By Karen Gorby
President and CNO, Angel Medical Center
There is a tool that is carefully woven into the fabric of every aspect of patient care: technology. Medical technology touches and enhances patient lives in countless ways every day, and helps providers deliver safer, more sophisticated care.
Every area of the hospital is augmented by technology, from medical screenings like CT scans and ultrasounds, to electronic patient records. Advancements in technology have also made many surgical procedures far less invasive and therefore far safer with less recovery time. Technology enables us to do much more for our patients in every arena, keep care locally accessible, and save patients time and travel.
Telemedicine continues to change the face of medicine and impact treatments across all service areas. It provides patients with opportunities to connect with specialists and services the hospital may not have on-site. Consultations between patients who suffer from chronic conditions such as diabetes and COPD and their providers are now often done via audio-visual conferencing tele-visits. Examples of telemedicine include the following: a consultation can occur via a telemedicine robot with a distant stroke specialist to treat a stroke patient immediately, we can access mental health treatment for patients through remote behavioral healthcare providers or patients suffering from seizures can “meet” with a neurologist to plan their care.
Through the addition of telemedicine, we can provide physician coverage/access during the night for our patients and staff. A Board-certified physician will assess and treat patients, and answer their questions via a robot that can interact, see and listen just as if the physician was present.
Technology even heightens staff performance. Collaboration and education are possible, and made easier, with the advent of real-time video conferencing. Providers can access complete patient profiles instantly – from their medical history to current medication summaries – in a highly coordinated way. This streamlined process translates to higher quality care, improved operational efficiency and better patient outcomes. Patients and staff benefit from depression-therapy sessions and weight-loss consultations through Chronic Care Clinic videoconferencing.
Technology’s starring role in medicine allows us to equalize care for our community members, and we will continue to seek out, trial and adopt innovative systems and tools. Openness to adopting progressive technology doesn’t just lead to serving patients more fully, it steers us toward new avenues of care that we have yet to envision. Combined with compassionate local caregivers, it provides the best of both worlds for our community.
Karen S. Gorby, RN, MSN, MBA, CENP, FACHE, is the President/Chief Nursing Officer of Angel Medical Center. Gorby is a Fellow of the American College of Healthcare Executives (ACHE). For nearly three decades, she has served hospitals and health systems in Ohio before assuming her role at Angel Medical Center. Gorby received her MSN from Saint Joseph’s College in Standish, Maine, and her MBA from Wright State University in Fairborn, Ohio.
For more information on Angel Medical Center, visit AngelMed.org.
With spring weather comes the opportunity to be more active outdoors, like hiking, running and biking. Regular exercise can help increase your energy and improve your balance, health and mood. The American Heart Association recommends at least 150 minutes per week of moderate exercise or 75 minutes of vigorous exercise. Before you put on your athletic shoes and start a new routine, we’ve got some tips to help keep you safe and healthy.
While everyone can benefit from talking with their doctor before beginning a new fitness program, it’s important for pregnant women and people with a history of cardiac disease or other health issues to consult a physician beforehand, said Thomas Minton, PT, Cert. MDT, CRTS, a physical therapist with CarePartners Outpatient Therapy Clinic.
“New exercisers should start gradually, slowly adding exercise and increasing the effort level,” said Minton. “Do a little bit more each day, but not too much, and consider adding a variety of activities to more evenly distribute the new stresses on the body.”
Get Fitted to Get Fit
For new cyclists, the key to success is fit. “Make sure you purchase a bike that fits well,” said Minton, also a certified bike fit and running technique specialist. “After the initial sizing, consider a bike-fitting session with a trained specialist to ensure optimum adjustment. This involves a physical examination including flexibility and strength testing along with an interview of the individual’s goals and history of injury. The bike fitting session is performed on the individual’s current bicycle, and adjustments are made to optimize performance, prevent injury, and optimize comfort.”
New runners can also avoid injury by consulting a physical therapist trained in running gait evaluation and technique instruction. “New runners may consider learning proper technique with a coach or physical therapist specializing in teaching running technique,” said Minton. “It’s important to find someone who specializes in running injuries and is able to actually teach correct technique.”
