Community - Littleton Regional Healthcare

FALL 2010
ReportCard
Community
L i t t l e ton R e giona l Ho spi ta l • 6 0 0 S t. Joh nsbu ry Roa d, L i t t l e ton, N H 035 61
Mission
To provide quality,
compassionate and accessible
healthcare in a manner that
brings value to all.
Vision
Littleton Regional Hospital
will be the leading provider
of healthcare and the best
organization in which to
work.
Values
Integrity
Respect
Compassion
Excellence
2010 Trustees
Guilbert Vickery, Chairman
John Starr, Vice Chairman
Mell Brooks, Secretary
William Bedor, Treasurer
Milton Bratz
Dr. Edward Duffy
Dr. Andrew Forrest
Susan Presby
Anna Rioux
Wayne Rioux
Dr. John Sauter, Emeritus
Maggie Starr
Steven Trooboff
Warren West, CEO
Dr. Charles Wolcott
Welcome to
Dr. Joseph
DellaValla,
Sleep Specialist
Littleton Regional Hospital (LRH)
and Androscoggin Valley Hospital
(AVH) will be opening the Center for Sleep Medicine at
Androscoggin Valley Hospital and Littleton Regional Hospital. The
Center for Sleep Medicine will open in December at AVH and in
January at LRH. Dr. Joseph P. DellaValla, internal medicine
physician and sleep disorder specialist, will join sleep technologists
at AVH and Littleton to provide this vital service to patients from
northern NH and VT. Dr. DellaValla comes to LRH and AVH from
Portage Internal Medicine Associates in Hancock, MI where he
provided inpatient and outpatient clinical services in Sleep Medicine
and general Internal Medicine.
Dr. DellaValla earned his undergraduate degree at the University of
Scranton in Scranton, PA. He completed his Doctor of Medicine at
Jefferson Medical College in Philadelphia, PA and his Internal
Medicine Residency at Christiana Care/Medical Center of Delaware
in Newark, DE. Dr. DellaValla completed his training in sleep medicine at the School of Sleep Medicine in Palo Alto, CA, the Portage
Health Sleep Disorders Center in Hancock, MI the Upper Peninsula
Sleep Disorders Center in Iron Mountain, MI.
Dr. DellaValla is board certified in Sleep Medicine by the American
Board of Internal Medicine, a Fellow of the American College of
Physicians and an active member of the American Academy of
Sleep Medicine and American Medical Association.
Dr. DellaValla lectures on numerous sleep medicine topics including obstructive sleep apnea, sleep in preschoolers, sleep in athletes,
sleep and the diabetic patient sleep and women’s health.
The Centers for Sleep Medicine
Recent research suggests the quantity and quality of our sleep plays
a big part in staying healthy. Problems with our sleep can increase
our chances of developing serious illnesses including diabetes,
obesity heart disease. Sleepy people crash their cars much more
often than those who are well-rested. Recent research also suggests
that those of us getting adequate sleep perform better at work and
in our relationships.
The Center for Sleep Medicine at AVH and LRH will provide
comprehensive evaluation and treatment of patients with sleep
problems. This includes patients who are too sleepy (hypersomnolence), not sleepy enough (insomnia) or have something going
wrong while they sleep (like an abnormal type of breathing called
sleep apnea).
littletonhospital.org
603.444.9000
800.464.7731
Printed on 50% post-industrial fiber
manufactured using biogas energy.
Soy-based inks are used throughout.
Please join us for the
Grand Opening
Littleton Regional Hospital
Medical Office Building
Thursday, November 18, 2010
5:30–7:30 pm
600 St. Johnsbury Road, Littleton, NH 03561
Enjoy tours of our new 56,000 sq. ft.
expanded medical office building
• Free Health Screenings
• Flu Vaccine Clinic
• Children’s Activities
• Appetizers & Beverages
LRH kindly requests an RSVP! Please call (603) 444-9355 by November 12.
How well do you sleep?
Here’s a list of simple questions to help determine if
you may have a sleep disorder.
❑ Do you snore loudly?
❑ Do you stop breathing or gasp for breath during sleep?
❑ D
o you feel sleepy or doze off while watching TV,
reading, driving or while engaged in daily activities?
❑ D
o you have difficulty sleeping three nights per week or
more? For example, do you have trouble falling asleep,
wake frequently during the night, wake too early and
cannot get back to sleep or wake unrefreshed?
❑ D
o you feel unpleasant tingling, creeping feelings
Some symptoms of a sleep problem are obvious—like not being
able to fall asleep or stay asleep. Some are less obvious:
• Snoring interrupted by pauses and gasps
• Decreased daytime alertness
• Daytime sleepiness, especially when leading to falling asleep
at work, driving or during conversation
• Loss of energy or constant fatigue
• Irritability, short temper
• M
orning headaches
• Irregular heartbeat
• C
hange in mood or behavior
• Difficult to treat hypertension
The first step in evaluation will be a visit with Dr. DellaValla at
Littleton or AVH. Some sleep problems can be diagnosed and
treated based solely on things like history, physical examination
and sleep logs. However, some common sleep problems, like trouble
breathing while you sleep, require a sleep study for diagnosis and
treatment. During a sleep study, the patient sleeps overnight in a
Fortunately, most people can be helped once their condition
is diagnosed.
continued on page 4
nervousness in your legs when trying to sleep?
