Evolution of Care by Gannett Wisconsin Media

SUMMER 2010

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Golden LivingCenter – Dorchester congratulates Door County Medical Center on their

Evolution of Care! Golden LivingCenter – Dorchester is proud to be part of the Evolution of Care as we are the former site of the original hospital. Today, as healthcare continues to evolve so does Golden LivingCenter – Dorchester. We provide the continuum of care that patients need following hospitalization, with innovative services such as our Golden Rehab short-term therapy, skilled nursing care, and specialized programs like Alzheimer’s care and diabetes management.

Experience the Golden Difference. Call us today for a tour.

Golden LivingCenter – Dorchester 200 N. 7th Avenue Sturgeon Bay, WI 54325 920-743-6274

www.GoldenLivingCenters.com/TheDorchester.html

GoldenEvolution LivingCentersof offerCare servicesMDCMC and programs to residents without discrimination on the basis of race, color, creed, religion, gender, sexual orientation, national origin, age, disability, status as a Vietnam era veteran, qualified disabled veteran, recently separated veteran, or other protected veteran, or source of payment. GLS-06106-10-NR

From the President and CEO,

I wo woul uld d li like ke to to ta take ke thi thiss op oppo port rtun unit ityy to tha thank nk the the ccom ommu muni niti ties es we we se serv rvee, as well as all of the employees, providers and community partners who have made it possible for us to not only sustain quality health care, but to continually improve and grow the services we provide. During the 22 years that I have led this organization, I have witnessed a true evolution of care. When I began this th leadership journey, our patients were almost exclusively in beds and patient rooms – nearly 80% of our services were provided r to those patients who only received care in or near their hospital room. Today, by comparison, nearly 80% of our services e are provided to patients who arrive and leave the same day, and we are in seven locations in Door and northern Kewaunee n Counties. This transition has been both rewarding and challenging, but has always involved the renovation or construction i of very different facilities and the corresponding equipment and stafﬁng needs. This most recent exciting chapter in our evolution, the replacement of all inpatient rooms and the most extensive s outpatient service – the Emergency Department – is now a reality. After years of exploration, investigation and planning, ng we now celebrate the opening of our largest state-of-the-art facility construction project. The patient rooms are all private, w with space and amenities for family and visitors. The Emergency Department is comprised of all private rooms as well. This publication is an opportunity to celebrate the beginning of the hospital’s existence on this campus as well as showcasing the organization’s progression and the completion of our most aggressive facility improvement project to date. at As you review the following pages, you will be treated to the perspectives of the past as well as the fulﬁlled vision of our current r leaders. There are interviews and pictures from caregivers who worked at the “new” hospital in 1964 and the same from o patient care services providers today. We hope you are as proud and genuinely pleased as we are that our community and Ministry Health Care have made this evolutionaryy step p po p ssible,, and we look forward to welcomingg you at our communityy op pen house on Augu g st 8,, ffrom 1:00 to 4:0 4:00 0 PM PM. Sincerely, Si l

Gerald M. Worrick President and CEO MDCMC

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Evolution of Care MDCMC

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Strongg Foundation........................ 6

Most Wired Hosppital ..................... 29

Past Perspective .......................... 12

Q & A with Jerry Worrick............... 32

Door County Medical Center ......... 20

Practice Makes Perfect................. 38

DOOR COUNTY PUBLISHING: 0 / "OX . RD !V s 3TURGEON "AY 7) 4OLL &REE s s &AX s % MAIL ADVOCATE DOORCOUNTYADVOCATE COM WWW GODOORCOUNTY COM s $OOR #OUNTY -EDICAL #ENTER S %VOLUTION OF #ARE HAS BEEN MADE POSSIBLE BY

The Door County YMCA is proud to partner with Door County Medical Center as wellness advocates in the community. From youth sports, to fitness for seniors, the YMCA is grateful for the many additional opportunities we offer thanks to our partnership with Door County Medical Center.

DOOR COUNTY

YMCA

Together Changing Lives www.doorcountyymca.org MDCMC

Evolution of Care

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STRONG ABOVE: 1964 Contractor Joseph Zettel laying time capsule & corner stone with Frank Kellner, President of the Board of Trustees.

For decades, decades the communities served by Ministry Door County Medical Center have been extremely supportive of the growth and prosperity of this critical health care organization. Having MDCMC here is one of the reasons people continue to relocate here. The DCMH Foundation has been responsible for raising funds to replace capital facilities since 1988 and, since 1998, this effort has been led by Michael Herlache, the Executive Director. Currently, Nell Herlache, Mike’s mother, serves on the Foundation board of directors. Mike’s Father,

Evolution of Care MDCMC

Story by Donna Marie Pocius

Behind the Scenes

John Herlache, MD, has been actively fund-raising for the hospital for many years, and his uncles, Ralph Herlache (retired attorney) and Tom Herlache (retired Baylake Bank president) have been members of the hospital board of directors. Tom also served on the Foundation board of directors for a number of years. But fund-raising for the future of Door County’s hospital began long before that, most notably in the early 1960’s. Herlache’s grandfather, Cliff Herlache, former president of the Bank of Sturgeon Bay (now known as Baylake Bank), served on the steering committee to replace the hospital facility in the early sixties. That committee would become known as the “Citizens Building Committee.” It was cochaired by L.F. Matheys and C.R. Christianson and also included such prominent community individuals as Mrs. Howard Bosman, D. C. Pisha, Fred Peterson, Virgil Starr, Frank Keller, Dr. John Beck, Don Reynolds, Otis Trodahl, Wilford Prange and Mrs. John Weber. W. H. Cornell was the campaign manager and E.B. Mickelson served as a consultant to the committee. The fund raising campaign began in June 1962 and was completed several moths later when one of the most successful fund raising campaigns in the county’s history finished with $470,000. The sum, combined with previously raised $250,000 and $480,000 in federal Hill-Burton funding, comprised the anticipated building cost of $1.2 million. Fund-raising materials from that time were headlined: “Protection when needed.” They pleaded: “We need a new hospital to insure (sic) that Door County residents now and in the future will have facilities for adequate medical service.” The amount of property that became the 16th Place site for this thi relocation and construction project was something that current hospital President and CEO Gerald Worrick ssaid has been crucial in the hospital’s ability to expand to meet the demands of modern health care. understand from doing just a little research myself that “I unde original planning committee must have caught a lot of the origina flack for bbuying all this land,” said Worrick. “We haven’t cramped for land which has been a real benefit. They been cram real foresight by plan or by luck in the amount of showed re land they purchased because we’ve never been short of land. They could have just bought the corner where the hospital was built and houses could have built up around it.” Since the creation of the

