warmemorialhospital.org JANUARY 2017

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Hospital Healthy at Any AgeRead about vaccines for older adults on page 7

What to Expect in 2017

A messagefrom President and CEODavid Jahn

Hospital ChatHere are some excerpts from letters and comments shared with our CEO from patients and families:

Recently I have had the opportunity to experience the expertise of the Emergency Room and its staff. Because of these visits I have had the opportunity to see in action the improvements over what once was. The attending doctors and nurses were outstanding and very kind, as well as professional. It makes me feel proud to be a resident of Sault Ste. Marie.

I am a regular patient of Dr. Andrew Alshab and it goes without saying that without his care and that of his caring and professional staff, I wouldn’t be walking – period.

Recently I had my Gram in for an ultrasound. Angela was her ultrasound tech and she was wonderful. She was extremely caring and thoughtful. Afterward we went to Dr. Woolever’s office. The staff is always wonderful, caring and super thoughtful.

January is the perfect time to share with our community

the special projects and goals we will undertake here at War Memorial Hospital in the coming year.

ELECTRONIC HEALTH RECORD UPGRADE

The One Patient, One Record project will enhance and upgrade our electronic health record. During the first 10 months of 2017, our employees and our consultants will build this new system from the ground up, and then test it to make sure it works as we want. After the initial testing, we will run parallel testing on actual patients, which means we will be running our old software and our new software at the same time to make sure our processes are working on the new system.

Once all of this testing is done we are hoping to go live with the new software on October 1, 2017. All information on each patient will be within one record so that anyone treating that patient will know everything that is happening with his or her medical care. This new system will also provide a patient portal where the patient can go in and see all of their medical history and test results.

NEW PHYSICIANS IN 2017

Two new physicians will join WMH this summer. The first, Dr. Zara Massod, is a Psychiatrist who will do work out at the Behavioral Health Clinic in Kinross. She will also help staff our outpatient Psychiatric practice as well. The second new physician coming to WMH will be Dr. Kevin Binsell who will work as an Emergency Room physician. Both will start in July 2017 and we look forward to them joining our team.

HIGH RELIABILITY ORGANIZATIONS – HRO Another area of focus for 2017 will be our participation in the second level of the HRO process. We will be one of only nine hospitals in the State of Michigan who will be taking part in a journey to get to zero defects-zero errors. The healthcare system in the United States is one of the most complicated fields of business and it is also dealing with life and death issues each and every day. Because of this complexity, there are many preventable deaths that happen each year in hospitals across the country. The HRO journey will allow us to put systems and processes in place to prevent these types of situations from happening. Being part of this collaborative gives WMH a head start when compared with other hospitals in the State to get to zero defects and zero harm.

TRANSPARENCY

One of the items that hospitals in the United States have been reluctant to share with their communities is their quality data. There is a fear that if they release their infection rates or other complication rates to the general public, it will drive people to seek care elsewhere. Our goal over the next six months is to start sharing this data with our community so that you are aware of what our quality data is and how we compare with other hospitals. By being transparent, patients that choose to come to WMH will know what our results are and our employees will know what processes need to be changed to improve these results. Over time, our community will see the improvements that have been made which should increase the confidence level of people seeking healthcare services at WMH.

WMH HEALTHBEAT 3 JANUARY 2017

Patients receiving care for advanced-stage cancers at War Memorial Hospital’s Cancer Care Center may now benefit from a multi-disciplinary team of specialists offering expert advice on treatment options. Dr. Belisario Arango, WMH’s oncologist, has made the connection between his department and specialists at a variety of well-known cancer centers with the help of a company called Massive Bio. “By utilizing the services of Massive Bio,” the doctor explains, “we get direct consultation with oncologists at renowned institutions who sometimes only specialize in a very specific cancer, but because of that focus, they know everything about it.” Arango will send medical records, tissue samples, lab work and other necessities to what he referred to as a “virtual tumor board” – something that exists in large medical centers and allows specialists in several disciplines to review a patient’s case together. By using this approach, patients in the Eastern Upper Peninsula will get the consultation and expertise of a multi-disciplinary team from the best institutions across the country. “Sometimes patients have gone through the standard treatments and they are still strong enough to explore other options. Massive Bio will bring that additional expertise to us without the patient having to endure the cost and inconvenience of travel,” the oncologist explained. The patient, with the advice of Arango, will still be the ultimate decision-maker regarding course of action.

