Your Health Today - Fall 2017

your

health today FALL 2017

passionate Dr. Alicia Vinyard, cancer surgeon and survivor

Also in this issue: A parent’s experience transforms care for all Balanced, delicious meals in a bowl

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UP FRONT HEALTH SYSTEM NEWS

In This Issue

2 4 6 8 10 11

at the core of

Up Front

Patients and families first

Powerful Medicine Breast surgeon has been on both sides of cancer

Partners in Care

Transforming life experience into improved patient- and family-centred care

Family Health & Wellness

Relationships that work, plus more uses for pumpkins

‘‘

care

The Center for Patients and Families

When I hear the words patient- and familycentered care, it means not doing to a patient but doing with a patient.”

—Julie Ginn Moretz, chief experience officer and associate vice president of the Center for Patients and Families

Dignity. Respect. Collaboration.

At Augusta University Health, these aren’t just words—they are part of the principles of patient- and familycentered care that every employee takes to heart.

Patient- and family-centered care is a philosophy that focuses on putting patients and their families first,

Healthy Living

Caregivers should take it easy once in a while

while building partnerships between them and health care providers in order to improve quality, safety

Eating Well

and satisfaction.

Getting a full, balanced meal in a yummy bowl

“When I hear the words patientand family-centered care, it means not doing to a patient but doing with

The materials in Your Health Today

a patient,” said Julie Ginn Moretz,

are not intended for diagnosing or

chief experience officer and associate

prescribing. Consult your physician before undertaking any form

vice president of the Center for

of medical treatment. For more

Patients and Families. “To me, that

information, visit our website

shows inclusion and partnership. It’s

at augusthealth.org or call

the expectation for care here and has

706-721-2273 (CARE).

Copyright © 2017 Augusta University

2

your health today  Fall 2017

A better perspective To learn more about patient- and familycentered care at Augusta University Health, visit augustahealth.org/PFCC.

been since the early 1990s.”

Augusta University Health is recognized as a pioneer in patient-

THE FOUR PRINCIPLES OF PATIENT- AND FAMILY-CENTERED CARE

and family-centered care by the American Hospital Association and the Institute for Patient- and Family-

1

We treat patients and families with dignity and respect.

2

We provide clear, comprehensive information in ways that are useful and empowering.

3

We create opportunities for patients and families to participate in ways that enhance their control and independence.

4

We ensure that collaboration is inherent in our policies, programs, education and delivery of care.

Centered Care. Augusta University Health first incorporated the approach in 1993, when patients and families were involved in the planning and design of the Children’s Hospital of Georgia at Augusta University.

“Before it truly became part of the way health care is expected to be delivered, we came up with standards of care in collaboration with the Institute for Patient- and Family-Centered Care,” Moretz said. “Now these standards are something everyone is abiding by, which is great because we’re all in this together; we’re all about taking care of patients and their families.”

Patient- and family-centered care, however, is more than a philosophy at Augusta University Health—it’s a full department, recently renamed the Center for Patients and Families. The center serves as support for patients, families and staff; helps to develop initiatives to enhance work and areas of the hospital; collaborates with patient and family advisors; and works with clinicians on communicating with

PATIENT- AND FAMILY-CENTERED CARE AT WORK

When patients and families are actively involved in health care decisions, quality of care and patient satisfaction improves. For this reason, Augusta University Health has incorporated patient and family perspectives during the planning and design of various buildings and areas of the hospital.

patients and families in an effective and respectful way.

“Patient experiences are improved, because they are part of the team and included in the conversation,” Moretz said. “They help us to ensure that we’re getting it right and meeting them where they are now.”

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3

POWERFUL MEDICINE New breast surgeon brings fresh perspective to cancer patients

E

‘‘

ight years ago, Alicia Vinyard started her fourth year of

I was already fit medical school. before my diagnosis, “I always knew I wanted but I used exercise to be a doctor from a very as therapy during early age,” she said, “and I my treatments and was excited that I was finally also appreciated that reaching that dream as I entered my final year of I had the physical medical school.” ability to run several But as she was studying for her board certification miles each day, when exam in February 2009, she found a lump in other cancer patients her left breast. The lump was painful—which is couldn’t. I ran—and uncharacteristic of cancer—plus, she was only still run—for them. ” 25 years old, and no one in her family had breast —Alicia Vinyard, DO

cancer. All signs pointed to “benign.”