Mix It Up
One of the best ways to build muscle or burn calories is to switch up your workout routine. “The body adjusts to repetitive movements over the long term, so alternate your fitness activities to see ongoing results,” said Minton.
Thomas Minton, PT, Cert. MDT, CRTS, is a physical therapist with CarePartners Outpatient Therapy Clinic.
For a personalized running analysis or bike fitting at the CarePartners Outpatient Therapy Clinic with Thomas Minton, call (828) 213-0850 or visit carepartners.org.
Colin Bird, MD, a surgeon at Regional Surgical Specialists, an affiliate of Mission Health, and the only board-certified colorectal surgeon in western North Carolina, has seen this time and again, not just in published statistics, but among his own patients. “Colorectal cancer can be preventable,” he said. “The key to it being preventable is early detection. And the gold standard of early detection remains the colonoscopy.”
Follow the Schedule
According to current screening recommendations, anyone who doesn’t have a personal or family history of colorectal cancer should get a colonoscopy at age 50 – then every 10 years after that, if the screening is clear.
Anyone with a family history of colorectal cancer should get his or her first colonoscopy 10 years before the age a first-degree relative was diagnosed with colon or rectal cancer. “If your mother was diagnosed at age 45, you should start getting screened at 35,” said Dr. Bird.
For those with a history of polyps or cancerous tumors, Dr. Bird said screening recommendations are highly tailored based on the patient’s specific diagnosis and treatment history.
Listen to Your Body
While you should plan to follow standard screening recommendations in most cases, don’t hold off on a colonoscopy until your next scheduled screening if you have concerns about your colorectal health.
In February 2017, at the age 57, Lu Anne Sheffield of Asheville didn’t have an upcoming colonoscopy on her calendar, but she scheduled one anyway because she sensed something was wrong.
“Things didn’t seem right,” said Sheffield. “I felt like I couldn’t empty myself. I knew something was affecting me, and thought it might be a polyp. I said to myself, ‘I’ll just have it checked out so that I can move on with my life.’ It’s a good thing I did because that decision saved my life.”
Dr. Bird said Sheffield did the right thing, but it’s something a lot of people choose not to do, which can have a negative effect on survival rates. He said the decision can be due to a lot of factors, many of them fears or misunderstandings.
“Some people just don’t want to deal with the awkwardness, or they mistakenly believe it will be painful,” he said. “Then there are some who are afraid of a diagnosis and just don’t want to know.”
“Listen to your body, pay attention to your body,” continued Sheffield. “If you think there’s something that might be wrong, have it checked out.”
Dr. Bird said that significant improvements in how colonoscopies are performed and the corresponding bowel preps have greatly improved patient experiences. He said many patients will be surprised to find that the test isn’t the big deal they thought it was.
Seek Immediate Treatment
Sheffield wasn’t afraid of the test. Nor was she worried about a diagnosis – although she initially assumed it would be something minor, like polyps. Ultimately, Sheffield ended up with a diagnosis of rectal cancer, which Dr. Bird would later identify as stage III cancer, but she is glad she got the screening when she did.
“As soon as the tumor was discovered, they got right on it,” she said. “The fact that it was found sooner rather than later made a big difference in my outcome.”
Dr. Bird explained that colorectal cancers under stage IV are usually staged following surgery. “As a surgeon, our first goal is to assess and rule out metastatic disease, stage IV cancer, which for colorectal cancer typically means extension to their liver or lungs,” he said. “Once we have ruled this out, we are able to use surgery as the backbone of our treatment and work towards curative intent. However, only after we’ve taken out the cancer can we truly tell if it’s stage I, II or III.”
Staging the tumor will determine whether subsequent treatment, such as radiation or chemotherapy, will be necessary. Sheffield had stage III cancer, which meant that her lymph nodes were also involved and that she would therefore require chemotherapy.
Sheffield’s treatment was also a little different in that she underwent radiation prior to her surgery. Dr. Bird explained that in some cases of rectal cancer it’s advantageous to begin chemotherapy and radiation first.
