my care of my patients both here in the clinic; and when I am invited to ‘join them’ in their kitchens and living rooms. Please don’t forgo your health care; your health care needs don’t stop because the world is shifting around us – and as always we are here to help.” Routine care and vaccinations are especially important for children, said Pediatrician Rosana Go, MD of Arlington Pediatrics. “Keeping your children’s vaccinations up-to-date is very important now more than ever especially during this time of uncertainty. Vaccines will help children fight off viral and bacterial infections and continue to keep them healthy!” Dr. Go said. “The health and wellbeing of your children will always be our top priority. We are always here to help and answer any questions you have.”

General Surgeon Jimmy Barger, DO, FACOS, who joined Skagit Regional Health in April 2020, as the virus was increasing in prevalence, has been impressed from the beginning with the organization’s safety standards and adherence to local, state and national guidelines.

“Skagit has taken excellent precautions every step of the way,” Dr. Barger said, noting ample PPE is available and staff, patients and visitors wear masks.

With the presence of the virus in the community, Dr. Barger emphasized that people should take the right precautions and seek care as needed.

“The risk of contracting the virus is not any higher in our clinics and hospitals than it is going to the grocery store,” he said. “It is safe. We have screening and masking measures in place and it’s very important to see your physician for concerns and maintenance of routine and chronic issues.”

By Erin Charles, MD Pediatric Hospitalist, Skagit Regional Health, in partnership with Seattle Children’s

We have all been hearing about COVID-19 and how it mostly affects adults. What about our children?

While, in general, children have not been as sick with COVID-19 as adults, there are pediatric patients who have had COVID-19.

Finding reliable information on the internet can be a challenge. I refer my families to:

American Academy of Pediatrics website for families in English and Spanish about illness, growth and development of children age 0-18 years Healthychildren.org Centers for Disease Control and Prevention: https:/www.cdc.gov/ coronavirus/2019-ncov/index.html Seattle Children’s: www.SeattleChildrens.org

Children can also be infected with COVID-19 without being sick and then weeks later develop severe symptoms. A small number of children, including some in Northwest Washington, have developed a serious illness which may be linked to COVID-19 called Multisystem Inflammatory Syndrome in Children (MIS-C).

What is MIS-C?

MIS-C is a very rare condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms including abdominal (belly) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes or feeling extra tired. It is not yet known what causes MIS-C. However, many children with MIS-C have had the virus that causes COVID-19 or had been around someone with COVID-19.

Early studies suggest that MIS-C may involve how the body’s immune system reacts to the virus. The body’s defense system may overreact and cause harm to the body it is trying to protect.

MIS-C may be part of a disease spectrum including Kawasaki Disease, which also may involve the heart, rash and high fever among other problems. Kawasaki Disease typically affects children younger than age 5, however, MIS-C has been seen in patients ages 6 months to 21 years. The peak age of MIS-C is 8 years. Children with MIS-C are admitted to a children’s hospital with multispecialty care and a pediatric intensive care unit. There are several kinds of treatments and, in spite of the severe symptoms, most children recover. Contact your child’s doctor, nurse or clinic right away if your child has symptoms of COVID-19 such as fever or chills, cough, fatigue or body aches, headache, new loss of taste or smell, mild nausea, vomiting or diarrhea. If your child has trouble breathing, pain or pressure in the chest that does not go away, new confusion or sleepiness, bluish lips or face, or severe abdominal pain, vomiting and diarrhea, go to the Emergency Room or call 911.

At Skagit Regional Health, the pediatricians working at Skagit Valley Hospital are part of the Regional Hospital Medicine Program at Seattle Children’s. Skagit’s Pediatric Hospitalist Team works closely with Seattle Children’s, just as pediatricians in our community have for decades.

The Pediatric Team at Skagit Regional Health and Seattle Children’s are prepared to care for children with MIS-C. Experts at Seattle Children’s have created guidelines to help diagnose and treat our patients who may have MIS-C. If a child needs to be transferred to Seattle Children’s, the Emergency Medicine and Transport Communication Center connects us quickly to the intensive care and transport teams to ensure our patients are transferred swiftly and safely.

Mask up! Wash hands! Stay six feet apart! Cloth face coverings are an additional step to help slow the spread of COVID-19 when CLOTH BARRIER combined with every day preventive actions and social distancing in public settings.

