Health Matters The latest news on the health and wellness issues that matter most January 2015



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Health Matters The latest news on the health and wellness issues that matter most January 05 NCH ACCREDITED as a Chest Pain Center Acclaimed as one of the top 50 cardiovascular hospitals in the nation, the NCH Healthcare System sought accreditation from the Society of Cardiovascular Patient Care (SCPC) for its cardiac care services, striving to ensure a continuum of improvement in care and efficiency. NCH s Associate Chief Nursing Officer of Operations Jonathan Kling, said that in August 04, NCH was notified it had achieved the accreditation for the NCH Downtown Campus that is recognized as the area s eminent Chest Pain Center with percutaneous coronary intervention (PCI). PCI involves balloon insertion to open blood flow to the vessels. While both the North and Downtown NCH Campuses provide exceptional cardiac care and protocols in identifying heart attacks, cardiovascular patient care is centered at the latter campus where heart catheterizations, pacemaker insertions, open heart procedures and valve replacement procedures are performed. Two SCPC surveyors spent one day interviewing those in the emergency room setting, including EMS partners, physicians and catheterization lab staff to evaluate standards of care in eight key areas with 07 measurement points. Cardiac services evaluated included those from admission, to procedures, to discharge for chest pain with PCI that is performed in less than 60 minutes from arrival. NCH has hit this mark consistently for three years running. Kling said that the validation of the order set, established on evidencebased criteria, ensured that proper care was provided in a timely manner and that all points of care or bundle elements were met. Now, with new standards of care, benefits are numerous: quicker intervention, quicker assessment of a patient s condition, quicker treatment, less time in hospital and quicker time in opening vessels to improve blood flow to the heart, Kling said. Formerly, to determine a heart attack, our lab tested for enzymes three times in a 4-hour period. With the new standard of care protocols, physicians can determine the presence of a heart attack within six hours of arrival rather than 4 hours. Also measured were the partnership, protocols and data sharing with Lee and Collier County EMS staff. Best practice includes a good pre-hospitalization protocol and relationship with local EMS providers. Kling noted that from the start of the accreditation process in Aug. 03 to Aug. 04, the length of stay for the patient program was 84 hours. Now the time has been cut to 34. hours. Previously, after a heart attack was ruled out, you would have had a stress test in the hospital. Now the goal is to try and discharge the patient and do the stress test in the cardiologist s office. For all cardiac care, patients can now remain in the community knowing their care is the gold standard, Kling added. The chest pain protocol and identification order process is the same at both NCH campuses. If a patient is admitted at the NCH North Naples Campus but found to need cardiac intervention, then we will transfer the patient to the NCH Downtown Campus. With an efficient process of improved communication and a process that is streamlined, reducing waste and variability, patients can cut three days off their hospital stay to.5 days. BENEFIT OF IMPROVED STANDARDS OF CARE Reduced costs to patients Reduced length of hospital stay Quicker diagnosis and treatment plan: 34. hours versus 84 hours No waiting in the ER for a bed for those who are in need Improved patient satisfaction For more information about the NCH Heart Institute and the Chest Pain Center, call Jonathan Kling at (3) 55-77.

NICU: Giving Back with a of Love With the completion of the NCH Neonatal Intensive Care Unit (NICU) last July, thanks to funding by local benefactors like Bill and Marie Pastore, the facility now provides superior medical attention and treatment to premature babies as well as newborns with complications. The Level II unit, located within the NCH BirthPlace, is the only such facility in Collier County. Once the decision was made to begin the expansion of the overfilled nine-bed NICU in the summer of 03, an immediate need for equipment became apparent. After being made aware of the need and responding to the tug of their heart strings, the Pastores stepped up and provided breast milk warmers for each of the 8 beds that doubled the unit s capacity. They also funded a critical need for four open Giraffe incubators, Bill and Marie Pastore Chatham, Massachusetts and now spends part of the year in Naples. For the Pastores, philanthropy