continued on pg. 8

Ribbon Cut by Margorie Newman R.N., Direcotr of Nursing in 1964

“The Citizens Committee”, Left to right SEATED: Mrs. Howard Bosman, Co-Chairmen L.F. Matheys and C.R. Christianson. STANDING: D.C. Pisha, Fred J. Peterson, Virgil Starr, Frank Kellner, Dr. John Beck, Don Reynolds, C.H. Herlache and E.B. Mickelson. Not shown are Milford Prange and Otis Trodahl.

MDCMC

Evolution of Care

Behind the Scenes

strong foundation continued from pg. 7 DCMH Foundation, over 20 years ago, many donations have been made to help create new services, update technology and renovate aging facilities at MDCMC:

Construction of the Emergency Department, Diagnostic Imaging, Pharmacy and a new Admitting Department in 1989 The expansion and renovation of the Intensive Care Unit in 1993 In 1996, the construction of the North Shore Medical Clinic, and the addition of the Chapel and Chapel Courtyard (the Chapel and Courtyard thanks to the generosity of the DCMH Auxiliary)

Now, in 2010, we are witnessing the ﬁnal chapter of the legacy campaign – the opening of the new inpatient rooms, Emergency Department and entrance. The new patient room addition will feature all private patient rooms, both in the inpatient units and in the emergency department. This is the largest of all the new construction projects in Ministry Door County Medical Center’ss ten year vision to replace the aging facilities. Center The community has supported this endeavor by contributing $2.5 $2 5 milmil lion in 2009. This level of commitment will ensure that quality health care will continue to be delivered at MDCMC for gencome. Future proj projerations to come ects will primarily involve the updating and utilization of existing space.

continued on pg. 10 The “Our Legacy of Quality Care” capital campaign was implemented by the Foundation in 2001, under the leadership of Herlache, to help make certain that quality health care will be provided here for many generations to come. During the last ten years, $11.0 million has been raised to help make this huge undertaking a reality. More than 10,000 people have contributed to that effort, including $500,000 donated by MDCMC employees. Examples of new facilities and improvements since the legacy campaign was launched include:

In 2003, a state of the art Surgical Services addition was completed – thanks, in large part, to the fundraising efforts of John Herlache, MD, Mike’s father, who spearheaded the accumulation of $5.0 million in donations The Door County Cancer Center, part of the Regional Cancer Collaborative based at St. Vincent Hospital in Green Bay, opened in 2005, adding radiation therapy services to already strong medical & chemotherapy services The new Women’s and Children’s Health Center, a fully integrated facility, opened in 2007 – as well as a new permanent MRI facility

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Behind the Scenes

Building the foundation for the new wing. Photo by Matt Normann

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Evolution of Care MDCMC

“Everyone throughout the recent history of MDCMC understands we have to have a high quality facility and high quality health care here, because we are so isolated, and the nearest hospitals are so far away. Without a modern and technologically equipped hospital here, Sturgeon Bay residents would need to travel more than 40 miles for care. For Gills Rock residents, the journey to the nearest hospital would be 100 miles,” Herlache said. The Door County Memorial Hospital Foundation is planning for the future by accumulating and managing over $1.0 million in endowment funds. The David L. Spude Endowment Fund was created in 2006 to support the Door County Cancer Center facility and to help make cancer treatments affordable for all community members in need. This endowment fund is growing quickly and is now valued at over $150,000. Donors’ names are engraved on displays, which hang in a prominent place in the hospital’s main entrance. Soon, a new board will go up to recognize donations of all sizes to the inpatient services and Emergency Department addition. “There are still plenty of ways to give to the hospital to make sure it continues on for many generations to come,” said Herlache. To make a donation, or for more information on the DCMH Foundation, visit ministryhealth.org or call 920/746-1071.

MDCMC

Evolution of Care

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Looking Back

past Storyy byy PAMELA PARKS

As technology and innovation continue to change the delivery of medical care in Door County, the building housing the services will also evolve. As the $20.5 million, 31,000 sq. ft. addition to MDCMC is completed in August, emergency and outpatient services will have new facilities and patient rooms will be transformed Arriving at a state-of-the-art hospital in Door County has been a process that has spanned more than two decades of medical care.

Steps towards hospital care

TIMELINE ‘64

From 1851 to 1901, the challenge for medical care in Door County was attracting a doctor to live and practice in the ﬂedgling community. A solution was found in 1867 with a $1,000 subscription fund which attracted the practice of Dr. Pommier, eventually deemed a specialist in tapeworm extraction and little else. Following was Dr. Despin, who established Door County’s

continued on pg. 16

Door County Memorial Hospital opens its doors!

‘93 ‘69 sing Facility Skilled Nur of existing built ontop e. structur

Evolution of Care MDCMC

Renovation of Intensive Care Unit.

‘94

Rehab Servi ces relocates to Cherry Point Mall.

first drug store, and Dr. Young, who moved medical care delivery towards a hospital care model with the area’s first combined doctor’s residence, clinic and dispensary. In the winter of 1901-02, Dr. Sibree opened the area’s first private hospital that included care by a trained nurse. The three-story Bay Shore Hospital and Sanitarium, located on Memorial Drive and later called the People’s Hospital, was soon followed by Dr. Egeland’s private residence hospital on Jefferson Street in 1914 — rebuilt in 1923 after being destroyed by fire — and Dr. Leasum’s private hospital at Michigan and Third Street in 1928. All three privately owned hospitals served the public for more than twenty years, each with multiple owners.