The pain worsened, prompting her to get a mammogram and ultrasound in May 2009,

call; I was expecting to finish my last year of medical school.”

Several days later, she underwent further surgery to remove residual cancer and had lymph nodes in her underarm removed to curtail the spread of her disease. She then began chemotherapy—but losing her hair wasn’t the hardest part for her.

“The hardest part of all of this was that I had to take a break from medical school,” said Vinyard, who took five months off for her surgery and chemotherapy, which she completed in November 2009. “My lifelong dream had to be put on hold.”

which also showed benign findings. But the pain remained. It made her so uncomfortable that she

ANSWERING HER CALLING

had the lump removed in June 2009.

Immediately after chemotherapy and in the midst of six weeks of daily

THE LIFE-CHANGING PHONE CALL

radiation treatments, Vinyard returned

Three days later, Vinyard was at home in Charlotte,

to her fourth and final year of medical

North Carolina, recovering from the surgery and

school and began her first clinical

packing to return to her clinical rotations when her

rotation. Of all specialists to which

doctor called to break the news: The pathology report

Vinyard could have been assigned

showed that she had invasive ductal carcinoma, a type

after surviving breast cancer, she was

of breast cancer that begins in the milk ducts and then

paired with a breast surgeon.

spreads to the surrounding breast tissues—the most common type of breast cancer.

4

The first surgical case was placement of a chemoport, a small

“None of it made sense,” said Vinyard, who was

device that is implanted under the

well aware that less than 1 percent of breast cancer

skin to assist in the delivery of the

cases in the United States are in women under the

chemotherapy drug. The patient felt

age of 30, but when it occurs in this group, it tends

uneasy about her course of treatment

to be more aggressive. “I was not expecting that

and asked what a chemoport would

your health today  Fall 2017

p

passion when

If it’s cancer, see us first.

To learn about our cancer specialists and services like breast surgery, visit augustahealth.org/cancer, or call us at 706-721-6744.

meets practice

look like. Without hesitation, Vinyard pulled down her collar and said, “It looks like this.”

“It obviously relieved the patient’s anxiety,” she said, “and it allowed me to connect to her in a deeper way.”

This encounter gave Vinyard’s career aspirations new meaning and validated her decision to become not just a general surgeon but a specialist in breast cancer surgery. Her personal experience with breast cancer has motivated her in a profound way and has influenced how she approaches patient care.

“I can empathize with my patients and easily put myself in their place,” she said. “With each patient, I tailor their surgical options to what is best for them but also to what they can deal with each day going forward.

During surgery, I consider the placement of their scars, because I want them to be able to look in the mirror and not be constantly reminded of their disease. Fortunately, I had an excellent breast surgeon, and my scars are so well healed that I don’t see them—I want that for them.”

In her role as breast surgeon, Alicia Vinyard, DO, is very sensitive to the needs of her patients, having fought breast cancer herself while in medical school.

augustahealth.org

5

PARTNERS IN CARE How personal experience shaped the patient experience for all

Julie Moretz (left) confers with members of the Center for Patients and Families team to foster more compassionate care for all.

small

inspiration, major transformation

J

ulie Moretz sat quietly in the pediatric intensive care unit

dedicate her life’s work to developing and

with her son, Daniel—until a team of physicians flooded

implementing a transformative health care delivery

in to discuss his case. She was asked to leave the room … model: patient- and family-centered care (PFCC), which to leave her son’s side.

She saw other parents leave their young children, so

she exited without questioning. But it didn’t feel right.

in a patient’s life.”

“PFCC is about connecting the care team and the

Shouldn’t a patient’s parent or health care advocate

patient and family on a totally different level,” Julie

be allowed—welcomed, rather—to participate in

said. “It’s about going deeper by partnering with the

this important discussion?

patient and family in all aspects of care and giving them

It was this very thought that inspired Julie to

6

Julie defines as “the experience and foundation of care

your health today  Fall 2017

a voice in their care.”