If you answered “yes” to one or more of these questions, you
may need to be evaluated for a sleep disorder.
Patient-Centered Care
Getting Ready for a Doctor’s Appointment–
How to Prepare
A basic plan can help you make the most of your appointment whether you are
starting with a new doctor or continuing with the doctor you’ve seen for years.
The following tips will make it easier for you and your doctor to cover
everything you need to talk about.
Make a list of your concerns and prioritize them
❑ Do you have a new symptom?
❑ Do you want to get a flu shot?
❑ Are you concerned about how a treatment is affecting your daily life?
❑ If you have more than a few items to discuss, put them in order and ask
about the most important ones first.
Take information with you
❑ B ring a list of all of your prescription drugs, over-the-counter medicines,
vitamins and herbal remedies or supplements.
❑ B ring your insurance card, names and phone numbers of other doctors
you see and your medical records if the doctor does not
have them.
Make sure you can see and hear as well as possible
❑ Remember to take your eyeglasses to the doctor’s visit.
❑ If you have a hearing aid, make sure that it is working well and
wear it.
❑ L et the doctor and staff know if you have a hard time seeing or hearing.
For example, you may want to say: “My hearing makes it hard to
understand everything you’re saying. It helps a lot when you speak slowly.”
Consider bringing a family member or friend
❑ B ring a family member or close friend with you as it is helpful to have
someone take notes for you and can help you remember what the doctor
said.
Find an interpreter if you know you’ll need one
❑ If the doctor you selected or were referred to doesn’t speak your language,
consider bringing an interpreter with you.
Plan to update the doctor
❑ L et your doctor know what has happened in your life since your
❑
❑
❑
last visit.
If you have been treated in the emergency room or by a specialist, tell the
doctor right away.
M
ention any changes you have noticed in your appetite, weight, sleep or
energy level.
A
lso tell the doctor about any recent changes in any medications you take
or the effects they have had on you.
Summary: Getting Ready for an Appointment
• Be prepared: make a list of concerns.
• Take information with you.
• Make sure you can see and hear as well as possible.
• Consider bringing a family member or friend.
• Find an interpreter if you know you’ll need one.
• Plan to update the doctor on what has happened since your last visit.
Resource: USA.gov: www.nia.nih.gov/HealthInformation/Publications/
TalkingWithYourDoctor
Patient Quality & Safety at LRH
Medical errors are one of the Nation’s leading causes of death and injury. A recent
report by the Institute of Medicine estimates that as many as 44,000 to 98,000
people die in U.S. hospitals each year as the result of medical errors. This means
that more people die from medical errors than from motor vehicle accidents, breast
cancer or AIDS.
Government agencies, purchasers of group health care and health care providers are
working together to make the U.S. health care system safer for patients and the public.
Caring for patients and their families and
providing the highest quality of healthcare has
been the focus at Littleton Regional Hospital
(LRH) for more than 100 years. This is why
LRH is the first hospital in New Hampshire to
participate in a statewide effort with New
Hampshire Hospit a l Ass o ci at ion and
Foundation for Healthy Communities to work
together to eliminate preventable patient harm
by 2015.
The New Hampshire Hospital Association,
Foundation for Healthy Communities and
hospitals statewide are working together to
deliver the safest possible care to every
patient. NH Hospitals have ranked #1 in the
country for nearly 10 years providing the
appropriate evidence-based processes of
care for patients being treated for heart
attacks, heart failure, pneumonia and
patients undergoing surgery; but more work
remains to be done to continue to ensure
that all patients receive the right care each
time they are treated.
Warren West, CEO states, “Our goal at
LRH is to be the safest hospital in New
Hampshire. Our Quality Services team is
dedicated to providing valuable patient
safety and quality information to patients,
their families and to nationally recognized
organizations who track patient safety
measures, allowing LRH to be transparent
in their patient safety initiatives both
locally and nationally. LRH is taking the
lead in this statewide initiative by researching a number of nationally recognized
patient safety indicators and making the results available to patients and to the National
Healthcare Safety Network (NHSN).” The above brochure with LRH data is updated
regularly and is available at various public locations throughout the hospital.
Patient Safety is always on the forefront of our minds. One tool LRH uses to
keep our surgical patients safe is the Surgical Safety Checklist developed by the World
Health Organization (WHO). The New Hampshire Health Care Quality Assurance
Commission (NHHCQAC), which represents all hospitals statewide, has strongly
recommended using the WHO checklist in all surgical facilities. They report that
facilities using the checklist saw a 36% average drop in postoperative complications.
The checklist identifies three phases of an operation, each corresponding to a
different part of the patient’s surgery. In each phase, a Registered Nurse coordinates
and confirms that the surgery team has completed necessary steps before they
move on to the next part of surgery:
❑ During Sign In (before the induction of anesthesia), the surgical team verifies
Easy Online Patient Registration
To reduce your time during the registration process, you can now pre-register
using our secure online patient registration form. This form must be filled out and
submitted at least four days before your procedure. Types of procedures you can
pre-register for are surgery, obstetrics, cardiac laboratory and x-rays.
To pre-register online, visit www.littletonhospital.org. Click on Your Visit to LRH
follow the link to Online Pre-Registration. Simply fill out and submit the form to save
time when you arrive at LRH for your procedure. If your information is incomplete,
a member of the admitting department will assist you in completing the registration
form by telephone or when you arrive.
