Issue 3, 2013 St. Elizabeth Health Center • St. Elizabeth Boardman Health Center HMpartners.org

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A video that gives laypersons a gooddescription of what sepsis is and how tohelp prevent it is now posted on Humilityof Mary Health Partners’ Internet website:HMpartners.org/patientvideos. Sepsis is the body’s reaction to aninfection. In severe sepsis, the body’snormal reaction to an infection becomesharmful instead of helpful. If not corrected,it can overwhelm all normal body functionsand lead to death. Rhonda Gluckner, sepsiscoordinator for HMHP, has been workinghard to educate staff and the public aboutsepsis. Gluckner said the statement at thebeginning of the video really sets the stagefor what the video is about: 215,000Americans die every year of a disease thatmost people have never heard of: Sepsis. “I believe the video is effective in helpingpeople understand that this condition canaffect anyone, at any age, at any time – andthe devastation it has the potential tocause,” she said. This video is designed for patients andfamilies using easy-to-understandterminology to help define and understandsepsis. It includes two personal stories oftwo young women affected by sepsis. Onesurvived, but with many physicaldisabilities. The other one died. Her fathercreated the Sepsis Alliance, which createdthe video. For more information about HMHP’ssepsis program, call Gluckner at330-480-2935.

Sepsis EducationVideo Available Online

The National Committee for QualityAssurance (NCQA) has recognizedAustintown Family Health Center as thearea’s first Patient-Centered Medical Home(PCMH). While they may be the first inthe area, they are not the last. According toRod Neill, director, physician practicemanagement, the goal is for all of theHMHP Physician Associates primary carepractices to earn this distinction by 2014. It is not a small goal. Practicesrecognized as a PCMHs meet a rigorous setof standards that describe clear and specificcriteria designed to improve primary care.The PCMH standards require a doctor’soffice to organize care around patients,work in teams, coordinate, and track careover time. In a medical home practice, the doctoris the patient’s champion and the practiceis the patient’s “home-base” for health andwellness. Working with the staff, doctorslead and coordinate a patient’s overall care.A patient can rely on their doctor to notonly treat current health conditions, butalso work with them to plan their overallhealth and wellness, and if needed,coordinate and monitor care fromspecialists. For patients, having a “medical home”means better access to their doctor.Extended hours, same day appointments,and ease of communication are hallmarks

of a PCMH. For example, AustintownFamily Health Center uses an electronichealth record to maintain a single medicalrecord for each patient. This technologygives patients access to their healthinformation through MyChart, a secure,online service. With MyChart, patients canlog into their personal account, from acomputer or smart phone, to request anappointment, renew a prescription, viewtest results, or send a secure message totheir doctor or care team member. “We’re always striving to improve carefor our patients and it’s exciting to be onthe leading-edge and to make a realdifference in our patients’ experience,” saysNancy Lesniewski, manager, AustintownFamily Health Center.

About The NationalCommittee for QualityAssurance

The National Committee for QualityAssurance (NCQA) is a private,not-for-profit organization dedicated toimproving health care quality. Since itsfounding in 1990, NCQA has been acentral figure in driving improvementthroughout the health care system, helpingto elevate the issue of health care quality tothe top of the national agenda.

HMHP PhysicianAssociates LaunchFirst Patient-CenteredMedical Home

The Austintown practice isthe first primary caremedical practice in the areato earn this nationaldistinction.

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New Option for Chronic Sinusitis Available atHowland Ear, Nose, and Throat

A clinically proven, minimally invasivetechnology used by surgeons who treatchronic sinusitis is now available atHowland Ear, Nose, and Throat, anHMHP Physician Associates practice. TheBalloon Sinuplasty System by Acclarent™uses a small catheter and balloon to quicklyopen and expand blocked sinuses. Sinusitis is one of the most commonchronic health problems in the U.S.,afflicting 37 million Americans each year.Patients suffer headaches, congestion,fatigue and other symptoms. This conditionsignificantly affects an individual’s physical,functional, and emotional quality of life. Typically, the first treatment forsinusitis is medication. However, at least20 percent of patients do not respondadequately to medications. Sinus surgery isoften the next step towards finding relief.Conventional sinus surgery requires boneand tissue removal in order to open upblocked sinus passageways. This may lead topost-operative pain and bleeding thatrequires uncomfortable nasal packing tocontrol. Now ENT doctors can use minimallyinvasive sinus balloon catheters to position aballoon into the blocked sinus passageway.The doctor gently inflates the balloon torestructure and open the sinus passageway,facilitating normal sinus drainage andfunction. Jared Bunevich, DO is one of the firstphysicians in this area to offer thistechnology. “The Balloon Sinuplasty is atrue advance in sinus care. In many cases, itcan be done without removing any tissue orbone, which means less pain, and a fasterrecovery,” he says. Sinusitis patients can learn more aboutthe Balloon Sinuplasty by contactingHowland Ear, Nose, and Throat at330-856-2520 or by visitingHMpartners.org/sinus.

