SPECIAL REPORT 2018
www.BizTucson.com
THE REGION’S BUSINESS MAGAZINE
Fall 2018
>>>
BizTucson 123
BizHEALTHCARE
The New
Carondelet Redefining the Healthcare Network
PHOTOS: COURTESY CARONDELET HEALTH NETWORK
By Mary Minor Davis In its 135-year history in Southern Arizona, Carondelet Health Network has built a legacy of providing compassionate care at its three hospitals serving Tucson and Southern Arizona. While the network has undergone significant changes over the years, it has thrived and continued to evolve with a dedication to innovation and cuttingedge treatments for patients who put their trust and faith in the hands of Carondelet caregivers. “It’s a very bright future for the Carondelet Health Network,” said Mark Benz, CEO for the network which encompasses St. Mary’s and St. Joseph’s hospitals in Tucson and Holy Cross Hospital in Nogales. “We are placing emphasis on evidence-based best practices as well as a discipline of laser focus on patient safety and quality, developing resources to build a very 124 BizTucson
<<<
Fall 2018
comprehensive network of care.” Through all the innovation and the changing healthcare environment, Carondelet has maintained its Catholic identity through an ongoing relationship with the Diocese of Tucson, making it the only sanctioned Catholic healthcare system in the region. Carondelet Health Network’s culture is reflected in a passion for healing and innovation. A recent rebranding introduced a new logo signified by compassionate hands upholding personalized service and healthcare excellence. A flame reflects the passion for combining leading technology with advanced healing to serve the community and the people within it. Carondelet now operates under a joint venture formed in 2015 between Tenet Healthcare, Dignity Health and Ascension, with Tenet serving as the ADVERTORIAL
operator. Support and investment from Tenet have resulted in a transformation of the way Carondelet provides quality healthcare across its three hospitals, the Carondelet Medical Group, three ambulatory surgery centers and its new microhospital in Marana. Over the past few years, Carondelet has invested in infrastructure, staffing, technology and education for both staff and the community. The hospitals are attracting well-known, respected physicians in many specialties and talented nurses and other clinical staff. “Physicians are taking notice and inquiring about opportunities to practice at Carondelet hospitals and bringing enhanced capabilities for the benefit of our Southern Arizona residents,” Benz said. Carondelet’s investment also means it is bringing a new type of facility to www.BizTucson.com
the booming Marana area. In 2019, Carondelet will open a microhospital at Interstate 10 and Cortaro Farms Road in Marana. “Medical care continues to evolve with a consumer focus and this is a new model for bringing healthcare services into the community,” said Benz. When the new Carondelet Marana microhospital opens, it will include a 14-bed emergency department, two operating rooms and eight inpatient rooms, along with additional services. “The Marana facility will offer a patient-friendly design with emergency and acute care services in an efficient, convenient location,” Benz said. “It’s designed to provide close integration with our other facilities for patients who may require more complex care. “Our goal is providing an integrated www.BizTucson.com
system of care closer to home for those who choose Carondelet Health Network for their care. We want to be able to provide the right care, at the right time, at the right place.” Even under the Affordable Care Act consumers were subjected to increased pressure through higher deductibles and copays making the philosophy of right care, at the right time, at the right place more important than ever. “This is why evidence-based care, providing value for our patients, and educating our community on preventive care is so important to us as caregivers today,” said Benz. “We want to help individuals proactively manage their health, while providing the highest-quality care and service that patients expect when they use Carondelet services.”
By the Numbers 450,000 patients served annually More than 3,400 employees, 900 medical staff and 250 volunteers More than $5.2 million invested back into the community 70 community events sponsored 10,000 people reached through free education, support groups, health fairs and screenings Source: Carondelet Healthcare Network Branding Guide, 2017
continued on page 126 >>>
Fall 2018
>>>
BizTucson 125
New Carondelet Brand Represents Leadership in Healthcare
The vision of the Carondelet Health Network is a culture united in a passion for healing and innovation. These two passions provide the framework for our new logo. The hands signify our compassion and dedication to personalized service and healthcare excellence. The flame signifies our passion for combining cutting-edge technology with advanced healing to serve our community and the people within it. This new logo is not just a mark – it is a representation of our leadership in all aspects of healthcare. Carondelet Health Network Identity The Carondelet Health Network has evolved in recent years into one of Southern Arizona’s largest, most integrated Catholic healthcare systems, offering access to many specialized services at multiple locations. Our new brand is designed to better represent this modern, technologically advanced healthcare system that we have grown into, while still celebrating our 135-year tradition of providing compassionate, personalized care. Our name will remain the same to honor our history dating back to the Sisters of Carondelet of St. Joseph’s, but our mark reinforces our position as a leading provider in healthcare in Southern Arizona. Our message to strengthen the Carondelet Health Network name and our conversation will evolve to communicate who we are today. This new identity is based on research conducted both internally as well as in the community. The new image underpins our message to the community that the Carondelet Health Network is a modern, advanced system of care – committed to our patients. This is more than a cosmetic rebrand of logos and signage. It reflects a fundamental repositioning and strategic approach to how the community will see and understand our brand. It is also part of an overarching strategy to bring our strong, expansive network together.
