2022-11-17 - Health Care Quarterly (Vol. 38) - Fall 2022

100 New FDA Approved Cancer Treatments

COMPREHENSIVE CANCER CENTERS has participated in the development of 100 new FDA approved cancer treatments. With 170 ongoing clinical research studies, right here in Southern Nevada, we are entering a new age in cancer treatment — where people are no longer entrenched in their battle against cancer, but instead living with cancer . These new cancer therapies are increasing the quality of life for our patients and their families, and most importantly, giving them the opportunity to live their lives to the fullest.

Clinical Research at Comprehensive has led to

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EDITORIAL + ART

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From the editor

FFor nearly ten years, I’ve had the opportunity to cover many different facets of health care in Southern Ne vada. In interviewing and speaking with physicians, nurses, administra tors, and more, I’ve seen firsthand the need, and the subsequent evolution, of medical education in the Valley. Developing the student-to-provider pipeline has been high priority for many years, and today, our community boasts a state-ofthe-art medical school that is educating the next generation of providers to meet the ever-growing demand.

One of the people I’ve spoken with regularly about medical ed ucation is Jennifer McDonnell at MountainView Hospital. For many years, we’ve discussed the physi cian shortage and the initiatives at MountainView Hospital to develop and retain providers in Southern Nevada. In this issue, she gave us an update on the many exceptional fellowship and residency programs offered through MountainView and the other Sunrise Health hospitals and medical centers. Maureen Shafer, CEO and President of Nevada Health and Bioscience Corporation, also contrib uted to this issue with information about the new Kirk Kerkorian Medical Education Building and what this incredible facility means for Nevada. Administrators and educators at the Cleveland Clinic Lou Ruvo Center, Nathan Adelson Hospice, and Optum Care’s Family Medicine Residency Program are featured prominently as well. The landscape of medical education is comprised of these individuals and many others—all working together to ensure a fortified and successful medi cal infrastructure for lifetimes to come.

Also in this issue, you’ll find a dialogue about the Nursing Licensure Compact. Nevada is not a part of the NLC, but many think it should be, and this article explores the issue with Dr. Susan VanBeuge, professor-in-residence with UNLV School of Nursing and President of the Nevada State Board of Nursing, and Cathy Dinauer, Ex ecutive Director with the Nevada State Board of Nursing. There are also important articles about the strides the UMC Center for Transplantation has made over the past two years, an eye-opening exploration of the connection between traumatic brain injury and substance use disorder, and a firsthand account of how much mammography has improved— both in patient experience and imaging results.

This entire issue is a testament to the excellence of health care in Southern Nevada. It is the passionate, thoughtful, and dedicated leadership that has facilitated the prodigious growth of the industry here—and a visionary look forward. As always, the team at Health Care Quarterly can’t wait to see what comes next.

Emma Wolff Director of Strategic Content emma.wolff@gmgvegas.com

Medical News

MUSEUM EXHIBITS INTRODUCE CHILDREN TO THE WORLD OF HEALTH CARE THROUGH

PLAY

Discovery Children’s Mu seum opened the Museum’s Eco City gallery, the exhibit that offers children and fam ilies a chance to learn, play and explore health care.

Inside the new space, they can play on a large replica classic Operation game, a hands-on baby doll nursery, a display that simulates X-ray scans and more.

“Children and families will be able to learn about health care in a comfortable and fun environment while taking on the role of a patient or health care provider,” said Dr. Paul Krakovitz, Intermountain Healthcare Region President.

“This exhibit creates numerous ways for children to develop and grow to un derstand the importance of health care while giving them a window to various careers in the health care field.”

MEDICAL ASSISTANT APPRENTICESHIP LAUNCHES

The Institute for American Appren ticeships and UnitedHealth Group are launching a new apprenticeship program for individuals to become medical assistants in Southern Nevada.

Apprentices are hired by United Health Group and are immersed in a comprehensive education program that prepares them with the skills and training necessary to be a successful medical assistant.

This opportunity provides appren tices with a fulfilling, in-demand career and positive impact in the health care industry. IAA has developed and implemented programs to serve nearly 2,000 apprentices in 22 different non traditional apprenticeship programs for more than 30 regional and national partners. They also provide technical assistance around the US to assist in developing and registering apprentice ship programs.

The education incorporates applied learning, structure, and mentoring to support apprentices. As a nonprofit, IAA looks to bring its tried-and-true philosophy and experience to provide an opportunity to individuals looking to make a change in their lives, as well as close the gaps in workforce dispari ties in Southern Nevada.

Dr. Vipindas Chengat is MayaMD Founder & CEO Christian Habermann is MayaMD Co-founder

MayaMD harnesses AI technology for efficient, accurate health care

BY CHRISTIAN HABERMANN

AI has been utilized in health care for many years, but in the past de cade, it has taken off for a few rea sons. There’s excitement around its potential and with that comes a tsunami of investment money. The Electric Health Record has been a game changer, as has the processing speed of computers today. All of this momen tum, data influx and enormous investment has created a per fect atmosphere for growth. We believe this is a new chap ter and an exciting time in the health care industry.

At MayaMD, we use AI and our state-of-the-art engage ment platform to help patients —especially those with chron ic conditions — and providers offer timely and appropriate care, whether it’s remotely or in person. Patients receive the right care at the right time, and providers can use their time and resources more effi ciently and effectively.

Too much time and money is spent on inefficiencies. We’re helping modify this behavior with an AI virtual care solution, using it for as a digital front door for triage, education and telehealth.

MayaMD can collect more than 25 decision points in less than 90 seconds from the patient via our app. With this data, MayaMD creates a secure, shareable clinical note with differ entials sorted by probability, suggested labs, physical signs, and triage with maps to the

nearest provider. This e-note can be instantly sent to the patient’s provider, so that on the other end, the provider has the intake done in seconds, saving documentation time. We also have comprehensive chronic care management programs that we utilize with our fast growing remote patient monitoring platform.

Lo cally, we are starting AI and remote pa tient monitoring (RPM) projects with a top nephrologist group and cardiologist, helping to educate and manage their patients with chronic kidney (CKD) and cardiac disease. It can create chronic dis ease management algorithms quickly for just about any con dition.

Working with this local ne phrology group, we are creat ing treatment and health liter acy algorithms that can be used not only for patients with CKD in Las Vegas but anywhere.

With the local cardiologist, we are piloting a reengineered discharge program designed to reduce readmissions.

AI can be a positive asset for communities, and we are thrilled to be able to work with local professionals and patients here in Las Ve gas. Our mission and goals are to expand health care access and optimize performance-im proving patient outcomes.

By utilizing AI machine learning to better understand a patient population, we can assist providers with their programs and infrastruc ture to support patients in an effective and ef ficient manner.

Terrence Thornton is Executive Director of Special Olympics Nevada

Expanding resources, awareness for th0se with intellectual disabilities

BY TERRENCE THORNTON

People with intellectual disabilities (ID) are one of the largest and most medically underserved populations. Because of a range of systemic chal lenges, including inadequate provider training and inaccessible facilities, they have less access to quality health care and health promotion pro grams.

According to the American Association of Medical Colleges, “The United States does not have nearly enough mental health professionals to treat everyone who is suffering. Already, more than 150 million people live in federally designat ed mental health professional shortage areas.”

To compound the problem, there is a lack of training and educational resources available for mental health professionals that would guide them in their interactions and help address the unique health needs of patients with ID which can impact diagnosis, treatment and support.

Through Special Olympics Nevada Healthy Athletes volunteer program, interested health care providers and students can gain such knowl edge. The program shares best practices in car ing for and communicating with people with ID through training and hands-on experience during screenings or via free e-learning courses. Health care providers demonstrate improved awareness and self-efficacy in providing care for and com municating with patients with ID after complet ing training.

In addition to training and education, provid ers can share information with their peers about available resources and programs. For youth with ID, providers can get involved at the school level.

Strong Minds, an emotional health program developed by Special Olympics, is an interactive learning activity focused on developing adaptive coping skills and active strategies for maintain ing emotional wellness under stress.

The need to further develop the Strong Minds program and tailor it to address what Nevada resi dents are experiencing was fueled by the effects of COVID-19 on students and their families.

SONV received $1 million in American Rescue Plan Act funds from the state of Nevada to further develop mental health support services to be dis seminated in Clark County and Washoe County School Districts, and to provide mental health wrap-around services for teachers, students with intellectual disabilities and their parents and caregivers. With input from a psychology consul tant, SONV plans to launch the revamped model for the program early next year.

Health care providers and organizations can re move barriers to services and improve access for people by: ensuring programs and physical spac es are accessible and welcoming to people with ID; ensuring communications, including written and spoken language, materials, and interactions with the community are accessible to people with ID; and building intentional and sustainable in clusion by changing organizational culture to val ue and understand inclusion.

“The United States does not have nearly enough mental health professionals to treat everyone who is suffering. Already, more than 150 million people live in federally designated mental health professional shortage areas.”

—American Association of Medical Colleges

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Health equity is essential to providing quality health care

BY RITCHIE DUPLECHIEN

In health care, you may hear the term “health equity,” but what does it mean? Simply put, it’s ensuring that every per son has an opportunity to live the health iest life possible.

Social detriments of health and unmet basic needs can include poverty, food insecurity, hous ing instability, education, employment, access to transportation, and other circumstances. These factors contribute to health disparities among underserved and vulnerable populations and directly affect lifelong health-related decisions and actions.