On the day of your procedure, check in at the Main Lobby to finalize the registration
process. Please call (603) 444-9210 for more information.
2
L i t t l e ton R e giona l Ho spi ta l
that all relevant documents and test results are reviewed and available prior to
the surgery. After verification from the patient, the surgeon marks the surgical
site. The surgical team must be in agreement on the procedure to be conducted
and the exact site of the surgery.
❑D
uring Time Out (just before incision), the entire surgical team pauses to check
that the correct patient is about to undergo the correct procedure on the correct
body part.
❑D
uring the Sign Out phase (after the incision is closed, but before the patient
leaves the operating room), members of the team evaluate the patient’s status to
identify any additional needs the patient may have during recovery.
Use of the WHO Surgical Safety Checklist is just one more way that Littleton
Regional Hospital does everything to ensure that our patients receive the best
possible care and experience the safest surgical outcomes.
Clinical Quality Measures
Hospital Quality Alliance Measures
Good information helps you make good decisions about your health and healthcare needs. The Hospital Quality Alliance is a national collaboration to improve the quality of care
provided by the nation’s hospitals by measuring and publicly reporting on 21 measures of hospital quality care in the areas of heart attack, heart failure, pneumonia and surgical
care improvement. These results show you how we measure up compared to national data and accepted care standards. LRH’s participation in this program has led to many
important improvements in our patient care. For more information about the Hospital Quality Assurance (HQA): Improving Care Through Information, please visit the Hospital
Compare website sponsored by the Department of Health and Human Services and Centers for Medicare and Medicaid Services: www.hospitalcompare.hhs.gov.
Clinical Quality Measures for Surgical Services: Antibiotic Use
Antibiotic Timing
Clinical Quality Measures for Heart Attack Patients
Antibiotic Duration
100%
Aspirin
at Admission
Aspirin at
Discharge
Beta Blocker at
Discharge
‘05 ‘06 ‘07 ‘08 ‘09 ‘09 ‘09
‘05 ‘06 ‘07 ‘08 ‘09 ‘09 ‘09
100%
80%
80%
60%
60%
40%
40%
20%
20%
0%
‘05
‘06
‘07
‘08
‘09
‘09 ‘09
LRH
‘05
‘06
‘07
‘08
NH
‘09
‘09 ‘09
US
0%
LRH
Device Associated Infections
One measure of patient safety and clinical quality is how well we prevent infections from
developing when a medical device is placed in the body. Littleton Regional Hospital participates
in the CDC’s National Healthcare Safety Network (NHSN) to collect and report information
about infections that develop in patients who have one of the following devices in place when an
infection starts, or had the device in place up to 48 hours before the infection starts:
• Catheter Associated Urinary Tract Infections (CAUTI)—A urinary catheter is a tube that is
used to drain urine from the bladder.
• Central Line Associated Blood Stream Infections (CLABSI)—A central line is an IV placed
into a large vein used to give fluids or medications that might be irritating to smaller veins.
• Ventilator Associated Pneumonia (VAP)—A ventilator is a machine that helps people
breathe.
Device Associated Infections per 1000 Device Days
15%
Catheter Associated Urinary
Tract Infections
Central Line Associated
Blood Stream Infections
Ventilator Associated
Pneumonia
NH
US
Clinical Quality Measures for Heart Failure Patients
100%
Left Ventricular
Systolic Function
Evaluation
ACE Inhibitor or ARB for
Patients with Left Ventricular
Systolic Dysfunction
Discharge
Instructions
80%
60%
40%
20%
12%
0%
‘05 ‘06 ‘07 ‘08 ‘09 ‘09 ‘09
9%
‘05 ‘06 ‘07 ‘08 ‘09 ‘09 ‘09
LRH
6%
‘05 ‘06 ‘07 ‘08 ‘09 ‘09 ‘09
NH
US
Clinical Quality Measures for Pneumonia Patients
3%
0%
‘05 ‘06 ‘07 ‘08 ‘09 ‘09 ‘09
‘08 ‘09
‘10 ‘06–‘08
‘08 ‘09
LRH
0%
‘10 ‘06–‘08
0%
‘08 ‘09
0%
‘10 ‘06–‘08
NHSN POOLED MEAN
Antibiotic Selection
‘05‘06‘07 ‘08 ‘09‘09 ‘09
‘05‘06 ‘07 ‘08 ‘09 ‘09 ‘09
‘05 ‘06‘07 ‘08 ‘09 ‘09‘09
Influenza
Vaccination
80%
Care-A-Van
Littleton Regional Hospital is fully
aware of the growing need for public
transportation, particularly for the
elderly. Like New Hampshire, LRH
has already begun looking into boosting
their public transit as a rising number
of patients are unable to seek nonemergency medical attention.
40%
If you need transportation to or from the hospital or your doctor’s office, please call
800-499-0231 for more information.
Smoking Cessation
Education
100%
60%
Beginning January 1, 2011, LRH will offer extended hours for transportation to and
from doctor’s appointments at LRH from 7:30 am to 5:30 pm. These expanded hours
will benefit patients with a late afternoon appointment who previously had no means of
transportation home after 3:30 pm.
Pneumococcal
Vaccination
20%
0%
0%
LRH
NH
‘05‘06 ‘07‘08 ‘09 ‘09 ‘09
US
The data provided in this Community Report Card is for general informational and comparison purposes
only. It does not constitute a statement as to the standard of care, nor should it be used as evidence of a
standard of care, nor does it waive our QI privilege. As every individual patient and his/her presentation
is unique, this general information may not be applicable to an individual case.