The Academic Health Center Advantage There are a number of advantages to choosing an academic health center for care. To learn more, visit auhealthadvantage.com.

ONE LITTLE BOY,

with parents, clinicians, staff and

MANY BIG CHANGES

administrators, we did, because it was

Daniel, Julie’s second son and third

the right thing to do and the right time

child, was born in 1991 with three

to do it.”

heart defects.

“Many clinicians thought he’d

Three years later and after repeated offers to join the hospital staff, Julie

never leave the hospital,” she said,

accepted a full-time position as director

“regardless, I needed to be at his

of family services development.

bedside. We knew that his own heart would never let him grow up, so we

BEING TRULY PRESENT

accepted the fact that he would need

Despite a heart transplant at age 8,

a host of surgeries, and most likely, a

Daniel’s heart failed him when he was

heart transplant at some point.”

just 14. Thanks to the adoption of PFCC

Administrators and clinicians noticed

at Augusta University Health, Julie and

Julie’s tireless commitment to her

her husband, David, were permitted

son’s care and that she was asking why

to be at their son’s side when the team

such restrictive policies were in place.

worked to resuscitate him.

So, they began soliciting her input

“I’ll always remember the tall

on decisions that would enhance the

technician pumping Daniel’s chest

experience for all patients and families.

under the bright lights and the sweat

In 1993, she was asked to serve as

dripping down his face,” Julie said. “If

Julie Moretz went from being asked to leave her son’s room to sitting at the head of the table—and inviting others to join her in pioneering patient- and family-centered care.

the first volunteer chair of the newly-

we hadn’t implemented patient- and

center for four years. Her new office is

formed Family Advisory Council,

family-centered care, then my husband

located in the same space where Daniel

whose work informed the design of

and I wouldn’t have been able to be

received his pediatric cardiology care

the Children’s Hospital of Georgia at

with Daniel during that critical time or

in the ’90s. But Julie doesn’t feel pain

Augusta University and positioned the

see how hard our team worked for him.

or sorrow.

larger health system, Augusta University

Even though the outcome was not what

“I feel like I’m home,” she

Health, as a pioneer for PFCC.

we wanted, this means more to us than

said. “Daniel always felt like this

anyone will ever know.”

was his hospital and that he was helping

“Our goal was to keep families together with patients as much as

other sick children; he didn’t even

possible, which impacts quality and

‘I FEEL LIKE I’M HOME’

view himself as sick. I feel his presence

safety,” Julie said. “We learned that

Julie recently returned to Augusta

inspiring me as we work to improve the

clinicians were just bound by outdated

University Health after working with

experience for all patients and families.

policies and procedures, which told us

PFCC on a national level for seven

We were blessed to have him in our

it was time to revisit that. In partnership

years and for another academic medical

lives for 14 years.”

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7

FAMILY HEALTH & WELLNESS HELPFUL TIPS AND RESOURCES

good-for-you 5 signs you’re in a healthy relationship

T

love

here are a lot of indicators a capacity to deal with differences

 Have patience and stretch yourself to

of a healthy romantic

and contain their need to convince

see things from your partner’s point

relationship, but Bernard

the other to adopt their own views,”

of view.

Davidson, PhD, a licensed Davidson said.

psychologist with Augusta University Psychiatry and Health Behavior, shares

4. S eparate interests and/or friendships

 Match your nonverbal communication (eye contact, facial expressions, tone of voice) with your words.

five key characteristics:

Each person should always be able

1. Mutual and self-respect

to pursue their own interests and

your partner that you need to take

It’s critical for you and your partner

friendships outside of the relationship

a break from a discussion when you

to respect each other, but it’s just as

without their partner feeling jealous

feel it’s beginning to escalate into

important for you both to respect

or threatened. This will not only create

an argument.

yourselves. Don’t allow the focus of

opportunities to support each other,

the relationship to become skewed by

it also helps to maintain a separate

centering too much around yourself or sense of self. “You can only be as your partner. Neither a self-centered

together as you can be separate,”

nor a co-dependent relationship leads

Davidson said.

to a lasting state of satisfaction.