A public hospital and era was born In 1943, a group of concerned citizens formed the nonprofit hospital corporation and purchased the Egeland Memorial Hospital to create the first Door County Memorial Hospital. After serving the public for about twenty years it was in need of replacement. The 25-bed capacity hospital was expanded in 1944 with a new wing, quickly built with wartime materials and $90,000 from the government to accommodate the influx of people dur-

continued on pg. 14

‘96 North Shore Medical Clinic is added at the Door County Memorial Hospital site.

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‘03

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Door County Memorial Hospital afﬁliates with Ministry Health Care, based out of Milwaukee, joining a system of 13 Hospitals, and numerous clinics and other healthcare facilities throughout Wisconsin and Minnesota.

MDCMC

The new surgical services addition is constructed above the existing Emergency Services Department.

Evolution of Care

Looking Back

past perspective continued from pg. 13 ing the wartime shipbuilding era. The facility provided medical care to many — and at times was full beyond capacity and would have patient beds lining the halls. “In summer, we had many migrants. They would be lined up in halls with screens between the beds … it was a busy, busy time of the year,” said LeNore Bubnik, a DCMH RN of 41 years. Sometimes the hospital would care for loved ones while their caretaker traveled during the winter, as hospital stay durations were not limited. In her early era of nursing, Bubnik worked six days a week for $150 a month. “That was a lot of money then,” said Bubnik. Carol Newman, a RN who began working for DCMH in 1961 for $1.50 an hour, recalls nurses washing rubber gloves and drying them on a rack, an Emergency Room not staffed with a doctor — if a patient arrived a doctor was called in. As demand increased and technology evolved, the need for a new hospital building grew evident. “The old hospital did not have bathroom facilities in all of the rooms. Things were just so un-handy — there was no oxygen piped into the rooms. We would have to cart around a big tank and tie it on to the bedpost,” explained Bubnik. “In the old building, we had to walk continued on pg. 16

New laundry room in 1964.

New cafeteria in 1964.

From bold commitment comes bold results. Congratulations to Door County Medical Center on their new North Wing addition and lab renovation. We’re proud to be a part of your success. 800.99.BOLDT | boldt.com 14

Evolution of Care MDCMC

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Evolution of Care

Looking Back

past perspective continued from pg. 14 down the hall to carry back water to give a patient a bath. And the same with the bed pans, too — there were no plumbing facilities in the rooms,” said Newman.

Building a modern facility In 1959, a citizens advisory committee with representatives from every hamlet in the county was established to address the need for a new DCMH building that came with a $1,200,000 price tag. This would be the third attempt to rally the community. Two prior attempts had raised $250,000. This time, a matching federal grant under the Hill-Burton act and a federal distressed area windfall of $120,000 provided added incentive to get the job done. Residents from every town and village donated to the cause which had generous pledges from the hospital employees, Auxiliary group and medical professionals. “They had asked if the employees would make a $12,000 gift toward the cafeteria,” said June Peterson, who worked for DCMH for 40 years and was in charge of the operating room for 30 of those years. “We had various projects to make money besides having money taken out of our paychecks … We would use the kitchen in the evening and make big dinners … and we ended up giving $14,000 to the project.” The result was a modern facility built on 25 acres between 16th and 18th avenues 16th Avenue flanked by Rhode Island Street. It’s interesting to note, that 16th Avenue was specifically built to provide access to the hospital connecting Michigan and Rhode Island streets. “The site is centrally located in Door County,” explained fundraising material. “Remote enough from the commercial and industrial areas to insure that traffic and

TIMELINE

continued on pg. 19

continued from pg. 13

‘08

‘05 ‘07

The Door County Cancer Center is constructed adjacent to main entrance of DCMH. The center is home to the Regional Cancer Collaborative.

noise will be at minimum. Both beauty and practicality are combined in the site of the new hospital. The spacious grounds will provide ample space for parking.” Years later, the abundance of land would prove beneficial during an ambitious expansion. When completed in 1964, the new hospital featured up-to-date conveniences that ranged from the large cafeteria to sanitation equipment to functional patient rooms. In a Nov. 12, 1964 Door County Advocate article, Dr. Dan E. Dorchester said “the new hospital was worth waiting for. It’s something to be proud of.” “This hospital is the fulfillment of a cherished dream,” wrote hospital Chief of Staff Dr. Jeffrey Brook. “It will give the medical fraternity an opportunity to render more efficient service to the community.” Brook wrote on behalf of the hospital’s ac-

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Rehab Services expands into northern Door County by opening a satellite location in Scandia Village/ Good Samaritan.

Aug. ‘10 Door County Memorial Hospital becomes Door County Medical Center and opens its all new Inpatient Services and Emergency Department.

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We salute Door County Medical Center for serving as an integral partner in the vitality of the community, and for helping make Door County a great place to work, live, and play. Thank you, and congratulations, Door County Medical Center, for your continual growth and success in meeting the needs of the community.

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Evolution of Care

We Congratulate Door County Medical Center on their dedication to a higher standard of care for the community.

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CONGRATULATIONS DOOR COUNTY MEDICAL CENTER ON YOUR BEAUTIFUL NEW WING. THANK YOU FOR LETTING US BE A PART OF IT.

