Providence health spring 2014 by Providence Health & Services

Primary Care Physicians Hold All the Cards

Teamwork is the Foundation for Managing Diabetes

Technological Advances Elevate Cardiac Care

THE PURSUIT OF WELLNESS IN SOUTHERN CALIFORNIA | PROVIDENCEHEALTHONLINE.ORG | SPRING 2014

ONE BIG, HAPPY

FAMILY

Providence welcomes Saint Johnâ&#x20AC;&#x2122;s Health Center and its patients to the regional network

OUR MISSION

letter

from the Chief Executive Welcome to a very special edition of Providence. We are changing the look of our magazine and

welcoming the newest member of our Providence family: Providence Saint John’s Health Center and its John Wayne Cancer Institute, both serving the Westside community and beyond. Providence is growing and continues to improve access to quality and affordable health care while creating healthier communities. Read all about Providence Saint John’s and its tradition of quality care on the Westside. We’re also proud to share the news that all five of our eligible hospitals in Southern California received the Distinguished Hospital Michael Hunn Award™ from Healthgrades, one Sr. Vice President, of the nation’s leading healthcare rating organizations. This honor, Regional Chief Executive the first ever achieved by a California healthcare system, ranks our medical centers among the top 5 percent in the nation. As more and more Americans gain access to healthcare, it’s important for all of us to have a “medical home,” which is a base for whatever care you need, headed by your primary care physician. Read inside about our comprehensive healthcare platform, which includes thousands of physicians, six award-winning medical centers and numerous outpatient clinics, urgent care centers and ancillary services. Among our highly recognized services is the bariatric (surgical weight loss) program at Providence Saint Joseph Medical Center. If you’ve struggled with obesity, read the story about a mother and daughter who celebrate their successful surgeries and are living healthier lives. Lastly, we’d like to introduce you to one of our “People of Providence.” Marc Cohen, who faces a number of his own challenges, is a long-time volunteer at Providence Tarzana Medical Center and was honored recently as a Hospital Hero. We hope you enjoy his inspiring story.

As people of Providence, we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.

Core Values Compassion

Caring for each person as part of our family.

Justice

Working for a fair and equitable society.

departments

Respect

Affirming the God-given dignity and worth of each person.

2 | Letter from the Chief Executive 10 | On the Horizons 30 | Happenings 34 | Shout Outs

Excellence

Continually improving all that we do.

Stewardship

in good health

Wisely caring for and sharing human, environmental and financial resources held in trust.

Senior Vice President and Regional Chief Executive Michael Hunn Providence Editor-in-Chief Nancy Franklin Providence Managing Editors Patricia Aidem Jennifer Fagnani Connie Matthews Kirk McDonald Diana Reynar Natasha Shows Andrew Werts

Contributors Ann Beurskens Tiffany DeVall Brenda Goettemoeller Gail Malloy Juanita Perea Kathryn Sprague Ellen Wise

contents

9 features

profiles

12 | Celebrating the New Addition 22 | Steady As Clockwork Saint John’s Health Center becomes the sixth Providence medical center in Southern California

18 | Heartfelt Advances

Providence hospitals excel in the latest cardiac services and technology

24 | The Diabetes Epidemic

Volunteer Mark Cohen has been serving others for 40 years

28 | The Weight-Loss Project

A mother and daughter opt for bariatric surgery

As diabetes rates soar, providers strive to do more

58 11th Street, Hermosa Beach, CA 90254 Tel 310-376-7800 Fax 310-376-0200 moontidemedia.com

VP, Branded Media, Emily S. Baker; Art Director, Ajay Peckham; Editor, Shari Roan; Copy Editor, Laura Watts; Managing Partners, Charles C. Koones, Todd Klawin

PROVIDENCE SPRING 2014

ON THE COVER The children of Bryan and Lauren Castanos, Carson, 3, and Harlan, 9 months, were born at Saint John’s Health Center in Santa Monica. SPRING 2014 PROVIDENCE

in good health

At 4, Kaylee Chiang picked up her first violin.

Find Your Medical Home

At 6, she played Carnegie Hall. PERCENTAGE OF PEOPLE WITH A MEDICAL HOME

You’d never guess she spent her first 10 weeks of life in a Providence neo-natal intensive care unit funded by your generous donations.

AGE UNDER 18

95.6% AGE 18 TO 24

AGE 25 TO 44

76.4% AGE 45 TO 64

88.6%

70.4%

AGE 65 & OLDER

96%

The “medical home” is a relatively new term that means each American has a primary care doctor who can track a patient’s health over a long period of time and keep a detailed health history for that person. Having this information on hand with one particular doctor means that health changes can be spotted quickly. Having a medical home leads to coordinated care, improved health outcomes and higher patient satisfaction, according to numerous studies. Most Americans are heeding this advice, although changes in insurance status or personal circumstances, such as moving or loss of employment, can leave people without a medical home. Young adults have a particularly hard time establishing a medical home. Overall, the rate of Americans with a usual place to go for healthcare remained unimproved from 1997 to 2012.

Source: Centers for Disease Control and Prevention

Sneak Fruits and Vegetables Into Your Diet

california.providence.org

At Providence, we know what it takes to care for even the smallest, most fragile of patients. You’ll also find that same dedication and caring in such vital areas as cancer and cardiology; women’s services; stroke care and neurosciences; rehabilitation and emergency services.

1-888-HEALING (432-5464)

When you give to Providence, you’re helping create not only better medical facilities but also a better community — one person or one family at a time. You may not know them, but your generosity will change their lives for the better, forever. That’s the power of giving.

To make a donation or for more information about our Providence hospitals and hospice services, visit us online at providencepowerofgiving.org.

Providence Holy Cross Medical Center | Mission Hills

Providence Saint Joseph Medical Center | Burbank

Providence Little Company of Mary Medical Center | San Pedro

Providence Tarzana Medical Center | Tarzana

Providence Little Company of Mary Medical Center | Torrance

Providence TrinityCare Hospice

Providence Saint John’s Health Center | Santa Monica

According to dietary guidelines, everyone should consume two cups of fruit and 2½ cups of vegetables each day. Sounds difficult. But the experts at the Academy of Nutrition and Dietetics suggest mixing fruits and vegetables into meals in subtle and flavorful ways. For example: • Add onions, peppers, mushrooms and pineapple to meat or seafood kebabs. • Puree apples, berries, peaches or pears in a blender for a sauce on grilled or broiled seafood or poultry, or as a topping for

pancakes, French toast or waffles. • Top a baked potato with beans, salsa or broccoli. • Add grated, shredded or chopped vegetables, such as zucchini, spinach and carrots to lasagna, meat loaf, mashed potatoes, pasta sauce or rice dishes. • For dessert, try fruit on the grill, such as kebabs with pineapple, peaches and banana. Grill on low heat until fruit is hot and slightly golden. Visit California.providence.org for free online health tools.

Nutrition guidelines call for Americans to consume three to five servings of vegetables and two to four servings of fruit per day. But a recent survey showed most people don’t consume fruits and vegetables at every meal. • Average adult fruit consumption: 1.1 times per day • Average adult vegetable consumption: 1.6 times per day • Average teen fruit consumption: 1.0 times a day • Average teen vegetable consumption: 1.3 times a day Source: CDC State Indicator Report on Fruits and Vegetables, 2013

SPRING 2014 PROVIDENCE

in good health

It’s Good to Have a Go-To Doctor Written by SHARI ROAN

To Derek Williams, MD, every aspect of a person’s health is like a piece of a jigsaw puzzle. There’s preventive health, health history, family history, current illnesses, medications, care from outside providers, lifestyle habits, emotional and spiritual wellbeing and so on. As a primary care provider, it’s his job to assemble the puzzle with the patient. People who don’t have primary care physicians may not have someone who will provide a comprehensive look at their health. That can mean some aspects of care fall through the cracks. “Having a primary care provider means a patient has one person who has all the pieces of the puzzle,” says Dr. Williams, medical director of the Vasek Polak Health Clinic and Hawthorne Primary Care. But it’s important to try to select one doctor and stick with that person as long as possible, says Maureen Swenson, MD, a family physician with Providence Medical Institute in Redondo Beach. “The family physician will know you and the other members of your family. I think that is really helpful. The primary care doctor is the one person who has all the information about you—whether you’ve gone to different specialists, had various procedures—the person who has all of your records and tests.” With the advent of electronic medical records, the primary care physician is the person responsible for overseeing that file to get the “big picture” of a person’s health and coordinating care among all of the doctors who may be seeing that patient, such as cardiologist or obstetrician or dermatologist. The primary care doctor will examine the e-health records to make sure wasteful, duplicative tests are not ordered and that you’re not unknowingly prescribed medications that will cause harmful interactions. It’s all about communication, says Dr. Swenson. “You need someone to do that coordination of care. Some people don’t think they need a primary care doctor because they have a cardiologist for their heart problems or an endocrinologist for diabetes. The truth is, when you’re ill with multiple

PROVIDENCE SPRING 2014

in good health conditions or diseases, you do need to see a primary care doctor. And it’s an advantage to see someone who has all of your health history.” There are other, more intangible reasons for having a primary care physician, too. Building a relationship with one doctor is deeply reassuring to people, says Jane Ekejiuba, MD, a primary care physician with Providence Medical Institute in Carson. “I chose to go into primary care medicine because I wanted to be able to maintain a relationship with my patients,” she explains. “When you have a long-term relationship with your patients, you get to know them better. You’re able to give your patients the right care in the right setting and in a way that’s consistent with the patient’s views, values and desires.” It’s just easier to talk to a doctor who knows you. “The physician and patient are a team,” Dr. Ekejiuba says. “The physician comes up with a medical recommendation about a patient’s problems, but the patient stays actively involved in decisions.” Patients who have regular contact with primary care physicians will develop trust in their doctors, Dr. Williams adds. And that translates to better health. “The most important part of having a primary care physician is having the trust and reassurance that the physician really cares about you,” he says. “That is difficult to experience in a single visit or procedure. But if you see someone over time, you get a sense for that patient. And if they know that you care, they are much more likely to adhere to the recommendations.”

