Award-winning Health Care

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1 the healthcare magazine for englewood hospital and medical center Healthy You Award-winning Health Care spring 2013 Super Facts About Superfoods & Revolutionary Heart Care englewoodhospital.com

2 Advancing Severe Aortic Stenosis Care A revolutionary valve replacement procedure at Englewood Hospital and Medical Center offers some patients suffering from severe aortic stenosis a renewed lease on life. Aortic stenosis (AS) is a potentially lifethreatening heart valve condition caused by a narrowing that prevents the flow of blood from the heart to the body. Transcatheter aortic valve replacement (TAVR) provides a potentially lifesaving treatment option for some patients suffering from aortic stenosis and are at high risk for traditional operation. We re very excited to have access to this groundbreaking procedure that s only been FDAapproved for about a year, says Adam Arnofsky, MD, Director of Cardiac Surgery Services at Adam Arnofsky, MD Englewood Hospital. It s a real privilege and honor to be among the first hospitals nationally to perform it, and Englewood Hospital is one of only a handful in New Jersey where it s available. Prior to this, high-risk patients with congestive heart failure from severe aortic stenosis had limited treatment options. Now, they have a chance to return to near normal life expectancy. According to Dr. Arnofsky, patients who have undergone the procedure have noted an almost immediate improvement in congestive heart failure symptoms and have reported back with relief of their symptoms. Pioneering Technique Welds Team and Technology The new procedure is performed in Englewood Hospital s Hybrid Operating Room, which combines the advanced technology, environment, and equipment required for the technique. The cardiothoracic surgeon and interventional cardiologist partner with clinical cardiologists and other members of Englewood Hospital s award-winning cardiac team to ensure success. You can t perform this procedure without a smooth-functioning, multidisciplinary team, Dr. Arnofsky says. This procedure emphasizes the high level of collaboration that exists among members of the cardiac team at Englewood Hospital. We rely on everyone s individual skill set and knowledge to get the best outcome for our patients. To learn more about TAVR, call Englewood Hospital s Heart and Vascular Institute at (201) TAVR at Englewood Hospital and Medical Center This is a very exciting time at Englewood Hospital, says Richard Goldweit, MD, Director of Interventional Cardiology at Englewood Hospital. Patients who have severe aortic stenosis with symptoms, those Richard Goldweit, MD who are considered inoperable often because of many comorbidities or frailty or patients who are deemed high risk with an STS [Society of Thoracic Surgeons risk score] greater than 8 percent are candidates for this procedure. Transcatheter aortic valve replacement (TAVR) is an extraordinary advance, transforming a formerly open-heart procedure into a minimally invasive one. Englewood Hospital s TAVR program is built on the only interventional cardiology program in the state recognized two years in a row for their low 30-day mortality ratings after heart attacks. The minimally invasive procedure for aortic valve replacement fits well with our blood management program because it can result in less blood loss, fewer transfusions, and better outcomes, Dr. Goldweit says. Patients come to Englewood Hospital from all over the country and around the world because of what we accomplish in terms of outcomes. 2 Healthy You Spring 2013

3 Atrial Fibrillation Patients Benefit from New Procedure Grant R. Simons, MD Atrial fibrillation (AF) is the most common identifiable cause of stroke in the United States. An innovative new procedure at Englewood Hospital and Medical Center s Arrhythmia Center offers new hope for patients at risk. AF an irregular heartbeat that can allow blood to pool and clot within the heart puts patients at high risk of a potentially deadly stroke if a clot develops and travels to the brain. For many of those patients, taking blood thinners to lessen the risk of stroke is not an option, because traditional blood thinners may cause bleeding complications. For patients who can t take blood thinners, we now have an FDA-approved device, called the Lariat, that we can use to tie off the left atrial appendage where clots may form, says Grant R. Simons, MD, Director of Cardiac Electrophysiology at Englewood Hospital. The Lariat is a catheter with a round wire at the tip that looks sort of like a lasso. The procedure uses the catheter to deploy a stitch that closes the neck of the left atrial appendage the area where approximately 95 percent of clots originate. The procedure is minimally invasive, and it only requires two needle punctures. Changing Patient Outcomes Several patients with high stroke risk have already undergone the minimally invasive procedure at Englewood Hospital, with excellent outcomes. I am very satisfied with the results of the first procedures, Dr. Simons says. In both cases, we were able to use ultrasound to verify that the left atrial appendage was closed off. Advancing Arrhythmia Treatment Englewood Hospital is the first hospital in New Jersey to use the procedure, adding to the Arrhythmia Center s advanced technology and treatment options. We re very excited about this excellent alternative for patients who have the very real dilemma of being at risk of stroke but can t receive anticoagulant therapy, Dr. Simons says. The Arrhythmia Center continues to explore leadingedge therapies so we can remain at the forefront of treatment of heart rhythm disorders. To learn more about the Arrhythmia Center at Englewood Hospital and Medical Center, visit BestHeartDocs.com or call (201) Atrial Fibrillation and Stroke Arrhythmias are irregular heartbeats that occur when the electrical signals that control the heartbeat become erratic. Symptoms can range from a mild sensation in the chest or neck to sudden cardiac arrest. According to the National Institutes of Health, the most common type of arrhythmia is atrial fibrillation (AF). Persons who experience AF may be in danger of a clot forming in the atrial chamber of the heart when blood pools in the chamber. The pooling comes from the interruption of the normal contractions of the heart in AF. Spring 2013 Healthy You 3