is very much a family matter. Their decision to support the NICU was made with the agreement of their adult children and young grandchildren via the family s foundation. This is where it starts, being able to help the children grow up in a healthy environment. We want to encourage others to think about supporting such projects, not only to benefit our own needs but for the betterment of the entire community, added Marie Pastore. We have received so much happiness from being able to support this wonderful program. In addition to the Pastores, other individuals, along with funding from the 0 NCH Hospital Ball, have providing fragile newborns an ideal environment to grow and thrive. Later, after touring the facility, the couple decided to make a second generous donation toward the new unit s overall construction costs. Our grandparents came from Italy and we didn t have very much growing up; but we worked hard, and now, we are fortunate in what we have. I was a premature baby and know how critical the need is for specialized care and equipment, said Bill Pastore. We are blessed with healthy children and grandchildren, and we love children. We have always taught our family that charity begins at home, and we have always helped our relatives. Now, we feel the need to give back. Originally from Brooklyn, New York, the couple settled in North contributed to the equipment purchases and expansion. The expanded NICU has given the clinical team new resources to enhance the care of the community s tiniest treasures. We now have a three-bay private lactation room and a comfortable family waiting room where families can receive updates on their baby s care in privacy. Also, when the baby is ready to transition to home care, we have a rooming-in room where a family can stay one or two nights in a hotel-like setting, said Cathy Ravelo, NCH nurse manager for the NICU and pediatrics. We check on the baby s vital signs periodically, are available for questions and provide support in the use of any special equipment, ensuring the parents are comfortable with caring for their baby before going home. To make a donation contact the NCH Healthcare Foundation at (3) 64-000, or visit www.nchmd.org/donate. For more information about the NCH BirthPlace, Neonatal Intensive Care Unit call (3) 55-774. Meet Brian Wallace,Orthopedic Surgeon Brian Wallace, DO, orthopedic surgeon, recently moved to Southwest Florida from Cincinnati, Ohio. He works alongside Dr. H. Kurtis Biggs in providing comprehensive orthopedic care as an orthopedic specialist in sports medicine and arthroscopy. Dr. Wallace has privileges with the NCH Healthcare System. He originally chose the field of orthopedics after having surgery on both knees in college and experiencing a positive outcome. He attended the Ohio University Dr. Brian Wallace College of Osteopathic Medicine and completed a sports medicine and arthroscopy fellowship. Today, in addition to general orthopedic care and with his extensive training in joint reconstruction and fractures, his interests include the arthroscopic treatment of the shoulder, elbow and knee. Among new techniques in the field, he said many are minimally invasive with faster recovery times and decreased pain. In considering treatment, he said that he first uses non-operative modalities such as platelet rich plasma (PRP) injections and orthobiologics before surgical options. Orthobiologics is a newer way of treating problems with options like stem cell hierarchy. It offers increased function with the ability for patients to get back to their daily activities more quickly than ever before, he said. According to the American Academy of Orthopaedic Surgeons (AAOS) web site (orthoinfo.aaos.org), orthobiologics, in use for 5 years, includes stem cell harvesting from the patient s body to assist in rebuilding cells at the injury site, turning them into muscle, tendon, bone or cartilage. The technology results in improved and faster healing with the goal of returning the injured site to its preinjury condition. Future advances in the field are promising. The AAOS site states that researchers are currently working on a bone glue that would not only fix fractured bones, but also provide substances to aid the healing process. A sports enthusiast, Wallace enjoys golf, fishing and outdoor activities, plus he also serves as the team physician for Ave Maria University, offering sideline medical coverage to players. BENEFITS OF ORTHOPEDIC TREATMENT Faster return to activities Quicker recovery Decreased pain Increased function For more information about the NCH Orthopedic Services call Suzanne Graziano, Director of the NCH Orthopedic Center of Excellence at (3) 64-36. To make an appointment with Dr. Wallace, call (3) 6-663.

