Shore Health System - Navigator by Shore Health System

E X C E P T I O N A L

C A R E ,

E V E R Y

D A Y .

Shore Health System is committed to providing equal opportunity in the areas of employment practices and patient services. There shall be no discrimination against any persons because of race, color, belief, religion, gender, age, national origin, disability, sexual orientation or financial status. The information provided in this publication is intended to educate readers. It is not intended to be medical advice nor a substitute for a consultation with a healthcare provider. Please speak with your physician or provider for specific guidance.

ON THE COVER: Emergency Services Medical Directors Jane Wang, MD, Michael Joyce, MD, and Salvatore Verteramo, MD.

EXECUTIVE EDITOR

PATTI WILLIS, SENIOR Vice President, External relations & development

in this issue

MANAGING EDITOR

Emergency departments are the front door to the hospital

Triage...focused on the patient

George King: Putting the sunshine back in life

Queen Anne’s Emergency Center: Care where you need it

LINDA MASTRO, Editorial Specialist EDITORIAL ADVISORS

Christopher Parker, MSN, RN, SENIOR VICE PRESIDENT, PATIENT CARE SERVICES & CHIEF NURSING OFFICER MICHAEL SILGEN, VICE PRESIDENT, PLANNING & BUSINESS DEVELOPMENT MICHAEL TOOKE, MD, SENIOR Vice President & CHIEF MEDICAL OFFICER

Emergency Medical Services begin out on the road

Maryland Express Care... a rolling ICU

Safety Net available 24/7

Why did you choose emergency nursing?

Next steps in a medical emergency

PARAGON LIGHT STUDIOS MELISSA GRIMES-GUY PHOTOGRAPHY

New Medical Staff News Notes Happenings

17 19 21

KIM QUIGLEY, PUBLICATIONS SPECIALIST/ WEBMASTER

join our online communities

CONTRIBUTING WRITERS

JUDY GRILLO, LINDA MASTRO, JULIE HEIKES, MANNING LEE, AMY STEWARD

PHOTOGRAPHY

GRAPHIC DESIGN

NAVIGATOR is produced by the Corporate Communications Department of Shore Health System • 219 S. Washington St. Easton, MD 21601 • 410-822-1000, ext. 5222 • www.shorehealth.org • TTY phone numbers: 410-820-5704 and 410-228-7685.

@SHSNews and @ShoreJobs Find Shore Health System on Facebook

Emergency departments are the front door to the hospital When Shore Health System was formed 15 years ago, bringing together the Memorial Hospital at Easton and Dorchester General Hospital, responding to a growing need for emergency services topped the list of priorities.

Shore Health System consulted with Brian Browne, MD, Chief of Emergency Medicine at the University of Maryland Medical Center, who organized a new group of emergency medicine physicians dedicated to living and working in communities on the Eastern Shore. Today this group, Eastern Shore Emergency Medicine Physicians, which is part of the University of Maryland Emergency Medicine Network and the University of Maryland School of Medicine, provides the backbone for the emergency services delivered around the clock at the two Shore Health System hospital Emergency Departments and at the newly opened Queen Anne’s Emergency Center. Dr. Browne reflects, “I developed a strong interest in how emergency medicine is provided in the community, based on my first job in emergency medicine in rural upstate New York. The lack of medical resources there created a fire in my belly and motivated me to make a change in how emergency services are delivered in rural areas.” Dr. Browne adds, “Emergency departments are the front door to the hospital and emergency physicians are the silent partner in every physician’s practice. Physicians and communities depend upon a well-run emergency department which covers patient care 24 hours a day.” Practicing medicine as a team Salvatore Verteramo, MD, joined Eastern Shore Emergency Medicine Physicians in 2001 after completing an emergency medicine residency at the University of Maryland Medical Center. He has been the Medical Director of Emergency Services at Memorial Hospital since 2006 and was recently named Regional Medical Director of Eastern Shore Emergency Medicine Physicians with leadership responsibilities for the three Shore Health System emergency facilities. The group he leads includes Michael Joyce, MD, Medical Director for Dorchester General Hospital, Jane Wang, MD, Medical Director for the Queen Anne’s Emergency Center and a team of 21 full-time physicians, 13 part-time physicians, a nurse

“Physicians and communities depend upon a well-run emergency department which covers patient care hours a day.” - Brian Browne, MD

practitioner and a physician assistant. Together, they provide coordinated emergency care to the residents of the Mid Shore region. Dr. Verteramo comments, “Our certified emergency physicians and family practice physicians who have emergency department experience are credentialed at all three Shore Health System sites and rotate between them, with a core of physicians working regularly at each facility. Mid-level practitioners, such as nurse practitioners and physician assistants, play a vital role in helping to initiate treatment for patients, especially on busy days.” He adds, “A call schedule among the physicians also ensures that we have coverage during surge times at each of the sites.” Dr. Verteramo notes that following similar processes at each facility also helps provide a uniform environment for delivering patient care, including standardization of computer entry for testing and procedures, nursing documentation and physician order entry. The clinical staff at all three locations also follow the same standards of care for sepsis, heart attack and stroke and protocols for transferring patients to other facilities. Collaboration among physicians is also essential to delivering quality physician services. Having emergency physicians on committees with their colleagues in radiology, pharmacy, laboratory and other clinical specialties gives the emergency physicians the opportunity to offer their ideas for achieving system-wide patient care. Attracting physicians to rural communities In 2006, Shore Health System joined the University of Maryland Medical System. Dr. Browne explains, “Our goal is to make sure that all patients get the same quality of care and the same quality physician in all hospitals that are affiliated with UMMS. Shore Health System has succeeded in the delivery of quality physician care by finding the right people to do the right jobs in their emergency facilities.” Dr. Browne, who is also a professor and Chair of the Department of Emergency Medicine at the University of Maryland School of Medicine, says, “While it continues to be a big challenge to recruit physicians to community hospitals in a rural areas like the Eastern Shore, we have had success in recruitment because of the relationship Shore Health System has with the University of Maryland School of Medicine.” Laura Pimentel, MD, Vice President and Chief Medical Officer, University of Maryland Emergency Medicine Network, comments, “Physicians’ access to continued medical education and educational resources at the University of Maryland School of Medicine enhances the quality of patient care they are able to provide.” Dr. Pimental adds, “In addition, Shore Health System does an excellent job of providing the same infrastructure and equipment in all three emergency care facilities which also helps with quality care and patient safety. We do our part in recruiting good doctors, but Shore Health System has to provide the environment for these doctors and other professionals to succeed, and they do this very well.”

