Bon Secours Good Sharing

Powhatan EMS & St. Francis EDIntervene in Record Time

GoodSharing — Tue, 07 Sep 2010 14:05:19 +0000

Within 24 hours, Powhatan EMS brought two patients having heart attacks to the St. Francis Medical Center’s Emergency Department so that they could receive state-of-the-art treatment in record time. Having brought these patients from the country, Powhatan EMS and the cardiology team at St. Francis were able to perform life-saving interventions within 38 minutes or less. This was made possible by the EMS providers calling the St. Francis Emergency Department prior to their arrival.

Chris Atkins, Tom Ward, Scott Dixon, Aubrey Smith, Dr. Mark Xenakis, Dr. Robert Sisson, as well as the whole St. Francis Emergency Department and Cath Lab staff, played a crucial role in treating the two patients.

“Our goal is to intervene within one hour, but 30 minutes from a rural county area is world-class healthcare,” said Martha McAloon, Emergency Preparedness Coordinator at St. Francis.

Dr. Robert Sisson, the Director of Emergency Cardiac Care at St. Mary’s Hospital and St. Francis Medical Center credits the quick turnaround to the hospital’s strong relationship with Powhatan EMS.

“The EMS is a critical component of our STEMI Team. The ability of the Powhatan EMS providers to accurately diagnose patients with heart attacks and give pre-arrival notification to our Emergency Department really can save lives in our community,” said Dr. Sisson.

Early recognition of heart attack symptoms is critical for survival and positive outcomes. For an online self-assessment, visit http://bsva.org/HeartAware or visit http://bsva.org/a3mhv1 for information about heart attack warning signs.

Protected: Noah’s Children

ndawson — Wed, 18 Aug 2010 15:19:09 +0000

Big Hearts Doing Hard Work

dsisson — Tue, 10 Aug 2010 16:24:06 +0000

It is difficult to be put in a position of confronting injustice. We often feel challenged to take an action we know is right, but hesitate because the repercussions are out of our control.

(Left to right: Patty Hall, Bonnie Price, Sara Jennings)

Patty Hall, a volunteer with the Regional Hospital Accompaniment Response Team (RHART) since November 2009, and the Forensic Nursing Team at St. Mary’s Hospital face the after effects of domestic, sexual or interpersonal violence every day.

“It’s not like on TV. Exams can take two to four hours, not including paperwork,” said Bonnie Price, Clinical Coordinator of the Forensic Nursing Program. “The amount of time takes a toll on patients, which is why RHART volunteers like Patty, make a real difference.”

Known for her compassion and selflessness, Patty is a true testament to the phrase good help to those in need. Bonnie describes an instance where Patty reached across traditional volunteerism boundaries to help console a patient.

“It is late in the evening and the pager goes off. The St. Mary’s Hospital ED is calling about a patient brought in by police and a forensic exam is being requested. The patient has no family or friends at the hospital with her. The next call I make is to the Regional Hospital Accompaniment Response Team (RHART) Hotline. RHART is a team of specially trained volunteers, who provide emotional support for patients who have been a victim of sexual and/or domestic violence. Moments after arriving at the emergency department, Patty Hall walks in. Patty, a Bon Secours RHART Volunteer, immediately began to put the patient at ease with her soft, calming voice and her cheerful yet sympathetic smile. Patty stayed with the patient for hours, while the forensic exam was completed. Upon completion of the exam, the patient was asked by police to return to what was believed to be the scene of the crime with them, in order to confirm the location and in hopes of finding additional evidence. Without a moment’s hesitation, Patty offered to go with the patient; an offer which the patient quickly and gratefully accepted. Patty’s selfless act made a difference in the life of our patient. At Bon Secours, not only is our staff World Class but also our volunteers!”

When asked why the RHART volunteers and Forensic Nurses do what they do, Sara Jennings, a Forensic Nurse Examiner, replied, “It’s a wonderful rewarding job. Being able to help and seeing the effect on the patient makes all the difference.”

RHART is a collaboration between Bon Secours, Hanover Safe Place, Safe Harbor, and the YWCA of Richmond. Trained RHART volunteers are called in by Bon Secours Richmond Health System hospitals to provide accompaniment during forensic or medical exams. RHART volunteers provide supportive counseling, crisis intervention, advocacy, resources and referral information. They also connect patients to additional domestic and sexual violence follow-up services, including counseling, court advocacy and emergency shelter.