To learn more about the importance of having a primary care physician and how to locate a doctor, go to providencemedicalinstitute.org. You can also find information about the electronic medical record program called My Chart, including how to set up appointments online and email your doctor.

Providence Sets New Healthgrades® Benchmark

Providence Health & Services, Southern California, has received top state honors as the first and only health system in California to achieve Healthgrades’ Distinguished Hospital Award for Clinical Excellence™ for all five of its inpatient hospitals eligible for the honor. These include Providence Little Company of Mary Medical Center Torrance, Providence Saint John’s Health Center, Providence Saint Joseph Medical Center, Providence Tarzana Medical Center and Providence Holy Cross Medical Center. Healthgrades is a leading independent healthcare ratings company that provides patients and communities information about quality of care. The Distinguished Hospital Award for Clinical Excellence™ is granted to hospitals that rank among the top 5 percent in the nation for performance on 27 of the most common diagnoses and procedures. Only 262 hospitals in the nation received this recognition. Providence Little Company of Mary Medical Center San Pedro, while not eligible for these rankings due to its size, was recognized in October 2013 with Healthgrades’ five-star and top 10 percent ratings in nine service areas. Michael Hunn, senior vice president/chief executive of Providence Health & Services, Southern California, attributes the high marks to the organization’s core value of excellence and focus on creating healthy communities. “Every Providence caregiver stands on the shoulders of our founding sisters, whose 157year tradition of excellence and compassion lives today in all our hospitals,” Hunn says. “We are proud to be recognized by Healthgrades for our successes in providing the best care for our patients.” Distinguished Hospitals have a 30.9 percent lower risk-adjusted, in-hospital mortality rate across 18 conditions and procedures, as compared to all other U.S. hospitals.

New CT Scanner in Torrance Providence Little Company of Mary Medical Center Torrance is home to the Aquilion ONE 320 CT scanner—the only hospital in the South Bay with a 320 detector CT system. The scanner reduces diagnosis time from hours and days to just minutes for patients experiencing stroke, serious heart conditions and other life-threatening diseases. Detecting and treating disease at its earliest stages can significantly improve quality of life. With the Aquilion ONE, it is possible to image an entire organ, including the brain, in a single rotation, ensuring greater accuracy and diagnostic confidence. Physicians can see not only a three-dimensional depiction of an organ, but also how the blood flow moves within and around the organ. The Aquilion ONE can perform comprehensive exams that can reduce overall healthcare costs by replacing the need for multiple tests and invasive procedures while reducing the amount of contrast material and radiation exposure a patient receives.

Save the Date for the Providence High School Gala Providence High School’s biggest fundraiser of the year is just around the corner. The 2014 gala will be held on Saturday, April 5, at Lakeside Golf Club in Toluca Lake. This year’s honorees include Providence High School alumnus from the class of 1987, retired Major League Baseball player Jeff Cirillo, and Michael and Caroline Cusumano—each of who generously give of their time, talent and treasure to many organizations in the Burbank area, including Providence Saint Joseph Medical Center. Join us for a spectacular evening complete with complimentary cocktails and hors d’oeuvres, great live and silent auction items, dinner and dancing. If you are unable to attend, you can bid on silent auction items by visiting biddingforgood. com/ProvidenceHigh. For more information, please contact Vickie Bagwell at 1-818-846-8141, ext. 14403 and Vickie. Bagwell@providencehigh.org or visit providencehigh.org.

Providence on the Web: Know Your Risk for Breast Cancer

Providence’s free, personalized risk assessment will take you on a journey to help you better understand your individual breast cancer risk. The online tool calculates risk based on your family’s health history, individual health history, age and lifestyle factors. You will not only learn more about your risk but also what actions you can take. Take the test today at providence.org/knowyourrisk.

SPRING 2014 PROVIDENCE

in good health

In Good Hands

Healthy Eating

Chili isn’t just a heavy, winter-only dish. It also can be an incredibly nutritious meal. This version is based on black beans. By Joanne C. Feldman, RD, Certified Diabetes Educator, Providence Little Company of Mary Medical Center San Pedro

Veggie Black Bean Chili

Directions: Using a large soup pot, add a small amount of olive oil. Sauté onion until clear but not browned. Add all the raw vegetables and cook until semi-soft, stirring frequently (about 10 minutes).

The Benefits of Fiber

Chili is a healthy dish in part because it’s high in fiber. Fiber in the diet helps lower cholesterol levels and slow the absorption of glucose. Most adults should try to consume about 20 to 30 grams of fiber per day. Chili can be made with various kinds of beans. Although the fiber levels vary a bit, all are good sources of fiber.

BEANS

FIBER*

PORTION**

Kidney

5 grams

20%

Pinto

8 grams

32%

Ladle into soup bowls and garnish with cheese.

Lima

5 grams

20%

**If using canned beans, use two 16-ounce cans, drained. If using dried beans, start with 2 cups and soak the beans overnight before cooking. Use fresh water to cook.

Black

7.5 grams

30%

Add spices and mix well. Add canned tomatoes with juice, drained/rinsed beans and broth. Continue to cook for about 1 hour until flavors blend. Add extra broth as needed if chili becomes too thick.

* per half-cup serving ** portion of Recommended Daily Intake Source: United States Department of Agriculture

Serves 6–8

PROVIDENCE SPRING 2014

ILLUSTRATED BY ANITA BILAN

Ingredients: ½ large onion, diced 1 yellow squash, diced into chunks 1 zucchini squash, diced into chunks ½ orange bell pepper, diced into chunks 1 large stalk celery with leaves, chopped 1–2 teaspoons ground cumin 1–2 teaspoons ground coriander 1 tablespoon oregano leaves 1–2 tablespoons chili powder 1 tablespoon garlic powder 1 16-ounce can petite diced tomatoes with juice 4 cups cooked black beans, rinsed and drained** ½ cup vegetable stock or low-sodium vegetable broth Optional: reduced-fat cheddar cheese, grated

Human hands endure long, hard days. We open bottles, grip spoons, pound on keyboards, write checks and clutch steering wheels. It’s no wonder that surgeries for hand conditions have soared over the past 25 years, jumping 34 percent in the 1990s alone, according to one study. This increased demand has led some orthopedic surgeons to specialize in treatment of the hand, says Richard Alan Rogachefsky, MD, a board-certified orthopedic surgeon. Dr. Rogachefsky, who joined the staff of Providence Little Company of Mary Medical Center San Pedro in 2012, has authored numerous papers and books about orthopedic hand conditions. “The hand is so intricate,” he explains. “There’s a lot of thinking that goes into the treatment for hand conditions. Many different structures are involved—nerves, tendons, arteries and bones. There’s a lot of anatomy packed into a small area.” The most common reason people consult a hand surgeon is for carpal tunnel syndrome. The incidence of this condition almost has doubled over the past two decades. Use of technology, such as computers, has a lot to do with carpal tunnel syndrome, which is caused by increased pressure, or pinching, on the median nerve in the wrist. Hand conditions also are linked to aging. Osteoarthritis is a degenerative disease in which the cartilage that covers and cushions bone surfaces begins to wear out. The disease can cause painful, locked or swollen joints. People with hand problems often fear surgery is the only treatment option, Dr. Rogachefsky says. That’s not the case. Hand surgeons often recommend non-surgical treatments, including

occupational therapy, to restore movement and function and to eliminate pain. Some surgeons recommend acupuncture. Other trends include vigorous occupational therapy to work on range of motion, hand strength, scar management, swelling control and increased function. “Early range-of-motion therapy is pushed more now and it has improved the results,” Dr. Rogachefsky explains. “Getting patients moving faster really seems to improve recovery. Implants in the hands for joint replacement and fracture care also have improved a lot in recent years. “Many of the conditions that people come down with can be treated and resolved,” he adds. “People can get their normal function back through surgical or nonsurgical treatments.”

The wrinkles on the knuckles mark areas where the skin is attached to tendons. The thumb is controlled by nine individual muscles.

The advice “If you can move your finger, it isn’t broken” is false.