If a person is stressed about losing their job, the ability to afford child care or not having a dependable vehicle to get to and from school or work, it can leave them less able to focus on good health. Chronic stress over unmet basic needs can also increase the chance of developing un healthy behaviors, such as smoking, drinking in creased amounts of alcohol, less frequent fruit/ vegetable consumption, and less exercise.

What can we do? The best approach is to con sider the following:

n Make a Commitment to Health Equity: This cannot be achieved overnight, but a con tinued commitment to addressing concerns and building an action plan to shrink dispari ties will improve health outcomes over time.

Establish a team within your organization that will conduct ongoing research on the caus es of health disparities among member popula tions, create and implement policies that will spur reductions in health care effectiveness data and information set disparities, and over see continuing education for your staff.

n Invest in Community Partnerships and Programs: Partner with and invest in commu

nity-based organizations that will help connect your members with needed services. If needed, build new solutions to expand the capacity of community-based organizations.

For example, identifying that education fund ing is a barrier for some of its members, Silver Summit Healthplan partnered with the Nevada Women’s Fund to provide $100,000 in scholar ships to its members. Food insecurity identified as another barrier, the plan partnered with The Just One Project to launch a no-cost Farmers Market, which connects members that live in identified food deserts with access to culturally appropriate fresh fruits and vegetables.

n Meet People Where They Are: Once so cial determinants of health have been identified and partnerships and programs are in place to address unmet basic needs, you must connect your members to those services. That may mean bringing those services directly to them.

How can you do this? Encourage communi ty providers to increase their capacity to serve expanded service hours of rural, minority and marginalized primary care practices; support community-based reproductive health educa tion and support for healthy birth outcomes initiatives; support physical health and behav ioral health integration by incorporating basic behavioral health services, including global screening and treatment of anxiety and depres sion; establish a “curb-to-curb” rideshare pro gram that will pick up members from their homes and take them to and from their doctor appointments.

SilverSummit established a Community Connections Helpline, which assists callers by connecting them with more that 2,200 communi ty-based solutions including unemployment bene fits, housing, food and utility assistance, transpor tation and child care.

Ritchie Duplechien is Senior Director of Health Equity, SilverSummit Healthplan

Uniting the Heart & Science of Healthcare

COLLEGE OF DENTAL MEDICINE – COLLEGE OF NURSING – COLLEGE OF PHARMACY COLLEGE OF GRADUATE STUDIES – COLLEGE OF MEDICINE (CURRENTLY IN DEVELOPMENT)

Naomie Warner D.O. is a pediatric ophthalmologist at Nevada Eye Physicians

It’s critical that infants receive medical screenings after birth

BY NAOMIE WARNER D.O.

Recent surges of home births are leading to newborns missing out on crucial tests conducted at hos pitals after birth, including pre liminary vision screenings.

Pew Research reported a 19% increase in home births nationwide in 2020, likely because of the COVID-19 pandemic. While safe ty for the mother and the child is always a valid concern, many fami lies may not realize the importance of the screenings that take place at hospitals after birth and how not receiving these tests could lead to severe unwanted consequences for the child.

Like many other tests given to newborns, a vision screening’s primary purpose is to detect issues that, if not found or treated at an early stage, could lead to perma nent conditions and/or vision loss. However, in most cases, if they are caught when the child is a new born, eye issues are much easier to treat and often result in few to no long-term side effects.

For example, these screenings are essential in the detection of Primary Congenital Glaucoma, a condition that affects one in every 10,000 babies from birth to 3 months old. Though the number of children affected every year might be lower, unde tected and untreated Primary Congenital Glauco ma can lead to serious vision issues and blindness or even loss of an eye. Yet when detected and treat ed early, 80-90% of babies and infants react posi tively without further issues later in life.

At birth, a newborn’s vision is between 20/200

and 20/400, often only being able to see up to 12 inches away. Their eyes are also uniquely sensitive to light, and their extraocular muscles still need time to strengthen. These factors often make it dif ficult for non-medical professionals to detect ab normalities in newborn vision, particularly with out the proper tools, environment, or experience. While vision screenings for newborns vary from state to state and can look different depending on the circumstances, there are some things that may be expected. The child’s pupil response to light is a good indicator of eye health, and a physician will likely use a small light to test this.

The red-light reflex test can also determine if the anatomy of the eye is normal or if there is some thing blocking the vision, such as a cataract. Four in 10,000 children develop cataracts in the womb or early infancy that can cause irre versible blindness if not corrected in the first few months of life.

A child’s eyes evolve at an in credible rate for the first 12-24 months of their life. This makes it a crucial time to continually moni tor them, including the first screening 12-48 hours after birth.

This being said, many mothers may feel more comfortable giving birth at home. This should not prevent them from seeking medical assistance and ensuring their child gets the necessary and essential screenings post-birth. Even if it appears that the child has no glaring issues, there are many factors to look out for that may not be obvious. In fant eye health can only be confirmed by a qualified professional and the universal screenings they can perform.

A CHILD’S EYES EVOLVE AT AN INCREDIBLE RATE FOR THE FIRST 12-24 MONTHS OF THEIR LIFE. THIS MAKES IT A CRUCIAL TIME TO CONTINUALLY MONITOR THEM, INCLUDING THE FIRST SCREENING 12-48 HOURS AFTER BIRTH.

A NEW ERA

According to U.S. News and World Report, Nevada ranks 30th in health care quality, 30th in public health and 39th in health care overall. Amid the world-class practitioners in our community, there has long been a void for modern facilities to enrich and inspire the medical leaders of tomorrow. In efforts to bring this facility to life in the past 10 to 15 years, many have tried to make progress and, in some instances, alone. But the reality is that this issue has affected far too many, for too long without any substantial progress being made.

OF MEDICAL EDUCATION IN NEVADA

Workers wrap up finishing touches on the Kirk Kerkorian Medical Education Building in September. The state-of-the-art facility could change the medical landscape in Nevada forever.

(Steve Marcus/Staff)

But the tides have turned.

On Oct. 5, the Kirk Kerkorian Medical Education Building celebrated its grand opening.

Developed by the Nevada Health and Bioscience Corporation (NHBC) and designed by TSK Architects, the Kirk Kerkorian Medical Education Building broke ground in October 2020 and took two years to complete. It is the first ever to bear Kerkorian’s name, who was a philanthropic and business trailblazer in Southern Nevada whose legacy carries on.

THE NEVADA HEALTH AND BIOSCIENCE CORPORATION’S ROLE IN NEVADA’S MEDICAL FUTURE

BY MAUREEN SCHAFER CEO and President of Nevada Health and Bioscience Corporation

NHBC is the nonprofit partner for innovative discov ery and creativity in healthcare research, education, and clinical programming that the Valley needed to make this collaborative effort happen. It was founded on the concept that we are stronger when we choose to work together. This concept is what drove the inspiration for its first project and will be a throughline of what is ahead.

The development of medical education programs, phy sician recruitment and retention efforts are a priority now more than ever before. Health care community workers are needed throughout the medical sector, and there is a desper ate need for academic medicine to bolster private medicine.

The Kirk Kerkorian Medical Education Building now accommodates a class size of up to 120, doubling the school’s prior capacity. Among its features are training spaces for clinical skills, simulation, anatomy — including virtual and cadaveric dissection — as well as classrooms designed to support problem-based learning, administrative offices and a learning resources center.

Most of the project was funded by more than $150 million in private donations, including contributions from the Estate of Kirk Kerkorian, Engelstad Foundation, philan thropist Mary Kaye Cashman, and the Boyd Family Foun dation. The state of Nevada contributed $25 million to the project and the largest corporate donation, $1 million, came from Bank of America. The public-private partnership with University of Nevada, Las Vegas enabled the capital project to be built with multiple funding sources and in an efficient and timely manner.

A collaboration of ideas, from design to funding to imple mentation, is how NHBC ensures commitment and sustain ability. To do something that had never been done before in Southern Nevada required a change in thinking.

The stateof-the-art, 135,000square-foot facility is located on a 9-acre site at 625 Shadow Lane, situated within the heart of the Las Vegas Medical District.

A FAR-REACHING IMPACT

It’s estimated that by 2030, this better health care infrastruc ture will contribute $2 billion to the Las Vegas economy. As the medical school continues to be built, the Las Vegas Medical Dis trict and the school complex will create thousands of high-paying jobs and provide billions in economic development per year.

This project is a symbol of resilience. After decades of faltering efforts, NHBC accomplished this feat through astonishing condi tions. This building is an example of the possibility the com munity can achieve during the worst of times, through a global pandemic and widespread economic uncertainty.

The hard work of many has equated to a new home for the next generation of doctors that can not only be a shining example of a transformative project gone right, but become a model going forward for innovative health care development in Nevada and beyond.

There are plans to apply this model moving forward and there are already additional projects in the works, including a future ambulatory care and mental health clinic and pathology lab on the campus of the Kirk Kerkorian School of Medicine at UNLV.

So, amid this landmark moment for the Las Vegas community, remember this:

This is still just the beginning.

Interior gathering space in the Kirk Kerkorian Medical Education Building (Steve Marcus/Staff)

A

A NEW ERA

hospital learning environment in the Kirk Kerkorian Medical Education Building. (Steve Marcus/Staff)

PROGRAM AIMS TO HELP FILL ‘NEUROLOGY DESERT’ GAP

The Alzheimer’s Association deemed Nevada a “neurology desert,” meaning that by 2025, we will have fewer than 10 neurologists per 10,000 patients with dementia, putting us in the bottom 40% nationwide.