4 Every physician, nurse, and staff member at Englewood Hospital and Medical Center is dedicated to ensuring the hospital remains the region s best provider of high-quality, safe, and compassionate health care. This commitment to exceptional care has resulted in many awards and recognitions from prestigious, national organizations year after year. Last fall, the hospital received nearly 50 awards for quality, safety, and patient satisfaction. Excellence Rewarded Setting Standards Reaching and exceeding benchmarks for clinical excellence and patient satisfaction requires dedication and vigilance. Englewood Hospital s pledge to deliver an outstanding patient experience at every turn begins with a clear set of institution-wide goals. As an organization, Englewood Hospital has a culture of consistent safety and quality, says Kathy Kaminsky, MS, RN, Vice President of Clinical Effectiveness. To maintain a high level of patient care, Englewood Hospital both proactively and retrospectively monitors care across all services. This helps to identify areas of excellence as well as processes that may require adjustment information that is vital to organizational goal setting. By regularly analyzing how staff performance measures against hospital standards and by incorporating valuable feedback from patients, physicians, staff, and community members, Englewood Hospital makes certain its team is doing everything possible to provide the best care. Distinguished Care Positive feedback from patients is an invaluable measure of Englewood Hospital s success. Kathy Kaminsky, MS, RN Additionally, distinctions from nationally recognized, independent organizations also are very important because they provide third-party validation of the exceptional level of care that patients receive. Among many recent national recognitions (see Making the Grade ), Englewood Hospital recently was honored with the Distinguished Hospital Award for Clinical Excellence from HealthGrades. This exclusive award ranks Englewood Hospital among the Top 5 percent of hospitals in the United States for clinical performance. These national awards highlight the extraordinary commitment to patient care and safety by our dedicated healthcare team, Ms. Kaminsky says. Our dedication to our patients is our No. 1 priority, and these distinctions confirm that we are successfully exceeding our goals. Frank Moore, MD, FACS A safe and high-quality medical experience is every patient s right, and we will continue to make it our priority at Englewood Hospital. Spotlight on Spine Surgery While many specialties within Englewood Hospital have received prestigious awards and distinctions, its multidisciplinary Spinal Surgery Program stands out for the particularly exclusive accolades it has received. Most impressively, Englewood Hospital was named by HealthGrades as America s 100 Best Hospitals for Spine Surgery in According to Brian Cole, MD, FAAOS, orthopedic spine surgeon at Englewood Hospital, patients can rest assured they are receiving the best in personalized attention when they choose to seek spine care at Englewood Hospital. Englewood Hospital and Medical Center is very sensitive to the patient experience. Because we offer a full range of services from conservative treatment through minimally invasive to tradition open surgery we re able to start with a conservative outlook and provide the most suitable level of intervention for each individual patient. When patients recognize they are receiving the proper 4 Healthy You Spring 2013

