For Your Health Winter 2016

Committed to the Health & Well-being of El Dorado County
DECEMBER 2015
CONNECTED and
COMPASSIONATE
Marshall’s Community Care Network

Slow down! Holiday stress management tips

Say What? What you don’t know about hearing loss

New ICU/CCU underway
www.marshallmedical.org
S P E C I A L A D S|E C T I O
| FOR YOUR HEALTH
1N
DID YOU KNOW
New Intensive Care Unit Under
Construction at Marshall Hospital
Patients who are in need of intensive care
are the most vulnerable and delicate there
are—and the same can be said for their
families, who are often stressed by the
situation and worried about their loved
ones’ condition. This difficult situation
benefits from an Intensive Care/Critical Care
Unit (ICU/CCU) that is carefully planned,
spacious and private, and that is just what
we are building in our South Wing.
New ICU under construction at Marshall Hospital
The new ICU/CCU has many upgrades over
the current unit—the one thing that will stay
the same is the dedicated, compassionate care of unit staff. Kathy Krejci, Chief Nursing
Officer, outlines some of the features of the new ICU/CCU, which has an anticipated
completion of spring 2016, pending inspector approval.
“Each room will be private and we are expanding from eight beds to 12,” Kathy
explains. “The nursing station is centrally located to allow visibility into all rooms
and each room will have abundant windows, maximizing exposure to natural light.”
The new unit will be located on the second floor of the South Wing, providing more
privacy, and family members will be accommodated with a special area in each
room. “Nighttime dimmable lights in the corridors will enhance evening sleep for our
patients,” Kathy says. “State of the art monitoring and mechanical patient lifts will be in
each room and the unit will be equipped for future telemedicine advances.”
On top of the private rooms and technological advances, the new ICU/CCU will be
much larger. The current unit is 2,500 square feet, and the new one will be 5,000,
doubling its size.
Opening information will be provided at our web site, www.marshallmedical.org,
as we approach completion.
Pa Vang, FNP-C
Marshall Family and
Internal Medicine
3581 Palmer Drive, Suite 602
Cameron Park, CA 95682
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Marshall
Welcomes New
Providers
2
Aidan Maguire, PAC
Marshall Wound Care Center
1095 Marshall Way, Suite 203
Placerville, CA 95667
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www.marshallmedical.org
ABOUT MARSHALL
MEDICAL CENTER
Marshall Medical Center
is an independent,
nonprofit community healthcare
provider located in the heart
of the Sierra Foothills between
Sacramento and South Lake
Tahoe. Marshall Medical Center
includes Marshall Hospital,
a fully accredited acute care
facility with 113 beds located in
Placerville; several outpatient
facilities in Cameron Park,
El Dorado Hills, Placerville
and Georgetown; and many
community health and
education programs. Marshall
has over 200 board-certified
physicians and a team of over
1,500 employees providing
quality healthcare services to
more than 175,000 residents of
El Dorado County.
For Your HEALTH
is published as a community
service by
MARSHALL MEDICAL CENTER
1100 Marshall Way
Placerville, CA 95667
telephone 530-622-1441
or 916-933-0913;
www.marshallmedical.org
It is intended to provide
information about health in
general as well as healthcare
services and resources
available in El Dorado County.
Information comes from a wide
range of medical experts. If you
have any concerns or questions
about specific content that
may affect your health, please
contact your healthcare
provider.
If you have questions, concerns
or suggestions for future topics,
contact the editor, Carrie
Poggio, at (530) 626-2816 or via
email at
[email protected].
TAKING CARE OF YOU
Say What?
Five Things About
Hearing Loss You
Probably Didn’t Know
Most of us take our hearing for granted. Like all of the
five senses, unless you have a problem with it, we rarely
contemplate what it would be like to have an impairment.
Michelle Throp, MS, CCC-A, is a licensed audiologist
with Marshall Hearing Center in Cameron Park, and
she routinely meets patients who are very surprised to
learn they have a hearing problem. Here are some of her
observations:
1. You’re often the last to know – Do you often have to
ask family and friends to repeat what they say? If so, you
may be experiencing hearing loss. Michelle explains,
“Typically, it’s the clarity of speech that goes first. It’s not
that you’re not hearing, but it may sound like people
are mumbling or not speaking clearly.” Often, family
members may be frustrated by the recurrent requests
to repeat themselves. This can be a clue that hearing
loss should be explored, because it can be stressful and
frustrating to the entire family.
2. Poor hearing is a safety issue—When your brain is
working overtime and straining to hear and process
auditory cues, you may be more prone to turn your
head and focus on what you’re ears are not hearing
well, and this can lead to mishaps, such as bumping
into things, falling, and other hazards. “Poor hearing
can also impact balance, which is another fall and
injury risk,” Michelle says.
