Striving for excellent patient care

On 700 East, PCAs Megan Cloyd and CJ Rogers respond to a call light above the door to a patient room. Many areas will soon add “no pass” zones, which remind all staff members to respond to call lights in person, regardless of their role on the unit. 

Yvette Williams has worked closely with CoxHealth's Experience Excellence team to research the best tactics for providing great service. In this column from CoxHealth Connection, she details a few ways we're working to offer patients the best service:


Thinking about CoxHealth’s stroke care, two words come to mind: compliance and consistency.
Earning national recognition as a Joint Commission accredited Primary Stroke Center and becoming one of only 91 health systems in the nation to earn the Stroke Gold Plus Performance Achievement Award doesn’t happen by accident. It requires every single person who works with patients to have a high degree of consistency and compliance with a set of evidence-based practices. The goal for our stroke care is zero defects, which means providing the same high standard of care to every patient, every time. 

We can apply the same formula of compliance and consistency as we strive for excellence in service. Given CoxHealth’s strategic goal to be in the top 10 percent nationally in HCAHPS patient perception survey scores and that survey’s emphasis on the Top Box score of “Always,” the goal once again is zero defects. 

Reaching and sustaining our service goals will require everyone’s compliance with a set of behaviors and attitudes found in the delivery of excellent customer service and everyone’s consistency with those behaviors with every patient and family member, every time. 

How can we successfully shape patient perceptions of our care? The HCAHPS survey is behavior based, asking patients how often certain behaviors were performed and CoxHealth’s goal is to have the answer be “always.” Meeting that goal means the emphasis will be on us, our words, actions and behaviors. This will definitely take a team effort, which is exactly the direction Dr. John Duff, CoxHealth senior vice president and chief hospital officer, gave to a group of Experience Excellence team members. 

The group was asked to research best practice behaviors that have been shown to improve patient perceptions around certain HCAHPS dimensions, focusing first on two key areas – responsiveness and quietness. An education program was developed that included two videos, one for each dimension. The videos feature staff members in skits that demonstrate the six responsiveness tactics and five quietness tactics we identified. 

This spring, 300 nursing, ancillary and support services leaders were trained on these tactics. Then, leaders were asked to hold staff meetings to introduce them to employees and begin to monitor their use. Later this year, more educational programs will be developed to focus on the other key HCAHPS dimensions. 

Fortunately, these tactics are not new to CoxHealth. As you’ll see, these behaviors have already been implemented to some degree in several areas of our hospital services. The key now is to apply these tactics consistently among the entire patient care team. 

During a shift change in the Emergency Department at Cox North, nurses Tiffany Schneider and Nick Osborn talk with Hugh Harvey and his daughter, Devannie. Staff members in the North ED are now conducting bedside shift handoffs so patients can meet their new nurse and ask any questions they may have. 

Responsiveness 
Patients equate quality care in part with our responsiveness and courtesy. How quickly staff members respond to patient requests and needs throughout the hospital stay is one of the top predictors of overall patient satisfaction. An emphasis on improving responsiveness is already under way in several hospital units. 

Tactic No. 1 – Face-to-face response to call lights. One way of making responses more personal for the patient is to respond directly to a patient’s room to turn off the call light instead of answering the call light at the nurses’ station. 

400 West put this tactic into practice earlier this year. Donna Miller, unit secretary, says the change was difficult at first, but staff now see how this tactic is making a difference in the unit’s responsiveness. 

“We’d find that sometimes we’d answer the phone and then on the way to the room, we’d get sidetracked by another patient need,” says Miller. “Now we’re more responsive and able to respond to all our patients’ needs much faster.” 

Tactic No. 2 – No pass zones. All hospital units will become no pass zones where everyone on the floor is asked to respond to call light needs without passing by a room except when isolation or security reasons exist. Patient care assistant Sherri Elkins says a version of this tactic is already in use on 700 East. 

“We really look out for each other,” says Elkins. “If we see call lights going off and it’s not ours and we’re passing by, we just stop and answer it, that way we help each other out. We’re a team up here.”
To deploy this tactic, staff from ancillary and support services departments will be asked to respond to call lights. Phlebotomist Jamie Mast says she already responds when she’s on the way out of a unit. 

“I just walk in and introduce myself and turn off the call light. Then I ask the patient what they need. Usually it’s something I can take care of but if not, I tell the patient I have to get the nurse or PCA. I always come back and tell the patient what I did and that help is on the way,” says Mast. 

For those of you who might be uncomfortable answering call lights, it’s important to know that research shows 80 percent of the call light needs can be taken care of by anyone. Phlebotomist Rowena Hull finds this to be true. When she’s finished drawing blood, she asks if there’s anything else she can do. 

“Sometimes they have something little they want, like they can’t reach their tray, or their cell phone has fallen on the floor or they can’t reach their phone or their menu,” says Hull. 

Ancillary and support services staff should respond to call lights only after taking care of the patient they were helping originally. You can tell when a call light has been activated when the white light on the top of the light bank above a patient’s door is on. 

Tactic No. 3 – Caring rounds. This tactic is Nursing’s hourly rounding protocol. Consistent use of hourly rounding can actually reduce call lights. 