Commu nity R eport Car d
3
A Healing Environment
Sentinel Lymph Node
Biopsy—a New Option
for Women with Breast
Cancer
Dr. Alice F. Rocke, general surgeon at LRH
specializing in Breast Care, is now offering
Sentinel Lymph Node Biopsy at Littleton
Regional Hospital.
What is a lymph node? A lymph node is part
of the body’s lymphatic system. In the lymphatic
system, a network of lymph vessels carries clear fluid
called lymph. Lymph vessels lead to lymph nodes, which
are small, round organs that trap cancer cells, bacteria
or other harmful substances that may be in the lymph.
Groups of lymph nodes are found in the neck,
underarms, chest, abdomen and groin.
What is a Sentinel Lymph Node? The sentinel lymph
node is the first lymph node to which cancer is likely
to spread from the primary tumor. Cancer cells may
appear in the sentinel node before spreading to other
lymph nodes.
What is Sentinel Lymph Node or SLN
Biopsy?
Sentinel Lymph Node Biopsy (SLN) is a procedure in
which the sentinel lymph node is removed and examined
under a microscope to determine where cancer cells are
present. The idea behind sentinel node biopsy is instead of
removing one or more lymph nodes and analyzing
Dr. Alice F. Rocke, general
all of them to look for cancer, remove only the
surgeon at LRH specializing in
nodes that are most likely to have it. Removal of
breast care states, “Sentinel
just one or a few key underarm nodes can lymph node biopsy is an excellent,
less invasive choice for many
accurately assess overall lymph node status in
women with breast cancer. It
women who have relatively small breast cancers.
Who Is a Good Candidate for Sentinel
Lymph Node Biopsies?
helps to answer the question, ‘Has
the cancer spread?’ which helps
doctors develop a more effective
treatment plan for breast cancer.”
Keep your heart healthy
with LRH Cardiac Rehab
Fitness Tips
Keep walking this winter…
1. If you’re going to walk outdoors in
winter, start with time vs. distance.
In cold weather you wear heavier
clothing, walk on challenging
surfaces and may be walking against
a cold wind. This means that
walking during the winter months
can be more difficult. Your winter
walk may take more time with less distance, but the workout will be equal.
You’ll feel energized instead of worn out. As you get used to winter walking
you’ll be able to cover a greater distance in the same amount of time.
2. Choose indoor walking options for days when it is just too cold to get outside.
There are a variety of exercise DVDs available that require very little space to
accomplish or a local health club is another option!
3. Recruit a walking buddy. You’re more likely to stick to your program if you
walk or workout with a friend.
4. Be safe! Dress appropriately when you do walk outdoors and if your normal
walking route is ice covered keep your workout indoors.
Centers for Sleep Medicine
continued from page 1
private room at the center. While the patient sleeps, technologists monitor and record features of the patient’s breathing, movements, brain waves and heart rhythm.
The results help the team at the center make an accurate diagnosis and form a
treatment plan.
Referrals are accepted but not required for evaluation at the Centers for Sleep
Medicine. Medicare and most major insurers cover these services.
How To Reach Us
For more information about the Sleep Disorder Center at LRH, call (603) 444-9000
or for information about the Sleep Disorder Center at AVH call (603) 326-5847.
Sentinel Lymph Node Biopsy is a good option for women with early-stage, invasive
breast cancer who have a low-to-moderate risk of lymph node involvement.
In general, Sentinel Lymph Node Biopsy is not appropriate for the following women:
• Anyone who is likely to have cancer in the lymph nodes.
Ginger-Squash Soup
• Women with any prior surgery or treatment that could have altered normal
pattern of lymph drainage.
Makes 4 (about 1 cup) servings
Prep: 20 minutes | Cook: 20 minutes
• Women who had chemotherapy before surgery to reduce the size of a large
cancer to treat many involved lymph nodes.
½ cup chopped onion
How is the Sentinel Lymph Node Biopsy done?
A radioactive substance or blue dye is injected near the tumor. The surgeon will
then use a scanner to find the sentinel lymph node containing radioactive substance
or stained with dye. Once the sentinel lymph node is located, the surgeon makes a
small incision in the skin and removes the lymph node.
If the sentinel lymph node does not show any cancer, it is likely that no other lymph
nodes contain cancer the chances are good that the cancer has not spread beyond
the breast. If the sentinel lymph node does contain cancer, another treatment step
may be needed including:
• Your surgeon may decide to remove more nodes, if the lymph node is
affected by cancer. In some cases, this is done during initial surgery.
• If the laboratory finds significant cancer present in the sentinel node/s
after surgery, the surgeon may recommend additional surgery to remove
and analyze more lymph nodes from the armpit.
•Radiation treatment may be recommended instead of more surgery.
For more information about Sentinel Node Biopsy or to schedule an appointment
with Dr. Alice F. Rocke, general surgeon specializing in breast care at LRH, please
call (603) 444-0997.
2 tsp canola or olive oil
4 tsp grated
fresh ginger
2 cloves garlic, mashed
½ tsp salt
2 pounds buttercup squash, peeled
& cut into 1˝ pieces (4 cups)
Pinch cayenne pepper
2 14-ounce cans reduced sodium
chicken broth or vegetable broth
2 medium apples, cored & chopped
(optional)
In a large saucepan, cook onion in hot oil 3 minutes stirring occasionally.
