Friday, February 28, 2014

Free infant massage classes at CoxHealth

Infant massage helps parent and baby bond; builds baby’s coordination, language development and muscle tone; and may provide relief when baby experiences colic, muscle tension and more. It even helps baby sleep, lowers stress hormones and may decrease the “baby blues.”

Why wouldn’t a parent want to learn more?

CoxHealth will offer two free Infant Massage classes this month in Suite 130 of the CoxHealth Turner Center, 1000 E. Primrose:

· Tuesday, March 11, 11 a.m. – noon
· Thursday, March 27, 6:30 – 7:30 p.m.

New parents with their babies, and expectant parents, are invited to attend. Call 269-LADY for more information.

Wednesday, February 26, 2014

CoxHealth holds Diaper Drive to benefit area agencies

This is the second year for the event; organizers hope to collect 10,000 diapers

Every year, many local babies are born to families who cannot afford necessities for their child, including diapers. March 1-29, CoxHealth in Springfield, Branson and Monett will hold a Diaper Drive to collect this, the most basic and necessary of infant supplies.

Donated disposable diapers in all sizes will be given to Diaper Bank of the Ozarks in Springfield, Crosslines and the Tri-County Pregnancy Center in the Monett area, and Jesus was Homeless and Christian Associates in the Branson area.

This year CoxHealth hopes to collect 10,000 diapers from employees and the public. In addition to the drop-off locations below, collection bins will be available during the 26th annual CoxHealth Baby Affair at Cox South on Saturday, March 29. Drop-off locations:


Cox South: Main lobby (North entrance off Primrose), West Pavilion entrance and Turner Building main lobby
Cox North: Outpatient entrance off Robberson
The Meyer Center: Fitness Center lobby
Hulston Cancer Center: Allenbrand Resource Center


Cox Monett: Administration, third floor, 8 a.m. – 5 p.m.


Cox Branson: Skaggs Foundation office, Plaza One, 8 a.m. – 5 p.m. or Cox Branson Administration, 8 a.m. – 5 p.m.

Monday, February 24, 2014

Safety key: preventing patient falls

CoxHealth’s falls reduction team tracks data and partners with others to keep patients safe.

On our patient floors, you may have noticed the red stop signs on some doors, indicating a patient who is a high fall risk. You may see staff members with their own gait belts on at all times, in case they need to assist a patient who is at risk for a fall. And you may notice rubber fall mats in place in some patient rooms.

These examples are just a few of the most visible parts of an effort to keep our patients safe by preventing falls. A variety of changes, combined with a heightened awareness of the issue, are going a long way toward improving a safety risk that is a common one for all hospitals.

The project, led by CoxHealth’s falls reduction team, is one of many quality and safety improvements throughout the system that have come about as part of our involvement with the Hospital Engagement Network, or HEN, which CoxHealth joined in 2012. The HEN, which includes the member hospitals of the Missouri Hospital Association, is a collaborative effort designed to address the most common causes of patient harm.

CoxHealth’s success with falls reduction gained national attention last summer, when our program was featured in a video produced by Hospitals & Health Networks Daily.

The project is just one example of how CoxHealth is using collaboration, staff-driven changes and continuous quality improvement projects to deliver quality care and keep patients safe.

“Patient safety is one of our values, and there’s a good reason for that,” says Connie Deck, administrative director of Nursing, clinical services. “Caregivers come to work to take care of patients, not cause harm. We want to do anything we can to anticipate what might harm a patient, and then make sure we prevent that harm.”

The HEN has set a goal of reducing harm to patients by 40 percent and reducing readmissions by 20 percent. For the falls reduction team, this meant reducing falls by 40 percent by Dec. 31, 2013. That was a big goal, especially for an issue like falls, which had been an internal focus in the past.

With so many variables and individual patient circumstances, staff members know that not every fall can be prevented. The team was tasked with creating standardized practices to reduce the chance of falls and limit injuries in the cases when they do occur.

Deck says participation in the HEN was key to formalizing efforts to reduce falls – allowing the team to access data from other hospitals and providing a network with which to share best practices.

“This effort has helped us hone our focus,” Deck says. The standardized measurement required by the project was a powerful step to creating positive change. “We had been measuring, but not in this format and not against others. The HEN project put structure around how we report and let us look at our data in a different way.”

The multi-disciplinary team – made up of physicians, pharmacists, physical therapists, and nursing staff – was able to participate in online discussion forums and Listservs with other hospitals. There, they could see what tactics were successful and they could ask and answer questions from other professionals in the field.