Coby Smith, nurse at the Meyer Orthopedic Center, says his goal through caring rounds is to keep patients informed. “I introduce myself and tell them a little bit about myself to make them feel comfortable. I tell them what they can expect for the day and about the time frames. I always ask them what else I can do for them in that moment, whether it’s bathroom, position, pain needs or just to find out if they have a concern about anything. It usually puts them at ease and shows that I do care.” 

Tactic No. 4 – Key words. Smith uses another tactic during his caring rounds: key words at key times and the AIDET method of communication, which stands for Acknowledge, Introduce, Duration, Explanation and Thank you. 

Key words are verbal signals of actions being taken for the patient that explain what you are doing and why. CCU/MICU nurse manager Lenny Shepard says his staff is getting into the habit of using AIDET in critical care, where families generally experience anxiety related to not knowing what the machines and monitors do or what the alarms mean. 

After acknowledging the patient and the family and introducing themselves, staff members are describing and explaining what they are doing and how long an intervention should take. They also encourage questions. Our consistency with key words and explanation can positively influence patient perceptions. 

“I just had the wife of one of our patients stop me to tell me how wonderful and how at ease she has been since all the nursing staff has explained everything happening and every medication they are giving,” says Shepard. “I have witnessed AIDET throughout the unit and I’m very excited about the success.” 

Tactic No. 5 – Check before you go. This tactic asks staff to assess a patient’s bathroom needs before leaving the room or before transporting a patient to another area. 

Tactic No. 6 – Bedside shift report. This tactic involves holding the shift handoff at the bedside to reassess and engage the patient regarding how well we’re responding to their needs. Staff members in the North Emergency Department were reluctant at first to use this tactic, but patient care manager Rachel Wells says they now see the value in it. 

“It forces us to have more face time with the patient and then the patient knows who to ask for as soon as the switch is made,” says Wells. “Patients seem to like it because they’re more informed.”

Quietness 
Rest is an important part of a patient’s recovery, but hospitals can be noisy places. Patients who can’t sleep due to noise or bright lights may be more irritable and anxious, which may negatively affect healing and a patient’s overall experience. Several departments have already deployed these tactics and others to promote a healing environment. 

Tactic No. 1 – Close the doors. Unless a safety concern exists, staff should close doors to protect privacy and reduce noise. 

Tactic No. 2 – Bunch tasks when possible. When possible, staff should “bunch” certain nighttime tasks so they can be performed at the same time. Patients won’t have to be repeatedly disturbed and our care will appear more coordinated. 

Tactic No. 3 – Offer sleep kits. Sleep kits are available on hospital units and should be offered to patients routinely. These kits provide tools such as ear plugs and masks to help patients get better rest.
700 East nurse manager Kim Cash says after hearing about this tactic, staff began offering them to patients. “I’ve seen multiple patients on the floor with those sleep masks, so I’m excited to see them wearing them even in the afternoon!” 

Tactic No. 4 – Reduce staff noises. Sometimes the cause of the noise is us. Staff voices can be very loud, especially at night and we can play a major role in reducing noise by keeping voices down when speaking in patient care areas. Nurse manager Lorinda Rehagen says night staff members on 700 West do a good job of helping each other keep noise levels down. 

Tactic No. 5 - Key words at key times. This tactic can also help staff explain why we care about maintaining a quiet environment and why some activities must be performed at night. 

Some units aren’t stopping at these tactics to offer a quiet environment. Several hospital units offer nap times, when lights are dimmed and staff voices are subsequently lowered, during the day. In a pilot project, nurses on 700 East wear pagers that send specific instructions about patient needs to nursing staff without the use of overheard paging. This also improves responsiveness. On 900 West, new sound-masking machines are helping decrease noise. 

Just imagine what our patient care areas will look and feel like if everyone is practicing these same behaviors and tactics. Our patients will see and feel a consistency in our efforts to create an experience that emphasizes responsiveness and quietness, making it more likely that their perceptions will be that we always made these important factors in their care a priority. 

Pedestrians, drivers need to exercise caution

CoxHealth Trauma Services has noted an increase in the number of vehicle vs. pedestrian accidents over the past few months in Springfield and surrounding communities. A number of these cases have been fatal.
“Most of the victims have been in their teens and early 20s,” says Jami Blackwell, CoxHealth Trauma Services coordinator.
Blackwell attributes the increase to a number of factors, including warmer temperatures and healthier lifestyles causing more people to walk, run and bike along area roadways. That, combined with drivers who are often distracted by texting or talking on cellphones, can lead to serious, and sometimes fatal, accidents.
“We want to remind everyone of the precautions they can take to stay safe,” she says.
Blackwell also urges staff driving on CoxHealth property to exercise caution.
“There have been several close calls in our parking lots, particularly at Cox South along the southern edge of the parking lot immediately north of James River Freeway,” she says. Blackwell says cars routinely drive this route at speeds in excess of 20 mph, and there have been several instances where cars have nearly been hit when pulling out of parking spaces, and when employees walking to their cars have almost been struck by vehicles passing by too quickly. 