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Evolution of Care MDCMC

Looking Back

past perspective continued from pg. 16 tive medical staff which included Dr. Nicholas Wagener, Dr. Roland Evenson, Dr. John Beck, Dr. Dorchester, Dr. Weldon Sheets, Dr. H.R. Peters, Dr. W.S. Hobson, Dr. H.D. Grota and Dr. Raymond Rogers. The new, modern 1964 hospital had built-in telephones in every bed and an intercom system to page a nurse. There was also “only two people to a room and nobody in the hall. Every room had its own bathroom with a sink, and shower or tubs. It was very up to date for that time,” said Mary Aznoe, a surgical ﬂoor RN at the hospital for 38 years. “And we had electric beds; we didn’t have to crank beds any more.” Central oxygen was also piped into each room.

Making the move Building a modern facility is one thing but getting everyone and everything from the old facility to the new is another adventure. All willing and voluntary hands — and available vehicles — were called upon to help. “They took any kind of vehicle they had to haul the patients over there — delivery trucks for babies in incubators to the funeral home hearse — which was the ambulance in those days,” said Bubnik. “The ﬁrst day we brought them all over there, we had dinner there and everybody was happy.” Time has a way of repeating itself. After the public views the new addition to the hospital at an open house on Aug. 8, MDCMC staff will prepare to move patients into the new wing — although delivery trucks and funeral hearses won’t be necessary this time. The move will be structured like a disaster drill on Aug. 16, with everyone moving in on the same day just like in 1964.

Improvements and ‘old fashioned care’

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The new addition is “one of the last major steps in replacing the facility built in 1964. Current rooms are over 40 years of age,” MDCMC CFO Bob Scieszinski said. “We are excited that we are able to replace what was built over 40 years ago with new construction, excited about what it will bring to residents of the county, and thankful of the support from community residents for this project.” Although the buildings and medical delivery may change, one thing will remain the same — the care. “Things just keep improving with medications and procedures but the old fashioned care is pretty much the same. The people were nice 40 years ago and still are today,” Aznoe said. “The care never changes; it is always top notch.”

Serving Communities Through Partnership.

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Story by JON GAST Diggitaal Rennderings by BSA A (Bernner-Schober Assoociates, Inc.)

NEW NAME, NEW FACILITY, NEW CAPABILITIES … A NEW BEGINNING When the decision was made in the early 1960’s to build a new hospital in Door County it became clear that limited property and growing health care demands would require the community to look elsewhere in Sturgeon Bay to make that dream a reality. The new hospital was built on the edge of city limits with the foresight that has produced one of the most remarkable rural health care facility expansions in Wisconsin. With plenty of land upon which to expand, Door County Memorial Hospital and Ministry Health Care has changed the face of health care in Door County. In the process it is also changing its name to Ministry Door County Medical Center which coincides with the dedication of a new 31,000 square foot, $20.5 million expansion that effectively ushers in the next generation of in-patient care and emergency services to the peninsula.

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e rooms have been designed with three separate areas – one for nursing, one for the patient and one for family support.” — Jody Boes

Evolution of Care MDCMC

VP of Patient Care Services

Phot Ph oto o by M Mat attt No Norm rman ann. n.

Combined with the addition of a Surgery Center, the Door County Cancer Center and the Women’s and Children’s Health Center over the past decade, the new two-story addition has effectively transferred nearly all of the health care services from the original hospital building to newer facilities. In short, a new hospital has arisen around the original one to provide superior care for succeeding generations of Door County residents and its visitors. “That was 45 years ago, and reﬂected how medicine was practiced then,” said Ministry Door County Medical Center President and CEO Gerald Worrick, referring to the original structure which in part hous-

es his and other administrative staff ofﬁces. “This (new) project is about ensuring the community has a state-of-the-art facility, and that we are responding to

continued on pg. 22

MDCMC

Evolution of Care

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contiinued from pg. g 21 patients and their needs.” Maintaining state-of-the-art care in a rapidly changing health care industry is not easy and is clearly reﬂected with the number of changes and additions the hospital has made. “We have excellent physicians, nurses and ancillary staff (laboratory, diagnostic imaging, rehab and others),” said Jody Boes, vice president patient care services. “We have come so far, especially in the last 10 years. But what limits us is the shell of the building.” The new “shell” carries very little resemblance to the in-patient ﬂoors in the

Evolution of Care MDCMC

original hospital. Rather than the long straight hallways that provide for a more institutionalized setting, curved hallways add an artistic element and different feel to the new wing. Most importantly, they reduce noise. “It’s not something we thought of,” said Boes, crediting input from a Ministry Health Care consultant. But working out the aesthetic qualities of the building was just a fraction of the time and

effort that went into the wing’s planning. Boes said that once ﬁnancing was secured for the project, a structure was put in place to best draw from staff working with the affected departments. In all, these oversight teams enlisted between 20-25 people who worked directly with the architect. “We had tremendous buy-in from the staff,” said Boes. “Right from the start the priority was to design

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e rooms will feel more like a living room than a hospital.” — Jennifer Fischer, Director of Inpatient and Women’s & Children’s Services

MDCMC

Evolution of Care

evolution of care

Labor, Delivery, Recovery, Postpartum Nurses’ Station.

contiinued from pg. 23 the new space for the patient as well as design it for employee satisfaction. We went so far as to build a mock patient room at the Cherry Point Mall so people could try out the look and feel of the items in the space.” In all, there are 28 private rooms for medical/surgical, intensive care, as well as birthing and other women’s inpatient health. All are private. “One thing patients have asked for is private rooms,” said Worrick. Ministry Door County Medical Center found itself in an advantageous position to supply the private accommodations due to its designation as a Critical Access Hospital (CAH) which is determined by the hospital’s size and geographic location. While the

Congratulations to

Door County Medical Center.

19870

Thank you for expanding your facility to beneﬁt our community.