Renowned cancer experts now available to EUP patients

“It is still an experimental approach and patients first need to start with the standard practices and treatment options used to treat their kind of cancer,” he explained. “You don’t want to utilize experimental approaches on patients in early stages because you risk short-changing them until you have tried the commonly-tested, standard treatments.” Utilizing Massive Bio and the “virtual tumor board” costs approximately $1,500 and is not currently covered by insurance. The ultimate truth about cancer care is that there is no cure, so Dr. Arango cautions about keeping expectations realistic about all treatment, including the work of Massive Bio. “In some instances, we may not have an answer, no matter who is consulting,” he explains. But by using Massive Bio, Arango can also find out if there are any trials appropriate for the patient and get extra help facilitating that process.

Part of the process also involves performing genetic testing on the cancer tumor itself to identify the gene mutations found within it. Those mutations give scientists additional information to consider. With additional sets of trained eyes and minds, patients may find new avenues to explore. The oncologist shared an example of how it might work. “Let’s say we’ve tried three or four treatment options for a melanoma and, through gene mutation testing, we see some similarity to leukemia. I would have never thought to give this patient a leukemia drug but now, with this new information, we can try that drug and also make a case to the insurance company to show this patient is eligible for this treatment because of the gene mutation found in testing,” he explains. Arango is quick to explain that, even with the services of Massive Bio and the focus of other specialists, there is no silver bullet where cancer is concerned. It is only for patients with advanced cancers who are running out of options.

Spend five minutes talking with Sharon Portice, RN, and you will be left with no doubt that she is worthy of the Daisy Award for Exceptional Nurses. She is a nurse who has been known to give patients a hug and, in her current role, almost always talks to patients by phone on Thanksgiving, Christmas, and New Year’s Day.

This 32-year veteran of nursing believes to her core that “the world is a better place with kindness” and “if we can make someone feel a little better, we go home knowing it’s been a good day.”

Portice currently holds the title of Pain Coordinator at the Upper

before Thanksgiving, Christmas, or New Year’s Day have received a follow-up call from this dedicated nurse who takes time out from her own holiday to make the call. She has also been known to give patients her cell phone number and says “in 32 years, I’ve never had anyone misuse my cell phone number.”

The work of a pain clinic was new to Portice when she joined the staff, which was part of its appeal.

“I like to learn and, as you continue to grow in your career, if you stay in the same area, you don’t get to keep learning,” she explained. “Dr. Alshab and Dr. Daha have done a great job of helping us learn to provide hope to our patients who are in pain. Dr. Alshab once told me ‘Sharon, some people don’t have hope any more and we have to help them get hope back.’”

Portice says she was honored and humbled when learning she was chosen for the Daisy Award.

“I just feel like I’m doing my job. It’s something I’ve always loved to do - taking care of people. When I decided to become a nurse, I gave up a scholarship that would have helped me to become a CPA. Aside from marrying my husband and having children, it was absolutely the best decision I ever made,” she states emphatically.

Portice’s supervisor, Marion Burton, the WMH Director of Nursing Marla

Bunker and CEO David Jahn

presented Portice with flowers and a sculpture that is symbolic of caring.

Pickford’s Sharon Portice, RN honored

Peninsula Pain Institute in Kinross. She has worked in this War Memorial Hospital practice since 2012. Her career has been spent at WMH, Sault Tribe’s health division and Dr. Hampton’s office. After getting her RN from Lake Superior State College, Portice started at WMH before later leaving to work elsewhere and then returning to the hospital in 2008.

The Pickford native now oversees UPPI, which includes the services of two physician providers, an ambulatory outpatient clinic, an outpatient surgery room and a recovery room.

Dr. Andrew Alshab was the person who nominated Portice for the Daisy Award. He praised her willingness to get patients the care they need and her practice of addressing patient concerns both during and after work hours.

“Everyday interactions of consistent patient-centered care by Sharon have provided for the growth of UPPI,” he remarked.

For the past five years, patients who have received an injection the day

WMH HEALTHBEAT 5 JANUARY 2017

For people grappling with a major depressive disorder, schizophrenia, bipolar disorder or other mental illnesses, the world can be an overwhelming place. When the situation is particularly dire and self-harm is a concern, patients and families in the Eastern Upper Peninsula find help close to home at the WMH Behavioral Health Center.