Safety tips for walkers, runners and bike riders:

• Be aware of your surroundings, and make eye contact with people driving vehicles near you.
• Avoid texting, talking on your cellphone and listening to music.
• Cross at crosswalks and obey all traffic signals and signs.
• Wear bright, reflective clothing, especially at night.
• Don’t step off the curb between parked cars.
• Parents should be near small children at all times when outside in areas where moving vehicles may be present.

Safety tips for drivers:

• Don’t text or talk on a cellphone while driving.
• Pay attention to your surroundings and make note of any pedestrians in your vicinity.
• Be especially mindful in neighborhoods where children may play outside and in parking lots. 

Improving the ER flow at Cox Monett

In the Cox Monett ER, charge nurses Julia Eden and Margaret Kleiboeker check the patient tracking board, which offers an at-a-glance view of work under way in the department. The board was recently expanded to include more details about what tests have been ordered and which are complete. The changes were one part of a lean project aimed at coordinating care in the department. 

The culture of an emergency room is, by definition, fast-paced; when problems present themselves, people move quickly to solve them. That approach is ideal when you’re dealing with acute, immediate issues like injuries and illnesses. But taking on broad challenges, like improving patient flow in a busy ER, requires a different approach.

Since February, staff members in Cox Monett’s Emergency Department have been improving the way they work through a lean project that is focused on throughput and workflow efficiency. For those who have built a career in emergency care, the systematic approach of lean has been a major shift of gears. 

“The pace is very logical and methodical, but you have to do it,” says Beverly Morris, nurse manager in the ER. “It’s tough for fast-paced ER types to slow down and take a step back.” 

Over the past few months, the lean team has helped staff members do just that. They’ve been examining how patients experience care in the ER and looking at ways to streamline their work to reduce wait times. At the same time, staff members have become versed in the methodology of lean, which requires carefully mapping all the steps in a process and looking for waste that can be eliminated. The team has gathered people from a variety of departments to look for ways they can work together to improve care and the patient experience. 

“We’ve spent a lot of time understanding the current situation,” says Genny Maroc, president of Cox Monett. “This is a very data-driven approach to build the business case for the project.” 

The lean project continues this summer, but so far the measured, big-picture approach is paying off for staff members and patients. 

When the project began last winter, it was designed to improve throughput and efficiency in the ER. About 1,200 patients visit the Cox Monett ER each month and that number is up by 5.2 percent over this time last year. As the volumes rise, so does the number of patients who leave without being treated. If the lean team could find efficiencies and reduce that number, it would have a two-fold benefit: improving satisfaction, for both patients and employees, and capturing revenue for the system. 

Early on, Morris says it was clear that the issue of throughput was an “elephant-sized” problem; to address it, it would need to be broken into smaller parts. The lean team began looking at the door-to-door times: how long it took from a patient’s initial arrival at the ER until they were discharged or admitted. 

Maroc says the data indicated that if total door-to-door time could be improved by 20 percent, it would cut out 30 minutes from each visit. That, in turn, would allow the ER to serve 700 more patients per year. 

To begin getting a handle on how to make that improvement, the team further broke down the patient experience. They focused on the first half of that door-to-door process: the time spent between patient arrival and the work done by ancillary services such as laboratory, radiology and respiratory care. That timeframe, called “door-to-ancillary complete,” would be the first target for improvements. 

In a relatively small facility like Cox Monett, many ancillary departments multi-task, managing their own outpatient volumes and duties in the hospital with working in the ER as needed. 

It can be tough to coordinate the ancillary work in the ER, especially if a patient needs assistance from multiple departments. 

“When respiratory care, lab and X-ray all respond at the same time, it can disrupt a smooth patient flow,” Morris says.  

The lean team identified two major solutions, or countermeasures, they could put in place to improve that flow: an enhanced computerized tracking board and adding a patient flow coordinator. 

The ER already had a computerized tracking system, but the team worked with staff members to identify improvements that could make it a more effective tool for coordinating all of the work that takes place in the department. 

Jeff Graham, applications technology manager in IT, worked with the team to add new features that offer more detail about what tests have been ordered and how close they are to completion. 

The ER tracking board now shows four new icons: CT/ultrasounds; urinalysis orders; in-house labs; and labs that have been sent out. In the past, a column for labs on the tracking board might have shown, for example, that eight labs had been ordered and six were back. What it didn’t make clear is that the remaining two were sent out- of-house. Now, the board shows how many labs have been ordered; a hospital icon indicates they are in-house, while a bus icon indicates they have been sent out. 

“The tracking board has been a great success,” Morris says. 

The icon for urinalysis orders provides a quick visual cue for everyone in the department, letting them know which patients require a urine sample. Staff members can then easily check in with waiting patients and collect the sample when patients need to use the restroom.  

In addition to the new levels of detail, ancillary departments can now see tracking board information from their desktops, which helps staff members see when the ER is getting busy and where the ER staff is in its workflow. 

“They can see our volumes and know when to expect orders,” Morris says. “They used to look at individual orders on the computer, but now they can just pull up the whole tracking board.” 