5 level of care from the appropriate providers, they are satisfied with the quality of their care. Frank Moore, MD, FACS, Chairman of Neurosurgery at Englewood Hospital, says the Medical Center s key to excellence in spine surgery is teamwork. Our team is well-oiled from doing the same procedures every day for a total of about 400 per Lawrence I. Livingston, MD year, Dr. Moore says. Our nursing staff, electrophysiology monitoring, and radiology technicians know how we operate, allowing us to duplicate the same level of excellence on each surgery. The team also extends to the nurses in the holding area who follow patients after surgery and the nurses on the floor who are familiar with the unique postoperative needs of spine patients. This team approach to spine surgery was developed over years of orthopedic and neurosurgeons working together to establish a model for success. As a result, complex neuro-related spine surgery and spine fusion have established a successful track record of several decades at Englewood Hospital. Lawrence I. Livingston, MD, Chief of Orthopedic Surgery at Englewood Hospital, echoed the importance of the team approach. Our specialized staff physicians, nurses, and rehabilitation professionals cares for spine patients daily, Dr. Livingston says. This dedicated team of professionals is instrumental to the consistency and quality of care we provide. To learn more about Englewood Hospital and Medical Center s commitment to quality patient care, visit EnglewoodHospital.com. Making the Grade U.S. News & World Report s Best Regional Hospital, ranking 5th in the New York metro area; high-performing in 10 clinical areas HealthGrades 2013 Quality Achievements: Distinguished Hospital Award for Clinical Excellence 2013; among the Top 5 percent of hospitals in the United States for clinical performance Top 100 Best Hospitals in the United States for Spine Surgery, No. 1 in New Jersey for Spine Surgery; No. 3 in New Jersey for Overall Orthopedic Services Top 5 percent nationwide for Neurosurgery Top 10 percent nationwide for Neurosciences Top 10 percent nationwide for Maternity Care Top 10 percent nationwide for Treatment of Stroke Top 10 percent nationwide for Overall Pulmonary Services; No. 4 in New Jersey Top 10 percent nationwide for Overall GI Services Top 10 percent nationwide for General Surgery Awarded an A for Outstanding Patient Safety by The Leapfrog Group Recognized by CareChex as one of America s Top Quality Hospitals (2012); Top 100 nationwide for Medical Excellence in Heart Attack Treatment and Interventional Carotid Artery; Top 10 percent nationwide for Medical Excellence in Cardiac Care, General Surgery; Top 10 percent nationwide for Patient Safety in Cancer Care, GI Care, GI Hemorrhage, Heart Attack Treatment & Heart Failure Treatment, Hip Fracture Repair, Major Bowel Procedures, Neurological Care, Overall Medical Care, and Stroke Care 100 percent Survival Rate in Cardiac Bypass Surgery; one of only three hospitals in NJ with a perfect record as identified by The NJ Department of Health and Senior Services Magnet Designation (2002, 2004, 2010) by the American Nurses Credentialing Center for nursing excellence Recognized by The Joint Commission as a Top Performer on Key Quality Measures Designated by The Joint Commission and the New Jersey Department of Health and Human Services as a Primary Stroke Center and Certified for Joint Replacement Awarded the Gold Seal of Approval for Spinal Fusion by The Joint Commission Spring 2013 Healthy You 5

6 A Good Night s Sleep Is Good for the Heart Insufficient sleep can do more than wreck your nerves; it can hurt your heart literally. According to the Centers for Disease Control and Prevention, sleep disorders can increase people s risks for cardiovascular diseases and other heart-related issues. For a person suffering with a sleep disorder, the thought of trying to get a good night s sleep can send the heart racing and pulse pounding. The National Sleep Foundation confirms that patients with cardiovascular issues such as hypertension, heart failure, and stroke have a high prevalence of sleep disorders that can often be warning signs of a more serious illness. A report in the Journal of the American Medical Association states that sleep deprivation and sleep disorders promote calcium buildup in the arteries of the heart. The buildup can then break apart, causing heart attacks and strokes. Sleep disorders include: Getting to the Bottom of What s Keeping You Up If you re not getting restful nights sleep you should be. The Center for Sleep Medicine at Englewood Hospital and Medical Center offers a comprehensive, state-of-the-art diagnostic program to help identify sleep disorders. The treatments are non-invasive, non-stressful, and allow patients to return to their natural, restful sleep patterns. Accredited by the American Academy of Sleep Medicine in recognition for their outstanding level of care, sleep specialists carefully access patients with mild to severe disorders. If you feel you may be suffering from an undiagnosed sleep disorder, says Mitchell Engler, MD, board-certified Pulmonologist and Director of The Sleep Center at Englewood Hospital, you should discuss such symptoms with a physician who can refer you to our Center. Mitchell Engler, MD Insomnia Narcolepsy Restless legs syndrome Sleep apnea Richard Goldweit, MD People with obstructive sleep apnea have an increased risk for stroke and other cardiovascular problems, explains Richard Goldweit, MD, Director of Interventional Cardiology at Englewood Hospital and Medical Center. Men and women with obstructive sleep apnea a disorder where the flow of air to the brain is interrupted for multiple intervals throughout the night should be evaluated for cardiovascular problems with an eye toward prevention. According to the American Thoracic Society, a new study shows obstructive sleep apnea can increase a person s risk of having a heart attack by nearly 30 percent during a four- to five-year period. Left untreated, sleep apnea produces worse cardiovascular outcomes and leaves the patient at increased risk for arrhythmias, stroke, and even heart attack, Dr. Goldweit says. No matter what the reason, a person struggling with a sleep disorder should seek medical attention before the problem leads to something worse down the road. For more information about Englewood Hospital s awardwinning cardiovascular services, visit BestHeartDocs.com. If you do not have a personal physician, call The Sleep Center at (201) to be referred to a highly skilled sleep specialist. 6 Healthy You Spring 2013