Each hand contains about 29 bones and 29 major joints and at least 123 named ligaments and 34 muscles. Source: The Electronic Textbook of Hand Surgery

There are no muscles in the fingers. One-fourth of athletic injuries involve the hand and wrist.

Loss of a fingernail changes the feeling on the palm side of the fingertip. SPRING 2014 PROVIDENCE

on the horizon

Providence hosts dozens of lectures, events and classes each week across the region. Here are some upcoming highlights. Check our website for more activities. Living with Knee Pain? Attend a lecture on April 8 or April 22.

MARCH 27 The Art of Healing Community Art Program Providence Holy Cross Medical Center, North Building Conference Room, 4:30 to 6:30 p.m. Program and presentation at 5:30 p.m. A grand art display and unveiling, featuring the talents of young artists from San Fernando Valley elementary schools. >>For more information: 1-888-HEALING (432-5464) or providence.org/art Anton Bilchik,MD, PhD

PROVIDENCE SPRING 2014

APRIL 5 John Wayne Cancer Institute Auxiliary’s 29th annual Odyssey Ball Four Seasons Beverly Wilshire Hotel, Beverly Hills We will honor the Mandela Family with the “True Grit” Humanitarian Award at the 29th annual Odyssey Ball. Anton Bilchik, MD, PhD, professor of surgery and chief of medicine, John Wayne Cancer Institute at Providence Saint John’s Health Center, will receive the “The Duke” Special Service Award. The yearly fundraising event benefits the Institute and is organized by the John Wayne Cancer Institute Auxiliary. The Auxiliary has raised more than $18 million to fund a wide array of the Institute’s priorities including groundbreaking research, new laboratory equipment and the nationally renowned Surgical Oncology Fellowship Program. >>For information and sponsorship packages: Tess Csiszar, Providence Saint John’s Health Center Foundation, Tess.Csiszar@ stjohns.org or 1-310-829-8168

An Evening of Art & Wine at the Disney Family Cancer Center on May 3

APRIL 8 AND APRIL 22 Lecture: Living with Knee Pain? April 8 event: Doubletree Hotel, 21333 Hawthorne Blvd., Torrance, 6:30 to 8:30 p.m. April 22 event: Manhattan Beach Marriott, 1400 Park View Ave., Manhattan Beach, 6:30 to 8:30 p.m. >>For more information: 1-888-HEALING (432-5464) or providenceclasses.org

of Providence TrinityCare Hospice Foundation and Sandpipers philanthropic programs. >>For information, tickets and sponsorships: 1-310-316-2837 or 4Rchildren.net

MAY 3 An Evening of Art & Wine to benefit The Disney Family Cancer Center On the rooftop of the Disney Family Cancer Center at Providence Saint Joseph Medical Center >>For more information: Jacqueline Jordan, 1-818-847-4698

APRIL 27 Honda presents the 29th annual For Our Children Food and Wine Festival Honda campus in Torrance

MAY 10 Revlon Run/Walk for Women Los Angeles Memorial Coliseum

Enjoy fabulous food and wine from nearly 100 of the finest food and beverage purveyors in Southern California. Entertainment, silent and live auctions under the tent. Proceeds benefit TrinityKids Care, a program

Join the Providence Southern California Team benefiting women’s cancer care and help us scrub out cancer! >>For more information: Jan Marie Perry, 1-818-847-6397 or janmarie.perry@ providence.org

MAY 12 Every Second Counts When A Stroke Strikes. Learn the Warning Signs of Stroke and Your Treatment Options Providence Tarzana Medical Center, 18321 Clark St., Tarzana, 7 to 8:30 p.m. Please join us for this free lecture featuring Peter-Brian Andersson, MD, PhD. Parking is free. >>RSVP to 1-888-HEALING (432-5464)

MAY 13 Lecture: How to Prevent and Survive a Stroke Doubletree Hotel, 21333 Hawthorne Boulevard, Torrance, 6:30 to 8:30 p.m. >>For more information: 1-888-HEALING (432-5464) or providenceclasses.org

MAY 29 Annual Stroke Awareness Fair Providence Saint Joseph Medical Center, 501 S. Buena Vista Street, Burbank, 5 to 7 p.m.

JUNE 19 19th annual Providence Saint Joseph Foundation 2014 Golf Classic, presented by Comcast NBC Universal Robinson Ranch Golf Club

Light refreshments, parking, free blood pressure, carotid screening and stroke assessments will be provided. >>RSVP to 1-888-HEALING (432-5464)

Proceeds benefit neonatal and pediatric services at Providence Saint Joseph Medical Center. >>For more information: Jacqueline Jordan, 1-818-847-4698

VISIT US ONLINE From support groups to fitness classes, Providence provides the programs you need to live healthfully. View our many classes, events and screenings online at ProvidenceClasses.org or call 1-888-HEALING (432-5464)

MAY 19 Honda presents the Providence Little Company of Mary Foundation 34th annual Golf Classic Palos Verdes Golf Club A day of friendship and philanthropy in support of Providence Little Company of Mary. Enjoy the redesigned bunkers, greens and majestic ocean views at one of Southern California’s finest clubs.

2014 Golf Classic committee co-chair and golf pro David Conforti and his wife, Kristen

The fundraiser includes a shotgun start, BBQ lunch, hosted cocktail reception, auction and awards dinner. >>For more information: Jan Marie Perry, 1-818-847-6397

SPRING 2014 PROVIDENCE

Family

Grows A

Written by SHARI ROAN

Photographed by REMY HAYNES

Saint John’s Health Center in Santa Monica joins Providence Health & Services

ryan and Lauren Castanos decided they were going to be very careful in choosing a hospital for the birth of their first child in 2011. The Brentwood couple toured several area hospitals before selecting Saint John’s Health Center in Santa Monica. It was a perfect choice. “After I had Carson, I told two or three friends who were pregnant, ‘Dude, you need to go to Saint John’s,’” says Lauren, sitting down with Bryan one recent evening after the whirlwind of putting Carson, 3, and Harlan, 9 months, to bed. “It was a wonderful experience.” The anesthesiologist who cared for her during childbirth returned to her room the next day just to say hello. Nurses who were ending their shifts stopped by to say goodnight or to see the baby. “Everyone we were in touch with was like our family by the time we left the hospital,” she says. “Everyone knew our names. They were genuinely happy for us. We weren’t just patients.” The meticulous and compassionate care associated with Saint John’s Health Center is just one of the reasons why Providence Health & Services was interested in assuming sponsorship of the hospital last year. On March 1, Saint John’s Health Center became the sixth hospital of Providence Health & Services, Southern California. Nationally, Providence Health & Services, which is headquartered in Renton, Wash., encompasses 33 hospitals in California, Alaska, Montana, Oregon and Washington. Saint John’s Health Center previously was part of the Sisters of Charity of Leavenworth Health System based

PROVIDENCE SPRING 2014

in Denver. “We are now becoming part of a powerful system in Southern California,” says Paul D. Natterson, MD, chief medical officer of Saint John’s Health Center. For Providence Health & Services, the addition of Saint John’s Health Center means an expanded geographical presence in the Southland and an integrated network of providers and services. Moreover, the 72-year-old hospital is renowned for its reputation

“

Everyone we were in touch with was like our family by the time we left the hospital. Everyone knew our names. They were genuinely happy for us. We weren’t just patients.” of providing high-quality, academic-level medicine in a beautiful, private setting. Saint John’s Health Center was heavily damaged in the 1994 Northridge earthquake. But a 20-year rebuilding effort recently was completed with the opening of the hospital’s elegant entrance, the Mullin Plaza and Mullin Gardens, facing Santa Monica Boulevard. “The reputation of Saint John’s clinicians is outstanding,” says Dale Surowitz, regional chief operating officer for Providence Health & Services, SPRINGSPRING 2014 PROVIDENCE 2014 PROVIDENCE 13

A Family Grows

Santa Clarita

Porter Ranch

118

210 5 170 101

Tarzana Encino 405

134

North Burbank Hollywood 110

Santa Monica

Network

Expands 72,000

710

105

Torrance

405

Providence Health & Services patient admissions + Saint John’s Health Center:

275,000

11,960

110

Providence Health & Services emergency room visits + Saint John’s Health Center:

12,000

28,815

Providence Health & Services employees + Saint John’s Health Center: DATA FROM 2013

PROVIDENCE SPRING 2014

1,300

San Pedro

“

The John Wayne Cancer Institute is one of the most reputable internationally recognized cancer research centers in the world.”

