Keynote speaker, workshops and lunch with the experts are part of the program

WellWomen: Spring Fling will be held 8 a.m. to 1 p.m., Saturday, March 3, at the Collegiate Performing Arts Center, York College. The program features a morning full of information on a variety of women’s topics.

Deborah Bernal, M.D., is the keynote speaker. She will discuss “Align Your Mind, Body and Spine: How Emotions and Stress Affect Your Health and Well-Being” from 8:45 to 9:30 a.m.

Bernal is a specialist in physical medicine and rehabilitation with more than 20 years experience.

Afterwards, participants can choose from a number of different workshops.

The workshops are offered in two sessions, 9:45 to 10:30 a.m. and 11 to 11:45 a.m. Workshop topics include:

• Brain Attack! Women and Stroke
• When Things Leak and Drop
• Benefits of Antioxidants, Even a Little Chocolate
• What, Me Worry? How Not to Let Worry Get the Best of You
• Get a Grip! Using Complementary Therapies to Calm Yourself and Improve Health
• Women and Osteoarthritis
• Boning Up on Osteoporosis
• How Sweet It Is: Diabetes Update for Women
• Back on the Weight Loss Wagon
• Self-Care for Women
• Brain Power: Practical Ways to Enhance Memory and Improve Concentration
• Foot Problems in Women

Participants can lunch with the experts and hear them discuss a variety of topics from noon to 12:45 p.m.

“WellSpan offers comprehensive women’s health services and we showcase our system’s expertise at this event,” said Dianne Moore, R.N., women’s services coordinator.  “We try to be responsive to topics women are asking for, and that is one of the reasons we have a good turnout every year.”

Moore said she’s always impressed with the response and willingness of the speakers to participate in the program.

Cost is $25 per person and includes continental breakfast and lunch with the experts. Registration deadline is Tuesday, Feb. 21. You may register online by clicking here. If you have any questions, call 851-2241.

Proceeds benefit the “Young Women’s Leadership Conference,” a self-esteem program for local seventh grade girls.

Recognition reflects the efforts of dedicated care teams to improve patient care

Present for the presentation of the VHA Achieving Patient Care Excellence (APEX) awards were, from left to right, Allison Arrowood, R.N., Emergency Services; Terry Whittington, R.N., A-2; Mark Tino, VHA; Michelle Bretzman, R.N., Nursing Administration; Sharon Fruehan, R.N., Infection Control; Kathy Williams, VHA; and Charlie Marley, D.O., vice president, Medical Affairs.

For the second time in less than six months, Gettysburg Hospital has been recognized by a national organization for its ongoing efforts in demonstrating excellence in patient safety and quality.

Gettysburg Hospital recently received two 2011 VHA Achieving Patient Care Excellence (APEX) awards for prevention of catheterassociated blood and urinary tract infections. The recognition reflects the efforts of dedicated care teams to improve patient care.

The APEX Award for zero catheter- associated blood stream infections reflected the hospital’s 18 consecutive month period from Jan. 1, 2010, to June 30, 2011. The hospital’s award for zero catheter-associated urinary tract infections covered seven months from Dec. 1, 2010 ,to June 30, 2011.

“Receiving the VHA APEX awards is further validation of our continual efforts to offer every patient safe and effective care,” said Cheryl Hale, clinical director and patient safety officer, Gettysburg Hospital.

“The work of our staff throughout the hospital continues to result in real improvements in patient care. While we used to aim for being at least ‘average,’ we now have a culture that is dedicated to ending health care-associated infections altogether.”

Hospital care teams worked together to successfully overcome challenges presented by both types of catheter- associated infections. Process and technique improvements and changes to clinician protocols played key roles in helping to prevent these infections.

“We are pleased to honor Gettysburg Hospital with this award,” said Mark Tino, vice president, Performance Improvement for VHA Pennsylvania. “VHA is working with hospitals across the nation to help them improve clinical performance. Within the Pennsylvania region, this award validates Gettysburg Hospital’s continued commitment to improving clinical quality and patient care.”

VHA’s annual APEX awards are designed to honor organizations that have differentiated themselves by demonstrating extraordinary levels of clinical performance. The recognition program is open to all members of the VHA Pennsylvania region, and hospitals are evaluated in several areas that include infection control and patient safety.

The VHA APEX award follows the recognition Gettysburg Hospital received last October of being named a top performer on key quality measures by The Joint Commission.

To learn more about Gettysburg Hospital’s clinical improvement initiatives visit www.wellspan.org and to learn more about VHA and its clinical improvement initiatives, visit www.vha.com.

One of only six Pennsylvania healthcare networks to make the list

WellSpan has been named a Top 100 Integrated Healthcare Network for the sixth consecutive year by IMS, a health care data and consulting company in Danbury, Conn.

Researchers determine the rankings by compiling a system’s overall score measuring 33 attributes in eight differently weighted performance categories.

Overall integration is the most heavily weighted. Other categories include integrated technology, financial stability, hospital utilization and contract capabilities.