Michelle Throp, MS, CCC-A
4. Financial assistance for hearing devices is
available—many people endure poor hearing because
they can’t afford the cost of assistive hearing devices.
Michelle encourages anyone who needs a hearing device
to explore financial options. She says, “Here at Marshall,
we work with Wells Fargo to arrange affordable financing
so that hopefully, anyone who needs a hearing device
can work it into their budget.” There are also other
options for low income patients. At Marshall Hearing
Center, our audiologist will help explain all the financial
options—so don’t let fear of the cost deter you from
getting the life-changing help you need.
5. Today’s hearing devices are technological game
changers—the technology available with today’s hearing
devices is truly amazing. Not only are today’s hearing
devices so discreet that people will probably not even
know you’re wearing one, but many are now equipped
with blue tooth technology, enabling phone and TV
connectivity and more. This technology changes people’s
lives,” Michelle says.
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Hearing devices of today are not what you might
think of—the big bulky and obvious hearing aids of
old. Hearing is one of the most important health and
lifestyle aspects we take for granted. If you think you
3. Some hearing loss can be cured, if treated right
might have a hearing problem, schedule an exam with
away—if hearing loss is sudden, such as associated with
one of Marshall Hearing Center’s licensed Audiologists.
an illness or suspected virus, get to a doctor right away.
Appointments are available in
“Too often people think they’re not
Placerville and Cameron Park. For
hearing well due to wax buildup,
Marshall Hearing Center
Medicare patients, a referral from
allergies or a minor cold, when really
4300 Golden Center Drive, Suite D
your primary physician is needed,
Placerville, CA 95667
it could be a specific virus that causes
530-344-2010
but other insurance that allow selfhearing loss,” Michelle explains.
referral is also accepted. Don’t wait
“If it’s treated quickly with steroid
3501 Palmer Drive, Suite 201
to improve your hearing, you never
medications, the hearing loss can often
Cameron Park, CA 95682
know what you might be missing
be reversed, but if treatment is delayed,
530-672-1112
out on.
hearing loss can be permanent.”
For more information about Marshall, visit www.marshallmedical.org or follow us on Facebook.com/
marshallmedicalcenter, twitter.com/MarshallMedical or Google+ Marshall Medical Center.
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COVER STORY
Community Care Network
Expands Healthcare Beyond
Hospital Walls
The mission of the
Community Care Network
(CCN) is to provide high
quality, compassionate,
patient centered health care
coordination that is based on
improved outcomes for people
in our community.
SPECIAL AD SECTION
Shown here, left-right (back row): Betsy Carroll, Heidi
Gonzales, Allison Jilbert, Jennifer Fiterre. (front row):
Betsy Krohmer, Penny Lehrman, BRSN
4
M
any people in our
community struggle with
health problems, are
chronically ill and vulnerable, and
often are without supportive family.
Often these people are affected by
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FOR YOUR HEALTH
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several chronic medical conditions
(such as heart disease, COPD, diabetes,
etc.), take multiple medications and
are prone to hospitalizations.
With a goal of helping these
www.marshallmedical.org
vulnerable people have a better
quality of life, Marshall embarked
on an ambitious program called the
“Community Care Network” (CCN)
in January of 2014. In just two short
years, the program has blossomed and
Finding great optimism in this model
program, Marshall appointed Penny
as the Clinical Director and Bill Klas,
MD, a longtime family medicine
physician at Marshall, as the Medical
Director. They then set about creating
the framework for Marshall’s version
of the effort, which would be known
as the Community Care Network. The
CCN is a team effort comprised of the
leadership and other experts such as
social workers, RN case managers,
pharmacists, certified diabetes
educators, registered dietitians,
Marshall Home Health services and
volunteers.
An essential part of the CCN program
is the Health Coach, who are
volunteers. Penny says, “We have five
amazing and active health coaches
right now, and nine more are being
trained.
The volunteer work of a health coach
can take many forms. Sometimes, it’s
just a phone call and someone for the
patient to talk with. Other times, it’s
reminding the patient of an important
medical appointment or lab test, in
addition to checking on transportation
to appointments. “We get to know these
patients and become their advocates,
so that they don’t feel so alone,” Penny
says. “These relationships are built on
On Being a
Health Coach
Jennifer Fiterre, Health
Coach for the CCN
and coordinator of
Marshall’s Adult
and Jr. Volunteer
program, was
among the first
employees to
become a volunteer
Health Coach. This is what
she has to say about the experience:
“In my work so far, I’ve helped people
get medication questions answered
and obtain appropriate resources,
all according to the health goal
established with their health provider
and CCN. What this means, is that
health coaches are an extra pair of
eyes and ears looking out for the
patient and a link between patient
and healthcare provider. It’s a very
rewarding relationship and is improving
lives.”
trust and respect and meeting people
where they are. We extend kindness
and compassion beyond the walls of
the hospital to people who really need
it and are willing to engage with us.
