FirstHealth Magazine - Winter 2011 by FirstHealth of the Carolinas

Spring 2011

the magazine from FirstHealth of the Carolinas

Reid Heart Center The FirstHealth Cardiac & Vascular Center

firsthealth.org

You Say Weâ&#x20AC;&#x2122;re Tops in Patient Satisfaction! Whether you need inpatient, outpatient, emergency or surgical services, your friends and neighbors say FirstHealth Montgomery Memorial provides a highly satisfying experience. But donâ&#x20AC;&#x2122;t take our word for it; take theirs by visiting www.firsthealth.org/mmh and see our high patient satisfaction scores. In these days of rising gas prices, convenience is more important than ever. Choose FirstHealth Montgomery Memorial Hospital for highly satisfying health care, close to home.

www.firsthealth.org/mmh 983-170-10

firsthealth CEO message

The culture of innovation

in·no·va·tion (in'-v'-sh-n) n. (LL innovatio) 1 the act or process of innovating 2 something newly introduced; new method, custom, device, etc.; change in the way of doing things

Charles T. Frock

Chief Executive Officer FirstHealth of the Carolinas

n a recent blog for the Harvard Business Review’s Health Care Innovations Insight Center, Gardiner Morse, a senior HBR editor who focuses on innovation, emerging technologies and sustainability, opined on the need for innovation in health care: “If ever a field needed a makeover, it’s medicine,” he said. “…There’s no shortage of clever ideas, but barriers to innovation are just as abundant.”

“Innovation is so much a part of the FirstHealth mentality that it is becoming ingrained as part of our culture.”

Despite the barriers, which include what he described as “heart-stopping price tags for technology” and a sometimes stubborn reluctance toward change, Mr. Morse proposed 10 innovations that he believes could “transform medicine.” While some of his suggestions, innovations that concern regenerative or genetic medicine, for example, are obviously more suited for research institutions, others—medical checklists, surgical robots, online portals for patient information and evidence-based decisionmaking—are already common practice for FirstHealth of the Carolinas. Still others, accountable care organizations and innovative options for physician payment, are being investigated. In fact, innovation is so much a part of the FirstHealth mentality that it is becoming ingrained as part or our culture. It might be argued that the very seeds of our organization were sewn in a climate of innovation. Few people thought that the tiny Moore County Hospital, created at the beginning of the Great Depression more than 80 years ago, would survive, much less thrive. But it did and FirstHealth of the Carolinas, its 21st century descendant, is now a comprehensive health care system that serves the mid-Carolinas with technology, programs and services that are rare—if not unique—for a community of this size. Over the years, we have developed our culture of innovation by being open to and, when appropriate, welcoming change. Unlike large

teaching institutions, we don’t have a research and development program. So instead, we rely on instinct, good judgment, professional education and the successes—or lack thereof—of others when considering new technology, programs and services. We are blessed with a Community Health Services department with an eye for innovation and a talent for aligning itself with innovationsupporting organizations that include The Duke Endowment, the Kate B. Reynolds Charitable Trust and the W.K. Kellogg Foundation. We also have outstanding financial support from the Foundation of FirstHealth, and we can depend on the talents of a bright and motivated staff and the advice of an involved medical community for ideas. Several years ago, Dr. Mike Rowland, one of our general surgeons, encouraged us to investigate robotic surgery. We did, eventually investing in the da Vinci Robotic Surgical System, which has greatly enhanced the options we can offer to patients who need certain urologic and gynecologic surgeries. More recently, physicians and staff encouraged us to include two dual-purpose (also known as hybrid) operating rooms in the new Reid Heart Center and the staff of the FirstHealth Centers for Health & Fitness introduced the Exercise is Medicine (EiM) concept to a community eager for disease prevention and wellness. The dual-purpose ORs, which merge the high technology of a cardiac catheterization lab with the sterile environment of an operating room, give us the flexibility for complex cardiac and vascular procedures with untold opportunities for the future. The EiM program partners physicians with the fitness experts of the Centers for Health & Fitness to encourage physical activity as a regular part of daily living. These and other innovations are highlighted in this issue of FirstHealth, and each—according to the musings of Gardiner Morse—portends the future of health care. I can assure you that more are on the way for FirstHealth of the Carolinas. firsthealth.org

155 Memorial Drive P.O. Box 3000 Pinehurst, NC 28374 Editor, FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . Brenda Bouser Managing Editor. . . . . . . . . . . . . . . . . . . . . . . . . . . Jason Schneider Creative Director . . . . . . . . . . . . . . . . . . . . . . . . . . . Jan McLean Senior Art Director . . . . . . . . . . . . . . . . . . . . . . . . . . James Davis Production Director. . . . . . . . . . . . . . . . . . . . . . . . . . Traci Marsh

4 . . . . FHC Happenings

f i r s t h e alt h . o rg

9 . . . . Calendar

Contributing Writer Brenda Bouser

Contributing Photographer Don McKenzie

Board of Directors FirstHealth of the Carolinas

10 . . . New providers 26 . . . Letters

Mr. Alex Bowness, Chair Mr. Julian King, Vice Chair Robert Bahner Jr., M.D. Mr. H. Edward Barnes Jr. David Bruton, M.D. Mr. James H. Bulthuis Mr. David L. Burns David M. Cowherd, M.D. John N. Ellis, M.D. Walter S. Fasolak, D.O. Mr. Charles T. Frock Mrs. Carolyn D. Helms

Mrs. Anna G. Hollers Mr. John M. May Dr. Susan R. Purser Bruce S. Solomon, D.O. John S. Stevenson, M.D. William L. Stewart, M.D. Stephen A. Szabo, M.D. Mr. Robert E. Tweed Mr. David Woronoff

Corporate Officers Chief Executive Officer, FirstHealth of the Carolinas

. . . .

Mr. Charles T. Frock

Chief Operating Officer, FirstHealth of the Carolinas President, Moore Regional Hospital. . . . . . . . . . . . . . . . . . . Mr. Stuart G. Voelpel Chief Financial Officer, FirstHealth of the Carolinas . . . . . Mrs. Lynn S. DeJaco Chief Information Officer, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. David Dillehunt Vice President, Human Resources, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. Daniel F. Biediger

26 Letters

Vice President, Finance, FirstHealth of the Carolinas. . . . Mr. Jeffrey A. Casey Vice President, Community Services, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Vivian Harrington Vice President, Quality, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Cindy McNeill-McDonald Vice President, Patient Care Services/CNO, Moore Regional Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Linda Wallace President, Montgomery Memorial Hospital. . . . . . . . . . . . Mrs. Kerry Hensley President, FirstHealth Richmond Memorial Hospital . . . Mr. John J. Jackson President, FirstCarolinaCare Insurance Company. . . . . . . Mr. Kenneth J. Lewis President, Foundation of FirstHealth . . . . . . . . . . . . . . . . . . Mrs. Kathleen Stockham The not-for-profit FirstHealth of the Carolinas is headquartered in Pinehurst, N.C., and is composed of Moore Regional Hospital, Montgomery Memorial Hospital, Richmond Memorial Hospital (a division of Moore Regional Hospital), the Foundation of FirstHealth, FirstCarolinaCare Insurance Company, and Regional Health Services. Comments on FirstHealth of the Carolinas magazine or changes of address should be directed to bbouser@firsthealth.org or to (910) 715-4278.

FirstHealth of the Carolinas is published three times a year by Vitality Communications 407 Norwalk St. Greensboro, NC 27407 (336) 547-8970 President. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William G. Moore Senior Staff Accountant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kelly Carter © Copyright 2011 by Vitality Communications, an operating company of StayWell/MediMedia USA, and FirstHealth of the Carolinas, Inc. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Vitality Communications. Articles in this publication are written by professional journalists who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional adviser. All editorial rights reserved. Opinions expressed herein are not necessarily those of Vitality Communications or FirstHealth of the Carolinas. Models are used for illustrative purposes only.

On the cover In its 15-year history, FirstHealth of the Carolinas has achieved a reputation for innovation that reached a new level with the opening of the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. This issue of FirstHealth recalls FirstHealth of the Carolinas’ first 15 years with a look at some of the highlights in technology, services and programs that have taken the organization from two hospitals in 1995 to a comprehensive multicounty health care network by the end of the first decade of the 21st century.