PHOTOGRAPHED BY LUKE GIBSON

Mission Hills

Southern California. “But the physicians and employees also have tremendous commitment, staying with the hospital during very challenging times. The passion the staff feels about the community and the Health Center is incredible.” Saint John’s Health Center will add to the luster of the Providence family in Southern California. In the most recent national Healthgrades report, which provides hospital quality rankings, the hospital was recognized as one of America’s 50 Best Hospitals™, the eighth straight year the hospital has received this recognition. The rankings also include: • Patient Safety Excellence Award™ (2009–2013) • Top 5% in Nation for Patient Safety™ (2013) • 100 Best Hospitals for Cardiac Care™ (2012–2014) • 100 Best Hospitals for Cardiac Surgery™ (2014) • 100 Best Hospitals for Coronary™ Intervention (2012–2014) • 100 Best Hospitals for Joint Replacement™ (2013–2014) Saint John’s Health Center also is home to the prestigious John Wayne Cancer Institute, which conducts multidisciplinary basic, clinical and translational research on some of the most complex cancer problems. The Institute is recognized internationally

for its work in melanoma, breast cancer, colon cancer, liver cancer, pancreas cancer and brain cancer. “The John Wayne Cancer Institute is one of the most reputable internationally recognized cancer research Donald L. Morton, MD centers in the world,” says Anton J. Bilchik, MD, PhD, professor of surgery and chief of medicine at the Institute. “There is a lot of important research and science going on at universities around the country, but that doesn’t necessarily translate to practice changes. The Institute, under the leadership of its co-founder, Donald L. Morton, MD, who recently passed away, has been instrumental in developing the clinical and scientific means of identifying melanoma, breast cancer and colon cancer at early stages, improving staging accuracy and reducing unnecessary operations in millions of people.” The Institute is the recipient of major federal grants and, within the past 12 months, its faculty has authored numerous peer-review publications including two papers in the prestigious New England Journal of Medicine. The Institute was founded by the family of actor John Wayne and Dr. Morton and moved to Saint John’s

Health Center in 1991. Dr. Bilchik says the Institute will benefit from sponsorship by Providence. “Being associated with a reputable organization like Providence will provide the Institute the opportunity to grow and to recruit. Looking at the Providence system and seeing what they’ve done with cancer programs in Seattle and Portland, they understand the importance of breakthroughs in cancer research and the need to support clinical trials.” Joining Providence Donna F. Tuttle Health & Services also allows Saint John’s Health Center to reach out to a larger pool of insurers and patients, says Donna F. Tuttle, chair, board of directors, Providence Saint John’s Health Center. “We benefit by having someone close by who knows the marketplace and has a stake in it. When we talk about our vision, they understand it. They understand the competitive nature. They understand the need to reach out and have alliances with other medical institutions. You can’t be isolated in the marketplace.” Besides its outstanding medical services and prime geographical location, Saint John’s Health Center is the right fit for SPRING 2014 PROVIDENCE

A Family Grows

Providence for another reason: Both notfor-profit, Catholic healthcare institutions are committed to the needs of the poor and underserved, says Michael Hunn, senior vice president and chief executive of Providence Health & Services, Southern California. Both organizations were founded by religious orders—the Sisters of Providence and Sisters of Charity of Leavenworth—that came to the Western United States to care for the growing communities of people who lacked healthcare. “It starts with our respective Missions,” Hunn says. “Both organizations are focused and dedicated to their communities, and they are very clear about their service to the poor and the vulnerable. Because our Missions are so aligned—our histories are so similar, the foundresses of the two orders have so many similarities, the passion for healthcare—it’s a wonderful match-up.”

A Family Grows

A CONVERSATION WITH MICHAEL HUNN Providence Health & Services, Southern California, is under the direction of Michael Hunn, senior vice president and regional chief executive. Here he discusses the history, values and strategic plans of the organization as Saint John’s Health Center in Santa Monica joins the Providence family.

physician and administrative leadership. We need to have engaged trustees, board members and volunteers. We

Why is Saint John’s Health Center such a great addition to Providence Health & Services, Southern California?

How do patients benefit from an additional Providence hospital in Santa Monica?

need to work together in a spirit of

“It’s a truly amazing health center—in

“The communities of the Westside and

affordable values-driven model and we

the top 50 hospitals in the United

Santa Monica can be reassured that

need to make sure that our community

States eight years running, according

the health center—which has been so

is, as consumers of healthcare, happy

to Healthgrades. I have personally

cherished by the community—will continue

and feel that they have been treated

experienced the incredible support that

its core mission of outstanding healthcare

with respect and compassion. If we do

the trustees, physicians and community

and will thrive and continue to meet the

all of this TOGETHER, we will meet the

have for their Saint John’s Health Center

needs of the community. Saint John’s

monumental challenges head-on and

and their Foundation. This amazing

Health Center brings additional expertise

succeed in our mission!”

Catholic ministry is also strengthened by

to Providence, and Providence will provide

Being associated with a reputable organization like Providence will provide the Institute the opportunity to grow and to recruit.”

its world-renowned research at the John

new resources for Saint John’s to build on

Wayne Cancer Institute, its innovative,

its culture, traditions and values.”

Of course, the real winners are the patients who will have access to a broader range of services and healthcare providers as Providence Health & Services expands in Southern California—people like the Castanos family. “Even if we didn’t live close by, we would probably go there for our healthcare,” Lauren says. While Lauren has been admitted to Saint John’s Health Center twice to give birth, Bryan has been a patient, too. In 2009, he was admitted for an emergency appendectomy. As someone who works in the restaurant business and appreciates hospitality, he was interested in more than just the healthcare. “They took great care of me. All of the nurses were there whenever I needed help,” Bryan says, adding, “I really liked the food.”

PROVIDENCE SPRING 2014

and the year-in and year-out excellence in

deliver the highest-quality care in an

Explain why the Mission statement remains at the heart of all of the strategic plans and decisions made at Providence Health & Services?

PHOTOGRAPHED BY LAUREN PRESSEY

“

minimally invasive neurosurgery program

trust and collaboration and we need to

addition, Saint John’s delivers some 1,700

Having an additional Providence hospital in the Southern California region is also an added convenience for patients, isn’t it?

babies and its emergency department

“Yes. It means there are options for

sees 27,000 patients a year. Another core

patients. Patients have many hospitals

strength is the doctors of Saint John’s—a

they can go to. But patients like to go to

cohesive group of quality, dedicated

quality institutions they trust. Saint John’s

primary care and specialty physicians

Health Center is trusted and loved by the

driven by clinical excellence and a

community. Having a convenient Westside

concierge attitude toward patient care.

option as part of Providence here in Los

through our doors each day. With the

The clinical expertise is both impressive

Angeles allows more patients to remain

opening of Mullin Plaza and Mullin

and remarkable. Providence is honored

closer to home for their care, especially if

Gardens a few months ago, Saint John’s

and privileged to welcome Saint John’s as

their health insurance already includes the

Health Center has, for the first time in

its newest ministry.”

Providence network.”

19 years, a front door. The door now is

orthopedic, oncology and cardiac care. In

“The Mission statements of the Sisters of Charity of Leavenworth—the former sponsor of Saint John’s Health Center— and Providence Health & Services focus on caring for the poor and vulnerable: poor in spirit, poor in health or poor in economics. We have a fundamental obligation to care for those who come

open at Providence Saint John’s Health Why is Saint John’s Health Center such a good fit with Providence? “Saint John’s was founded by the Sisters

Center and we are here to welcome the

of Charity of Leavenworth whose mission

What values have helped Providence Health & Services build on its long history of providing quality healthcare in the Western United States?

was to care for the poor and underserved.

“Saint John’s was first opened in 1942, and

here for generations to come. Our local

The community of caregivers, trustees,

Providence has been in the West since

community ministry hospital boards are

volunteers and physicians at Saint John’s

1856. Being able to honor the heritage

truly empowered to carry forward this

has remained dedicated to that very

and legacy of those whose shoulders we

mission for 72 years. It is such a good fit because Providence shares the same

community in the traditions that have Our role is to be the stewards of these

us? And how can we best support our

defined the excellence of Saint John’s

vital healthcare resources so they will be

physicians?”

for 72 years. On February 28, at 1 p.m., a ceremony was held in the atrium of Saint John’s during which the Sisters passed a

work, including helping to establish our

How will Providence adapt to meet the monumental changes occurring in healthcare?

stand on is critical. None of our hospitals

strategic plans in support of our Mission.

“The core strategy of Providence

symbolic, it was a call to honor the

would be here without the support of

The fundamental question is always: How

is “creating healthier communities,

legacy and heritage of the Mission—the

values, culture and mission to serve the

the community, trustees, physicians,

do we meet community need? What is it

together.” The word TOGETHER is key.