Services and access, outpatient utilization and physician services also are measured. Although WellSpan isn’t privy to how IMS compiles the scores, it strives to further advance its integration objectives each year in order to better serve its communities.

Two categories where WellSpan has made significant progress in the past couple years are integrated technology and service and access.

An electronic health record (EHR) is one of the measures of integrated technology. For several years, WellSpan has been moving toward an EHR, which consists of a multitude of individual projects such as Computerized Physician Order Entry (CPOE), My eCare, PowerChart, Health Information Management, Care Aware and PACS.

R. Hal Baker, M.D., chief information officer, said WellSpan is approximately 75 percent toward reaching its goal of an EHR. WellSpan’s goal is to develop one medical record, which is safe, secure and reliable, for each patient. The EHR can be viewed individually or simultaneously by members of the health care team, regardless of where they are.

WellSpan is focusing on leveraging the EHR to improve patient care.

Looking around, it’s easy to see how WellSpan is increasing access for patients. In 2011, WellSpan opened three CareExpress locations, the Neuroscience and Pain Center and a rehabilitation facility in southern York County.

WellSpan recently opened second offices for Apple Hill Internal Medicine and WellSpan Orthopedics. In the next several months, the health system will open the new Surgery and Rehabilitation Hospital, an expanded Emergency Department at Gettysburg Hospital and a larger Wheatlyn Family Medicine facility.

WellSpan, ranked No. 51, is one of only six Pennsylvania health care networks to make the list. The others are Geisinger Health System (No. 2); Lancaster General Health (No. 53); Crozer-Keystone Health System (No. 75); Heritage Valley Health System (No. 89); and Conemaugh Health System (No. 98).

For a complete list of the Top 100 Integrated Healthcare Networks go to www.imshealth.com/ihn100.

A 2011 poll conducted by the University of Michigan’s C.S. Mott Children’s Hospital revealed that childhood obesity and drug abuse are the two major childhood health concerns, according to adults who took the survey.

Although childhood obesity remains on top of the list for the fourth consecutive year, drug abuse moved up into a tie for first place. 

The top overall concerns and the percentage of adults who rated each item as a “big problem” in the survey:

The perception of drug abuse as a big problem matches recent national data showing increasing use of marijuana and other drugs by U.S. teens.

Although obesity remains atop the list, the level of public concern has declined over the last few years in the poll. 

• Childhood obesity, 33 percent
• Drug abuse, 33 percent
• Smoking and tobacco use, 25 percent
• Teen pregnancy, 24 percent
• Bullying, 24 percent
• Internet safety, 23 percent
• Stress, 22 percent
• Alcohol abuse, 20 percent
• Driving accidents, 20 percent
• Sexting, 20 percent

Two-week visit filled with educational experiences

Eunice Tole, left, and Diana Kassaman, center, nurses from Aga Khan University Hospital in Nairobi, Kenya, Africa, present an African plate to Keith Noll, senior vice president, WellSpan, and president of York Hospital, as a token of their appreciation.

Near the end of her two-week visit to WellSpan, Diana Kassaman, a nurse from Aga Khan University Hospital in Nairobi, Kenya, Africa, posted this message on her Facebook page: “Dreams do come true.  In my wildest imagination, I never thought I would see things I had only read about.”

Kassaman and co-worker Eunice Tole made the 18-hour flight to York to learn more about the roles of a Magnet project director and a patient safety officer.

Their trip, which was their first to the United States, was filled with talking to administrative leaders and staff members, attending committee meetings, visiting various departments and nursing units and asking questions.

“Diana and Eunice had a true WellSpan experience,” said Valerie Hardy-Sprenkle, vice president of acute care nursing practice.  “They interacted with staff members at York Hospital, Gettysburg Hospital and the WellSpan Surgery and Rehabilitation Hospital.”

Besides experiencing York and Adams counties, Kassaman and Tole traveled to Washington, D.C., Lancaster and Baltimore.  They visited the Smithsonian and other landmarks; toured Amish country and ate Amish food; and received a tour of Johns Hopkins Hospital.

“The visit to WellSpan exceeded our expectations,” said Tole.  “Everyone was so warm, friendly and extremely helpful.  We developed many great resources and friends while we were here.”

Tole visited the Emergency Department, Operating Rooms and various nursing units to observe patient safety processes.  She also attended committee meetings.  She witnessed Da Vinci robotic-assisted surgery and termed it “out of this world.”

Kassaman talked to Magnet ambassadors and was impressed by their “enthusiasm and passion.”  She also was impressed by the electronic health record and the IV team.

Different cultures, similar issues

Barb Buchko, director of evidence-based practice and nursing research, and Linda Pugh, Ph.D., a York College nursing professor, visited Aga Khan University Hospital in August 2010 to help teach other nurses about evidence-based practice, which involves using the best practices and research evidence to make decisions about the care of patients.

Aga Khan University Hospital, a 250-bed, private facility, offers open heart surgery, performs organ transplants and is in the middle of a building campaign to expand to 600 beds.  It is seeking Joint Commission International accreditation and Magnet designation (only five international hospitals are Magnet designated).