The falls reduction team participated in the HEN’s monthly reporting system, sharing the data they were tracking and looking at what other hospitals in the network were reporting.

“Before we had the HEN group, you would do the old-fashioned literature search to find what other places are doing,” Deck says. While literature searches still play a role, the HEN collaboration allows a real-time look at what is working for other health care providers.

In most cases, hearing from other hospitals validated what the CoxHealth team was doing. Other times, the HEN group offered ways to tweak our approach.

A good example is the use of floor mats, which can be key to reducing injuries when a patient has an unavoidable fall. Some units had tried the mats in the past and found them to be big, bulky and generally not a good fit for their daily work.

In participating in the online discussion, though, the team began seeing other hospitals having success with the mats. Deck says that was enough for the team to revisit the possibility.

When they talked to their counterparts at other hospitals, they learned that the mats in use were significantly different than what CoxHealth had tried in the past. The mats in use elsewhere are smaller and lighter, with beveled edges and reflective tape so they can be easily seen in a dimly lit room.

“There were upgrades to those products that we didn’t know about,” Deck says. “We might not have gone back and revisited those if we hadn’t seen the discussion going on in the Listserv.”

Those mats will be in widespread use at Cox South soon, playing a crucial role in preventing injury in the cases where falls can’t be prevented, such as from a sudden drop in blood pressure.

Throughout the falls reduction team project, the overall trend line for falls at Cox South has been steadily decreasing. By August 2013, CoxHealth met the goal of a 40 percent reduction in falls. Leaders say that improvement resulted from a combination of tactics, large and small. A few examples:

• Yellow bracelets and red socks for those who are a fall risk.

• Widespread use of the fall risk stop sign magnets and a “stoplight” system in rooms that provide a visual reminder of a patient’s risk status.

• Replacing the previous fall risk assessment tool with the Morse scale fall risk assessment tool and its corresponding interventions. The addition of the Cerner Lighthouse platform paved the way to use the scale, which was already in place at Cox Medical Center Branson.

• Addition of the most recent fall risk assessment to the nursing communication page – making it easy to see falls information at a glance.

The team also took a cue from other organizations in devising a way to involve patients and their families in the effort to reduce falls: the “Partnering with the Patient” agreement. The document reminds patients of the risks posed by falls and it reminds them to call for help if they need to get out of bed. Patients sign along with their nurse.

The team has implemented other steps as well, upgrading some safety recommendations to requirements. Previously, it was recommended that gait belts be available for staff use. In practice, though, a belt wasn’t always handy when a patient needed assistance. The falls reduction team made the decision to make gait belts mandatory, to be carried by staff members during their shifts.

The falls project has also led to the development of a standardized method of investigating the root cause if there is a patient fall. Any fall leads to a post-fall huddle, with staff, the patient and family. The huddle provides an immediate assessment of what caused the fall, how it could have been prevented and what actions can be taken to keep it from happening again.

Each week, managers will report on a “drill-down” they do if they’ve had a fall on their unit. Unit leaders look at why it happened, whether procedure was followed and what measures can be put in place to prevent another similar situation.

In addition to the sharing of best practices, leaders say participation in the HEN projects is helping teams use data to drive improvements. For example, Nursing has created a weekly flyer posted in all hospital units that breaks down the current numbers on falls, hospital-acquired conditions, infection rates and more. Deck says having that information front and center keeps patient safety in the forefront of everyone’s mind.

“Staff members care about their patients and they want those numbers to be good,” Deck says. “Staff members know their unit picture and they like having the flyer where they can see how the unit is doing. Every unit has to be successful for all of us to have that overall success. We want to build the overall pride in what we do.”

The wording also makes a difference – the flyer presents the data as “weeks since we have caused harm.”

“That really makes it personal,” Deck says. “Think about your mom, your grandma, your dad, your kids. Do what you would want others to do for your family. That puts a focus on patient safety in a way that numbers alone cannot.”

Constant improvement is a way of life in health care

Quality and safety have always been at the forefront of patient care, and now experts say hospitals are incentivized more than ever to pursue constant improvement.

Vicki Good, CoxHealth’s administrative director of patient safety, is on the front lines of monitoring where we stand on key performance measures and where we need to be in the future to serve patients and meet an increasingly complex set of requirements.

“Constant improvement is a way of life for health care. Consumers and payers want us held accountable and reimbursement is one way they do that,” Good says.