Mission is at the heart of all we do and

poor and vulnerable.”

volunteers, caregivers and foundations.

our patients are asking and seeking from

We need to develop and retain excellent

will continue to do.”

burning candle from Leaven ministries to Providence ministries. It was not merely

SPRING 2014 PROVIDENCE

New programs and resources keep Providence hospitals at the leading edge of cardiac care. Written by LINDA MARSA Photographed by MONICA OROZCO

Take

Heart

PROVIDENCE SPRING 2014

n June of last year, Sari Edber was awakened before dawn by the sounds of her husband, Daniel, moaning and gasping for breath. When she tried to awaken him, he was unresponsive and had no pulse. Sari didn’t know it at the time, but he was in full cardiac arrest, his lungs filled with fluid from a viral infection that had also weakened his heart. She immediately called 911 and began CPR, which she had learned two years earlier after her infant son spent 100 days in the neonatal intensive care unit at Providence Tarzana Medical Center. The 911 operator explained how to adjust the resuscitation technique for an adult and kept her focused until the arrival of the paramedics, who used a defibrillator on Daniel as he was lying on their bedroom floor to restore his heart rhythm. They rushed him to the hospital. “Before they wheeled him into surgery, they asked if I wanted time alone with him,” recalls Sari, a 34-year-old teacher. “I knew what that meant. I didn’t want to lose hope, but I knew the gravity of the situation and that this could potentially be our last moments together.” Daniel, 38, remained in critical condition for several weeks in a medicallyinduced coma, and doctors had no idea if he would live or be permanently disabled. But thanks to the care he received at Providence Tarzana Medical Center, the same facility that saved his son’s life when he was born prematurely and weighed only 1 pound, 15 ounces, Daniel made a complete recovery and was back working at his law firm six weeks later. But what truly made all the difference in Daniel’s survival were Sari’s efforts at CPR, which kept oxygen-rich blood circulating to his brain and vital organs

even though his heart had shut down. “We had no way of knowing how long he had been deprived of oxygen,” says Sari. “Doctors told me that if I had started CPR even a minute later, it probably would have been too late.” That CPR class may have rescued Daniel Edber from almost certain death or permanent disability. And it’s just one of several lifesaving projects at Providence hospitals that range from patient education classes to the latest technology. Recently Providence has augmented several cardiac programs.

CRITICAL CARE TRANSPORT When someone is stricken with a heart attack or stroke, they’re normally taken to the nearest hospital. However, many community hospitals or urgent care centers don’t have the advanced interventional care to effectively treat severe heart conditions or strokes.

“

Before they wheeled him into surgery, they asked if I wanted time alone with him. I knew what that meant. I didn’t want to lose hope, but I knew the gravity of the situation and that this could potentially be our last moments together.” But every minute counts, and doing all the paperwork entailed in transferring gravely ill patients to hospitals with state-of-the-art facilities can translate into critical delays in receiving the right treatment. That can mean the difference between life and death … or making a full recovery and a lifetime of disability. Four years ago, Daniel Eisenberg, MD, chief of cardiology at Providence Saint Joseph Medical Center in Burbank, decided to do something about the issue. Armed with a half-million-dollar grant from the UniHealth Foundation, the emergency and cardiovascular services department

leadership worked collaboratively to develop and launch a new critical care transport service to ferry patients from 15 area hospitals to Providence Saint Joseph Medical Center, which has certified cardiac and stroke programs. The hospital has cardiac catheterization and interventional radiology laboratories with advanced imaging technology, such as MRI and CT scanners, which enable doctors to do intricate procedures to diagnose and treat heart attacks and strokes. Typically, the tests can detect whether plaque is narrowing or shutting down arteries, which can cause strokes and heart attacks. Surgeons can then do relatively minor procedures, such as inserting stents or balloons, to open blocked vessels and restore blood flow. In Saint Joseph’s emergency department, emergency nurses carry dedicated cell phones and are available 24/7. When a call comes in from a partner hospital, a nurse is dispatched in a specially-outfitted ambulance with high-tech equipment and medications so lifesaving care can be administered even while patients are in transport. Since the program began two years ago, 322 patients have been treated. “This became a home run pretty fast because there was a real need in the community,” says Dr. Eisenberg, who notes that the hospital accepts all patients regardless of their ability to pay. “We’re saving lives.”

THE HEART VALVE CENTER Heart murmurs—that whooshing sound a doctor may hear through a stethoscope when he listens to your heartbeat—are normally nothing to worry about. But if a heart murmur is accompanied by such symptoms as rapid heartbeat, swelling or sudden weight gain, shortness of breath, a chronic cough, or heavy sweating, it could be the sign of a more serious underlying heart problem, like leaky or stiff heart valves that can force the heart to pump harder to satisfy your body’s oxygen needs. But sometimes it’s tricky telling the difference between something that’s harmless and a condition that requires treatment. SPRING 2014 PROVIDENCE

Take Heart

That’s where Providence Saint Joseph Medical Center’s new heart valve center comes in. Doctors do an extensive physical exam and can refer patients for further diagnostics, such as an echocardiogram, which is an ultrasound that shows detailed images of the heart’s structure and function. The test can usually detect if heart valves are abnormal—they may be calcified or leaking—and can also spot most heart defects. Armed with this information, patients can then make informed decisions regarding the best strategy. Treatments can range from medications to ease conditions that might worsen the heart murmur, including diuretics to remove excess fluid or ACE inhibitors to lower blood pressure, to surgery to mend a hole in the heart or fix or replace a valve. “This is a diagnostic program to identify patients at risk for significant heart problems due to abnormalities in their valves,” says Robert Gottner, MD, chairman of cardiac surgery and heart valve center co-director. “This is specifically targeted to patients who are confused about their treatment options and want more advice,” adds Prahbdeep Sandhu, MD, heart valve center co-director. Patients who are concerned about their

COOL UNDER PRESSURE After Gary Wayland was felled by a heart attack while driving—his passenger saved him—he recovered with the help of novel hypothermia treatment.

Take Heart

murmur can call 1-844-MY-MURMUR (1-844-696-8768) to schedule a consultation with the heart valve center team.

This became a home run pretty fast because there was a real need in the community. We’re saving lives.”

Providence Holy Cross Medical Center in Mission Hills, which provides comprehensive heart and vascular services including screening and diagnostic tests and emergency cardiac care, is one of the few hospitals in Southern California to offer minimally invasive heart valve surgery. The heart has four valves that control the flow of blood through the heart, but if they’re leaking or not working properly, they need to be surgically repaired or replaced with an artificial valve. Traditionally, these types of procedures involved making a large incision in the center of the chest and splitting open the breastbone. But new technology enables surgeons to make much smaller keyhole incisions and use specialized instruments to repair or replace damaged valves. Surgeons at Providence Holy Cross also use minimally invasive techniques to repair abdominal aortic aneurysms, which occur when the aorta, a major blood vessel about the thickness of a garden hose, becomes enlarged. Because the

Since his near-fatal heart attack, Daniel Edber cherishes time with his family.

Gary Wayland was driving to work on

implanted a small defibrillator—a device that

October 29, 2012, with his business partner

will shock his heart if it stops again.

seated next to him, when he suffered a heart attack and passed out. But luck was on his side that day. His friend managed to park the

Best of all, Wayland, 60, was released with no signs of brain damage. When he arrived at the hospital,

outcomes utilizing this therapy.” Providence Little Company of Mary Medical Center Torrance began using this technique in 2010, championed by

But today they can insert a guide wire through the groin and use a radiographic guidance system to thread it through the arteries to the right location. They then deploy a stent, which is a stainless steel mesh liner, to repair the aneurysm. Doctors use a similar strategy to repair aortic aneurysms in the chest. Instead of spreading open the ribs—which can cause serious complications because of its invasive nature—surgeons use endoscopic tools to guide wires through the groin and deploy the stents. “In the past five years, there have been incredible advances in vascular surgery,” says Azmi Atiya, MD, a cardiothoracic

within an hour. Hypothermia treatment is also offered at Providence Saint Joseph, Providence Holy Cross and Providence Tarzana Medical Centers.

car, which ended up in front of a fire station

emergency room physicians determined he

Robert Chang, MD,

in Hermosa Beach. A firefighter emerged

was a candidate for the Arctic Sun cooling

an intensivist (a

from the station and began providing care.

treatment. During the treatment, pads

physician who cares

are applied to the torso and thighs, and

for patients in

Manhattan Beach

Little Company of Mary Medical Center

the device cools those areas under very

intensive care). So

Athletic Foundation,

Torrance, where he met the criteria for

controlled conditions, slowing the heart rate

far about 40 heart

which operates after-

hypothermic treatment, a system that cools

and thus the body’s demand for regular

attack patients have

school programs and

the body to limit the possibility of neurologic

blood flow.

received the therapy

Wayland was then rushed to Providence

the brain.

Catrice Nakamura, RN, the hospital’s critical

at the Providence

care nurse manager, likened the treatment to

Torrance hospital. The

the ability of near-drowning victims to survive

therapy is recommended by

accountant, was on his way to recovery. A

because they were in very cold water. “You’re

the American Heart Association

stent was inserted to open one clogged artery,

cooled to such a state that it preserves

for those whose circulation and function

and near the end of his hospital stay, doctors

your brain functions. We’ve seen very good

is able to be returned to normal levels

Within days, Wayland, a certified public

PROVIDENCE SPRING 2014

“

THE HEART AND VASCULAR INSTITUTE

damage caused by a lack of blood flow to

aorta is the body’s main supplier of blood, if the aneurysm ruptures, it can cause lifethreatening bleeding. In the past, surgeons had to open a patient’s stomach to repair the bulging blood vessel.

Wayland is back to his active life. A runner, he helped establish the

helps manage school booster clubs. He also referees Pac-12 college football and basketball. He’s grateful to many people. “The doctors have been fantastic. The ICU staff has been fantastic,” he says.

surgeon at Providence Holy Cross and Tarzana medical centers. “These new techniques help patients heal faster with less pain and fewer, potentially lifethreatening, complications.”