Kassaman presented three evidence-based practice projects Aga Khan University Hospital had undertaken to the Nursing Research Council.  She also made a presentation about ISO 9001 certification to the WellSpan Surgery and Rehabilitation Hospital staff.

Despite differences in cultures, Tole said Aga Khan University Hospital and WellSpan share many similar issues.
Some of those issues include preventing falls, improving nurse-physician relationship and decreasing interruptions and distractions in the Operating Room.

“I was pleased with how excited all of our staff members were to meet Diana and Eunice and share information with them.  It reaffirmed to me that WellSpan is an amazing organization,” said Buchko.  “I think our staff members also gained knowledge from talking to Diana and Eunice.”

 Before leaving for Nairobi, the two nurses presented many WellSpan leaders with gifts from their native country, as a token of their appreciation.

 “We learned so much during our visit,” said Tole.  “Now, we are going to take it back and apply it at our hospital.”

Cardiologist, based in Gettysburg, added to CDA practice

Last fall, Gettysburg Hospital’s Heart Center welcomed the addition of a new local cardiologist to the Cardiac Diagnostic Associates practice. Michelle Consolini, M.D., became the first Cardiac Diagnostic Associates (CDA) physician to be based in Gettysburg to serve the needs of area patients.

“WellSpan is focusing on getting more local,” Consolini recently told the Gettysburg Times. “More people are coming to the doctor for cardiac care. That can be attributed to more awareness and it is easy (for Adams County residents) to get to Gettysburg versus traveling to York.”

Benefitting from Consolini’s expertise and the skills of the other clinicians who see patients in the hospital’s heart center, several diagnostic testing capabilities available to patients have also expanded. Invasive procedures such as pacemaker and defibrillator implants have been performed in the Gettysburg Hospital Heart Center for the past two years. With the addition of Consolini, more patients will have the ability to be evaluated by her and subsequently have such a procedure performed locally.

In December, Consolini and the cardiovascular services staff began performing transesophageal echocardiograms (TEE). A TEE is an outpatient procedure that serves as an excellent tool for visually evaluating blood clots and heart valve function. Available to patients via a cardiology consult or office visit, it is a service enhancement that allows people to get advanced diagnostic testing performed closer to home.

“We’re committed to providing the highest level of cardiac care to the residents of Adams County by continually expanding the services offered locally,” said Brian Heldibridle, manager, cardiovascular services, Gettysburg Hospital. “The addition of TEE procedures further enhances the ability of Gettysburg Hospital to serve in the role of primary provider of cardiovascular care to our customers.”

In addition to the new TEE capabilities, Gettysburg Hospital’s Heart Center continues to provide diagnostic cardiac studies that include stress testing, EKGs, stress echocardiography, nuclear stress testing, cardiac catheterization and synchronized cardioversion.

These enhanced efforts in Gettysburg, which demonstrate WellSpan’s full spectrum of cardiac care, are supported by services including nutrition management, preventive cardiac care and cardiac rehabilitation.

One millionth new prescription filled since pharmacy opened in 1988

Anne Hoover, right, picks up her prescription from Julie Millar, cashier at the WellSpan Pharmacy at Apple Hill. Hoover‘s recent new prescription was the one millionth in the pharmacy’s 23-year history.

When Anne Hoover dropped off a new prescription at the WellSpan Pharmacy at Apple Hill recently, she had no idea she was making history.

Hoover’s prescription was the one millionth new prescription for the pharmacy since it opened in October 1988.

Hoover, who has been using the WellSpan Pharmacy at Apple Hill for more than 20 years, said, “I’ve been very happy with their customer service. Everyone has been able to answer my questions about the medications and they are very cooperative.

“I really appreciate the positive attitude of the staff,” she added. “Everyone is extremely helpful.”

Hoover, who lives in Spring Garden Township, said the WellSpan Pharmacy is conveniently located. She also likes the 24-hour automated system that allows customers to leave refill information.

“One million new prescriptions speaks well to the trust we have built with the community,” said Clint Roderick, senior pharmacy manager. “When customers bring us new prescriptions, it means they have confidence in us.

“We recognize that customers have a wide choice of pharmacies. So, we appreciate it when they choose us.”

New prescriptions are tracked by the Rx number. The first prescription filled by WellSpan Pharmacy at Apple Hill was number 6000001.

Besides averaging 4,500 new prescriptions each month, WellSpan Pharmacy at Apple Hill filled more than 109,580 prescriptions last year.

Roderick said the goal is to provide customers a “great experience” at the WellSpan Pharmacy locations and improve customer satisfaction scores.

“We want our customers to keep coming back,” he said. “We have tried to minimize wait times, improve our phone system and design our work flow to make our staff more efficient. We have emphasized to our staff the importance of friendly customer service and we are seeing our customer satisfaction scores trend upward.”

Roderick expects the volume of new prescriptions to increase for the WellSpan Pharmacy at Apple Hill when the WellSpan Surgery and Rehabilitation Hospital opens this spring.

WellSpan Pharmacy at Apple Hill will celebrate the one millionth new prescription with a staff luncheon on Tuesday, March 6. Other WellSpan Pharmacy locations include York Hospital, Dallastown, Fairfield and WellSpan Adams Health Center.