As a second countermeasure to help coordinate care, the department was getting set to try a new position beginning in late June: an ER flow manager. The flow manager (a nursing staff member) will be responsible for knowing the status of all patients in the ER and triaging the workflows; knowing which patient the physician needs to see next and coordinating the work of ancillary departments for maximum efficiency. 

“In the past, you’ve had three nurses telling the doctor information; one nurse doesn’t know what the others have shared,” says Heidi Clark, house supervisor. “This position, with one person aware of everything, may fix that.” 

The flow coordinator will also have access to a new push-to-talk phone system similar to the ones in use in the Cox North and Cox South ERs. The phones will allow the ER to have instant communication with ancillary staff members.  

“When the patient orders go in, the flow manager can push a button and talk to lab and X-ray staff together and instruct lab to come first, followed by X-ray. There is no phone call to interrupt workflows,” Morris says. 

In late June, the department was going to do three test periods with a flow manager to collect data to see how much difference the position makes. 

In addition to the major countermeasures, the lean project has also uncovered some simple fixes that have made work flow more smoothly. One example involves the location of printers that produce the printed orders for lab and radiology. In the evenings, there are fewer techs in those departments and they may be working in the back and miss an order that prints out in the front of the office. The solution? Move a printer into the back of the department, so orders print where staffers are in the evenings. 

Charge nurse Julia Eden says those simple changes that make things smoother for employees can do a lot to improve employee satisfaction. 

“Sometimes, patient frustrations are more easily seen, but it’s frustrating for staff, too, when there are delays and inefficiencies,” she says. “A lot of these changes help us work smarter, not harder.” 

Pat Blamey, director of Radiology, says the lean team meetings were a chance to boil down the steps in the patient experience and better understand the challenges faced by  each department. Just by talking to one another, the group was able to find ways to be more efficient. 

For example, Blamey says ER staff members had developed a workaround to cope with the wait times for radiology films to be read. After a test was completed, the film would be read at Cox South. ER staff get the results by calling a dictation line, but staff members reported that they often had to listen to a couple of unrelated results to get to the one they needed. 

“When I heard that, I asked them, ‘Are you using the shortcuts?’” Blamey says. “It turns out that they had lost those instructions. So we printed new ones!” 

Also, ER staffers didn’t know how quickly their films would be read. They didn’t want to call twice, so they would wait to make sure the results would be ready by the time they called, which caused delays.

“Someone else in the room pointed out that there is a fix for that – an IT solution that would group your orders and let you see when they have been completed,” Blamey says.

Staff members say the opportunity to sit down with co-workers from across a variety of departments to talk about the patient care process and work on solutions together is a big part of the power of a lean project. 

“It’s eye-opening for everyone to see how things affect other departments. As much as areas like lab, ER and radiology work together in the interest of the patient, we tend to work in our own segmented groups; we know our processes but we don’t know 100 percent what their processes are,” Clark says. “Very seldom do we have meetings with all of those entities present at the same table. You get a better understanding of what everyone has to do and it makes it easier to work together as a team for the patient.” 

Having everyone at the table working together has produced a clear understanding of the ER’s needs and it has allowed the team to prioritize the improvements they’re considering. Meanwhile, the lean project has provided a data-driven framework for assessing those needs and tracking the effectiveness of the countermeasures, which justifies the investment some improvements require. 

“Some of these ideas are ones people have had for a while, but lean has allowed the right people to be involved to make these changes,” Clark says. “It’s allowed us to move forward and make those ideas a reality.” 

In the coming months, ER staff will be studying the success of improvements like the tracking board and the flow coordinator. They’ll also be working on smaller changes, such as adding color-coded flags for each patient room, to indicate quickly and visually where a patient is in the process.

As the project heads into its final stages, participants say the fast pace of their daily work is improving as a result of decisions made in the methodical lean process. Their advice for other departments who are about to embark on a lean project? Be ready to change the way you think and be willing to follow where the lean process takes you.

“You have to let the process guide you. With the meetings and the tools you’re given, it’s like the lean team is in a boat, in a river, and it will take you there; you have to not paddle against it,” Morris says. “I’m used to paddling, but you have to float.”

 Going with the flow of a lean project is easier when everyone remembers that the goal is to keep the patient at the center of everything we do.

“You have to be open-minded,” Eden says. “People are afraid of change, but this is about a better work environment and it ultimately will make patients happier.”
About lean 

Lean thought has its roots in a process improvement discipline developed by Toyota. While it began in the world of manufacturing, the lean approach can be used to examine and improve a variety of work processes. Here are a few of the terms you’re likely to hear as lean projects are deployed at CoxHealth:
Muda: A Japanese term for an activity that is wasteful and doesn’t add value.
Gemba walk: When leaders examine first-hand how work is done on the front lines. They’re visiting “gemba,” or “the real place” in Japanese.
Value stream: All the steps in a process of producing or delivering a product or service. Value streams are mapped to show the flow of information and work in the process. How work is carried out at the beginning of a lean project is defined on a current state map while a goal for how processes could be improved is spelled out in a future state map.

Help CoxHealth “Stuff The Bus” for Springfield school kids

Did you know an overwhelming number of students in our community do not begin the school year with basic supplies for their education? Simple items that some take for granted like pencils, crayons, paper, or even backpacks to carry supplies are unavailable due to limited family resources.