Evolution of Care MDCMC

designation offers reimbursement beneﬁts from the federal government, it also restricts the number of patients it can admit under inpatient status. That pretty much dictated the size of the wing with 18 rooms set aside for medical/surgical patients, 6 rooms for birthing and women’s inpatient care and 4 for intensive care. Boes said considerable research went into the design of each room. “The rooms have been designed with three seperate areas – one for nursing, one for the patient and one for family support,” said Boes. Each room has a bathroom with shower, sitting area as well as a sink and countertop space. Two rooms will have patient lifts, something Director of Inpatient Services Jennifer Fischer said has become increasingly necessary. “Our population is increasingly obese and to move a 400-500 pound person is extremely challenging,” said Fischer. “It presents the possibility of injury to the patient and to the staff.” You might not notice some of the other additions like the supply closets in each room that will allow the caregiver access to materials he or she needs without leaving the room. The closet can also be accessed from outside the room when being reﬁlled so as not to bother the patient. Windows have been added to the room doors so

“

e functionality will allow the care giver to be with the patient. Nurses won’t have to go back to the nurse’s station – nearly everything is in the patient’s room. We’re making sure the patient’s needs are met by bringing as much care to the patient’s bedside as we can.”

— Mary Lopas

CChief Ch i Information Officer nurses can make a late night check without having to enter the room. All windows are double paned housing blinds to eliminate dust and possible bacteria. “From an information/security standpoint the new addition will have significant upgrades,” said Mary Lopas, the medical center’s chief information officer. “There’s a computer in every room. The functionality will allow the caregiver to be with the patient. Nurses won’t have to go back to the nurse’s station – nearly everything is in the patient’s room. We’re making sure the patient’s needs are met by bringing as much care to the patient’s bedside as we can.” “If you can increase the nurse-to-patient one-on-one time the patients and nurses will feel better about the care they

receive and provide,” said Boes, who said that multiple centralized nursing stations are being employed rather than one in the middle of a long hallway. The single most signiﬁcant upgrade from a communications standpoint is the Hill-Rom nurse call and locator system. This state-of-the-art device will be worn by nurses and provide instant communication with on-duty nurses and the ability to locate them more quickly and easily. Fischer half-heartedly joked that ﬁnding nurses has pretty

continued on pg. 26

MDCMC

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evolution of care

Ministry Door County Medical Center much been a “Has anyone seen Jenny?” process. The new system will allow nurses to stay with patients and signal a need for assistance. “Huge,” is how Fischer felt the new system will aide in providing better bedside care. Both Fisher and Boes pointed out that the system offers another beneﬁt

Nursing/Physicians Station in the new Emergency Department.

c contin nued from pg. 25 in that it isn’t necessarily meant as a device to monitor nurse performance, but it will allow supervisors the ability to calculate response time. The Women and Infants Center not only caters to expectant families but women recovering from surgery. There are 4 Birthing Center rooms. “The rooms will feel more like a living room than a hospital,” said Fischer, citing furniture and interior design that will hide much of the necessary medical equipment and lighting until needed. Flexibility is another key feature that the design teams considered when sitting down with the architect. The new Emergency Department is a prime example of just such ﬂexibility. The new ER has eight private treatment rooms with the ability to add two more if demand requires it. The rooms surround a spacious glassed in nursing/physicians station that allows for a full 360-degree view of the entire department.

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Evolution of Care MDCMC

method at the beginning of the project by not using a bidding process, but rather choosing a contractor and architect to work with the design teams and make the best decisions to keep the project under budget. “It’s on the high end of state-of-theart,” said Lopas, admitting that budget limitations couldn’t comply with everyone’s wish list. “We picked the things that will have the most impact.” But there was an eye to the future since not all of the new wing will immediately be used. Boes said the eye to future growth partnered with knowing that building costs years down the line will only be greater. And much of this capability, according to Michael Herlache, executive director of the Door County Memorial Hospital Foundation, reﬂects the commitment of the community. The Foun-

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“The staff is very excited about it and proud of it since they played a part in its design,” Zywicke added. The ability to ﬂex rooms extends beyond the ER into the inpatient wing. For example, pocket doors allow the medical/ surgical space to be expanded into the birthing/women’s care area. Some of the rooms, including those in the intensive care unit, are designed to accommodate different level of patient illness. So a patient recovering in intensive care may not have to be moved to a medical/surgical room. Each room, which is furnished with a chair and a couch for the family, has been designed to help the patients and their families feel more comfortable, points out Boes. Fischer, who also has experience with big city health care, feels the new addition elevates the level of care at the Ministry Door County Medical Center to that offered in larger communities. “We need to celebrate our smallness,” said Fischer. “We can do what big city hospitals can’t do – change. We can do the little things and make things better without all the effort.” Boes said the hospital used a bit of an unorthodox

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dation’s work in raising $11 million dollars since 2001 to fund the on-going hospital expansion reﬂects the community and hospital partnership insuring that a health care facility will not only survive in this somewhat rural setting, but keep pace well into the future. The launch of the new name, Ministry Door County Medical Center, and opening of this new addition signals the completion of a rebuilt Door County Memorial Hospital. With service locations from Washington Island to Algoma, this health care provider has been transformed during the last 20+ years. It is, and promises to be for generations to come, key to providing the health care needs of Door County and northern Kewaunee County.

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Two of the treatment rooms are negative pressure rooms that prevent the ﬂow of the air outside the room and consequently reduce the chances of infection. There is also a grieving room in the area as well as a decontaminant shower room. Susan Zywicke is the director of specialty services and oversees the Emergency Department. Having experience in big city hospitals, Zywicke admitted she was pleasantly surprised by the level of sophistication when she arrived in Door County a few years back and admits the new facilities will far exceed what she’s been familiar with before coming here. “Our (design) teams took a look at facilities all across the state,” said Zywicke. “We looked at other new ones. Privacy has always been of primary importance. Frankly, I’ve felt bad for our patients. We only had three private rooms.” That’s changed in a big way as the old curtain partitions have been replaced with walls. Technology enhancements include integration of vital signs monitors with the computer charting system. Registration will take place in an enclosed area, affording patients privacy and security.

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Evolution of Care MDCMC

Did you hear?