Stir in garlic, cook and stir 1 more minute.
Stir in squash, chicken broth, ginger, salt and cayenne pepper. Bring to
boiling; reduce heat. Simmer, covered 15–20 minutes or until squash is very
tender. Cool slightly.
Transfer one-third of the soup mixture to a blender or food processor. Cover
and blend or process until smooth. Repeat with remaining soup. Return
mixture to saucepan; heat through.
Ladle soup into bowls. If desired, top with chopped apples.
Nutrition Facts: Servings Per Recipe: 4 (about 1 cup) servings. Calories 122, Total Fat
3g, Saturated Fat 3g, Monounsaturated Fat 1.4g, Polyunsaturated Fat 0.9g, Sodium
772mg, Carbohydrate 23g, Total Sugar 7g, Fiber 4g, Protein 5g, Vitamin C 42 (DV %),
Calcium 7 (DV %), Iron 8 (DV %).
*Percent daily values are based on a 2,000 calorie diet.
4
L i t t l e ton R e giona l Ho spi ta l
Patients Come First at LRH
Patient Satisfaction
The Anna Connors Patient &
Family Resource Center
Meeting and exceeding your expectations for quality care and service is very
important to us. From time to time, you may receive a patient satisfaction survey in
the mail from a company in Florida that conducts surveys for our hospital. The
input provided by our patients on these surveys is an essential tool in helping us
continue to improve the care and services we provide to our community.
The Anna Connors Patient & Family Resource Center is located within the
Gale Medical Library. It’s a place where patients, families visitors can learn
about any aspect of their healthcare. A trained health sciences librarian is on
hand to help you sort through a large amount of information and get just
what you need (from very basic to more in-depth information). Examples of
topics include:
•Sleep
• Headache
• Hearing Loss
•Nutrition
•Strength & Power Training
•Diabetes
•Depression
• Lyme Disease
• Restless Leg Syndrome
•Arthritis
•Pneumonia
LRH Physician Practices Customer Satisfaction Scores
LRH Physician
Practices Overall
90%
Physician Care
91%
Office Staff
90%
Billing
84%
0%
20%
LRH 2007
40%
LRH 2008
60%
80%
LRH 2009
If you are searching the web for health information, a great place to start is
MedlinePlus at http://medlineplus.gov. To learn more, contact Anne Conner,
MLS, at (603) 444-9564.
100%
AVATAR DATABASE
Outpatient Services Customer Satisfaction Scores
Outpatient
Services Overall
Emergency Services Customer Satisfaction Scores
Emergency
Services Overall
88%
Physician Care
87%
Nursing Care
87%
Pain Management
82%
Billing
80%
91%
Environment
94%
Billing
81%
0%
20%
LRH 2007
40%
LRH 2008
60%
80%
LRH 2009
100%
0%
AVATAR DATABASE
LRH 2007
Inpatient Services Customer Satisfaction Scores
90%
Physician Care
93%
Nursing Care
90%
Pain Management
92%
Patient Safety
90%
Expectations
87%
Environment
91%
Meals
89%
Billing
77%
20%
LRH 2007
40%
LRH 2008
60%
LRH 2009
80%
40%
LRH 2008
60%
80%
LRH 2009
100%
AVATAR DATABASE
Ambulatory Surgery Customer Satisfaction Scores
Inpatient Overall
0%
20%
100%
AVATAR DATABASE
Ambulatory
Surgery Overall
94%
95%
Surgeon Care
96%
Nursing Care
Pain Management
93%
Environment
96%
Billing
82%
0%
20%
LRH 2007
40%
LRH 2008
60%
LRH 2009
80%
100%
AVATAR DATABASE
Commu nity R eport Car d
5
What’s New at LRH
Meet Dr. Fitzpatrick, our new Otolaryngologist specializing
in Allergy and Facial Plastic Surgery
Dr. Patrick M. Fitzpatrick joined our Medical
Staff in July 2010. He is an otolaryngologist
(ear, nose & throat) who specializes in Facial
Plastics and the treatment of Allergic
Disorders.
Dr. Fitzp at r ick is b o ard elig ible in
Otolaryngology and Facial Plastic Surgery
and joined Dr. Deanne Rankin at LRH’s
North Country Otolaryngology. In addition
to general ENT, Dr. Fitzpatrick enjoys
working with patients with allergies and
will be offering immunotherapy (commonly
called allergy shots) and intra-dermal
testing (skin testing for allergies).
Dr. Fitzpatrick’s other areas of interest
include treating patients with both cosmetic
and functional facial plastic concerns. He will
offer face and neck cosmetic surgery including
r h i nopl a s t y, f a c e l i f t s , ot opl a s t y, c h i n
augmentation, neck liposuction and facial
implants. In addition, office-based facial
renewal techniques using Botox®, facial fillers
like Juvederm® and Restylane® are non-surgical
options for men and women interested in reducing
the appearance of facial wrinkles and fine lines.
F acial “Plastic” Treatments Now
Offered at LRH
Botox® and Facial Fillers—Are these for you?
increasingly popular and are in almost as much demand as Botox. Patients use
Botox and fillers to delay surgery and prolong the results of surgical procedures.
Dr. Fitzpatrick also offers facial plastic surgical procedures at LRH, these include
blepharoplasty (eyelid lift), chin augmentation, neck liposuction rhinoplasty (nose
surgery).