For systems like CoxHealth, staying on top of quality and safety means carefully measuring our performance, seeing how we compare with other providers and making changes to improve care and keep our patients safe. Good says hospitals are now influenced by measures tied to value-based purchasing, the cost-sharing program Medicare and Medicaid use with hospitals. Those measures include outcomes, processes of care (core measures), patient experience and efficiency of care.

It’s vital to provide high quality care all the time, but the data tracked in these categories gives hospitals a place to focus their improvement efforts.

The core measures include data on performance in areas such as heart failure, pneumonia, stroke and surgical improvement (SCIP measures). This data is all watched closely because of public reporting, and a subset of these measures affects CoxHealth’s payment structure.

Good notes that core measures look at processes: How often do you get an aspirin to a patient? How often does a patient get to the cath lab in 60 minutes?

“In order to add to the robust nature of quality, both process and outcomes must be measured,” Good says. Outcome-based measures used for value-based purchasing track how well do we do on 30-day mortality for events such as acute myocardial infarction, heart failure and pneumonia.

Under value-based purchasing, hospitals have part of their reimbursement tied to performance. Average performers don’t gain or lose money; low performers have part of their reimbursement withheld; and top decile performers stand to get money back.

“Hospitals are really focused on the measures in value-based purchasing because of the financial implications,” Good says. “All of these measures revolve around quality and safety.”

Under value-based purchasing, hospitals will be reimbursed based on a composite “patient safety index” score called a PSI 90. The composite score includes data on pressure ulcers, post-op hip fractures, post-op sepsis and a variety of other complications. Based on patient population and their risk, a prediction is made about how many complications a provider is expected to have. The PSI 90 score is a ratio of the actual number of complications compared with those predicted.

A score of 1.0 means that exactly as many complications as expected occurred. But the program is designed to encourage hospitals to beat those expectations. Currently, the median performance (required to be eligible for money back) is .62, while high performers have a score of .45.

Good says CoxHealth performed in the .28-.3 range in November and December, positioning us well for value-based purchasing. However, since all hospitals are striving to perform better than the median, everyone is chasing a moving target to remain in the group of hospitals that receive additional reimbursement.

That strict standard is producing significant improvements in hospitals nationwide. For central line infections, for example, a hospital must have fewer than .05 infections per 1,000 catheters just to reach the average, break-even level of performance.

Good says that watching these measures closely and constantly working to improve everything we do is vital to providing the best care for our patients.

“Just like with patient satisfaction, it’s not good to be 90 percent. An ‘A’ performance is below average on percentile,” Good says. “When you think you’ve caught up, others have caught up and gone further.”

Marie Pearl joins 'Food for a Woman's Heart'

The 2014 edition of Food for a Woman’s Heart, held Thursday at Touch Restaurant, drew a big crowd that helped raise money for the CoxHealth Foundation’s Cardiology Services Fund.

The event featured special guest Marie Pearl from NBC’s “The Biggest Loser.” Pearl, who has continued her weight loss by working out at The Meyer Center, talked about her journey and how anyone can make changes in their lives with determination and support from family and friends.

Dr. Robert Vorhies gave the keynote speech and Becky Watts spoke about the life-saving equipment that has been purchased with assistance from the Cardiology Services Fund.

Our thanks to everyone who attended and everyone who worked so hard to make the event a success!

Over-the-counter allergy medications warrant caution for some

Nasal allergy sprays can now be purchased without prescription; allergists offer advice as allergy season looms

The next time you’re at the local pharmacy, you may be surprised to see your prescribed allergy nasal spray available over-the-counter. Many drug manufacturers are pushing for this move to make finding relief easier for some of the 50 million Americans with allergies. However, Ferrell-Duncan Clinic allergists urge caution.

“Allergy sufferers may no longer need a prescription for certain allergy nasal sprays, but they might need an allergist’s advice,” said allergist Minh-Thu Le from Ferrell-Duncan Clinic. “Some medications merely mask symptoms without tackling the root of the allergy. And often patients will find a medication that once suppressed their symptoms, no longer does.”

The over-the-counter availability of these nasal sprays may lead to questions from allergy sufferers. To help eliminate confusion, Drs. Bill Micka and Minh-Thu Le, along with the American College of Allergy, Asthma and Immunology (ACAAI) have answered the seven most common questions:

1. Is it safe?
Not only can these OTC nasal allergy sprays relieve congestion, sneezing and a runny nose, they also do not cause drowsiness and are non-habit forming. Improper use of nasal sprays may cause nasal bleeding. Follow the package instructions and inform your allergist if bleeding occurs.

