Health HealthWorks Works Health care news and information Caring for life. Fall 2007 Carondelet Heart Institute Part of National Initiative Cutting Door-to-Balloon Time Saves Lives here have been some recent changes in cardiology practices that are not only saving lives, but also improving the quality and long-term
outcomes of patients suffering from a
heart attack.
Last year, the American College of Cardiology (ACC) and the American
Heart Association developed national
guidelines setting a door-to-balloon
time goal of 90 minutes or less for at least
75 percent of patients with a common
type of heart attack known as ST-
elevation myocardial infarction (STEMI).
A person with STEMI has a blood clot or a rupture of plaque in the coronary
artery, explains Jane Falk, RN, director of
the Carondelet Heart Institute. The clot
or rupture prevents blood from flowing to the heart muscle. The muscle becomes starved
for oxygen and eventually dies. The sooner you unblock the coronary artery, the more
heart muscle you can salvage. National Alliance The ACC brought cardiologists and cardiac nurses together to examine research and procedures. The evidence showed that the best way to treat these patients and decrease
mortality is with immediate balloon angioplasty. A national goal was set to treat STEMI
patients within 90 minutes of arrival to the Emergency Department.
The result: D2B: An Alliance for Quality was launched by the American College
of Cardiology. The goal is to save time and save lives by reducing door-to balloon times
in U.S. hospitals performing angioplasty and stenting. Carondelet Heart Institute has
joined this alliance. As part of the alliance, the Carondelet Heart Institute has committed
to implementing the evidence-based strategies. continued on page 3 30-Minute ER Guarantee Quality and Respect Key in Treatment his summer, St. Joseph Medical Center started offering a 30-minute guarantee to emergency patients. Patients will be seen by a doctor
or nurse practitioner within thirty minutes
of coming through the door.
We want patients to know we respect their time, says Kara Wineinger, RN,
Emergency Services director. We are not
going to leave them waiting unnecessarily.
And when they do have to wait longer, its
acknowledged.
As part of this initiative, processes have changed and improvements are still being
made. Three physicians were added this
summer and Wineinger is hiring several
nurses. Construction on a new waiting area
was just completed which is also helping to
streamline the process. We are not seeing
everyone within 30 minutes, but overall,
we are cutting wait times, and it continues
to improve, says Wineinger.
St. Josephs Emergency Department sees more than 37,000 patients a year.
Since implementing the guarantee,
volumes have increased. continued on page 2 T Gerald Mancuso, MD, Medical Director, Interventional Cardiology, at the Carondelet Heart Institute T Carondelet Health Names CEO leury Yelvington is on board as Carondelet Healths
President and Chief Executive Officer. Yelvington comes
to Kansas City from St. Marys of Michigan in Saginaw,
where she has served as President and Chief Executive Officer
since 2004.
Yelvington has an impressive record spanning more than 23
years as a health care administrator working for St. Marys of
Michigan, Bayview Health System in Tampa, Shands Hospital
at the University of Florida in Gainesville and University
Medical Center in Jacksonville. She received her Master
of Business Administration and Master of Health Services
Administration degrees from the University of Florida in
Gainesville and holds a Bachelor of Arts degree also from the University of Florida.
Fleurys focus on developing state-of-the-art clinical practices, building strong
physician partnerships and creating a reputation for quality health care exhibit the
visionary and strategic thinking Carondelet Health seeks in its leadership, states Richard
Beyer, chairman of the Carondelet Health Board of Directors.
I look forward to contributing to Carondelet Healths growth and presence in the
Kansas City market and investing energy in the faith-based health care ministries
provided by St. Joseph Medical Center, St. Marys Medical Center and its many
affiliates, says Yelvington, My husband, (Barry Solomon, MD) and I are looking
forward to becoming active and involved members of the Kansas City community. www.carondelethealth.org 2 30-Minute ER Guarantee continued from page 1 Lauron Hohl was recently in the St. Joseph ER with shortness of breath. She
says she didnt really pay much attention to
the guarantee, I always come here. I come
for the care. (She was seen in 28 minutes.)
We have a reputation for providing quality care and that remains our focus,
says Douglas Coe, MD, an ER physician.
We do not rush patients; we take the time
to listen to them and talk with them so they
understand their discharge instructions. Its
funny. Ive not had one patient bring up the
guarantee.
And they dont have to. Patients not seen within 30 minutes of their arrivals get a
letter and the movie passes in the mail.
We ask for feedback from our patients
says Wineinger. We want our patients to
know we do care about how long they have
to wait and we will continue to assess our
processes in order to respect their time. To receive a free pocket first aid kit, call 816-9HEALTH (943-2584). F More Convenient Mammography Walk-Ins Welcome heres no debate about the fact that
early detection of breast cancer
greatly increases survival rates.
Thats why the American Cancer Society
recommends a screening mammogram
every year for women age 40 and older.
The risk of breast cancer greatly
increases as women age. With the
improved technologies, including digital
mammography, available at St. Joseph
Breast Center, breast cancer can be
detected earlier with better outcomes.
And now, St. Joseph is making it more
convenient to get screening mammograms.