“For rectal cancer, the mass is in a fixed spot in the pelvis, not free-floating in the belly,” he said. “This anatomic relationship lets us utilize additional modalities like radiation. In these cases, not only does the up-front radiation augment surgery, the multidisciplinary approach leads to improved outcomes.”
Sheffield successfully completed all of her treatments – radiation, surgery and chemo. With regular follow ups, she anticipates a cancer-free 2018.
“That’s the value of a colonoscopy,” said Dr. Bird. “There are other tests, such as stool analyses or imaging studies that may detect cancer, but only the colonoscopy allows us to diagnose and visualize the tumor at same time.”
Considering all of the advantages of a colonoscopy, Sheffield said she wants people to see how important it is to not be afraid of the test. “You have the right to go find out,” she said. “You need to treat yourself with that kind of respect. And if they find something, at least you have peace of mind and can move forward with whatever treatment is necessary to save your life.”
Colin Bird, MD, of Regional Surgical Specialists, an affiliate of Mission Health, is the only board-certified colorectal surgeon in western North Carolina.
While anyone can lose weight using conservative measures, only 5 percent of people can keep the weight off after it’s lost. Therefore, virtually 95 percent of people who suffer from severe obesity would benefit from bariatric surgery.
Why losing the weight is important
Severe obesity can contribute to the following health problems:
Increased risk for stroke and many cancers
Fortunately, many of these diseases can be avoided, improved or even cured with significant weight loss.
What makes bariatric surgery a good option?
The National Institute of Health recognizes bariatric surgery as the only effective treatment to correct severe obesity and maintain weight loss long term. In fact, studies have shown that 90 percent of surgical weight-loss patients are able to maintain weight loss of 50 percent or more of their excess weight, with long-term success, after undergoing bariatric surgery.
Mission Weight Management offers both of the most common types of bariatric surgery: Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Both of these operations has its own advantages and disadvantages, and these should be discussed between you and your physician, along with other elements of your health history.
What are the keys to success?
While both types of bariatric surgery procedures have great success rates when it comes to keeping the weight off, they should be viewed as only one tool to help you achieve successful weight loss.
The operation represents one-third of your success, diet another one-third, and exercise the final one-third of your formula to weight-loss success.
W. Alan Bradshaw, MD, FACS, is a bariatric surgeon with Mission Weight Management.
To learn more about Mission Weight Management and to sign up for a free information session, call (828) 213-4100 or visit missionweight.org.
I often hear about the struggles of eating healthy on a budget. However, it is possible to achieve the daily requirements for fruits, vegetables, grains, dairy and protein without breaking the bank.
Plan your weekly menu with recipes that fit around your busy schedule. Use your day off as prep day for time-consuming recipes. Make a grocery list and update it as you run out of certain foods. Organize your list by food group.
Here are a few tips for grocery shopping:
The priciest items are often at eye level – Search high and low for better deals. Clip coupons, read the sales flyer, join the loyalty membership program and ask for a raincheck if the item is sold out. Remember that stores utilize first in, first out (FIFO), so pick from the back for later sell-by dates.
Pick fresh fruits and vegetables that are in season – Think “outside the store.” Stop by a local farm stand on your way home from work, visit a farmer’s market on Saturday or contact your local farm about community-supported agriculture programs. If buying canned fruits and vegetables, look for “no added salt” and for fruit “in their own juice.”
Purchase and freeze family sized or value packs – This can be especially helpful with meats such as chicken, turkey and lean ground beef. Other low-cost protein-rich items include eggs, peanut butter, beans, peas and canned or frozen seafood.
Make half your grains whole grains – Look for whole wheat bread, flour and cereal. Oatmeal is a whole grain and can be consumed by itself as a hearty breakfast option or in a recipe. Popcorn is a great, whole grain snack.
Look for low-fat and fat-free dairy products – It’s also helpful to buy items like plain yogurt in bulk containers, then add your own fruit and toppings.
Incorporate these tips when planning your meals and shopping to help create your healthy, budget-friendly dishes.
Nicole Cook, RDN, LDN, is a registered dietitian at Highlands-Cashiers Hospital.