Salvatore Verteramo, MD

Brian Browne, MD

Laura Pimentel, MD 4

triage...

focused on the patient

A visit to the emergency department is seldom a first-come, first-served experience. Critical injuries and severe illnesses must take priority. The process of prioritizing medical care known as “triage” (from the French word “trier” - “to choose or to sort”) dates back to one of Napoleon Bonaparte’s army surgeons, who evaluated and categorized wounded soldiers without regard to military rank. “Nurses are on the frontline when someone comes to Shore Health System for emergency medical care,” says Christopher Mitchell, MSN, RN, NEA-BC, Director of Emergency and Outpatient Services. “In the Emergency Departments at Dorchester General Hospital and Memorial Hospital and at the Queen Anne’s Emergency Center, a nurse distinguishes life-threatening cases from the less critical.” Melanie Donaway, MSN, RN, CEN, Emergency Services Educator for Shore Health System, says, “The triage nurse makes the very important first assessment of your emergency condition according to the type of illness or injury, the severity of the problem, and the essential resources required to diagnose and treat,” says You’re Next Shore Health System uses a five-tier triage system. The process not only reduces wait time but enhances patient safety through accurate and reliable triage at one of five levels. Emergency care is further advanced by a “pull-to-full” approach that accelerates the in-flow of patients and the start of treatment. When a bed is available, a patient is moved out of the waiting room and given bedside triage in a treatment room. In addition to taking vital signs, the triage nurse collects a history of current medical complaints, past medical problems, medications and allergies. Registration occurs bedside as well, so patients receive care first, then deal with the paperwork. “When you initially arrive at the ED, someone from our staff will simply ask your name, birth date, social security number and the principal reason you’re seeking medical attention so emergency care can begin as quickly as possible,” explains Donaway. Emphasis on the Patient “People are less likely to leave the ED without being seen if we can start treatment sooner,” says Grace Gonzalez, BSN, RN, Manager of Emergency Services for Memorial Hospital. “The combination of five-level triage, the pull-to-full approach to care that keeps people moving through the ED and the use of symptom-driven pathways all work together to improve the patient experience.” Symptom-driven pathways are used for complaints commonly reported by patients who come to the ED. The pathways provide the ideal sequence and timing of how care is delivered. For example, for a sprained ankle, the triage nurse will prop the injured leg, apply ice and order an x-ray before the patient is seen by the emergency physician. “The triage process is just one of the many ways that we continue to transform the emergency department to put our patients at the center of compassionate and efficient care,” says Cathy Weber, BSN, RN, CEN, Manager of Emergency Services for Dorchester General Hospital. Resources are available to address the emotional and spiritual needs of the patient and their loved ones. “This is an innovative and supportive environment where we offer professional care at many levels to our patients,” says Weber. “If a patient requests a chaplain or a family member needs crisis counseling, we can help there, too.” Gonzalez adds, “Our commitment to relationship-based care – a philosophy that keeps patients and families at the center of all that we do – is especially appreciated during a medical emergency. We are often the ones that are with patients and their loved ones when they receive a life-changing diagnosis. Our team in the ED and our colleagues in other departments come together to help a family deal with the shock of receiving and responding to this news.”

The Shore Health System Emergency Services team is led by (left to right), Cathy Weber, BSN, RN, CEN, Nurse Manager, Dorchester General Hospital; Christopher Mitchell, MSN, RN, NEA-BC, Director of Emergency and Outpatient Services, Shore Health System; Grace Gonzalez, BSN, RN, Nurse Manager, Memorial Hospital at Easton; Mary Alice Vanhoy, MSN, RN, CEN, CPEN, NREMT-P, Nurse Manager, Queen Anne’s Emergency Center; and Melanie Donaway, MSN, RN, CEN, Emergency Services Educator.

Using a 5-tier triage system ensures that the sickest people get care the fastest Level 1: The patient is in immediate danger and exhibiting life-threatening conditions. This person may need resuscitation and, if not given emergency care by a physician immediately, may be at risk for death. Level 2: A high-risk patient who may exhibit signs of chest pain, a sudden onset of a severe headache with no past history or other conditions that could become fatal quickly. The nurse may need to place the person on a heart monitor, start an IV or give oxygen before physician evaluation occurs. At this level, critical decisions are made in less than 10 minutes. Level 3: For this “acute” patient, the condition comes on quickly, or it lasts only a short time, or both. The triage nurse takes vital signs (temperature, pulse, respiratory rate and blood pressure) and determines the number of resources the patient is predicted to require, such as x-rays, IV fluids or lab work. Level 4: The patient requires a quick consultation or minor evaluation or treatment. For example, a person who has fallen and has ankle pain may need an x-ray to determine if it’s a strain, sprain or break. Level 5: The patient requires little treatment. While the triage nurse will check that vital signs are stable, this patient may be out of blood pressure medication and require a short-term prescription until his physician’s office opens. 6

Putting the Sunshine Nearly three years ago, George King of Easton was working in the yard when he suddenly was unable to swallow or talk. A neighbor who stopped by saw that King was having difficulty and helped get him get into the house. King, now 71, recalls, “I denied I was having a problem until my wife, Joan, put me through a battery of tests to check me out. Before I knew it, she was calling 911.” Joan King, a retired nurse, knew the symptoms of stroke and knew how important it was to get treatment for her husband as soon as possible. The paramedics who responded to the 911 call quickly assessed King’s symptoms and immediately started an IV. At the same time, the emergency response team began consulting with a physician at the Memorial Hospital Emergency Department. By the time King arrived at Memorial Hospital, which is a designated Primary Stroke Center, the Brain Attack Team (BAT) was ready for him. The Memorial Hospital BAT - comprised of an emergency department nurse and physician, a neurologist, a neuroscience nurse, a laboratory technician, a radiology technologist, a radiologist and a pharmacist - is ready to respond 24 hours a day to patients who are experiencing stroke symptoms in the emergency department and in the hospital.