Concept is to bring a multidisciplinary group rapidly to the bedside

Nurses checking the Code Neon supply cart prior to a simulation are, from left to right, Karen Smith, Mary Miller and Heather Scheidegg. Labor and Delivery is the first unit to conduct multidisciplinary, videotaped simulations live on the floor.

York Hospital’s newest rapid-response team has been busy since its launch in mid-September. The Code Neon team for pregnancy-related emergencies has already responded to eight calls. As many as one in 50 pregnancies involve a serious complication.

“In a heartbeat it can change to an emergent situation,” said clinical nurse educator Jennifer Leash, RNC-OB. “Since we have a Level 3 NICU, a high-risk transfer unit and a trauma center, we do get more high-risk moms and babies.”

The team is ready on a 24/7 basis to handle emergency C-sections, cardiac arrest, post-delivery hemorrhaging, and any other critical problems that may arise.

“Code Neon is for any obstetrical emergency that occurs anywhere in the hospital, not just on Labor and Delivery,” explained Missy Garavente, M.D. “The concept is to quickly bring a multidisciplinary group rapidly to the bedside."

Even though an obstetrical rapid response team is a Joint Commission requirement, the group’s professional diversity sets it apart from others. Attending physicians, residents, nurses, and administrators from several different departments plan and train together.

Code Neon stemmed from emergency response research by clinical nurse educator Karen Smith, RNC-OB. Evidence-based medicine was used to begin training the team over the summer. Training included two full-scale simulations, which were held on Tower 4.

The Code Neon team collaborated with the medical code team and the NICU team to run codes just as they would occur in real time. The team also worked with the blood bank to incorporate MTP into hemorrhage emergencies, as this is a major cause of maternal mortality and morbidity.

Smith said Labor and Delivery is the first unit to conduct multidisciplinary videotaped simulations live on the floor. The simulations, the most recent in February, have attracted dozens of observers. A debriefing follows each simulation and systems are critiqued. Potential problems are identified and an action plan is developed.

The process has helped identify supplies and medications that were needed on the cart. The team now has several fully stocked rapid-response carts with medications to take along on an emergency call. During every shift, nurses from Labor and Delivery and Tower 4 are designated for Code Neon.

“We have a large pool of experienced nurses to draw on, which is a big step in building a successful team,” Smith noted.

When someone dials 66 to report an obstetrical emergency, the Code Neon nurses and other team members receive a mass page. All critical team members now also carry phones to promote direct communication.

A recent Code Neon call involved a pregnant trauma patient who required an immediate C-section. The team had practiced a similar simulation just a week earlier.

April Paskey, R.N., was involved in both the simulation and the real case. “The teamwork we had just worked on during the simulation dramatically improved our response time,” she said. “We had an excellent outcome. It was a great feeling.”

The Code Neon project has been selected for poster and oral presentations at the Alliance for Independent Academic Medical Centers conference this month in Tucson.

Works to stem drunk driving in York County

Marie Kellett, M.D., left, accepts the WellSpan Medical Group Community Service Award from Kevin Alvarnaz. Kellett, who had her left leg amputated as a result of being hit by a drunk driver, shares her personal story with drunk-driving offenders.

Marie Kellett, M.D., recently received the WellSpan Medical Group Community Service Award for her efforts to stem drunk driving in York County. It’s a problem with which the Hayshire Family Medicine physician is painfully familiar.

Kellett was a fourth-year medical student, just 25 years old, when she was struck by a drunk driver in downtown Baltimore.

“It was a Sunday morning,” she remembered. “I was picking up my friend to take her to the airport. I had gotten out of my car to load her luggage into the trunk, and got hit from behind by the drunk driver.”

The car’s impact mangled her left leg.

Surgeons had to amputate it above the knee.

Endured a dozen surgeries

Events afterward melted into a blur. She spent a month in intensive care, endured a dozen surgeries, and received more than 40 units of blood. During it all, Kellett remained focused on a single goal: returning to medical school and finishing on time.

“I think I was scared that if I didn’t do it right away I might never do it,” she says now. University of Maryland School of
Medicine grants its students two months off from their studies. Most use this free time for a vacation and to interview for residencies. Kellett spent her two months learning to walk with a prosthesis.

Ultimately, she kept her pledge returning to school and graduating with her classmates. She also learned to forgive the drunk driver who took her leg.

“My story is really a lot about forgiveness, and not being dragged down by something that happened to me,” she said.

She refused to let the injury keep her from doing the things she wanted to do, like hiking, skiing, and learning to scuba dive. Some challenges, like walking on the beach, she has yet to master.

Shares her story with drunk driving offenders

A decade and a half have passed since that dreadful Sunday morning, and today Kellett tells her story to York County drunk driving offenders in the district attorney’s accelerated rehabilitation program.

“I sort of go through what happened to me, and how somebody else’s decision to drink and drive has impacted me and my life,” she said of the group talks.