You can make a difference to help give school children in Springfield a great start to the school year.

CoxHealth is partnering with James River Assembly, Care To Learn and Chick-fil-A for an event called “Stuff The Bus” from 11:30 a.m. – 1:30 p.m., Friday, July 27, 2012 on the Cox South campus.

With your help, the goal is to literally stuff a school bus – floor to ceiling, front to back – with school supplies for children in need who attend Springfield Public Schools!

Supplies to bring to provide one child with a backpack full of school supplies include:

· Backpack

· School box

· Crayons (24 count)

· Glue sticks (2)

· Glue Bottle

· Scissors

· Pencils

· Eraser

· Spiral notebook

· Pocket folders (3)

· Composition notebook

You can bring enough supplies to stuff one backpack or provide what items you can. We appreciate any donation of items on this list!

The “Stuff The Bus” school bus will be parked on the parking lot near the southwest corner of National and Primrose near the former emergency room.

For participants at Cox North

Do you work at Cox North and want to participate in “Stuff the Bus” at Cox South this Friday? No problem! Thanks to Dan Morton and his team in the Mail and Shuttle Services departments, mail shuttle vans will be available to transport your backpacks filled with school supplies to Cox South.

Just bring backpacks to the Cox North receiving dock at the end of the old ER alley off of Robberson at least 15 minutes before any of the times listed below and the shuttle drivers will deliver them to the school bus!

Cox North “Stuff The Bus” shuttle times

Friday, July 27

· 4:45 a.m.

· 7 a.m.

· 8:30 a.m.

· 9:30 a.m.

· 10:30 a.m.

· 11:20 a.m.

· 1:05 p.m.

Also, the school bus will stop by the Cox North campus at 1 p.m. Tuesday, July 31. They will be parked in the corner of the northwest parking lot on Robberson Street.

As another way to help with this cause, Chick-fil-A will have lunch items available for your purchase and will donate 10 percent of all lunch proceeds to the “Stuff the Bus” program. This is a way for you to participate if you aren’t able to bring supplies. Employees who donate school items will receive coupons for their next visit to Chick-fil-A. 

Come and show our community what our value of compassion is all about! Join us for “Stuff The Bus” Friday, July 27 from 11:30 a.m. – 1:30 p.m. on the east parking lot along National Ave. near Primrose on the Cox South campus. See you there! 

CoxHealth named a ‘Best Hospital’ by U.S. News & World Report

U.S. News & World Report today released its annual Best Hospitals rankings. CoxHealth was the only Springfield hospital named to the list, and the only Springfield hospital recognized as “high performing” in any medical specialty.

Of the more than 100 hospitals in Missouri, CoxHealth tied for fourth in the state only behind such well-known institutions as Barnes-Jewish Hospital, University of Missouri Health Care and Missouri Baptist Medical Center.

The Best Hospitals’ rankings are largely based on objective measures of hospital performance and hospital resources, such as patient survival rates and nurse staffing levels. Each hospital’s reputation among physicians is also a factor. 


Additionally, CoxHealth was recognized by the publication as a high-performing hospital in five specialties: Ear, Nose and Throat, Gastroenterology, Gynecology, Neurology and Neurosurgery, and Pulmonology. 


“We are proud to be the only Springfield hospital included in this ranking, and to be recognized among the best health care institutions in the state. We are committed to continuing to provide world-class care to the people of southwest Missouri,” said Steve Edwards, CoxHealth president and CEO. 


The hospital rankings, said U.S. News Health Rankings Editor Avery Comarow, are like a GPS-type aid to help steer patients to hospitals with strong skills in the procedures and medical conditions that present the biggest challenges. “All of these hospitals are the kinds of medical centers that should be on your list when you need the best care,” said Comarow. 


In February, CoxHealth was named a Best Regional Hospital by the publication, one of only 247 hospitals in the nation to receive this honor. 


The complete rankings and methodology are available at http://health.usnews.com/best-hospitals/area/mo.

Skaggs Regional Medical Center signs letter of intent with CoxHealth

Today, the Skaggs Regional Medical Center Board of Directors and CoxHealth took the next step in the evolution of healthcare in the Tri-Lakes region by signing a letter of intent to form a strategic partnership. The letter is an agreement that offers a framework to bring the organizations together to build on the legacy of community-based care that is a hallmark of both hospitals.

Today’s action is a significant advancement of the process started in late January, when Skaggs’ Board of Directors issued a request for proposal (RFP) seeking a partner to ensure Skaggs will maintain jobs and continue to provide high quality care in Branson.

The letter of intent will allow the organizations to work closely together to explore the details of one another’s business practices. After this period called due diligence, the Skaggs Board of Directors will recommend a definitive agreement to the Skaggs Board of Trustees for approval, likely in the early fall.

“On behalf of the Skaggs Board of Directors and in support of the highest quality of care for our community, we had two very good potential partners. While the decision was difficult, we are pleased to announce our intent to move forward with CoxHealth,” says David Smith, chairman of the Skaggs Board of Directors. “We have all put hundreds of hours toward this effort and believe that we have found the partner that best meets our operational objectives and the needs of the Branson community. We also believe that CoxHealth provides the best fit for us, sharing our commitments to maintaining jobs and providing the highest quality of care. The Branson community is very familiar with the excellent services provided by CoxHealth and the board thanks the community, physicians and staff for their input throughout the process.”