Considering that the Silver State is also home to the third-fastest aging popula tion in the country, with age being the greatest risk factor for Alzheimer’s disease, the circumstances are dire. We must increase access to neurologi cal care in order to meet the growing needs of our community.

About 70% of physicians practice medicine within the com munity where they completed their graduate medical education (GME) — internships, residencies and subspecialty fellowships. One of the most efficient ways to bring and keep top-tier talent in Southern Nevada is to offer high-demand medical education programs. With this in mind, Cleveland Clinic Lou Ruvo Center for Brain Health has worked to build a robust GME program for specialized neurology.

The Lou Ruvo Center for Brain Health offers Nevada’s first and only fellowship programs in:

BEHAVIORAL NEUROLOGY AND NEUROPSYCHIATRY

BY DR. DYLAN WINT, MD Director, Cleveland Clinic Lou Ruvo Center for Brain Health

Since opening the doors in 2009, it’s welcomed 14 fellows, and four have stayed to practice in Las Vegas, increasing access to physicians with expertise in neurodegenerative disorders.

Fellowships provide advanced training within a sub-specialty, allowing physicians to become leaders and experts within a niche area of medicine. Today, fellows have completed more than 35,000 hours of intense training, and the center is recuiting for a newly approved fellowship in Movement Disorders starting in 2023, which is also a first-of-its-kind fellowship here in Nevada.

The success of this GME program is an achievement of many. GME is expensive, time-consuming and requires support of the government, philanthropy, practicing physicians and those who believe in the right to quality health care.

BY SUSAN FARRIS, MED Program Manager, Cleveland Clinic Lou Ruvo Center for Brain Health

The Lou Ruvo Center for Brain Health received government and philanthropic support to help fund these fellowship pro grams, including support from the Engelstad Foundation and Diana and Rick Chapman.

The center has hosted residents from across the Valley in neurol ogy, physical medicine and rehabilitation, internal medicine and family medicine, providing about 6,300 hours of clinical training.

Consider Arturo Montes Jr., MD, of Las Vegas. A former un dergraduate intern at the Lou Ruvo Center for Brain Health, Dr. Montes was a member of the second class to graduate from the

Kirk Kerkorian School of Medicine at UNLV

He began his internship in internal medicine at Las Vegas’ University Medical Center in July 2022, and in 2023, will commence a residency in neurology at the University of Southern California.

“I’m so grateful to the donors who fund these training programs,” said Montes Jr. “If I had the opportunity to come back to Cleveland Clinic for a fellowship, who wouldn’t do that? My roots are here, my family is here and Las Vegas is extremely underserved from a medical perspective. I speak Spanish, I’m Latino. I want to come back home and help my community.”

Accredited by UCNS in 2012, this fellowship program provides the knowledge and skills to prevent, detect, treat, and research disorders of cognition and behavior and their complications. To date, it’s had three fellows graduate and welcomed a new trainee in July.

CLINICAL NEUROPSYCHOLOGY POSTDOCTORAL

Designed for clinical psychologists, this fellowship has a strong research component that continually advances knowledge in the field, in addition to developing the clinical skillset to accurately diagnose disorders of cognition. The neuropsychology fellowship is Lou Ruvo Center for Brain Health’s largest producing program, with six graduates and two current trainees.

CLINICAL NEUROIMMUNOLOGY AND MULTIPLE SCLEROSIS

The fellowship prepares neurologists and physiatrists for a career in patient care and clinical research in multiple sclerosis (MS) and related disorders. To date, it’s had one graduate and welcomed a new trainee in July.

‘A CULTURE OF LEARNING AT EVERY LEVEL’

BY JENNIFER MCDONNELL Director PR/ Communications, MountainView Hospital

In 2014, MountainView Hospital was a typical community hospital — a busy ER, with 300+ patient beds and a busy labor and delivery unit. It also had a recurring challenge experienced by many hospitals and clinics in the valley — not enough physicians.

Graduate medical education programs, the last stage of a physician’s training in residen cy, were extremely limited in Nevada at that time, and to address this issue, executives at the hospital sought to build a premier grad uate medical education program to help to elevate patient care, attract physicians from other states and keep physicians in Nevada after their residency.

Then-Nevada Governor Brian Sandoval called the idea “commendable.” Las Vegas Mayor Carolyn Goodman said it was a “giant step” toward a program in Nevada.

The hospital’s GME program received its initial accreditation in 2015, and in 2016, welcomed its first class of residents. Mounta inView’s inaugural class of 52 resident physi cians was comprised of 38 internal medicine residents and 14 general surgery residents.

Since that time, MountainView Hospi tal, Southern Hills Hospital, and Sunrise Hospital & Medical Center received approval from the ACGME to join forces under the Sunrise Health Graduate Medical Education Consortium, and received accreditation for general surgery, family medicine, OB-GYN, transitional year, emergency medicine, anesthesiology, physical medicine and reha bilitation, psychiatry, radiology diagnostics,

neurology and four fellowship programs, addiction medicine, critical care anesthesiol ogy, endocrinology, diabetes and metabolism, and gastroenterology.

Today, the Sunrise Health Graduate Medical Education Consortium is one of the largest residency programs within HCA Healthcare.

The consortium welcomed 110 new residents this summer and following the in coming 2022 class, there will be a total of 219 Sunrise Health GME Consortium residents at MountainView Hospital.

Each year, the competition for limited spots grows.

The Anesthesiology residency program received more than 1,000 applications for eight positions, Diagnostic Radiology received more than 400 for five positions, and Physical Medicine and Rehabilitation received more than 400 for seven positions. The Anesthesiology and Physical Medicine and Rehabilitation programs are the only programs of its kind in Nevada.

“The graduate medical education ser vice line’s continued focus is to train and retain local and regional talent,” said Jesus Medrano, Vice President of GME, Far West and Mountain Divisions for HCA Health care. “We are working with the area medical schools to integrate medical students into our MountainView Hospital resident training teams and providing exposure to our learning environment. The ultimate objective is to attract UNLV, Touro, and other regional

medical students into our residency programs. The med ical schools are focused and working on doing the same. These aligned efforts create an area talent pipeline to fulfill the existing and projected physician needs of our Nevada community.”

In addition to the medical students who are inte grated into the hospital alongside the residents, efforts have been made to include other healthcare disciplines — such as nursing, radiology and physical therapy — into the hospital for clinical experiences. The hospital partners with many universities, schools and training programs to provide students throughout the Valley their clinicals and training experiences.

“We truly believe that we can provide excellent patient care in a medical education environment,” said Hiral Patel, MountainView Hospital’s Chief Executive Officer. “We are laying the groundwork for a strong and deep workforce here in Nevada.”

UNLV has many students completing clinics at MountainView Hospital, including in its Occupational Therapy Program.

“Mountain View Hospital is an invaluable community partner for our students to develop into competent clini cians,” said Christina Bustanoby, OTD, OTR/L Academic Fieldwork Coordinator and Assistant Professor-in-Res idence at UNLV’s School of Integrated Health Sciences. “They deliver excellence in education, hands-on train ing, and scholarly innovation, allowing lifelong learning opportunities.”

While the hospital continued to grow its physician resident program and pre-graduate opportunities for Nevada students, executives realized the unmet need for post-graduate education in other health fields.

MountainView Hospital launched its Pharmacy Resi dency program in 2018 with three positions, receiving 64 applications from around the country.

“We decided to flip the model and grow our own experienced, qualified, clinical pharmacists to meet the growing demand at MountainView,” said Matthew Cova, MountainView Chief Operations Officer.

The program has since expanded to include postgrad uate year one (PGY-1) and postgraduate year 2 (PGY-2) infectious diseases pharmacy residents. This summer, eight PGY-1 and one PGY-2 pharmacy residents were welcomed.

Patel said MountainView’s positive reputation for its pharmacy training program allows the hospital to recruit the best students from across the country.

“Our program continues to develop and provide highly specialized and diverse rotations that aren’t always present or easy to find all in one program. Every year

“They’ve created this wholesome dynamic and welcoming educational environment. It’s a solid mix of the Socratic process, physical practice and even down to educational psychology concepts. Their teaching styles draw in the entire class; they know when to support and when to push.”

— Steve Wike MountainView Paramedic Institute Student and Firefighter for Henderson Fire Department

our well-experienced clinical pharmacist preceptors and leadership staff strive to create a rich residency experi ence,” said Pavlin Dimitrov, Pharmacy Residency Program Director.

Another program that has gained national attention is MountainView’s Paramedic Institute, launched in 2020, in order to facilitate the growth and education of paramedic students in the community.

“The Las Vegas Valley, much like the rest of the nation, is experiencing a Paramedic/EMS provider shortage,” said Susie Kochevar, MSN, RN, Paramedic Institute Lead Paramedic Educator. “This has been exasperated by an aging workforce, COVID-19 and overall decline in interest in the paramedic profession. We hope by partnering with EMS agencies, we can bolster the ranks of paramedics in our community.”

MountainView is the only hospital in Las Vegas and the

ERA

I wasn’t able to be there for my grandpa to provide care. When I see patient, I think what would I do if this was my grandparent. There is always something new to learn. I love coming to work every day and I am never dreading walking in the door.”