Bon Secours Virginia Health System response to Sisters’ Accident

GoodSharing — Thu, 05 Aug 2010 02:37:02 +0000

Bon Secours Virginia Health System and the Sisters of Bon Secours join the Benedictine Sisters in asking for prayers for all those involved in Sunday’s tragic accident.

Our own Sister Charlotte Lange was recently involved in the serious car accident. On Sunday August 1st, Sr. Charlotte, along with Sr. Denise Mosier and Sr. Connie Ruth Lupton were struck in a head-on collision. Sadly, Sr. Denise lost her life at the scene of the accident. Sr. Charlotte and Sr. Connie Ruth remain in critical yet stable condition in a northern Virginia hospital.

Those who know Sr. Charlotte know her as a compassionate being; someone whose very presence lifts spirits. Sr. Charlotte is well-known around St. Mary’s Hospital, the entire Bon Secours Virginia Health System and the Richmond community as an upbeat ray of sunshine. We know her enduring faith and warm heart will provide her strength in the coming days.

At this time, we invite our community to visit our Facebook page and offer healing thoughts and prayers as well as stories that honor Sr. Charlotte and Sr. Connie Ruth. We also invite comments of remembrance for Sr. Denise.

The following video message from St. Mary’s CEO Toni Ardabell has been provided to the employees and community of Bon Secours Virginia Health System. It is shared here in the interest of keeping our commmunity updated on how to be involved in supporting Sr. Charlotte.

Celebration of Empowered Employees

dsisson — Mon, 02 Aug 2010 12:29:04 +0000

Today, we celebrate our employees—for they are some of the most engaged individuals in Virginia. At Bon Secours, we create an environment where employees are motivated to reach their potential, empowered to respond to the needs of our patients and behave as “owners” in the organization.

“Bon Secours has created a culture where employees are empowered to behave as owners. We have been given the latitude to ensure that our patients and their families are comfortable,” said Megan Walworth, Customer Relations Manager. “We know more moments of good help happen when all 12,000 Bon Secours Virginia employees are engaged in the process of creating world-class environments of care.”

As part of our series celebrating the dedication and compassion of our employees, here are a few of our “WOW” stories—examples of good help happening every day.

Empowered Solution Seeker

Sandra’s story is an example of a fully engaged employee who behaves as an owner of
Bon Secours. Sandra is truly an empowered solution seeker.

Recently, a gentleman came into the Tidewater Surgical Specialists office looking for his dialysis center. He was in the wrong place and was very confused. He had been dropped off at the facility by his brother and could not get in touch with him. Seeing an opportunity to be of good help, Sandra took charge! After learning the name of the gentleman’s dialysis center, Sandra called to let them know he would be there shortly for his appointment. Instead of giving the patient the address and sending him on his way, Sandra took ownership of the situation and sought a world-class solution. Knowing he did not have transportation and needed to make his appointment, Sandra drove the gentleman to the dialysis center herself.

“Owning” the Unexpected

Every so often, our employees find themselves in unexpected situations. Just last week, Sonia Figueroa, a tech with Richmond Community’s Radiation Department, found herself in a situation she never could have expected.

A patient inexplicably set off the sprinkler system on Richmond Community’s third floor, causing flooding which quickly spread to the first floor CT area. Sonia had two choices: call Engineering or respond herself.

Considering herself an owner of Bon Secours, Sonia responded quickly by covering the CT equipment in plastic and containing the water to one area. Sonia’s quick thinking avoided flooding of the control room and a potentially disastrous situation. Her response saved the equipment, avoiding major expenses and repairs. Her response demonstrated her commitment to Bon Secours and her passion to always do what it takes for her workplace and her hospital.

Guest Post: Vice President Cheney, Heart Failure and Heart Pumps

GoodSharing — Mon, 19 Jul 2010 13:58:53 +0000

Editors note: the following post was originally published on Dr. Marc Katz’s HavHrt blog. You can find the original post here. Dr. Katz is a cardiac surgeon and Chief Medical Officer for the Bon Secours Heart and Vascular Institute. To learn more about the Bon Secours HVI or to schedule an appointment with Dr. Katz, call 804-359-WELL

The news is awash with reports that former Vice President Dick Cheney had a “heart pump” implanted last week as treatment for his congestive heart failure. Although the details are not available, multiple reports consistently state that he has had heart problems through out most of his adult life, sustaining his first heart attack at age 37. He is quoted in the recent release as stating the he was “entering a new phase of the disease when I began to experience increasing congestive heart failure” and it is further stated that he had a ‘heart pump’ implanted.