“
We are placing emphasis on evidence-based best practices as well as a discipline of laser focus on patient safety and quality, developing resources to build a very comprehensive network of care. – Mark Benz, CEO Carondelet Health Network
”
continued from page 125
Carondelet serves more than 450,000 patients each year. Health education and screenings – important community benefits consistent with Carondelet’s mission – are regularly offered across the network. Hundreds of educational events, screenings and presentations have been held over the years that provided thousands of community members the opportunity to be proactive in taking charge of their health. “Regular physician visits, education and having a community that actively engages with preventative care is absolutely necessary so that people don’t get sick from things that can be prevented,” Benz said. Carondelet is also building interest in healthcare professions by engaging students as they are coming to an age where they are looking at career options. Carondelet works with several high schools, including University High School and San Miguel High School, both in Tucson, providing internships where students can learn about all of the potential careers in healthcare. Holy Cross works with schools in Nogales and Rio Rico, as well as Cochise College, which educates nearly 70 percent of Holy Cross’s nursing staff in its program. With the strengthened resources now available to the Carondelet network, there has been expansion in the existing hospital programs and specialized services as well as the addition of greater technology, more treatment centers and expansion of services within departments. “We are fortunate that we’ve been able to take advantage of resources that were not previously available for the hospitals and network to make these investments that are so important to our success and the health of our patients,” said Benz.
Source: Carondelet Healthcare Network Branding Guide, 2017
126 BizTucson
<<<
Fall 2018
www.BizTucson.com
BizHEALTHCARE These are just some of the recent investments and advancements made at Carondelet: St. Joseph’s Hospital
• • • • • •
Expansion and continued development of the Carondelet Neurological Institute Upgraded cardiac catheterization labs Added electrophysiology lab and services Advanced technology and resources for critical care and emergency room services New Level II trauma program to open in 2019 Women & Infants program expansion including midwifery and natural birthing
St. Mary’s Hospital
• • • • •
Expansion of the Carondelet Heart and Vascular Institute Addition of an accredited Surgical Weight Loss Center Women’s Services expansion of gynecological and gynecological oncology services Breast Center advancement with 3D mammogram technology and the first in Southern Arizona to earn accreditation from National Accreditation Program for Breast Centers Expansion of surgical robotics program for total and partial knee replacement
Carondelet St. Joseph’s Hospital
Holy Cross Hospital
•
Carondelet St. Mary’s Hospital
For Holy Cross, the future holds great promise for patients in the southeast corner of the state. “The infrastructure investments Carondelet is making means greater integration into the network and greater access to quality care for residents of Nogales and throughout Southern Arizona,” said hospital CEO Debra Knapheide. Benz also envisions great opportunity in the coming years. “I see us increasingly integrated across the network, working together to make sure we have complete services for our community,” he said. “I see us continuing to implement improved technology to provide the best inpatient services and care.” Carondelet’s commitment to quality and service were recognized as St. Joseph’s Hospital and St. Mary’s Hospitals were the only hospitals in greater Tucson to receive an “A grade” for quality and patient safety in the Leapfrog Group’s Spring 2018 hospital safety report card. “I’m extremely proud of the hard work our associates do every day to meet these high standards,” said Benz. “Our new tagline, ‘Our Specialty is You,’ is important more now than ever.”
Biz www.BizTucson.com
PHOTO: BRENT G. MATHIS
PHOTOS: COURTESY CARONDELET HEALTH NETWORK
• •
Recognized for its Excellence in Collaborative Emergency Services by the Federal Office of Rural Health Policy Implementation of the only inpatient rehabilitation program in Santa Cruz County Recognized for providing advanced breast imaging technology and expanding services for women across Santa Cruz County
Carondelet Holy Cross Hospital Fall 2018 > > > BizTucson
127
“
For me, healthcare is not a job, it’s not a career – it’s a calling. We’re privileged to make a difference in the lives of others.
