Thursday, October 28, 2010

Making way for new critical care beds

Work has begun on the southeast corner of Cox South to make way for construction of the new critical care unit, which is set to open next year.

When the new unit opens, it will complement the new Emergency Department by adding 24 new critical care beds. Dr. John Duff says that in planning sessions five years ago, trends were predicting a shortage of critical care beds by 2010. Those predictions are now coming true as southwest Missouri’s population grows and greater numbers of acute patients are coming into the facility.

“We decided that now is the right time to fix that,” Dr. Duff says. “This will help support the new ED; we anticipate that with the growth of the Emergency Department we’ll see even more critically ill and injured patients.”

Construction begins this fall and the $17 million facility is expected to be complete in fall 2011.

The beds will be located on the ground floor in the same corridor as Cox South’s current critical care beds. The unit will extend to the south along National from the current unit. The construction will create 27 new beds, but it will also involve losing three surgical ICU beds, leaving a net gain of 24. It will bring the total number of adult critical care beds to 76.

“We’ve worked hard to ensure that patients return to their home environments as soon as they can and to keep beds free for the next patients,” Dr. Duff says. “By adding these beds, we’ll be able to accept patients more rapidly from the ED and eliminate delays.”

Tuesday, October 19, 2010

Skeleton Scurry fun run, costume party set for Saturday

Kids, join CoxHealth Fitness Centers for a Halloween costume party and
outdoor fun run to celebrate fitness and the Halloween season!

The 8th annual Skeleton Scurry will be held 10 a.m. - noon, Saturday, Oct. 23, at The Meyer Center, 3545 S. National Ave., in Springfield.

The Scurry is for ages 2 – 11. All participants will receive a prize, goodie bag and pizza lunch sponsored by Dominos. There will be games and inflatables, too.

Tickets are $10 in advance or $15 the day of the event. Pre-registration is encouraged at any CoxHealth Fitness Centers location (Cox North, The Meyer Center, Republic or Willard.) or you can visit to print out a registration form. For more information, call 269-3282.

‘Tailoring your Lung Cancer Care’

Dr. William Cunningham, a medical oncologist with Oncology Hematology Associates, will speak at this free event for lung cancer patients and their families or caregivers.

He will discuss how physicians decide which chemotherapy treatment is right for each patient and the future of targeted therapy. Marilyn Bauer, director of Cancer Research for the Ozarks, will speak about clinical trials. This is a free program, but registration is required by Oct. 29. A light dinner will be served.

Join us Tuesday, Nov. 2, 5 – 6:30 p.m., in the Dogwood Room inside Hulston Cancer Center, 3850 S. National. Call 269-INFO for more information or to register.

Learn about osteoporosis at 'cheesy' event

Join The Women’s Center at CoxHealth for “The Power of Cheese and Exercise,” an interactive speaker/audience demonstration of exercises for those with (and at risk for) osteoporosis with physical therapist Robyn Holland. Oh, and be sure to enjoy the cheese buffet!

Studies estimate more than 52 million U.S. men and women aged 50 or older suffer from osteoporosis and low bone mass. The majority may never know until they suffer a fracture from a minor fall, or in advanced cases from a sneeze or even spontaneously.

Patti Roper, RN, osteoporosis nurse educator with The Women’s Center says, “For most people, osteoporosis is a preventable disease if they do the right things, such as getting the recommended daily amount of calcium, doing weight-bearing exercises and not smoking.”

This free program will be held 7-9 p.m., Monday, Nov. 8, in Foster Auditorium at Cox South, 3801 S. National Ave. Registration is required. Call 269-LADY today.

Tuesday, October 12, 2010

'Joint Camp' a bridge to health

With the help of physical therapist Deana Hicks, Barbara Boyher takes her first steps on stairs after having knee replacement surgery at the Meyer Orthopedic Center. Boyher underwent rehab therapy as part of the Joint Adventure program, which offers patients inpatient physical therapy over three days after their surgeries. The program is designed to help patients adapt and recover after surgery, allowing them to return home more quickly, usually within a few days of their procedure.