Howland Ear, Nose, and Throat is locatedat 1950 Niles-Cortland Rd. NE,Suite 4 in Howland, Ohio.

St. Joseph HealthCenter’s Diagnostic Sleep Labin Howland has earned accreditation fromthe American Academy of Sleep Medicine(AASM) for a period of five years. The fa-cility has changed its name to the St.Joseph Sleep Center, whichbecame possible after the AASMaccreditation. AASM accreditation is the goldstandard by which the medical communityand the public can evaluate sleep medicineservices. The Standards of Accreditationensure that sleep medicine providers main-tain proficiency in areas such as testingprotocols, policies on patient safety andfollow-up, and physician and staff trainingand accountability. Steven Pavlak, manager of theSt. Joseph Sleep Center, said there are some2,500 AASM-accredited sleep centersacross the country. “The accreditationprocess was quite extensive. It required anapplication that was more than 200 pages.After the applications was reviewed andaccepted, a site visit was scheduled toevaluate our compliance with themandatory standards,” said Pavlak. Pavlak credits the entire sleep centerstaff for this successful accreditation,including Dr. Fernando Chaves, medicaldirector; Bill Boccia, ambulatory directory;Shelly Ventura, coordinator; and sleeptechnicians Jaclyn Williams (days), SteveRose, Wanda Boyd, Lisa Clontz, TiffanySalomone and Josellen Hrusovsky (nights). AASM accreditation is voluntary.“Although accreditation is not yet requiredfor reimbursement in Ohio, certaininsurance providers are mandating it forsleep testing to be reimbursed. Experts feelthat AASM accreditation will be requiredfor coverage of sleep testing in the nearfuture,” said Pavlak. The St. Elizabeth Sleep Center inWarren is also accredited by the AmericanAcademy of Sleep Medicine.

St. Joseph SleepCenter Earns NationalAccreditation

A minimally invasive, in-office procedure could bring dramaticrelief to those who suffer from chronic sinus pain, pressure,and infections.

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The goal of the Clinical Documentation Excellence (CDE) program is to ensure providerdocumentation in the health care record clearly reflects the quality of patient care andseverity of illness. To be successful, the program requires true collaboration betweenphysicians and CDE specialists. Physician documentation is the basis for diagnoses codes. CDE specialists cannot assumediagnosis codes from clinical findings. When reviewing medical records, CDE specialistscreate physician queries. They place the queries in CarePath as CDI Sticky Notes.

Physician documentation must include the following to ensure acomplete record reflecting accurate severity of illness:

• Document a patient assessment daily, the patient active problem list should not be used as the assessment unless updated daily

• Specify the acuity of conditions. Specify CHF acuity and type (Systolic, Diastolic, acute, chronic)

• Document suspected causative organism in infections

• Document cause and effect – Acute organ dysfunction related to sepsis; GI bleed and the probable source

• Document if debridement was excisional or non-excisional, depth, tissue excised and instruments used.

• Specify anemia- acute or chronic blood loss anemia, iron deficiency anemia, etc.

• Document pressure ulcers site, stage and Present On Admission status

• Document if suspected conditions have been ruled out, still suspected or confirmed after study

• Document the likely etiology of symptoms

• Document all diagnoses in the discharge summary that impacted the patient’s stay

We would like to thank all the physicians for helping to improve health care recorddocumentation.