”
Mark Benz, CEO Carondelet Health Network
PHOTO: TOM SPITZ
–
128 BizTucson
<<<
Fall 2018
BizHEALTHCARE
Benz Returns to Roots ‘It’s a Calling’ for Carondelet CEO By Mary Minor Davis Mark Benz knows the halls of St. Mary’s Hospital very well. When he was a young boy, the Phoenix native would board a Greyhound bus to Tucson with his grandmother to visit his great-aunt, Sister Theresa Joseph, who served her ministry at St. Mary’s Hospital from 1903 until she passed away in 1968. The convent on the hospital campus was “very hot,” Benz said, recalling days when he would run through the halls of the hospital. Today, he walks the halls as CEO of Carondelet Health Network which operates St. Mary’s and St. Joseph’s hospitals in Tucson and Holy Cross Hospital in Nogales. Raised by a single mom with four children – Benz was just eight years old when his father died of lung cancer – Benz said he learned that hard work was the key to success, developing an “attitude of gratitude.” It paid off for him early on when, after graduating from high school, he was named crisis center director of Terros Health, a behavioral health and chemical treatment center founded in 1969 by young people who saw there was a need for substance abuse treatment. Today, Terros has grown to more than 1,100 providers serving the Phoenix, Tucson, Flagstaff and Kingman areas, according to the organization’s website. Terros helped Benz work his way through college, earning both a bachelor’s and a master’s degree in social work. “Organizational development and healthcare were my real interests then,” he said. “I worked my way in through behavioral healthcare at a time when mental illness was becoming less stigmatized.” After a stint as a unit director of the Maricopa Medical Center’s psychiatric annex, Benz landed his first job as a www.BizTucson.com
CEO for the Charter Medical Group. He was 30 years old. Positions and companies took him to Philadelphia, Atlanta and St. Louis. He joined Tenet Healthcare Corporation in Hickory, North Carolina, and returned to Arizona in 2015 when Tenet was acquiring majority ownership of Carondelet. Benz was named CEO of St. Joseph’s, and then in February was named CEO of the network. “For me, healthcare is not a job, it’s not a career – it’s a calling,” Benz said. “We’re privileged to make a difference in the lives of others.” In the last three years, Benz said, Carondelet has quickly stopped the hemorrhaging of a financially challenged organization. Buoyed by the investment from Tenet, Carondelet is reinvesting in staff and infrastructure and is now positioning itself to provide healthcare for the future. “Our priority is to provide the highest level of patient safety, quality care and experience,” Benz said. “We’ve made marked improvements in quality metrics, and we continue to benchmark against health systems nationally.” Benz said Carondelet is focusing on investments in high-acuity procedures in areas such as neurological, orthopedic, cardiovascular and women’s and infants’ services. The health system also is expanding its footprint throughout the community with ambulatory surgical centers, medical and specialty practices, urgent care centers and microhospitals to ensure they are meeting the evolving needs of the community. “We know in five years, more and more procedures are going to be performed at ambulatory or outpatient centers,” he said. Carondelet is dedicated to what Benz calls “patient-centric care,” he said.
“It’s a very prescriptive practice.” Examples of how nurses care for patients in the hospital include rounding on patients every hour, answering patient call bells in a timely fashion, including patients in shift changes so they can ask questions, and communicating daily care and activities on a board in the patients’ room to ensure that they are able to be involved in their care and treatment options. Senior leadership also rounds on patients to ensure they are receiving the best care possible. “Carondelet has reinvested its earnings back into competitive wages for bedside staff, capital improvements and expanding services,” said Dr. Joseph Chambers, chief of staff and chair of the Medical Executive Committee at St. Joseph’s Hospital. “From the physician perspective, it has realigned the focus on providing the best healthcare to our patients and community.” Patients also want more accessible and convenient care closer to home. Carondelet expanded its physician network with 125 medical providers located at 14 locations. Recently, the health system broke ground for a neighborhood hospital in Marana. Dr. James Metcalfe Gillard, chief of staff at St. Mary’s, said he’s been pleased with the way Tenet works hard to keep with the spirit of Catholic community hospitals while opening new sites to provide more care to the community. “St. Mary’s has deep roots in the community,” he said. “We’ve got such a rich history here, and we’re very excited about the future, about providing healthcare services throughout the community,” Benz said. “I’ve got the best job in the world.”