— Ennah C.

HCA Healthcare enterprise to offer an extensive education al and training program for prehospital professionals.

“The MountainView Hospital Paramedic Institute was es tablished to give clinically immersive educational opportu nities to individuals pursuing a greater career in paramed icine,” said Troy Tuke, RN, NREMT-P, Institute Director. “Through greater education and training, our patients will be able to receive an even greater quality of medical care prior to their arrival at the emergency department.”

The paramedic students have access to MountainView’s high-fidelity simulation lab, helping to provide a high level of paramedic training.

“The end result is a pre-hospital provider that is prepared in critical thinking, decision making and able to apply this knowledge for better patient outcomes,” Tuke said.

This March, the institute graduated its first class of para medic students. The cohort included 19 students represent ing five EMS agencies including Clark County Fire Depart ment, North Las Vegas Fire Department, AMR, Community

“Pharmacy school full of abstract ideas. In residency, we are applying those ideas and seeing how they work. Once you get into a hospital and its hands on, all that information becomes real.”

MountainView Hospital Pharmacy Residency Program, Class of 2021/2022, University of Florida

Occupational

— Alex Wise

Therapy Doctorate Student University of Nevada — Las Vegas, Graduating May 2023

Ambulance and Medic West Ambulance.

To graduate, students completed 57 weeks of a clini cally immersive program, two didactic blocks with two clinical block rotations. Students also had to complete numerous industry certifications.

The team behind the Paramedic Institute is also looking to offer an EMT class to the public in the next six months and are teaching an EMT class at Amplus Academy.

“It introduces students who may have thought about medicine or an EMS program,” Tuke said. “If we intro duce them early, it’s a springboard to all allied health professional careers.”

Dan Shinn, EMS Director for Sunrise Health, said the goal is that the MountainView’s paramedic pro grams become a destination for education.

“Like nursing and other areas of healthcare, EMS is experiencing a national shortage in personnel,” he said. “Introducing students to EMS training is good for the community, and allows students to experience all that health care is; it really is an exciting time.”

Experienced nurses have long been difficult to come by, and even more so after the pandemic. Mountain View Hospital, along with other HCA Healthcare hos pitals in Las Vegas, take part in the StaRN program. StaRN stands for “Specialty Training Apprenticeship for Registered Nurses.”

The StaRN program is designed to provide intense post-graduate training to newly licensed nurses. The paid 10-week program combines classroom instruc tion, a robust simulation experience and hands-on clinical training. Upon completion, the newly licensed nurses are equipped with the knowledge and skill set typically found in a more experienced staff nurse.

“The goals of the program are to provide new RNs with a solid clinic foundation for the unit they are starting in,” said Ruth Kain, MountainView Hospital Chief Nursing Officer. “Too often, new nurses leave their career before its even started. We strive to give new nurses multiple sources of focused support so the successfully integrate as nurses and are successful in their first year and beyond.”

The number of nurse graduates in the program has steadily grown over the years, with a projected 140 StaRNs at MountainView by the end of 2022.

“We see this as only the beginning of our education offerings at MountainView,” Patel said. “We believe in meeting the needs of our community — whether that is our patients, their families or students by bringing together the right faculty members, physicians and students — to create a culture of learning at every level.”

“I remember in kindergarten, for career day, seeing my name on the board with ‘physician’ after it — it was always something I was going to do. Nevada is my home, it is my community. No matter where I ended up, I was always going to come back home; it’s the community that I want to serve.”

— Brittiany Narvaez

PGY-1 Emergency Medicine Resident, University of Nevada, Reno

FELLOWSHIP PROGRAM BOLSTERING PALLIATIVE CARE IN NEVADA

BY ANGELA COLLINS CHIEF OPERATING OFFICER AT NATHAN ADELSON HOSPICE

In 2020 there were 156 graduate hospice and palliative medicine training programs in the United States, and only 407 filled slots. At the current rate, these training pro grams would take 20 years to graduate about 5,300 hospice and palliative medicine certified physicians. However, in 2010 the American Academy of Hospice and Palliative Medicine (AAHPM) estimated that it would take 8,000 to 10,000 physicians to meet the hospice and palliative program needs at that time.

The U.S. Census Bureau’s estimates of the increased aging of the population will mean that even more individ uals will have serious illnesses and need palliative or hos pice care, leading to an even greater need for physicians trained in this area.

According to the AAHPM: Although the number of palli ative care programs has grown dramatically during the past

decade, the physician workforce needed to provide appro priate palliative care, mentor and teach the next generation of physicians in the core precepts of palliative medicine and develop the knowledge base required to provide the best quality care for patients and their families is inadequate.

THE FELLOWSHIP IN HOSPICE AND PALLIATIVE CARE MEDICINE

Nathan Adelson Hospice is home to an Allopathic and Osteopathic Graduate Medical Education Fellowship in hospice and palliative care medicine. The fellowship program is increasing the number of hospice and palliative care certified physicians to improve quality of health care for seriously ill individuals in Southern Nevada. It trains two or more physicians a year and is accredited by the American Osteopathic Association and the Accreditation Council for Graduate Medical Education. The program strives to be a model for excellence in providing compas

sionate and evidence-based education for graduate physicians seeking additional skill, competence, and certification in hospice and palliative care medicine.

The fellowship program offers board certifica tion in the specialized care of patients with serious or life-limiting illnesses.

The Fellowship Program began under the direction of Dr. Warren Wheeler, an NAH doctor and renowned specialist in hospice and palliative care who was named a “Visionary in Hospice and Palliative Medicine” by the AAHPM in 2013. Dr. Diane Lee became director in 2022.

A RIGOROUS COURSE OF STUDY

Fellows in the program complete one year of intensive hands-on study, providing hospice and palliative care to Nathan Adelson Hospice patients. They demonstrate competence and compassion and develop a wide scope of interdisciplinary skills for managing chronic palliative patients and patients with life-limiting illnesses. The program is designed to provide training to physicians from the fields of child neurology, family medicine, internal medicine, pediatrics, physical medicine and rehabilitation, neurology, radiation oncology, anesthesiology, emergency medicine, obstetrics and gynecology, psychiatry, radiology, and surgery.

“It’s all about the patients and families and do ing what’s right so the patients have a peaceful end of life,” said Dr. Catrisha Cabanilla-Del Mundo, the program’s first graduate.

BENEFITS TO THE COMMUNITY

The Fellowship Program not only benefits Nathan Adelson Hospice, but local hospitals and other hospice and palliative care programs. Prior to NAH’s Fellowship Program, medical school students finishing their residency who were inter ested in specializing in hospice and palliative care had to leave Nevada.

This program enables the state to retain medical professionals and attract them regions, alleviating the ongoing shortage of hospice and palliative care certified professionals locally.

“It’s really important to make sure the fellow ship program keeps this going to provide more physicians to the community,” said Dr. Cabanil la-Del Mundo. “There’s already a shortage; with more people retiring here, more visitors, more hospitals and facilities, unless we produce more physicians trained in this area, we are just not going to have enough.”

OPTUM CARE’S FAMILY MEDICINE RESIDENCY PROGRAM CELEBRATES

FIRST GRADUATING CLASS

As our community grows, so does the demand on our health care system. To meet this challenge, Valley Hos pital, a member of the Valley Health System, partnered with Southwest Medical to create an outpatient Family Medicine Continuity Clinic.

Before becoming full-fledged doctors, the physician residents who participate in this program care for pa tients under the supervision of an attending physician. The program includes 30 residents and graduated its first class of 10 primary care physicians in July. It’s the largest family medi cine residency program in Nevada.

BY DR. NEIL GOKAL, MD, FAAFP Medical Director of Education, Optum Care Nevada, and Associate Program Director, Valley Health System Family Medicine Residency

As medical education expands its ability to educate medical students, it must also ensure that it trains medical graduates in aspects of quality care based on a rapidly growing population with many unknown needs and untapped resources. It needs to maximize student successes and increase their opportunities to remain in this community, where their support is so needed and valued.

We look proudly at 10 fine physi cians who are setting out into the world to care for communities in need with genuine compassion and astute medical skills.

Though from different back grounds, each of them share a tenacity and determination that has carried them through intense training and many firsts. In addition to being the first class of residents in the program, they were among the first in the city to set up drive-thru clinics and mobile urgent cares at the height of the pandemic, the first in our organization to use virtual health in primary care, the first of our residents to travel abroad with One World Surgery, and the first to serve as team physicians to USA Boxing (the national governing body for Olympic-style boxing).

They have paved a path for their classmates and future graduates, breaking down walls to unite systems, increase access and deliver care to patients from all walks of life. Their adaptability has built the Valley Health System Fam ily Medicine Residency program into what it is today and influenced its future growth.

Our first graduating class of fully licensed board-cer tified family physicians found their calling in a variety of settings, and their respective communities are fortunate to have them.

uring the past two years, the UMC Center for Transplantation has ex perienced an impressive resurgence, leading to reduced waitlist times and a record number of life-saving kidney transplants for Nevadans.

With new physician leadership in place and a committed team of clinical professionals, Nevada’s first and only transplant center has quickly grown to become one of the top kidney transplant programs in the U.S. Recent data published by the Scientific Registry of Trans plant Recipients highlights UMC’s impressive progress, with the UMC Center for Transplantation now ranked second in the U.S. for its one-year kidney survival rate. This valuable metric serves as a key indicator of successful outcomes. Among UMC’s transplant recipients, more than 97 percent are expected to have functioning kidneys one year after their surgeries, surpassing the national average of 94.43 percent.