Tea is among the most popular beverages in the world. It is second only to water in terms of how much it is consumed worldwide. Green tea, specifically, has been enjoyed for centuries for its flavor and health benefits. Recently, there has been growing interest in green tea as a weight-loss aid.
What makes green tea green?
True tea comes from the Camellia sinensis plant, and comes in many different varieties. Green tea differs from the more popular black tea in that the harvested leaves are not exposed to air, and therefore not oxidized. Green tea originated in China, but is now produced in Japan and India as well. After harvesting, the leaves may be steamed, producing a bright green tea or roasted in a wok, which creates a pale green-colored tea.
Green tea’s health benefits stem from its high antioxidant content. Antioxidants are chemical compounds that can protect our cells from damage and may help protect us against cancer and heart disease. Green tea contains a variety of antioxidants including catechins, theaflavins and the flavanol quercitin. Green tea also contains caffeine, about 25 mg per 8 oz. cup, which is about one-third the caffeine in an 8 oz. cup of coffee.
Can green tea help you lose weight?
According to current research, the antioxidants and caffeine present in green tea seem to cause an increase in metabolic rate. In theory, increasing metabolic rate would cause more calories to be burned, which could lead to weight loss. This effect, however, is minimal and most likely will not show up on the scale.
A 2009 meta-analysis of 11 studies did show a positive effect between catechins and weight loss, but since most studies isolate these compounds it is difficult to pass these results on to brewed green tea.
Supplements vs. the real thing
There are many green tea supplements available that claim to boost metabolism and burn fat, but most experts, including the American College of Gastroenterology, recommend avoiding these supplements due to reports of liver damage.
If you are interested in adding green tea to your diet, avoid supplements and instead enjoy a brewed cup. According to the Institutes of Medicine, it is just as hydrating as water, and up to 9 cups per day is considered safe.
General health benefits
As for the health benefits of green tea, research does show that it may help protect against cardiovascular disease by preventing the oxidation of LDL cholesterol and reducing blood clotting. A meta-analysis of 13 randomized controlled trials, showed that it significantly lowered blood pressure, as well as LDL cholesterol and total cholesterol. So, adding a few cups of unsweetened green tea each day may be beneficial for heart health.
When it comes to weight loss, there is no substitute for healthy eating, reduced calories and increased exercise. Replace sugary beverages with unsweetened green tea to reduce calories, and enjoy drinking it for its possible cardiovascular benefits, but avoid costly and possibly dangerous supplements. Green tea can be enjoyed hot or iced and can be brewed with herbal or fruit teas for interesting alternatives to plain water and healthy alternatives to sugary beverages.
Nicole Martinez, MHS, RD, LDN, is a Clinical Nutritionist Educator with Mission Weight Management.
To learn more about Mission Weight Management and to sign up for a free information session, call (828) 213-4100 or visit missionweight.org.
By Michele Pilon President/CNO, Transylvania Regional Hospital
Every medical care provider I know would certainly list patient safety as the top priority in their work with patients, and the most significant contributor – aside from their expertise – to successful patient outcomes. National regulatory bodies like The Joint Commission and the Centers for Medicare and Medicaid Services (CMS), as well as state agencies, set care standard benchmarks that hospitals and health systems must meet or exceed in order to receive Medicare or Medicaid payments.
I’m focusing on patient safety this month because March 11th-17th is National Patient Safety Awareness week, and aside from talking about what that means at TRH, I want to share information on safety-related events that we’ve planned throughout March. In fact, TRH’s full accreditation from The Joint Commission signifies our commitment to delivering the highest quality and safest patient care we can. Our Transitional Care Unit has also received a five-star CMS rating – the highest possible, and our third consecutive award – which indicates that we meet the most rigorous patient safety criteria.
Well-known care standards require important universal practices include now-standard protocols, like the “time out” practice, where a surgical team pauses before starting a procedure to ensure that a patient’s identity is confirmed, that the surgical procedure about to be performed is the right one, and all surgical team members understand where the surgical site is located. Communication among hospital staff, medication safety, infection prevention steps, and patient risk assessments, for example, are all measures instituted to provide patients with the safest care possible.