Opened in 2007, the BHC is the only inpatient facility north of Traverse City and east of Marquette.

“It placed an enormous burden on families when someone needed inpatient behavioral health services and they had to drive hours away to get this service,” said David Jahn, WMH CEO, explaining the decision to open the unit. “Our leadership team and our Board took the leap to invest in this service so we could have behavioral health services in our community.”

Located in Kinross, the BHC has 20 beds and draws patients from all over the state. Corinna Haller, RN-BSN, is the Director of Nursing and works alongside staff who not only help patients, but work to eliminate the stigma surrounding mental illness.

“If you had cancer, you would get it treated. If you had diabetes, you would go to the doctor. This is the same thing,” she says matter-of-factly.

On top of the stigma, patients used to struggle with getting insurance coverage for care, but that has changed.

“With mental health services now having parity with physical health services, I think we will see more people take advantage of the programs we have,” Jahn commented.

BHC: Help in a mental health crisisThere are two paths that lead a patient to inpatient admission at the BHC, according to Haller. A voluntary admission is the optimal path, but sometimes an involuntary admission is necessary.

“In the voluntary situation where a person knows they need help, we encourage people to go to the Emergency Room and let them know there have been thoughts

situation, a family member or friend would seek out a court order for admission. It starts with a visit to the probate court in Chippewa County - a crucial partner in helping people get the mental health treatment they need.

One thing to keep in mind is that threat of self-harm doesn’t have to be explicitly stated. “They don’t have to say the words ‘I’m going to kill myself’ but if they haven’t eaten for weeks, don’t get out of bed, daily living is impacted negatively - that can be a danger,” Haller explained.

Typically patients stay at the BHC for a period of five to seven days. Some admissions last longer and others much shorter depending upon each individual situation.

“Family members may wonder what you can do in five to seven days, but remember that we are able to move medications along much more quickly. Some dosing that would take weeks or months to achieve if the patient were home we can accomplish in a matter of days under supervision,” Haller said.

During the course of that stay, patients participate in group therapy sessions, one-on-one counseling

with the psychiatrist and psychiatric nurse practitioner, goal-setting exercises and other discussion groups focused on medications, coping skills, motivation and more. They can also spend time with visitors every afternoon.

“Thank you for being there for

me. My life is more fulfilled by the

moments I shared within your

walls. Thank you for being my

shelter during a needed time in

my life.” –from a BHC patient

of self-harm. They will perform a community mental health screening and may draw some lab work to make sure the person is medically stable,” Haller explains. From there, the ER staff will make contact with the BHC and the admission process will begin.

At times, a loved one may not realize that they need help. In an involuntary

What it means to be YOUR community hospital By Teresa Armstrong, Director Community Relations and Development Fund

Every year, we are required to provide our “Community Benefit” information to the IRS. When compiling it, I find that we do so much more than fits on the form provided and I would like to share it with you.

War Memorial is YOUR com-munity hospital. Every year, we invest thousands of dollars in programs and services in the local area. In 2016, we supported local causes and events while also providing educational pro-grams to help our community be well. Our doors are always open to students of all ages. In 2017, we conducted tours of the hospital for students as young as pre-K all the way through to visiting international college students. No matter the age, we want to provide opportunities for youth to learn about professions in healthcare.

We are proud to provide health and wellness events to our com-munity, including:

• Community Baby Shower• Heart Month activities• Health Fair• Tackle Cancer• First Aid at events like Engineer’s Day and Gus Macker • Participation in Senior Day, Downtown Days, Lakerpalooza and more!

Our employees serve our com-munity as well. I am constantly amazed by their generosity in giving both time and financial support. There is often a bake sale, t-shirt sale, raffle, etc, taking place in the hallway by the cafe-teria. Employees are members of countless community boards and organizations. Dedicated WMH employees spend countless hours and dollars rallying around the important work happening in our community.