NCH BABY FAIR Scheduled for February 05 On Aug., 04, NCH held its first ever Baby Fair at the NCH North Naples campus. The event was so successful with 75 women and more than 00 attendees total that a second Baby Fair has been announced for this upcoming February in the Telford Center at the NCH Downtown campus. The Baby Fair is an opportunity for women in the community who have either delivered babies in the last two years or who are currently pregnant to come to NCH to be educated on the services we offer, explains Bernadine Hinton, NCH Director of Women BABY FAIR AUGUST 04 The Importance of Breast-feeding and Children Services. It is also a time to meet the vendors in the area that have products or services that pertain to them or their children, and attend some educational offerings focusing on important newborn topics, she adds. Last August, one educational lecture on safe sleep with Dr. Harry Moreau was so well attended it will reappear at the upcoming event. In the planning stages are two other educational lectures, presented by pediatricians, focused on the importance of breast-feeding and early interventions with children. Everyone can come or go as they please and select the topics that interest them the most. The most beneficial part is the education we offer. New research is occurring all the time, Hinton explains. As for vendors, there is an open invitation to everyone in the community. Twelve vendors, including Dillard s, Once Upon a Child, Twinkle Twinkle Little Store, the NCH Safe and Healthy Kids Coalition and other smaller, local businesses attended in August. This February the hope is to double that. The Baby Fair is open to everyone: grandparents, siblings, aunts, uncles, fathers, mothers and those who support them. We hope to see you at the Baby Fair. For more information, contact Bernadine Hinton, NCH Director of Women and Children Services, at (3) 55-757. NCH Outpatient Rehab Caring for the Painful Thumb When ordinary daily tasks look at the functional limitasuch as opening toothpaste tions, manipulative ability and tubes, food jars and bottles or appearance. We then formueven turning door knobs belate a customized treatment come painful, it may be time plan, McBride said. Our goal to seek a referral from your is to help patients improve general physician, rheumatoland maintain their range of ogist or orthopedic specialist motion, increase strength and to treat your painful thumb. function and decrease pain Therapy from an occupaso that they can have a better tional therapist is an effecquality of life. tive remedy. Kerri McBride, Treatments include custom OTR/L, CHT, is an NCH ocsplinting to rest the thumb, reccupational therapist, and has ommendations for assistive debeen a Certified Hand Theravices, strengthening and range pist for 0 years. of motion exercises, instruc While men also experition on using hands with less ence the condition, one third stress on the thumb joint and of women over age 40 will exinstruction in using the entire Kerri McBride, (left) demonstrates an evaluation of painful perience arthritic changes in hand rather than fingers for liftthumb with NCH staff therapist Anna Nelson. the base of the thumb. Pain can ing and grasping movements. originate from overuse, laxity of the joints, trauma, a long term wear and Other options include wrapping foam, cloth or tape around knobs, tear of the joint or genetics. Most commonly, pain occurs with pinchkeys, pots and other handles to build them up and cushion them. ing or grasping motions such as turning a key, writing, holding a book Additional treatments include using lever door handles, jar openers and or opening plastic bags, McBride explained. We apply pressure to the in some cases using heat and ice and physician-prescribed medication. base of the thumb even when it is used to support body weight when moving from a seated to standing position. The thumb provides 50 perbenefits OF OCCUPATIONAL cent of the function of the hand. AND HAND THERAPY The painful thumb condition can result in contracture of the thumb Increased strength Increased range of motion joint, changes in its shape and deformity at the base of the thumb. This leads to a weakened and barely functional hand. Decreased pain Improved function Initially, we evaluate range of motion, strength and sensation and For more information, call the NCH Outpatient Rehabilitation Center at (3) 56-0834, located at 330 Immokalee Rd., in the Greentree shopping plaza.

Marco Urgent Care Center 84 MARCO ISLAND CELEBRATES ITS URGENT CARE CENTER S 30 th Anniversary On Feb. 4th from a.m. until noon there will be an open house to celebrate the 30th anniversary of Marco Island s Urgent Care Center. It will include health screenings, blood pressure screenings, Ask-the-Doctor booth, tour of the campus, as well as giveaways and light refreshments. There are many different reasons why patients drop by the Center. People visit the Urgent Care Center for simple things, Betsy Novakovich, RN, MSN, CEN, Director of NCH Emergency Services and Marco Urgent Care explained. These include cold, flu, eye redness, minor lacerations, fever, sore throat, urinary tract infections, etc. The center does not replace the necessity for a primary care physician or emergency department, but it does provide a great deal of help to many local residents who use it quite frequently. With two physicians, seven RNs as well as their director (Novakovich), five customer service representatives, an administrative assistant, environmental service and lab personnel staff, two radiology techs, all patients are well taken care of. The Urgent Care Center keeps two very important relationships, one with the auxiliary and the other with the local fire/ems department, which is directly across the street. Patients walk into the Urgent Care Center with chest pain, stroke and other serious problems that need to be treated at the hospital. The fire department is key in collaborating with the health center to safely transport them to an emergency department for the care they need. The auxiliary provides fundraising and hands on support year round with increased assistance during the seasonal influx. Many of the center s staff members live on the island. It s people caring for others in their community. That s key. They really do care about what we provide to all people: both fulltime residents and visitors. It s a unique place, Novakovich said. This anniversary is far from the last the center will have. The center opens its doors at 8 a.m. and continues seeing patients until 7:30 p.m. It s open 365 days a year, including weekends and holidays. Not only is this incredibly beneficial to fulltime residents, but also very helpful for vacationers who wish to seek medical help during their stay without leaving the island. DON T MISS MARCO URGENT CARE 30 TH ANNIVERSARY When: Wednesday, February 4, 05 am - pm Where: MARCO ISLAND URGENT CARE 40 Heathwood Drive Marco Island, Florida 3445 For more information, call the Marco Island Urgent Care Center at (3) 34-834.