Women dont have to plan weeks ahead
to schedule a mammogram. Walk-In
Mammogram program allows women to
simply walk in, or call just ahead of time,
to find a convenient time on the same day. We have expanded hours for easy
scheduling. Call 816-9HEALTH
(943-2584) and mention Walk-In
Mammography for same day service. T Fleury Yelvington, Caronde- let Health. President and CEO Lauron Hohl, (right) seen here getting a breathing treatment from Shaun Miller, RT, says its quality care that brings her to St. Joseph. www.carondelethealth.org 3 Heart Institute continued from page 1 D2B Strategies The Carondelet Heart Institute initiated a multidisciplinary team consisting of interventional cardiologists, Emergency Department physicians and nurses, and Cath
Lab nurses to assess practices and implement the D2B recommendation.
Strategies include: EKG within 5 minutes of arrival Emergency physician activating cath lab team immediately on EKG review EKG from paramedics activating cath lab team (patient does not stop in ER; goes directly to cath lab for treatment) Standard protocols so staff knows the treatment plan for these patients Every case is reviewed by the team; feedback for improvement is given immediately to all physicians and nurses involved. Results Evidence shows its working. In the first quarter of 2007, the average door to balloon time for patients coming to the Carondelet Heart Institute at St. Joseph was 86 minutes.
Most recent data in July shows 100 percent of STEMI patients accessing the Emergency
Department at St. Joseph received angioplasty in less than 90 minutes.
We are very committed to this initiative, says Gerald Mancuso, MD, medical director, Interventional Cardiology at Carondelet Heart Institute. Time is muscle for
our patients. Patients do significantly better when immediate angioplasty is performed. I
am proud of the hard work and dedication all members of the Emergency Department
and the Carondelet Heart Institute have exhibited in this alliance.
To schedule a heart risk assessment, call the Carondelet Heart Institute at 816-9-HEARTS (943-2787). St. Joseph Stroke Center Minutes Matter eople hear it all the time, when it comes to heart attack and stroke, every minute counts. The longer you wait, the more damage you may have. This spring, St. Joseph Medical Center opened its stroke center and improved processes for patients coming to St. Joseph with stroke symptoms. In the months since the stroke
center opened, volumes have nearly doubled. What is stroke? A stroke occurs when blood flow to the brain is disrupted. The most common type is a so-called ischemic stroke. Thats when a blood clot or piece of plaque blocks a vessel
to the brain. In a hermorrhagic stroke, a blood vessel in the brain bursts, spilling blood
into the surrounding tissue. Treatment for these two types of stroke is very different.
Identifying which kind of stroke the patient is having is crucial in care because if a patient
is having an ischemic stroke there is a promising treatment available, the clot-busting
drug called tPA, but it must be given within a three-hour window from the onset of
symptoms. continued on page 4 Kidney Stones Stone Crushing
May be the Answer f youve ever had a kidney stone,
you know how painful it can be. While
most kidney stones pass through the
body without much trouble, sometimes
intervention by a physician is needed.
One commonly used procedure is extracorporeal shock wave lithotripsy
(ESWL)a big term for a fairly simple
procedure. Lithotripsy is a Greek word
meaning stone crushing. ESWL uses shock
waves, not surgery, to break up stones so
they can pass through the body. Patients
lie on a cushion and the shock waves pass
through the body to be delivered to the
stones. St. Joseph Medical Center now
offers this treatment through a cooperative
agreement with area urologists. A mobile
unit specifically equipped for lithotripsy
comes to St. Joseph four days a week.
During the procedure, a urologist sends about 100 waves each minute to the
stone. Its not painful, but patients are
sedated because they will feel a little sting
or snap, explains Harold Delaughder, RN,
the technician helping with the treatment.
It usually takes about 30 minutes to
deliver 4,000 hits. Patients do not spend
the night in the medical center after
treatment.
A big advantage to lithotripsy is that many patients can be treated for kidney
stones without surgery and that usually
results in fewer complications, less cost
and a faster recovery. But not all kidney
stones can be treated with lithotripsy
and sometimes, additional treatments are
needed. P I 4 www.carondelethealth.org From the Foundation New Board Officers and
Directors Announced The St. Joseph Medical Center Foundation welcomes its Board of
Directors for fiscal year 2008: Officers: Michael McVey, Chair Sam Sabaugh, Vice Chair John L. Brown, Treasurer Laura Foley, Secretary New Members: Charles F. Jensen Karin Morgan LeeAnn Orscheln
Our gratitude for their years of board service goes to retiring members
Phillip A. Orscheln and B. Max Wuellner. Join the Friends of
St. Joseph The Friends of St. Joseph is a membership organization that provides
opportunities for fellowship and service
on behalf of St. Joseph Medical Center.
Several fun events are planned throughout
the year including presentations on civic
and healthcare issues and social outings
at local attractions. We welcome new
members. If you are interested in
joining, we invite you to attend the
Friends of St. Joseph breakfast on
Wednesday, October 24, at St. Joseph
Medical Center. For more information
about joining the Friends of St. Joseph,
call Jennifer Fisher at 816-943-2766. Stroke Center continued from page 3 What is Transient Ischemic Attack (TIA)? TIAs are caused by a temporary interruption in the blood supply to the brain. While it is not a stroke, about a third of all strokes are preceded by one or more
TIAs.