2. Can I stop antihistamines? If you find solely using the nasal allergy spray is helping to suppress your symptoms, you may not need to take an antihistamine. Each person is different and they will have to be the judge of how they feel only using one medication. However, if you’re not finding relief from one or both medications, you should speak with your allergist.

3. Is it safe to give my child? The medication is approved for children two years of age and older. But it may complicate some infections your child might have, so check with your allergist.

4. Can it be used year-round? Yes, it is approved for year-round use. Many allergy sufferers that have year-round allergies to pets, dust and mold often find nasal sprays are not enough for symptom relief. Many allergists prescribe immunotherapy (also known as allergy shots), which not only provides symptom relief, but can modify and prevent disease progression.

5. Will my insurance cover it?
It is unlikely your insurance provider will cover an over-the-counter nasal allergy spray, even if it was covered when it was prescribed.

6. Do I need to continue following up with my allergist? Allergy sprays are merely a medication and not a cure for allergy. Because allergies can change over time, it’s important to be under the care of an allergist for proper testing, diagnosis and treatment that may go beyond over-the-counter medications. Allergies can also cause symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.

“Allergies and asthma are serious diseases,” said Dr. Bill Micka. “Misdiagnosis and inappropriate treatment can be dangerous.”

Thursday, February 20, 2014

Leading the way for CoxHealth leaders

This month, we sat down with Dr. Bob Lunn, CoxHealth’s executive director of leadership development. Over the past year and a half, Dr. Lunn has developed CoxHealth’s Leadership Institute. For him, it’s the latest chapter in a career that has combined hands-on health administration and leadership as a university professor.

His path has led him from some of the nation’s largest academic medical institutions to Missouri State University, where he founded a Master of Health Administration program 15 years ago. He chuckles when he says that CEO Steve Edwards occasionally refers to him as a “wise old man.” The fact remains: you can learn a lot from a 30-minute conversation with someone who has spent more than 40 years as a leader and a trainer of leaders. Here’s a bit of what he had to say:

• I got into hospital administration by accident. During the Vietnam War, the draft drove me to a medical service corps commission and the rest is history.

• When I was first training, I remember seeing patients – especially little kids – who were really sick, and it was troubling to me. I wondered if I could do this long term. The more I got into it, the more I really got a heart for what was going on with patients. We trained right on the clinical floors with house staff and nurses, and that training made me sure I would never do anything else.

• I’ve been blessed to have a career that has combined academic work and hospital administration practice. Being able to do both is what I set out to do – it’s the only thing I’ve ever planned that worked out like I hoped it would when I was 25 or 30.

• I put myself through my MHA with three jobs, working as a guard at a juvenile correctional facility and working overnight in the blood gas lab at Duke. In the evenings after class, I worked as a dancing waiter – but not the Chippendales kind. The bartender and the wait staff at our club were all men and part of our job was to do dance routines – like The Temptations – and to dance with the women in the club. I was glad to get my MHA done and get just one job!

• As part of my life plan, I knew that around age 50 I wanted to run an MHA program. I looked all over the country for opportunities and the one that popped up was here at Missouri State. I was an attractive candidate to them because I was willing to start it from the ground up. I think I was the only one who would take that job (laughs).

• CoxHealth is so attractive because there’s a real commitment to developing leadership, even in a time when resources are tight.

• People are hungry here, they want the opportunity to train. We have our own college, we’re training our own professionals, and as we get involved with the MU medical school and the BJC Collaborative, we have the chance to become more academically oriented.

• To be effective as a leader, you need to have an authentic relationship with the people working close to you. Everybody has their battles; everyone has their scars. Great leaders know and appreciate the backstory and they’re effective in matching the skills of the people they work with to the needs of the organization.

• Leaders don’t have to be geniuses, but they have to be thoughtful and intelligent. They have to be able to analyze data, put things together and see patterns. And they have to have the willingness to lead.

• Great leaders have an intense curiosity, achievement orientation and a high level of conscientiousness – people who grab something and don’t let it go until it’s done. Leaders need tangibles – like critical thinking and the ability to solve problems – and intangibles, like force of personality, what you might call “sparkle” or “thrust.”

• You can get caught up in the drama and the details of doing your own job and you can forget that your main job is to make your boss more effective. We all have a boss and when you’re sensitive to how you can help the boss be more effective, your worth to the organization goes up dramatically.

