For Your Health - Winter 2016

Committed to the Health & Well-being of El Dorado County

DECEMBER 2015

CONNECTED and COMPASSIONATE

Marshall’s Community Care Network 

Slow down! Holiday stress management tips

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Say What? What you don’t know about hearing loss

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New ICU/CCU underway www.marshallmedical.org

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DID YOU KNOW

New Intensive Care Unit Under Construction at Marshall Hospital Patients who are in need of intensive care are the most vulnerable and delicate there are—and the same can be said for their families, who are often stressed by the situation and worried about their loved ones’ condition. This difficult situation benefits from an Intensive Care/Critical Care Unit (ICU/CCU) that is carefully planned, spacious and private, and that is just what we are building in our South Wing.

New ICU under construction at Marshall Hospital

The new ICU/CCU has many upgrades over the current unit—the one thing that will stay the same is the dedicated, compassionate care of unit staff. Kathy Krejci, Chief Nursing Officer, outlines some of the features of the new ICU/CCU, which has an anticipated completion of spring 2016, pending inspector approval.

“Each room will be private and we are expanding from eight beds to 12,” Kathy explains. “The nursing station is centrally located to allow visibility into all rooms and each room will have abundant windows, maximizing exposure to natural light.”

The new unit will be located on the second floor of the South Wing, providing more privacy, and family members will be accommodated with a special area in each room. “Nighttime dimmable lights in the corridors will enhance evening sleep for our patients,” Kathy says. “State of the art monitoring and mechanical patient lifts will be in each room and the unit will be equipped for future telemedicine advances.”

On top of the private rooms and technological advances, the new ICU/CCU will be much larger. The current unit is 2,500 square feet, and the new one will be 5,000, doubling its size.

Opening information will be provided at our web site, www.marshallmedical.org, as we approach completion.

Pa Vang, FNP-C Marshall Family and Internal Medicine 3581 Palmer Drive, Suite 602 Cameron Park, CA 95682

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Marshall Welcomes New Providers

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Aidan Maguire, PAC Marshall Wound Care Center 1095 Marshall Way, Suite 203 Placerville, CA 95667

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ABOUT MARSHALL MEDICAL CENTER Marshall Medical Center is an independent, nonprofit community healthcare provider located in the heart of the Sierra Foothills between Sacramento and South Lake Tahoe. Marshall Medical Center includes Marshall Hospital, a fully accredited acute care facility with 113 beds located in Placerville; several outpatient facilities in Cameron Park, El Dorado Hills, Placerville and Georgetown; and many community health and education programs. Marshall has over 200 board-certified physicians and a team of over 1,500 employees providing quality healthcare services to more than 175,000 residents of El Dorado County.

For Your HEALTH is published as a community service by MARSHALL MEDICAL CENTER 1100 Marshall Way Placerville, CA 95667 telephone 530-622-1441 or 916-933-0913; www.marshallmedical.org It is intended to provide information about health in general as well as healthcare services and resources available in El Dorado County.

Information comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider.

If you have questions, concerns or suggestions for future topics, contact the editor, Carrie Poggio, at (530) 626-2816 or via email at cpoggio@marshallmedical.org.

TAKING CARE OF YOU

Say What?

Five Things About Hearing Loss You Probably Didn’t Know Most of us take our hearing for granted. Like all of the five senses, unless you have a problem with it, we rarely contemplate what it would be like to have an impairment.

Michelle Throp, MS, CCC-A, is a licensed audiologist with Marshall Hearing Center in Cameron Park, and she routinely meets patients who are very surprised to learn they have a hearing problem. Here are some of her observations: 1. You’re often the last to know – Do you often have to ask family and friends to repeat what they say? If so, you may be experiencing hearing loss. Michelle explains, “Typically, it’s the clarity of speech that goes first. It’s not that you’re not hearing, but it may sound like people are mumbling or not speaking clearly.” Often, family members may be frustrated by the recurrent requests to repeat themselves. This can be a clue that hearing loss should be explored, because it can be stressful and frustrating to the entire family.