15 years of innovative services, programs and technology

12 15 years of innovative

services, programs and technology

20 A FirstHealth tradition

of innovation

28 2010: A FirstHealth of

the Carolinas year in review

A FirstHealth tradition of innovation firsthealth.org

FirstHealth

FirstHealth offers digital mammography in Hoke County FirstHealth of the Carolinas now offers digital mammography through its outpatient facility in Raeford. The new Hologic Breast Imaging system at the FirstHealth Raeford Center is identical to the fullfield digital system that is used at FirstHealth Moore Regional Hospital. An enhanced communications line allows images to be transmitted from Raeford to a Pinehurst reading room where they are interpreted by a board certified radiologist from Pinehurst Radiology. “From the patient’s point of view, having a digital mammogram is very much like having a conventional screen-film mammogram,” says Emily Averbook, M.D., of Pinehurst Radiology. “Both film-based and digital mammography use compression and X-rays to create clear images of the inside of the breast. Unlike film-based mammography, however, digital mammograms produce images that appear on the technologist’s monitor in a matter of seconds. There is no waiting for film to develop, which can mean a shorter time spent in the breast imaging suite.”

firsthealth.org/hoke

Spring 2011

For more information on any of these stories, call (800) 213-3284 or visit firsthealth.org

MMH patients appreciate their hospital

n a health care environment that has become increasingly conscious of quality, providers of health care have become increasingly aware of how patients feel about the care they receive. This is especially true of small hospitals like FirstHealth Montgomery Memorial Hospital, where patients and hospital caregivers are often relatives and friends. Consistently high patient satisfaction scores for the past three years at Montgomery Memorial indicate that patients are very pleased with the care they receive at their local hospital. Mean (average) score trends for fiscal years 2008, 2009 and 2010 remained in the mid- to high 90s for the hospital’s inpatient, transitional and ambulatory surgery units with scores for the Emergency Department only slightly lower. MMH President Kerry Hensley attributes the consistency of the scores to the staff. “I believe that we can attribute these scores to the quality of the staff we have,” she says. “Members of our staff stay up to date with their clinical knowledge and skills while giving compassionate care to our patients who are often their friends and neighbors.”

Orthopedics clinic opens in Richmond County FirstHealth of the Carolinas has opened an orthopedics clinic in Rockingham that is dedicated to providing orthopedics care—from initial office visit to surgery—in Richmond County. Staffed by five board certified orthopedic surgeons from Pinehurst Surgical’s Orthopaedic and Joint Replacement Center, the Richmond Medical Group – Orthopaedics Clinic is located in the FirstHealth Richmond Medical Plaza, 809 Long Drive, Rockingham. David Casey, M.D. David Casey, M.D., is the clinic’s medical director. “We are proud to be part of a hip and knee replacement program that has been top-rated by a national quality rating organization,” he says. “We are excited as we work together to continue this same quality of care in Richmond County.” In addition to Dr. Casey, the Pinehurst Surgical orthopedic surgeons who staff the new clinic are David Strom, M.D.; Ward “Pat” Oakley, M.D.; John R. Moore IV, M.D.; and Kurt Wohlrab, M.D. All are certified by the American Board of Orthopaedic Surgery.

firsthealth.org/mmh firsthealth.org

firsthealth.org/mri

True open MRI scanner is unique to region

irstHealth Moore Regional Hospital has become the first hospital in the entire FirstHealth of the Carolinas service area, and one of only three in North Carolina, to offer MRI scanning with a completely open scanning system. Open scanning is especially beneficial for patients who feel anxious or uneasy in the confined spaces of traditional closed MRI scanners or the partially open MRI systems that some hospitals now have. Unlike closed or partially open scanners, Moore Regional’s Hitachi Oasis MRI can accommodate very large, heavy patients. With a table that will lower to 18 inches off the floor, it is also more convenient for patients with limited mobility. From a diagnostic standpoint, the greatest advantage of Oasis over the partially open MRI system it replaced is the improvement in image quality. Michael Edwards, M.D., a neuroradiologist with Pinehurst Radiology, says the clarity of the Oasis-produced images is comparable to that of the hospital’s closed MRI scanners. “Overall, we get the same quality,” he says. Moore Regional has three MRI scanners: two closed units in the main hospital and the true open Oasis open scanner in the outpatient FirstHealth Imaging Center in Pinehurst.

firsthealth.org/mri 6

Spring 2011

HEART CENTER OPENING Pamela Sands, R.N., the nursing supervisor for Interventional Cardiology Services, talks to a tour group visiting one of the electrophysiology suites in the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. Tours of the new facility highlighted a Jan. 9 open house that attracted about 1,500 visitors to the campus of FirstHealth Moore Regional Hospital.

reidheartcenter.org

Visit reidheartcenter.org for more information on the Reid Heart Center at FirstHealth Moore Regional Hospital.

McLEAN HOUSE DEDICATION OLYMPIC GUEST Olympic snowboarding medalist Chris Klug (second from left) participated in a deepwater jogging class taught by Kelley Kibler, of the FirstHealth Center for Health & Fitness–Pinehurst, during a visit to Pinehurst for a Foundation of FirstHealth “Promise of Hope” program. Both Klug, a bronze medalist during the 2002 Winter Olympics, and Kibler are liver transplant recipients.

FirstHealth of the Carolinas celebrated the construction of the Clara McLean House with a Nov. 30, 2010, dedication ceremony at the hospitality house’s FirstVillage construction site. Yvonne Sneed, Miss McLean’s longtime caregiver, (pictured) spoke about her friend during the dedication program.

firsthealth.org

Foundation funds RMH ICU renovation A recent remodeling project at FirstHealth Richmond Memorial Hospital is making a difference for families and patients. “The project to refurbish our Intensive Care Unit (ICU) offers a variety of enhancements that directly and indirectly Raven Currie, R.N., (seated), improve patient care,” says and Clinical Director Christy ICU Clinical Director Christy Land, R.N., work at the Land, R.N. “Although we did nursing station in the renovated Intensive Care not increase the actual size Unit at FirstHealth Richmond of the unit, we reorganized Memorial Hospital. the area to take advantage of the existing space and to add special features that improve patient safety and staff efficiency.” A $200,000 contribution from the Richmond Memorial Hospital Foundation, which included funds from the A.A. Webb Fund, assisted with the renovation. The cost of the project totaled about $350,000. The RMH ICU includes 12 beds with updated headwalls piped for oxygen as well as extra outlets to accommodate needed equipment and a monitoring system complete with advanced touch screen technology. New computerized documentation stations not only enable providers to complete documentation immediately, but also allow physicians and other health professionals to provide education right at the bedside. Other changes include a new nursing station, the expansion of a supply/ medication room to house patient care supplies, and an on-site workstation for physicians and case managers.

Spring 2011

MMH recognizes family with nursing unit dedication FirstHealth Montgomery Memorial Hospital recognized three generations of a Montgomery County family known for its philanthropy during the Jan. 6 dedication of a hospital nursing unit. The naming of the newly renovated Blair Hall pays tribute to the late Ada Allen Blair; her son, the late Joseph Reece Blair; and his children, some of whom remain civically active in the Montgomery County community. Located on the hospital’s third floor, the unit provides both traditional hospital and rehabilitation care. Ada Allen Blair donated the land on which Montgomery Memorial Hospital was built 60 years ago as well as the land for Montgomery Community College. The nursing unit named for her family provides a full-range of services including physical and occupational therapy, extended IV antibiotic therapy, recuperative care for cardiac bypass and orthopedic surgery patients, and nursing care for patients transferred from other hospitals.

For information on any of these events, call (800) 213-3284 or visit firsthealth.org/calendar.

March “Eating Green” Tuesday, March 22 5:30 p.m. FirstHealth Center for Health & Fitness-Pinehurst It is easy to eat green. Learn what it means to eat organic and discover how and when to buy organic and how to eat healthier while minimizing your impact on the environment and your wallet. Reid Heart Center Education Series March-June 2011 Join us to learn more about the heart and vascular system – how it works, what can go wrong and all of the treatment options that are available at FirstHealth Moore Regional Hospital at the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. • Thursday, March 31 “Got Heart Problems? Come and Learn from the Experts” John F. Krahnert Jr., M.D., heart surgeon, and David Cowherd, M.D., cardiologist • Thursday, April 21 “Diagnosing & Treating Heart Disease” Peter Duffy, M.D., cardiologist

• Thursday, May 19. “Is Your Blood Flowing Like It Should: Abdominal Aortic Aneurysm and Peripheral Artery Disease (PAD)” Clinton K. Atkinson, M.D., and Joel Berman, M.D., vascular surgeons • Thursday, June 9 “Shopping for Quality Heart Surgery: What Hospitals Measure and Why” Art Edgerton, M.D., heart surgeon • Thursday, June 30 “Valve Disease – So You Think You Have a Heart Murmur?” Peter Ellman, M.D., heart surgeon All programs begin at 6 p.m. and will be held at the Reid Heart Center on the campus of FirstHealth Moore Regional Hospital (Page Road off Highway 211 and Memorial Drive). Registration is required.

April “Nutrition and Irritable Bowel Syndrome” Thursday, April 7 5:30 p.m. FirstHealth Center for Health & Fitness-Pinehurst Many people live with the pain and discomfort of IBS, yet medical treatments are limited. Learn nutrition strategies to manage the symptoms of IBS from a FirstHealth registered dietitian.

Run for the Ribbons 5K & 1K Saturday, April 9 Carolina Horse Park at Five Points This annual community fitness event benefits the Moore Regional Hospital Foundation’s Cancer CARE Fund. “The Color of Health” Monday, April 11 5:30 p.m. FirstHealth Center for Health & Fitness-Pinehurst Learn about the phytochemicals and antioxidants in fruits and vegetables that can help improve health and reduce risk for disease. Montgomery Foundation Spring Event Saturday, April 16 7 p.m. The Garner Center 211 Burnett St. Troy Proceeds from the annual fundraiser for the FirstHealth Montgomery Foundation will be directed toward dental health needs in Montgomery County. Moore Regional Hospital Pregnancy Fair Thursday, April 21 6 to 7:30 p.m., The Fair Barn, Harness Track, Highway 5, Pinehurst

firsthealth.org

Anesthesiology

Hospitalist

David L. Chandler, D.O.