• Leadership is a huge responsibility. You’re affecting lives – first our patients, and then the people who work for you. To do this poorly is a form of professional ‘malpractice.’

• With my kids grown up, my interests outside of work are mostly church-related. I’m chair of the board of trustees at Schweitzer United Methodist, and I serve as a Stephen Minister – counseling people through bad situations. To some extent the things I do outside of work are still work (laughs). If I had life to do over again, I’d learn to play golf!

• If I wasn’t doing this, I would probably be a teacher. Or maybe a nurse or a psychologist, working with people and helping them with their challenges. If I had it to do over again, I’d look seriously at that.

Hospital grants are another way CMN meets needs

When you think of how Children’s Miracle Network Hospitals supports kids in our community, you tend to think of the obvious: programs like the Child Life department, the CARE Mobile and the Baby Buggy. And, of course, the direct help they provide to families in need with meal trays, vouchers and travel expenses.

But there are behind-the-scenes ways CMN is helping, too. When you see a program or specialized piece of equipment that serves our young patients, there’s a good chance CMN Hospitals and their generous donors have played a key role.

This spring, CMN is preparing to distribute nearly $250,000 in grants to departments throughout CoxHealth, from the Neonatal Intensive Care Unit at Cox South, to Family Beginnings at Cox Branson and community outreach programs.

“Funding these projects is a more indirect way we give back to our community,” says Justin Bess, assistant executive director at CMN Hospitals. “People may think of us giving money directly to families, but if we can purchase a piece of equipment that will help 100 kids throughout the year, that can have a huge impact.”

Interested departments typically submit grant proposals for things that will benefit children, but may fall outside of the usual budgeting process. A committee of volunteers helps CMN leaders review the applications and decide how the funds will be distributed.

This year, CMN Hospitals has approved 26 proposals. Among the projects:

• Cox Branson Family Beginnings: $36,000 for jaundice meters, Panda infant warmers and scales, and a handheld hearing screening unit

• Cox Monett Labor and Delivery: $62,000 for three Panda infant warmers

• Cox South NICU: $64,000 for Atom Dual INCU equipment, vein illuminators, motion seats, incubators and specialized bed-attaching IV poles.

CMN leaders point out that even beyond the annual grants, when there is a need for children, they work to fill it. For example, one grant request was for a new, state-of-the-art isolette for the Baby Buggy, CoxHealth’s specialized ambulance for infants. The $95,000 price tag made it a challenge to fund through a traditional grant, but because the need was so great, CMN found a way to fund the project through its endowment, which helps fund the Baby Buggy program and the CARE Mobile.

“It’s all part of meeting the needs of our youngest patients, whatever those needs may be,” says Tim Siebert, executive director of CMN Hospitals. Siebert points out that in challenging financial times, distribution grants are key to giving departments what they need to provide the best care for patients.

“CMN Hospitals is here for kids and to make a difference,” says Siebert. “If we can provide a lifesaving piece of equipment, or fund a program that will have an impact in the life of a child, that’s what it’s all about.”

Radiothon set for March
Don’t forget to tune in to the 2014 Radiothon on Power 96.5 on March 6 and 7. The fundraiser will be broadcasting live from the main lobby at Cox South.

Patient voices inspire us at CoxHealth

From financial reports, to clinical quality scores, to employee and patient satisfaction survey data, several important tools are available to measure and track our organizational success at CoxHealth.

One of the most meaningful ways to gauge our progress that goes to the heart of our mission, vision and our values is hearing directly from our customers – our patients and their families. What they say about us regarding their experience with CoxHealth is important and powerful. It validates the effort put forth to deliver medical care in a way so that customers understand that we care for them, and it helps us improve when customer experiences fall short of expectations.

Besides the patient satisfaction survey results themselves, other methods capture this voice of the customer – comments that can illuminate the specific words, attitudes and behaviors that make up an exceptional hospital or clinic experience. These methods include the Contact Us form on, word-of-mouth stories shared with a co-worker, and Guest Services and Administration staff who receive calls and notes from our customers on a regular basis.

“Our customers are talking and it is important to listen to what they are saying,” says Jennifer Pyck, Guest Services manager. “Hearing positive feedback is a source of pride, inspiration and celebration to recognize high performance in service and as a catalyst to do an even better job for our customers.”

Pyck says staff members always appreciate hearing patients and families express a compliment about their care at the time of service, and it’s especially impactful when the customer makes the extra effort and takes time to write or call after their visit.