NCH Healthcare System on U.S. News and World Report NCH HEALTHCARE SYSTEM Top 5 List In Florida U.S. NEWS AND WORLD REPORT Top 5 List in Florida The NCH Healthcare System is the only healthcare system in Collier and Lee Counties to make the list of the US News & World Report 04 top 5 medical centers in Florida. NCH is ranked #7. The report looked at 65 hospitals in Florida. This is the 5th year the publication has ranked hospitals. The 04-5 U.S. News and World Report national rankings cover nearly 5,000 medical centers across the country and span 6 medical specialties from cancer to urology. NCH has been ranked high-performing in the following five specialties: Orthopedics, Gastroenterology & GI Surgery, Diabetes and Endocrinology, Urology, and Geriatrics. We appreciate being nationally recognized for the third time by this most trusted news organization, said Allen Weiss, M.D., President and CEO, NCH Healthcare System. The residents and visitors in Southwest Florida deserve great health care and the NCH team continues to demonstrate its commitment to deliver the highest levels of excellence across the board. These rankings and accolades are a reflection of the important work being done every day for our patients. U.S. News bases the rankings largely on objective data on hospital performance, such as patient survival rates and resources like nurse staffing. Each hospital's reputation, as determined by a survey of physician specialists, is also a factor. The complete rankings and methodology are available at http:// health.usnews.com/best-hospitals. Avoid common food portion pitfalls by following these tips: Familiarize yourself with healthy serving sizes. Visual examples can be helpful when determining an appropriate serving size; for example, a serving of cereal or pasta (/ cup) should be the size of a hockey puck, a serving of fish (3 ounces) should be the size of a deck of cards, and a serving of butter ( teaspoon) should be the size of the tip of your thumb. When serving dinner at home, keep serving dishes off of the table. Serve food directly onto individual plates and leave any extra in the kitchen to avoid the temptation of going for seconds. Instead of eating snacks right from the box, put an appropriate serving size in a bowl and put the box away to avoid grazing. Buy single-serving treats for easy, no-stress snacks. Forget about spoiling your dinner; eating small, healthy snacks throughout the day as you get hungry will help keep you from overeating at mealtimes. Separate the contents of large packages of food into several smaller bags or containers to create convenient, ready-to-go snacks and avoid accidental overeating. When buying in bulk, store what you don t need right away somewhere harder to get to. If it isn t within easy reach, you will be less likely to grab for it. Keep any especially tempting or unhealthy foods out of sight, storing more healthy options in front at eye level. Restaurant portions are particularly large. When eating out, try splitting a meal with a friend or asking for a to-go box right away so that you can immediately box up half of your meal to eat later. Many restaurants also offer light or lunch menus with more appropriate serving sizes. Slow down! While you are eating, pay attention to the color, scent, taste, and texture of each dish, and take the time to stop between bites to talk with friends or family. When you eat slowly, your body will be better able to recognize when it is full, and you will be able to fully appreciate what you are eating. For more tips to keep your portions in control, visit choosemyplate.gov. For more information, call the NCH von Arx Diabetes and Nutrition Health Center at (3) 64-3450.