did you know? The Talbot County Stroke Survivor’s Group meets on the first Thursday of each month from 1:00 to 2:30 p.m. at the Talbot County Senior Center, 400 Brooklets Avenue in Easton. For more information, contact Christina Ball, 410-822-1000, ext. 5068.

back in life

Christina Ball, RN, CNRN, Neuroscience Specialist and Stroke Center Coordinator for Shore Health System, explains, “Time is of the essence in achieving a good outcome following a stroke. It is very important to initiate treatment within three hours of the onset of symptoms.” Neurologist Terry Detrich, MD, Medical Director for the Primary Stroke Center, adds, “Patients coming to the hospital with stroke symptoms are moved to the head of the line for treatment in the emergency department and for hospital admissions, including expedited CT scans, lab tests, risk factor management and physical therapy.” Physicians must quickly determine whether the stroke was caused by a clogged artery or a hemorrhage in the brain. Ball comments, “The earlier we can intervene to stabilize blood pressure, hemorrhagic clotting or other complications, the better the outcomes will be.” In King’s case, a ‘clot busting’ drug was administered to dissolve the clot that caused his stroke. He recalls, “Within 20 minutes of them giving me the drug, I began talking. When they did another CT scan, they found the clot had dissolved.” Ball says, “The number one reason patients may not be candidates for this life-saving drug is that they waited too long before they came to the hospital after the onset of symptoms.” After spending the night in Memorial Hospital’s intensive care unit, King was transferred to the hospital’s neuroscience unit for three days for continued observation and assessment. On this unit, neurologists and neuroscience nurses work with patients to identify any deficits that persist following the stroke and to initiate physical, occupational and speech therapy. They also discuss lifestyle changes that may need to occur, including diet and exercise, to prevent future strokes. George King left Memorial Hospital with only preventative dietary restrictions and no orders for therapy. He comments, “What I had was not a life threatening stroke, but it could have been a life altering stroke. I can’t say enough about the care I received.” Following his stroke, King joined the Memorial Hospital Auxiliary and currently volunteers as a patient escort at the hospital. He also helps Ball promote stroke awareness in the community as a participant in the Talbot County Stroke Survivor’s Group. King comments, “Memorial Hospital is an amazing place. Because it was so good to me, I wanted to pay the hospital back by volunteering. The hospital has put the sunshine back into my life. I want to help keep the clouds away for someone else.”

time is brain

know the signs of stroke Knowing what to do if the symptoms of stroke occur could save your life. Act quickly if one or more of these warning signs appear: • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body • Sudden confusion, trouble speaking or understanding • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination • Sudden, severe headache with no known cause If you experience any of these stroke warning signs, call 911 immediately. Every second counts, and acting quickly makes a difference in surviving a stroke and reducing disability.

8 Visit www.shorehealth.org/ services/stroke for more information.

Queen Anne’s Emergency Center

care where you need it

In early 2007, state and county officials recognized a need in Queen Anne’s County for an emergency medical treatment facility. Shore Health System, the University of Maryland Medical System and Queen Anne’s County partnered to build the Queen Anne’s Emergency Center, a freestanding emergency center serving residents of Queen Anne’s County and the surrounding area 24 hours a day, seven days a week. A full service licensed emergency center, the Queen Anne’s Emergency Center has 14 beds, four ambulance bays and a helicopter pad. The staff includes board certified emergency physicians, nurses experienced in emergency care, and radiology technologists and medical technologists with hospital experience. The center is equipped to take standard x-rays and CT scans, and has a full-service clinical testing laboratory, which can do blood work and provide emergency blood supplies. Special equipment for eye injuries is available as well as neonatal resuscitation beds for newborns. Since opening the doors on October 4, 2010, the Queen Anne’s Emergency Center staff has been busy. “We see everything and everybody,” says Jane Wang, MD, Medical Director for the Queen Anne’s Emergency Center. “We see everything from fevers, coughs, bumps and bruises to strokes, heart attacks, breathing emergencies and traumatic injuries.” Dr. Wang adds, “Within the first month, we had our first critical trauma patient. We were able to stabilize the patient, do an initial assessment and then arrange for transfer by helicopter to the University of Maryland Shock Trauma Center in Baltimore.” As nurse manager for the Queen Anne’s Emergency Center, Mary Alice Vanhoy, MSN, RN, CEN, CPEN, NREMT-P, is responsible for clinical operations. An emergency nurse for more than 30 years, Vanhoy joined Shore Health System in 1994. For 14 years she was Shore Health System’s Emergency Medical Systems Coordinator. In 2006, she took on additional responsibility as the educator for the Emergency Department staff at Memorial Hospital and Dorchester General Hospital. She has also served as Shore Health System’s clinical expert for disaster management. “Mary Alice has been an invaluable asset to bringing this emergency center to Queen Anne’s County,” says Christopher Mitchell, MSN, RN, NEA-BC, Director of Emergency and Outpatient Services for Shore Health System. “Her nursing experience and the respect she has earned from our staff and in the community where she lives and works made it possible for us to create this new service that is already saving lives in the community.” 9

“Many people come to the emergency center with what appear to be relatively minor symptoms, some of which are signs of a more serious health emergency,” - Jane Wang, MD, Medical Director for the Queen Anne’s Emergency Center.

Critical patients who come to the Queen Anne’s Emergency Center are often transferred to Memorial Hospital or Dorchester General Hospital. Patients needing highly specialized care can be transferred by ground or air to University of Maryland Shock Trauma Center or other specialty centers. “Many people come to the emergency center with what appear to be relatively minor symptoms, some of which are signs of a more serious health emergency,” says Dr. Wang. Vanhoy offers examples. “We had a child who hit her head early one day and it hadn’t seemed to be a big problem,” Vanhoy remembers. “But later that night she was brought in to our emergency center. We did a CT scan and found that she had internal head bleeding. We had her flown to a specialty medical center. After she recovered, the girl came back to visit; she wanted to meet the people who had helped her.” Another day, a man came to the Queen Anne’s Emergency Center after he had fallen off the back of a truck. Vanhoy explains, “He was complaining of shoulder pain. After we heard what had happened to him, we immobilized his spine and took x-rays. We found out that he had a broken neck. We contacted Maryland ExpressCare’s ground ambulance and had him transferred to Shock Trauma.” Vanhoy adds, “In both cases, these were seemingly benign, common complaints that turned out to be very critical in nature.” For patients who need hospital care, the physicians at the Queen Anne’s Emergency Center work closely with the hospital’s admitting physician. “Because we have already done the initial assessment and testing,” Dr. Wang explains, “and we have discussed the case with the hospital physician, when patients arrive at the hospital, a bed is waiting for them.” The Queen Anne’s Emergency Center is located at 115 Shoreway Drive, at the intersection of Nesbit Road and US Rt. 50, near Grasonville. For more information about the Queen Anne’s Emergency Center 8visit www.qaemergencycenter.org.

