Saturday, April 8, 2017 • Page 1B
Making care affordable Memorial Hermann-affiliated physicians working together to improve quality while lowering costs In 2015, Memorial Hermann embarked on a new adventure in the journey towards population health through the initiation of the Accountable Care Organization Service Line (ACOSL) projects. Under the auspices of the Memorial Hermann Accountable Care Organization (ACO), these projects aim to increase efficiency and decrease cost for Medicare inpatients in the areas of Orthopedics, Heart and Vascular and Hospital Medicine. In its inaugural year, these projects saved approximately $1.7 million dollars. These savings are directly attributable to the efforts and commitment of our affiliated physicians, who strive to provide the very best evidence-based care in the most efficient and coordinated way possible. Quality Data and Processes Shape Care Shahid Rahman, M.D., an interventional cardiologist affiliated with Memorial Hermann Greater Heights, leads the hospital’s Heart and Vascular ACO Service Line projects. “ACOs are a new way of looking at health care,” says Dr. Rahman. “There is an ACO Service Line projects team for Hospital Medicine,
Heart and Vascular and Orthopedics. Each team examines performance metrics to demonstrate the value of care to patients. For example, cardiologists used to consider it a success to open up a patient’s blocked artery with a stent after a heart attack. Now, with the ACO Service Line structure, we take a holistic approach, ensuring that kidney function remains stable throughout hospitalization, all medications shown to save lives are administered, and a referral to cardiac rehabilitation is made when the patient leaves the hospital.” Through the ACO Service Line, quality gaps are addressed and optimum processes and procedures are developed to improve patient care and reduce hospital re-admissions. At Memorial Hermann Greater Heights, follow-up care is particularly important for patients leaving the hospital, so numerous procedures help ensure patients continue their care with the appropriate healthcare professionals. “Medicine is no longer the lone wolf doctor, but a team sport,” says Dr. Rahman. “For example, a patient who experiences a heart blockage needs a great critical care team, cardiologist, cardiothoracic surgeon, nurses and See Care, P. 2B
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Photo supplied Dr. Shahid Rahman leads the Heart and Vascular ACO Service Line Projects at Memorial Hermann Greater Heights.
By Betsy Denson betsy@theleadernews.com
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Running on a variety of surfaces instead of sticking to just one surface may help runners reduce their risk of injury. Officials with the USA Track and Field’s Sports Medicine and Science Committee recommend that runners vary their runs so they run on pavement, trails and tracks. While it helps to run on various surfaces, researchers do not believe one particular surface is better than another. In fact, while running on asphalt has long been assumed to increase injury risk because of the presumption that harder surfaces produce greater impact forces on the body, a recent study from researchers at the Hannover Medical School Department of Plastic, Hand and Reconstructive Surgery found that running on asphalt surfaces decreased mid-portion tendinopathy risk while running on sand surfaces increased that risk tenfold. Photo by Christina Martinez There are far flung trails which Leader readers frequent, but they also like to stick to favorites close to home.
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Different people have different tolerance levels for Houston’s spring and summer weather but whether it’s in the (relative) cool of the early morning or evening, or even during the noonday sun, active readers shared their favorite running and walking trails. “For the last four years I’ve run the streets of Garden Oaks and Shepherd Park Plaza and loved every minute of it,” said Vanessa Smith. “I literally run out my front door and can run six to seven miles without ever having to get in my car to go anywhere. Every week I get to see how the neighborhood changes.” Sarah Cruise seconds this: “Apollo to Sue Barnett is just shy of a mile. I love seeing familiar faces.” Kara D’Agostino sticks to Candlelight Plaza and Shepherd Park Plaza. “There is a loop that goes around the outer edges of the neighborhood and it is about three miles long,” D’Agostino said. “It is a great loop when I am training for longer races. It is also easy to zig zag up and down the streets to get the miles in. The roads are also smooth with none of the holes that you can find in other places so it is a pretty easy run. The bonus is when training for the Houston Half and there are lots of long runs in December, you get to look at the amazing Christmas lights in the neighborhood.”
Other votes include the trail down Heights Boulevard where you can take in ‘Art Trek’, the latest installation of a unique sculpture project. You can check out the Stude Park route on the USA Track & Field website at http://www. usatf.org which includes Heights Boulevard and is nine miles. Natalie Griffin likes the Buffalo Bayou trails from Sabine Street and Allen Parkway to Memorial Park. For a run in a different direction, Candice Croker suggests starting at Spotts Park, 401 South Heights Blvd., and going along Allen Parkway all the way downtown along the bayou. Casey Gage is a fan of the White Oak Bayou trail “especially now that it’s connected to the Heights trail.” Meredith Raine says the White Oak trail is also a favorite for her training for the AVON 39 The Walk to End Breast Cancer. Raine prefers Candlelight Park in Oak Forest for short, early morning walks. Ella Lee Forest residents know that the loop in their neighborhood is a little over a mile. A number of people utilize the TC Jester Park trails for their exercise. Bethlehem, a long street which crosses both Candlelight Estates and Oak Forest, was singled out for its lack of traffic. For walkers, who don’t mind taking a drive first, the Houston Arboretum is a good spring and summer choice. “I like that it’s dog friendly,” said Laurie Pitzer. “I love watching for critters and taking advantage of lots of shade.”
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Athletes are one of a few populations that are likely to fall prey to fads that claim to improve their performance. There are many fads that are popular right now. Let’s take a look at the scientific research that has been proven to be the best way for elite athletes to weekend warriors to fuel their body’s for Catherine Kruppa, peak performance. MS, RD, CSSD, LD Carbohydrates (whole grains, fruits, vegetables and low fat dairy products) are the main fuel for muscle activity and for brain function. Even if you are trying to lose body fat, 5060% of your diet should be comprised of carbohydrates. Fat burns in a carbohydrate fire, meaning you must have carbohydrates to burn fat efficiently. Carbohydrates are also stored in your liver and muscle as glycogen to be easily broken down for energy. Severely lowered liver and muscle glycogen levels during exercise induces early fatigue and decreased intensity of exercise, despite an almost unlimited potential energy from stored fat in the body. If you are a marathoner, this is called “hitting the wall”. A cyclist may refer to it “bonking”. Prior to exercise or competition you want to consume adequate low glycemic index carbohydrates that are digested and absorbed quickly as your main energy source along with a small amount of protein and fat. Aim for 0.5-2 grams of carbohydrate per pound 1-4 hours prior to exercise. Examples of pre-workout snacks include: 1. Half a chicken, turkey or lean roast beef sandwich on whole-wheat bread 2. Low-fat yogurt with a sliced banana 3. Low-fat string cheese and 6 whole-grain cracker 4. Hard-boiled eggs, yolks removed and replaced with hummus 5. Skim milk blended with frozen fruit to make a smoothie Many of my clients do not consume enough food and carbohydrates prior to exercise and it comes back to haunt them during exercise or later in the day. If you are exercising consistently for 90 minutes or longer,
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