BY SCOTT KERBS Public Relations Director at University Medical Center

In addition, the highly respected national registry also ranks UMC’s transplant program third in the nation for the shortest amount of time spent waiting for a kidney transplant. Most patients at the UMC Center for transplantation spend about 18 months to two years on the waiting list, a fraction of the 5 year national average. In some large cities across the U.S., patients can wait 10 or more years before receiving transplants, said Dr. Sunil Patel, Program Director of the UMC Center for Transplantation.

“Patients who would have waited five or ten years are now receiving kidney transplants in a matter of months at UMC,” Dr. Patel said. “Our team works tirelessly to find suitable donor kidneys for our patients. When patients receive a transplant quickly, their chances of survival increase significantly.”

SAVED FROM ‘PURGATORY’

With a renewed focus on moving patients quickly through the transplant process to promote the best possible outcomes, the UMC Center for Transplantation has a life-changing effect on patients like Duane Christensen.

Christensen, a 70-year-old Southern Nevada man, started dialysis in 2014 after being diag nosed with kidney disease. He joined the kidney transplant wait list at a nationally recognized hospital outside of Nevada, but after years and years of waiting, he recognized the need for a better option.

“I was on the other hospital’s list for about four or five years, and I didn’t hear anything from them,” he said. “I was living in purgatory.”

After discussing the situation with the staff of a local dialysis center, Christensen made the decision to visit the UMC Center for Trans plantation. UMC’s transplant experts worked alongside Christensen to analyze his health and determine his eligibility for a transplant.

He officially joined the transplant wait list at UMC in September 2021. Six months later, he received a life-changing call. “They called me at 3:30 a.m. and said ‘we have a kidney for you,’” he said. Several hours later, Dr. Patel successfully performed Christensen’s kidney transplant surgery at UMC.

While receiving care at the hospital following the surgery, UMC’s team detected and began treating an unrelated heart issue, requiring specialized care from the UMC Cardiology and Stroke Center.

“No matter what Duane went through, Dr. Pa tel and his team always came to check on him,” Roxanne said. “That meant the world to me.”

Christensen continues to visit the UMC Cen ter for Transplantation for frequent post-trans plant check-ups. UMC’s transplant team closely monitors patients one year after surgery, working diligently to monitor their health and address any issues. For Christensen, this rela tionship is built on a solid foundation of trust.

“I have complete faith in you,” Christensen said to Dr. Patel, smiling as he greeted the physi cian during a recent outpatient visit at the UMC Center for Transplantation.

A NEW APPROACH

The UMC Center for Transplantation now performs about 145 kidney transplants each year, nearly triple the number of transplants performed annually prior to 2020.

“Our team remains committed to providing

Nevadans with improved access to life-saving kidney trans plants,” Dr. Patel said. “We take pride in working alongside our patients, building strong relationships as we guide them to better health and improved quality of life.”

Dr. Patel and his colleagues have introduced a number of in novative strategies to expand the transplant program, and they’ve reach a larger number of Neva dans by expanding the criteria for kidney recipients.

In the past, many patients were immediately considered ineligible based on their age or body mass index. “Rather than relying solely on these metrics and automatically disqualifying individuals, our team of experts assesses each patient individu ally and reviews a wide range of health factors to determine their eligibility,” said Dave Tyrell, UMC’s Director of Transplant Services. “Every patient is unique, and we have a responsi bility to thoroughly assess their health and care for them as individuals, rather than simply numbers on a piece of paper.”

This innovative approach, combined with the dedicated ef forts of staff, has led to improved community outreach, stronger partnerships and the addition of a significant number of patients to UMC’s transplant recipient list. With more patients listed, UMC’s team members have improved chances of finding a matching kidney that meets the unique needs of an individual patient, Tyrell said.

UMC’s transplant coordi nators work around the clock to locate viable kidneys from deceased donors. These team

members field offers from across the country, working with organ procurement organizations to match kidneys with patients and arrange for immediate transporta tion of the organs. In many cases, this means immediately arranging for a courier and booking air travel to get the kidney to UMC as quickly as possible.

“You need to be able to move quickly,” Tyrell said. “Any amount of time that the kidney is out of the body, the quality starts to deterio rate.”

With transplant coordinators in place 24/7, locating matching kidneys for patients, Tyrell said the UMC Center for Transplantation team reviews every possible option

for their patients. “There is noth ing more rewarding than calling a patient and telling them we found a match,” he said.

As the UMC Center for Trans plantation continues to grow and evolve, it plans to further elevate the level of care provided for patients in Nevada by performing pancreas transplants in the near future.

“Thanks to the dedicated efforts of our team members, we’ve truly built a world-class transplant program for our community,” Dr. Patel said. “We look forward to continuing our mission and expanding our services while deliver ing the highly specialized care our patients deserve.”

NEVADA DONOR NETWORK AND RELIGIOUS LEADERS HELP COMMUNITY FIND FAITH IN DONATION

Every November, Nevada Donor Network observes National Donor Sabbath, a three-day observance that is meant to educate faithbased communities about the importance of organ, eye and tissue donation. In the United States, there are more than 100,000 people on organ transplant waiting lists, more than 600 of whom are Nevadans.

Faith leaders from many religions, donor families, transplant recipients and donation/ transplantation profes sionals participate in services to express the need for the lifesaving and healing gifts passed to others through trans plantation, while also encouraging communi ties to register as organ, eye and tissue donors.

The decision to give the gift of life is a deeply personal one. As such, it’s common for indi viduals to look toward faith and religion to help them make that choice. One of the most frequently asked questions is, “how do I know if my religion supports organ, eye and tissue donation,” but all major orga nized religions in the United States encourage and support organ, eye and tissue donation and view it as a final act of charity and love.

vides a time to honor the donor’s decision, and it also inspires those in attendance to leave behind a legacy of hope.

One donor was 16-year-old, Jorge Contreras, who died in 2021 and became a donor, saving and healing lives in the process. “As the realization started to come to frui tion that I am losing my son forever, knowing he lives on and continues to do amazing things by saving the lives of others through organ donation filled my heart in a way that is indescribable,” Con treras’ mother Mindy Contreras explained.

BY ADRIANA CONNELLY

Multicultural

“I am a Christian and raised all of my chil dren Christian; it took leaning on God and his understanding that brought me out of the darkest part of this grief journey.”

Nevada Donor Network’s staff is honored to work alongside donor families to honor loved one’s deci sions to give the gift of life. Wheth er this means playing their favorite song during their honor walk before an organ recovery or having the surgical team recite a prayer that is important to the loved one, all of this is done in an act of kindness and respect.

In 2021, Nevada Donor Network’s Aftercare Team created a funeral home program that allows arrang ers to work with a donor’s loved ones to include their donation as a part of the funeral service. This pro

It is the selfless and courageous gifts from donors and donor families that have saved so many. They inspire hope in those still on waiting lists. When some one says ‘yes’ to becoming a regis tered organ, eye and tissue donor, the impact is enormous. One donor can save up to eight lives, help heal up to 75 through tissue donation and give the gift of sight to up to two people through eye donation.

Through National Donor Sabbath and outreach in the faith-based communities, Nevada Donor Network hopes to increase registrations and spread the word about donation.

Nevada Donor Network is a federal ly designated 501c(3) not-for-profit organ procurement organization (OPO) committed to maximizing the gift of life and health through organ and tissue donation. For more information, please visit. nvdonor.org

Outreach Liaison, Nevada Donor Network

Get on board: Modern mammograms have changed

BY DENIELLE CHONG

Working to dispel common myths about mammograms, we often remind women that it takes less time than getting a cup of coffee. Technology has advanced, it isn’t as uncomfortable as the machines of the past, image quality has progressed, cancer is being found much earlier, and the survival rate is higher. Here’s a step-by-step look at the process.

Although less than 20% of diagnosis are linked to family history, a first-degree relative with history does increase your risk.

6. After a few minutes, a mammography technologists will call you to the Mammo Suite. She’ll explain the process and verify your information. Then the screening begins.

7. The technologist will help position each breast on the plates of the machine. There will be four “squishes” total — two on each breast. Each compression only lasts a few seconds each, and the entire screening is completed within minutes.

The verdict

Today’s equipment was designed by women, for women. They examined even the most minor details to make the process as comfort able as possible. More importantly, the image quality has progressed beyond what anyone could have imagined 40 years ago. Mammo grams are now in 3D with AI assistance and instead of four analog images. Hundreds of digital images create a full view of the breast.

A few important things to note for after your first mammogram:

n Your doctor will receive your results in 48-72 hours after your appointment. These results are also available in the patient portal.

Denielle Chong is Marketing Director for Steinberg Diagnostic Medical Imaging

1. Don’t wear deodorant, lotions or perfumes for your exam. These can cause arti facts on images which may make the images unclear or show something that’s not atually there. This can lead to re-taking the images or a call back to redo the entire mammogram.

2. Patients are asked to arrive 30 minutes prior to their appointment time to complete paperwork. Note: most insuranc es cover an annual mammogram at 100%.

3. Once your paperwork is complete, you will be asked back to the mammo gram sub waiting area. Many of Steinberg Diagnostic Medical Imaging’s facilities have women only sub-waiting rooms, if this is im portant to you, ask during scheduling. In the waiting area, you will change into the “pink jacket” gown — the jacket’s design makes positioning during the exam easier.