Who should NOT use cloth face coverings: children under age 2, or anyone who has trouble breathing, is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

• Wash your hands before putting on your face covering • Put it over your nose and mouth and secure it under your chin • Try to fit it snugly against the sides of your face • Make sure you can breathe easily Cloth face coverings are NOT surgical masks or N95 respirators. Currently, surgical masks and N95 respirators are critical supplies that should be reserved for healthcare workers and other first responders. 6 ft CLOTH BARRIER

• Wear a face covering that covers your nose and mouth to help protect others in case you’re infected with COVID-19 but don’t have symptoms • Wear a face covering in public settings when around people who don’t live in your household, especially when it may be difficult for you to stay six feet apart • Wear a face covering correctly for maximum protection 6 ft6 ft • DON’T put the face covering around your neck or up on your forehead • DON’T touch the face covering, and, if you do, wash your hands or use hand sanitizer to disinfect

• Stay at least 6 feet away from others • Avoid contact with people who are sick • Wash your hands often, with soap and water, for at least 20 seconds each time • Use hand sanitizer if soap and water are not available

• Untie the strings behind your head or stretch the ear loops • Handle only by the ear loops or ties • Fold outside corners together • Place covering in the washing machine • Be careful not to touch your eyes, nose, and mouth when removing and wash hands immediately after removing.

MISSION The mission of the Skagit Valley Hospital Foundation is to raise, manage and distribute funds to assure the continued availability of quality health care services and programs at Skagit Regional Health. The Foundation will foster awareness of and community support for Skagit Regional Health through the involvement of the people it serves.

BOARD OF TRUSTEES Volunteers are the key to the Skagit Valley Hospital Foundation’s efforts in securing philanthropy. We are pleased to acknowledge the efforts of our trustees who unselfishly give their time and resources as an example to all, and who provide leadership in the Foundation’s prudent stewardship of gifts.

Zach Barborinas Katie Biringer Lesha Boucher Kati Collins Mary June Curtis Bob Fiedler Bobbi Fisher Jacqueline Hawkins

Linda Frizzell Executive Director Dr. Joshua Hawkins Alicia Huschka Brian Ivie Barbara Jensen Katie Jungquist Aldi Kllogjeri Matt Lehman Mike Lervick Mike Marken

STAFF

Wendy Ragusa Development Coordinator

Evelyn Morse Holly Nielsen Larry Otos Jill Pickering Dale Ragan Jim Spane Brent Thompson Kris Wollan

Kylee Dowe Development Associate

To learn more about how you can support the Skagit Valley Hospital Foundation, visit www.skagitvalleyhospitalfoundation.org

Skagit Valley Hospital Foundation P.O. Box 1376 Mount Vernon, WA 98273 360-428-2140

Like us on Facebook at www.facebook.com/ SkagitValleyHospitalFoundation New Foundation Officers Installed During the annual May meeting of the Skagit Valley Hospital Foundation, the following community leaders were installed as officers for the 2020-2021 year: President: Mary June Curtis Vice President: Larry Otos Treasurer: Aldi Kllogjeri Assistant Treasurer: Alicia Huschka Secretary: Zachary Barborinas VP/Sunrise Inn: Kate Biringer VP/Cancer Care: Katie Jungquist VP/Planned Giving: Bob Fiedler

Photo L to R: Skagit Regional Health Chief Executive Officer Brian Ivie, Skagit Regional Health Oncology Director and Foundation Trustee Barbara Jensen, Skagit Regional Health Chief Financial Officer Paul Ishizuka and Foundation Trustees Holly Nielsen, Bobbi Fisher and Campaign Co-Chair Zach Barborinas.

The Skagit Valley Hospital Foundation was pleased to present a check for $2 million to Skagit Regional Health in support of the Skagit Imaging Pavilion project. The $2 million goal was reached after a 20-month capital campaign.

Proceeds helped to support the purchase of diagnostic imaging equipment for the Women’s Imaging Center, including 3D mammography. The Skagit Imaging Pavilion, a partnership between Skagit Regional Health and Skagit Radiology, opened in Fall 2019 and features the latest in diagnostic imaging including 3D mammography, MRI, Ultrasound, CT and Stereotactic Biopsy.