Evelina G. Kartsimaris, M.D.

Pinehurst Anesthesia Associates Hospital Affiliation: Moore Regional Hospital Training: D.O., Kirksville College of Osteopathic Medicine, Mo. Internship/Residency: Walter Reed Army Medical Center, Washington, D.C.

Moore Regional Hospital Hospitalist Service Hospital Affiliation: Moore Regional Hospital Training: M.D., Jagiellonski University School of Medicine, Poland Internship/Residency: Bassett Healthcare, N.Y.

Cardiac and Thoracic Surgery

Hospitalist

Art Edgerton, M.D.

John Shoffeitt, M.D.

Board Certified

FirstHealth Cardiovascular & Thoracic Center Hospital Affiliation: Moore Regional Hospital Training: M.D., Bowman Gray School of Medicine, N.C. Internship/Residency: Wake Forest University Baptist Medical Center, N.C.

Board Certified

Moore Regional Hospital Hospitalist Service Hospital Affiliation: Moore Regional Hospital Training: M.D., Eastern Virginia Medical School Internship/Residency: Medical University of South Carolina

Emergency Medicine

Hospitalist

Lisa B. Cowan, M.D.

James W. Shaffer, P.A.-C

Sandhills Emergency Physicians Hospital Affiliation: Moore Regional Hospital, Richmond Memorial Hospital Training: M.D., East Carolina University, N.C. Internship/Residency: East Carolina University School of Medicine, N.C.

Moore Regional Hospital Hospitalist Service Hospital Affiliation: Moore Regional Hospital Training: P.A., Methodist University, N.C.

Emergency Medicine

OB/GYN

Scott A. Hollrah, M.D.

Mohamed A. Y. Ibrahim, M.D.

Board Certified

Sandhills Emergency Physicians Hospital Affiliation: Moore Regional Hospital, Richmond Memorial Hospital, Montgomery Memorial Hospital Training: M.D., University of Kansas Internship/Residency: McGaw Medical Center, Northwestern University, Ill.

FirstHealth Richmond Medical Group– Women’s Center Hospital Affiliation: Richmond Memorial Hospital Training: M.D., University of Khartoum, Sudan Internship/Residency: Federal Ministry of Health, Sudan; Wad Medani Teaching Hospital, Sudan; St. Joseph’s Regional Medical Center, N.J.

Spring 2011

OB/GYN

Physical Medicine & Rehabilitation

Angela Morrison, M.D.

Paul G. Singh, M.D.

FirstHealth Richmond Medical Groupâ&#x20AC;&#x201C;Womenâ&#x20AC;&#x2122;s Center Hospital Affiliation: Richmond Memorial Hospital Training: M.D., Eastern Virginia Medical School Internship/Residency: Reading Hospital & Medical Center, Pa.

Board Certified

Carolina Spine Center Hospital Affiliation: Richmond Memorial Hospital Training: M.D., Rosalind Franklin University of Medicine & Science, Ill. Internship/Residency: Rush University, Ill.; Hospital of the University of Pennsylvania

OB/GYN

Plastic Surgery

Daniel L. Rowland, M.D.

Russell B. Stokes, M.D.

Board Certified

Pinehurst Surgical Hospital Affiliation: Moore Regional Hospital Training: M.D., Ross University School of Medicine, West Indies Internship/Residency: Newark Beth Israel Medical Center, N.J.; Lutheran General Hospital, Ill.

Pinehurst Surgical Hospital Affiliation: Moore Regional Hospital Training: M.D., UCLA, Calif. Internship/Residency: University of California Davis Medical Center

Ophthalmology

Radiology

Wilson McWilliams, M.D.

Glen Toomayan, M.D.

Carolina Eye Associates Hospital Affiliation: Moore Regional Hospital Training: M.D., Medical University of South Carolina Internship/Residency: Baylor Hospital System, Texas; University of Virginia Medical Center

Pinehurst Radiology

Board Certified

Hospital Affiliation: Moore Regional Hospital, Montgomery Memorial Hospital Training: M.D., Duke University, N.C. Internship/Residency: Duke Medical Center, N.C.

Orthopedics Orlinda A Martinez, P.A.-C Pinehurst Hip and Knee Hospital Affiliation: Moore Regional Hospital Training: P.A., Chicago Medical School, Ill.

Orthopedics Kurt P. Wohlrab, M.D. Board Certified

Pinehurst Surgical & FirstHealth Richmond Medical Group-Orthopaedics Clinic Hospital Affiliation: Moore Regional Hospital, Richmond Memorial Hospital Training: M.D., Chicago Medical School, Ill. Internship/Residency: Tripler Army Medical Center, Hawaii

For a complete listing of FirstHealth of the Carolinas providers, visit the website at firsthealth.org/ physician. If you prefer a printed copy, call (800) 213-3284

firsthealth.org

1995 In 2010, FirstHealth of the Carolinas observed its first 15 years as a comprehensive health care system serving the mid-Carolinas. This timeline highlights the organization’s progress as a health care leader in programs, services and technology during those 15 years.

FirstHealth of the Carolinas is formed with the merger of Moore Regional Hospital in Pinehurst and Montgomery Memorial Hospital in Troy. What began as a two-hospital organization is now a comprehensive health care system with three hospitals (with 582 beds) and a variety of health services, including the Reid Heart Center, a rehabilitation center, three sleep disorders centers, three dental clinics, family care and specialty services centers, six fitness centers, a laundry, four charitable foundations, a Hospice program, home health services and an insurance plan as well Critical Care Transport, EMS and Medical Transport services. Moore Regional Hospital’s Clarke Neonatal Intensive Care Unit, which opened in 1977, moves to renovated space. The 16-bed Level III nursery will again move to a larger renovated space in 2004. An Intensive Outpatient Chemical Dependency Program begins under the supervision of FirstHealth Behavioral Services. Moore Regional Hospital is re-accredited for a new three-year term by the Joint Commission on Accreditation of Healthcare Organizations. The hospital has been continuously accredited since 1961. The cancer program at Moore Regional Hospital earns its first accreditation from the American College of Surgeons Commission on Cancer. The FirstHealth Center for Health & Fitness– Pinehurst, a medical fitness center, opens with 3,000 members.

Spring 2011

Community Hospital Comprehensive Cancer Center

Clarke Neonatal Intensive Care Unit

1996

Sandhills Hospice merges with FirstHealth of the Carolinas. The nonprofit that provides services to patients with life-limiting illness is now known as FirstHealth Hospice & Palliative Care. An early fundraiser that is established as the Hospice Pottery Auction eventually becomes the Pottery Plus Auction. With the support of the Moore Regional Hospital Auxiliary and the 1996 U.S. Womenâ&#x20AC;&#x2122;s Open Golf Championship, FirstHealth of the Carolinas purchases a 35-foot van and begins providing mobile health services that currently include vascular, diabetes, blood pressure and cholesterol screenings. FirstHealth unveils a community benefit program targeting at-risk populations, the community at large and other not-for-profit organizations. Mobile Health Services

FirstHealth Center for Health & Fitness-Pinehurst

The Moore Regional Hospital Rehabilitation Center, which opened in 1994, is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). A contract with the Montgomery County Board of Commissioners to provide emergency medical services sets the stage for what is now the FirstHealth Regional EMS, a program serving residents of Chatham, Montgomery and Richmond counties in North Carolina and Chesterfield County, S.C. The system also includes Medical Transport in Moore County, wheelchair vans in Montgomery and Hoke counties, and Critical Care Transport. Assisted by funding from the Kate B. Reynolds Charitable Trust and the NC Office of Rural Health, FirstHealth breaks ground on a $3.5 million, two-story medical arts building on the Montgomery Memorial Hospital campus. The building will house physician offices and a pharmacy.

firsthealth.org

Dental Care Centers

Ellen Willard, M.D.

1997

FirstHealth adopts its core purpose (â&#x20AC;&#x153;to care for peopleâ&#x20AC;?) and core values (respect for the individual, integrity, service to others, excellence).

The In Love and Service campaign (supporting a patient tower, outpatient admissions, cancer center and emergency department at Moore Regional Hospital) begins. By the time the campaign ends in September 1999, $10.4 million has been raised for these projects.

