APP News - Northern News Edition

Issue 3 Volume 3 November 2023 In this Issue: • Expert Corner: Advanced care planning • APP spotlights: Clinical Excellence Awardees • Caring Angels Raffle

Independence Health System

APP NEWS Northern News Edition

As we move into the holiday season we want to thank everyone for their continued support and performance throughout Independence Health System. We are in the planning stages for new and exciting events for the coming year. We are excited to have advanced practice providers from across the organization joining us in the development of new committees. These committees will bring new opportunities in the areas of Quality Improvement, Education, and Community Engagement. Stay tuned for more information as we develop. We enjoy working with all of you and look forward to another great year.

-Rachel and Lindsay

Advance Care Planning Contributors: Angela Como, PA-C and Lisa Doverspike, PA-C

Advance care planning (ACP) is a process that elicits a patient’s personal values, life goals, and preferences regarding future medical care. This process may include completion of an advance directive.

Advance directives are the documents a person completes to ensure their values are reflected when considering how treatment decisions should be made on their behalf in the event they lose the capacity to make decisions. A surrogate decision-maker should be identified for all patients, regardless of condition, because lost decisional capacity is common and occurs unexpectedly.

Advance directives should be periodically revisited and updated, particularly when there is a change in the person’s health or clinical decision making is needed. Some instances which may indicate a need to review and update a written plan may include but are not limited to: a Medicare Annual Wellness Visit, patient request, a new diagnosis, a recent hospitalization, an upcoming planned surgery, an illness complication.

In an ideal ACP discussion, clinicians, the patient, and their loved ones think through particular approaches to follow if or when the patient’s health declines. These discussions are important to have before time of crisis. Unfortunately, may patients face medical decision-making at a time they lack the capacity to make decisions for themselves. In these cases, surrogates must step in to make decisions that they feel are the decisions the patient would have made for themselves, or if this is unknown, are in the best interest of the patient.

How to initiate an ACP discussion: 1. Invite the patient and their family to discuss their current condition and medical care.

2. Assess the patient’s knowledge about their current health. Knowing the patient’s level of knowledge at baseline will help you understand what kind of information the patient will need to make an informed choice about future medical care.

3. Provide the patient with clear and specific information about their current health status and what choices they may face in the future.

4. Introduce the dilemmas at hand.

5. Explore values and beliefs: Try to understand the person’s values and beliefs, what it means to “live well”, and what goals they seek to obtain with medical treatment.

6. Determine ACP preferences: Ask the patient what they would want regarding issues like CPR, the utilization of “life support”, inpatient hospitalization, and place of death.

7. Identify a health care surrogate.

8. Document their preferences. The patient should document their preferences in writing.

9. Review regularly.

Congratulations to our Clinical Excellence Award Winners 2023 Carolyn Hemphill, PA-C 1. Favorite activities: antiquing, gardening, jigsaw puzzles, Bible study group, restoring antique furniture, paying with my dogs, biking and spending time with my family 2. First job: Buyer for Westinghouse and the Navy Nuclear Program 3. Favorite vacation: We have been going to Cape May, NJ for 23 years and love it there. Another bucket list trip that we did was Egypt, Jordan and Israel which was amazing. We have a family trip to Italy planned for 2024 so very much looking forward to that trip too.

4. Future goals: Learn how to play the piano and looking forward to retirement in the next several years and being able to spend more time with my family.

5. Favorite thing about my career: I get to learn and see new ortho pts/problems every day, teaching new staff, helping improve pt's lives thru our surgeries, and being able to work with an amazing group of Orthopedic surgeons, APPs and staff at Independence Health System. Plus having fun while I do all those things!

Joe Grosso, PA-C 1.What is your favorite thing about your career.

I get to work with amazing PA’s and NP’s. Working with the best cardiac surgeons has made me a better PA. And since then the medical physicians I work with daily, has rounded-out my career overall. Obviously working with other members of the health care team; nurses, PT/OT/ST, respiratory therapist’s, anesthesia, perfusion, case management/social workers make it all GOOD! 2. What are your future goals?

I would like to eventually move to a clinic in Montana where there are no computers and help the people who need medical attention the most.

3. What and where was your favorite vacation?

One time me and my fiancé had a week off together in the summer. We decided to go on a road trip and had no idea where to go. We had both dogs with us and she said ‘let’s head north. We ended up in Erie, Niagara Falls, Toronto, looped around Lake Ontario and then came back through the Adirondack Mountains before heading home. It was the greatest trip never planned!