Thank you, as always, for supporting the Skagit Valley Hospital Foundation. You may be aware that Congress passed the Coronavirus Aid, Relief and Economic Security Act (CARES Act) in March 2020. Several provisions were included for those who give to charity:

For many people who no longer itemize their charitable giving and instead take the standard deduction, the CARES Act will now also allow individual taxpayers to additionally deduct up to $300 per taxpayer ($600 for married couples) on their 2020 federal tax return. The new deduction is only for cash gifts given to a public charity. There are new provisions for corporate donors as well.

Mount Vernon resident and La Venture Middle School 8th grade student Darian Whiton presented several bouquets to the Emergency Department Nursing staff on Monday, July 20 as a thank you for their work. Darian grew these beautiful blooms with the purpose of giving gratitude to the dedicated nursing staff at Skagit Valley Hospital. Emergency Department Charge Nurse Brenda Hubin-Price happily accepted the fresh bouquets on behalf of her staff. “The staff was so grateful,” said Hubin-Price. The Foundation thanks Darian for his generosity!

For the past four summers, former oncology nurse Tammy McNeil of La Conner has grown and sold tomato plants with the proceeds benefitting the Skagit Regional Health Cancer Care Center. The Foundation thanks Tammy for sharing her green thumb and for the $1,100 she has donated to support patient care!

The 5th annual Super Bowl Doubles 9-Pin No-Tap Charity Bowling Tournament, held on February 1, 2020 at Riverside Lanes in Mount Vernon, raised $9,265 to benefit the Skagit Valley Hospital Foundation’s Cancer Care Patient Assistance Fund. This fund assists local cancer patients, who are undergoing cancer treatments, with support to help pay for utility bills, cab rides to medical appointments, medications and other essential items. We are grateful to the Skagit Valley USBC and the many people who continue to make this event a success.

THE SKAGIT VALLEY HOSPITAL FOUNDATION IS PLEASED TO PRESENT

This rich red glassybaby is etched in gold with this year’s Festival of Trees gift logo and is exclusively available through the Skagit Valley Hospital Foundation. Proceeds from the sale of ‘the gift’ will support the Skagit Valley Hospital Foundation.

Preorders must be placed by October 31, 2020. Each glassybaby is $75 and presented in a white gift box with white ribbon. PREORDER PURCHASES ONLY Visit www.skagitfestivaloftrees.org or call 360-814-8376. Purchasers will receive an email with specific instructions for pick up.

You shop. Amazon gives. Shop and give! It is easy to download the AmazonSmile app and select the Skagit Valley Hospital Foundation as your charitable beneficiary! Each time you shop, just click on the AmazonSmile app to shop and give. Thank you!

Although the Skagit Valley Hospital Foundation’s 2020 Festival of Trees will look a little different this year, one thing that isn’t changing is our commitment to keeping it just as special.

As with many fund-raising events this year, the Foundation Board of Trustees and staff had to pivot and replan to assure the safety of our guests, donors and volunteers.

In partnership with the Mount Vernon Downtown Association and Festival Title Sponsor Heritage Bank, the Festival will showcase more than a dozen elaborately themed Christmas trees that will be displayed in downtown Mount Vernon storefront windows. Friends of the Festival of Trees and Downtown Mount Vernon guests will enjoy a “Tree Stroll and Silent Auction” sponsored by Peoples Bank and Banner Bank from November 9th through the 28th. The community will have the opportunity to purchase a tree outright at a guaranteed price or bid for a tree online via a silent auction.

Additional Festival of Trees online giving opportunities will include: • Give an outright donation to the

Festival of Trees fund

• Purchase a 26-inch fresh noble fir wreath with a gold bow • Purchase one or more limited-edition

Christmas-red glassbaby. This year’s glassybaby is named ‘the gift’ and it features an etched image of a gift in gold. • Purchase a “Kids’ Holiday Gift Box” filled with Christmas cookies, activities and more.

• …and other fun opportunities

Proceeds from this year’s event will support Skagit Regional Health’s projects and programs for patient care. Photos of the designed evergreens may be viewed, beginning Monday, November 9th on the Foundation’s website by visiting www.skagitfestivaloftrees.org.

The Festival’s annual “Breakfast at the North Pole” will not be held this year.