"We are delighted and honored to have been selected by the Skaggs board, and as the Springfield area’s only locally-governed, not-for-profit health system, we’re pleased that Skaggs shares our values,” says Steve Edwards, CoxHealth president and CEO. “For more than a century CoxHealth has been dedicated to being the best for those who need us. We believe this partnership will allow us to combine our traditions of caring for the community, providing high-quality healthcare and investing in the health of our fellow Ozarkers in the Tri-Lakes region.”

Once a final agreement has been reached, various government agencies must also give approval, and the Missouri Attorney General will conduct a thorough review. This process could take several months.

The finalized partnership will provide significant independence to Skaggs while allowing the organizations to act as one entity for purchasing, contracting and other business-related matters. Skaggs will become a subsidiary of CoxHealth, but retain its board, current employees, management and medical staff. Skaggs will also retain its long-standing name.

“CoxHealth will keep Skaggs’ governance and dollars local, and the investment that we are making with this partnership will allow us to bolster the services available to the Branson Tri-Lakes region,” says Edwards. “We will expand services, facilities and the talent pool with a focus on ever improving the level of quality care provided.”

“Changes in healthcare are moving quickly and it is important we as physicians have the resources to provide our patients with the highest quality of care,” explains Dr. Robert Blackshear, Skaggs Chief of Staff. “We believe our partnership with CoxHealth will help us accomplish this mission as well as position us as the provider of choice in the Branson Tri-Lakes area. In addition we feel our CoxHealth partnership will help attract highly trained medical personnel to our area as well as provide needed equipment to deliver advanced medical care to our patients.”

CoxHealth’s proposal also includes a significant investment in Skaggs and the Branson Tri-Lakes community. Capital investments could include operating room and emergency department improvements, general refurbishment of facilities, technology upgrades and more. While these items will be a focus, it is a constant goal of all health care institutions to continuously improve care. This partnership will bring the breadth of CoxHealth’s resources to bear in Skaggs’s continuing pursuit of quality patient care.

“We believe our combined expertise and resources will make both of us stronger and better able to serve the Ozarks and adjust to the changing healthcare landscape,” says Edwards. “A partnership with Skaggs reflects our absolute commitment to the region and will provide a stable continuum of care for the people of the Branson Tri-Lakes region and throughout southwest Missouri.”

Despite the ruling by the Supreme Court today, Skaggs remains committed to providing quality healthcare to the area. “Regardless of the Supreme Court’s ruling today, important changes are underway in healthcare that have a profound impact on how hospitals operate,” explains William K. Mahoney, Skaggs CEO and President. “Like other community hospitals, we are developing new relationships to enhance how we operate and what we offer to the community. This partnership with CoxHealth allows us to maintain jobs and continue providing high quality care in Branson. As this next period of due diligence begins, we will continue to provide updates and Skaggs’ Board, management, employees and medical staff will continue to serve our patients every day with the same dedication and quality as we have for the past 62 years.”

About Skaggs
Skaggs Regional Medical Center is a 165-licensed bed community-owned and supported healthcare facility dedicated to improving the health of all area residents. Skaggs holds the highest national accreditation available for medical facilities from the Joint Commission on Accreditation of Healthcare Organizations. Skaggs has also earned the Gold Seal of Approval™ for its advanced inpatient diabetes care and is an Advanced Primary Stroke Center through the Joint Commission on Accreditation.

About CoxHealth
CoxHealth is accredited by The Joint Commission and distinguished as one of the nation’s Top 100 Integrated Healthcare Systems (2006-2012). Established in 1906 and based in Springfield, Missouri, CoxHealth serves more than 1 million people in a 22-county service area in southwest Missouri and northwest Arkansas. Their comprehensive array of primary and specialty care includes four hospitals and more than 65 physician clinics in 20 communities. The health system includes Oxford HealthCare (a home health agency), Home Parenteral Services (home infusion therapy), CoxHealth Foundation, Cox College, Cox Family Medicine Residency Program and much more.

Contacts
Michelle L. Leroux
Media Relations Specialist
Direct: 417-335-7460
Fax: 417-335-7100
E-mail: michelle.leroux@skaggs.net

Laurie Duff
Vice President of Corporate Communications
Direct: 417-269-3070
Fax: 417-269-3104
E-mail: laurie.duff@coxhealth.com

CoxHealth Trauma Services notes increase in vehicle vs. pedestrian accidents

Following simple safety tips for pedestrians and drivers can save lives

CoxHealth Trauma Services has noted an increase in the number of vehicle vs. pedestrian accidents over the past few months. A number of these cases have been fatal. “Most of the victims have been in their teens and early 20s,” says Jami Blackwell, CoxHealth Trauma Services coordinator.

Blackwell attributes the increase to a number of factors, including warmer temperatures and healthier lifestyles causing more people to walk, run and bike along area roadways. That, combined with drivers who are often distracted by texting or talking on cell phones, can lead to serious, and sometimes fatal, accidents. “We want to remind everyone of the precautions they can take to stay safe,” she says.