Pyck and her team enjoy passing along customer comments to those areas that played a role in a particular patient’s care and to the Corporate Communications team as a Connect Daily submission for the Voice of the Customer segment. Some of the letters and cards are placed in a booklet called “From the Lives We Touched,” which is published every year or two. Copies of the latest edition are available at Cox South Administration.

“We get a lot of comments and I love sharing those messages highlighting the positive experiences of our patients and families,” says Pyck. “It confirms what a great organization CoxHealth is and reminds us what we’re here for and the great things we are doing as a team. Every person who comes into contact with our customers can shape perceptions of CoxHealth. Everyone has the ability to make that lasting impression.”

Pyck says it’s usually the little aspects of a patient’s care that can make or break an experience. How well we communicate with patients and families is a consistent theme in customer compliments as well as customer concerns.

“Communication makes a world of difference,” says Pyck. “For example, if a patient has a delay, as long as they are told about the reasons for the delay, they are put at ease and they feel like they are respected. Our effort to keep people informed of what’s going on with their care makes a huge difference in how they perceive their care. Feeling well informed is one of the ways patients feel well cared for. They feel we are on top of things.”

When you read through customer comments, you get a picture of what is valued by our customers and ultimately, the words, behaviors and attitudes that should be incorporated into our everyday work. These comments can encourage us, reignite our fire for the work we do and remind us that it takes both our hands and our hearts to be the best for those who need us.

Our customers speak
From feedback given to Guest Services: “My daughter was seen in the emergency room after an ATV accident. I was very impressed with the upbeat, friendly people who worked there. I did not once come in contact with one negative person. As with all emergency rooms, there was waiting, but the pleasant people all around made it nice.

Not only were the nurses attentive to me, but every time I saw one, they asked my family who were with me if they were OK or if they needed something as well. I will always recommend CoxHealth to anyone who asks. Thank you!”

From a “Contact Us” message: “I have been sick for 15 years and I have never felt as satisfied to leave a doctor’s office in my life. She cared, she listened to me. I got in my car and started crying! She was amazing and doctors like her are so rare. I called my husband, mom, and sister, everyone to tell them about it. I can’t wait to see her again. The fact that she listened just means the world.”

From a patient compliment to Cox Monett: “If there is such a thing as ‘a pleasant surgical experience,’ then I had one on the morning of Oct. 7 in your fine hospital, thanks to the professionalism shown and the warm confidence felt. I was completely at ease through the whole procedure. Thanks to Dr. Harms, nurse Rhonda and all of your capable staff.”

A patient’s mother called Guest Services at Cox South to share the experience she had while her son was a patient: “The nurses and staff in the NTICU were awesome. When they came into the room, they explained everything they were doing. They answered every question we had and they answered in a way that we could understand. They were kind and brought us some cookies and fruit to snack on. One of the nurses really impacted me because when she came in to reposition my son she used the nickname our friends and family always used, and this was so special to me. Brian was awesome: there were days that I wanted to curl up and hide because I could hardly stand what was happening; Brian was so good and kind that he made this terrible situation livable. Brian even came upstairs to be with us while my son passed away. Every person I encountered at Cox went above and beyond; money couldn’t buy what they’ve given us.”

From a letter to Cox Medical Center Branson: “Just a note to let you know how much I appreciate the lab at the heart center. Both Kara and Beth are wonderful at their jobs. No matter how busy they are, they always have time for their patients. Thanks for your support of these ladies.”

From patient survey feedback for the Cox South Emergency Department:
“Staff with great people skills. They paid attention to the fact that they had the air conditioning way too low for somebody of advanced years like my mom and they did something about it. Great people skills, great listening skills, very, very attentive, very good at communication, very good at answering questions.

I’m a caregiver and I have a lot of questions for medical staff. They did great and did not treat me in a demeaning way or make me feel that I was not of value.”

From a “Contact Us” message through “I was at the Pediatric Urgent Care with my daughter. From the moment we walked in the door I was amazed. Everyone I came into contact with was wonderful and friendly and seemed to genuinely care about their jobs.

My daughter had been to see her regular doctor where we are from, but Dr. Kumar and his nurse, Lori, took very good care of my daughter. She was taken care of very quickly and I love the way she was treated. She has since decided that if she gets sick again, then we have to drive the 80-plus miles it would take to get her to CoxHealth so that she can be seen by your doctors. Thank you so much for taking such wonderful care of my daughter!”