A very special thank you to the Cascade Mall for offering the former JC Penney retail space to hold the 32nd annual Festival of Trees. The possibility to present the trees and events in this location was met with so much enthusiasm. We are disappointed the Festival could not be held there this year due to the current restrictions placed on large gatherings. We sincerely thank the Cascade Mall for its support of the Foundation and the Festival.

The Skagit Valley Hospital Foundation appreciates the community’s understanding of these event changes implemented for the safety of our Festival of Trees guests, sponsors, tree designers and volunteers. We are hopeful and committed to bringing back all the events of the Festival in November of 2021.

For more details or tree sponsorship information, please contact the Foundation office at 360-814-5747 or foundation@skagitregionalhealth.org. Festival updates may also be viewed on the Skagit Valley Hospital Foundation Facebook page.

Out of concern for the health and safety of our golfers and volunteers, the Skagit Valley Hospital Foundation made the difficult decision to cancel the ParTee Golf Classic, scheduled to take place at the Skagit Golf and Country Club on August 14th. The Foundation is humbled and extremely grateful for the outpouring of support from our event sponsors who then donated their sponsorship fees to the Foundation despite the cancellation. The canceled tournament raised gross proceeds of nearly $40,000. These donations support the Skagit Valley Hospital Foundation’s ability to assure the continued availability of quality healthcare services and programs at Skagit Regional Health.

TITLE SPONSOR

Arrow Conservation Baird Private Wealth Management –

Jeff Stewart Banner Bank Alfie Hill-Banta Biringer Nursery Cascade Natural Gas Chad Fisher Construction CPI Plumbing & Heating Dwayne Lane’s Auto Family Floyd, Pflueger & Ringer G&W Commercial Interiors Heritage Bank Janicki Industries Lisser & Associates, PLLC Maple Wood Farm Potatoes In Loving Memory of Paige Marken McKinstry Energy Services Moss Adams, LLP MV Police Services Guild Peoples Bank Piper Sandler Premera Blue Cross PRIMAC Electric Property Trio Retail Lockbox SaviBank SB&C, Ltd. Skagit Aggregates Skagit Law Group

Skagit Regional Health Skagit Transportation, Inc. Skagit Valley Hospital Auxiliary Smiley Insurance Services State Farm Insurance Agents –

Carol Lawson, Brad Methner and Keith Sorestad Thomas Cuisine TRICO Companies, LLC USI Insurance VSH Certified Public Accountants Whidbey Coffee WAFD Insurance Group Dr. Rob Zwick

SIGNS OF GRATITUDE

Early in the morning of April 20, a sea of signs sharing messages of gratitude and encouragement arrived in the landscape of many Skagit Regional Health facilities from Oak Harbor and Mount Vernon to Darrington and Arlington.

The signs and banners, designed to lift the spirits of healthcare workers during the COVID-19 pandemic, were the brainchild of a newly minted organization called Skagit Attitudes of Gratitude.

ABOVE: Indira Rouw Wagenbach and her son Adam Wagenbach, pictured above, drove through the night — about 270 miles over 13 hours — to help get the signs up.

CVH MEDICAL STAFF PRESENTS SCHOLARSHIPS TO LOCAL SENIORS

The Cascade Valley Hospital Medical Staff presented $1,000 scholarships to three local high school seniors. The award winners are: • Ivy Ewing, Arlington High School • Jensyn Smith, Arlington High School • Jaylene Priebe-Garcia, Lakewood

High School

These students were on the honor roll for four years and are planning to pursue a degree in the medical field.

Connie Davis, MD, Skagit Regional Health’s Chief Medical Officer was named to the Skagit County Board of Health in April 2020.

The appointment followed approval in December 2019 by the Skagit County Board of Commissioners of an ordinance to adopt Skagit County Code Chapter 12.01, expanding the size of the Board of Health from three to five members.

Dr. Davis, who joined Skagit Regional Health as the Chief Medical Officer in 2012, has more than 30 years of health care experience. Dr. Davis previously served as Director of the Kidney Care Line and Co-Director of the Kidney and Pancreas Transplant program at the University of Washington. She received her medical degree at the University of Washington and went on to residencies and a nephrology fellowship at the University of Texas Southwestern Medical Schools Hospitals and Clinics. She also participated in a research fellowship at Ludwig Maximillian University in Munich.

Skagit Valley Hospital was recently honored with the Organ Donation Achievement Award and the Collaboration Achievement Award from LifeCenter Northwest.