Emergency Medical Services begin out on the road

When someone you love needs emergency medical attention, there are good reasons to go for the phone instead of your car keys.

Thomas Chiccone, MD, and Terry Satchell, BSN, RN

“We’re taking the emergency room out of the hospital and putting it into the ambulance” - Terry Satchell, BSN, RN Emergency Medical Services Liaison

Ambulance crews can provide the first 20 minutes of treatment that would take place in a hospital emergency department. And they aren’t working alone. Emergency Medical Services (EMS) providers in the field collaborate with emergency department physicians to bring hospital level care to patients before they reach an emergency care facility. “We’re taking the emergency room out of the hospital and putting it into the ambulance,” says Terry Satchell, BSN, RN, NREMT-P, Emergency Medical Services Liaison for Shore Health System. Satchell has gained experience in many areas of emergency services since he began training as an emergency medical technician (EMT) in 1982. Now, in addition to being a nurse, paramedic and educator, Satchell is the communications link between the staff in the emergency departments at Dorchester General Hospital and Memorial Hospital, the staff at Queen Anne’s Emergency Center and ambulance personnel in Caroline, Dorchester, Queen Anne’s and Talbot counties. “Statewide protocols cover every medical situation that EMS providers can encounter in the field,” Satchell explains, “including stroke, heart attack, asthma attack, congestive heart failure, shortness of breath, trauma, car accidents and falls. EMTs do not diagnose; they treat symptoms according to specific medical guidelines.” EMTs and paramedics can take a person’s vital signs, administer oxygen, start IV therapy, begin cardiac monitoring and give medications. They can intervene if a patient has an irregular heartbeat and open the patient’s airway. At a patient’s home or in the ambulance, EMS providers often call the hospital emergency department or the Queen Anne’s Emergency Center to give the attending physician information about the patient. The physician can direct further treatment, if needed, such as administering other medications. Satchell explains, “Even though EMTs and paramedics are administering treatment according to protocol for symptoms they observe, the ER doctors are still diagnosing and recommending additional treatments over the radio and prepping the hospital or emergency center for that patient’s specific needs.” Thomas Chiccone, MD, an emergency physician on staff at Dorchester General Hospital and Memorial Hospital, has been with Shore Health System since 1993 and wears a variety of hats in emergency services. As jurisdictional EMS Medical Director for Talbot County, Dr. Chiccone is responsible for medical care provided by EMTs and paramedics in the county. “It really helps my work as an emergency physician to know the EMS directors in the other counties served by Shore Health System and all the EMS providers in the field,” Dr. Chiccone says. “I have a relationship with them and it’s a comforting feeling to hear a voice that I know on the radio.” Those relationships are strengthened when EMTs, paramedics and hospital emergency staff take required classes together to increase their education and to stay current with changes in treatment protocols. Maryland EMS protocols are controlled by the Maryland Institute for Emergency Medical Services Systems (MIEMSS). In April 2010, MIEMSS appointed Dr. Chiccone as Regional EMS Medical Director for the Eastern Shore of Maryland. In this capacity, Dr. Chiccone attends a protocol review committee that determines needed changes. He also provides direction to the jurisdictional medical directors and acts as liaison for information from MIEMSS when changes are planned “I’ve ridden in the ambulance as an observer,” says Dr. Chiccone. “Being the first on the scene is very different from working in the ER. At the hospital, I usually see patients after some stabilization has occurred. There are no crowds of people. I was really impressed to watch how our EMTs and paramedics worked. They do their jobs very well.”

Maryland Express Care: a rolling ICU

Michael Joyce, MD

Maryland ExpressCare, an affiliate of the University of Maryland Medical System, is a statewide system dedicated to transporting critically ill patients to specialized medical centers. Maryland ExpressCare’s satellite in Easton primarily moves patients from Dorchester General Hospital, Memorial Hospital, Queen Anne’s Emergency Center and Chester River Health System, all of which are UMMS affiliates. Colin Fluharty, BSN, RN, CCRN, CEN, CFRN, NREMT-P, Critical Care Transport Supervisor at the Maryland ExpressCare Easton satellite office, describes Maryland ExpressCare as “a rolling intensive care unit. We can do almost everything in our ambulances that can be done in an ICU. We also can fly patients to Baltimore in about 15 minutes using our flight team.” Specially equipped air and land ambulances are staffed by teams who have specialized training for transporting critical patients. Each team includes a transport nurse, paramedic and, for ground transport, an EMT-B emergency vehicle operator, or for air transport, a pilot. Michael Joyce, MD, Medical Director for ExpressCare’s Eastern Shore satellite, says, “Our ExpressCare ambulances are under continuous medical direction, from the time they pick up a patient at the sending facility through arrival at the receiving facility.” Dr. Joyce adds, “If the transport team has a concern about the appropriateness of transport by ground, they can call for medical direction and we will discuss the case with the attending physician who is overseeing the transfer. Likewise, if there is a concern during actual transport, the team can consult for medical direction. All transports are reviewed for quality of care purposes.” Fluharty adds, “Our goal is to stabilize the patient for a smooth transition to specialized care, usually at the University of Maryland Medical Center. The people we transport are most commonly trauma and cardiac patients but ExpressCare also has the first pediatric transport team in Maryland for pediatric specialty care transportation.” Dr. Joyce, who is also Medical Director of Emergency Services for Dorchester General Hospital, says, “I have been practicing on the Eastern Shore for over 25 years and over half of them without ExpressCare in place. It is extremely satisfying to know that a critical patient I’m sending from Cambridge for an hour and a half ambulance ride to Baltimore is being cared for by people and with equipment that is equivalent to a hospital ICU.” 12