We listen.”
In order to find patients to recruit
into CCN, Penny and Dr. Klas visit
hospital patients who are frequently
admitted and explain the program’s
benefits to them. “At first, there is a lot
of skepticism because most people
can’t believe this program is a no cost
“We extend
kindness beyond
the walls of
the hospital to
people who really
need it.”
program, no strings attached, and
is purely voluntary,” Penny recalls.
“We do not bill anyone, so we don’t
discharge anyone either. Over time
people that enrolled saw how things
were improving for them and have
become more trusting and engaged.”
There are currently 96 people
enrolled in the CCN and some have
done so well that now they merely
receive a friendly follow-up phone
call once a month. Newer enrollees
receive more extensive support,
but the key is patients receive what
they need. “Many people who are at
the highest health risk are alone in
our community. We treat everyone
with respect, and don’t give up on
them. We recognize that each person
is unique.” Penny says. “It’s about
building trust based on honesty, so
they know they always have someone
on their side that they can call.”
In addition to the personal and health
benefits the CCN is delivering to the
community, there is also the financial
aspect to consider. The hard truth is that
the sickest 5% of patients in healthcare
account for 50% of the costs; they also
tend to stay longer in the hospital,
which can lead to being more prone
to infection and other complications.
Thus far, the CCN has reduced costs
by over $3.6 million dollars. Those
dollars are reinvested into caring for
ALL patients, so it’s a benefit for the
larger community. Also, CCN program
patients experience a one day decrease
in their length of stay if re-admitted
to the hospital. Inpatient stays of any
length have been cut in half since April
in the 96 people enrolled.
“We want to continue growing this
program so that more and more
people can benefit,” Penny says. “Our
next goal is to begin identifying
patients of ‘rising risk’—those patients
who may not be the sickest right now,
but have all the characteristics of
going in that direction. By reaching
out and meeting people where they
are, we can make a difference.” And
they are.
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made a big difference in many lives.
Penny Lehrman, BSRN and Clinical
Director of the program, explains its
origin. “We modeled our program
after one that was started in another
small community in Meadeville,
Pennsylvania,” said Penny. “The idea
was for a team of health professionals
to extend care outside the hospital.
This team would make the effort to
get to know, support and provide
assistance with coordinating patients’
healthcare when they were at home.
We soon found that, with support,
patients became invested in their own
health. It reduced their emergency
room visits and admissions to the
hospital.”
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YOUR TIME
Holiday Overload?
Tips for managing holiday stress
It’s a busy time of year and we tend to be pulled in multiple directions. It can get overwhelming—between the kids’ holiday school
activities, visiting family and friends, shopping, decorating, traveling, baking—sometimes there is no “you” time to find. But that’s
just what you need to maintain a positive balance and good attitude, says Pa
Vang, FNP, a new addition to Marshall Family & Internal Medicine in Cameron
Park.
“What I stress to my patients who are doing too much is that you really do need
to take time to take care of yourself,” Pa says. “I know it can be difficult, but if you
don’t, it has a domino effect and translates to stressed relationships, fatigue and
burnout.” Taking time for yourself doesn’t necessarily mean you have to book
a spa weekend away in the midst of the hustle and bustle—although wouldn’t
that be great? Decompressing and distressing your life can be done in small but
healing steps such as the list Pa shares here.
 Take a brief “time-out.” Grab a magazine and cup of tea, and take 15 minutes
to clear your mind and just “be.”
 Move. Take a walk, meditate, do a mini-yoga routine. Getting your body
moving and your blood pumping will release feel-good endorphins and leave you
feeling cleared and energized.
 Don’t be afraid to say “no.” How hard is this? Very hard, but if you
overcommit, you risk feeling so stretched you might just check out and not feel
up to doing the things you really want to do.
 Appreciate beauty and life. Take a few minutes to look at soothing images
or old photos. Reconnect to the things you love in life. Buy yourself a bouquet of
flowers.
 Take a nap. A short “power nap” can rejuvenate you and leave you feeling able to take on the rest of the day.
SPECIAL AD SECTION
NO-COST Pregnancy and Parenting
Workshop Series!
6
A new series of classes is
being offered for expectant
parents. All About...Having
a Baby combines core
educational components of
pregnancy and parenting
essentials with helpful
hands-on workshops, guest
speakers and a support
group element where
pregnant moms can benefit
from their peers. Workshop
topics will include infant massage, lactation education,
post partum depression and baby soothing techniques.