5. Good communication

2. A sense of playfulness

The words you say to your partner,

A willingness to be playful and

the body language you use and

express emotion with one another

listening are all equally important in

is important. “It reflects trust in a

a relationship. People usually don’t

relationship and promotes individuals

remember what a disagreement was

to be themselves,” Davidson said.

about, but they remember the

Plus, it usually leads to increased

form of the argument. Here

expressions of physical affection.

are a few tips to help you and

3. Being able to accept differences

your partner communicate

Differences are inevitable in

better with each other:

relationships, and individuals

 Make the effort to repeat

shouldn’t constantly feel the need

what your partner said

to be right. “Healthy relationships

to check if what you

are marked by individuals having

heard is correct.

8

your health today  Fall 2017

 Create a signal to communicate to

Keep love alive To find a psychologist or primary care physician or schedule an appointment at Augusta University Health, visit augustahealth.org, or call 706-721-2273 (CARE).

long live the

pumpkins!

P

Repurpose pumpkins to extend Halloween happiness umpkins and jack-o’-lanterns are essential Halloween decorations. But

GET CRAFTY

once the trick-or-treaters have come and gone, what can you do with

Birds love the taste of pumpkin just

these festive gourds? Rather than just throwing them in the trash or

as much as we do. Making a bird

compost pile, repurpose your pumpkins with any of these ideas.

feeder is a great option for your leftover jack-o’-lanterns and is a fun

GET COOKING

activity for the kids!

Pumpkin is a healthy ingredient that can be used in a variety of delicious

What you need:

recipes, such as soup, hummus, salads and more. It’s best to use the fleshy part

 Hollowed-out pumpkins, cut

of fresh uncarved pumpkins for recipes. But if you are carving, you can use the

in half horizontally

innards to make a great vegetarian pumpkin stock. Here’s how:

 Two wooden dowel rods

1. Place fresh pumpkin goop and seeds in a large stock pot with other

 Bird seed

chopped vegetables, such as onions, carrots and celery.

 Strong twine or cord

2. Fill the pot ¾ full with water and bring to a boil.

How to:

3. Reduce heat and simmer for about an hour, or until it starts to change color.

1. Insert the dowels

4. Allow to cool, then strain out seeds, guts and vegetables.

 Poke a dowel into the pumpkin a

Use the stock in soups, casseroles or goodies, or freeze for later.

few inches down from the top edge.

Push it straight out through the opposite side of the pumpkin.  Poke the second dowel through the pumpkin so it crosses just under the first dowel.

PHOTO COURTESY OF KITCHEN COUNTER CHRONICLES

Family-friendly fun For all of your pediatric and adolescent needs, trust the experts at Children’s Hospital of Georgia at Augusta University. For the latest and greatest in kids’ health and parenting tips, visit blog.gachildrens.org.

2. Add the twine  Cut the twine into four equal lengths.  Tie a strand to each dowel, then tie the loose ends together in a large knot at the top.  Fill with seeds and hang in your yard.

Project adapted from the National Wildlife Federation

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9

HEALTHY LIVING STRATEGIES FOR A GOOD LIFE

T

here are many reasons why adults become family caregivers.

Loved ones who are disabled, ill or elderly might require an extra level of care. Whatever the circumstances, it is important for caregivers to build in time to take care of themselves.

Wanda Jirau-Rosaly, MD, is a geriatrician with Augusta University Internal

Medicine. She acknowledges that caregivers are doing amazing, giving and loving work when they take care of a loved one’s needs, whether for a child, parent or spouse. But sometimes, caregivers can get overwhelmed.

“Caregivers can be paying so much attention to the condition of their family member that they start to neglect their own needs,” Jirau-Rosaly said.

Some signs of caregiver stress are feeling anxious, irritable or forgetting things; suffering from body pains or headaches; or inability to sleep well at night. This can be even more serious if a caregiver neglects their own health concerns, such as diabetes, high blood pressure, a suspicious skin spot or a breast mass.