Safety tips for walkers, runners and bike riders:

· Be aware of your surroundings, and make eye contact with people driving vehicles near you.

· Avoid texting, talking on your cell phone, and listening to music.

· Cross at crosswalks and obey all traffic signals and signs.

· Wear bright, reflective clothing, especially at night.

· Don’t step off the curb between parked cars.

· Parents should be near small children at all times when outside in areas where moving vehicles may be present.

Safety tips for drivers:

· Don’t text or talk on the cell phone while driving.

· Pay attention to your surroundings, and make note of any pedestrians in your vicinity.

· Be especially mindful in neighborhoods where children may play outside, and in parking lots.

To learn more safety tips for pedestrians and drivers, listen to our podcast at http://www.coxhealth.com/body.cfm?id=5459.

Buy your tickets now for humorist Jeanne Robertson’s upcoming performance

Event will raise funds to support cancer screenings in the community 
The CoxHealth Auxiliary is bringing award-winning humorist Jeanne Robertson to Springfield to raise funds to support cancer screenings in the community. Robertson will hold one performance at 7 p.m., Saturday, June 9, at Evangel Chapel, 1111 N. Glenstone Ave., in Springfield. Tickets are still available.

Jeanne is past president of the National Speakers Association and was the first woman to win NSA's top honor, the Cavett Award. An author of three books on humor, Jeanne has produced six DVD/CD humor programs and can be heard daily on Sirius XM Radio's Laugh USA, the Family Comedy Channel.

Her event in Springfield will support the CoxHealth Auxiliary’s work to fund cancer screenings in the community through the CoxHealth Foundation. Each year, the Missouri Association of Hospital Auxiliaries commits to a cause selected by the organization’s president. The current president, CoxHealth Auxiliary member Margie Beadles, has selected the importance of cancer screenings as the cause hospital auxiliaries around the state will work to support.

Tickets to Jeanne’s performance are $25. A discounted rate of $20 is available for groups of 10 or more. For additional information or to purchase tickets, call 269-4169 or visit www.coxhealth.com. To learn more about Jeanne and see clips of her performances, visit www.jeannerobertson.com.

2012 Children’s Miracle Network Hospitals Telethon raises more than $1.4 million for area children

The 27th annual Children’s Miracle Network Hospitals Telethon raised $1,462,269 to benefit local sick and injured children thanks to the outpouring of generosity from people in the community, despite these difficult financial times.

“We could not have asked for a better event,” says Tim Siebert, director of Children’s Miracle Network Hospitals at CoxHealth. “Thank you to everyone who donated, to our sponsors and volunteers, for helping us help families across the Ozarks.”

Seibert acknowledged the generosity of a few sponsors including the following: Sensory Integrations, Downhome Productions, Re/Max, Great Southern Bank, Credit Unions for Kids, Price Cutter Charity Championship, CoxHealth, MSU Dance Bear-A-Thon, Mason’s, Dairy Queen, Kum & Go, KY3, Walmart, Power 96.5, Ace Hardware, Loves, IHOP, Marriott International, Golden Corral, The System - a Paul Mitchell Partner School, Kiwanis International and CoxHealth Auxiliary.

KY3 televised the event live beginning June 2 and ending at 5 p.m., Sunday, June 3, making it possible for the children’s charity to share “Miracle Kid” stories with the communities served by CMN Hospitals and CoxHealth.

About CMN Hospitals: Children’s Miracle Network Hospitals of CoxHealth is a non-profit organization that provides financial assistance to sick and injured children in the Ozarks. CoxHealth underwrites all administrative expenses of the charity locally, so that every dollar raised stays in our community and helps children. For more information on Children’s Miracle Network Hospitals or to donate, visit www.coxhealth.com/cmn.

Working to keep kids healthy

 
A Cox Monett program that teaches children about health and exercise is expanding to Springfield.

The mission in health care is a seemingly straightforward one: improve the health of our community. In the hospital, we see every day how that mission plays out as we work to help the ill and the injured. But it takes more than fixing things when they go wrong to improve a community’s health. Health care isn’t limited to doctor’s offices, surgery suites and emergency rooms. On a recent Tuesday night in Mt. Vernon, the work of community health is being done in a school cafeteria, where kids are learning how proper nutrition and exercise can help them lead healthier lives.

“Can anyone give me an example of a good fat?” educator Lauren Holland asks the group of a dozen students and their parents. Hands shoot up. Peanut butter? Olives? The kids in attendance have done their homework. They’re participating in an event called CARDIAC Fun, which is the evening component of CARDIAC Kids, a program based at Cox Monett that works with fifth graders at several Ozarks schools. By the end of that Tuesday evening, the CARDIAC Fun participants have had a full refresher on nutrition, experienced a Crossfit-style workout, courtesy of sports science students at Missouri Southern, and learned how to make healthy burritos at home. All the attendees also leave with a free pedometer to track their steps as they go about their days at school and work.