STEMI PROGRAM Because of Providence Saint John’s technological capabilities and expertise, the Health Center was asked to join the STEMI Program—a nationwide initiative developed by the American College of Cardiology and the American Heart Assn. to improve the treatment of patients with symptoms of a heart attack. STEMI is an acronym for ST segment elevation myocardial infarction. This is a severe type of heart attack that occurs when the coronary artery is completely blocked by a blood clot. The program is a partnership among paramedics, hospital emergency departments and cardiologists designed to ensure that patients experiencing STEMIs are diagnosed, transported and treated quickly. All of Providence’s Southern California hospitals participate in the STEMI Program. As soon as a person with a suspected heart attack is placed in the ambulance, a paramedic does an EKG with an automated system that is able to identify a STEMI. If the patient is found to be experiencing a STEMI, the paramedic immediately notifies the emergency department of the nearest STEMI Receiving Center and the hospital moves into high gear. “It’s like an Indy 500 pit stop, where everyone rushes to be in place before the patient arrives,” explains Dr. Peter C. Pelikan, MD, medical director of the cardiac catheterization lab at Providence Saint John’s Health Center. “Entering through the emergency department, the patient is rapidly transported to the team waiting in the cath lab.” “One of the keys to success of the STEMI program is the availability of a cardiologist 24/7, which we offer,” he adds. “And with four cath labs equipped with the latest technology, we are even better prepared to save lives.”

SPRING 2014 PROVIDENCE

profiles in health

A Smile is Good Medicine Award-winning volunteer Mark Cohen’s joy is therapeutic. Written by SHARI ROAN Photographed by LAUREN PRESSEY

PROVIDENCE SPRING 2014

profiles in health

ot many people volunteer at a single organization for 40 years. But Mark Cohen possesses the kind of charitable heart and perseverance that makes such a feat possible. Cohen, 69, recently celebrated his 40-year anniversary as a volunteer at Providence Tarzana Medical Center. He was also recently awarded the Hospital Association of Southern California Hospital Hero award. The award recognizes healthcare professionals and volunteers who are dedicated to patient care. Cohen, who has cerebral palsy, is unable to drive a car but lives just a few blocks from the hospital and rides his three-wheel bike to work. Even heavy rains can’t keep him from his twiceweekly shifts. He helps the hospital staff with packaging materials and delivering supplies to various units. “I love everything about this hospital,” Cohen says. “Everyone is so nice—the nurses, doctors, volunteers and the people in the kitchen. It is very satisfying working here.” The feeling is mutual. Cohen’s hospital colleagues praise him for his unending cheerfulness and reliability. He is a bright spot in the day. “He is someone everyone enjoys seeing,” says Nancy Alaniz, the hospital’s volunteer director. “He’s always smiling and greeting people. He says ‘hi’ to everyone. I’ve been here 21 years; I don’t remember this hospital without Mark. He’s part of the culture.” And, says Brenda Scott-Manzur, director of nursing quality, “Every time I pass Mark in the hallway or in the elevator, he says, ‘Good morning, young lady’ or ‘Have a good day.’ Seeing him always brings joy to my heart.” Besides his scheduled volunteer work, Cohen participates in hospital events, such as the Leukemia & Lymphoma Foundation’s Light the Night walk, hospital holiday parties and community outreach and charity events. About 15 years ago, Mark’s bike was stolen. But when word spread among the hospital staff, Cohen’s co-workers stepped in to help. The Providence Medical Center Foundation board donated funds to purchase a new bike. “Mark is such a positive person,” says Jerry Clute, chief executive. “Even with his own physical challenges and adversity, he always

has a smile, says hello and has a desire to help others.” Volunteers like Cohen are vital to the operation of a busy medical center that makes compassionate care one of its core values, Alaniz says. About 230 people, from high school students to senior citizens, volunteer at Providence Tarzana Medical Center.

Mark is such a positive person. Even with his own physical challenges and adversity, he always has a smile, says hello and has a desire to help others.” “Our volunteers are so appreciated by all the staff,” she says. “Each department is affected differently by their volunteers.” Many volunteers are long-timers. “I think volunteer work gives more meaning to people’s lives,” Alaniz says. “They understand that they’re giving back. For Mark, I think the hospital is a home away from home for him. Because he’s so personable, I think being able to socialize with everyone makes this fun for him.”

SPRING 2014 PROVIDENCE

For Diabetes Care, It Takes a Village

Providence patients are assisted by a team of healthcare professionals to manage the disease. Written by VICTORIA CLAYTON

little more than two years ago, John Matarrese of Redondo Beach started losing weight inexplicably. He also noticed he was thirsty all the time, and he was having trouble with his vision. “I was often seeing double,” he says. “And I knew what that probably meant: diabetes. My mother and grandmother both had it.” Sure enough, once he visited Olga Calof, MD, an endocrinologist with Providence Medical Institute, a blood test sent to the lab (called a hemoglobin A1C test) soon confirmed Matarrese’s suspicions. He had type 2 diabetes, a diagnosis shared by about 26 million Americans. An A1C, as well as tests such as the fasting plasma glucose test and the oral glucose tolerance test, are used to determine blood glucose—or sugar—levels in the body and the way the body handles sugar. “Diabetes is really a metabolism disorder,” explains Dr. Calof. “The body isn’t using digested food for energy the way it should.” But Providence Health & Services patients learn quickly that there is much they can do about this common disease. A comprehensive approach to care that involves a strong partnership among the patient, physicians, nurses, dietitians and diabetes educators typically produces significant improvements in health. “That’s where our program comes in,” says Geri Harmon, RN, certified diabetes educator and supervisor of diabetes education at Providence Little Company of Mary Medical Center Torrance. “We’re here to team up with the provider, patient and family to come up with a plan that works.” Helping patients understand the disease is one of the healthcare team’s first objectives, she says. When non-diabetics eat carbohydrates, their digestive systems break them down into glucose. With the help of the hormone insulin, they then absorb glucose and use it for energy. But, Harmon explains, “People with diabetes either do not produce enough insulin or their body doesn’t use the insulin effectively. This is called insulin resistance.” As a result, glucose

“

builds up in the blood. She uses this example: “Imagine pouring water through your blood vessels. It pours fast and freely. That’s good. That’s what we want. Now imagine pouring pancake syrup through those blood vessels. That’s what it’s like when you have high blood sugar. The circulation to all parts of the body through small and large blood vessels is compromised, a little at a time, over the course of years.” Over time, high blood glucose can damage nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease and even amputations. Being overweight is one risk factor for type 2 diabetes, though age (older than 45), storing fat primarily in the abdomen, family history and inactivity also are risk factors. When Matarrese’s test indicated he had diabetes, Dr. Calof prescribed medication— including insulin that he injects twice daily. “I didn’t get diabetes because I was eating a completely unhealthy, junk-food diet or because I was extremely overweight. For me, it was much more subtle than that. It was a year, two, three of not exercising regularly and not eating the best diet—being somewhat overweight—combined with a strong family history of diabetes,” says the 57-year-old engineer. Matarrese also had a history of breathing problems and regularly used a steroid inhaler, which he later discovered also increases the risk for diabetes. What he did immediately after he was diagnosed, though, has been the crucial factor in his nowhealthy life, according to Harmon. Dr. Calof referred Matarrese for diabetes education. The Providence diabetes education program counsels patients in understanding how to monitor their blood sugar, take medication properly and eat and exercise for maximum health. Diabetes is a progressive disease, but with close attention it can be slowed. Sometimes, that progression can be stopped, says Paul Murata, MD, a primary care doctor with Providence Medical Institute and affiliated with Providence Little Company of Mary Medical Center Torrance.

Getting diagnosed with diabetes can even be that wakeup call someone really needs to start living a better life.”

D I A B E T E S : J U S T T H E FA C T S

Almost 19 million Americans have been diagnosed with type 2 diabetes. Experts believe another 7 million have the condition but remain undiagnosed. Some experts say all adults over age 45 should be tested for type 2 diabetes. Ask your doctor if you’re concerned. 24

PROVIDENCE SPRING 2014

SPRING 2014 PROVIDENCE

For Diabetes Care, It Takes a Village

HEALTHY EATING FOR DIABETICS Becky Gerl, RD, a nutritionist and certified diabetes educator at Providence Little Company of Mary Medical Center Torrance, offers these healthful eating tips:

Moderation works. “Diets that

Snack. To ensure stable blood

eliminate carbs or other food

sugar, eat a healthy mid-morning

groups simply never work long-

and mid-afternoon snack between

term,” warns Gerl. “It’s best to eat

meals. “Something in the 200-calorie

everything but learn how to control portions.” Avoid trigger foods that cause overindulgence, like chips or ice cream. Avoid sodas and sports drinks.

range is usually good, and it helps if it has protein, fiber or both,” says Gerl. A handful of almonds or a piece of whole-grain toast with peanut butter are good options. Embrace exercise. Even moderate

“The body doesn’t recognize

exercise, like a 10-minute walk after

these drinks as food, and they

a meal, will force your muscles to

raise blood sugar too quickly,” she says. Even diet versions aren’t recommended. “If you must have it, though, limit your intake to one diet

use more glucose, the sugar in your bloodstream. Over time, exercise lowers blood sugar levels and makes the insulin in your body perform better.

drink a day.” Focus on fiber. Diets rich in fiber Eat fruit, rather than drink fruit juice, which may be high in sugar. A piece of fruit contains healthy fiber and other nutrients.

lower glucose levels, blood pressure and cholesterol, plus reduce the incidence of heart disease. “Fiber also helps with weight loss because it creates a sense of fullness that helps you eat less,” says

Don’t skip meals. Studies have shown that skipping meals leads

Gerl. Fruits and vegetables, oats and wholegrain foods all contain fiber.

to overeating later. Also, skipping meals wreaks havoc on blood sugar. “If you skip meals you’ll get low blood sugar, which tells your body to dump sugar into your blood,”

Practice a good attitude. People who think positively about making dietary changes do a lot better. “I always tell my patients that it’s best not

says Gerl. “We want to stabilize blood sugar.

to think of their new eating routine as a diet.