SAFETY NET AVAILABLE 24/7 For more than 20 years, the nurses who staff Shore Health System’s Sexual Assault Forensic Examiner Program (SAFE) have been a part of a safety net for adults and children who have been victims of sexual assault. SAFE nurses work intimately with women, men and children who have experienced acute and chronic abuse. The nurses are on call 24 hours a day and work primarily in the Emergency Departments at Dorchester General Hospital and Memorial Hospital. They are also part of the team that staffs the Talbot County Children’s Advocacy Center, a partnership between the Talbot County Department of Social Services and Shore Health System. Karen Jackson, RN, FNE A/P, Coordinator for Shore Health System’s SAFE program, explains, “The SAFE nurses have a critical role during the initial interactions with victims of sexual abuse or assault, since it is likely that these individuals have also been subjected to psychological and physical trauma.” The SAFE nurses are trained to obtain a preliminary patient history and to conduct a physical examination to collect evidence that may eventually lead to prosecution of the attacker. “We also collaborate with law enforcement officers and may be asked to testify in court,” Jackson says. “Our work includes educating victims about pregnancy and treatment for sexually transmitted disease. We also provide referrals for follow-up care, as needed.” In 2009, the Violence Against Women Act was enacted. Now all states are required to offer victims of sexual assault the option to receive medical care under the ‘Jane Doe’ provision of the act. This federal mandate ensures that victims of sexual assault are no longer required to participate in a law enforcement investigation in order to undergo a forensic medical exam and to receive treatment and counseling. During the medical examination, SAFE nurses collect physical evidence from the ‘Jane Doe’ victims even when they initially choose not to prosecute their attackers. The nurse educates the victim about the legal process, and, for three months following the exam, the nurse periodically calls the victim to check in. Jackson explains, “These calls ensure the well being of the victims and reminds them that the option to prosecute is still available. If the victim chooses not to pursue the matter through the law after three months, we notify the appropriate authorities that the case is closed. We keep the patient’s confidential medical records through the SAFE program.” Victims who initially decide not to prosecute soon realize the importance of prosecuting their attackers. Jackson says, “This ‘Jane Doe’ provision gives victims of assault time to get immediate medical attention and time to think about how important their testimony is to the community.” Jackson adds, “The victims often have a strong desire to keep their attackers from harming anyone else. Many cases are settled before they reach the courts as a result of strong forensic evidence collected during the medical exam.” 13

Karen Jackson, RN, FNE A/P, (right) coordinates the Shore Health System SAFE Program. The SAFE nursing team includes Linda Ferara, RN, FNE-AP (left) and (not pictured) Rhiannon Cummings, RN, FNE A/P, Leslie Collier, RN, Michelle Halverson, RN, and Kathleen Wallace, RN.

Shore Health System is one of a select group of US hospitals and health systems chosen to receive the Magnet® recognition for excellence in nursing services from the American Nurses Credentialing Center. Achieving Magnet designation confirms that Shore Health System’s relationship-based approach to nursing care results in the highest quality patient care and the most supportive and innovative working environment for nursing professionals. “Few Magnet hospitals are community hospitals like ours and even fewer are in a rural setting,” says Chris Parker, MSN, RN, Senior Vice President, Patient Care Services, and Chief Nursing Officer for Shore Health System. “Our nurses have embraced a culture of nursing practice that emphasizes collaboration, leadership and research in ways normally only associated with major teaching hospitals. Making this journey to Magnet shows that we are doing this and doing it well.”

why did you choose emergency nursing um, RN ari Cheez

Vernon Usilton, RN

Mary She

pherd, RN

Three nurses who are models of relationship-based care and the Magnet principles were asked to comment on why they choose to practice emergency nursing at Shore Health System. Kari Cheezum, RN, Dorchester General Hospital “I have been an emergency nurse for thirteen years. I chose the emergency room because of its fast pace. Each day has an unknown element about it. When a patient is in need, being able to immediately make a difference in that patient’s life brings such satisfaction. What I really like about Shore Health System is how professional the management is. I appreciate how they provide such great support for me as an employee. At Dorchester General Hospital, the whole emergency department works so well together as a team or, better yet, as a family.” Vernon Usilton, RN, Memorial Hospital at Easton “I have been an emergency nurse since June 1993. I started out as a medical technician in 1988, but I really liked interacting in the emergency room and its pace, so I became a nurse. In the ER, we treat everyone who comes through our doors, so we have to know a little about so many different things. It seems that we never see the same thing twice. Shore Health System is just a great place to work. There are a lot of things I like, but mostly I like my co-workers and how everyone puts forth a great team effort. Mary Shepherd, RN, Queen Anne’s Emergency Center “I have been an emergency nurse since 1998. I was fascinated with the high energy and the fast pace that required so many different aspects of my training, every day. My passion is working closely with my patients and feeling as though I make a difference in their lives. Shore Health System and my co-workers at the Queen Anne’s Emergency Center are my family. Both the doctors and the nurses have built up such trust with one another. When I have off for a few days, I look forward to coming back to work.