Clinical Documentation Excellence (CDE)

HMHP’S Regional Tobacco TreatmentCenter has received Joint Commissionaccreditation. Outstanding qualitycombined with exceptional outcomes hasphysicians referring to the center more thanever. 2012 statistics include end oftreatment quit rate of 96 percent, 77percent at three months, and 69 percent atsix months. The Tobacco Treatment Centercontinues to adhere to CDC’s ClinicalPractice Guidelines for Treating TobaccoUse and Dependence outlining ‘BestPractices’ which combines behavioralcounseling with pharmacotherapy. Staffincludes licensed chemical dependencycounselors with certification as TobaccoTreatment Specialists, RN’s, and a MedicalDirector. The Center continues to receive grantfunding from HMHP’s Foundationallowing participants to receive treatmentat no out-of-pocket cost including both thecounseling and medications. Medicationsinclude OTC and prescriptionmedications. When indicated, clientsreceive a combination of two medicationsto further improve the chances of quittingand alleviating withdrawal symptoms. Forexample, the nicotine patch and gum orlozenge or the combination of Buproprionand gum or lozenge. Chantix is notcombined with any other medications. Physicians may make a referral directlyto the center by calling 330-306-5010 ext.101 or may request a personalized “FastFax” form. A customized Fast Fax formallows the physician to make an immediatereferral along with permission for theTobacco Center’s staff to do all the followup with their patient. To request a Fast Fax form call or emailthe Center’s manager, Terri Grimmett at330-306-5010 x108 orTerri_Grimmett@hmis.org.

Regional TobaccoTreatment CenterEarns Accreditation

Hospice of the Valley has expanded its service area to western Pennsylvania with theopening of its office at Villa Maria, Pa. The faith-based, non-profit service isCMS/Medicare approved and all staff is licensed by the state of Pennsylvania. The servicearea includes Mercer, Lawrence and Beaver counties. All hospice services are available toqualified patients in their homes, nursing homes, assisted living facilities, hospitals oranywhere the patient calls home. For more information, call Gerianne Costantini, clinicalmanager, at 724-964-1082. Hospice of the Valley also serves patients in Mahoning,Trumbull and Columbiana counties in Ohio.

Hospice of the Valley Opens Pennsylvania Office

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Laser Sheds Light on New Options in Facialand Body Rejuvenation

Looking younger has never been so easy thanks to cutting-edge Sciton Lasertechnology now available from HMHP Physician Associates plastic surgeon, Adam D.Cash, MD. This state of the art instrument introduces affordable new options in facialand body rejuvenation. The face shows signs of aging with the passage of time and effects of gravity. Loss offullness in the face, specifically in the cheek area, loss of skin glow, and an increase in redand brown pigment to the skin, as well as both deep and fine wrinkles are some of thefirst signs. The combination of laser procedures available with the Sciton Laser can helpdiminish these signs. Laser treatments are significantly more affordable than surgery andrequire a very short recovery period. With the introduction of the Erbium YAG Ablative Laser as well as BroadBand Lightwavelengths, women and men of all ages can improve appearance and turn back thehands of time.

The St. Elizabeth Family MedicineResidency has received a full accreditationfor an additional five years from theAccreditation Council for GraduateMedical Education (ACGME). TheACGME is the national organization thataccredits all medical residency programs –more than 9,000 in the U.S. - leading tocertification by the American Board ofMedical Specialties. Five years is the maximum length ofaccreditation awarded by the ACGME, andindicates that the St. Elizabeth FamilyMedicine Residency continues toprovide the highest quality residencytraining available in the specialty.Accreditation follows a rigorous reviewprocess that includes complex reportingrequirements, a site visit from an ACGMEspecialist, interviews with faculty, staff, andresidents, and a review by the nationalcommittee of all findings. “This announcement is a testament tothe efforts of multiple people, butespecially to the current faculty of theresidency and the residency coordinator,Rosie Hilland,” says Rudolph M. Krafft,MD, FAAFP, director, St. Elizabeth FamilyMedicine Residency. The St. Elizabeth Family MedicineResidency has graduated more than 120physicians in more than 30 years ofoperation. Training involves patient care atthe Family Health Center as well asrotations throughout the institution andprivate offices of staff physicians innumerous specialties.

Residency ProgramContinues Traditionof Quality

Rudolph M. Krafft,MD, FAAFP

Look as young as you feel

“My face feels revived and my friends have noticed a fresher look! My skin looks and feels younger.” Kris C.

Photos courtesy of Jason Pozner, M.D.

with Sciton’s ProFractional™ +MicroLaserPeel®

combination treatment

younger looking skin | tone and texture improvementscar revision | wrinkle reduction

The Sciton Joule Laser platform can effectively improve any of the following conditions:

• Tighten fine lines and wrinkles of the face

• Improve facial fullness

• Vertical lines around the mouth

• Facial scars caused by injury or accident

• Scars caused by acne

• Areas of uneven pigmentation, such as age spots

• Lines on the cheeks caused by sun damage

• Vascular lesions/Rosacea

• Acne

Patients are treated in the office with minimal pain and without the need for a tripto the operating room. Recovery generally occurs over a long weekend.