The accelerated program isn’t for repeat offenders. It’s for people who made a mistake and, fortunately, haven’t hurt anyone yet. Kellett’s goal is to show them the seriousness of their mistake so they won’t do it again.

“I don’t go from a script, so the talk is always a little bit different,” she said.

“Sometimes when I’m talking people cry, sometimes they have to get up and leave. I usually take my prosthesis off and hold it up. It comes as a bit of a shock to them, which is sort of what I’m going for.”

Mark Catterall, M.D., nominated Kellett for the Community Service Award on behalf of everyone at Hayshire Family Medicine. “Her desire to give to her community in this personal way in our minds makes her deserving of special recognition,” he wrote.

Kellett’s other community service activities include Catholic Engaged Encounter, Catholic Harvest Food Pantry, Natural Family Planning educator, Children’s Liturgy volunteer and school volunteer at St. Joseph’s School.

More than 150 new providers have been recruited in less than two years

Thomas Stein Jr., M.D., of Jefferson Family Medicine reviews a patient’s medical history at the beginning of her appointment. Stein is one of more than 150 new providers recruited by WellSpan Medical Group in the past two years.

WellSpan Medical Group has been adding new providers faster than at any time in its history. Last fiscal year, the medical group welcomed 77 new providers to practices across York and Adams counties. So far this fiscal year, that number stands at 78.

“This is turning into the largest recruitment year we’ve ever had,” said Tom McGann, M.D., medical group president and WellSpan senior vice president.

The recruiting surge is part of WellSpan’s on-going commitment to making primary care more accessible across the region. It’s not an easy task, mainly because new doctors are hard to find. National demand for primary care physicians continues to rise, yet most medical school students still look to other specialties.

Stepping in to fill the void are nurse practitioners and physician assistants, known collectively as advanced practice clinicians (APCs). McGann noted that APCs are essential to the medical group’s growth.

“We’re seeing very solid acceptance of their skills by patients and by the physicians who provide supervision,” he said. Increasingly, however, even the APCs are in short supply.

“In the last year or two, most of our APC recruits have been local people,” McGann said, “but that well is pretty dry now.”

The medical group employs three full-time recruiters who conduct a never-ending, nationwide search for talented primary care providers.

“We’re looking for people who are able to use their excellent skills as part of a team,” McGann said. “The practice of medicine is becoming much more team-oriented and collaborative.”

Often, graduates of York Hospital’s family medicine residency program go on to join the medical group.

“The resident who’s been here knows the community, knows our health system, and knows our electronic health records, so it’s a very easy transition,” McGann said. “They know us and we know them.”

The medical group’s employed-practice model appeals to new physicians because it offers financial security, opportunities for collaboration, considerable resources and administrative support.

The model has also begun attracting physicians who are already established in independent practice.

“We’ll get a call from a physician who says, ‘Hey, I’d like to learn about employment,’” McGann explained. “That trend has been increasing in the last two or three years. The economic pressures of independent practice are pretty steep.”

Physicians who join WellSpan Medical Group tend to stay. McGann said the turnover rate of five percent, which includes retirements, falls below the national average for medical groups. WellSpan Medical Group currently employs more than 500 providers at 70 sites across south central Pennsylvania.

WellSpan will showcase two of its facilities to the community over the next several weeks.

Gettysburg Hospital’s newly expanded Emergency Department has scheduled a Community Open House, noon to 3 p.m., Saturday, March 31.

The WellSpan Surgery and Rehabilitation Hospital has a Community Open House set for noon to 4 p.m., Sunday, April 15.

Additionally, an open house will be held for staff members, volunteers and clergy, 7-9 a.m. and 11 a.m. to 2 p.m., Friday, April 13.

The Gettysburg Hospital Emergency Department will offer an enhanced patient-centered experience. Construction of the new facility began in November 2010 and was completed for $18.1 million.

The department was expanded from 6,500 square feet to 19,000 square feet. It is the largest Gettysburg Hospital construction project in the past 20 years.

The new facility features 18 private treatment rooms, enhanced privacy and new patient amenities such as a vending area, café seating, a pediatric waiting room and more patient and visitor restrooms.

Besides touring the facility during this open house, visitors can take their children through the ED’s teddy bear clinic to learn about common injuries and how they’re treated. The new Gettysburg Hospital Emergency Department will officially open on Wednesday, April 4.

The WellSpan Surgery and Rehabilitation Hospital, located on the Apple Hill Health Campus, features 73 beds, 48 beds dedicated to rehabilitation and 25 beds and four operating rooms for orthopedic and spine patients. The hospital was completed at a cost of $71 million.

The hospital offers private rooms with Cerner Smart Room technology. It also features state-of-the-art therapy equipment, a driving simulator, a brain injury unit, a patient activity room and a pathway healing garden.

The operating rooms are one-third larger than traditional operating rooms, allowing for better patient flow, efficiency and reduced risk of surgical infections. Additionally, the operating rooms include mobile monitors mounted on robotic arms to allow them to be moved throughout the OR for enhanced viewing.

The WellSpan Surgery and Rehabilitation Hospital is expected to officially open on Monday, April 23.