Congestive heart failure is a condition in which the heart muscle is severely weakened reducing its ability to adequately pump blood. It is a very common condition and affects almost 5 million people in the U.S. Heart failure is the single most common reason people are admitted to the hospital. Some heart failure statistics:

4,8000,000 people with heart failure in US, 2% of population in their 50′s, 5% in their 60′s, and 10% of population over 70
875,000 hospital admissions every year in US for heart failure (2400/day). Number one admitting diagnosis
400,000 newly diagnosed cases of heart failure annually in US (1100/day)
55,000 people in US die every year due to heart failure (139/day)
66% of heart failure patients die within 5 years of their diagnosis (worse then most cancers)
2 people died of heart failure while you were reading this blog post.

Obviously there is considerable room for improvements in the treatment of this condition. Common symptoms of heart failure are shortness of breath, initially with significant exertion, but as it progresses this occurs with less activity. In it’s more severe extent, New York Heart Association classification 3B or 4, these patients cannot walk undertake normal activities of daily living without having to stop due to shortness of breath. Other symptoms include swelling of the legs, waking up at night short of breath, having to sleep with the head elevated to facilitate breathing, having to urinate multiple times at night, palpitations and generalized fatigue.

The most common causes of heart failure include coronary artery disease, heart valve problems, and viral cardiomyopathy. Treatment includes dealing with the underlying etiology, which may totally alleviate the heart failure, and/or medicines. As heart failure progresses, in situations where the underlying cause was not reversible, it becomes harder to treat and the symptoms interfere with normal daily activities.

Heart Pumps In severe cases of heart failure, when medications are no longer effective, and a patients symptoms progress to the point of interfering with normal activities of daily living, a heart pump or left ventricular assist device may be recommended. These bits of ingenious technology have progressed significantly in recent years. The HeartMate II system is the most advanced system currently approved by the FDA. Although not confirmed, this is the device VP Cheney has been purported to have received.

The HeartMate II is a continuous flow device, with a single moving part, a propeller, of sorts, that spins at around 10,000 rpms to aid in the emptying of the heart and restoring normal circulation. Since this device moves the blood at a constant, consistent rate, rather then the rhythmic squeezing type of pumping, these patients usually do not have a palpable pulse.

The indications for implantation of a left ventricular assist device, or LVAD, are for bridging to transplantation, or destination therapy. Bridge to transplant is just what it sounds like, maintaining adequate circulation and restoring the ability to resume full activities while awaiting availability of an appropriate donor organ. Destination therapy is for patients who are not candidates for transplantation and the LVAD serves as the permanent treatment for heart failure in these patients.

In recent studies, the HeartMate II has proven to be very reliable, with 2 year patient survival at about 90% and overall complication rates significantly lower than previous generation devices. Additionally most patient are able to resume full activities. A number of the early recipients of this device are now over 5 years out from their initial implant.
Considering almost 5 million heart failure patients and only 2500 LVAD implants in the US, there is room for much improvement in the lives of many people with this remarkable new technology. I wish Mr. Cheney, and all patients in similar circumstances, a speedy recovery and best wishes for a bright and fulfilling future.

See http://www.youtube.com/watch?v=2auyZ54x2uA for an interview with a recent HeartMate II recipient.

Dr. Katz on Food, Part 1 – Changing our diet can prevent heart disease

GoodSharing — Thu, 08 Jul 2010 14:26:28 +0000

“Out of the top six causes of death… four are preventable by dietary changes.” – Dr. Marc Katz

In this video, Dr. Marc Katz, Cardiac Surgeon and Chief Medical Officer for the Bon Secours Heart and Vascular Institute, talks about his decision to adopt a no fat, vegan lifestyle.

Cardiovascular diseases kill more people each year, worldwide, than all other illnesses combined. More than half of those deaths are preventable by dietary changes alone.

Blockages occur over time, as poor diet causes fatty deposits to develop in the arteries. When those blockages, in arteries that feed the heart, rupture a massive heart attack occurs.