Biz Fall 2018
>>>
BizTucson 129
Carondelet Investment in Standards & Quality Care
Construction Underway on Carondelet Marana Microhospital
IMAGE: COURTESY CARONDELET HEALTH NETWORK
ER, Operating Rooms and Inpatient Services Construction is underway on a new Carondelet Health Network microhospital in Marana. A groundbreaking ceremony was held in July for the facility, which is expected to open in Spring 2019. The microhospital will focus on providing emergency care and less complex inpatient procedures as part of Carondelet’s continuum of care. Nearly 100 community members, first responders, business leaders and hospital staff attended the groundbreaking. Speakers included Carondelet CEO Mark Benz, Marana Vice Mayor Jon Post and Monsignor Jeremiah McCarthy. Carondelet’s Marana microhospital is expected to offer quality jobs in STEM fields with approximately 50 full-time equivalent clinical and support staff positions. Located at Interstate 10 and Cortaro Farms Road, the 32,500-square-foot microhospital will include a 14-bed emergency room, two operating rooms and eight inpatient rooms. The facility will also include a laboratory and diagnostic imaging services such as X-ray, computed tomography (CT) and ultrasound. The healthcare industry is ever-changing, and Carondelet Health Network continuously evaluates new ways to meet the needs of its patients, said CEO Mark Benz. “We recognize that the community is looking for healthcare that is convenient, accessible and provides high-quality, patient-centered care. The Marana microhospital embodies this mission and we are so proud to be able to break ground in Marana,” he said. “The Marana facility will offer a patient-friendly design with emergency and acute care services in an efficient, convenient location,” Benz said. “It’s designed to provide close integration with our other facilities for patients who may require more complex care. “Our goal is providing an integrated system of care closer to home for those who choose Carondelet Health Network for their care. We want to be able to provide the right care, at the right time, at the right place.” Source: Carondelet Health Network 130 BizTucson
<<<
Fall 2018
Carondelet’s investment in the network has led to leading certifications, establishing these services as exceeding industry standards.
St. Joseph’s Hospital
Recognized by U.S. News & World Report as Best Regional Hospital, 2017 Cardiovascular Accredited by the Society for Cardiovascular Care as Chest Pain Center Neurosciences Certified through The Joint Commission as a Primary Stroke Center and Inpatient Stroke Rehabilitation Center Received the highest stroke performance achievement awards from the American Heart/American Stroke Association’s Get with the Guidelines® Orthopedics First in the nation to receive Joint Commission certification for all four joint replacement procedures – knee, hip, ankle and shoulder
St. Mary’s Hospital
Cardiovascular Accredited by the Society for Cardiovascular Care as Chest Pain Center Bariatrics Accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) of the American College of Surgeons and American Society of Metabolic and Bariatric Surgery Breast Imaging and Surgery First breast center in Southern Arizona to earn accreditation from National Accreditation Program for Breast Centers (NAPBC) Neurosciences Certified through Joint Commission as a Primary Stroke Center and Stroke Rehabilitation Center Orthopedics Performed one of the first robotic-assisted Total Knee Replacements in Tucson
Biz www.BizTucson.com
BizHEALTHCARE
Expanding Healthcare Excellence Institutes Excel in Technology, Impact More Lives By Mary Minor Davis and Jay Gonzales
It’s a point of emphasis in the Carondelet Health Network that its Tucson hospitals are no longer known as just the Catholic hospitals. They are bringing advanced technology and innovative treatments to patients and are leading the way with healthcare excellence. “We’re just so much more than the hospital we were,” said Mark Benz, CEO of the network that includes St. Mary’s Hospital and St. Joseph’s Hospital in Tucson and Holy Cross Hospital in Nogales. Over the years, Carondelet has seen ever-changing healthcare trends, changes in ownership and financial challenges that threatened the survival of the hospitals. Through all of this, the network has risen above the fray and reinvented itself. Today, under the majority ownership and direction of Tenet Healthcare, Carondelet is positioning itself to take the lead in advancing some of the best practices in medicine. The Centers for Excellence at St. Joseph’s and St. Mary’s hospitals are setting new standards in heart, ortho, vascular and neurological treatment. These award-winning programs provide advanced programs with the latest technologies that allow more patients to www.BizTucson.com
receive excellent care right in their own community. Patients who go to one hospital for treatment can be assured the entire network is ready to get them on the road
“
You can see the life-changing effects unfold right before your eyes, and that takes a team effort to achieve.