TAVR is an alternative to open heart surgery

Dale Murphy of Spring Garden Township retrieves his mail during a recent Spring-like day. The simple act of walking to his mailbox used to tire him out and cause difficulties breathing. Murphy, who suffers from severe aortic stenosis, was the first patient at York Hospital to undergo a transaortic valve replacement (TAVR) procedure.

Dale Murphy put on his Greek fisherman’s style hat, slipped on his coat and headed to his mailbox about 20 yards in front of his house. It’s a short trip, but one the 91-year-old retired teacher couldn’t make a couple months ago without getting tired and feeling chest pains.

Murphy, however, makes the trip today without any problems. The difference is the surgical procedure he underwent on Feb. 7 at York Hospital. He was the first patient to have a Transcatheter Aortic Valve Replacement (TAVR).

The procedure is an alternative for those who can not have open heart surgery.

“I feel fine since the surgery,” said Murphy. “I can’t believe the difference it made. I can breathe better, have more energy and my appetite has returned.”

TAVR is used to treat severe aortic stenosis, a narrowing of the aortic valve opening that does not allow normal blood flow.

In elderly patients, severe aortic stenosis is often caused by the build-up of calcium, forcing the heart to work harder to push blood through the aortic valve.

“Severe aortic stenosis is a serious problem,” said William Nicholson, M.D., interventional cardiologist. “Without treatment, half of the people who feel sick from this problem die within an average of two years.”

TAVR provides almost immediate relief

Larry Shears, M.D., cardiothoracic surgeon, added, “Some patients because of their age and physical condition are not candidates for open heart surgery. TAVR is less invasive and provides almost immediate relief.”

Nicholson, Shears and James Mills, M.D., performed the TAVR procedure on Murphy. TAVR involves inserting a sheath (a short hollow tube) into the femoral artery and putting a small balloon through the sheath into a blood vessel to reach the
aortic valve.

The balloon is inflated to open the narrowed valve, deflated and then removed. A transcatheter heart valve is placed on the delivery system (a long tube with a small balloon on the end) and compressed on the balloon to fit through the sheath.

The delivery system carries the valve to the aortic valve, where it is inflated with fluid within the diseased valve. The balloon is deflated and the new valve is positioned in place, taking over for the old valve.

“The doctors explained all the benefits and risks to me,” said Murphy, “and I thought the benefits outweighed the risks, particularly at my age. I think I would definitely feel worse, if I hadn’t had the procedure. I had great confidence in the doctors and their team at York Hospital. I was very impressed with them.”

York Hospital was chosen by Edward LifeSciences as one of three hospitals in the state to begin performing TAVR, partly for the teamwork approach they take to their work, according to Dr. Nicholson.

“It’s a good feeling to know we can offer patients an alternative to open heart surgery,” said Dr. Nicholson. “TAVR is an amazing procedure.”

Four patients have undergone the TAVR procedure since Murphy and all have done extremely well, according to Dr. Nicholson.

A team of about 20 York Hospital staff members were involved in the delivery

Four physicians attended a media conference last week to discuss the first-ever birth of quadruplets at York Hospital. They are, from left to right, Wendy Davis, M.D., York Women’s Health Center; Jonathan Liss, M.D., WellSpan director of neonatology; Mary Jo Johnson, WellSpan director of perinatology; and Marian Damewood, M.D., WellSpan vice president, women and children’s service line. WGAL TV 8, ABC 27, CBS 21, Fox 43, the Hanover Evening Sun and the York Dispatch covered the media conference.

During her 72-day stay in York Hospital, Heather Toomey got to know the nursing staff and physicians very well. In fact, she joked that she and her husband, Greg, had talked about taking the nursing staff home with them.

That probably wouldn’t be a bad idea since Heather had quadruplets on Saturday, March 24. With a three-year-old daughter, the Toomey family expanded to five children faster than anyone ever imagined.

The birth of quadruplets was the first at York Hospital.

“I became very close with the York Hospital team,” said Heather at a media conference last week. “I developed a real friendship with a lot of the team members. They certainly made my journey much happier.”

Heather said she and her husband learned what to expect with quadruplets in the coming days, weeks and years from the physicians and staff.

“Everyone did a great job of keeping us updated on all the changes and answered all of our questions. They tried to make sure we had whatever we needed or wanted.  We’re happy everything turned out so well,” she said.

Marian Damewood, M.D., WellSpan vice president, women and children’s service line, attributed the positive outcome to “tremendous teamwork and planning.”

She said, “We had many physicians with special expertise, a fabulous nursing staff and support personnel involved.”

Everyone was ready when the time came

Mary Jo Johnson, M.D., WellSpan director of perinatology, said, “Everyone was ready when the time came for the birth. Everyone worked together great. I’m thrilled with how well Heather has done.”

“The Cesarean section went beautifully,” said Wendy Davis, M.D., York Women’s Health Center. The surgical procedure took about one hour. There was only a matter of seconds between the births of the babies. A team of about 20 people was involved in the delivery. “The teamwork was remarkable,” emphasized Dr. Davis.