FirstHealth Richmond Memorial Hospital

1998

FirstHealth begins a unique service to dentally underserved children with the opening of the first of three FirstHealth Dental Care Centers. Programs are now located in Southern Pines, Troy and Raeford. Ellen Willard, M.D., a medical oncologist and hematologist, becomes the first physician in North Carolina to become board certified in hospice and palliative medicine. A FirstHealth Center for Health & Fitness opens in Troy, the first medical fitness service to be opened in the small, rural communities served by FirstHealth. Moore Regional Hospital is approved as a member of a national cancer trials group with its designation as an affiliate of the National Cancer Institute-sponsored Gynecologic Oncology Group. FirstHealth becomes one of 13 national learning laboratories to help improve health care quality and access with the award of a $2.5 million grant from the W.K. Kellogg Foundation. The initial program is directed toward medically underserved populations in Moore, Montgomery and Hoke counties, and is later expanded to include Richmond County. FirstHealth introduces home health care to its family of medical services. FirstHealth Home Care initially operates as a franchise of a national chain of home health services.

Spring 2011

FirstHealth Montgomery Memorial Hospital

1999

FirstCarolinaCare is formed as a wholly owned subsidiary of FirstHealth of the Carolinas. In October 2000, it is licensed by the North Carolina Department of Insurance to offer products in 51 counties. The Foundation of FirstHealth is established as the umbrella organization for Moore Regional Hospital Foundation, FirstHealth Hospice Foundation and FirstHealth Montgomery Foundation. The FirstHealth Richmond Memorial Hospital Foundation is added after the purchase of Richmond Memorial Hospital. The signing of a management agreement with the Board of Trustees of Richmond Memorial Hospital brings the Rockingham facility into the FirstHealth family. The hospital is soon renamed FirstHealth Richmond Memorial, and its acquisition as a full FirstHealth entity is finalized on March 1, 2001. Montgomery Memorial Hospital becomes the first hospital in the state to officially submit a letter of intent in the Critical Access Hospital program. A response to the 1997

Center for Health & Fitness-Raeford

Balanced Budget Act, the Critical Access designation allows small, rural hospitals to base Medicare reimbursements on actual cost rather than on predetermined diagnosisbased payment. Community leaders from throughout the region are recruited to serve on a FirstHealth Community Health Board designed to work toward meeting the needs of the underserved, those with public assistance, those without health insurance and the working poor. The firsthealth.org website is introduced as the cyberspace address for FirstHealth of the Carolinas. An $8.5 million, 24,980-square-foot Outpatient Center, part of Phase I of the FirstHealth MRH 2010 Project, opens at Moore Regional Hospital. Phase I will also include a Central Energy plant; a new Emergency Department, Cancer Center and Patient Tower; parking facilities; and interior hospital renovations and refurbishments. FirstHealth expands its cardiac diagnostic and treatment services with the operation of its first mobile

cardiac catheterization lab and the conversion of a cardiac cath lab to an electrophysiology suite. The FirstHealth Central Laundry opens in the Sandhills Industrial Park in Aberdeen to serve the linen needs of FirstHealth and other organizations in the area. FirstHealthâ&#x20AC;&#x2122;s cancer program is designated a Community Hospital Comprehensive Cancer Center by the American College of Surgeons Commission on Cancer. The Hospice Challenge begins with the goal of raising the Hospice Foundation endowment to ensure annual support for FirstHealth Hospice operations. The three-year fundraiser increases the endowment from $2 million in 1999 to $10 million in 2002. FirstHealth joins the Hoke County community to celebrate the opening of the 39,000-square-foot FirstHealth Raeford Center. The facility houses primary and specialty care clinics and a Center for Health & Fitness. A Dental Care Clinic is located on the same campus.

firsthealth.org

2000

A Patient Tower housing the FirstHealth Community Hospital Comprehensive Cancer Center, an enlarged and renovated Emergency Department, and medical and surgical nursing units opens at Moore Regional Hospital. The FirstHealth Dental Care Centers earn national attention as FirstHealth CEO Charles T. Frock and Sharon Nicholson Harrell, Dental Care Center director, participate in the Washington, D.C., release of the Surgeon General’s first report on dental health. The newly introduced FirstHealth Intranet allows employees, physicians and volunteers to search for information within the corporation. During a 2002 overhaul, the Intranet is named FirstWeb.

In a banner year for patient care recognition, Moore Regional Hospital is named one of the nation’s Top 100 hospitals for cardiovascular, stroke and orthopedics care.

FirstHealth Montgomery School Health Centers

Spring 2011

Ultrasound becomes Moore Regional Hospital’s first “filmless” department. The state of North Carolina credentials FirstHealth’s school-based health center program. Services are offered through a partnership between FirstHealth and Montgomery County Schools at East Middle School in Biscoe and West Middle School in Mt. Gilead with support from the FirstHealth Montgomery Foundation. FirstHealth opens the Center for Health & Fitness–Pembroke in Robeson County and breaks ground for the Center for Health & Fitness– Richmond in Rockingham.

2001

FirstHealth receives a major grant from the American Legacy Foundation to promote tobacco-use prevention and cessation.

The FirstHealth Child Development Center receives a five-star rating from the state of North Carolina. Cardiac surgeons at Moore Regional Hospital begin offering off-pump bypass surgeries. The Cancer CARE Fund is established with the opening of the FirstHealth Community Hospital Comprehensive Cancer Center. A Heart CARE Fund has existed since the early 1990s, and more care funds are subsequently added to support children, emergency services, neurosciences, arthritis/ orthopedics and behavioral health.

2002

The implementation of a wireless communication network connects the entire FirstHealth organization. Richmond Memorial Hospital wins a state award for volunteerism for its participation in the Richmond County Chamber of Commerce’s School/Business Partnership.

FirstHealth Child Development Center

2003

The FirstHealth Center for Health & Fitness–Richmond opens on the campus of Richmond Memorial Hospital. FirstCarolinaCare develops FirstPlan, a health benefit plan for small businesses that provides a premium subsidy for eligible employers and lower-wage workers. The Employee Health Improvement Program (EHIP) offers financial incentives to FirstHealth employees who improve their health through diet and physical activity. Participating employees receive their first reward checks, as much as $240, in July 2004.

Hospitalist physicians begin seeing patients at Moore Regional Hospital. The program is later expanded to include Montgomery Memorial and Richmond Memorial. High Dose Rate (HDR) Brachytherapy, a form of internal radiation therapy that precisely delivers radiation from the inside out, is added to FirstHealth’s cancer program.

2004

The Chest Center of the Carolinas begins accepting patients at Moore Regional Hospital. The program consolidates board certified thoracic surgeons, pulmonologists, medical and radiation oncologists, pathologists and radiologists dedicated to the treatment of diseases of the chest.

On July 4, FirstHealth becomes the first hospital system in North Carolina to go tobacco-free when it declares its “independence from tobacco.” The FirstQuit program is introduced to support members of the greater FirstHealth community as well as FirstHealth employees in their tobaccocessation efforts. The Stepping Stones campaign begins with a goal of $25 million. The goal is raised to $30 million in 2007. The $34 million that is actually raised by the time of the campaign’s conclusion in 2008—through community, physician, employee and governance donations— will support the Reid Heart Center, Clara McLean (hospitality) House, Hospice House and renovations to the Emergency Department at Moore Regional Hospital. FirstHealth takes a giant step into the electronic world with the implementation of paperless patient records.

Surgery Center of Pinehurst

Moore Regional Hospital and Pinehurst Radiology form a partnership called FirstImaging of the Carolinas to offer PET (positron emission tomography) imaging.

2005

Ground is broken for FirstVillage, a 15-acre project that will ultimately include the Surgery Center of Pinehurst, a new Pinehurst Surgical building, the Clara McLean House and a multi-level parking deck. FirstHealth of the Carolinas is awarded a certificate of need for a designated heart hospital on the campus of Moore Regional Hospital. A dedication ceremony introduces an expanded and renovated Emergency Department at Richmond Memorial Hospital. The Moore Regional Hospital Auxiliary observes its 75th anniversary with the announcement that it has fulfilled a $1 million pledge toward a construction and renovation project for the FirstHealth Child Development Center. A Specialty Centers Division is established in the former Pinehurst Surgical building on the Moore Regional Hospital campus. The Specialty Centers Building now houses the Infectious Diseases Program, the FirstHealth Wound Care & Hyperbaric Center and the FirstHealth Back & Neck Pain Center. The Moore Regional Hospital Foundation funds a pilot telemonitoring program through FirstHealth Home Care. The program has since been expanded several times and now provides home-monitoring technology for 120 patients. N.C. House Speaker Pro Tempore Richard Morgan of Moore County announces the award of a $177,300 state grant to the FirstHealth Dental Care Center in Southern Pines. Most of the money will be used to add two treatment rooms and a consultation room to the facility.

firsthealth.org

2006

A newly renovated building housing the enlarged FirstHealth Center for Health & Fitness-Southern Pines opens on Davis Road in Southern Pines. The FirstHealth Regional EMS System adopts the STEMI-alert protocol for heart attack response. FirstHealth takes a “generational leap” in the treatment of prostate surgery with the implementation of the da Vinci Robotic Surgical System at Moore Regional Hospital. The robotic program has since expanded to include certain gynecological procedures.

Da Vinci Robotic Surgical System

2007

Spring 2011

Richmond Memorial Hospital receives two national 2006 Compass Awards from Press Ganey and Associates for patient satisfaction. Tug transport robots begin delivering medications from the Pharmacy to nursing units at Moore Regional Hospital.