”
– Dr. Eric Sipos Medical Director Neurological Institute St. Joseph’s Hospital
back to better health. Walking in the door at St. Mary’s means the advanced technology at St. Joseph’s can be part of the treatment if that’s where the best technology resides. Heart & Vascular Institute, St. Mary’s Hospital
When it comes to fixing a heart problem, Carondelet Health Network has
built a team at its Heart & Vascular Institute at St. Mary’s Hospital that covers the bases. “Medicine is a team sport,” said Dr. Craig Hoover, an interventional cardiologist on the Carondelet medical staff. “In the last couple of years, we have put a lot of effort into our team approach because it’s not just me, it’s not just the machine. “It’s the fact that the nurses do the explanation. They recognize if there are problems after a procedure. After you have heart surgery, the surgeon is not always going to be in the room. But we have intensive-care specialists making rounds in the ICU, and trained nurses, so people move through the system appropriately and don’t just stagnate. If there are any concerns, they get flagged early while they’re little problems.” Along with that, the institute continues to invest in the latest technology – in staff, training and equipment – to benefit the hospital’s patients. “The Carondelet system has always had this sense of outreach and community service. That didn’t go away,” Hoover said. “The history and the local input is really community-focused in continued on page 132 >>> Fall 2018
>>>
BizTucson 131
continued from page 131 Tucson.” What has evolved is how local patients can get some of the best heart and vascular care in Tucson. Carondelet owned the former Tucson Heart Hospital on Stone Avenue and River Road and moved it to the St. Mary’s campus in 2012. The move formed the foundation for what is now the Carondelet Heart & Vascular Institute and its use of stateof-the-art technology and approach to care. Equipment and facilities were upgraded and investment from Tenet Healthcare continues. For example, the institute built what Hoover called a “hybrid” operating room where surgical teams and interventional cardiology teams work sideby-side on a patient who might need both types of care. “One of the themes in modern cardiovascular medicine is this hybridization, if you will,” Hoover said. “It’s not either surgery or interventional cardiology. Sometimes it’s a little of both and you need a space to do that.” Dr. Monty Morales, a cardiologist, has been practicing at St. Mary’s for 25 years and is chief of the Department of Cardiology. He said his goal is to implement a full structural cardiology program, where traditional surgeries that once required opening the chest cavity can now be done through minimally invasive or alternative practices. Morales said there are three components to implementing a structural cardiac program: “You’ve got to have the doctors – we do; you’ve got to have the hospital’s support – we do; and you’ve got to have the procedures – which we have.” Dr. Talal Moukabary, a specialized cardiologist called an electrophysiologist, an expert in rhythm abnormalities in the heart, treats patients with the most innovative tools. “He’s the guy who will take care of these complex rhythm abnormalities,” Hoover said. “There are not a lot of them in town. Atrial fibrillation is a common problem that is sometimes difficult to control with medications. He can go in and modify areas of the heart so the atrial fibrillation goes away.” continued on page 134 >>>
132 BizTucson
<<<
Fall 2018
www.BizTucson.com
PHOTOS: COURTESY CARONDELET HEALTH NETWORK
BizHEALTHCARE
Joint Technology in High Demand
Carondelet Advances Robotics for Replacements By Mary Minor Davis If you need an aching joint replaced Carondelet Health Network will put advanced technology to work. St. Mary’s and St. Joseph’s hospitals have invested in robotics for more precise and longer-lasting partial or total replacements so patients can reduce or eliminate the joint pain preventing them from leading more active lives. The American Joint Replacement Registry recently released its most comprehensive report on joint replacements, examining procedures and other data from 2012 to 2016. With 4,755 surgeons from more than 650 institutions reporting, the data showed total hip and knee replacements rose from 45,500 in 2012 to an astounding 860,000 in 2016. Estimates are that joint replacements will quadruple by 2030. This is no surprise to the physicians at Carondelet Joint Replacement Center at St. Joseph’s Hospital and The Orthopedic Center at St. Mary’s Hospital. Both hospitals have been committed to enhancing lines of service and bringing in the latest technology to address increasing demand in the community. “Certainly, the aging population is a factor,” said Dr. George Bradbury, medical director of the Carondelet Joint Replacement Center. “Other health factors can be obesity or injuries and physical work demands that can cause arthritis.” St. Joseph’s was the first hospital in the nation to receive Gold Seal accreditation by The Joint Commission for all four joint programs – knee, hip, ankle and shoulder. The Joint Commission is an independent, not-for-profit organization that accredits and certifies healthcare organizations and programs in the United States. St. Joseph’s has been recertified each year since then and, in 2017, U.S. News & World Report recognized the center as highly performing in knee and hip rewww.BizTucson.com