TRH also uses a progressive analytical tool known as Root Cause Analysis (RCA) that systematically examines safety-related events on multiple levels. Through the RCA, we take a “deep dive” into an event and ask “why” repeatedly, in order to identify what contributed to the event, approach it from many angles, and prevent future occurrences.
TRH is dedicated to creating what’s known as a “just culture,” or culture of transparency. We support our staff by encouraging the reporting of potential errors or care inconsistencies they may have been involved in or witnessed. Our staff regularly complete a Culture of Safety survey that measures indicators that impact patient safety, including how burnout, the workplace learning environment, local leadership, teamwork, the safety climate, and work-life balance affect our team members. Additionally, we survey our patients about all aspects of their care experiences.
This month, TRH will host a traveling patient safety “road show” throughout the hospital. We’ll share information about the Reporting and Learning System that hospital staff use to report actual and potential events, and formulate preventive, creative solutions to increase patient safety, as well as trend and monitor events. Staff will also discuss what motivates them to report events and some innovative safety-focused TRH programs will be highlighted, including our “Great Catches” program which recognizes reported items that significantly impacted patient safety, and our Caring for the Caregiver program to combat staff burnout. Staff members will have the opportunity to sign a pledge for patient safety, which reflects their commitment to provide the safest care possible to their patients.
Please join us at TRH to celebrate our providers’ commitment to the wellbeing of every patient.
Michele Pilon, MS, BSN, RN, NE-BC, is the President and CNO of Transylvania Regional Hospital. Her diverse professional experience includes service as a bedside nurse and over a decade as a leader at healthcare institutions in Virginia, Florida and North Carolina. Pilon earned a Bachelor’s in Nursing from Ohio’s University of Akron and a Master’s in Health Services Administration from the University of St. Francis in Illinois; she is also a board-certified Nursing Executive.
For more information on Transylvania Regional Hospital, visit trhospital.org.
It is heartwarming to be recognized for the quality of care our teams provide for our region. Getting patients to their desired outcome drives everything that we do at Mission Health, so we are honored and humbled to see Mission Hospital named the No. 1 hospital in North Carolina by Business NC magazine for the second year in a row. Additionally, our patients chose three Mission Health hospitals as their “Top Picks.”
While awards are not what drives us, and they are not why we do what we do at Mission Health, they reflect our commitment to the people we serve. As Ronald A. Paulus, MD, President and CEO of Mission Health, points out in a Q&A in this month’s issue of Business NC, ensuring quality outcomes for our patients is the “absolute top priority.” Dr. Paulus added, “We have provided the tools, resources, focus and measurement to ensure that success.”
Ranked No. 1 in NC – What does that mean for you?
So, your local hospital has been named the top hospital in the state – but what does that mean for you, as a resident of western North Carolina?
The answer is simple. Care of the highest quality, close to your neighborhood – and with the data and outcomes to show for it. You don’t have to leave home to get the most reliable care with the best outcomes for major procedures such as cancer treatment, heart and vascular operations, hip and knee replacements.
Business NC used real data that represents real patient outcomes to formulate their rankings. The list ranks North Carolina hospitals based on performance in 25 metrics, including critical healthcare information provided by the U.S. Centers for Medicare & Medicaid Services, patient-satisfaction surveys, infection rates, and readmission and death rates for common conditions and procedures, as well as patient-safety records from a variety of organizations.
Mission Hospital is now ranked No. 1 in North Carolina for the second consecutive year, and has been in the top two each year since 2012. This means the care you and your family receive is consistently the highest quality.
WNC patients cast their vote for our hospitals
In addition to Mission Hospital’s recognition as the No. 1 hospital in the state, three Mission Health hospitals were recognized by our patients. In the Business NC’s Top Hospitals “Patient Picks,” Mission Hospital is ranked No. 4; Highlands-Cashiers Hospital is ranked No. 15; and Angel Medical Center is ranked No. 30. It brings us great joy to know our neighbors choose Mission Health hospitals as their top pick. We’re humbled to have so many of our hospitals and care teams recognized by our patients.
Several organizations have recently announced top hospitals and services regionally and nationally. Many Mission Health hospitals have been recognized for outperforming other hospitals and specialty services in quality measures, patient outcomes and patient satisfaction.