From a letter sent to Oxford Hospice by a patient’s family member: These two ladies are jewels! Alicia F. was our assigned nurse. She did everything she could to make my husband comfortable. She knew he was in a great deal of pain and did everything she could to reassure him and prepare him for what was going to happen. He waited for her to get there to take his last breath. Amy K. was our on-call nurse and was there within a moment’s notice. She was always pleasant and truly wonderful with us. She was very gentle and caring. She has a big heart and cares not only for the patient, but also for the family.”

From a letter by the family of a patient at Cox South:
“Our family would like to take this opportunity to thank the entire staff of 900 West for the tender, compassionate care they have given our family member. Because she has been on the floor for a week, the staff had an opportunity to get to know her. Each staff member has been wonderful. Not only have they wonderfully cared for her, but they have been considerate and kind with our entire family and friends. You should be very proud to have such a great staff.”

From a patient call to Guest Services, Springfield:
“I came in to the Radiology Care Unit for a bone marrow biopsy. My nurses, Amy and Lisa, were wonderful. Dr. Roberts was great, too. The care I received was unreal. They were the kindest people I have come across yet. They really went above and beyond.”

Councils offer patient perspective

Members of the Patient Family Advisory Council study a Continuous Quality Improvement daily management board on the third floor at Cox South. The council recently did a series of Gemba walks led by Scott Rogers, administrative director, organizational development, to see how departments approach performance improvement.

We see every day how complex health care is, with collaborating departments, complementary fields of practice and many experts required to care for those who need us. Ultimately, all the complexity, and all of our work, is in service of one thing: our patients.

We’re all striving for patient-centered care, but how do we really hear from patients and see things from their point of view? A new Patient Family Advisory Council (PFAC) is now formalizing that process, offering leaders and staff members access to a patient perspective. The council, now in place at Cox South and Cox Monett, is designed to give voice to patient concerns and to improve collaboration between caregivers, patients and families.

“Our goal is to create an environment where patients and family are seen as part of the care team,” says Jessica Lightfoot, Guest Services patient advocate and coordinator of the PFAC at Cox South. “We want open and honest communication – being willing to talk about opportunities for improvement is important for changing and improving the ways we provide care.”

The council was founded in April 2013 and is made up of participants – CoxHealth volunteers, employees and community members – who have been patients or patient family members. The group meets one evening per month to discuss issues affecting the patient experience and learn about efforts to improve care and service throughout the system.

The PFAC is a key resource for departments as they undertake projects that will affect patient care. Departments are able to seek the council’s input on a project; council members brainstorm possible approaches and then present solutions over the course of 2-3 meetings.

Lightfoot says that, so far, improving communication with patients has been a common theme. One recent example is a project in the CCU/MICU. The unit was working on new welcome information for patient families and approached the council for input. The PFAC reviewed the welcome packet – asking questions like: what information needs to be included? Is this presented in a way the average person can understand it?

All of those efforts to improve communication can help reduce the time staff members spend individually answering common questions.

The PFAC has partnered with leaders on the unit to help staff members coordinate their ongoing communication with families during a patient’s stay.

“Families need to know that we want to keep them in the loop of their loved one’s care, but every time we answer a phone inquiry about a patient, it takes away time from patient care,” Lightfoot says. The unit is currently tracking the volume of family phone calls on their Continuous Quality Improvement daily management board.

“We’re working to meet most family needs and still facilitate bedside care.”

At Cox Monett, the PFAC is similarly focused – their council has been working with administration to examine the communication the hospital provides to patients and visitors, with an eye toward making sure information is easy for patients and families to understand.

“We want to make sure patients have positive outcomes and communication is a big part of that,” says Leichelle Cotney, who coordinates the Monett PFAC. “And, for our members, the council gives them ownership in the hospital and the things going on here.”

The Monett council is currently working on a new patient handbook for the hospital and they’re advising on signs and wayfinding in the parts of the facility that are currently being renovated.

All of the projects, along with several more coming up in 2014, are small, coordinated steps in the ongoing pursuit of excellence. Improving patient care and customer service requires constant evaluation of how we’re doing and what we can be doing better. Lightfoot and Cotney agree that the councils are a key tool in making every patient’s stay the best it can be.

“We want to be the best. We’re doing a good job, but we can always do better,” Cotney says. “Any tool to help us meet that objective is to the benefit of everyone.”