2. Poor hearing is a safety issue—When your brain is working overtime and straining to hear and process auditory cues, you may be more prone to turn your head and focus on what you’re ears are not hearing well, and this can lead to mishaps, such as bumping into things, falling, and other hazards. “Poor hearing can also impact balance, which is another fall and injury risk,” Michelle says.

Michelle Throp, MS, CCC-A

4. Financial assistance for hearing devices is available—many people endure poor hearing because they can’t afford the cost of assistive hearing devices.

Michelle encourages anyone who needs a hearing device to explore financial options. She says, “Here at Marshall, we work with Wells Fargo to arrange affordable financing so that hopefully, anyone who needs a hearing device can work it into their budget.” There are also other options for low income patients. At Marshall Hearing Center, our audiologist will help explain all the financial options—so don’t let fear of the cost deter you from getting the life-changing help you need.

5. Today’s hearing devices are technological game changers—the technology available with today’s hearing devices is truly amazing. Not only are today’s hearing devices so discreet that people will probably not even know you’re wearing one, but many are now equipped with blue tooth technology, enabling phone and TV connectivity and more. This technology changes people’s lives,” Michelle says.

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Hearing devices of today are not what you might think of—the big bulky and obvious hearing aids of old. Hearing is one of the most important health and lifestyle aspects we take for granted. If you think you 3. Some hearing loss can be cured, if treated right might have a hearing problem, schedule an exam with away—if hearing loss is sudden, such as associated with one of Marshall Hearing Center’s licensed Audiologists. an illness or suspected virus, get to a doctor right away.

Appointments are available in “Too often people think they’re not Placerville and Cameron Park. For hearing well due to wax buildup, Marshall Hearing Center Medicare patients, a referral from allergies or a minor cold, when really 4300 Golden Center Drive, Suite D your primary physician is needed, Placerville, CA 95667 it could be a specific virus that causes 530-344-2010 but other insurance that allow selfhearing loss,” Michelle explains. referral is also accepted. Don’t wait “If it’s treated quickly with steroid 3501 Palmer Drive, Suite 201 to improve your hearing, you never medications, the hearing loss can often Cameron Park, CA 95682 know what you might be missing be reversed, but if treatment is delayed, 530-672-1112 out on. hearing loss can be permanent.”

For more information about Marshall, visit www.marshallmedical.org or follow us on Facebook.com/ marshallmedicalcenter, twitter.com/MarshallMedical or Google+ Marshall Medical Center. www.marshallmedical.org | FOR YOUR HEALTH

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COVER STORY

Community Care Network Expands Healthcare Beyond Hospital Walls

The mission of the Community Care Network (CCN) is to provide high quality, compassionate, patient centered health care coordination that is based on improved outcomes for people in our community.

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Shown here, left-right (back row): Betsy Carroll, Heidi Gonzales, Allison Jilbert, Jennifer Fiterre. (front row): Betsy Krohmer, Penny Lehrman, BRSN

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any people in our community struggle with health problems, are chronically ill and vulnerable, and often are without supportive family.

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several chronic medical conditions (such as heart disease, COPD, diabetes, etc.), take multiple medications and are prone to hospitalizations.

With a goal of helping these

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vulnerable people have a better quality of life, Marshall embarked on an ambitious program called the “Community Care Network� (CCN) in January of 2014. In just two short years, the program has blossomed and

Finding great optimism in this model program, Marshall appointed Penny as the Clinical Director and Bill Klas, MD, a longtime family medicine physician at Marshall, as the Medical Director. They then set about creating the framework for Marshall’s version of the effort, which would be known as the Community Care Network. The CCN is a team effort comprised of the leadership and other experts such as social workers, RN case managers, pharmacists, certified diabetes educators, registered dietitians, Marshall Home Health services and volunteers.

An essential part of the CCN program is the Health Coach, who are volunteers. Penny says, “We have five amazing and active health coaches right now, and nine more are being trained.