By Jackie Medland President/CNO, Highlands-Cashiers Hospital
Easter calls to mind rebirth, and on the Plateau spring bursts forth with unparalleled beauty. There’s another rebirth happening at Highlands-Cashiers Hospital and the Eckerd Living Center – one that is making a difference in many lives. We are revitalizing our volunteer program, because without our volunteer corps, we simply couldn’t function in the manner that we desire. Since April is National Volunteer Month, there’s no better time than now to talk about the profound difference our volunteers make in the lives of both our patients and our staff.
I’m often struck by how many ways our community members give: they invest in HCH philanthropically, they share their thoughts and ideas with me about making HCH the very best it can be, and our volunteer pool makes our patients’ lives brighter and our staff members’ work lighter. As we reflect on the difference our volunteers have made in the life of HCH over the past year, it’s important to note that we’ve had over 50 active volunteers give their energy and efforts to support their community. Our volunteers have dedicated over 14,000 hours to us this past year as well, which represents the equivalent of approximately seven full-time employees – that’s remarkable.
Our volunteers perform countless services: they stock our small library, provide clerical support, accompany residents to community activities, tend our gardens, and even bring their pet dogs in to warm both laps and hearts. For residents who cannot participate in group activities, volunteers provide companionship through conversation, reading, or simply holding a patient’s hand.
Linda Arnold is a wonderful example of our volunteers’ efforts. She is well loved at ELC, and plays dominoes with the residents, calls BINGO most Friday nights, and leads a women’s devotional group. Volunteers mean so much to our ELC residents. Since these patients receive long-term care, they build rich relationships with our volunteers, and count on seeing them regularly.
We are also fortunate to have our Ladies Auxiliary support the operation of our hospital gift shop, under the dedicated leadership of Patty Hutchins. The new gift shop’s prominent location means that the volunteers’ faces will be some of the first that our patients and families see when they enter the hospital later this spring.
As one might imagine, to work in a hospital setting potential volunteers must go through background checks, get necessary vaccinations, and schedule their work well in advance, so we know, before they even start. We want to know that our volunteers are serious about working with us and fit with such a special breed of compassionate human beings.
Aside from acknowledging our current volunteers, I ask our community members to consider devoting some time to HCH or the Eckerd Living Center themselves. Whether it’s on the front lines or behind the scenes, there’s a task that matches each person’s talents. You will make a difference in the lives of your community members, and I guarantee that you will be a key ingredient in making our community stronger and healthier!
For more information on Highlands-Cashiers Hospital, visit hchospital.org.
Whether you’re a weekend warrior or simply enjoy a recreational activity or two, you may be in need of orthopedic care at some point due to an injury. Here’s what you should look for when choosing an orthopedic specialist:
1 – Training
“I believe the surgeon’s training is an important factor, and if they are board certified and maintaining the continuing medical education for continued board certification,” said David Pope, MD, an orthopedic surgeon with Asheville Orthopaedic Associates, an affiliate of Mission Health. Dr. Pope is fellowship trained in sports medicine and specializes in advanced arthroscopic surgery of the knee and shoulder, including complex ligament repair of the knee, rotator cuff repair and stabilization of shoulder injuries.
2 – Availability
Having care available when you need it is also important. “We are currently offering full-service orthopedics five days a week in Spruce Pine, as well as Burnsville on one of those days,” said Dr. Pope. “We’re capable of treating the majority of orthopedic issues at Blue Ridge Regional Hospital, but I am also associated with Asheville Orthopaedic Associates if added expertise is needed.”
3 – Personal Care
When you’re injured, you want to know that your provider will take the time to explain your injury and the treatment required. “The biggest factor, I think, is spending time with the patient and letting them know you care about their problem or injury,” said Dr. Pope. “Being available to answer questions and responding to problems that may arise during the course of their treatment in a timely fashion.”
David Pope, MD, is an orthopedic surgeon with Asheville Orthopaedic Associates, an affiliate of Mission Health.
Mission Community Orthopedics and Sports Medicine is located at 189 Hospital Drive in Spruce Pine.