5. You’ll fill out additional mammo gram-specific paperwork. Make sure you’re aware of any family history of breast cancer.

n You will receive a letter in the mail about a week after your appointment. This letter will give you basic results and will let you know if you are one of the 40% of women with dense breasts.

n Your results will indicate a BIRAD Score (Breast Imaging Reporting and Data System). This score is a risk assessment and quality as surance tool developed by the American Col lege of Radiology. A quick internet search will break down the seven assessment categories.

Paul’s Vegas Photography

Connecting the dots between brain injuries and addiction

BY DEREK PRICE

There is ample evidence that trau matic brain injury (TBI) and sub stance use disorders (SUDs) are linked. The rate of substance use disorders among those who have experienced a TBI is estimated to be up to six times that of the general population. However, astonish ingly little about the science surrounding this connection is well understood.

individuals was 53%, which is between 2.5 and four times higher than the general population.

n People who drink alcohol. People who drink are four times more likely to experience TBI in their lifetime than teetotalers. Approx imately 30-50% of people that suffered a TBI were intoxicated at the time of injury.

Nearly 75% of people seeking treatment for co-occurring mental health and substance use disorders have been impacted by brain injury. Despite the staggering prevalence of substance use and traumatic brain injuries, experts are only beginning to understand the complex connection between the two.

However, we do know that substance use and TBIs share a two-way relationship. Drug and alcohol use increases the likelihood of experi encing TBI, and people who experience TBI are at greater risk of developing a substance use disorder.

Derek Price is the CEO of Desert Hope Treatment Center

With TBI affecting nearly 1.5 million Ameri cans each year and 40.3 million suffering from past-year SUD in 2020, the connection between TBI and addiction is not one we can afford to ignore.

A traumatic brain injury can happen to anyone, for any number of reasons. The leading causes of TBI in the United States are falls, mo tor vehicle accidents, firearm-related injuries and assaults.

Certain demographics are at greater risk, including:

n Military service members and veterans. Between 2000 and 2019, around 414,000 service members experienced a TBI. More than 185,000 veterans that rely on Veteran’s Affairs (VA) benefits have had one or more TBI in their lifetime.

n Athletes. Sports-related injuries account for approximately 10% of all TBIs in the United States.

n People experiencing homelessness. A 2020 review published in The Lancet found that the lifetime prevalence of TBI among unsheltered

Biological and psychological factors are believed to play a role in the development or worsening of an addiction following TBI. For one, there is evidence that injury-related dis ruptions to the brain’s dopamine pathways and orbitofrontal cortical processing could help ex plain TBI survivors’ vulnerability to addiction. Additionally, the emotional trauma or chronic pain that results from sustaining a TBI could lead to self-medicating with drugs and alco hol, which could increase the risk of addiction development.

On the other hand, drug and alcohol use impairs a person’s judgment, which may lead to putting oneself in situations that could increase the chances of experiencing TBI, such as driv ing under the influence.

TBIs can also occur during a drug overdose. Opioid overdoses often deprive the brain of oxygen. If a person survives an overdose, they may continue to struggle with persistent issues related to anoxic brain injury. Overdose survi vors who have brain injuries are at higher risk for future overdoses.

Unfortunately, treating addiction among people who have experienced a TBI poses challenges. For one, TBIs often go undiagnosed. Without a diagnosis of a TBI, many patients and health providers may be unaware of how the injury affects them and of necessary special treatment considerations. Many addiction treatment programs fail to screen for TBIs, even though evidence-based screening tools are available.

TBIs are also linked to co-occurring mental health conditions like depression, anxiety disorders, and post-traumatic stress disorder, which are associated with poor er adherence to treatment programs and higher dropout rates. Research shows that treating comorbid conditions together is more effective than treating any condition alone. Treatment for substance use disorders among people who have experienced TBI should therefore address their addiction, brain injury, and any mental health issues simultaneously.

As a state, Nevadans can work together to do more to support people who have been im pacted by TBI and substance use disorders. We can fund research on TBI and substance use disorders to better understand this rela tionship and determine the most effective treatments. Legislators in our state can pass laws that support treatment, rather than punishment, for those with addictions.

Treatment facilities and providers can incorporate screening for TBI into their admissions process and provide comprehen sive, individualized treatment. Desert Hope Treatment Center in Las Vegas, for example, offers a range of addiction treatment services that are tailored to the individual, including a specialized program that addresses the unique needs of veterans and first respond ers, a population at risk of experiencing traumatic brain injury.

As a society, we can work to end the stigma surrounding addiction by learning about it and encouraging our loved ones to get the help that they need. We can be careful to avoid judgmental or stigmatizing language when we talk about addiction, understanding that substance use disorder is a disease, not a choice. Taking steps to reduce stigma can encourage more people to seek help with less fear of judgment.

All of us must work together to help evoke change. Whether you are a treatment provid er, legislator, or citizen, we can all do our part to help understand and support those suffer ing from TBI and substance use disorders.

Learn to recognize and respond to signs of suicide

DR. NICHOLE BAUKNIGHT-BOLES

Suicide is on the rise nationally. Ac cording to the Centers for Disease Control and Prevention, more than 45,000 Americans died by suicide in 2020, making it the 12th leading cause of death in the United States. The problem is even more apparent in Nevada, with the state ranking 50 th in behavioral health chal lenges, 46 th in frequent mental distress and 40 th in suicide.

n Withdrawal from friends and family n Talking about feeling unworthy, helpless, or hopeless.

Recognizing the problem is only the first step. Addressing mental health concerns requires bringing up uncomfortable topics in conversation while providing a judgment-free, safe space for discussion.

For some families, talking about mental health may be an everyday occurrence. For oth er families, it may be a new topic. But the more you discuss it, the more comfortable it will feel.

Optum, a subsidiary of UnitedHealth Group, offers much needed conversation starters to encourage comfortable, honest dialogue among loved ones. To download all 30 conversation starters, visit optumconversation.com

If you know someone that may be suicidal, here a few ways you may be able to help:

1. Take the person seriously. Be calm, open and know that it’s OK to ask questions and talk about it. Talking openly about suicide won’t raise the risk that they’ll follow through with it.

2. Let them know how much you care. Ask about their thoughts and feelings while listen ing attentively.

Dr. Nichole Bauknight-Boles , is Senior Director at HPN Behavioral Health.

Despite an increase in mental health aware ness, the stigma surrounding mental health and suicide still exists — keeping many at-risk individuals from seeking the help and treatment that they need.

Death by suicide affects people from all walks of life, but many don’t want to talk about it or don’t know how to talk about it.

Risk factors for suicide include:

n Family history of suicide

n Past attempts or gestures of suicide

n Substance use

n Mental health conditions such as depres sion, anxiety, or psychosis

n A significant life event such as loss of a job or loved one, end of a relationship, or financial problems

n Chronic medical conditions

Warning signs may include:

n Thinking or talking about death or suicide

n Drastic changes in behavior

3. Help keep thems safe by removing things in the environment that might be used to harm themselves like guns, prescription or over-thecounter medications, etc.

4. Encourage them to get help. Offer specific steps they can take, such as calling the National Suicide Prevention line, helping them get to a mental health professional or connecting them with loved ones.

5. Acknowledge the person’s feelings without judgement. You can’t talk them out of what they’re going through.

Managing mental health wellness is a complex issue that requires the help of not just medical professionals, but family and loved ones as well. While providing help, it is crucial for everyone to listen without judgement. Be cognizant of feelings of despair, acknowledge struggles, and never minimize someone’s challenges.

With nearly one suicide death every 11 min utes, it’s crucial for us as a community to work

If you are seeking immediate help for yourself or a loved one, call 911 or any of the emergency resources below:

n New national 988 Suicide and Crisis Lifeline: a 24-hour, toll-free, confidential support, prevention and crisis resources for you and your loved ones

n Substance Use Helpline: 1.855.780.5955

n National Domestic Violence Hotline: 1.800.799.7233 and 1.800.787.3224 (TTY)

n The Crisis Text Line: Text “Home” to 741741

towards ending the stigma associat ed with mental health care. In addi tion to the unnecessary loss of life, suicide and suicide attempts cause serious injuries that affects the emotional, physical and econom ic wellbeing of surviving friends, family and loved ones—possibly leading them to experience thoughts of suicide themselves.

For those looking learn more about mental health and suicide prevention, Health Plan of Nevada (HPN) and the American Founda tion for Suicide Prevention (AFSP) have partnered up to create Help, Hope & Action: A Suicide Preven tion Town Hall, a valuable online ed

ucational resource offering insight into mental health issues faced by teens, young adults and seniors. The three-part town hall panel brings together people who have dealt with suicide first-hand, local and national mental health clinicians and a wide range of prevention ad vocates to have a candid discussion to talk about risks, interventions and the keys to communication and support—each offering critical in sight and tools for those navigating through their own crisis.

To view the town hall in its entirety, please visit takingonhealthy.com/asuicide-prevention-town-hall

Bridging the gap between dentists, other health care professionals

BY DR. DEE DEE MEEVASIN

For a long time, dentists only fo cused on teeth, but throughout the past couple of decades, the dental field has been evolving quickly.

Dentists moved on to addressing issues with mouth joints, and then airway and sleep disorders. Today, with the oral systemic link, dentists can see early signs of diabetes, heart disease, Alzheimer’s and more.

but it still exists.