According to LifeCenter Northwest’s annual report, hospitals with high donation rates excel at recognizing donation referral criteria, making timely calls, maintaining the opportunity for donation and collaborating with LifeCenter Northwest for planned donation discussions. Achieving a high donation rate requires an ongoing

Dr. Davis has served on the Population Health Trust of Skagit County since its inception and has critical firsthand knowledge of the health issues in Skagit County.

“I have a passion in my work as a healthcare provider for improving the health and wellness of the people of our communities through data analytics, cultural understanding, policy and positive change,” Dr. Davis said. “I am truly honored to bring my expertise and energy to the Skagit County Board of Health.” Until this year, the Board of Health had solely been comprised of the Skagit County Commissioners, who regularly sought advice from the Population Health Trust Advisory Committee. “The timing is perfect to add Dr. Davis to the Board of Health as we retool public health policy,” said Commissioner Lisa Janicki. “She has a distinguished medical career and genuinely cares about the people of Skagit County. We are grateful she is

willing to serve on the Board of Health.” commitment to ensuring every donation opportunity is realized.

Organ donation requires collaboration between the hospital and LifeCenter Northwest staff. LifeCenter Northwest noted, “One of the most important areas for collaboration is at the time of family conversation regarding donation.” The Collaboration Achievement Award honors hospitals that excel in planning a collaborative family conversation with LifeCenter Northwest. LifeCenter Northwest is a federally designated non profit organ procurement organization.

Both Skagit Regional Health acute care hospitals have received stroke care honors from the American Heart Association and American Stroke Association 2020 Get with the Guidelines® program.

Cascade Valley Hospital in Arlington received the 2020 Get With The Guidelines® - Stroke Silver Quality Achievement Award and also qualified for the Target: Type 2 Diabetes Honor Roll recognition.

Skagit Valley Hospital in Mount Vernon received the 2020 Get With The Guidelines® Stroke Gold Plus with Honor Roll Elite achievement award and Target: Stroke honors.

The awards recognize the commitment and success by hospital staff and leadership in implementing a high standard of stroke care by ensuring that their stroke patients receive treatment that meets nationally accepted, evidence-based standards and recommendations.

The first group of newly graduated nurses to enter Skagit Regional Health’s Nurse Residency Program started on the job in summer 2020 and will benefit from an additional year of training and mentorship.

During the one-year program, nurse residents will complete monthly education, including classroom sessions, simulation and patient experiences, to advance their knowledge, skills and confidence in the complex healthcare setting. Each nurse resident will also have a skilled preceptor to help provide support.

“We are so excited to have a program that will support our Nurse Residents as they transition from student nurse to Registered Nurse,” said Michelle Marty, Director of Clinical Practice and Education / Acute Care at Skagit Regional Health.

Participants must be post-baccalaureate and associate degree nurses with less than six months experience and be licensed as a Registered Nurse in the State of Washington. They will participate in a curriculum and program structure following the Vizient/American Association of Colleges of Nurses model.

Applications for additional, future cohorts of students will be accepted. For more information at the Nurse Residency Program, go to www.skagitregionalhealth.org/careers or email questions to HR@ skagitregionalhealth.org.

Janicki Industries in Sedro-Woolley typically designs and builds carbonfiber aerospace parts and production tools, but when COVID-19 began impacting the local community, they quickly turned their attention to helping area hospitals.

In early April, Janicki Industries was asked to help find a way to better isolate COVID-19 patients during oxygen-nebulizer treatments. Janicki announced an internal contest with product designs due in three days. Bryan Harris, Program Manager at Janicki Industries, won the design contest with a 4-foot by 4-foot clear polycarbonate booth that was 8 feet tall. Transparent walls allow for patient monitoring and comfort. The booth was sized to allow for wheelchair access and includes a ceiling fan with a 0.3-micron HEPA filtration system that creates a slight vacuum to prevent air that may carry COVID-19 from leaving the booth.

The Janicki team completed the entire design and fabrication process in nine days. The booth was delivered to Skagit Valley Hospital on April 21.

“All clinicians know that right beside them is a great engineer who can actually make dreams happen,” said Chief Medical Officer Connie Davis, MD, who advised on the project. “Doctors identify a need and then have the creativity of the people who know materials, form and mechanics. Janicki has been a leader in innovation for years and we are grateful for their creation!”