The volunteer work of a health coach can take many forms. Sometimes, it’s just a phone call and someone for the patient to talk with. Other times, it’s reminding the patient of an important medical appointment or lab test, in addition to checking on transportation to appointments. “We get to know these patients and become their advocates, so that they don’t feel so alone,” Penny says. “These relationships are built on

On Being a Health Coach Jennifer Fiterre, Health Coach for the CCN and coordinator of Marshall’s Adult and Jr. Volunteer program, was among the first employees to become a volunteer Health Coach. This is what she has to say about the experience: “In my work so far, I’ve helped people get medication questions answered and obtain appropriate resources, all according to the health goal established with their health provider and CCN. What this means, is that health coaches are an extra pair of eyes and ears looking out for the patient and a link between patient and healthcare provider. It’s a very rewarding relationship and is improving lives.”

trust and respect and meeting people where they are. We extend kindness and compassion beyond the walls of the hospital to people who really need it and are willing to engage with us.

We listen.”

In order to find patients to recruit into CCN, Penny and Dr. Klas visit hospital patients who are frequently admitted and explain the program’s benefits to them. “At first, there is a lot of skepticism because most people can’t believe this program is a no cost

“We extend kindness beyond the walls of the hospital to people who really need it.” program, no strings attached, and is purely voluntary,” Penny recalls.

“We do not bill anyone, so we don’t discharge anyone either. Over time people that enrolled saw how things were improving for them and have become more trusting and engaged.”

There are currently 96 people enrolled in the CCN and some have done so well that now they merely receive a friendly follow-up phone call once a month. Newer enrollees receive more extensive support, but the key is patients receive what they need. “Many people who are at the highest health risk are alone in our community. We treat everyone with respect, and don’t give up on them. We recognize that each person is unique.” Penny says. “It’s about building trust based on honesty, so they know they always have someone on their side that they can call.”

In addition to the personal and health benefits the CCN is delivering to the community, there is also the financial aspect to consider. The hard truth is that the sickest 5% of patients in healthcare account for 50% of the costs; they also tend to stay longer in the hospital, which can lead to being more prone to infection and other complications.

Thus far, the CCN has reduced costs by over $3.6 million dollars. Those dollars are reinvested into caring for ALL patients, so it’s a benefit for the larger community. Also, CCN program patients experience a one day decrease in their length of stay if re-admitted to the hospital. Inpatient stays of any length have been cut in half since April in the 96 people enrolled.

“We want to continue growing this program so that more and more people can benefit,” Penny says. “Our next goal is to begin identifying patients of ‘rising risk’—those patients who may not be the sickest right now, but have all the characteristics of going in that direction. By reaching out and meeting people where they are, we can make a difference.” And they are.

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made a big difference in many lives.

Penny Lehrman, BSRN and Clinical Director of the program, explains its origin. “We modeled our program after one that was started in another small community in Meadeville, Pennsylvania,” said Penny. “The idea was for a team of health professionals to extend care outside the hospital.

This team would make the effort to get to know, support and provide assistance with coordinating patients’ healthcare when they were at home.

We soon found that, with support, patients became invested in their own health. It reduced their emergency room visits and admissions to the hospital.”

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YOUR TIME

Holiday Overload?

Tips for managing holiday stress

It’s a busy time of year and we tend to be pulled in multiple directions. It can get overwhelming—between the kids’ holiday school activities, visiting family and friends, shopping, decorating, traveling, baking—sometimes there is no “you” time to find. But that’s just what you need to maintain a positive balance and good attitude, says Pa Vang, FNP, a new addition to Marshall Family & Internal Medicine in Cameron Park.

“What I stress to my patients who are doing too much is that you really do need to take time to take care of yourself,” Pa says. “I know it can be difficult, but if you don’t, it has a domino effect and translates to stressed relationships, fatigue and burnout.” Taking time for yourself doesn’t necessarily mean you have to book a spa weekend away in the midst of the hustle and bustle—although wouldn’t that be great? Decompressing and distressing your life can be done in small but healing steps such as the list Pa shares here.  Take a brief “time-out.” Grab a magazine and cup of tea, and take 15 minutes to clear your mind and just “be.”  Move. Take a walk, meditate, do a mini-yoga routine. Getting your body moving and your blood pumping will release feel-good endorphins and leave you feeling cleared and energized.  Don’t be afraid to say “no.” How hard is this? Very hard, but if you overcommit, you risk feeling so stretched you might just check out and not feel up to doing the things you really want to do.  Appreciate beauty and life. Take a few minutes to look at soothing images or old photos. Reconnect to the things you love in life. Buy yourself a bouquet of flowers.  Take a nap. A short “power nap” can rejuvenate you and leave you feeling able to take on the rest of the day.