placement. Bradbury credited Carondelet’s efforts to operate its joint programs through the centers-of-excellence model – with consistent approaches in patient care – for that success. “Institutions that work with a coordinated approach tend to have better patient outcomes,” he said. “We recognize that each patient is unique, but if we are consistent in how we approach patients, we know we can provide quality care.” St. Mary’s is one of the first hospitals in Tucson to offer robotic technology for total joint replacement. “Total joint replacement technology has really made a lot of progress in the last five years,” said Dr. Bradley Norris, an orthopedic surgeon affiliated with St. Mary’s Orthopedic Center. “We’ve gone from partial to total replacement in just the last two to three years. It’s been a pretty exciting transition.” Norris said the patient outcomes with robotics-assisted joint replacement include more precise placement that can ultimately lead to longer life for the new joint. “The research is still out, but the average life of traditional joint replacement is 25 to 30 years. We’re pushing that to 30 years,” Norris said. He said keeping up with technology is one of the ways that Carondelet has remained competitive and on the cutting edge of innovative patient care. “It’s important that when we can, we need to push the envelope in technology, in service to our patients,” he said. Bradbury agreed and said that it also is important to ensure that Carondelet provides service in a way that is meaningful and appropriate for patients. “The biggest advances in joint replacement have been in the delivery of the technology,” he said.
Biz
Fall 2018
>>>
BizTucson 133
BizHEALTHCARE continued from page 132 “We are one of the places in town that’s really comprehensive with inpatient to outpatient services,” Hoover said. “Whether hospital-based or outpatient, the objective is long-term attention to care. For people with chronic heart failure, I think we do a good job at managing those things.” Morales agreed. “Medicine is always changing, especially in cardiology since heart disease is the No. 1 cause of death in this country,” he said. “There are a lot of great cardiologists here. One of the things we want to make sure at St. Mary’s is that we’re doing everything with a patient-centered focus and that we’re doing it well.” The Neurological Institute, St. Joseph’s Hospital
There is much ado about some of the latest developments in spine, stroke and neurology care that are leading to better patient outcomes and saving more lives. Dr. Eric Sipos, chief of neurosciences at St. Joseph’s Hospital and medical director of the Carondelet Neurological
134 BizTucson
<<<
Fall 2018
Institute, eagerly outlined how the institute is able to respond to these changes thanks to the use of advanced technology and new research on stroke response. “We’ve been developing our spine services to meet the community’s needs since our inception,” he said. “Our patients demand a comprehensive spine program that includes inpatient and outpatient treatments that include both surgical as well as minimally invasive procedures.” Sipos noted the military, seniors and the continuing aging population as well as younger people with spinal injuries are the drivers of an advanced spinal program. Under the new Tenet ownership, Sipos said, St. Joseph’s and the institute have been able to invest in advanced technology and specialty care. Recently they added a surgeon who specializes in adult deformity of the spine and expanded both their in-house and outpatient rehabilitation services. Newer technology allows specialists to perform more procedures, which in turn allows them to help more people. Another boost is in the neuro-oncology area where advanced technology has simplified the institute’s ability to treat
cancers and benign tumors that are metastases from other cancers, including outpatient stereotactic radiosurgery. “For example, let’s say a patient has multiple metastases in several lobes of the brain,” Sipos explained. “We can use a laser-guided focus with a threedimensional target to hit the tumor without affecting other areas around it at treatment levels that could not otherwise be tolerated.” Another major breakthrough has been in how they’ve traditionally held the patient’s head still for treatment. Where once they had to literally use pins to hold the head to a frame, Sipos said they now can use a face mask without ever breaking skin. “This allows us to treat a lot more people safely and with the same accuracy,” he said. “That’s been huge for brain tumor patients.” Another important focus area for the institute has been in stroke and vascular care. Sipos said landmark research that has extended the window of time between when a stroke occurs and the response time for “measurable levels of improvement.” “It used to be that the window of
www.BizTucson.com
Critical Access at the Border
time when treatment would work was much more narrow,” he said. “Numerically, this dramatically increases the number of lives that we can positively impact. It’s the biggest news in the last year or two.” The term “door-to-needle” applies to the amount of time that it takes to get a stroke victim to treatment. Sipos said the team at St. Joseph’s has worked to not only meet the guidelines established for measurable levels of improvement, they are setting new standards. “We’ve set response times envied by our hospital peers around the country. You can see the life-changing effects unfold right before your eyes, and that takes a team effort to achieve.” St. Joseph’s average response time is 36 minutes compared to the Arizona “all hospital” average of 45 minutes, according to data which is tracked by the American Heart Association’s Get With The Guidelines®-Stroke program. A “Brain Attack Team” responds to every potential stroke patient for rapid assessment and diagnosis. St. Joseph’s Hospital is also certified as a Primary Stroke Center by The Joint Commission. “It’s nice to bring that to the Tucson community,” he said, adding, “Certification is not the goal. The goal is putting all of the elements in place that meet or exceed certification standards.”