In 2009, hospital administration made a commitment to provide free transportation to patients needing radiation treatments. Road to Recovery has been transporting EUP residents ever since. We coordinate the vehicle, the schedule and train the ded-icated group of volunteers who make the five-days-a-week drive to Petoskey. This program is funded by amazing support from the community. We often get

calls from groups, churches, and individuals who wish to donate or fundraise on behalf of the program. War Memorial has also made a financial commitment to activities in the region through financial sponsorships of fundraisers, non-profit organizations and services in our community. All dollars stay local and often sup-port youth and/or health. There are far too many to name, but here is a sample:

• Corner Pieces • EUP K-12 school athletics and programs • EUP Special Olympics• EUPISD Beginnings Library• Families Against Narcotics of Chippewa County• Girls on the Run• Hospice of the EUP• I-500• Michigan Youth Hunter Education• Northstar Habitat for Humanity• Salvation Army • Sault Theatre Project• Suicide Prevention Programming• Youth Basketball & Hockey• And many more!

I am constantly amazed by good works in our community and the generosity of our organization and its employees. I can’t wait to see what 2017 will bring!

WMH HEALTHBEAT 6 JANUARY 2017

that is clearly marked with your dose, usually in mL, tsp, or tbsp. If

your liquid medi-cation does not

come with a measuring device, ask your pharmacist for one.

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Stories by Angela Nebel, Summit Public Relations Strategies, LLCDesign and printing by Paul Ignatowski and Sault Printing Co.Selected graphic elements by Freepik.comCover photo by Picture This Photography & Design

War Memorial Hospital is an equal opportunity provider and employer.

Pursuant to the authority granted to Det Norske Veritas Healthcare, Inc. by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, this organization is deemed in compliance with the Medicare Conditions of Participation for Hospitals (42 C.F.R. §482). This certificate is valid for a period of three (3) years from the Effective Date of Accreditation. Effective Date of Accreditation: October 26, 2014.

WMH HEALTHBEAT 7 JANUARY 2017

MEDICINE MOMENT – Did you know you should NEVER measure liquid medications with household utensils?

Household utensils are not uniformly sized and this can cause either too much or too little medication to be given. Always use a measuring device (like a dose cup or an oral syringe)

SHINGLES VACCINEAdults who are 60 years of age and older are advised to get a shingles vaccine, even if they have already had shingles. This is a live vaccine delivered through a single injection, typ-ically in the arm. Some people may still develop shingles, but the vaccine may reduce its severity.

Side effects of the shingles vaccine are tenderness, redness and swelling at the injection site, as well as headaches. A chickenpox-like rash occurs in some people after getting the vaccine.

Three vaccines older adults should consider

The vaccine isn’t recommend-ed to those individuals who:• Have a weakened immune

system due to a disease that affects the immune system;

• Are receiving drugs that suppress the immune sys-tem, like steroids, Enbrel, Remicade, Humira, or treatments like radiation or chemotherapy;

• Have had an allergic reac-tion to the antibiotic neo-mycin, gelatin or any other components of the shingles vaccine.

• Have leukemia or lympho-ma or any other cancer that affects bone marrow or the lymphatic system.

PNEUMOCOCCAL VACCINESAccording to the CDC, pneumococcal disease claims the lives of thousands of adults each year and lands thousands more in the hospital. This disease leads to severe infection of the lungs (pneumonia), infection of the bloodstream (bacte-remia), and infection in the lining of the brain and spinal cord (meningitis).

There are two vaccines that can prevent pneumococcal disease:• PCV13 (pneumococcal conjugate vaccine)• PPSV23 (pneumococcal

polysaccharide vaccine)

These vaccines are safe, but mild side effects can occur. Talk to your doctor about these vaccines and whether they are appropriate for you.

As we age, we often are resigned to the fact that our future will hold a variety of illnesses and aches that are simply unavoidable. There are, however, some ailments that we can prevent. Have you spoken with your primary care provider about vaccines for things like shingles and pneu-monia? Here’s a brief snapshot on three vaccines that adults may want to consider.

Your local health care providers

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EAR, NOSE & THROATSault Otolaryngology M. Wallace, DO (906) 259-0244 EMERGENCY SERVICES *T.G. Adams, MD *J.M. Neri, DO *M. Oates, MD *B. Samuel, MD *A. Seidner, MD *K. Raycraft, MD GENERAL SURGERY K.L. Mc Cullough, MD (906) 635-1048 Advanced Surgical Care *J. Adair, MD *P. Rechner, MD (906) 253-9770INFECTIOUS DISEASEWMH Infectious Disease *A. Luka, MD (906) 253-2665INTERNAL MEDICINE E.J. Ranta, MD (906) 632-6823Lakeview Internal Medicine T. Chander, MD (906) 635-9090WMH Internal Medicine *C. Rivera, MD (906) 632-5824 *K. Sawruk, NP (906) 253-2665NEPHROLOGYWMH Nephrology *M. Haider, MD (906) 632-5824OB/GYNECOLOGY Sault Women’s Healthcare *S. Amo, MD *N. Cristof, MD *A. Donmyer RN, CNM *M. Guevara, DO (906) 635-3002ONCOLOGY WMH Oncology *B. Arango, MD *J. Brow, NP (906) 253-2685