Holland and Nancy Ridgley, Monett’s director of community wellness, have brought that comprehensive education to almost 6,000 students since the program began in 2003. Now, a grant from Kohl’s Cares is allowing the program to expand to Springfield. The Kohl’s CARDIAC Kids program will begin with a major health screening held at Kohl’s on Saturday, May 12. The event will be open to kids ages 6-18 and feature screenings for blood pressure, body mass index and cholesterol.

The Kohl’s CARDIAC Kids program represents a major expansion for the wellness effort. While Monett’s CARDIAC (Coronary Artery Risk Detection in Area Children) Kids focuses on fifth graders through school-based programs, Kohl’s CARDIAC Kids reaches out to a wider age range through large community events open to the public. Children’s Miracle Network Hospitals worked with Kohl’s to secure the $45,020 grant, which will fund a series of public events for families this summer.

“Childhood obesity is such a major issue and I’m thrilled we can face it head on,” says Tim Siebert, executive director of Children’s Miracle Network Hospitals. “Preventing cardiovascular disease and diabetes fits right into the mission of CoxHealth and CMN Hospitals.”

Holland and Ridgley say the prevalence of obesity makes the need for public education clear. 

“Kohl’s CARDIAC Kids will reach a much broader audience, and it’s new territory for us, but it’s definitely needed,” Holland says. According to data from the Centers for Disease Control, 39.4 percent of Missouri children are overweight, obese or at risk of obesity. Since 70 percent of obese children grow up to be obese adults, heading off that risk early is key to public health.  

That’s been the goal of CARDIAC Kids since its inception at Cox Monett in 2003. When Ridgley started in Cox Monett’s Wellness department, she worked with an administrator who was from West Virginia. At the time, West Virginia led the nation in obesity and Missouri wasn’t far behind. They talked about a program a pediatric cardiologist had developed in West Virginia and they decided to try something similar here. CARDIAC Kids was born and they soon began working with a dozen schools in Barry, Lawrence and Stone Counties.

“We’ve worked to expand from the beginning. We’ve always wanted to go statewide,” Ridgley says. “Our mission is to improve the health of our community and this reaches out directly to kids and their parents. The top risk factor for type 2 diabetes and heart disease is being overweight – hopefully we can reverse that.”

Holland originally joined the program as an intern. She was excited to pursue her passion of working with children, but she wasn’t prepared for how widespread childhood obesity is.

“The more you do this work, the more you see the need,” she says. Holland points out that the current generation of children is among the first who are expected to have shorter lifespans than their parents, due in large part to preventable medical conditions. As they age, today’s children will likely see medical issues in their 30s that previous generations didn’t see until their 50s. Holland says we’ve become so accustomed to most people being overweight that we don’t really notice when children are “stocky.” When those kids step on the scale, they’re often at risk for obesity. “I want children to live long, healthy lives; I want them to outlive their parents.”

Over the last nine years, the Monett-based program has made positive changes for the students it serves. In the first year, 50 percent of the students in the program had BMIs above the 85th percentile, by 2010, that had dropped to 39 percent. CARDIAC Kids students are retested as sixth graders; in the ’08-’09 school year, 86 percent had shown improvement. By 2009-10, that number had risen to 91 percent.

Leaders say the kids are always excited to learn and curious about the information presented at the events. Children respond to the cues in their environment at home; they eat what their parents buy, and they pick up on how active their parents are, or aren’t. Getting to children early is key to helping them change their habits before they become ingrained.

“By fifth grade, kids are starting to make some of their own decisions,” Holland says. “In our programs they may see something different than their regular environment, and they may see things they can do themselves.”

The kids, in turn, can also influence their parents. Simply raising awareness through the CARDIAC Kids program can be enough to get parents to buy more fruit, plan healthier snacks and take more steps with their pedometers.

“I’m a firm believer that our obesity problem is rooted in how we raise kids. People like to blame it on fast food or school lunches, but it starts at home,” Ridgley says.

Ridgley and Holland say the expanded nature of the community-based program will produce a higher turnout and an opportunity to reach more high-risk youths. The community exposure will also be good, helping to raise overall awareness.

“There are so many people who don’t know the basics on being active and eating healthy, it still surprises me,” Holland says. “You may not be able to revolutionize everything about someone’s life, but you can plant a seed and help them make small changes.”

Ridgley says the most rewarding part of working in wellness is seeing how being healthy can improve people’s lives.

“It’s a night and day change, not just physically, but mentally and emotionally, too,” she says. “We want people to see Kohl’s CARDIAC Kids as an opportunity – it’s cutting edge, and free, so take advantage of it.”

Summer events

The Kohl’s CARDIAC Kids program will kick off with a public event on Saturday, May 12, in the Kohl’s parking lot on Independence Street in Springfield.

The event, planned for 8-11 a.m., will feature complete health screenings, including body mass index, blood pressure and cholesterol. Screenings are available for kids ages 6-18 and the first 500 children screened will receive a $10 Kohl’s gift card.

The program includes two free Kohl’s CARDIAC Kids Family Fun nights in June:

Northview Center at Doling Park

6-7:30 p.m., June 14,

The Meyer Center

6-7:30 p.m., June 22,

The community events offer healthy snacks, activities, nutrition education and a free pedometer for participants.