What is Blepharoplasty (Eyelid Lift)?
The eyelid lift or blepharoplasty is a procedure designed to remove excess fat and
skin from the upper and lower eyelids. It improves droopy eyelids and puffy bags
below the eyes, features that may make patients look older and more tired.
Who is a Candidate?
• If you have excessive, sagging or wrinkled upper or lower eyelid skin.
• If you have excess upper eyelid skin that interferes with vision.
• If you have lost your natural eyelid crease.
• If you have puffy pouches of fat in the upper or lower eyelids that create a tired
or aged appearance.
Intended Results
• A more youthful and rested appearance of the eyes.
• Widening of the visual field.
What is Rhinoplasty (Nose Surgery)?
Rhinoplasty is an operation to improve the shape and size of the nose. Rhinoplasty
is surgical sculpting of the nose and is accomplished by careful contouring of the
bone and cartilage giving the nose its shape. At the same time, deformities that
cause breathing problems and some sinus disorders can be corrected. Most
incisions (seamless rhinoplasty) are placed inside the nose where they are least
visible.
Are you interested in a refreshed facial
appearance? Littleton Regional Hospital is
now offering patients a variety of procedures
to “rejuvenate” their facial appearance.
Rhinoplasty is performed under general anesthesia. The surgery takes approximately
one and one-half to two hours. The use of “seamless” nose surgery allows for no
visible external scars and discomfort is minimized because no plates, tubes or painful
packing are used.
Non-surgical facial enhancement services at
LRH include the most common procedures—Botox facial fillers
such as Juvederm® and Restylane®. Botox is intended to
temporarily block the nerve signal that causes the underlying
muscle to contract, which leads to unwanted signs of aging. Facial fillers can help
patients who have lost volume in their face regain a more youthful look.
Rhinoplasty is often an enhancement to facial rejuvenation, particularly in the
correction of the aging nose (drooping of the tip). A significant “combo” effect is seen
with facial augmentation in conjunction with cosmetic nasal surgery. In most
instances, change in appearance can be seen immediately with final results seen in
6-12 months.
These non-surgical treatments are extremely common and can help patients reduce
the appearance of facial wrinkles, fine lines and facial creases. Fillers have become
For additional information about these procedures or other facial plastic procedures
performed by Dr. Fitzpatrick, please call LRH’s North Country Otolaryngology at
(603) 444-2450.
New Treatment for Chronic Sinusitis and Chronic Headache
LRH now offers Balloon Sinuplasty™ System for patients suffering from Chronic Sinusitis.
What is Chronic Sinusitis?
Chronic Sinusitis is inflammation of the sinus lining lasting three months or more is one of the most
commonly diagnosed chronic illnesses. It is typically caused by a bacterial, viral or microbial infection.
Structural issues such as blockage of the sinus opening can also be the cause of chronic sinusitis.
What are the symptoms of Chronic Sinusitis?
• Facial pain, pressure, congestion or fullness
• Loss of sense of smell or taste
• Difficulty breathing through the nose
• Headache (cephalgia)
• Discharge of yellow or green mucus from
the nose
• Fatigue
• Teeth pain
• Bad breath
• Sore throat
What is the Balloon Sinuplasty™ System?
Dr. Patrick Fitzpatrick now offers Balloon Sinuplasty™ for patients suffering from chronic sinusitis. This
minimally invasive procedure opens up the sinuses using a tiny balloon that is threaded into the sinus
and then expanded, similar to how doctors open up blocked arteries during a balloon angioplasty.
For additional information about Balloon Sinuplasty™ or services provided by North Country
Otolaryngology, please call (603) 444-2450.
6
L i t t l e ton R e giona l Ho spi ta l
LRH Wishes You a Healthy Holiday Season
LRH Charitable Foundation
Supports Reach Out and Read,
Born to Read Programs
The Littleton Regional Hospital Charitable Foundation granted $5,000 to the Gale
Medical Library this year in support of LRH’s Reach Out and Read and Born to
Read early literacy programs. Reach Out and Read (ROR) is a national, non-profit
program that is working to make literacy promotion a standard part of pediatric
care, so that children grow up with books and a love of reading. ROR trains doctors
and nurses about the importance of reading aloud and to give books to children at
pediatric check-ups from six months to five years of age, with a special focus on
underprivileged children. Reach Out and Read programs are located in more than
4,535 hospitals and health centers in all 50 states. Reach Out and Read serves more
than 3.9 million children and families annually more than 6.2 million new,
developmentally appropriate books are given to children each year.
Born to Read is a program through the American Library Association’s Library
Services to Children division. The purpose of this program is to raise awareness among
new parents about the critical role which reading plays in a baby’s growth and well
being. Each mother who gives birth at the LRH Agnes Norris Birthing Center receives
a packet with a book and information about reading programs for children at area
public libraries; in addition, the packet includes a brochure which details how families
can teach their young pre-reading skills. Born to Read is in its fifth year at LRH.
Anne Conner, director of the Gale Medical Library at LRH is pleased with the
support from the LRH Charitable Foundation. Conner states, “The Reach Out and
Read program is a very important part of each child’s wellness visit at LRH. This is
the fifth year that we have been able to offer new books to our young patients to
take home. Littleton Regional Hospital physicians educate parents about the
importance of reading with their children every day. We are hopeful that this
program will have a lasting positive effect on all of our young patients.”