For years, Judee Steward had suffered with severe pain in both of her knees. “I was living on pain pills, using a cane, anything I could do to get to work, to manage, to last the day. That’s how bad it was,” she says. “I did not have quality of life.”

Steward, who is a senior advocate with Cox’s Senior Advantage program, had tried a variety of treatments but says eventually she reached the point where a knee replacement was the best option. “My doctor showed me the X-rays – there just wasn’t any cartilage left between the joints and it was just time to get it done,” says Steward.

So, Steward became one of the first patients to enter Joint Adventure – Cox’s new total joint program – and on May 3 she was the first patient treated at the new Meyer Orthopedic Center.

She credits the program and the seamless care it provides with her success – she was able to return to work only five weeks after her surgery. And Steward is not alone.

While leaders won’t be able to fully evaluate data until they can collect information on patient outcomes after their six-month follow-ups with their physicians, early indicators point to a program that’s successfully preparing patients for surgery, treating them, rehabilitating them and getting them on the road to an improved quality of life with their new joint.

A team approach to care

“Joint Adventure is different because it’s a real team approach to providing total joint care,” says Fred Lerche, director of musculoskeletal services.

Born from a working group with representatives from rehabilitation, nursing, Oxford Home Health, physician offices and other areas, the program is a five-step process that carefully and seamlessly leads each knee and hip joint replacement patient through their surgery and beyond.

Joint Adventure begins with a pre-surgery class for patients and their support person, or coach, about two weeks prior to the surgery. The goal is to create a prepared, confident patient and coach.

“In the class, we try to paint the entire picture for them from now to six months down the road,” Lerche says. “We talk them through the entire process, from which door they need to come in on the day of their surgery, through what to expect during their hospital stay, what exercises they need to do now and after surgery – it’s all about preparing the patient and putting their mind at ease.”

Currently, about 85 percent of patients having a hip or knee replacement are attending the class. While program leaders would like to see 100 percent compliance, they are happy that those attending are reporting satisfaction with the program.

Program leaders have worked hard to weave the patient-centered, information-driven, team-building approach outlined in the class through the rest of the Joint Adventure program.

“We’ve timed it so that often the group that attends the class together ends up having surgery on the same day – or nearly the same day – about two weeks later. They end up working their inpatient therapy together and it creates a bond. The patients encourage each other and it’s all a part of the seamless care we want to provide,” Lerche says.

While in the hospital, patients progress from individualized therapy to group therapy, from getting up and sitting on the side of the bed or in a chair to relearning how to go up and down stairs and get in and out of a car.

Steward says she found inpatient rehab incredibly helpful to her recovery.
“You have to learn how to walk again. I compensated so much trying to take the pain off my knees that I kind of walked with a waddle. They taught me how to feel like I had control again,” she says. “And the home health care I received with Connie from Oxford was extraordinary. She really helped me regain my usage and my function so I could get back to work.”

Early signs of success

While Lerche and other leaders have big plans to evaluate patient outcomes, early indicators provide hints of the program’s achievements.

“Eighty percent of our patients are discharged to home,” says Lerche. “That’s a big indicator of success, that we’re able to safely get a patient back home, rather than into skilled nursing. Where do patients want to go? They want to go home.”

Some programs in their benchmark group have a discharge-to-home rate of 22 percent; Lerche says such rates are not uncommon.

Joint Adventure leaders are also optimistic based on the feedback they’re receiving from patients and from physicians.

“Patients are telling us they can do things they couldn’t do before. They can take walks with their grandkids. They are enjoying their lifestyle so much more,” he says.

“Sometimes you have programs that are great patient pleasers. Sometimes you have programs that are great staff satisfiers. But when you blend them both together – isn’t that what you want? That’s success, and that’s what differentiates our program from any other program in the area.”

Looking toward the future

The population of people who will want or need a joint replaced is expanding at a rapid clip. The American Academy of Orthopaedic Surgery says experts predict a 673 percent rise in knee replacements alone by 2013. Lerche attributes this to not only the aging Baby Boomers, but to the increased durability of replacement joint components.