The best way to do this is with regular meals

It’s a process or project but never a diet,”

and snacks.”

says Gerl.

PROVIDENCE SPRING 2014

“We have a lot of very effective medications for controlling diabetes, and new medications seem to be constantly coming out that work in different ways,” he says. “But what I get excited about is when people make lifestyle changes. And I see it often enough. Once diagnosed, if you lose weight, exercise, eat properly and use your monitoring and medication, you have a very good chance of effectively managing this condition.” Providence’s team approach to care maximizes the chances for success. Oftentimes it takes patients a few weeks after initial diagnosis to digest the news and make the call to come into the program. But Harmon says, once they’re in the door they quickly realize that having diabetes doesn’t mean their health has to deteriorate and that they do not have to manage it alone. The team is there for educational and emotional support. “Getting diagnosed with diabetes can even be that wake-up call someone really needs to start living a better life,” she says. For Matarrese, that’s exactly what happened. “I visited Becky Gerl, a registered dietitian and certified diabetes educator at Providence Little Company of Mary Medical Center Torrance. She was magnificent. She worked with me to come up with an eating plan that’s really easy. There are things that I used to eat a lot of—Italian food and potatoes, for example—that I tend to avoid now because I learned what they do to my blood sugar. But other than avoiding a few things, my new way of eating isn’t a chore. I actually enjoy it.” Matarrese says that diabetes

A FOCUS ON GESTATIONAL DIABETES Last year, the Journal of Clinical Endocrinology & Metabolism published stricter guidelines for diagnosing

G.O.A.L. GREATLY IMPROVES PATIENT HEALTH

and treating gestational diabetes—diabetes that occurs during pregnancy. Experts say that as many as one in five women could

Recent research shows that daily lifestyle habits and home care

have gestational diabetes, but only about one-quarter of

practices can make an enormous impact on diabetes. People who

these cases were diagnosed under previous guidelines.

adopt healthy diets, exercise and adhere to their medications can

Now all pregnant women who have not been diagnosed

experience a significant reversal of the disease process.

with diabetes should get tested for gestational diabetes

The Get Out and Live Program (G.O.A.L.) offered at the Vasek

at their first prenatal visit. Ideally, this should be done

Polak Health Clinic at Providence Medical Institute in Hawthorne

before 13 weeks gestation. Doctors also are adhering to

is designed to reach out to the community and give people with

lower blood glucose levels to diagnose the condition.

diabetes the tools they need to manage the disease. With a referral

Gestational diabetes increases a woman’s risk of

from a qualified healthcare provider, patients can enroll in a 12-

developing type 2 diabetes later. It also increases the

week program featuring a weekly, three-hour class. The classes

risk for delivery of a large

cover such topics as diet, exercise tips, lab testing and a thorough

baby and having birth

review of the disease process and potential complications, says

complications.

Jessica Bushy, NP, who teaches some of the classes. “Diabetes doesn’t just impact one part of a person’s life,” she

“As a result of the changed guidelines, we’re seeing far more

says. “So we try to span the whole spectrum of the diabetes

pregnant women,” says Geri Harmon,

diagnosis. We ask our patients to learn how insulin works in the

RN, certified diabetes educator and

body and how to do carbohydrate counting. These classes help

supervisor of diabetes education at

them understand the disease and take care of themselves.”

Providence Little Company of Mary

The program is free. Classes are offered in English and Spanish.

Medical

Bushy also conducts a private, 15-minute consultation with each

Center

patient so she can address specific concerns and questions. Those

Torrance.

consultations—as well as lab tests and medications ordered by

“We work

Bushy—are typically covered by insurance. The costs of provider

very closely

visits and lab tests can also be covered by the patient with a small

with pregnant

cash fee or through grant funding at G.O.A.L.

women throughout

“The more patients understand the disease, the better they do,”

their journey. We want them to feel

she says. “I see massive differences in my patients who have gone

as comfortable as possible, enjoy

through the G.O.A.L. program. We see significant decreases in

the moments and know they have

blood sugar levels. And these patients are so thankful.”

support they need for a healthy mommy and baby.” Harmon says pregnant women are highly motivated to live

also forced him to recommit to exercise. He plays ice hockey and bikes regularly. Last year, he completed a 100-mile bike ride in 12 hours. “I feel better now than I have in years,” he says. “I always loved exercise, but for too many years I viewed it as a luxury, and I put work and other responsibilities ahead of it. That was a big mistake. Now because of the diabetes, exercise is a necessity in my life. Getting educated about how I needed to manage my condition was what allowed me to move forward to this place.”

healthfully. “Many of our pregnant women send us photos of the healthy, happy babies after delivery, and that always means a lot to us. We even get calls from some asking, ‘Can I keep eating this way from now on? I feel terrific!’” The answer: Absolutely … but don’t forget the exercise!

SPRING 2014 PROVIDENCE

profiles in health

A Family Weight-Loss Affair A mother and daughter relish better health following bariatric surgery. Written by SANDI DRAPER

Tracy Diaz and her mother, Jane Conklin, supported each other while undergoing weight-loss surgery.

racy Diaz was a yo-yo dieter for much of her life. “I’d lose 50 pounds and gain back 60. I did Lindora 13 times. I tried Jenny Craig, Weight Watchers, everything there was. I’d given up,” she says. At 5 feet, 4 inches tall, she peaked at 264 pounds when she was 46 years old. Diaz’s mother, Jane Conklin, was 5 feet tall and weighed more than 200 pounds when she was 69 years old. “That was too much for my frame,” Conklin said.

PROVIDENCE SPRING 2014

Daughter and mother gave up dieting and underwent bariatric surgery at Providence Saint Joseph Medical Center in Burbank in late 2012. Diaz has lost 128 pounds and Conklin 80. Both are maintaining their new lower weights. Maintaining long-term success after bariatric surgery means committing to a new lifestyle, says Philippe J. Quilici, MD, FACS, medical director of the Bariatric Wellness Center at Providence Saint Joseph. “The success rate of bariatric surgery is very patient-

dependent,” he says. “The lifestyle change expected after bariatric surgery is actually an essential part of the management of the patient. If a patient is thinking about undergoing bariatric surgery, we make it very clear to them that they must change their lifestyle, they must change their eating habits, they must start to exercise on a routine basis. If they are not willing to do this, there is no need to undergo bariatric surgery, because it’s not going to work well.” Diaz said Dr. Quilici put it to her succinctly: “Surgery is a tool, not a solution.” At Providence Saint Joseph, the bariatric program encompasses a comprehensive body-and-mind approach that includes nutrition counseling, psychosocial support and lifelong follow-up care. In advance of their surgeries, both Diaz and Conklin attended discussion groups and instruction groups together, going over everything from emotional to nutritional expectations. The pair leaned on each other for support. “It was nice to go through it together,” Conklin says. They were on a high-protein, liquid diet for two weeks before and after the surgery. Then soft foods were added. Once the healing was completed, they were free to add other foods within the dietary guidelines. “It was not that difficult. Once you get past the point where everything is healed and you can start adding things to your diet, you realize what agrees with you and what doesn’t,” says Conklin, who has trouble eating salads and other roughages. Unlike her mother, Diaz isn’t troubled by certain foods. “I can pretty much eat everything,” she says. “I eat what I like in small portions and in moderation. I can have bread, but I choose not to. Bread is bulky but not substantial. Chicken and veggies will keep me fuller longer. With protein and produce, you can’t go wrong.” Before surgery, Diaz was plagued by hunger. “Not even a full meal would fill me up. Now a half-cup of carrots and a couple rolled-up slices of turkey, and it’s like I had Thanksgiving dinner.” Diaz underwent a procedure called vertical sleeve gastrectomy, where the structure of her stomach was reshaped like a tube. This restricts the amount of calories her body absorbs. Diaz has had ulcerative colitis for 30 years and worried about gastric bypass, which would have rerouted her intestines, possibly worsening her colitis. She chose vertical sleeve gastrectomy because it seemed to her to be the most natural approach to

keeping her body doing all it’s supposed to do. Conklin had laparoscopic gastric bypass with Roux-en-Y limb, which was long considered the “gold standard” of bariatric procedures prior to the acceptance of verticle sleeve gastrectomy. In November 2012 when she had her procedure, Medicare would not cover vertical sleeve gastrectomy, although it does now.