TIA and stroke have the same symptoms: sudden weakness or numbness; sudden severe headache; loss of speech; loss of vision or dimness (particularly in
one eye); sudden dizziness or loss of balance. But TIA symptoms are temporary
and the body returns to normal.
Its important not to ignore the warning signs, even if they go away, says Kathleen Henderson, RN, St. Joseph Stroke Center co-director. A TIA is often
an early warning that a more serious stroke may occur. Its important to find out
the underlying problem causing the TIA and correct that before a stroke. Act F.A.S.T The symptoms of a stroke can vary widely and depend on the area of the brain affected. Medical experts say if you suspect someone is having a stroke, act
F.A.S.T for the best outcomes.
F = Face: Ask the person to smile. Does one side of the face droop? A = Arms: Ask the person to raise both arms. Does one arm drift downward? S = Speech: Ask the person to repeat a simple sentence. Can he or she? Are words slurred? T = Time: If the person shows any symptoms, call 911 or get to the Emergency Department fast. Time is brain. A stroke can happen gradually or suddenly. The most important thing to remember is that stroke is always a medical emergency.
For more information, or to receive a free refrigerator magnet with stroke warning signs, call 816-9HEALTH (943-2584). PAD: Assess Your Risk Peripheral artery disease, or PAD, is similar to coronary artery disease. With PAD, deposits of fat
and calcium narrow arteries and reduce the blood
flow to the limbs and vital organs such as the brain and kidneys. Blocked
arteries to the brain can cause stroke. Blocked arteries to the kidneys can cause
hypertension and renal failure. Blocked arteries to the legs can cause pain,
tissue damage and even loss of limb.
Find out if you are at risk for PAD. Visit the Vascular Center at Carondelet Heart Institute for a thorough evaluation which includes:
Cardiovascular history Blood pressure measurement Cholesterol check (including HDL, LDL, triglycerides and TC/HDL ratio Blood glucose level Exercise status Nutritional profile Body fat analysis Ankle Brachial Index Carotid artery status At the end of the assessment, your personal heart advocate provides consultation on controlling your risk factors. Call 816-9HEARTS (943-2787) to schedule your
risk assessment. $60 (a $200 value) Michael McVey, Chair, St. Joseph Medical Center Foundation Board of Directors. G 5 www.carondelethealth.org Call Center 816-9HEALTH (943-2584) Monday-Friday Physician Referral -
Knee and Hip Center 8 a.m. - 4:30 p.m. St. Joseph Offers Healing
Power of Pet Therapy Pets Trigger Our Feel Good Hormones any know and have experienced first hand the joy of adoring brown eyes, a
wet nose and wagging tail. The companionship of a pet gives its owner immeasurable satisfaction. But few realize how the presence of a pet can measurably improve physical health.
In a 2005 American Heart Association study, research on hospitalized heart failure
patients showed a 12-minute visit with a pet helped heart and lung function by lowering
blood pressure, diminishing the release of harmful hormones and decreasing anxiety.
For years, the Carondelet Health long-term care facility of Carondelet Manor has
offered pet therapy to its residents. Now, patients at St. Joseph Medical Center can
benefit from a visit with mans best friend through the Pets for Life program.
Pets for Life has 23 years of experience in pet therapy in Kansas City, says Susan
Ruiz, St. Joseph volunteer who initiated the program at the medical center. Pets
participating in the program are carefully screened and have had a temperament test and
medical evaluation by a veterinarian.
Those interested in becoming a pet volunteer must have owned their pet for a
minimum of six months, and their pet must be at least one year of age, healthy and
sociable and have no history of aggressive behavior.
If you would like to participate in the animal-assisted therapy program, call
Jeri Grimes, director of Volunteer Services, at 816-943-2775. St. Joseph Employee of the Year erald Robinson is the first to admit it. Hes a lucky man. Hes has a wonderful familya wife and two children. And, he really likes his job.
He must. Hes been the mailroom clerk
at St. Joseph Medical Center for 27 years.
Hes good at it too. So good, Robinson was
named St. Josephs Employee of the Year.
He considers one of the perks of his job
is getting around all areas of the medical
center. Im not a desk person, says
Robinson. I like being active and I really
enjoy the people I work with.
Coworkers say Robinson has a great
attitude and enjoys what he does. He takes interest in what is happening in others lives
and can have quick discussions while making deliveries about the latest best selling
book, or where the fish are biting this week. He says he interested in everything!
You could say Robinson has found a key to happiness. His motto: An enjoyable life is
doing something worthwhile everyday. Words to live by.
For job opportunities within Carondelet Health, go to www.carondelethealth.org, or call
816-943-JOBS ( 943-5627). M Gerald Robinson, St. Joseph Medical Centers Employee of the Year. Who can resist a happy hound? Renee (center) is the first Pets for Life volunteer. From left to right: Susan Ruiz, Kathy Madsen Nancy Richart and Kaye Martin. Health HealthWorks Works Health care news and information Caring for life. Fall 2007 Public Relations
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