Tug Transport Robot

Specialized wound treatment is introduced with the opening of Wound Care & Hyperbaric Centers at both Moore Regional and Richmond Memorial hospitals.

Moore Regional Hospital joins the best of the nation’s best with its selection as a Magnet Nursing Program hospital. At the time, only 216 health care organizations in 42 states had earned the recognition from the American Nurses Credentialing Center.

Richmond Memorial Hospital becomes one of only a few community hospitals in the state to acquire a computer-aided detection system for reading mammograms. CAD technology is now used throughout the FirstHealth organization.

FirstHealth Outpatient Cancer Center

FirstCarolinaCare broadens its structure, receives its license as a North Carolina insurance company and becomes FirstCarolinaCare Insurance Company Inc. The introduction of an innovative cafeteria pricing system encourages FirstHealth employees to eat better by lowering the price of healthy foods. A renovated and expanded FirstHealth Center for Health & Fitness–Pinehurst, with the full-service spa called firstspa, begins serving the FirstHealth community.

FirstHealth of the Carolinas and Pinehurst Medical Clinic partner to consolidate outpatient cancer services at the FirstHealth Outpatient Cancer Center. The facility houses the outpatient chemotherapy services of Moore Regional Hospital and the offices and clinics of the oncology/ hematology physicians of Pinehurst Medical.

2008

Moore Regional Hospital acquires a Stealth Station Treatment Guidance System. The GPS technology allows neurosurgeons to navigate throughout the body while using 3D images as their guide. A $155,000 grant from the North Carolina Office of Rural Health and Community Care allows Richmond Memorial Hospital to purchase and install a state-of-the-art information management system that replaces paper charts in the hospital’s Emergency Department with an electronic charting program. Clinical Trials, a program that was initiated at Moore Regional Hospital in 1995, becomes a formalized FirstHealth department.

Proposed Hoke Community Hospital

2010

With the introduction of Exercise is Medicine, area physicians begin referring patients to the FirstHealth Centers for Health & Fitness for a program that encourages physicians to consider physical activity as a patient vital sign just as they would blood pressure and weight. The opening of the FirstHealth Transfer Center streamlines the inter-facility transfer of patients to FirstHealth hospitals.

2009

The stroke care program at Moore Regional Hospital earns The Joint Commission’s Gold Seal of Approval and is named a Joint Commission-certified Stroke Center. FirstComm begins providing services. The centralized EMS operation dispatches 911 emergency calls for FirstHealth EMS-Chesterfield as well as inter-facility and non-emergency transports for the entire FirstHealth Regional EMS. It also handles calls from the RACE (Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments) hotline and FirstHealth Response, a personal emergency response service. FirstHealth begins an effort to increase health care services to Hoke County by applying for a certificate of need to build an eight-bed community hospital near Raeford. After Cape Fear Valley Medical Center appeals FHC’s approved CON application, a long application and appeals process ensues. A ruling from the state of North Carolina is expected during 2011.

Reid Heart Center: The FirstHealth Cardiac & Vascular Institute

The Employee Health Improvement Program (EHIP) surpasses the $1 million mark in paid benefits to participating FirstHealth employees. An open house introduces the expanded and renovated FirstHealth Center for Health & Fitness-Troy. Ground is broken for FirstHealth Hospice & Palliative Care construction, and the Clara McLean House is dedicated. With funding assistance from the FirstHealth Richmond Memorial Hospital Foundation, Richmond Memorial Hospital completes a renovation of its Intensive Care Unit.

In partnership with Pinehurst Surgical, FirstHealth opens an orthopedics clinic in Rockingham that is dedicated to providing orthopedics care—from initial office visit to surgery—in Richmond County. Construction nears completion on the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. The facility that consolidates cardiac and vascular services opens in January 2011. (A review of FIrstHealth during 2010 can be found beginning on page 28.)

firsthealth.org

A FirstHealth

tradition of innovation 20

Spring 2011

Innovation is a tradition for FirstHealth of the Carolinas. From tobacco-cessation programs to student health, from healthy eating incentives to patient-centered care, FirstHealth has been a leader in innovative health care throughout its more than 80-year history. There are many examples of this FirstHealth standard of innovation— far too many to share them all. Here are a few.

Student Health Family nurse practitioner Regina Smith (right) and nutrition educator Christina Turbeville, of the FirstHealth Montgomery School Health Centers, talk to a group of Montgomery County third-graders about nutrition. The HEAP (Healthy Eating Active Play) program they developed with the assistance of a registered dietitian received a Silver Star Award for Health Care from the N.C. Fruits & Veggies Nutrition Coalition.

f it takes dressing up like a vegetable or a piece of fruit to convince children about the value of healthy eating, Gina Smith and Christina Turbeville are happy to do it. Smith, the family nurse practitioner, and Turbeville, the nutrition educator, of the FirstHealth Montgomery School Health Centers in Montgomery County, are committed to helping children stay healthy in a part of North Carolina with an unusually high incidence of obesity and weight-related diabetes. The program’s innovative obesity prevention initiative, conducted in partnership with Montgomery County school staff and school nurses, recently received a $10,000 TIEs (technology, innovation, evaluation) award from the Blue Cross and Blue Shield of North Carolina Foundation. The FirstHealth Montgomery School Health Centers, located in Mt. Gilead and Biscoe, provide on-site medical, mental health and nutritional care that is open to any child in the Montgomery County School System. Thousands of children are assisted every year. In Moore County, a FirstHealth partnership with Moore County Schools and the North Carolina Department of Health and Human Services provides school-based nurses to 22 schools. The program has received both state and national recognition as a best-practice standard by contributing to the well-being and lifelong achievement of more than 12,000 school-aged children each year. In 2006, the Moore County School Nurse Program became the first in the nation to receive Magnet Nursing designation. “We have saved thousands of dollars in unnecessary emergency department visits through our innovative programs,” says Program Manager Phyllis Magnuson, R.N. “We were also the first school nurse program in the state to use an electronic medical record-keeping program that was designed just for us.”

firsthealth.org

Quit-tobacco programming

Health care reform In 2008, FirstCarolinaCare (represented by President Ken Lewis) received a Power of Prevention Award from the North Carolina Health & Wellness Trust Fund. Presented in the Innovator category, the award recognized FirstCarolinaCare’s efforts to reduce the growth in the number of uninsured in its service area while promoting preventive health care to its members.

hen health care reform was still a twinkle in the eyes—or a scowl on the faces—of members of the U.S. Congress, FirstHealth of the Carolinas had already begun to adopt its own reform measures. Some of them are identical to those found in the national reform legislation that was adopted last year. FirstCarolinaCare (FCC), FirstHealth’s nonprofit health plan subsidiary, has been developing ways to help reduce the number of uninsured in its service area since it was formed in 2000. The FCC measures date from 2003 with the development of FirstPlan, a health benefit plan for small businesses that provides a premium subsidy for eligible employers and lower-wage workers. The program has been nationally recognized for making health care coverage more accessible. In 2006, in a move previously unheard of in the health insurance industry, FCC returned to its clients a portion of the premiums they had paid for group health coverage during the previous year. The decision was based on FirstHealth’s mission as a not-for-profit organization as well as on FCC’s stronger-than-expected financial results for 2005. FirstCarolinaCare was again an innovator in 2007 when it extended coverage for members’ children through age 26. At the time, most of the state’s insurance companies offered dependent coverage only up to age 19. This FirstCarolinaCare tradition of innovation extends to a hands-on approach that includes free health screenings for members as well as nursing staff follow-up that helps members control their health costs while improving the status of their health. firstcarolinacare.com

Spring 2011

When FirstHealth of the Carolinas declared its independence from tobacco on July 4, 2004, it became the first hospital system in the state to become tobacco-free. It has since become a model for quit-tobacco services and programming. From the beginning of this organization-wide quit-tobacco initiative, FirstHealth leaders acknowledged that giving up tobacco is always a very difficult thing to do. As a result, the availability of Community Health Services quit-tobacco classes and support groups was increased throughout the FirstHealth service area. Participation in the FirstQuit classes involves only a nominal fee, and there is no charge to participate in a quit-tobacco support group. More recently, an inpatient tobacco-cessation program has started at both Moore Regional and Richmond Memorial hospitals. The program is designed to reach tobacco-users during their brief interim of tobacco-free hospitalization and to direct them to the long-term assistance of FirstHealth’s outpatient FirstQuit program in an effort to help them break their tobacco habit. In addition, all three FirstHealth hospitals provide free nicotine replacement gum to adult visitors to help them deal with their tobacco cravings while they are visiting. firsthealth.org/healthyliving

Patient-centered care

The concept of patient-centered care is not unique, but FirstHealth of the Carolinas, its providers and staff have taken this patient commitment to a new level—by combining medical excellence with the small-town touch. Cardiothoracic surgeon John F. Krahnert Jr. describes this unofficial FirstHealth philosophy as “big-city medicine in a community hospital.” FirstHealth made the practice official by adopting the simple pledge “to care for people” as its core purpose. Time and time again, this patient-centered effort has been nationally recognized. In 2006, for example, FirstHealth Moore Regional Hospital and several off-site nursing programs received the Magnet designation for excellence in nursing care from the American Nurses Credentialing Center. Three years later, the hospital earned The Joint Commission’s Gold Seal of Approval and was named a Joint Commission-certified Stroke Center for excellence in stroke care. The new Reid Heart Center, on the campus of Moore Regional Hospital, stands as a testament to medical excellence based on patient-centered care. “We do complex mitral repairs, aortic root surgery, arterial revascularization, minimally invasive radial artery harvest, high-risk cases, and we’ve been doing it for 20 years with excellent results,” Dr. Krahnert says. “We also do it in a personal and compassionate way not seen in bigger programs, so we provide the best of both worlds.”