NCH and the NCH Physician Group HEALTH SERVICES DIRECTORY Cardiology David Axline, MD Francis C. Boucek, MD Michael S. Flynn, MD Adam J. Frank, MD Sarah Lindsay, APRN Cindi Lukacs, ARNP Alejandrina Montas, PA-C Kearston Perfetto, ARNP Pediatrics Reisha F. Brown, MD Dulce V. Dudley, MD Andrew P. Podos, MD Debra G. Shepard, MD 3 Bruce A. Gelinas, MD Richard Prewitt, MD Tracey Roth, MD Carlo Santos-Ocampo, MD Herman Spilker, MD Gastroenterology & Hepatology Jan M. Barrios, MD Mazen Albeldawi, MD Beth Diamond, ARNP 6 Todd Vedder, MD Physical Medicine & Rehabilitation E. Sean Kelley, MD 3 7 David A. Stone, MD Silvio C. Travalia, MD Shona Velamakanni, MD Cardiovascular Surgeons Robert Pascotto, MD Dennis Stapleton, MD Concierge Medicine Robert E. Hanson, MD Jesse H. Haven, MD Julie Southmayd,MD Family Medicine Jose Baez, MD Andrew M. Bernstein, DO Christian O. Beskow, MD Natasha Choyah, MD Ruben Contreras, MD Jennifer A. DiRocco, DO Ruth Dupont, MD Rasai Ernst, MD Emily Essert, DO Lisa Gallagher, DO Richard S. Gould, MD Erik Hiester, DO Karen Hiester, DO Mark E. Josephson, MD Brian Menichello, MD Monica Menichello, MD Albert Scafuri, Jr., MD Gary Swain, MD Ashley L. Tunkle, MD Venkata Yerramilli, MD Angela B. Beckwith, PA-C 4 4 6 5 4 4 4 4 7 7 6 4 6 General Surgery JB Brockman, MD David Lamon, MD Luigi Querusio, MD Geriatric Medicine Angel H. Herrera, MD Obayedur R. Khan, MD Infectious Disease Gary A. Bergen, MD Vato Bochorishvili, MD Mark A. Brown, MD Miguel Madariaga, MD Internal Medicine George T. Crabb, DO Diana Daoud, MD, Robert Folsom, MD Mark R. Goldstein, MD Jorge Guzman, MD Karen Henrichsen, DO Larry Kohn, MD David Linz, MD Mary Ann M. LoMonaco, MD Bryan Murphey, MD Nelly Perez, MD David I. Sommerfeld, MD Joseph Stafford, MD Tracy Walsh, MD David C. White, MD Victoria Wadsworth, ARNP Orthopedic Surgery Jon S. Dounchis, MD Howard J. Kapp, MD 6 6 4 4 4 4 6 3 8 8 3 6 6 6 6 Psychiatry A. Kyle Hagstrom, MD Pulmonary, Critical Care & Sleep Medicine Lawrence H. Albert, MD Kenneth Bookman, MD Cartrell Cross, MD Douglas Harrington, DO David H. Lindner, DO Ismael Martin, DO Christopher A. Mendello, MD Bruce G. Roy, MD Rheumatology Eric J. Hochman, MD Jay Bombero, PA Urgent Care Karl Korri, MD Steven A. West, MD Michael Tanner, PA Barb Hulser, PA For an appointment with a physician, please call (3)436-855 5 5 0 0 0 0

3 4 5 NCH Downtown Naples Hospital Campus NCH Downtown Naples Hospital: 64-5000 Breast Health Navigator: 64-488 Business/Occupational Health: 64-4630 Community Blood Center: 64-45 Dr. John N. Briggs Wellness Center: 64-750 NCH Heart Institute: 64-400 Outpatient Cardiac Rehabilitation: 64-680 Outpatient Infusion Services: 64-4370 Outpatient Rehabilitation Center: 64-600 Physician Referral / Access Healthline: 64- vonarx Diabetes & Nutrition Health Center: 64-3450 NCH North Naples Hospital Campus NCH North Naples Hospital: 55-7000 The BirthPlace: 55-774 NCH Wound Healing Center: 56-884 Outpatient Infusion Services: 55-7747 Outpatient Pulmonary Rehabilitation: 64-6800 The Brookdale Center for Healthy Aging & Rehabilitation: 55-7 NCH Marco Island Campus Marco Urgent Care Center: 34-834 Outpatient Cardiac Rehabilitation: 33-4033 Outpatient Pulmonary Rehabilitation: 33-4076 Outpatient Rehabilitation Center: 33-407 NCH Wound Healing Center: 403-600 NCH Central Campus: 53-744 White Elephant Thrift Store: 53-7 4 0 8 8 6 5 W. Terry St. 5 6 6 5 3 4 7 7 7 6 7 8 Outpatient Rehabilitation Center: 56-0834 Whitaker Wellness Center: 56-00 Outpatient Rehabilitation Center: 657-8 Outpatient Rehabilitation Center: 47-4440 0 4 0 5 0 4 NCH Wound Healing Center: 45-45 Bonita Community Health Center: 4-050 NCH Urgent Care Center: 56-48 NCH Heart Institute Bonita: 30-56 NCH Physician Group - Rehabilitation Center: 54-78 NCH Physician Group - Women s Imaging Center: 64-8350 NCH Physician Group - Imaging Center: 643-880 For information on any of the NCH Healthcare System services, please call 64- or visit us online at www.nchmd.org. 3 3 The NCH Health Matters is a bi-monthly publication of the NCH Healthcare System. Every effort is made to ensure information published is accurate and current. NCH cannot be held responsible for any consequences resulting from omissions or errors. NCH Healthcare System, 350 7th Street North, Naples, FL 340, Telephone: (3) 64-5000, www.nchmd.org

WAIT TIME Wait from home, not the ER, Urgent Care Center or Doctor s Office. * Go to NCHmd.org and click on the InQuicker banner. Select a projected treatment time Complete a simple online form Arrive at our facility at your projected treatment time to be seen by a health care professional * For patients with non-life or limb-threatening conditions.