next steps in a While emergency medicine doctors make diagnoses for a variety of health conditions, they treat patients only for a few hours. If a stay for observation or a hospital admission is recommended, then patient care transitions to a hospitalist, an inpatient medical specialist. “A call from Emergency Services triggers an immediate consult between the ER doctor and a hospitalist to discuss the patient’s presenting complaints, the initial exam and diagnostic tests that may have been completed,” says Dennis DeShields, MD, a representing partner of Shore Hospitalists Associates, who provide inpatient care at Memorial Hospital. “The hospitalist then determines if the patient should be placed in observation or admitted to the hospital.” Behind The Scenes Simultaneously, professionals across departments are planning and coordinating to ensure a smooth transition to the next step in care for every patient. “From a nursing perspective, patients who are moving from one of the hospital emergency departments or from the Queen Anne’s Emergency Center require the same level of attention whether it is a brief observation period or a direct admission into the hospital,” says Anna Kusinitz, BSN, RN, Admissions Coordinator for Shore Health System. Kusinitz uses an electronic tracker board to monitor potential admissions to Memorial Hospital and Dorchester General Hospital from the hospital EDs or from the Queen Anne’s Emergency Center. She also tracks hospital admissions referred by other physicians. Once the patient’s level of care is determined, Kusinitz is charged with establishing the best possible environment of care. She considers issues such as allergies, privacy, equipment and the need for proximity to the nurses’ station. “Three times a day, unit managers, ED nurses and housekeeping staff meet in ‘bed huddles’ to ensure that we are proactively planning all staffing and space needs so patients have the highest level of care they need,” Kusinitz adds. Under Observation When a patient stays for observation, the time is used to evaluate progress. “Patients are observed to assess the effectiveness of medication, to monitor symptoms and vital signs, or to administer tests and short-term treatments,” says Paul Monte, MD, FACP, MHA, Medical Director for Eagle Hospitalists, a physician group that provides around-the-clock care at Memorial Hospital and Dorchester General Hospital. Often, patients will have symptoms such as dizziness or abdominal pain that are troublesome but may not be clearly defined. “Think of the otherwise healthy young man who presents to the ER with chest pain. It is very important that we look at potential illnesses as this could be a symptom of a heart attack, or it could be indigestion,” adds Dr. DeShields. 15

Paul Monte, MD, FACP, MHA

medical emergency

Terri Ross, LCSW-C, C-ASWCM

Dennis DeShields, MD

Anna Kusinitz, BSN, RN

Observation may be a few hours or last up to 48 hours. Based upon the hospitalist’s orders, this period will determine whether the patient remains in the hospital, transfers to another healthcare facility or is discharged home. If the person is admitted to the hospital, care continues to be managed by a hospitalist, who may consult with specialists and oversees all testing and treatments. Patient records are made available to the patient’s primary care physician and the hospitalists consult with the patient’s physician during the patient’s stay and following discharge. “We’re always in-house and this on-site presence, coupled with working relationships with all departments and medical staff members, translates to efficient and effective quality of care for the patient,” Dr. Monte adds. Guidance along the Way From the emergency department to discharge and every point in between, patients also have the support of case management staff to guide them and their families. The case management staff assesses the patient’s needs, assists in coordinating the plan of care with the patient, family and insurance company, and coordinates the discharge planning process. “When it’s time for the patient’s discharge, a plan is in place to address support and resources for the emotional, physical, medical and economic needs of the patient,” says Terri Ross, LCSW-C, C-ASWCM, Director of Case Management for Shore Health System. This includes services that can range from diabetes education to durable medical equipment, home care assistance or a transition to short-term rehabilitation. “We’re the liaisons between the patient and the interdisciplinary care team to assure each person receives quality care that’s both patient-centered and efficient,” Ross adds. 16

Welcome

new medical staff

Emergency Medicine

Eastern Shore Emergency Medicine Physicians Shore Health System 219 S. Washington Street Easton, MD 21601 410-822-1000

Craig Dates, MD

M. Michelle Diaz, MD

Michael Ganon, DO

Sana Khan, MD

Rhamin Ligon, MD

Eric Maniago, MD

Norbert Straub, MD

Alexander Wielaard, MD

Anesthesiology

Family Medicine Curtis Foy, MD River Family Physicians 555 Cynwood Drive Easton, MD 21601 410-820-7270

Family Medicine Kim Herman, MD, MSN Shore Family Medicine 920 Market Street Denton, MD 21629 410-479-1388

Hospitalists

Douglas Wiseman, MD Tidewater Anesthesia Associates Shore Health System 219 S. Washington Street Easton, MD 21601 410-822-1000

Samantha Kalakurthy, MD Eagle Hospital Physicians 219 S. Washington Street Easton MD 21601 410-822-1000

Edward Kimlin, MD

For more information about these and other members of the Shore Health System medical staff, visit www.shorehealth.org and click on “Find a Doctor.”

Internal Medicine Nadia Niazi, MD Miles River Physicians 508 Idlewild Avenue Easton, MD 21601 410-822-9133

Neurology

Bilal Saulat, MD, MPH Shore Neurology & Sleep Medicine 522 Cynwood Drive, Suite 300 Easton, MD 21601 410-770-5250

Neurosurgery

Orthopedics

Otolaryngology

Pediatrics

Psychiatry

Wound Healing

Khalid Kurtom, MD Chesapeake Neurological Surgery 505 A Dutchman’s Lane Easton MD 21601 410-820-9117

Laurie B. Porter, DO Chesapeake ENT, Sinus & Hearing Center 29466 Pintail Drive, Suite 3 Easton MD 21601 410-820-9119

Saif-Uddin Mohsin, MD Shore Behavioral Health Dorchester General Hospital 300 Byrn Street Cambridge MD 21613 410-228-5511

Corey Gilbert, MD Chesapeake Bay Orthopedics 410 Marvel Court Easton, MD 21601 410-770-9875

Kevin J. Karpowicz, MD Children’s Advocacy Center Memorial Hospital 219 S. Washington Street Easton, MD 21601 410-770-4848

Kelly O’Donnell, MD Wound Healing Center Memorial Hospital 219 S. Washington Street Easton, MD 21601 410-820-6500

Umang Shah, MD Shore Behavioral Health Dorchester General Hospital 300 Byrn Street Cambridge MD 21613 410-228-5511

news notes

ACCOMPLISHMENTS OF SHORE HEALTH SYSTEM STAFF, PHYSICIANS AND VOLUNTEERS

Shore Health System staff and physicians are working with architectural firm HKS to develop a design for a regional medical center planned to be built on a 257-acre parcel near the Talbot Community Center in Easton. Work continues with the Town of Easton, Talbot County and state officials to plan for roadways and utilities that will be needed for the site. A letter of intent to file a Certificate of Need application has been submitted to the Maryland Department of Health and Mental Hygiene. Groundbreaking and construction is anticipated to begin in 2012 with grand opening of the regional medical center planned for 2015. Construction is underway on a medical office building adjacent to the Queen Anne’s Emergency Center near Grasonville. The facility will provide convenient access to primary care physicians and a variety of specialties, including urology, gynecology, general surgery, neurology and psychiatry. Also onsite will be a diagnostic center for MRI, digital mammography and other imaging services and an outpatient rehabilitation center for physical, occupational and speech therapy. Shore Family Medicine will be relocating to new offices in the Fifth Avenue shopping center on Rt. 404 in Denton this spring. The suite of offices will also include a diagnostic testing center. The opening of this new facility is part of Shore Health System’s strategic plan to continue developing a network of outpatient service centers that are conveniently located within the communities where people on the Mid-Shore live and work. The Joslin Diabetes Center located at Memorial Hospital is now known as the University of Maryland Center for Diabetes and Endocrinology at Shore Health System. Under the medical direction of endocrinologist Kenneth Ligaray, MD, the Center for Diabetes and Endocrinology offers a program of medical management and education for individuals diagnosed with diabetes. The clinic is also a resource for people who require medical care for thyroid conditions, osteoporosis and other endocrinology conditions. 19