“Sometimes caregivers feel that no one will provide the same kind of care as they can provide,” Jirau-Rosaly said, “and that can lead to tremendous guilt about

CAREGIVERS: LOOK OUT FOR YOUR OWN HEALTH

 Accept help from friends or others in your circle. Keep a list of small tasks that others can help you with.  Have social interactions with friends who can give you emotional support.  Join a support group for caregivers who have a similar set of challenges. Groups are often organized based on the ailment of the person being cared for.  Eat right, exercise and visit your own health care provider for immunizations, screenings and checkups.  Investigate community resources for respite care, transportation or meal delivery. Whether weekly or monthly, taking one or two things off your to-do list can make a difference.

taking time to refresh and re-energize.” She said that caregiving experts agree that taking time for oneself is not selfish.

“I tell caregivers that they should think of the instructions we get on an airplane,” Jirau-Rosaly said. “You have to put on your mask first, then your child’s. You want to take care of yourself so you can give your best care to the person you are caring for.”

take a

10

your health today  Fall 2017

Caregivers are special To find a doctor who can help you address your health care needs or to schedule an appointment at Augusta University Health, visit augustahealth.org, or call 706-721-2273 (CARE).

Caregivers should care— for themselves

breather

EATING WELL PLANNING AND PREPARING HEALTHY MEALS

let’s go

B

bowling!

Hearty and healthy meals for the win

owl meals are rising in popularity—and for good reason. These

all-in-one meals are easy to prepare, good as a meal on-the-go, and chock-full of healthy ingredients. From smoothie bowls to grain bowls to macro bowls, these meals incorporate vitamin-packed

fruits and vegetables, whole grains and a variety of protein sources.

Depending on the types of ingredients you use, you and your family can eat a bowl meal for breakfast, lunch or dinner. Bowl meals can be as inventive as you want them to be. You can create a bowl around a specific vegetable or type of cuisine, such as Mexican or Indian, or based on a certain color, like an eye-popping purple smoothie bowl. Since each fruit or vegetable’s color is based on the kinds of vitamins, minerals and nutrients it contains, the more colorful your bowl is, the more nutritious it will be.

A bowl meal usually consists of a carbohydrate base, a choice of fruits or vegetables, a protein source, and a topping that gives the bowl a sweet, spicy or creamy kick. You can also add a crunchy texture with nuts or seeds.

To make preparation even easier, you can cut and cook your vegetables ahead of time or use leftovers from a previous meal. You can also make a large pot of your favorite whole grain and use it in bowls throughout the week.

SUPERFOOD TACO BOWL

INGREDIENTS (makes 4) 1 lb. lean ground 2 cups cooked shortbeef or turkey grain brown rice 1½ tablespoons ½ cup hummus 2 cups raw or chili powder steamed kale 1 teaspoon 1 cup sprouts garlic powder 1 cup diced tomatoes ½ teaspoon cumin ½ cup salsa ½ teaspoon paprika 1/5 teaspoon sea salt tortilla strips INSTRUCTIONS 1. Preheat skillet to medium-high heat.

2. Place ground beef or turkey in skillet and cook until slightly browned. Season with chili powder, garlic powder, cumin, paprika and sea salt, and continue cooking until fully cooked.

3. Drain any fat from the ground meat, and spoon portions into four bowls.

4. Add ½ cup rice, 2 tablespoons hummus, ½ cup kale, ¼ cup sprouts, ¼ cup tomatoes, 2 tablespoons of salsa and a few tortilla strips to each bowl.

INGREDIENT IDEAS

A successful bowl meal incorporates a variety of foods. Need help figuring out what kinds of carbohydrate bases, proteins and toppings to use? Consider these options: Base: brown or wild rice, quinoa, chickpeas, buckwheat noodles, barley, oatmeal or whole-grain pasta Protein: meat, poultry, fish, shellfish, tofu, eggs or lentils Sauce: tahini, Greek yogurt, Sriracha, salsa, peanut butter, honey or low-sodium soy sauce Crunch: almonds, peanuts, walnuts, Chia seeds, sunflower seeds or dried seaweed

Want more fresh, fast and fun ideas?

Trust the experts at Augusta University Health with all of your health and wellness needs. For recipes and more healthy eating tips, visit augustahealth.org/blog.

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