7 Superfoods: Facts vs. Fiction The myth of a superfood that acts like a dietary miracle has been around for many years, says Joanne Lewandoski, RD, CDE, Chief Clinical Dietitian at Englewood Hospital and Medical Center. People may get fixated on certain foods that do the trick for them, Ms. Lewandoski says. Superfoods are like fad diets; people pick up on a trend, and it becomes popular for a while. Can a single food save your life? But that s not to say those foods aren t beneficial. According to common wisdom, superfoods are high in nutrients and low in negative properties, such as saturated fats. Of course, many healthy foods fit that description, but superfoods often attract extravagant claims that they can cure cancer or add years to your life, for example. While some foods are definitely healthier than others, the key is moderation. Joanne Lewandoski, RD, CDE It s important to eat a healthy diet and a variety of foods, Ms. Lewandoski says. Increase your intake of foods that are high in fiber and low in fat, such as fruits and vegetables. Hometown Heroes Plenty of easy-to-find, inexpensive foods pack the same nutritional punch as exotic varieties. The Office of Research Services, with the National Institutes of Health, recommends the following superfoods. Apples are full of phytochemicals and flavonoids, both antioxidants. Apples are also high in fiber. Beans and other legumes contain fiber, folate, iron, magnesium, calcium, potassium, and zinc. They also provide a protein punch without the saturated fat found in many meats. Tomatoes are rich in vitamins A, C, and E, as well as fiber. They are also high in carotenoids and polyphenols. To learn about Nutrition Counseling available at Englewood Hospital, call (201) Are Supplements the Same as Food? Many people buy nutritional supplements over the counter, but Joanne Lewandoski, RD, CDE, Chief Clinical Dietitian at Englewood Hospital and Medical Center, urges caution. It s better to get your nutrients from food, she says. For example, salmon is high in omega 3s, and it s better to consume the actual fish. But for people who can t afford salmon or don t like the taste of fish, omega-3 and fish oil supplements are available. Ms. Lewandoski adds that a registered dietitian or primary care doctor can help people select the right supplements. Most people do pick up dietary supplements on their own, but there may be contraindications you don t know about, she says. For example, fish oil can cause bleeding, so you should avoid fish oil if you are going to have surgery. It s important to discuss all dietary additives, including supplements, vitamins, and extracts, with your primary care doctor. Ms. Lewandoski adds that primary care practitioners can refer patients to registered dietitians for in-depth consultations about diet and nutrition. Spring 2013 Healthy You 7

8 350 Engle Street Englewood, NJ Nonprofit Org. US Postage PAID Lynchburg, VA Permit No. 830 Healthy You is a publication of the Marketing and Communications Department of Englewood Hospital and Medical Center. Helping Kids Feel at Ease Before Surgery Child Life experts at Englewood Hospital and Medical Center help make an unfamiliar and potentially worrisome medical experience easier for our youngest patients. One of the best ways to ease the fears of children who will undergo surgery is to help them understand what to expect. Child Life Specialists at Englewood Hospital lead in-person, pre-operative tours to help children and families prepare for the surgical experience. These tours are arranged by appointment during weekdays. However, for families who are unable to take the tour in person, Englewood Hospital offers a new Virtual Pre-Surgical Tour. The Virtual Tour is a visual and narrative presentation that helps young children understand what will happen when they visit the hospital. Through the use of realistic photos and accurate explanations in age-appropriate language, children become familiar with the hospital environment and learn about the sequence of events on the day of surgery. This tool can help clarify misconceptions children may have about the upcoming experience and help families plan effective coping strategies for a child s hospital stay whether it is a few hours or several days. Everyone experiences anxiety prior to surgery. For children especially, what they imagine is often more frightening than reality. Parents can reduce their own anxiety and minimize their child s fears by preparing for what will actually happen, says Michelle Brauntuch, MS, CCLS, Certified Child Life Specialist. Preparation including the use of the Virtual Tour makes a medical experience more predictable, helps encourage a reassuring conversation, and makes feelings more manageable for everyone. If your child is scheduled to have surgery at Englewood Hospital, call (201) to schedule an in-person tour or visit EnglewoodHospital.com to take the Virtual Tour. Michelle Brauntuch, MS, CCLS Child Life Specialists help children and families manage the spectrum of challenges faced during hospitalization, surgery, medical procedures, and other psycho-social aspects of health care. Specialists work with children in inpatient and outpatient settings at Englewood Hospital and Medical Center and assess each child and family, provide support, and work with them to promote effective coping.