MDCMC recognized as “most wired small and rural hospital” by national health care publication/association Ministry Door County Medical Center is being nationally recognized in July as one of the “most wired small and rural hospitals” in the country. The award was made by Hospitals & Health Networks (H&HN) magazine’s Health Care’s Most Wired 2010 survey. H&HN is published by the American Hospital Association. The “most wired” organizations are hospitals that scored the highest on survey questions regarding information technology (IT). MDCMC is one of just 25 small and rural hospitals nationwide to earn the honor. “This really says a lot about the people who spent so much time working to put together the electronic medical record. It shows where we are compared to the rest of the country’s small and rural hospitals and that we are in a leadership role,” said Gerald Worrick, MDCMC president/CEO.

“Our goal is to meet requirements the federal government has set for hospitals to be fully electronic by 2017. Right now, we are ahead of that,” he continued. An electronic medical record (EMR) is a computerized medical record similar in structure to a paper-based record. It is capable of capturing, processing and storing information and is interoperable with other related systems such as billing and administrative applications, according to H&HN. MDCMC will receive national visibility in H&HN’s July magazine and on the website, hhnmag.com. Also, Mary Lopas, the hospital’s chief information ofﬁcer, who heads up IT, diagnostic imaging and the laboratory, will accept the award July 24 in San Diego. Lopas said the “most wired” award recognizes MDCMC for being on the right track. “Our staff and physicians are being acknowledged by national experts for doing the right things continued on pg. 30 MDCMC

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continued from pg. 29 and meeting guidelines and goals out there related to quality patient care,” Lopas said. “It’s an honorable distinction for a hospital this size and exempliﬁes our commitment to the communities we serve,” added Steve Quade, the hospital’s vice president of business and hospitality services. This is the seventh year MDCMC has completed the “most wired” survey. In 2008, the hospital earned a “most improved” award, a designation which recognizes health care organizations whose IT scores improved the most. “This year, we have the full award. We have achieved the goal,” Lopas said. Some of the more recent IT accomplishments at MDCMC include broadening IT programs to other areas of the hospital. For example, technology is being used to help ensure patients get the right medications in the right amounts. The implementation of safeguards began in inpatient services and has recently expanded to the Surgery Center, Lopas said. Another area that contributed to the hospital’s high score is the access patients have to their health care charges online and ability to pay their bills electronically. Also, MDCMC employees can access an Intranet and wide variety of hospital beneﬁts and information. Doctors use voice recognition dictation. For example, in Diagnostic Imaging, radiologist’s voice recognition dictation is associated with reducing the time doctors and patients spend waiting for information about health care tests.

“What Will Be Your Legacy” Wayburn Dean What will be your legacy? Are you known for the good that you’ve done? You only have one chance to write your story, So what’s it gonna be, your legacy! When should you begin to think about leaving a legacy? The time for you to decide how you want to be remembered is NOW. A charitable person once said: “I don’t want the cemetery to be the only place my children and grandchildren will see my name.” Your children may ﬁnd it meaningful to know that you provided for an organization that you supported during your lifetime. Keep in mind that the goal is not just to give money to a worthy cause, but rather to make a difference. Winston Churchill was quoted as saying: “We make a living by what we get, but we make a life by what we give.” What can you do to start the process? Speak with Robert A. Ross, an estate planning specialist, who can evaluate your individual concerns. Discuss the matter with your CPA, Financial Planner and Insurance Professional, also contact: Andy Boettcher or Mike Herlache at the Door County Memorial Hospital Foundation at 920-746-1071.

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Evolution of Care MDCMC

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MDCMC’s achievements also include a picture archiving communication system, which electronically manages and distributes images; computed radiography; digital rather than ﬁlm images; and e-management systems in the Emergency Department and North Shore Medical Clinic, a multi-physician group practice owned by the hospital. As to what is next for MDCMC’s IT, Lopas said there are “gaps” that she would like to see ﬁlled. For example, she wants to ensure that more information is being electronically captured at North Shore locations, so that it can be promptly available, for example, to the hospital’s Emergency Department. The modern hospital addition for inpatient services and the Emergency Department, opening in August, will support IT goals and make more initiatives easier, Lopas said. “The caregivers will be working with patients to electronically capture information about their care in the private practice rooms—instead of writing something on a piece of paper and going somewhere else like a nurses stations to put it in the computer,” she said. More information about IT ad MDCMC is online at ministryhealth.org or by calling 920-743-5566.

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Q&A

Jerry Worrick GERALD WORRICK, CEO and president of the Ministry Door County Medical Center, Center recently sat down in his ofﬁce located in the original hospital building built in 1964 to County Memorial Hospital in 1987 and, more speciﬁcally, the newest addition to the Center complex.

Evolution of Care MDCMC

Photo by Joe Sorelle.

discuss the evolution of health care since he came to Door

â&#x20AC;&#x153;

me to have a facility which represents the way the t inpatient is cared for in this day and age. Patients are demanding private rooms. They donâ&#x20AC;&#x2122;t want to sharee rooms and I donâ&#x20AC;&#x2122;t blame them.â&#x20AC;? â&#x20AC;&#x201D; Jerry Worrick

Q: Jerry, tell us the circumstances surrounding your coming to

Door County nearly 23 years ago.

You must have had some sort of a plan when you ďŹ rst came here in 1987, tell us a little bit about how you approached the job.

A: I came here on temporary assignment. The CEOâ&#x20AC;&#x2122;s position opened up.

