Issue 3, 2013 St. Joseph 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.

Warren doctor, Kimberly N. Jackson,has won the Family Practice Resident of theYear Award. The award, presented by theOhio Chapter of the American College ofOsteopathic Family Physicians, is given toan Ohio osteopathic physician who exhibitsthe exemplary characteristics of anosteopathic family physician. The recipientis chosen from nominations submitted byfamily medicine program directors inprograms approved by the AmericanOsteopathic Association (AOA). A graduate of Ohio University HeritageCollege of Osteopathic Medicine(OU-HCOM), Dr. Jackson is a resident atthe St. Joseph Health Center FamilyResidency Program where she has helpedrestructure the residency curriculum. Sheserves as a mentor to students, and duringmedical school she served as a mentor tominority undergraduate students who werepursuing degrees in math and science.Dr. Jackson is active in recruiting studentsto apply for family medicine, both atSt. Joseph and throughout Ohio. Dr. Jackson engages in many volunteerprojects, including with Habitat forHumanity and at nursing homes. At herchurch, she teaches classes and mentorsyoung people. In her community, shevolunteers to tutor adolescents strugglingin school. While attending OU-HCOM,Dr. Jackson participated in a researchproject in Kenya, studying health andnutrition and the likelihood of developingdiabetes and cardiovascular disease. Herresearch project won second place in anational AOA contest.

St. Joseph FamilyMedicine Residenthonored at Ohio Os-teopathic Symposium

Kimberly N. Jackson

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.

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New Appointments

Kathy Cook is interim president ofSt. Joe’s. She has been part of the HMHPsystem since 1980, when she started as anursing student at St. E’s School ofNursing. She has served HMHP as anassistant head nurse, head nurse, director,senior director, executive director and,most recently, chief nursing officer atSt. E’s. Kathy has a BSN from YoungstownState University and a Master’s in nursingadministration from Gannon University.She is also a graduate of the CHPLeadership Academy.

Molly Letcher is interim director ofsurgical and per-operative services atSt. Joe’s. Molly has worked for HMHPsince 2002 as director of the bariatricweight loss program and for the past twoyears as the nurse manager of surgery andperi-operative services at St. Joe’s. She hasher BSN and MSN from Kent StateUniversity and is certified as a clinicalnurse specialist.

Mara Piersol is the interim nursemanager of St. Joe’s intermediate CareUnit (IMC) in addition to her duties as thenurse manager for the ICU. Mara hasserved at St. Joe’s since 1980 as a staffnurse, nurse coordinator and nursemanager. She has her diploma from AkronCity Hospital’s Idabelle Firestone School ofNursing and her BSN from the Universityof Phoenix and is a certified critical carenurse (CCRN).

Congratulations

“Congratulations on achieving continued progress in length of stay and improving the O/Eratio. Keep up the good work! I would also like to thank the doctors for their judicial use ofproton pump inhibitors. The numbers have shown a significant improvement. Thanks.”

Dr. Novosel

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 beingprepped 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