Littleton Regional Hospital Charitable Foundation’s mission is to create community
and regional charitable support for Littleton Regional Hospital and programs and
4½-year-old Marty van Bergen enjoys one of the many Reach Out and Read books with
Director of the Gale Medical Library, Anne Conner.
services that promote the health and well-being of the communities it serves.
Executive Director, Gail Clark states, “We continue to seek ways to raise funds to
support LRH’s programs and services are grateful for the support shown by all of our
supporters. The Reach Out and Read and Born to Read programs are two ways that
the Foundation supports the programs and services at Littleton Regional Hospital.”
For more information about the LRH Charitable Foundation, please call the
Development and Community Relations department at (603) 444-9304.
No time to write holiday greeting cards? Let LRH Charitable Foundation
take the stress out of your holiday with our Greeting Card Campaign!
Are you looking for a special way to remember a loved one or friend this holiday
season? Making a gift to the LRH Charitable Foundation is a considerate and
thoughtful way to honor friends or loved ones for any special occasion.
This year LRH Charitable Foundation will take care of this for you by offering a
convenient alternative to writing and sending holiday cards… simply make a
donation to the LRH Charitable Foundation in honor or memory of a friend or
loved one we will send an attractive hand-written greeting card stating that you
have made a donation to the Foundation in their name (Please note: the amount of
the gift will not be revealed). You will receive an acknowledgement letter notifying
you of your tax-deductible contribution. All honor and memorial gifts will be
listed in a special section of the Littleton Regional Hospital annual report.
It is simple… make your check payable to LRH Charitable Foundation and mail to:
LRH Charitable Foundation, 600 St. Johnsbury Road, Littleton, NH 03561
addresses of those you
would like to honor this
holiday season! A minimum donation of $2.50
per card is required.
For additional information, please contact Gail
Clark, Director of LRH
Charitable Foundation
at (603) 444-9304 or
visit www.littletonhospital.org to make an
online donation.
Please be sure to include your name and address and the names and
✴ Holiday Gift Card Giving ✴
Please accept my gift of $_____________.
Make checks payable to LRH Charitable Foundation.
qM
emorial/In Honor (If in memory/honor, please print name)
_ ___________________________________________________________
Donor Name______________________________________________________
Street Address _____________________________________________________
City __________________________________ State/Zip _ __________________
Telephone (________)_ ________________________
Email____________________________________________________________
HOLIDAY GIFT CARD PROGRAM
Please send names and addresses of family members or friends that you wish to
recognize this holiday season through the LRH Charitable Foundation.
A minimum donation of $2.50 per card is required.
Please send acknowledgement to (if different from left):
Name____________________________________________________________
Street Address _____________________________________________________
City ____________________________________ State/Zip _ ________________
Please charge my
q Visa q MasterCard q American Express q Discover
Card #_ ________________________________________ Exp.Date________
Cardholder’s Signature_____________________________________________
q I wish to remain anonymous, please do not publish my name.
q Please contact me regarding your monthly giving program.
q Please contact me regarding planned giving opportunities.
Mail with payment to:
LRH Charitable Foundation
600 St. Johnsbury Road, Littleton, NH 03561
Commu nity R eport Car d
7
LRH Community Healthcare Providers
Since 1906, Littleton Regional Hospital has built a solid reputation for compassionate and innovative patient care. We continue to provide exemplary physical, emotional
spiritual care for each person who visits the Hospital. We are pleased to present you with a list of Healthcare Providers credentialed by Littleton Regional Hospital.
NURSE ANESTHESIOLOGY
Sharon Bolton, CRNA
Michelle Hannon, CRNA
Kevin Seale, CRNA
Brandon Zagst, CRNA
CARDIOLOGY
Anil Mukerjee, MD, FACC, FACP,
FASE, FASNC
Emil Pollak, Jr., MD, FACC
Peggy Piette, APRN
DERMATOLOGY
Arthur Daily, MD
EMERGENCY MEDICINE
Garrett Caputo, MD
Edward Duffy, MD, FACEP
G. Campbell McLaren, MD, FACEP
FAMILY PRACTICE
Virginia Alvord, MD
Jill Blumberg, MD
Rodney Felgate, MD
David Ferris, DO
John Ford, MD
Robin Hallquist, MD
Philip Lawson, MD, ABFP, CCPE,
ABHPM
David Nelson, DO
Kathleen Smith, MD, FAAFP
OPHTHALMOLOGY
John Spicer, MD
Charles Wolcott, MD
Patricia Kellogg, PA-C
Angela Hawkins, PA-C
Krista Haight, MD
Stephen Phipps, MD
ORAL & MAXILLOFACIAL
SURGERY
GASTROENTEROLOGY
Howard Mitz, DO, FACOI
Dennis Hannon, DDS
GENERAL SURGERY
ORTHOPAEDICS
Michael Kindred, MD
Alice F. Rocke, MD
Holly Blodgett, APRN
Andrew Chen, MD, MS, FAAOS
Lon Howard, MD, FAAOS
David Lovejoy, MD, FAAOS
Dougald MacArthur, DO, FAAOS
Daniel O’Neill, MD, EdD., FAAOS
Jessica Lorenz-Armstrong, PA-C
Ron Paul, PA-C
Joseph Prescott, PA-C
Jason Raehl, PA-C
HOSPITALIST
Stephen Goldberg, MD
Anurag Kushawaha, MD
INTERNAL MEDICINE
Rebekah Reeves, MD
Kevin Silva, MD, FACP
Malgorzata Taras, MD
Alicia Schramm, APRN
OTOLARYNGOLOGY
NEUROLOGY
Gopalan Umashankar, MD, ABPN
Patrick M. Fitzpatrick, DO
Deane Rankin, MD
OBSTETRICS/GYNECOLOGY
AUDIOLOGY
Nicholas Marks, MD, FACOG
Kathleen Govatski, APRN, CNM
Emily Kelly, APRN
John Sauter, MD, FACOG
OCCUPATIONAL HEALTH
Kariann Place, PA-C
ONCOLOGY
Erin Taylor, MS, CCC-A, F-AAA
PATHOLOGY
Armando Ciampa, MD, FAHC
PEDIATRICS
Cristina Culcea, MD
William Lakey, MD, FAAP
PHYSICAL MEDICINE &
REHABILITATION
Andrew Forrest, MD
PODIATRY
Hal Goolman, DPM
Denis Lamontagne, DPM
W. Kemp Schanlaber, DPM
PSYCHIATRY
Carol Lidstrom, MD
PSYCHOLOGY
Deborah Warner, PhD
RADIOLOGY
Dale Childs, MD
Harlan Herr, MD
We are proud to be a smoke-free
healthcare facility and campus. We
appreciate that being smoke-free
may be difficult and we can provide
support if you need assistance.