One of the best ways to combat the risk of blockage is to eat a diet rich in whole foods. Rather than subscribing to what Dr. Katz refers to as “fad diets” – those that stress the avoidance of things like carbs or inclusion of things like grapefruit – we should focus on eating a mostly plant based diet.

As first steps that can have a significant impact, Dr. Katz recommends:

Whole grains – whole grain breads, brown rices, cooked grains such a quinoa or bulgur

Whole foods – avoid refined carbohydrates like white bread and white rice. Avoid processed foods

Eat more fresh fruits and vegetables – a challenge due to convenience factor, but a critical part of a healthy diet

In addition to increasing the consumption of whole foods, Dr. Katz suggests reducing the consumption of red meat and carefully considering other meats which may also be high in fat.

Learning how to read labels is an important tool in developing a healthy diet. According to Dr. Katz, “everything on the front of the packet is false.” In processed foods, sugar may not be listed as a primary ingredient itself, although it may be broken into its many forms and listed separately. When added up, they become a primary ingredient. Look for foods with 10-30% or less of calories from fat.

Following a heart healthy diet is not hard, but does require some change. Dr. Katz acknowledges that finding foods we enjoy eating and enjoy cooking go a long way to helping us stay consistent. Dr. Caldwell B. Esselstyn’s Prevent and Reverse Heart Disease is packed with tips and recipes. http://www.heartattackproof.com/

In the end, making subtle changes to our diet will have a dramatic effect on protecting the delicate cell walls that line our arteries and will certainly help prevent heart attacks.

For an appointment with Dr. Katz, call 804-359-WELL
To learn more about Dr. Katz, visit his website here.

Good Privacy: Improved email encryption comes to Bon Secours

dsisson — Tue, 29 Jun 2010 13:35:02 +0000

E-mail has become a preferred method for communication for most of us. In order to maintain the confidentiality of private information and ensure compliance with privacy regulations Bon Secours Health System is implementing a new e-mail encryption service. The service will improve our ability to protect personal information of our patients, physicians, employees, and others from undesirable external parties on the Internet.

Bon Secours has always made privacy a hallmark of our electronic systems. Traditionally, any sensitive data had to be manually encrypted before it was emailed.

Beginning Tuesday, June 22, 2010, e-mails to or from Bon Secours Health System and containing confidential data will be automatically encrypted. This improvement means that our patient data is even more secure than it has been in the past.

Bon Secours’ Enterprise Security Engineer Jesse Crim, MSIA, CISSP shared his thoughts about the new system in this Q&A.

Q. How do you think the new email encryption service helps bring good help to those in need?

A. The new email encryption is essential to our Connect Care and EMR (electronic medical records) initiatives because it further safeguards the sharing of information between the patient, physician and health system, so that [the patient's] medical care is seamless.

Q. How many emails are sent at Bon Secours Richmond Health System in a day?

A. Around 60,000 emails.

Q. What kind of information is encrypted?

A. Personal information (such as social security numbers), financial information (such as account and credit card numbers) and personal health information.

Q. How do you retrieve an encrypted email sent by Bon Secours?

A. You will be asked to click on a link in the e-mail, which will connect you to our secure message center. There you will register a private password to retrieve and reply to your secure messages.

Below is a diagram outlining how our email encryption works.

Beat the summer heat – Dr. Danila on staying healthy in the heat

GoodSharing — Tue, 29 Jun 2010 00:52:31 +0000

Dr. Dan Danila, a hospitalist at Bon Secours St. Mary’s hospital, offers advice for recognizing signs of heat related illness and how to avoid them. According to Dr. Danila warning signs of heat exposure include:

leg cramps

muscle spasms

fever

fatigue

losing consciousness

Dr. Danila recommends beating the heat by drinking lots of water – at least 1 gallon and up to 2 gallons a day. He also advices avoiding the mid-day sun from noon until three pm, taking a multi vitamin supplement, seeking shelter and shade and checking on elderly neighbors.

If you feel ill or suspect you may have heat related illness, contact your doctor or a medical professional right away. If you need a doctor, contact us at 804-359-WELL, if it is an emergency, dial 911

Guest Post: on Barbara Walters and Aortic Stenosis

GoodSharing — Fri, 18 Jun 2010 17:00:26 +0000

Editor’s note: the following post is re-published in its entirety from Dr. Marc Katz’s Have Heart blog. Dr. Katz is the Chief Medical Officer for the Bon Secours Heart and Vascular Institute. You can also find Dr. Katz on Twitter.