“Now, we’re going ahead and doing joint replacements on younger people, where 15 or 20 years ago we would have told that person to wait because the components weren’t going to last.”

Another reason for the expected increase? It’s Generation-X, the generation that gave rise to the extreme sports movement. As they age, experts predict they will need new joints, too.

“You see those extreme sports? There’s trauma taking place,” says Lerche.

The MOC was built, and Joint Adventure was designed, to handle this growth.

“The numbers are unbelievable. We have to prepare for that and that’s why Cox has committed an entire hospital to orthopedics. The volume is going to be there, and we’ve built with room to grow,” Lerche says.

As for Steward, count her as part of that growth. Not for the knee she had replaced in May, but for the one that will be replaced in December.

“Both of my knees were bad, and Dr. Wester (her orthopedic surgeon) told me I could choose which one to have replaced first. I picked the right knee, since that’s the one I drive with,” she laughs.

“They tell you the next one may not be like the first one, and I am aware as far as the level of commitment it takes to get yourself back to independence,” Steward says.

“But I love my new knee – I can go up and down the stairs, I’ve gone back to the gym and I’ve lost 25 pounds – and I know my next experience will be just as challenging but also just as gratifying as this one was.”

Monday, October 11, 2010

Breast Care Fund receives matching donation from 'Fiddler on the Roof' tickets

Pictured above (from left): Jan Baumgartner, executive vice president, Springfield First Community Bank; Lisa Alexander, president, CoxHealth Foundation; Brian Straughan, president and CEO, Springfield First Community Bank.

The CoxHealth Foundation’s Breast Care Fund recently received a large donation from early “Fiddler on the Roof” ticket sales and a matching gift from Springfield First Community Bank.

Celebrity Promotions donated $5 for every ticket sold during a two-day ticket presale event for the upcoming “Fiddler on the Roof” production at Juanita K. Hammons Hall for the Performing Arts.

Springfield First Community Bank offered to match the amount to bring greater awareness to the community of their commitment to women's health. During the promotion, 481 tickets were sold for a total of $2,405. With the bank’s match, the total raised was $4,810.

The CoxHealth Foundation Breast Care Fund is one of the only resources in southwest Missouri that offers financial grants to women for their medical treatment for mammography, diagnostics and follow-up care if they are diagnosed with breast cancer.

L & D staff takes training to new level

When staff members in Labor and Delivery were preparing for their annual teamwork training and emergency drills, they wanted to practice in the most realistic environment possible. This year, they found just the place as they partnered with Cox College to train at the Nursing Resource Center.

In four sessions over three days, the L&D nurses and staff ran through several emergency scenarios – everything from a postpartum hemorrhage and a neonatal code to a maternal code and a fire in the operating room.

The training is part of a Joint Commission requirement that calls for staff to have regular practice with emergency scenarios, a key component in patient safety.

“The training allows staff to become adept at managing situations like these,” says L&D nurse Debbie Burgess. “This really helps build confidence in our ability to handle an event like this on the unit.”

For each of the scenarios, team members are presented with a history on the “patient” and they manage the situation just as they would in real life.

The training covers everything from basic clinical skills (washing hands and patient identification) to critical decision-making and complex technical skills. The exercises are also a chance to improve communication skills and work on overall teamwork.

Each clinical simulation is followed by a debriefing in which the participants discuss what was learned, what went well and what needs more practice.

“The simulations are amazing,” Burgess says. “The simulator bleeds when you start an IV and everything they prepared was very realistic – the staff really responded to that.”

“People loved it, I haven’t heard one negative comment about it,” says Cozi Bagley, an instructor at Cox College.

In years past, staff had trained on the unit with a staff member posing as a patient. Burgess says the simulations in the resource center allowed for a greater variety of scenarios and they were a great alternative.

“It can be harder to act like a scenario is real when the patient is a co-worker,” she says.

“This let everyone really get into it.”