UROLOGY
Douglas M. Whittemore, MD
SAVE
Jerome Terres, MD
✂
CLIP
ANESTHESIOLOGY
Jakow “Jerry” Diener, MD, FACP
Holiday Savings at
Moose Ledge
Gift Shop!
Present this coupon for 10% OFF
any ONE regular-priced item!
Cannot be combined with other offers.
Not valid on sale items. Expires 12/31/2010.
LRH Auxiliary manages the Moose Ledge Gift Shop. Proceeds benefit programs and services at
Littleton Regional Hospital.
Wellness Calendar
HEALTH & WELLNESS
Audiology & Hearing Services lunch & learn series at LRH. Next session will be held on Tuesday,
Nov. 9, 2010 from 10:00 am until 1:00 pm at LRH. Contact: Julie Mason at (603) 259-7692 for
more information.
Cardiac Rehab & Wellness Support for patients, their families and caregivers to learn about
heart-healthy lifestyle changes and living. Contact: Lannette Madden, RN, ACE-AHFS LMT at
(603) 444-9387.
Pregnancy, Birth & Parenting Series A series of eight, 2-hour classes for expectant parents. To
learn more about LRH’s Birth & Parenting Wellness Series, please call (603) 444-9335.
Breastfeeding Course A 2-hour course for expectant parents. To learn more about LRH’s
Breastfeeding Course, please call (603) 444-9335.
Gale Medical Library–Anna Connors Patient & Family Resource Center Supporting wellness
in the community by providing access to reliable consumer health information. Contact: Anne
Conner at (603) 444-9564.
SUPPORT GROUPS
NAMI Support Group First Tuesday of the month at 7:00–9:00 pm at the All Saints Parish House,
Littleton. Contact: Annette Charbonneau, 603-823-5374 or call the National Alliance for the
Mentally Ill 1-800-242-6264. www.naminh.org.
Weight Watchers Join our group meetings held at LRH in the H. Taylor Caswell, Jr. Physicians’
Office Building in Conference Room 3 on Thursday from 4:30–5:30 pm. Contact: Carrie Way, RN
603-444-9329.
Bereavement Support Group North Country Home Health & Hospice, Littleton. First and third
Tuesday of the month from 1:00–2:30 pm. Contact: Inga Johnson at 603-444-5317.
Alcoholics Anonymous Meetings are held every Saturday at 8:30 am in the H. Taylor Caswell, Jr.
Physicians’ Office Building Conference Center, Conference rooms 1 & 2. For more information
please contact NH Area Assembly at 1-800-593-3330
CALENDAR OF EVENTS
Save the date! 20th Annual North Country Women’s Health Conference Monday, May 9,
2011 at the OMNI Mount Washington Resort & Spa, featuring keynote Loretta LaRoche,
international stress management and humor consultant! . Watch for details... If you would like to
be added to our mailing list, please call (603) 444-9304.
Save the date! Littleton Hospital Association 104th Annual Meeting Tuesday, January 25,
2011. Watch for details...
LRH Auxiliary Calendar of Events
Tree of Lights Ceremony Thursday, Dec. 2 from 5:00–7:00 pm at the LRH café area (next to the
Moose Ledge Gift Shop). Join LRH’s Auxiliary for the Tree of Lights Ceremony—a special annual
remembrance program to honor the memory of a loved one. A donation of $2 per memorial name
is requested. Checks should be made payable to LRH Auxiliary. Send to LRH Auxiliary, Tree of
Lights, 600 St. Johnsbury Road, Littleton, NH 03561.
Holiday Cookie Sale LRH’s Auxiliary bakes delicious cookies in time for the holiday season. Too
busy to cook? Get your holiday cookies made especially for you by LRH’s Auxiliary. Friday, Dec. 17
from 9 am–Noon.
Visit www.littletonhospital.org for details!
Littleton Regional Hospital
600 St. Johnsbury Road
Littleton, NH 03561
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Community
Non-Profit Org.
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