Insurance adds to the misconception of what dentists can treat. Because dental insurance typically only covers services related to teeth, most insurance providers won’t cover oral cancer screenings, major surgery, sleep apnea treatments, or others, as those are commonly covered by medical insurance.

At Dee for Dentist, we utilize a cone-beam computed tomography system (CBCT), which is a focused CT scan of the head and neck.

While medical doctors refer patients to an imaging provider to have scans taken, we have the technology in-office. It’s an advanced machine that allows us to see hard and soft tissue, bones, and more in a 3D environment.

On occasion, we’ll detect abnormalities that should be evaluated by a medical professional, and we provide the patient with the scan on a USB stick to share with their doctor. In many instances, the doctor will not accept the USB or review the scan, instead asking how the patient feels. If the patient feels fine, they send them on their way. To try to eliminate this from happen ing, we partnered with a dental radiologist to evaluate the scan, so our patients can go directly to their doctor with a physical report.

Meevasin

Because of the history of the industry, and lack of awareness and education about the services and technology available in the dental field today, there remains a stigma and misconception that dentists should only address issues with your teeth, when really, they should be utilized as an integral asset in maintaining your overall health.

Today, many dentists can treat patients from the neck up and serve as an important asset to a patient’s team of medical experts.

In order to bridge the gap between dentists and a patient’s health care team, it’s import ant to encourage open communication. When abnormalities are found, we encourage our patients to immediately inform the appropriate medical expert, and we provide them with the necessary scans and reports to share.

Experiencing the stigma

The gap between dentists and other health care professionals has narrowed in recent years,

When treating sleep apnea, continuous posi tive airway pressure (CPAP) machines were the preferred treatment for many decades. Now, we have the ability to relieve mild and moderate cases with a custom oral appliance that is more comfortable and has better patient compli ance. However, getting a patient onto an oral appliance sometimes requires a sleep study and a prescription from a medical doctor.

When we first began treating sleep disorders, we referred patients to sleep doctors to undergo testing, and many times, doctors would question a dentist’s role in sleep evaluation. To provide a better standard of care, we partner with a national company that employs doctors who are aware of what we can treat and can prescribe the oral appliance for us to fabricate. There are some people who cannot tolerate a CPAP machine, so an oral appliance can drastically help improve their sleeping habits and daily life.

Treating patients from the neck up

With the latest technological advancements, dentists can treat patients from the neck up,

Dee Dee

DMD, is an expe rienced dentist with more than 22 years of industry experience.

Images above show a benign tumor behind the eye of a 24-year-old female captured on a CBCT image.

The SomnoDent Avant Oral Sleep Appliance, below, is one of the Oral sleep appliances used at Dee for Dentist. (Courtesy)

which can include solutions for snoring and sleep ap nea, and even detecting early-stage cancer.

In addition to oral appliances and CPAP machines, dentists can also provide laser treatments that target the soft palate, uvula, tonsillar areas, and back of the throat to stimulate collagen production causing the tissue to constrict, which in turn, opens the airway and decreases snoring.

When it comes to detecting cancer, we conduct an annual advanced oral cancer screening that includes a visual exam, physical exam, and an advanced visual inspection using “fluorescence technology.” The ad vanced visual inspection helps identify abnormalities

that the naked eye cannot see.

We’ve detected oral cancer and other abnormalities in patients of all ages, races, and sexes. In one instance, we detected thyroid cancer.

Dentists often treat patients regularly, at least twice per year, and sometimes as many as four times a year, so we are in a great position to detect changes quickly. We know when to defer cases to the appropriate spe cialist to best serve the patient.

Bridging the gap

As a dentist, if we can offer a higher standard of care, then it is our responsibility to do so. It is our duty to promote an open dialogue with physicians about how the field of dentistry has evolved and what today’s tech nology can help us identify and treat together, especial ly on the preventative side.

By bridging this gap, the quality of care for patients will improve, and through better communication, health professionals from all specialties can work to gether to treat conditions earlier when there are more options available, and deliver a better prognosis for our patients.

Dee for Dentist is a local family practice providing stateof-the-art digital dentistry by embracing the latest tech nology along with traditional dental services as a means to promote the long-term oral health of every patient.

Why we need the Nursing Licensure Compact

Transcripts taken from September 2022 Interview for Vital Views podcast, including edited introduction.

BY JOSEPH GACCIONE

Joseph Gaccione , Associate Director of Communications, School of Nursing, University of Nevada, Las Vegas

There is a nationwide agreement that could enhance nursing care state by state, but Nevada is on the outside looking in. This agreement is called the Nursing Licensure Compact (NLC). It allows nurses in one state to practice in another without having to go after additional licenses if those states are in the compact.

The National Council of State Boards of Nursing has 39 states listed as part of this compact, but Nevada is not one of them. Last year, it was introduced in the Nevada Legislature as Assembly Bill 142 but didn’t pass.

Dr. Susan VanBeuge, professor-in-residence with UNLV School of Nursing and President of the Nevada State Board of Nursing, and Cathy Dinauer, Executive Director with the Nevada State Board of Nursing discuss the NLC and why Nevada lawmakers may be hesitant.

Why was the NLC created in the first place? Was this to alleviate state resources in times of crisis without a lot of red tape?

CATHY DINAUER: Yes and also to facilitate nurses’ ability to practice quickly in another state with one license. It’s cost effective for

them, helpful when they’re starting a job in an other state, and they don’t have to wait as long as it would take getting a single state license.

Is the biggest benefit the quick turnaround to start practicing?

Or are there other benefits as well?

SUSAN VANBEUGE: There are a lot of benefits for Nevada nurses. If a Nevada nurse also works in the telehealth space, and they work in an organization that consults with patients in other states, that nurse would be able to give care in the telehealth space to patients in other states if they were part of the compact license.

What are the benefits of the NLC, education-wise?

VANBEUGE: We have highly educated nursing faculty here at UNLV and through out the state. If you have a student that’s in another state, and you have faculty that want to mentor them or work in that educational space, that nurse needs to be licensed in the other state. So, if a student was up in Utah, for example, a nurse educator would also have to get a license in that state to be able to deliver the education to that student. If we were part of that Nurse Licensure Compact and Utah was part of that as well, and the nurse had a compact license, they would not have to apply for that additional licensure, the fees and all the things that go along with that.

Back in August, Governor Steve Sisolak voiced his support for the NLC on our podcast, but he admitted he wasn’t sure why it had not passed yet. What would be drawbacks to the NLC?

DINAUER: There really aren’t any drawbacks. There is some opposition to the compact, and that’s generally coming from the nursing unions. Most other organizations that we have engaged with are in support of the nursing compact, including national education organizations, the national practice organizations, the Department of Defense, the veterans’ groups, they’re all very supportive. From what they’ve [nursing unions] said in statements, it has to do with crossing a picket line. If there’s a strike, how would a compact nurse impact that? Is there a drawback with continuing education requirements? But all of their questions have been addressed and have been answered.

This year, we did a survey of all the RNs and LPNs in our state to see what they thought about having the compact, and the results were overwhelmingly in support of a compact — 92% of the nurses in Nevada want the compact.

VANBEUGE: The Department of Defense has also backed the Nurse Licensure Com pact and had a really strong voice in this. I was a military spouse for a lot of years, and I worked as a registered nurse. At one point, I was carrying six state licenses. In 16 years, I moved 10 times. If the state was part of that compact, and you were going to another compact state, you wouldn’t have to pay that money all over again for the reappli cation.

What would it take to get this bill passed now?

DINAUER: It requires a change in our statute, which is a change in our law. So, in order for that to happen, it has to go before the legislature. The Nevada State Board of Nursing has been trying for at least 10 years to get the nursing compact passed.

The last session, there was a bill to go before the legislature, but it wasn’t introduced. Now what we’re waiting for is a bill draft. We have had some conversations with individuals who have voiced support for the nursing compact who would be willing to carry a bill draft before the legisla ture for the next session.

VANBEUGE: When you talk about legisla tive action and things happening, it’s about modernizing statute to what’s going on today. Perhaps the other attempts going before the legislature, it just wasn’t the right time.

Right now, we’ve just come out of, and we’re still in COVID, and we’ve learned a lot of lessons about portability of health care across

Dr. Susan VanBeuge

Cathy Dinauer

state lines —not only from nursing, but from medicine and every other profession.

We’ve learned some things and realized that this compact could be one way that we could have some lasting effects of being able to have that portability of nursing care across the state line with our colleagues throughout the United States. That safe, effective care can be delivered to the patients and having access to care is important.

There are so many rural and frontier areas outside Southern Nevada. Can you describe the ways the compact can help those communities?

DINAUER: There would be a much quicker way to get re sources to facilities, especially in our rural areas. An example would be last year’s fires in California. It was encroaching on Lake Tahoe, and there was a small facility in California that needed to transfer to the east, which was into Nevada. Had we had the compact, the nurses there would have been able to easily transport their patients that were being evacuated, and it would have been a streamlined process. Not having the com pact was challenging for those nurses who were transporting patients during an immediate evacuation rural facility, trying to get their patients into Nevada. ...