Holy Cross Hospital Provides Care through Innovation & Collaboration By Mary Minor Davis As the critical-access hospital in the border city of Nogales, Holy Cross Hospital bears the primary responsibility for providing care to the approximately 21,000 residents in the area. With only 25 beds, the hospital must rely on innovation and collaboration, both within the Carondelet Health Network and with partnerships in the Nogales community. They must be doing something right. Holy Cross is the leader in patient satisfaction in the Carondelet network and across the Tenet Healthcare network. “We’ve really put a lot of emphasis on the health of the community,” said Dr. Tanya Henry, chief of staff at Holy Cross. “We’re focused on providing good, safe, quality care in the best way possible.”
PHOTO: COURTESY CARONDELET HEALTH NETWORK
Biz
www.BizTucson.com
One way that Holy Cross achieves this is through its partnership with the Community Healthcare Integrated Paramedicine Program (CHIPP). The hospital works with emergency medical services in Nogales to address the needs of individuals who frequently use the 911 system and with the hospital emergency room to assess why these patients are returning and try to be more proactive in their treatment to reduce those ER visits. “For example, we had an elderly woman who kept coming to the ER because of falls,” Henry said. “We sent the EMS team to evaluate her home and discovered that she has difficulty seeing, and when she’d get up at night to use the restroom, it was very dark and she had no handrails. So, we installed rails and improved the lighting for her.”
In 2017, Holy Cross was recognized by the National Rural Health Resource Center for its work with CHIPP, receiving the Critical Access Hospital Recognition certificate. The hospital was one of only four in the nation to receive the honor. Henry said the hospital also focuses on providing education to the community on key health issues. Childhood obesity and pre-diabetes are on the rise and have become focuses for its education and outreach. Efforts to provide for the health of the Nogales community also have been bolstered by the Affordable Care Act, especially the Medicaid expansion. “When people have insurance, they use it,” Henry said. “They tend to engage in well-child visits and preventive care.” Henry said she worries that if the ACA goes away, the health of the community will suffer. With the injection of resources from Carondelet network operator Tenet Healthcare, Henry said that Holy Cross also has been able to improve facilities and add new technology such as 3D mammography. Holy Cross also was able to hire a full-time general surgeon, providing more surgical options and wound-care management. “Tenet has really recognized our efforts and has provided financial resources to maintain higher standards and offer quality patient care,” she said. “They’ve really engaged with us. Now we need to make sure the community knows what a gem they have for their healthcare needs.”