A: When I ďŹ rst came here, I looked at the institution, the building, staff

The board went to St.Vincentâ&#x20AC;&#x2122;s in Green Bay and asked if they would be willing to manage this hospital for six months while they looked at where they wanted to go and determine the type of person they wanted in here. St. Vincentâ&#x20AC;&#x2122;s agreed to do a management contract for six months. I was the assistant administrator at Sacred Heart in Eau Claire which is part of the system that runs St. Vincentâ&#x20AC;&#x2122;s. They contacted me through my boss in Eau Claire and I came up here for six months.

and programs. I saw the potential for it to grow and become more modern. At the same time a lot of the changes we have incorporated through the years since Iâ&#x20AC;&#x2122;ve been here reďŹ&#x201A;ect the changes in health care in general. Our ďŹ rst major project was around 1990 when we put on a new emergency department and radiology and we always called that the outpatient addition. It really reďŹ&#x201A;ected the change of hospitals from an in-patient model to an out-patient model. And the next major addition was the clinic and that really reďŹ&#x201A;ected a time when hospitals began to incorporate physician practices into their organizations. At that time, it was really difďŹ cult recruiting physicians so we needed a modern clinic just to get physicians to look at us They wanted a newer more modern facility to practice in so we kind of ďŹ lled that need. Then we did the surgery addition, the Womenâ&#x20AC;&#x2122;s Center and the Cancer Center. They all reďŹ&#x201A;ect the growth in the world of health care.

Q: It seems thatâ&#x20AC;&#x2122;s happened to a lot of people who come to Door County. They move here thinking itâ&#x20AC;&#x2122;ll be temporary and they end up staying. Why did you stay?

A: First of all, it wasnâ&#x20AC;&#x2122;t too difďŹ cult an assignment to say you have to go live in Door County. I really liked the people. They treated me very nicely. The staff and employees at this place were very, very nice; made me feel very welcome. From a career point of view it was an opportunity to get your foot in the door to become a CEO of a hospital because if you interview to go somewhere else they always want someone with experience as a CEO. From a selďŹ sh point of view that was what I was going to do. One thing led to another and we really liked it here. The people who have worked on the board have always been very supportive and my wife would say â&#x20AC;&#x153;Why would you ever want to leave?â&#x20AC;? You can always go and make more money in a larger city, but the lifestyle is great here.

Q: What does this new addition mean to the hospital? A: This sort of represents going back to the beginning â&#x20AC;&#x201D; looking at our core business which is the inpatient. It was time to have a facility which represents the way the inpatient is cared for in this day and age. Patients are demanding private rooms. They donâ&#x20AC;&#x2122;t want to share rooms and I donâ&#x20AC;&#x2122;t blame them. The layout of the ďŹ&#x201A;oor and the way we have designed the new ďŹ&#x201A;oor represents the way nurses practice as opposed to having this nurses station at the end of a long hallway. Some of

continued on pg. 34

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Q&AJerrry Worrick continued from pg. 33 the things built into it like nurse servers or the nurse call system represents new technology on how to locate people and communicate back and forth. This building was built in 1964 which means the design structure back then represents some of the methods of the 1950’s. You can tell by my own office - they didn’t install central air conditioning (he points out the window-mounted unit). So as we began to look at how we could modernize and our first thought was maybe we could modernize the existing building. The building is 45 years old and the plumbing needs to be replaced; it’s not wired right to take care of the power needs in terms of computers, technology and modern equipment. So as we looked at it, we finally felt it was impossible to remodel.

Dr. Shaun Melarvie and Gerald Worrick. Photo by Matt Normann.

Q: Will this change the nature of hospital care in terms of an emphasis on inpatient?

A: I still see there will be more and more emphasis on the outpatient. It will continue. Technology is geared to how can we do it on an outpatient basis in terms of savings for the insurance companies and the patient. It’s usually cheaper to do it outpatient than to bring them in.

Q: I’m sure that’s even impacted by your designation as a Critical Access Hospital (CAH).

Yes, we’re limited to 25 beds. Inpatient is down all across the country.When I came here, St. Vincent’s ran a census of about 300 patients a day. Now if they get 200, it’s a big day. There’s a continual shift to the outpatient model.

How often are you going to be at capacity in this new wing?

leadership role for hospitals our size with many studies putting us in the top 5 percent in computer technology with our electronic medical record keeping which is a big issue across the country right now. We jumped on that about 10 years ago and really have been pushing it.

Q: Touch on a few of the things that have made this hospital so successful. A: We allow people to have new ideas and allow them to go forward. We have a very supportive medical staff that works very well together. Across the country there is a lot of friction between physicians and hospitals. We don’t ﬁnd that here. Our employees are great and are very dedicated to our patients. They walk the talk of keeping patients ﬁrst in everything we do. It shows in our patient satisfaction scores. The community as a whole has really supported us. This fund drive that culminated with this building started almost 10 years ago with a goal of $10 million in 10 years. Our Foundation has worked very hard and the community has responded. The Door County community, with everyone pitching in and working together, has had a lot to do with it and a little luck.

Why has this rural facility, located so close to a large regional complex in Green Bay, been able to survive and thrive?

We hit the 25 number maybe 15 to 20 times a year. We do have three extra rooms, called observation rooms, which is a different classiﬁcation. I do expect you’ll see a bump up in census just because this is a new facility and more appropriately meets the desires of patients today.

continued on pg. 36

Congratulations Door County Medical Center

Q: This facility has to rank right up there with any other rural health care center, at least in the Upper Midwest.

A: This is going to be one of the nicest rural facilities. The

19882

physical plant is just part of it. Patients grade our staff and we’re in the 90th percentile and not just compared to other small hospitals, but with other big hospitals across the country. We’re in the 80-90th percentile in our inpatient settings and our Emergency Department has always been in the 90th percentile in patient satisfaction scores. So has housekeeping. Plus, we feel we’re in a real

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MDCMC

Evolution of Care

Q&A Jeerry Worrick

continued from pg. 35

Thatâ&#x20AC;&#x2122;s the result of having good physicians that people can trust and then a supportive community that wants to have a hospital. Physicians working together is huge.