Myron Szczukowski, Jr., MD, was chosen as the winner of the 2010 Shore Health System Arthur B. Cecil, Jr., MD Award for Excellence in Healthcare Improvement. An orthopedic surgeon and medical director of the Joint Replacement Center at Memorial Hospital, Dr. Szczukowski was chosen for implementing procedures that benefits people who come to the Joint Replacement Center for hip and knee replacements. Shore Health System was designated a Gold Start! Fit-Friendly Company by the American Heart Association. This award recognizes Shore Health System for promoting wellness for employees by implementing physical, nutritional and cultural changes. Through the 27th annual Tree of Lights holiday fundraising campaign, the Memorial Hospital Auxiliary met its goal to raise $7,000 for equipment for the Requard Radiation Oncology Center at Shore Regional Cancer Center. Members of the community made donations that were used to purchase a C-Qual™ Breastboard that makes patients more comfortable during radiation therapy. The Dorchester General Hospital Auxiliary inducted officers for a one-year term. Serving with President Vera Block are Ida Jane Baker, First Vice President; Joy Carpenter, Second Vice President; Alexandria Snell, Recording Secretary; Yoshi Smith, Corresponding Secretary; Janet Lawrence, Membership Dues; Nancy Gale, Financial Dues; and members at large Doris Brohawn, Carole Kramer and Suzanne Press. Friends of the Memorial Hospital Foundation stepped out for an evening of fun that raised over $75,000 for renovations that will enhance patient comfort at Shore Regional Cancer Center. The “Step Up for the Hospital” fundraiser began with a reception at Scossa Restaurant & Lounge. The main event was a performance by political satirists the Capitol Steps at the Avalon Theater.

happenings SCREENINGS

Blood Pressure Monday through Thursday, except holidays, 9:00 am to noon, Diagnostic and Imaging Center, 10 Martin Court, Easton. FREE. No appointment needed. Sponsored by the Memorial Hospital Auxiliary. Tuesday and Friday, 11:00 am to 1:00 pm, Dorchester General Hospital, main lobby, 300 Byrn Street, Cambridge. FREE. No appointment needed. Sponsored by the Dorchester General Hospital Auxiliary. Breast Cancer Shore Regional Breast Center, Memorial Hospital, 219 S. Washington Street, Easton. Day and evening appointments available. Open to uninsured or underinsured women, aged 20-39 and over 64, who meet income guidelines and medicare patients of any age. Call 410-820-9400 to schedule an appointment.

CHILDBIRTH CLASSES

Nick Rajacich Health Education Center, Memorial Hospital, 219 S. Washington Street, Easton. FREE. Pre-register by calling 410-822-1000 or 410-228-5511, ext. 5200. Labor & Delivery An overview of pregnancy and birth. Spouses and birthing coaches are encouraged to attend. Saturday, 8:30 am to 4:30 pm, April 2, May 7 or June 4 New Mom, New Baby & Infant Safety To be taken after the Labor & Delivery class. Learn about post partum care, pain management, nutrition, feeding, circumcision, cord care, how to take temperatures and more. Saturday, 9:00 am to 12:30 pm, March 19 or May 21 The Benefits of Breastfeeding Saturday, 9:00 am to 12:15 pm, April 16 or June 18 Big Brother & Big Sister For children anticipating the arrival of a new baby in the family. Saturday, 9:30 am to 11:00 am, March 12 or May 14 Infant CPR Monday, 6:30 pm to 8:30 pm, March 21, April 18, May 23 or June 20

SUPPORT GROUPS

Cancer Support Groups Shore Regional Cancer Center, 509 Idlewild Avenue, Easton. Day and evening group meetings. FREE. Call 1-410-546-1200 to pre-register.

Prostate Cancer Support Group Second Tuesday of the month, 6:30 pm, Shore Regional Cancer Center, 509 Idlewild Avenue, Easton. Open to men diagnosed with prostate cancer and family members. FREE. Call Sharon Richter, 410-820-6800, ext. 108. April 12, May 10, June 14 Insulin Pump Support Group Third Wednesday of the month, 6:30 pm, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital, 219 S. Washington Street, Easton. FREE. Call 410-822-1000 or 410-228-5511, ext. 5757. March 16, April 20, May 18 (No meetings in June or July) Diabetes Support Group Third Wednesday of the month, 7:00 pm, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital, 219 S. Washington Street, Easton. Call 410-822-1000 or 410-228-5511, ext. 5757. March 16, April 20, May 18 (No meetings in June or July) Gestational Diabetes Support Group Fourth Monday of the month, 5:00 pm to 6:00 pm, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital 219 S. Washington Street, Easton. FREE. Call 410-822-1000 or 410-228-5511, ext. 5757. March 28, April 25, May 23 (No meetings in June or July) Stroke Survivor Support Group First Thursday of the month, 1:00 pm, Talbot Senior Center, 400 Brookletts Avenue, Easton. FREE. Call 410- 822-1000 or 410-228-5511, ext. 5068. April 7, May 5, June 2 Pregnancy and Infant Loss First Monday of the month, 7:00 pm, Talbot Hospice House, 586 Cynwood Drive, Easton. FREE. Call Tina Basel, 410-463-9964. March 7, April 4, May 2, June 6 Better Breathers Support Group Tuesday, March 15, 12:00 pm to 1:00 pm, Board Room, Memorial Hospital, 219 S. Washington Street, Easton. FREE. Speaker: Greg Oliver, MD, chronic obstructive pulmonary disease. To register, call 410- 822-1000, ext. 5208 or 410-228-5111, ext. 8201.