Fitness programming The March 2010 kickoff of the HokeFit worksite wellness competition took place at the Hoke County Recreation Complex.

or many years, FirstHealth of the Carolinas has partnered with municipal planners and school and community leaders in an effort to keep people healthy and fit in a variety of innovative ways. They include: n Helping to develop comprehensive bicycle and pedestrian plans for local communities n Working with the Village of Pinehurst to develop a greenway walking trail and initiating a “Walking School Bus” that encourages children at Pinehurst Elementary School to walk to school n Partnering with Cooperative Extension and the Town of Southern Pines to start a community garden that gives Southern Pines residents a way to grow their own fresh fruits and vegetables n Offering an on-site, spring-to-fall Farmers Market at Moore Regional Hospital that is open to the community as well as to FirstHealth employees, and working with local Farmers Markets to accept SNAP (Supplemental Nutrition Assistance Program) benefits n Becoming a major sponsor of the Sandhills Race Series, an organization that encourages participation in area races while recognizing performance and providing support to the groups coordinating race events n Providing healthy living classes to low-income populations (The Happy Kitchen program teaches participants how to prepare healthy meals and how to save money when shopping for groceries. PLAY–People Living Active Year-Round – teaches participants how to increase physical activity in their everyday lives.) In programs directed toward working adults, FirstHealth collaborated with community partners to develop MooreFit and HokeFit, fitness initiatives that encourage employers in the respective communities of Moore County and Hoke County to get their workers to adopt physical activity and healthy eating as part of their lifestyle. Programs have included countywide fitness challenges that encourage participants to work more healthy foods into their diet or incorporate more walking into their day. Last fall, a MooreFit University offered classes in nutrition/eating, physical activity and overall wellness. Participants who completed one class from each participation category received a FitCertificate and became eligible for prizes.

Telehealth FirstHealth Home Care Services began its in-home telehealth venture with a pilot program funded by the Foundation of FirstHealth. The pilot was so successful and immediately worked so well that the agency soon purchased 20 monitors and four digital cameras to add telehealth monitoring to its wound care program. In 2007, a $250,000 Duke Endowment grant allowed FirstHealth to expand the program to 70 monitors and, in 2009, the program grew again with a $750,000 Telehealth Network Grant from the U.S. Department of Health and Human Services—one of only four awarded to agencies throughout the U.S. FirstHealth Home Care now monitors 120 patients via telehealth with plans to have up to 200 by the conclusion of the three-year HHS grant. Telehealth monitors are provided to eligible Home Care patients at no additional charge. The state-of-the-art technology sends patient data—blood pressure, temperature, blood sugar, pulse, weight and blood pressure—over a common telephone line to a central monitoring station where a registered nurse reviews it and determines if there is a need for additional care. In addition to giving patients and their caregivers a heightened sense of security, this in-home patient monitoring program has been shown to reduce hospitalizations and emergency room visits. firsthealth.org/homecare

firsthealth.org

Cafeteria pricing incentives A 2007 study conducted by the University of Washington found that low-calorie, nutrient-rich foods— mainly fruits and vegetables—are calorie for calorie more expensive than sweets and snack foods. This may help explain why the poorest Americans are usually among the heaviest. Now consider the cost of cafeteria meals at FirstHealth Moore Regional Hospital, where just the opposite is the case. In the Moore Regional cafeteria, where healthy eating has become a standard, a FirstHealth employee pays $2.95 for a pound of leafy greens and trimmings at the salad bar. Before the introduction of a cafeteria pricing plan designed to encourage FirstHealth workers to eat healthy foods, that same pound of salad-bar salad would have cost $4.64. The same pricing incentive is true for healthy entrees, vegetables and fruit. At the same time, less-healthy foods—hamburgers, cheeseburgers and French fries—now cost more than they used to. The changes in cafeteria pricing, which began with the start of FirstHealth’s 2008 fiscal year, are part of FirstFit, a program that encourages FirstHealth employees to improve their health while serving as models for the people they care for. While there are also exercise and physical activity components to FirstFit, the healthy eating aspect that includes the changes in cafeteria pricing is far and away the most ambitious. The cafeteria pricing initiative began as something of a noble experiment, but it has since become a successful way of life around FirstHealth, confirming what had long been suspected: that given the financial incentive to do so, people will choose healthy foods over junk. 24

Spring 2011

Dental Care Centers Sharon Nicholson Harrell, DDS, MPH, (seated) is director of the FirstHealth Dental Care Centers in Southern Pines, Raeford and Troy. Since the program opened in 1998, the Dental Care Centers have provided dental care to almost 22,000 underserved children.

couldn’t concentrate on their work. n May 2000, FirstHealth CEO Charles There were several reasons for this lack T. Frock and Sharon Nicholson of dental care, but the most common Harrell, DDS, MPH, director of the involved the low reimbursement rates FirstHealth Dental Care Centers, traveled for Medicaid services and the reputation to Washington, D.C., to take part in the Medicaid patients had for high no-show release of the U.S. Surgeon General’s firstrates in the few private dental practices ever report on oral health. that would accept them. What they heard was all too familiar to FirstHealth responded to the problem in them: that dental disease was contributing October 1998 with the opening of the first to numerous critical health problems in of three FirstHealth Dental Care Centers. the American population—especially In the 12-plus years since among low-income the opening of the first children and the elderly. program in Southern Pines, They were also able to the Dental Care Centers share what FirstHealth have treated nearly 22,000 of the Carolinas was children. already doing about the The service, which problem. provides routine dental Two years before, care, disease prevention, in 1998, school early detection and health nurses in the intervention in clinics in FirstHealth service Surgeon General David Satcher (left) Raeford and Troy as well area had approached and FirstHealth CEO Charles T. Frock are shown following a 2000 news as Southern Pines, targets the organization about conference on the state of American underserved children up to a concern that they oral health. age 18. considered to be the “About 70 percent of the children we number one unmet need among local lowsaw during our first year of operation had income children. Children, especially the either never seen a dentist or hadn’t seen a uninsured and those on Medicaid, were dentist within the last year,” Dr. Harrell says. not getting the dental care they needed, “Now we average 1,000 patient visits a the nurses said. They had mouths that were filled with cavities, and some were month across all three centers, and accept coming to school in so much pain that they 100 new patients per month.”

Cancer Wellness Program

arbara McInnis loved physical activity. The supervisor of Moore Regional Hospital’s Blood Bank, she was a triathlete who maintained a walking regimen until just a few weeks before cancer claimed her life. After McInnis died, her husband established an endowment for a wellness program—offered through the FirstHealth Center for Health & Fitness-Southern Pines—that would encourage other cancer patients to stay physically active. The FirstHealth Cancer Wellness Program supports individuals who are living with cancer through exercise and education while teaching them how to improve their quality of life. For patients undergoing treatment or survivors striving to rebuild strength and stamina, the Cancer Wellness Program provides individualized exercise routines designed to increase energy and stamina levels. According to Cinnamon LeBlanc, manager of the Southern Pines Center for Health & Fitness, participants in the Cancer

Wellness Program learn how to use the facility’s equipment and take part in low-impact group exercise classes, including Pilates and yoga. “We want people to make use of whatever they can to make them feel good,” LeBlanc says. “The program is very user-friendly.” Modeled after a pilot that originated in Santa Barbara, Calif., FirstHealth’s Cancer Wellness Program includes pre- and posttesting, as well as education, and classes that meet three times a week for seven weeks. Participants are introduced to helpful community resources, such as the Health Sciences Library at Moore Regional Hospital, and can seek assistance on matters of nutrition from a Center for Health & Fitness dietitian. Participation in the program has been shown to relieve stress and fatigue—both results of cancer diagnosis and treatment. “FirstHealth’s mission is to care for people, and we care for the whole person,” LeBlanc says.