Tell us a little about the planning process that went into this new wing

A: Jody Boes (Vice President of Patient Care Services) oversaw much

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of the planning process and has done a great job. The bulk of this new building is nursing and run by nursing departments. The way we set up the design of this building was we enlisted an architect and then we got a builder and three major subcontractors. We all sat down and designed the building together as opposed to having an architect design a building. We thought we could do a much more efďŹ cient and cost-effective method doing that. Then we made the decision that administration and architects really donâ&#x20AC;&#x2122;t know how to be nurses so we brought all the departments involved in this to also help in the design. The other thing we did was went over to the Cherry Point Mall and rented some space and built a mock patient room. That allowed all the departments that had to use this patient room to come in and critique it. So it really had their stamp of approval. We have weekly department meetings with departments affected by this building and they continue. From the employee side, Jody is the one who really spearheaded and organized that effort. Now sheâ&#x20AC;&#x2122;s in charge of orga-

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Evolution of Care MDCMC

“

ften thank them, whoever they were, for their foresight. They bought a lot of land and that’s allowed us to do everything we’ve done here.” — Jerry Worrick on the 1960’s building committee.

nizing all the teams on how we’re going to move the patients. That’s a real trick, too, because when we put the patients in there all our staff have to know where the equipment is. We’ve been 40-plus years in this building and you get used to where equipment can be found.

Q: What’s the plan for the inpatient space in the old building?

We’re just now looking at that plan. The remodeling of former operating room space into a new laboratory shows us we have more challenges than we thought we had with this building. I think we have to take a breath first. I think first we’ll move as many of the administrative office functions out of the basement and little cranny holes and design their departments so they’re more efficient. It will be non-patient functions. That will open up space for classrooms and conference rooms for the community. The one thing that will stay is the skilled nursing facility. But we need to look at that facility also because the demands of those residents and families are different than when they built it. The overall challenge is that we are limited in size to 30 beds by a freeze that has been in place in Wisconsin since 1979.

Could you have envisioned something like this when you ﬁrst came to Door County?

When I ﬁrst came here I told my wife this would be for a couple of years and we’ll move on. But that was 22 years agao! We have a totally different operation than we did when I started. No, I never envisioned everything we’ve accomplished.

Anything through the process that you didn’t expect or has surprised you?

A: When we started, I never envisioned a curved building. I can’t think of any surprises. Maybe there’s something I don’t know about, yet. I’ve just been impressed with how our employees have been involved in the design and bought into it. It’s really their place when we get done with it.

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Q: And I’m sure you feel the same way about the community? A: I can’t wait for the community to see it. I think they’ll be very, very pleased. They have been the ones over the years that have supported it.

After all, the hospital is one of those community-based institutions like City Hall, the schools, ﬁre and police that the community can take ownership in. It puts you in kind of a custodial position.

You’re right. They’ve entrusted me with a great responsibility, the community has. Seriously, it’s their hospital. Technically, it’s Ministry Health Care’s hospital but it goes back to being the community’s hospital. We do the best we can.

It appears that Ministry Health Care has been a good ﬁt for this hospital.

A: Ministry has been very supportive for us. We’ve been Ministry for 11 years. We joined at a time when healthcare was at an upheaval. It became apparent that we needed to look at something rather than being out here alone. From the time we started discussions with Ministry to the time we actually became Ministry was about six months. That’s really unheard of. That was really fast tracking. It became apparent that it was going to be a good ﬁt from the beginning since their values and our values were very similar. They believe in the community and meeting the needs of the community and that’s what we’re all about. It was probably best summed up by one of our board members who said the reason we were joining a system is because in a small hospital like ours we’re always on a tight rope. If we fall off we could kill ourselves and the whole organization. If you belong to a system like Ministry if you fall off they’re there to pick you back up and put you on the tight rope. They provide a lot of ﬁnancial backing which we really haven’t had to use. They keep us focused to our primary mission of taking care of our patients and doing what’s best for our patients.

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MDCMC

Evolution of Care

safety ﬁrst

practice There are only a few things in life that you can count on not changing. You may consider the location of your community hospital as one of those permanent fixtures in life. However, there comes a time when a situation arises that necessitates an orderly movement of patients from one location to another. The most dramatic example was during the recent hurricane in New Orleans when multiple hospitals needed to be quickly evacuated before the rising flood waters prevented them from continuing normal operations. Realistically, events can happen anywhere at anytime that may require a quick evacuation of patients. Medical facilities rehearse various drills (fire, severe weather, bomb threats, cardiac arrest etc.) on a regular basis. Each employee has an assigned job to do during such drills and it becomes an automatic reaction after a while. A mass evacuation is not quite as easy to rehearse however because of the potential inconveniences placed on patients within the hospital. The two most important elements of an evacuation are; 1) assuring patients’ safety and 2) the patients continue to receive quality care without interruption. This type of exercise cannot be practiced like a typical fire drill because of the size of this type of operation. In the past, small scale exercises using volunteers from the community have allowed key personnel to evaluate the hospital’s response to disasters, but large scale exercises are rarely attempted. Ministry Door County Medical Center will soon be in

Evolution of Care MDCMC

a very unique situation when the new Inpatient Addition is open and ready for occupancy. On August 16th, patients who are hospitalized within MDCMC will be part of a historic event involving moving them from their present location (the old inpatient rooms) into their new rooms. Since this event will involve the transfer of all the patients within the hospital, it is an excellent time to incorporate a very realistic training opportunity for hospital personnel and emergency service providers of Door County. On Monday morning, August 16th, patients within the hospital will be the stars of a patient evacuation exercise. Holding the lead role, they will remain in their bed and experience a very safe, comfortable ride from their current room to their new room in the new building. Behind the scenes, everyone from the hospital CEO on down will be carrying out their part as if this was a real hospital evacuation. Members of Sturgeon Bay Fire and Police Departments, along with Door County Sheriffs and Emergency Management personnel will be actively involved in the exercise just as they would be during an actual event. By taking advantage of a carefully orchestrated patient move into a new facility, hospital and community emergency service personnel will be able to experience a once in a lifetime event that hopefully will never have to be carried out in reality. However, if the need develops, both hospital and community services will be prepared to handle this type of situation.

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MDCMC

Evolution of Care

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