Celebrities deserve the same rights to privacy, with respect to their medical conditions, as everyone else. However, when they chose to go public with details about their health, it can raise the public awareness of medical conditions and aid in education. Such was the case this week with Barbara Walters revelation that she has aortic stenosis and was scheduled to undergo valve replacement surgery.

Aortic stenosis affects approximately 6% of the US population or about 3.5 million people. The incidence increases with age. About 2% of 60 year olds, 3% of 70′s and 4% of 80 year olds are affected.

The aortic valve is between the left ventricle (main pumping chamber of the heart) and the aorta (the main artery leaving the heart to the rest of the body). Normally it is comprised of 3 very thin leaflets. When the ventricle squeezes, the force of the blood ejecting opens the valve completely allowing the blood to pass into the aorta. The valve then closes so the blood does not leak back into the heart but continues its forward movement. The gradient, or pressure difference across the valve is normally essentially zero.

Aortic stenosis is a condition in which the leaflets of the valve thicken and stiffen. This then reduces their mobility and the heart is now pumping against a partially closed door. As this process continues the stiffness of the valve progresses and the opening shrinks leading to a significant gradient across the valve. About 15% of the population is born with an aortic valve that has 2 leaflets instead of 3. These valves are more prone to developing aortic stenosis, though usually not until later in life. Some however are tight from birth and require surgery in childhood.

A mean gradient of 40 mm of mercury is generally considered significant. With a gradient of 40 across the valve if the blood pressure measured in your arm is 120/ the pressure within the ventricle would then be 160/. If the gradient was 80 a BP of 120/ would mean the intra-cardiac pressure is 200, and so on. This is not a good situation for the heart.

Another measurement of the valve involves estimating the cross sectional area of the opening. Echocardiography is a good way to view this and an area of less than one centimeter is considered severe aortic stenosis.

As you would expect, the heart has to pump harder to push the blood through this smaller opening. It causes the muscle to strain and thicken. The jet going through the narrow opening is like putting your finger over the end of an open water hose. The resulting increased blood velocity can cause the aorta to enlarge. Also the straining of the heart to pump against this resistance can lead to chest pain, rhythm problems, fainting spells and heart failure. When fainting spells or heart failure develop from aortic stenosis there is a 50% risk of dying within 3 years.

For patients with symptomatic or severe aortic stenosis surgery to replace the valve is recommended. This is a mechanical problem and there are no medications to reverse it. There is also no good evidence that diet is implicated in its development or treatment.
Surgery to replace the aortic valve is typically performed through a sternotomy (splitting the breastbone), however in many cases minimally invasive options are available (see previous post). A procedure to implant aortic valves via a needle stick in the groin is currently under investigation in the US.

There are a number of choices of valve type for replacing the aortic valve. Bioprosthetic or tissue valves are the most common choice in the US. These valves are either the aortic valves from pig hearts or are constructed from the pericardium (sac the heart lives in) of cows or horses. These are mounted on a covered stent and are available in a range of sizes. The advantage of tissue valves is that no medication is required following their implantation. The disadvantage is that they wear out. Current generations of valves have improved durability and their longevity is said to be over 90% at 12 years following implant.

The second most common type of valve is a mechanical valve. These are manufactured from pyrolytic carbon and have a bi-leaflet design. They look like a disc split in half that pivots open and closed with the blood flow. The advantage of this type of valve is that it can last virtually indefinitely. The disadvantage is that a blood thinner (warfarin or Coumadin) is required indefinitely.

These two valve types account for the vast majority of valve replacements.
Other options include homograft (cadaver human) valves and autografts. Autografts involve a procedure known as the Ross procedure in which a patients own pulmonary valve is removed and placed in the aortic position, then a homograft in used to replace the pulmonary valve.

How is a decision made as to which type of valve to implant? In the absence of any mitigating factors, age is a reasonable guideline for deciding. It is generally recommended that individuals less than 65 receive mechanical valves and over 65 lean toward tissue valves. This is NOT a hard and fast rule but a guide, and either valve type can be reasonably placed in either population. Obviously if a patient is unwilling or unable to take a blood thinner and have his blood routinely checked, then a mechanical valve is not for him.

Bottom line is that there are many good options. A thorough discussion of options, pros and cons with your surgeon is imperative prior to proceeding with your surgery.