Medical Fitness Centers and Exercise is Medicine

s medical fitness centers, the FirstHealth Centers for Health & Fitness are more than gyms. The programs are medically based and physician-supervised. Their personal trainers have college degrees in the fitness field as well as national fitness certifications. The Pinehurst facility has a registered dietitian on staff. “I’m always available for medical input about viable exercise benefits,” says the program’s medical director, Darrell Simpkins, M.D. “Everybody there, physical therapists, exercise therapists, if they’ve got somebody with a medical problem and need to ask about exercise, I’m available to talk to them and many times to talk to patients. Whatever the problem, everybody has me as a contact. It adds to our credibility just tremendously.” In 2010, the Center for Health & Fitness-Pinehurst expanded its commitment to medical fitness by starting an Exercise is Medicine (EiM)

program. Launched by the American College of Sports Medicine and the American Medical Association, EiM encourages health care providers to make exercise a part of their regular patient treatment plans by regarding physical activity as a vital sign—just as they would weight, temperature and blood pressure. After being referred to the EiM program by a primary care provider, participants meet with an exercise technologist for a fitness assessment, goal development and exercise prescription. A free twoweek pass to the Center for Health & Fitness allows them to experience new forms of exercise and work with fitness professionals who communicate information about their participation and progress to the referring physician. There are no charges for the visit with the exercise technologist or for the individualized exercise plan, which can be followed in the location of the participant’s choosing.

“It’s amazing how our fitness center has changed over the last six months,” Dr. Simpkins says. “We’ve always been out of the box, but most centers have people in their 30s and 40s exercising and peak during the hours of 4 to 8 p.m. Our center has never been that way. It’s busy all day long. But since we initiated Exercise is Medicine, it’s amazing to see the numbers of people in their 70s and 80s.” According to John Caliri, director of the FirstHealth Centers for Health & Center, the overall medical fitness program builds on the EiM initiative by giving participating physicians the tools to make appropriate referrals to FirstHealth’s trained exercise professionals. “Participation in the program includes communication back to the physician so he can assist patients in effectively using exercise as a prevention or treatment method for attaining or maintaining health,” Calin says. firsthealth.org/eim

firsthealth.org

“… like I was the only patient in the hospital” No one likes going to a hospital for surgery, but FirstHealth makes the experience about as good as it’s going to get. From the pre-registration at the Outpatient Center, to the volunteer taking me out to the car in a wheelchair a few days later, everything was done to make me feel like I was the only patient in the hospital. Unless you personally experience it, it’s difficult to comprehend the incredible care for the patient exhibited by everyone at Moore Regional. Not only the professional staff of doctors and nurses, but the folks who deliver the food, clean the room, change the bed and the volunteers who stop by to make sure you have everything you need to be comfortable. A special thank you to the nurses and staff on First Floor Surgical: Karin Bethea, N.A.; Arlene Campbell, N.A.; Teresa Campbell, R.N.; Terri Kennedy, R.N.; Tameka Lloyd, R.N.; Elaine Spencer, N.A.; William Thomas, R.N.; Annie Thomas, N.A.; Christy Treadaway, N.A.; Ellen Wallace, R.N.; Mary White, N.A.; and Nakesha Williams, R.N. Absolutely superb patient care from the entire team. Thank you also to the people who care enough to hire the best, train them in the Core Purpose and Values of FirstHealth and then provide an environment that makes them want to stay here. This community is blessed to have you all here. Joel Shriberg Pinehurst

Spring 2011

firsthealth.org/surgery

Gloria Johnson, R.N., Elaine Gunter, R.N., (seated), and Colleen Gordon, R.N., work on the 4 Medical nursing unit at FirstHealth Moore Regional Hospital.

Wonderful, extraordinary care My sincerest thanks for the wonderful, extraordinary care I was given by the most competent nursing staff at FirstHealth Moore Regional Hospital. To Colleen Gordon, Tori Rogers, Elaine Gunter, Gloria Johnson (4th Floor Medical) and all of you who were so kind in making a difficult hospital stay as pleasant as conceivably possible, best wishes and thanks. J. Marshall Friedman Newport, N.H.

Praise from Hoke County

“Far and above the usual” Montgomery Memorial Hospital employees (seated) Stephanie Kornegay, R.N., Emergency Department; and Chris Sheffield, Imaging); and (standing) Jonathan Brower, M.D., Emergency Department; Tennille Blake, Patient Registration; and Tommie Marshall, Environmental Services.

Compliments for MMH My grandmother, Pauline Marley, was seen in the Emergency Department at FirstHealth Montgomery Memorial Hospital, and she can’t say enough about our facility. She said she was treated well by everyone she came in contact with. The names mentioned were Tennille Blake, Kellie Tedder, Nancy Garner, Stephanie Kornegay and Dr. Jonathan Brower, all from the ED. She also said she was treated very well in the X-ray department by Chris Sheffield and Kristi Fox. She said this was the cleanest hospital she had ever been in. I told her that we have wonderful housekeepers as well as Tommie Marshall, who keeps our floors “sparkling.” She was very impressed by the people here as well as the appearance of our hospital. Compliments like this only reinforce the sense of pride I have for working here at FirstHealth Montgomery Memorial Hospital. Pam S. Duncan, RT-R (CT) Director of Imaging FirstHealth Montgomery Hospital Troy

For more information on these or any of the services provided by FirstHealth of the Carolinas, please call (800) 213-3284.

I was an inpatient at FirstHealth Moore Regional Hospital from March 24 through April 1, 2010. I have been an inpatient in your hospital many times and, as a rule, I have received great service and care. On this admission, the care and attention was far and above the usual. I should start by mentioning (Hospitalist Service) Drs. Matthew Brady Holler and Suzanne Wilson. They attended me every day and were always aware of my status and always willing to listen to my feelings or concerns. I felt very secure in their care. All the staff was great, but some went that extra mile. Donna Johnson, Jo Ann Thomas and Bobbie Pate (Inpatient Oncology) were wonderful nurses. There was never a time when my needs were not met with care and professionalism. All the CNAs were so nice and kind. Sheila Jones, Melissa Murphy (Inpatient Oncology) and another lady—I apologize for not getting all the names, but they couldn’t have been any nicer. Daniel Korfmann in Physical Therapy was so kind. Inga and Shawn in Dietary treated me like family. If you have trouble with your food or selections, they are helpful and patient. Thank you for maintaining a wonderful health institution where our citizens can go and receive the care that is equal to any hospital in any major city in America. Lynette C. Norton Raeford

“First choice in hospital care” I want to extend a warm thank you to the nurses and staff who serve room 3308 at FirstHealth Moore Regional Hospital. All were warm and caring to my husband during his recent bout with pneumonia. Moore Regional is our first choice in hospital care. Kimberly Brown Raeford

firsthealth.org

A FirstHealth of the Carolinas year in review In a year characterized by unprecedented accomplishment, three areas of achievement stand out for FirstHealth of the Carolinas during 2010:

• Expansion projects that included construction of the Reid Heart Center: FirstHealth Cardiac & Vascular Institute, the dedication of the Clara McLean (hospitality) House and groundbreaking for the FirstHealth Hospice & Palliative Care campus • Increased medical and civic support to the medically underserved Hoke County community • Heightened efforts by both the Centers for Health & Fitness and Community Health Services to prevent illness and disease by promoting physical activity among the residents of the FirstHealth service area

Spring 2011

2010 A FirstHealth of the Carolinas year in review

Hoke County Playground Among many Hoke County activities, the FirstHealth Foundation supported the community with a $10,000 sponsorship for park playground equipment in Raeford. FirstHealth was also a Gold Sponsor of the area’s annual Turkey Festival. The addition of a family care provider at the FirstHealth Family Care Center-Raeford and growth in FirstHealth’s on-site outpatient rehabilitation program further strengthened the organization’s services to the area.

New Construction

Community Initiatives

Reid Heart Center: The FirstHealth Cardiac & Vascular Institute

Hoke County Certificate of Need Activities

Construction quickly progressed on the two-year Reid Heart Center project during 2010. The culmination of nearly 30 years of high-quality, cutting-edge cardiovascular care, the Reid Heart Center opened in January 2011.

Hospice Campus Ground was broken in spring 2010 for the new FirstHealth Hospice & Palliative Care campus. Located just off Highway 15-501 in Pinehurst, the campus will feature an 11-bed Hospice House for inpatient care, a Grief Resource & Counseling Center, an Administration Building and a chapel.

Clara McLean House The Clara McLean House, which will provide temporary housing and a variety of hospitality and information services for FirstHealth patients and their families, was dedicated Nov. 30, 2010, on the campus of FirstHealth Moore Regional Hospital. The program is expected to open in fall 2011.

In June 2009, FirstHealth of the Carolinas filed a certificate of need application with the state of North Carolina to build a hospital in Hoke County. Soon afterward, the Cape Fear Valley Health System filed an application for a hospital in western Cumberland County. Both CONs received state approval and were then appealed by both applying parties. During the same time, the state changed the Hoke County alignment for health care services to place Hoke in both the Moore and Cumberland County planning districts. Following that action, both FirstHealth and Cape Fear Valley filed CON applications in early 2010 to build hospitals in Hoke County. Again, both CONs were approved and subsequently appealed. Word on all of the appeals, both 2009 and 2010, is expected during 2011.

Diabetes Health Fair More than 250 people attended an inaugural Diabetes Health Fair, which introduced FirstHealth’s diabetes services to people living with the disease and their families. Held in October 2010, the event included free health screenings, cooking demonstrations and exhibitions. Various health care professionals were also on hand to answer questions about medications, supplements and other diabetes-related topics.

firsthealth.org

2010 A FirstHealth of the Carolinas year in review

“Run for the Ribbons”

Happy Kitchen & PLAY

More than 600 walkers and runners took part in the firstever “Run for the Ribbons” 5K and Family Fun 1K at the Stoneybrook Steeplechase on April 3, 2010, at the Carolina Horse Park in Hoke County. The event was a new fundraiser for the Cancer CARE Fund of the Moore Regional Hospital Foundation.