What’s more—there is no enrollment fee!
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www.marshallmedical.org
The 8 week series will be offered
several times in 2016, with the first
kicking off Thursday, January 7. Each
session will be held in Placerville
and will take place once a week from
6-8:30 p.m.
This no-cost series is made possible
by a grant from First Five El Dorado
and will be very
beneficial to
participants.
There will also be a participation incentive.
To sign up, call Marshall Community Health Education
at 530-626-2990.
FOUNDATION NEWS
www.marshallfound.org
“Mammo Men” Raise Awareness and Funds
This October, local Placerville merchants, wineries and orchards
participated in the 3rd annual “Pink in the Night” celebration as storefronts were decorated with strands of pink lights to symbolize being
united to fight against breast cancer.
David Combellack (left) with merchant Tod Pickett
Mammo Men dressed in pink kicked off the event by raising awareness of
early detection with fundraising for art and movement therapy for our cancer
patients though the Images of Hope program. Attorney David Combellack
joined the Mammo Men crew dressed in a white and pink tuxedo. He’s no
stranger to this life-changing disease, he lost his mother to breast cancer in
1999, and his wife Susan, a 2nd grade teacher at Camino School, is a cancer
survivor since 2000. Those who participated were passionate about raising
funds for Marshall’s Cancer Program, and shared in the goal to promote early
detection of breast cancer. For further information on how you can help,
contact Marshall Foundation at 530-642-9984.
America is at
a Crossroads
In one direction, walking in our communities is getting
harder and harder, and it happens less and less.
Meanwhile, the number of overweight children is growing
at an alarming rate, putting them at risk for lifelong health
problems. In the other direction, communities are building
sidewalks, trails and pathways, safe street crossings
and plentiful destinations within walking distance – all to
encourage us to get out and walk again.
The 11th annual iWalk to School event promoted physical
fitness and lifestyle changes; raised awareness of how
walkable a community can be; created awareness of how
people can take back their neighborhoods and create
awareness of reducing crime; and raised concern for
reducing traffic congestion, pollution, and speed near our
schools.
Healing Garden Brings
Hope and Peace
Sitting high on a hill in Placerville, the new wing of Marshall
Hospital is an inspiration for the community. Between the
shadows of the two largest buildings on the campus sits a healing
environment just off the circular driveway within the outstretched
wings of the hospital’s portico. “It is a space for contemplation,
peace, renewal and quiet reflection – something to help patients
and their families needing a respite while at Marshall,” related
Dana Rice, president of the 2014 Leadership El Dorado class who
developed the garden. “Our hope is to offer a place of serenity, a
garden that brings hope, peace, and a sense of renewal.”
Research regarding the positive effect of nature on patient
outcomes continues to grow with scientific evidence showing that
exposing patients to nature can alleviate pain and alter moods. In
2016, Marshall will embark upon another Healing Garden project
for the Cancer Center in Cameron Park. For more information on
how you can help, contact us at 530-642-9984.
2015 Mathewson-Bonser Nursing Scholarship Recipients
Teri Hinz, Catherine Lynch, Katrina Gutierrez, Janelle Montgomery and Bob
Gillett (vice president)
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AWARDS
Marshall
Receives
Stroke-Care
Award
The American Heart Association has awarded
Marshall a prestigious
and elite “Stroke Gold
Plus” quality award. The
award recognizes Marshall Medical Center’s
commitment and suc-
actual patient
cess in implementing a higher
standard of stroke care by
ensuring that stroke patients
receive treatment according
to nationally accepted standards and recommendations.
The team overseeing
Marshall’s stroke treatment protocols have
worked tirelessly to
ensure that patients who
come to Marshall as
positive victims of stroke
receive the most rapid,
advanced care available, supporting positive
outcomes.
Beautiful YOU
FREE CONSULTATION
Wrinkles or complexion problems?
Sun damage, scars or sagging skin?
Schedule a FREE CONSULTATION with
Reginald Rice, MD, facial plastic and reconstructive
surgeon to discuss your surgical and nonsurgical options
($100 value - new patients only)
Purchase a ZO skin care kit and receive a
before
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CHIN IMPLANT, EYELID LIFT
FREE FULL SIZE OLLUMINATE®
INTENSE EYE REPAIR,
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(value $135 - while supplies last)
4300 Golden Center Drive, Suite D • Placerville, CA
530-344-2000
marshallplasticsurgery.org
Some restrictions apply. Cannot be combined with other discounts or offers. Offers valid 12/1/2015 - 12/31/2015.
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6 Years in a Row