OPHTHALMOLOGY Grand Traverse Ophthalmology M. Madion, MD D. Thuente, MD P. vonKulajta, MD J. Wentzloff, MD (906) 635-9802ORTHOPEDIC SURGERYWMH Orthopedics *R.W. Ganzhorn, MD *S.M. Woolever, DO (906) 632-4740PAIN MANAGEMENTUpper Peninsula Pain Institute *A. Alshab, MD *A. Daha, MD (906) 632-5849PATHOLOGY C. Liu, MD (906) 635-4434PEDIATRICS *P. Newhouse, MD (906) 635-4401Sault Pediatrics *R. Beckman, DO (906) 253-2605PODIATRIC SURGERY R. Sehgal, DPM (248) 553-4040PULMONARY/CRITICAL CAREWMH Pulmonology *E. Al-Ghandour, MD *A. Ellis NP (906) 253-2652RADIOLOGYCedar Straits Medical Assoc., PC R.J. Duman, MD S. Bailey, MD (906) 635-4438SLEEP MEDICINEWMH Sleep Medicine *J. Sand, DO *F. Siddiqui, MD (906) 253-2788UROLOGYWMH Urology *L. M. McCormick, DO B. Gier, PA (906) 632-5808

Drummond Island Family Health Care, PC C. Cordray, CFNP, MSN (906) 493-6644Drummond Island Medical Center *S. Aldridge, MD *S. Daniels, PA (906) 493-5221ALLERGIST/ASTHMA Great Lakes Allergy & Asthma Center, PC P. Ranta, MD (906) 253-0400ANESTHESIOLOGY *Joe Beccario, CRNA *A. Daha, MD *D. Marjomaki, CRNA *N. Newhouse, CRNA *N. Sattar, MD *J. Slade, MD *F. Winkler, MD *E. Woolever, CRNA (906) 635-4589BARIATRIC (WEIGHT LOSS)Advanced Surgical Care *J. Adair, MD (906) 253-9770BEHAVIORAL HEALTH SERVICESBlue Water Behavioral Health *P. Sorgi, MD *D. Wilson, NP (906) 495-2209CARDIOLOGY Michigan Heart & Vascular W. Doghmi, MD D. Miranda, MD N. Overton, MD Jason Ricci, MD (906) 253-0668DERMATOLOGYWMH Dermatology *I. Siniakov, MD (906) 253-2652

FAMILY PRACTICE P.W. Niemi, DO (906) 632-1100Bay Mills Health Center D. Maloney, MD D. Furr, NP A. Rivard, NP (906) 248-5527Bridgeview Family Medicine T.E. O’Connor, MD J. Garlinghouse, MD J. Peterman, MD (906) 253-9374Community Care Clinic *S. Bartz, PA *R. Brand, NP *B. Gier, PA *W. Jamros, NP *T. Marino, NP *D. Paquette, PA *L. Tetzlaff, NP (906) 635-4401LSSU Health Care Center S. Bartz, PA-C M. McLeod, NP-BC (906) 635-2110Riverside Medical Associates M. Crawford, CFNP R.H. Mackie, MD T. Malloy, FNP-BC P. Nichols, CFNP J.P. Ockenfels, DO T.N. Tetzlaff, DO (906) 632-1800 Sault Tribe Health Center C. Behling, CFNP E. Javellana, MD G. Maloney, MD V. Sherman, MD L. Styer, MD R. Werner, MD (906)632-5200Superior Family Medical J.M. Pahn, MD Tracey Marino, NP (906) 632-0370 VA Community BasedOutpatient Clinic Colleen Burton, NP (906) 253-9383WMH Community Care - Kinross *C. Harris, MD *J. Sommers, NP (906) 495-1344WMH Family Care – Cedarville *B.M. Slater, DO *S. Daniels, PA (906) 484-2295WMH Family Medicine *E. Baccari, DO *P. Gunasekera, MD (906) 253-2665

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