Grant money from the Kate B. Reynolds Charitable Trust supports The Happy Kitchen and PLAY (People Living Active Year-round) programs offered by FirstHealth Community Health Services. Both programs are free and are designed to promote healthy living in low-income/ disparate populations.

HokeFit In an effort to create health-conscious workplaces in Hoke County, the Hoke County First-In-Health 2020 Vision Task Force implemented a corporate walking challenge titled “HokeFit—Ready, Set, Walk!”

MooreFit During the third year of the workplace wellness challenge called MooreFit, FirstHealth expanded its mission to improve the health of the Moore County workforce. During 2010, MooreFit went back to school with lessons on healthy living and, in an endeavor called MooreFit University, offered various classes in the disciplines of nutrition and eating, physical activity and overall wellness.

Hoops for Kids Members of the “White Coats” team, comprised of physicians and FirstHealth employees, celebrated a win over the “Roundball Brainiacs” from Moore County Schools during the sixth annual “Hoops for Kids” fundraiser. The event, which was held March 4, 2010, at Pinecrest High School, raised more than $7,000 for the Boys and Girls Clubs of the Sandhills.

Spring 2011

“Born to Run” During a January 2010 visit to FirstHealth of the Carolinas in celebration of the 15th anniversary of the Center for Health & Fitness-Pinehurst, nationally known author and running enthusiast Christopher McDougall discussed his running philosophy and his best-selling book, “Born to Run,” at a Moore Regional Hospital Foundation Promise of Hope lecture.

Quality MMH Patient Satisfaction Scores Consistently high patient satisfaction scores at FirstHealth Montgomery Memorial Hospital indicate that patients are very pleased with the care they receive at their local hospital. For the 2010 fiscal year that ended in September, mean scores for inpatient (96.36), swing bed (99) and outpatient (99.7) exceeded the hospital’s 2010 goal of 95.

Integrated Health Care In late 2010, the FirstHealth of the Carolinas Board of Directors endorsed recommendations from its Integrated Health System (IHS) Steering Committee that included a commitment to develop an IHS with the core principles of a physician-led, professionally managed and community-governed organization.

Transfer Center Opening With the opening of the FirstHealth Transfer Center, trained paramedics formed the core of an effort to streamline inter-facility patient transfers by coordinating patient movement throughout the organization. State-ofthe-art tracking and bed management software provides real-time metrics on patient census, patient requests, bed availability and housekeeping turntime as well as pending and confirmed discharges.

The nursing staff of FirstHealth Moore Regional Hospital and several off-site nursing programs submitted their application for renewal of the Magnet nursing excellence designation. The current application also includes the nursing staff of FirstHealth Richmond Memorial Hospital.

Joint Commission Surveys All three FirstHealth hospitals celebrated successful Joint Commission surveys during 2010.

Employee Satisfaction Survey With the assistance of an unusual mascot, FirstHealth of the Carolinas concluded a 2010 Employee Opinion Survey during May. The Charlotte-headquartered Morehead and Associates conducted the comprehensive systemwide point-in-time survey with coordination by FirstHealth Human Resources. FirstHealth employees serving as survey “ambassadors” helped communicate the survey process and philosophy, and the “HUHU” (Help Us Help yoU) mascot gave the internal communications plan a playful look that captured employee interest. In comparison to Morehead’s National Healthcare Average, the areas in which FirstHealth scored higher included: • Workforce commitment (a 4.24 or 76th percentile) • Patient safety and quality items • Provision of necessary tools and resources • Career development opportunities Some of the areas that scored below the Morehead National Healthcare Average included: • Satisfaction with benefits • Employee involvement in decision-making • The use of patient satisfaction results to influence quality initiatives Afterward, managers met with their individual units/departments to review their specific results and to develop action plans while administration took on broader issues such as satisfaction with benefits.

Just Culture The Just Culture concept of system safety that was introduced throughout the organization during 2010 endorses “open, fair and just”

cultures to encourage open communication and an accountability system that supports safe behavioral choices from the FirstHealth staff.

2010 A FirstHealth of the Carolinas year in review

Magnet Application

Strategic Planning Consultants An outside consulting group, The Beckham Company, worked with FirstHealth to develop driving strategies and supporting tactics for a major organizational strategic plan.

Service Expansion BRAC Participation As a steady stream of military personnel from the U.S. Army Forces Command (FORSCOM) continued its move from Atlanta to the counties surrounding Fort Bragg, FirstHealth of the Carolinas actively set out to engage this new population in its health services. The core FirstHealth service area counties of Moore, Richmond, Hoke, Montgomery and Lee expect to see an influx of military and defense contractor personnel over the next several years. Moore County alone is projected to welcome more than 4,000 new residents from the Base Realignment and Closure (BRAC), and hospital and health care service has been noted as a primary interest for families relocating to the area.

Richmond Orthopedics Program In fall 2010, FirstHealth of the Carolinas opened an orthopedics clinic in Rockingham that is dedicated to providing care—from initial office visit to surgery—in Richmond County. Staffed by five board certified orthopedic surgeons from Pinehurst Surgical, the Richmond Medical Group— Orthopaedics Clinic is located in the FirstHealth Richmond Medical Plaza at 809 Long Drive, Rockingham.

Exercise is Medicine A new initiative for the FirstHealth Center for Health & FitnessPinehurst encourages physicians to treat physical activity as a vital sign in an effort to get patients to incorporate exercise into their lifestyle. After discussing physical activity needs with their patients, participating doctors refer them to the Center for Health & FitnessPinehurst for a professional—and free—exercise assessment and firsthealth.org

2010 A FirstHealth of the Carolinas year in review

treatment plan developed by a trained exercise technologist. A referral gives the patient access to a no-cost physical fitness assessment, goal-setting and a physical activity program that is suited to their specific needs. Program participation includes communication back to the referring physician so he/she can assist patients in effectively using exercise as a prevention or treatment method for attaining or maintaining health.

Cardiac CARE-Net Based on a successful program that has served cancer care at FirstHealth Moore Regional Hospital for several years, Cardiac CARE-Net matches trained volunteers with new patients. Most of its volunteers have personal experience with cardiac issues, either as a patient or caregiver, so they understand the anxieties and concerns associated with the disease.

PTSD Programming A therapy program conducted by FirstHealth Behavioral Services and led by a FirstHealth psychiatrist with battlefield experience was formed to assist men who suffer from combat-related Post-Traumatic Stress Disorder (PTSD). The psychiatrist, Fernando Cobos, M.D., joined the U.S. Army Medical Reserves shortly after the terrorist attacks of Sept. 11, 2001, and has been deployed to Iraq three times since.

True open MRI Moore Regional Hospital becomes the first hospital in the entire FirstHealth of the Carolinas service area to offer MRI scanning with a completely open scanning system. Located in FirstHealth Outpatient Imaging at 30 Memorial Drive, Pinehurst, the Hitachi Oasis scanning system has a 1.2 Tesla magnet that provides exceptionally high-quality images. Unlike closed or partially open scanners, it can accommodate very large patients (up to 660 pounds) while offering comfort and convenience for patients with limited mobility or claustrophobia.

New Website A redesigned FirstHealth website replaced a 4-yearold site that had become cluttered and difficult to navigate with a new, more patient-friendly format featuring service line landing pages and an A-to-Z service listing. The redesign followed an in-depth analysis of the old site and the appointment of a web team that included personnel from Information Systems and Corporate Communications. 32

Spring 2011

Communication MedCenter Displays Nashville-based MedCenter Display assisted FirstHealth with the installation of five flat-screen patient and visitor education monitors in several facilities. Both FirstHealth Moore Regional and Richmond Memorial hospitals have cafeteria and emergency department monitors, and monitors were also installed at the Center for Health & Fitness-Pinehurst and the Reid Heart Center. Each monitor provides announcements as well as information on upcoming events and classes. Additional screens are planned for FirstHealth Montgomery Memorial Hospital during 2011.

“Period of PURPLE Crying” Both FirstHealth Moore Regional and FirstHealth Richmond Memorial hospitals joined a group of North Carolina health care organizations in a shaken baby prevention program called “The Period of PURPLE Crying.” Maternity nurses share the program’s message with the parents of babies born in their hospitals, and each infant born during the "Week of the Young Child" received a purple cap as a reminder of the special abuse-prevention program.

Pink Gloves for Breast Cancer Awareness Patient care personnel at all three FirstHealth of the Carolinas hospitals now wear pink exam gloves in an effort to raise breast cancer awareness. The Generation Pink Exam Gloves are provided by Medline Industries, which donates a dollar to the National Breast Cancer Foundation for each case of gloves purchased. Personnel at the FirstHealth Outpatient Cancer Center and the FirstHealth Specialty Centers in Pinehurst also participate in the pink gloves program.

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