Audrianna Nicole was born at 3:29 p.m., weighing four pounds, one ounce; Jesilyn Leah was born at 3:30 p.m., weighing three pounds and 11 ounces; Kennedi Marie also arrived at 3:30 p.m. and weighed three pounds and nine ounces; Hunter Garrett was delivered at 3:31 p.m. and weighed four pounds and one ounce.

Jonathan Liss, M.D., WellSpan director of neonatology, said, “The babies were remarkably well-grown and well-nourished.” Although the babies were born with respiratory distress, they were all breathing on their own within a couple days. Dr. Liss added that the babies had typical problems experienced by premature babies, but nothing serious. He expects them to go home in about a month.

Dr. Liss pointed out that the York Hospital NICU (neonatal intensive care unit) opened in 1985 and has a staff of more than 100 people who care for babies 24 hours a day, seven days a week.

York Hospital delivers approximately 3,000 babies a year. It averages 80 sets of twins and two sets of triplets annually.

“We had a lot of time to plan for the birth of the quads and that was helpful,” he said. “We had a different team for each baby. They were admitted to the NICU seamlessly.”

Pennsylvania is in the process of changing its pre-hospital protocol based on a national study in which York Hospital and White Rose Ambulance were participants.

The study, published in the New England Journal of Medicine, reported that seizures should be treated by paramedics with a single, emergency shot of midazolam in the thigh much the way EpiPens are used to treat allergic reactions, rather than a procedure that involves an IV and lorazepam while the patient is convulsing.

York Hospital enrolled 26 patients in the pre-hospital study, according to Dan Bledsoe, M.D., manager and associate medical director, Medic 97.

“The shorter the seizure time, the better it is for the patient,” said Bledsoe. “The longer the seizure, the greater the risk it will intensify and the patient will develop complications.”

On average, seizures lasted 90 seconds after patients were given a shot of midazolam, while the average was five minutes after the administration of IV lorazepam, according to the study.

Bledsoe added that the study’s findings reinforced the methodology practiced by York Hospital paramedics.

“The study’s results were what we expected, but for the first time we have conclusive evidence that intramuscular midazolam is the faster method,” he said.

Bledsoe said there was great interest in and support of the clinical trial from the Epilepsy Foundation and people with epilepsy in the community.

Due to the nature of the clinical trial, patients were not able to give their consent before treatment. All patients, however, received intramuscular midazolam or IV lorazepam.

“It’s rewarding and satisfying to have been part of this clinical trial,” said Bledsoe. “We hope to be involved in more clinical trials to answer important research questions and help shape the future of pre-hospital care."

As the weather improves and the signs of spring abound, people get the urge to take care of chores such as mowing the lawn, gardening, cleaning the house gutters and painting.

While these seem like simple tasks, statistics show that thousands of people are injured every year doing them.

According to the U.S. Consumer Product Safety Commission, last year more than 127,000 Americans were injured while operating a lawn mower; 41,000 were injured while gardening or using gardening equipment; and 35,000 people injured themselves using a stepladder.

Here are some helpful tips from the American Academy of Orthopedic Surgeons (AAOS) to prevent injuries while doing household chores:

• When gardening, avoid prolonged repetitive motions during activities such as digging, planting, trimming and pruning.
• Take frequent breaks.
• Ladders should be placed on a firm, level surface. Never place a ladder on ground or flooring that is uneven, soft or wet.
• When working on a ladder, over-reaching or leaning too far to one side can make you lose your balance and fall. Do not let your bellybutton go beyond the sides of the ladder.
• Be sure to wear proper footwear and eyewear for protection when mowing the lawn.
• Use a mower with a control that stops it from moving forward if the handle is released.
• Be sure all extension cords are properly grounded.
• Read product labels for proper use when using chemicals for gardening and cleaning.
• Take frequent breaks and replenish fluids to prevent dehydration.
• Keep a cell phone within reach in case of accident or injury.

If you have the misfortune to injure yourself, don’t forget about WellSpan’s three urgent care health options: WellSpan Care Express, WellSpan ReadyCare and WellSpan Orthopedics walk-in injury care.

You can use the urgent care finder at www.wellspan.org to help you locate the right option of walk-in case, based on your injury. If you still can’t decide, call (888) 520-5060.

Credits WellSpan for providing resources to support her efforts

When Dianne Moore, R.N., M.S.N., was in graduate school, she did a research project related to women’s health. The topic sparked an interest and she has spent most of her 20-year-plus career involved with women’s health.

Moore, WellSpan’s coordinator of women’s services, recently received the Athena Award at the York County Economic Alliance annual celebration event in recognition of her work.

The Athena Leadership Award recognizes women who:

• Have achieved the highest level of professional excellence
• Contribute time and energy to improve the quality of life for others in the community
• Actively assist others, particularly women, in realizing their full potential

“I was very humbled by the award, especially when I saw the list of past recipients and their accomplishments,” said Moore. “It’s a great honor. I’m proud to represent my profession and WellSpan.”

Marian Damewood, M.D., vice president of women and children service line, WellSpan, said, “Dianne has had a significant role in the promotion of women’s health and access to care for women in the York County community for more than 15 years, and more recently in Adams County.