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NO-COST Pregnancy and Parenting Workshop Series!

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A new series of classes is being offered for expectant parents. All About...Having a Baby combines core educational components of pregnancy and parenting essentials with helpful hands-on workshops, guest speakers and a support group element where pregnant moms can benefit from their peers. Workshop topics will include infant massage, lactation education, post partum depression and baby soothing techniques.

What’s more—there is no enrollment fee! |

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The 8 week series will be offered several times in 2016, with the first kicking off Thursday, January 7. Each session will be held in Placerville and will take place once a week from 6-8:30 p.m.

This no-cost series is made possible by a grant from First Five El Dorado and will be very beneficial to participants.

There will also be a participation incentive.

To sign up, call Marshall Community Health Education at 530-626-2990.

FOUNDATION NEWS www.marshallfound.org

“Mammo Men” Raise Awareness and Funds

This October, local Placerville merchants, wineries and orchards participated in the 3rd annual “Pink in the Night” celebration as storefronts were decorated with strands of pink lights to symbolize being united to fight against breast cancer.

David Combellack (left) with merchant Tod Pickett

Mammo Men dressed in pink kicked off the event by raising awareness of early detection with fundraising for art and movement therapy for our cancer patients though the Images of Hope program. Attorney David Combellack joined the Mammo Men crew dressed in a white and pink tuxedo. He’s no stranger to this life-changing disease, he lost his mother to breast cancer in 1999, and his wife Susan, a 2nd grade teacher at Camino School, is a cancer survivor since 2000. Those who participated were passionate about raising funds for Marshall’s Cancer Program, and shared in the goal to promote early detection of breast cancer. For further information on how you can help, contact Marshall Foundation at 530-642-9984.

America is at a Crossroads

In one direction, walking in our communities is getting harder and harder, and it happens less and less.

Meanwhile, the number of overweight children is growing at an alarming rate, putting them at risk for lifelong health problems. In the other direction, communities are building sidewalks, trails and pathways, safe street crossings and plentiful destinations within walking distance – all to encourage us to get out and walk again.

The 11th annual iWalk to School event promoted physical fitness and lifestyle changes; raised awareness of how walkable a community can be; created awareness of how people can take back their neighborhoods and create awareness of reducing crime; and raised concern for reducing traffic congestion, pollution, and speed near our schools.

Healing Garden Brings Hope and Peace Sitting high on a hill in Placerville, the new wing of Marshall Hospital is an inspiration for the community. Between the shadows of the two largest buildings on the campus sits a healing environment just off the circular driveway within the outstretched wings of the hospital’s portico. “It is a space for contemplation, peace, renewal and quiet reflection – something to help patients and their families needing a respite while at Marshall,” related Dana Rice, president of the 2014 Leadership El Dorado class who developed the garden. “Our hope is to offer a place of serenity, a garden that brings hope, peace, and a sense of renewal.”

Research regarding the positive effect of nature on patient outcomes continues to grow with scientific evidence showing that exposing patients to nature can alleviate pain and alter moods. In 2016, Marshall will embark upon another Healing Garden project for the Cancer Center in Cameron Park. For more information on how you can help, contact us at 530-642-9984.

2015 Mathewson-Bonser Nursing Scholarship Recipients

Teri Hinz, Catherine Lynch, Katrina Gutierrez, Janelle Montgomery and Bob Gillett (vice president)

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AWARDS

Marshall Receives Stroke-Care Award The American Heart Association has awarded Marshall a prestigious and elite “Stroke Gold Plus” quality award. The award recognizes Marshall Medical Center’s commitment and suc-

actual patient

cess in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations.

The team overseeing Marshall’s stroke treatment protocols have worked tirelessly to ensure that patients who come to Marshall as positive victims of stroke receive the most rapid, advanced care available, supporting positive outcomes.

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6 Years in a Row