Dr. Cash can help choose a treatment plan best for each individual in a privateconsultation at either his Howland or Boardman Location. For more information, visitHMpartners.org/plasticsurgery, or call Dr. Cash’s Howland office at 330-856-2545 orBoardman office at 330-729-3128.

Board ApprovalsSt. Elizabeth Health CenterRequest for Active ProvisionalStaff Status

Michael Banyasz, MD, Department ofEmergency Medicine

Patrick Brine, MD, Department ofInternal Medicine, Section of GeneralInternal Medicine,

Andrew Bushey, DMD, MD, Departmentof Oral & Maxillofacial Surgery

Louis Henn, MD, Department of Surgery,Section of Cardiothoracic Surgery

Karipineni Prasad, MD, Department ofPsychiatry and Behavioral Sciences

Ashley Reimer, MD, Department ofFamily Medicine

Keith Roller, MD, Department ofAnesthesiology

Ronald Yendrek, DO, Department ofPsychiatry and Behavioral Sciences

Resignations

Leyla Abdulhay, DMD, Department ofDentistry

Ying Amorn, MD, Department of InternalMedicine, Section of Gastroenterology andGeneral Internal Medicine

Linda Berry, CRNA, Department ofInternal Medicine, Section of GeneralInternal

Aron Blecher, MD, Department of InternalMedicine, Section of General InternalMedicine

Steven D’Sa, MD, Department ofAnesthesiology

Marc Estafanous, MD, Department ofEENT

Neville Irani, MD, Department ofRadiology

David Jackson, MD, Department ofEmergency Medicine

Loretta Jacob, CNP, Department ofInternal Medicine, Section of GeneralInternal Medicine

Michael Keller, DO, Department ofEmergency Medicine

Beth Magnifico, MD, Department ofInternal Medicine, Section of GeneralInternal Medicine

Peter Motolenich, MD, Department ofAnesthesiology

Brendan Patterson, MD, Department ofSurgery, Section of Orthopedics

Llewelyn Rao, MD, Department of EENT,Section of Ophthalmology

Michael Shumaker, PA-C, Department ofSurgery, Section of Orthopedic Surgery

Timothy Wagner, DO, Department ofFamily Medicine

Roger Wilber, MD, Department of Surgery,Section of Orthopedics

April Patterson, CRNA, Department ofAnesthesiology

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Focus on PatientsHealthy Food, HealthyHeart After suffering a heart attack in 2007,Jim Converse, manager of the NorthsideFarmers’ Market, underwent quintupleheart bypass surgery at St. ElizabethHealth Center in Youngstown. LastOctober, after setting up for a farmers’market at St. Elizabeth, Converse suffereda second heart attack. “It was a busy day and at first Ithought I over exerted myself,” Conversesays. “I had a headache and I wassweating. I sat and rested but thesymptoms persisted. Then I thought tomyself, ‘I think I’m having a heartattack.’” Not wanting to draw attention tohimself, Converse quietly left thefirst-floor lobby where the market wasbeing held and headed for the emergencydepartment. Within 10 minutes, HMHPPhysician Associates cardiologist,Dr. Walter Sweeney, had examinedConverse and confirmed that he hadanother blocked vessel. Ten minutes later,Converse was in the cath lab being

prepped for a heart catheterization. By the time Converse’s wife, PatRosenthal, arrived at the hospitalDr. Sweeney had inserted a stent intoConverse’s blocked artery and restoredblood flow. The next day, Converse wasup walking around. A rosy glow hadreturned to his face and he was feelinggood.

“I took it easy for a couple of days butI didn’t miss any farmers’ markets,” heboasts. In the year since his second heartattack, Converse has completed sixmonths of cardiac rehabilitation – threemonths under the guidance of health-careprofessionals at Humility of Mary HealthPartners and three months on his own.He has also switched to a vegan diet andlost 15 pounds. Converse says he hopesthat losing weight and eliminatingcholesterol from his diet will helpmaintain his heart health. In addition to managing theNorthside Farmers’ Market, Converseinitiated the HMHP-sponsored monthlyfarmers’ markets held in the privatedining rooms at St. Elizabeth and on thesquare in downtown Warren. Converse’smission is to make healthful, locallygrown fruits and vegetables readilyavailable to everyone, especially inner-cityresidents who may not have easy access tofresh produce.

Farmers’ Market ManagerJim Converse