CLASSES

Diabetes Education The University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital, 219 S. Washington Street, Easton. People with diabetes participate in a fun and informative educational series to learn more about their disease. For dates, times and cost, call 410-822-1000 or 410-228-5511, ext. 5757.

health and wellness classes for spring 2011

Easy-to-Learn Carb Counting Wednesday, April 6, 10:00 am 11:00 am, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital, 219 S. Washington Street, Easton. FREE. Call 410-822-1000 or 410-228-5511, ext. 5757. It’s Never Too Late To Prevent Diabetes Second Wednesday of the month, 10:00 am to 11:00 am, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital, 219 S. Washington Street, Easton. FREE. Call 410-822-1000 or 410-228-5511, ext. 5757. April 13, May 11, June 8, July 13 Understanding Food Labels Wednesday, May 4, 10:00 am to 11:00 am, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital. 219 S. Washington Street, Easton. FREE. Call 410-822-1000 or 410-228-5511, ext. 5757. Local, Home-grown, Organic and Natural Foods: What’s the difference? Wednesday, June 1, 10:00 am to 11:00 am, University of Maryland Center for Diabetes and Endocrinology, Memorial Hospital, 219 S. Washington Street, Easton. FREE. Call 410822-1000 or 410-228-5511, ext. 5757. Welcome Cancer Patients Second Thursday of the month, 6:00 pm to 7:00 pm, Shore Regional Cancer Center, 509 Idlewild Avenue, Easton Learn about free educational programs, support groups and other resources to assist during cancer treatment and into recovery. FREE. To register, call Pam Black, 410-820-6800, ext. 2257. March 10, April 14, May 12, June 9 Look Good…Feel Better Third Monday of the month, 10:00 am to noon, Shore Regional Cancer Center, 509 Idlewild Avenue, Easton. Helps women look their best as they are undergoing cancer treatment. FREE. To register, call 410-820-6800, ext. 5355. March 21, April 18, May 16, June 20

Resolving Phobias with Eye Movement Desensitization and Reprocessing Thursday, April 7, 6:00 pm, Center for Integrative Medicine, 607-B Dutchman’s Lane, Easton. FREE. Call 410-770-9400. Traditional Reiki II: Find Wellness within You Saturday April 16, 9:00 am to 6:00 pm and Sunday, April 17, 1:00 pm to 5:00 pm, Center for Integrative Medicine, 607-B Dutchman’s Lane, Easton. Cost: $225. Call 410-770-9400.

EVENTS

Book Sale Monday, March 14, 10:00 am to 4:00 pm and Tuesday, March 15, 7:00 am to 2:00 pm, Dorchester General Hospital, main lobby, 300 Byrn Street, Cambridge. Sponsored by the DGH Auxiliary to benefit services and programs of the hospital. Robin Hood Shop Birthday Celebration Tuesday, March 15, 9:00 am to 4:00 pm, 416 High Street, Cambridge. Featuring new spring merchandise. Sponsored by the DGH Auxiliary to benefit services and programs of the hospital. Jewelry Sale Monday, April 4, 9:00 am to 4:00 pm, Dorchester General Hospital, main lobby, 300 Byrn Street, Cambridge. Sponsored by the DGH Auxiliary to benefit programs and services of the hospital. Jewelry Sale Wednesday, April 13, 7:00 am to 4:00 pm, Memorial Hospital, Nick Rajacich Health Education Center, 219 S. Washington Street, Easton. Sponsored by the Memorial Hospital Auxiliary to benefit programs and services of the hospital. Everything is $6 Sale Wednesday, April 27 and Thursday, April 28, 7:00 am to 4:00 pm, Dorchester General Hospital, 300 Byrn Street, Easton. Featuring tote bags and fashion accessories. Sponsored by the DGH Auxiliary to benefit programs and services of the hospital.

Master Positive Thinking, Visualization and Affirmation Saturday, March 12, 19 and 26, 10:00 am to 11:30 am, Center for Integrative Medicine, 607-B Dutchman’s Lane, Easton. Cost: $65. Call 410-770-9400.

Linen Sale Wednesday, May 11, 7:00 am to 4:00 pm, Dorchester General Hospital, main lobby, 300 Byrn Street, Cambridge. Sponsored by the DGH Auxiliary to benefit programs and services of the hospital.

Finding Joy in Difficult Times Tuesday, March 22, April 26, June 28, (no May class), 6:30 pm to 8:30 pm, Center for Integrative Medicine, 607-B Dutchman’s Lane, Easton. Cost: $15 per session. Call 410-770-9400.

Bag Sale Wednesday, June 22, 7:00 am to 4:00 pm, Memorial Hospital, Nick Rajacich Health Education Center, Easton. Featuring name brand hand bags, totes, wallets and luggage up to 70% off retail prices. Sponsored by the Memorial Hospital Auxiliary to benefit programs and services of the hospital.

The Power of Presence: Why We Meditate Tuesday, April 5, 12 and 19, 6:30 pm to 8:30 pm, Center for Integrative Medicine, 607-B Dutchman’s Lane, Easton. Cost: $65. Call 410-770-9400.

Support the Queen Anneâ&#x20AC;&#x2122;s Emergency Center by buying a brick or bench that will be a visible reminder of your commitment to community health care. Support emergency medical care in Queen Anneâ&#x20AC;&#x2122;s County while honoring individuals, families or organizations. For a donation of $125, a donor can purchase a standard size brick; the price for a larger brick is $300. The bricks will be inscribed with the name of the honoree. Donors who choose to make a more substantial gift can purchase a granite bench for $5,000. The bench will be engraved with a personalized message. To purchase a brick or a bench, send donations to the Memorial Hospital Foundation, MHF-QAEC, 219 S. Washington Street, Easton, MD 21601. Make checks payable to : MHF-QAEC Brick Garden. For more information, call 410-822-1000, ext. 5915. Also visit www.qaemergencycenter.org.

NON-PROFIT ORG. U.S. POSTAGE PAID PPCO

219 S. Washington Street Easton, Maryland 21601

TO OUR FRIENDS AND NEIGHBORS AT POSTAL CUSTOMER