Friday, February 7, 2014

New stroke prevention guidelines are just for women

CoxHealth expert says women’s risk factors differ from those in men
Stroke kills twice as many women each year as breast cancer, yet most women are unaware of the risks. In a step to raise awareness and highlight stroke risks unique to women, the American Heart Association has issued new guidelines for the prevention of stroke in this group.
“Factors such as diabetes and high blood pressure during pregnancy can increase a woman’s stroke risk,” said Debra Mergen, CoxHealth Stroke Center coordinator. 
       According to the AHA, the following risk factors are more common in women than in men, or indicate a higher stroke risk:
· high blood pressure
· migraine with aura
· atrial fibrillation (an abnormal heartbeat)
· diabetes
· depression
· emotional stress.
To help manage stroke risk in women, the AHA recommends that pregnant women with chronic high blood pressure or previous pregnancy-associated high blood pressure receive risk-lowering therapy during pregnancy. The recommendations also include screening women for high blood pressure before prescribing birth control pills, and strongly recommend that women who have migraines with auras stop smoking. 
 Mergen says the new guidelines offer valuable information for women of all ages. “It is important to improve stroke awareness in younger women to reduce their risk of future stroke,” she said.
The CoxHealth Stroke Center is the only stroke program in Springfield to receive the American Heart Association Get With The Guidelines – Stroke Gold Plus Quality Achievement Award, and CoxHealth is the only health system in the Ozarks to be named to the American Heart Association/American Stroke Association’s Target: Stroke Honor Roll. CoxHealth was among the first hospitals in the U.S. to earn The Joint Commission’s Gold Seal of Approval for certification as a Primary Stroke Center.
For more information about stroke diagnosis, treatment and prevention, and patient stories visit

Wednesday, February 5, 2014

New treatment offers options for heart patients

CoxHealth is the first health system in the region to offer alternative to open heart surgery

Until recently, patients with severely clogged arteries known as chronic total occlusions (CTO) had few treatment options. Traditional minimally invasive angioplasty is unsuccessful for patients with this condition, leaving bypass surgery – and its risks and lengthy recovery time – as their main course of action.

Thanks to CoxHealth, local patients with this condition now have a minimally invasive option. Physicians are using the Crossboss and Stingray Coronary CTO Crossing and Re-entry system to attack these blockages from behind, through smaller arteries, so they can maneuver past the blockage and restore blood flow.

“Heart disease is the number one killer in the U.S.,” said Becky Watts, administrative director of CoxHealth Cardiovascular Services. “Opening partially blocked arteries through angioplasty, using a small balloon and a stent, has been the traditional treatment. But with CTO patients, angioplasty isn’t an option. With all our tools and technology, these blockages were so complete that we simply couldn’t get through.”

That left invasive bypass surgery, where a blood vessel is grafted to direct blood flow around the blockage, as the treatment of choice. Bypass surgery is risky, and recovery can take months. With this new procedure using the Crossboss and Stingray system, patients get the benefits of a minimally invasive procedure, and can be out of the hospital and enjoying some of their favorite activities in just a few days.

“More than 30 percent of patients referred for angioplasty have at least one CTO. This procedure allows us to give them the best, cutting-edge care,” said Watts.

CoxHealth began offering the treatment in June 2013.

Fun event raises awareness, supports women’s heart health

Annual "Food for a Woman's Heart" luncheon features special guest Marie Pearl, recent contestant on NBC’s "The Biggest Loser"

According to the CDC, heart disease is the leading cause of death in women. Yet with proper diet and lifestyle changes, it is largely preventable. During CoxHealth’s annual Food for a Woman’s Heart luncheon, women can learn how to reduce their risk.

This year the event, which raises money for the CoxHealth Foundation’s Cardiology Services Fund, will feature special guest Marie Pearl. Pearl, who recently competed on NBC’s The Biggest Loser, will participate in a red dress fashion show, and share her story of developing a healthy lifestyle – and a healthier heart. 

Food for a Woman’s Heart also includes a delicious meal from Touch Restaurant, a bag raffle, an auction of heart-shaped boxes filled with goodies by local female celebrities, and a lively talk about heart health with vascular surgeon Dr. Robert Vorhies. The event is Thursday, Feb. 20, at Touch Restaurant, 1620 E. Republic Road, in Springfield. Doors open at 10:30 a.m. 

Tickets are $20 per person for general admission, or $25 for VIP seating. For more information or to purchase tickets, call the CoxHealth Foundation at 269-7150 or visit