4. If you could go back in time where would you go and what year?

I would go back to the years I was a head-coach for youth football. I did this for 8 years because I had two sons at different age groups on the teams. Giving the kids confidence and teaching them to master the basics of football was really rewarding. On top of that my wife was the president of the league, so she always made the home games so much fun. My own sons still talk about those days and whenever I am out and hear ‘coach’, I turn around to see a grown man who remembers me from those days.

5. If you could hire a life assistant, what would it be? A cook, cleaning or yard work?

LOL, I do them now, since my wife said she did them all for the first 20 years of our marriage. I cook and clean and we both love to do yard work. She gets to lounge on the couch all day and do nothing!

Rachel Christy, CRNP 1. What are your favorite activities outside of work?

I spend most of my free time with my 2 kids; Grace (15) and Sam (12). We are always running to different activities for school and with friends. I love to spend my time with them, but when I get free time….

• One of my favorite activities is reading (and listening) to books. I feel like I can escape to another place and time. I love historical fiction and classics such as Jane Austen.

• I enjoy playing cards such as 500 Bid, 31, Kings Corners, and Rummy. I always played cards with my dad when I was younger and still enjoy the competition. I also really like to win!!! I do have a competitive spirit!

• I also enjoy being outdoors— taking walks with my dog JoJo, sitting by a camp-fire in the evening with my feet up, snow-skiing (although I’m a bit afraid of breaking now in my older age!), and anything on the water such as kayaking and stand up paddle boarding.

2.What/Where was your favorite vacation?

My favorite vacation spot involves the ocean. I love the Outer Banks of North Carolina. I could sit and listen to the waves all day long (while enjoying a good book!). I love how quiet Hatteras Island is and enjoy taking the ferry to Ocracoke. There is a shop on the right just off of the ferry where I always find amazing treasures. I also love the quaint old time feel of Cape May. There are historical homes, endless shops, so many flowers (love the hydrangeas!), and of course waves and salt water. All of my favorite things.

3.Who do you admire most?

I absolutely admire my mother the most. She is a saint and my hero! She had 8 children (I am the youngest) and always made each and every one of us feel important and loved. She is beautiful, classy, and talented. She taught herself how to play the organ and piano while raising 8 children. She strives to make herself better every day and believes in lifelong education! She always gives the best advice when faced with some of life’s greatest challenges. She continues to work hard and there is nothing she is afraid to take on with home improvements at the age of 88!

4.What is your favorite thing(s) about your career?

My favorite thing is to hear my patient’s stories. That never gets old! I love to have time to sit by their side and listen to their concerns and when I can help them, that is what makes me love my career.

Thursday, November 30 through Thursday, December 7 Nixon Sarver Classrooms, Butler Memorial Hospital Open 7 a.m. to 7 p.m. on weekdays and 10 a.m. to 4 p.m. on the weekend The contact for the Excela Foundation is: Cindy Scarpo Manager Latrobe Area Hospital Charitable Foundation One Mellon Way | Latrobe, Pennsylvania 15650 O 724-537-1983 | C 724-309-6088

cscarpo@excelahealth.org

If you have any information, accomplishment to be showcased, or any appropriate news that you would like to share, please contact Lindsay or Rachel.

If you would like to be a part of the Advance Practice Provider Committee or serve as a mentor for new hires please contact Lindsay or Rachel.

New APP hires/credentialing for Independence Health System: Jason Christopher Takacs Jr, PA-C: Orthopedic Surgery, Tri-Rivers Musculoskeletal Maddison Grace Dovenspike PA-C: Cardiothoracic & Vascular Surgery Meghan Ehko PA-C, BHS: Dermatology Associates Andrea Dorinsky, CRNP: Emergency Medicine, Faster Care Julia West, CRNP: Rheumatology. Tri-Rivers Musculoskeletal Centers.

Joseph Forazio III, CRNA: Nurse Anesthetist. Excela Health Anesthesia.

Melinda Woods, CRNA: Nurse Anesthetist. Excela Health Anesthesia.

Megan Spivak, CRNA: Nurse Anesthetist. Excela Health Anesthesia.

Lori Ann Droschak, CRNA: Nurse Anesthetist. Excela Health Anesthesia.

Tyler Nolf, PA-C: Cardiothoracic & Vascular Surgery. BHS Cardiothoracic & Vascular Surgery.

Tiffany Koelle, CRNA: Anesthesia. Locum.

Next APP Committee Meeting: January 10, 2024 12:00 NOON Tower Conference Room and Zoom See you then!