“Dianne has made notable contributions to the community along the lifetime spectrum of women’s health.”

Moore’s involvement in women’s health includes helping to coordinate the Young Women’s Leadership Conference, Spring Fling, Women’s Check Up Day, Go Red for Women Luncheon, Go Red for Women Fun Girls’ Night Out and special screening/educational programs and risk assessments for midlife and menopausal women. She also coordinates the WellWomen newsletter and supervises the ongoing parent education programs for expectant mothers and fathers.

Moore, however, is quick to point out that the award is not just about her. “I share this award with many others throughout our organization,” she said. “I have been fortunate to have the help and support of so many people who want to be part of the mission of caring for the health and wellbeing of women in our community.

“It has been wonderful to work for an organization and its leadership that is willing to provide the resources to support some of these outreach efforts.”

Community responds with positive reviews

Angie Johnston, R.N., nursing operations director at Gettysburg Hospital, demonstrates some of the features of a treatment room in the new Gettysburg Hospital Emergency Department.

There seemed to be an endless stream of community residents gathering in Gettysburg Hospital Emergency Department’s lobby, waiting to tour the new $18 million facility on Saturday, March 31.

More than 1,100 residents took the opportunity to get a first-hand look at Gettysburg’s newest gem prior to its successful opening to patients on Wednesday, April 4.

Gettysburg Hospital’s largest construction project in the past 20 years made a positive impression on visitors.

“It’s awesome,” Irene Gonzales told the Gettysburg Times. “I think it’s going to be great for all the patients.”

“I was impressed,” added Jenny Mortorff.

“It’s great,” added Anne Ketterman. “I love the private rooms.”

“From what I’ve seen, it’s going to be wonderful thing,” offered Gerald Miller.

Will Lavery, manager of public relations and communications, Adams County, said, “It’s an outstanding showing by the community. We take a lot of pride in offering this facility to the community.”

The new Emergency Department is 19,000 square feet, nearly three times as large as the old facility. The department treats approximately 30,000 patients a year.

Bill Steinour, M.D., medical director of the Emergency Department, said the hospital used a team approach to assure it can meet the demands now and into the future.

He said a sophisticated study, based on a three percent growth, revealed that 18 beds are adequate now and should be in the future. If the need arises, there will be enough extra space built into the project’s second phase for four additional treatment rooms. Two of the five fast care treatment rooms can be used as swing rooms, providing extra flexibility.

“It was more about people and processes, not bricks and mortar,” said Steinour. “Physicians, nurses and community members were involved in the efficient design of the Emergency Department.”

Special features of the Emergency Department include:

• Private rooms
• Two triage care areas
• Patient treatment areas dedicated exclusively to patients with minor injuries and illnesses
• A dedicated trauma resuscitation room
• A bereavement/consult room
• Multiple work pods for staff and providers, hospitalists and specialists with touchdown space for nursing supervisors, crisis workers and registration
• Improved staff support facilities, including a lounge, locker room and conference meeting space
• Financial counselor presence
• Improved registration and checkout area
• Patient/visitor vending area along with café seating
• Pediatric waiting area Increased patient/visitor restrooms

WellSpan VNA Home Care has become a national partner of We Honor Veterans, a pioneering campaign developed by the National Hospice and Palliative Care Organization (NHPCO) in collaboration with the Department of Veteran Affairs.

As a We Honor Veterans partner, WellSpan VNA Home Care Hospice will implement ongoing veteran-centered education for their staff and volunteers to help improve the care they provide to the veterans they serve.

Twenty-five percent of those who die every year in the U.S. are veterans.  The nation is seeing many of the veterans who served in World War II and in Korea pass away. The number of deaths of Vietnam veterans is beginning to rise.

We Honor Veterans partners can assess their ability to serve veterans and use resources provided as part of the campaign to integrate best practices for providing end-of-life care to veterans into their organization.

“Veterans sometimes have unique issues,” said Kelly Osmolinski-Smith, director of hospice services.  “Some suffer from post-traumatic stress disorder and others have terrible memories of their ordeal.

“By being aware of their service and listening to their experiences, we can find richer ways to support them.  Our goal is to walk them through their end of life’s journey with the dignity and respect they deserve.”

Veterans sometimes share their experiences

Rick Brittain, hospice social worker, recalled a veteran who told of riding in a transport truck with many dead soldiers during the Korean conflict. 

“That made a huge impression on him and his ideas of dying when he entered hospice care,” said Brittain.  “Knowing his story helped us to work through some of his unique concerns about death.”

The resources of We Honor Veterans focus on respectful inquiry, compassionate listening and grateful acknowledgement, coupled with veteran-centric education of health care providers caring for veterans.

J. Donald Schumacher, NHPCO president, said, “All hospices are serving veterans, but not all of them are aware of that person’s service in the armed forces.

“Through We Honor Veterans, we are taking a giant step forward in helping hospice and palliative care providers understand and serve veterans at the end of life and work more effectively with VA medical facilities in their communities.”