... During the height of the pandemic, there were emergency directives that were established by [Governor Sisolak] to allow for easy access to get licensure, so that we could get our health care providers out in the field. People could come to the state and practice without having to check in with our licensing board. We had more than 6,000 waivers, and of those 6,000, we had very few issues or concerns or problems with individu als coming here. In the face of a disaster, you really want to get those health care providers out and ready to go immediately, not the two or three days it might take to get a license. That doesn’t sound very long, but in the heat of a pandemic, or the Oct. 1 shooting, facilities needed nurses immediately.

There still needs to be background checks and routine research to make sure that NLC nurses are qualified to do this, correct?

DINAUER: Absolutely. There are mandatory uniform licensure requirements that every nurse must meet in order to be eligible for a multistate license. They have to have graduated from an approved nursing program. They have to have taken the National Nursing exam. They have to submit a background check. There are several requirements (11 of them). Right now, in Nevada just for our licensure, and we’re not part of the Compact. We would match, for the most part, every single one of those uniform licensure requirements. So, it’s important every nurse meet those requirements in order to be eligible for a multistate license.

Where can people find more information about the NLC to be more aware?

DINAUER: They can go to the National Council of State Boards of Nursing website, it’s ncsbn.org.

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‘We’re just getting started’

As

HCQ Notes

The State Interim Finance Committee awarded the Kirk Kerkorian School of Medicine at UNLV $70 million to fund an ambulatory care clinic and a pathol ogy lab. The clinic, which will have oper ating rooms for outpatient surgery, will provide coordinated care to patients, including mental and behavioral health. The lab will expedite the delivery of crit ical test results from the medical school campus to University Medical Center, strengthening the relationship between the university and the Clark County-op erated hospital. Private investment in the Las Vegas Medical District is led by the ongoing development of the school of medicine, an expansion of Valley Hospital Medical Center’s emergency room, and the recent completion of Optum Care Cancer Center located at the gateway to the LVMD.

Nathan Adelson Hospice, the leader in hospice and palliative care in southern Nevada, has announced three new fellows — Inga Pak Jeon, MD, Paige Kozlowski, and Bennett Aguilera Vitug — to its Fellowship in Hospice and Palliative Medicine Program. The program provides humanistic, holistic, evidence-based education for graduate physicians seeking additional skill, com petence, and certification in hospice and palliative medicine.

Taylor’s Gift Foundation, a nonprofit organization dedicated to support ing families of organ, eye, and tissue donors, announced that Nevada Donor Network has partnered with them to of fer its grief support program, “Kindred Hearts,” designed specifically for donor families. Donor families from across the country who participate in the Taylor’s Gift Kindred Hearts Program receive personal access to support groups and caring guides, trained to help them navigate through their grief journey. The groups are offered both virtually and in-person for individuals and family groups.

Merging Vets and Players (MVP), a nonprofit dedicated to providing peerto-peer support for combat veterans and former pro athletes in Las Vegas, announces that the organization has re

ALS Nevada raises more than $275,000

The ALS Association Nevada Chapter (ALS Nevada) raised more than $275,000 at their annual Food Is Art Fundraiser on the 108th floor of The STRAT Hotel, Casino and SkyPod. The funds go directly to continuing services focused on sustaining quality of life for over 100 Nevadans and their families affected by ALS. The services include monthly support groups, home visits by licensed personal and medical equipment loan programs to provide aids for daily living and sustain health. Patients also have access to local multidisciplinary ALS clinics, where they are provided with assistance from neurologists, speech, occupational and respiratory therapists, social workers, and dietitians. Families benefit with nonmedical respite programs to give caregivers a break from caring for their loved one with ALS.

ceived $46,000 as part of the additional Community Recovery Grant distribution. Approved by Nevada lawmakers to direct relief dollars to organizations that can make immediate impact for constit uents to alleviate challenges the pan demic introduced to the state, MVP will use the funds to increase engagement for programming and positive percep tion of mental health services. The Com munity Recovery Grants are intended to augment operations for nonprofits with pre-existing infrastructure, systems, and staff that enable them to help constitu ents quickly and efficiently in the wake of pandemic disruptions.

Leslie Hare assumed her position as

the Executive President of Behavioral Health for Health Plan of Nevada and Sierra Health and Life in May. Hare is responsible for the strategic devel opment, growth and operations of the Nevada Behavioral Health line of business, bringing the whole person care model to members and providers, while maintaining the highest quality of clinical behavioral care.

Candlelighters Childhood Cancer Foundation of Nevada hosted its most popular annual public event of the year, welcoming a record sold-out crowd of more than 1,750 participants and raising $325,000 for local families of children and teens diagnosed with cancer. In the

last decade alone, Candlelighters has provided nearly $13 million in financial assistance, emotional support and quality of life programs and services to families in the community in order to help with the significant costs of childhood cancer including medical expenses, rent and mortgage, and travel for treatment.

Candlelighters Childhood Cancer Foundation of Nevada has announced the addition of four new Board Members: Dustin Engel, senior vice president at Merrill Lynch; Craig Fjelsted, vice president of taxation at Caesars Entertainment; Dr. Ati Hakimi, founder and CEO at Vegas Direct Primary Care; and Reece Oswalt, associate superintendent at the Clark County School District. Board terms extend through December 31, 2025. Candlelighters serves 400 families locally and 1,200 children, both siblings and diagnosed children, each year.

Urology Specialists of Nevada added a new health care provider, Elizabeth Anne Smedley, APRN.

Southwest Medical has added new providers to help meet the growing need for health services in the Las Vegas community. Katherine “Kaytee” Ashwell, APRN, joined the Southwest Medical’s Rancho Urgent Care location (888 S. Rancho Dr.), where Ashwell specializes in urgent care. Neda Azizian, MD joins Southwest Medical’s Nellis Healthcare Center location (420-560 N. Nellis Blvd.) and specializes in adult medicine. Alexan der Abesamis, APRN joins Southwest Medical’s Tenaya Healthcare Center location (2704 N. Tenaya Way) and specializes in adult medicine. Timothy Brookes, DPM joins Southwest Med ical’s Oakey Healthcare Center location (4750 West Oakey Blvd.) and specializes in podiatry. Brady Syphus, PA joins Southwest Medical’s Rancho Urgent Care location (888 S. Rancho Dr.) and specializes in urgent care. Kevin Uson, DO joins Southwest Medical’s Tenaya Healthcare Cen ter location (2704 N. Tenaya Way) and specializes in adult medicine.

Optum Care Lung and Allergy Care has added new physician Simhean Lee, MD to Optum Care Lung and Allergy Care’s 4750 West Oakey Blvd. location.

Valley Health Specialty Hospital celebrates Inau gural Year of Care. From performing orthopedic surgery procedures to helping people recover from stroke, injuries or illness, the team at Valley Health Specialty Hospital has spent the last year caring for more than 2,250 patients.“Every patient has unique needs, and our goal is to always pro vide a customized plan of care that incorporates nursing, therapy, exercise, nutrition, education, socializing and a safe discharge plan,” said Jill Pichette, Administrator or the Valley Health Spe cialty Hospital.

Summerlin Hospital, which opened as a 148-bed hospital in 1997, is celebrating its 25th anniversary by adding 31 medical-surgical beds. Another 11 beds for general pediatric and pediatric intensive care will be added by 2024, bringing the hospi tal’s total bed count to 496.

New radiation treatment center coming to Las Vegas

ART Health (“Advanced Radiotherapy Technol ogies”), a Kingsbarn company, announced plans to develop a state-of-the-art radiation treatment center in Las Vegas. The radiation treatment center is expected to open for patient care during the first quarter of 2024 and will have the capacity to treat thousands of cancer patients annually. The new facility will include RefleXion Medical’s biology guided radiation (BgRT) X1 system, Varian Medical’s Edge Radiosurgical system, Siemen’s PET/CT, nuclear medicine, and brachytherapy. This will be the most advanced radiation treat ment center in the State of Nevada, providing the residents of greater Las Vegas access to the most cutting-edge technologies available today.

Nevada Donor Network (NDN) was awarded $15 million in American Rescue Plan Act funds from the State of Nevada, one of the largest amounts awarded to a single nonprofit organization by the Interim Finance Committee to date. The funding will support the creation of the Nevada Transplant Institute (NTI), which will collaborate with NDN, academic institutions, hospitals, payers, transplant centers and community healthcare providers in a singular, dedicated network to expand transplan tation programs and services throughout Neva da. The NTI will elevate all healthcare in Nevada and serve to correct health disparities in access within the diverse populations in desperate need of transplantation related services. This funding will go towards NDN’s $35 million “End the Wait” capital campaign launched in 2019, which is raising the funds necessary to expand upon the current kidney transplant program at University Medical Center and create a first-of-its-kind liver transplant program in Nevada.

Optum Care Cancer Care has added a new phy sician to help meet the growing need for health services in the Las Vegas community. Eric Gershman, MD joins Optum Care Cancer Care (2300 W. Charleston Blvd.) and specializes in oncology.

Optum Care Breast Care, part of Optum Care Cancer Care has added a new health care provid er, Ronald Ganzon, PA to the 4750 West Oakey Blvd. Location.

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At Intermountain Healthcare, you receive quality healthcare from the same Nevada caregivers you know and trust. But you also get more. More nationally renowned specialists. More digital options to simplify and improve your care experience. More comprehensive care, including preventive care and mental health support. What does getting more mean? A healthier, stronger you, and healthier, stronger communities. Because all of us are better, together.

Visit Intermountain.com/Nevada today to learn how you can get more from a healthcare provider.