Biz
Fall 2018
>>>
BizTucson 135
BizHEALTHCARE
Setting
New Standards
Healthy Women Across Generations By Mary Minor Davis Carondelet has always focused on providing quality and compassionate care to women of all ages and expectant mothers. As advances in delivery of services and technology have accelerated, the health network has been able to adapt in stride. With the added resources in recent years, Carondelet has been able to add to its neonatal arsenal and expand women’s care to a historically underserved part of the community. St. Joseph’s Women and Infant Services Center
Teresa Anzar knows a thing or two about moms and babies. After all, the director of Women and Infant Services at St. Joseph’s Hospital has dedicated her 27-year career to the field. “I have only ever worked obstetrics,” she said. “My passion is to make sure that every family has the best outcome and is able to enjoy parenthood.” Each month, the team at Carondelet St. Joseph’s Hospital Women and Infant Services helps new families bring about 200 babies into the world. As the head of one of Carondelet’s leading services – St. Joseph’s was voted Best Birthing 136 BizTucson
<<<
Fall 2018
Center for two years running by local newspaper readers – Anzar is excited to be a part of the network’s expansion in obstetrics and the integration with the other Carondelet hospitals. “Healthcare today is so fragmented,” she said. “Our goal is to defragment that care and do everything we can to keep mom and baby together, and deliver in the right place.” Anzar said St. Joseph’s and Holy Cross Hospital in Nogales, which also is part of the Carondelet network, work closely to make sure that happens. St. Joseph’s has a comprehensive obstetrics program with perinatology services, including a Level II EQ Neonatal ICU nursery. It also offers a midwifery program with alternative birthing options. “We can offer a combination of birthing experiences,” Anzar said. “Some women want the midwife, but may be a high-risk. They can have that experience in the hospital and have access to support nearby should something go wrong. Different choices do not have to be mutually exclusive.” As women choose to have children later in life, Anzar said those moms-to-
be must be monitored differently. “With older moms come other conditions at a higher rate, such as hypertension and diabetes. How do you approach their care differently?” Anzar said St. Joseph’s is revamping its entire education program, starting with educating moms-to-be on the importance of getting healthy before they conceive all the way to maintaining education and connections long after mom and baby go home. “We know that if moms go into a pregnancy healthy, it can lead to a healthy pregnancy that will benefit generations down the road,” she said. “We also don’t want to stop at birth. We’ve created a number of programs that provide continued education and support for new moms after they leave the hospital.” When it comes to high-risk pregnancy, Anzar said the facilities at St. Joseph’s offer one of the best approaches she’s seen. “We are one of the only intensive care units that has private neonatal rooms for moms and sleeping couches for dad and/or grandparents to enwww.BizTucson.com
Women’s Care
courage them to stay by the bedside,” she said. Other elements of the neonatal experience include providing tours of the neonatal unit prior to birth to reduce anxiety, a Serenity Garden that allows parents to take a break from all of the “bells and dinging” of the neonatal equipment, and weekly tea time with other moms of neonatal babies that helps anxious parents connect with one another. Anzar said the real difference at St. Joseph’s is the connection that moms and dads make with their caregivers. “Fancy rooms are great, but a positive birth experience is really about the connection and how well patients connect with their caregivers in the hospital,” she said. “When the public keeps ranking us No. 1, that says a lot. We excel at integrating mom’s birth plan with the services and technology we have, and the small-community feel that we’ve created here makes parents comfortable. “If we continue to focus on better outcomes, empowerment for women over their pregnancy through better education, and connecting with our www.BizTucson.com
patients, we’ll continue to make a difference.” St. Mary’s Women’s Center
As part of Carondelet’s commitment to advancing patient care in the community, it recently expanded surgical services at its Women’s Care Center at St. Mary’s Hospital, offering extended gynecological services and surgical opportunities not seen before on Tucson’s westside. Dr. Robert Samuelson, director of Women’s Services, said the center is now able to offer minimally invasive procedures, including robotics and laparoscopic surgeries for cancers and endometrial conditions as well as the management of incontinence. He and his partner, Dr. Arpit Dave (pronounced dah-vay), both completed fellowships in the practice of minimally invasive procedures from the Mayo Clinic. “The integration has been pretty seamless,” Samuelson said. “St. Mary’s surgical infrastructure was already in place with the Da Vinci robotic technology. It was really just a matter of additional training for the nursing staff, and that was minimal.”
The expansion enhances the center’s already extensive list of women’s healthcare, including menopause issues and digital mammography. In 2017, the Breast Center was named one of America’s Best Breast Centers by the Women’s Choice Award. The award signifies that St. Mary’s Hospital is in the top 7 percent of 4,789 U.S. hospitals offering breast-care services. Samuelson said patients often sought care in the emergency room – and then subsequently through follow-up treatments and surgery specialists – throughout Tucson. Now they can find that care closer to home. “I like being in an area that historically has been underserved,” Samuelson said. “The community is really embracing the addition of these services because people like to receive care as close to home as they can. “They like these services in their own neighborhood. Many women’s health issues can include multiple problems. St. Mary’s is really now able to offer the total package for women.”
Biz Fall 2018
>>>
BizTucson 137
PHOTO: COURTESY CARONDELET HEALTH NETWORK
for
138 BizTucson
<<<
Fall 2018
www.BizTucson.com