I was looking for a healthy outcome, not a cosmetic outcome. I knew the constant up-anddown on the scale wasn’t good for my body. I want to be there for my boys.” Both women had heard stories about people who had bariatric surgery and then regained all the weight. “They must not have listened in the classes,” Conklin said. “Why would you go to all that trouble and then not follow the instructions on eating?” For Diaz, now 48 and a mother of 10- and 14-yearold sons, the surgery was a step toward better health. “I was looking for a healthy outcome, not a cosmetic outcome. I knew the constant up-and-down on the scale wasn’t good for my body. I want to be there for my boys.” For Conklin, the weight loss has remedied a multitude of problems, including knee and hip pain, borderline high blood sugar and high cholesterol. “I feel much better. I’m very active—I was active before, but now I get around much easier. I’m 72, and nothing is wrong with me. That’s not a bad thing.” The Bariatric Wellness Center at Providence Saint Joseph is the only center in the region to earn all of the following recognitions for high-quality care: • Bariatric Surgery Excellence Award™, Healthgrades (2010-2013), placing the program in the top 5% in the nation • Center of Excellence, American College of Surgeons • Bariatric Center of Excellence Award™, American Society for Metabolic and Bariatric Surgery. If you’re ready to restart your life, visit restartlife.org to experience our interactive weight-loss center or call 1-888-HEALING (432-5464) to make an appointment.

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happenings

GIFTS FOR HOSPITALIZED CHILDREN More than 200 Christmas gifts and donations were collected by children and parents from St. Ephraim Cathedral in Burbank and presented to hospitalized children in the pediatric unit and emergency department at Providence Tarzana Medical Center in December. The children gathered at the hospital to learn about the importance of philanthropy from Patty Williams, executive director of the Providence Tarzana Foundation.

RECOGNIZING CHRIS W. CARAS Providence Little Company of Mary Foundation Benefactor Chris W. Caras was appointed trustee emeritus at a festive gathering at the Palos Verdes Golf Club on Dec. 11, 2013.

Sister Terrence Landini, LCM, congratulates trustee emeritus Chris W. Caras and his wife, Joan.

PROVIDENCE SPRING 2014

FEAST DAY OF GUADALUPE MASS CELEBRATION A Mass honoring the Feast Day of Our Lady of Guadalupe was celebrated on Dec. 12, 2013, at Providence Holy Cross Medical Center. The event featured a display of a painting by renowned artist Lalo Garcia in the Chapel.

Above: Special mariachi guests: Mariachi Nuevo de Cuicatla Left: Painting of Our Lady of Guadalupe in the Chapel Below: Mass celebration with mariachi guests

PROVIDENCE SAINT JOSEPH’S 70TH ANNIVERSARY GALA Angelique Campen, MD, and the entire Providence Saint Joseph Medical Center emergency services team were honored on Nov. 21, 2013, at the hospital’s 70th Anniversary Gala. Presented by Sam Solakyan/ Vital Imaging, the 1940s-themed event raised more than $400,000 for emergency care.

Juan and Alma Santander pose with their beautiful, newborn daughter, Kairi, on Jan. 18—the first baby to be registered on the Epic medical records system.

EPIC GO-LIVE On Jan. 18, Providence Holy Cross was the first California hospital in the Providence System to transition to the new electronic medical record system Epic. Left: Chief executive Bernie Klein, MD flips the ceremonial switch on the new Epic electronic medical records.

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happenings

CEREMONY WELCOMES SAINT JOHN’S HEALTH CENTER In an inspiring ceremony on Feb. 28, the Sisters of Charity of Leavenworth passed their local legacy—Saint John’s Health Center— to the Sisters of Providence, founders of Providence Health & Services. The now-named Providence Saint John’s Health Center, along with its internationally acclaimed John Wayne Cancer Institute, became the sixth Providence medical center in the Los Angeles area and the 33rd in the five Western states served by Providence for nearly 160 years. Archdiocese of Los Angeles Bishop Edward Clark attended the ceremony along with representatives of both the SCL Health System and Providence and other dignitaries.

YOGA PROGRAM FUNDRAISER WITH KATE BECKINSALE Maggie DiNome, MD, Medical Director of the Cancer Prevention Clinic at the Margie Petersen Breast Center, hosted a fundraiser with actress Kate Beckinsale on Feb. 13 to benefit the clinic’s new Yoga Program. The event was held at the home of Saint John’s Foundation trustee Mary Flaherty. Singer P!nk was also in attendance. The Yoga Program is for patients undergoing breast cancer treatment and those at high risk for developing the disease.

Right (L to R): Mandy Ingber, yoga instructor; Kamla Subramnian, yoga instructor for the Margie Petersen Breast Center Yoga Program; Maggie DiNome, MD, Medical Director of the Cancer Prevention Clinic at the Margie Petersen Breast Center; actress Kate Beckinsale; Michael L. Wall, Saint John’s acting president and CEO; singer P!nk; Jeanette Jenkins; Maureen Chung, MD, PhD, director of the Margie Petersen Breast Center; Mary Flaherty, Foundation Trustee and fundraiser host.

PROVIDENCE SPRING 2014

1: Providence and SCL Health System leadership and sisters 2: Sister Maureen Craig, SCL; Saint John’s Foundation trustee Mary Flaherty; Sister Therese Zimmerman, SCL 3: Sister Barbara Schamber, SP 4: Participants gather in the atrium 5: Daniel F. Kelly, MD, and Garni Barkhoudarian, MD, John Wayne Cancer Institute 6: Michael L. Wall, acting president and chief executive, Providence Saint John’s Health Center; Mike Slubowski, president and CEO, SCL Health System; Michael Hunn, senior vice president and regional chief executive, Providence 7: Dr. Kelly; Anton J. Bilchik, MD, PhD; Marilou Terpenning, MD, Saint John’s Health Center 8: Sister Juliana Casey, IHM, president, Providence Ministries 9: Sisters of Providence with the Sisters of Charity of Leavenworth.

8 THE PROVIDENCE HEALTH AND FITNESS CENTER IN BURBANK The Health and Fitness Center is dedicated to providing excellent education and support through individualized exercise and nutrition programs. Open to everyone, from those who are healthy to those battling health challenges, the staff caters to a wide range of abilities and orthopedic issues. Murphy Romano, a grateful member and Disney Family Cancer Center patient expresses, “The Health and Fitness Center has opened my eyes to a very healthy lifestyle. The staff, along with the friends I have made there, have shown me how easy it is to be fit while being part of a nurturing and active environment.” Call 1-818-953-4494 for membership information.

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providence health & services Southern California

shout outs We value feedback from our patients and visitors and strive to ensure that every individual entering Providence Health & Services is treated with kindness and respect. We are proud to share some of the wonderful comments we’ve received in the past few months. We invite you to share your story with us at providence.org/share or join us on Facebook at facebook.com/Providencecalifornia.

As a physician, I understand all too well how healthcare providers often hear more about negative feedback than positive. I wanted to take the time and share my very positive experience as a patient in your same-day surgery facility (at Providence Tarzana Medical Center). Healthcare providers were kind and supportive. Many thanks to RN Patty, RN Vita and Carlos, especially, for their lovely personalities and generous bedside manner.” — Pei Nie

“The nursing staff (at Providence Holy Cross Medical Center) is amazing! Wonderful bedside manner. Always kept my dad comfortable as possible while he was there. Very friendly. I can’t thank them enough for being so great. The trauma surgeons are great as well. Were always great with my dad. He received great care.” — Valerie Clayton

“Throughout the entire

“Joana was one of our

process from pre-op, the

first nurses that we met (at

care far exceeded Providence Little Company of Mary’s goal of VERY GOOD CARE. In fact it

“I believe God works in strange and wonderful ways;

was excellent care. PLCM’s

we were so blessed to have been treated at Providence

awards are not only earned,

Saint Joseph. The doctors, nurses and staff’s spirituality

but so very well-deserved.”

brought peace to our family even during the most critical times. May God continue to work through each of you!”

— Jim and Sarah Keen

Providence Holy Cross Medical Center), and after her shift I remember my mom saying that if all our nurses were that good, then she may want to stay as long as possible. I reminded her that this was not a bed-and-breakfast.” — Bob Daniels, Jr.

When it comes to quality care, Providence hospitals stand alone.

– Judith Marshall, Mother of Patient

I have had an amazing experience with the entire staff of Providence Medical Institute’s Burbank Women’s Health over the course of my first and now my second pregnancies. Everyone in the office is kind, caring, and professional, making it easy and pleasant to come in for visits. Jennifer Nava deserves special recognition for the outstanding job she does.” — Talya Kontras

Our daughter, Eloise Pilon, was born on January 1, 2014, the first baby of Saint John’s Health Center this year. We are writing this message to thank you and your staff for making the birth of our daughter such a wonderful experience. We particularly appreciated the nurses who have been so caring, so professional and so competent. The environment of Saint John’s Health Center is also amazing. It feels warm, spacious and welcoming. If we have a second child, we know where we will go.” — Laurent, Ellen and Eloise Pilon

PROVIDENCE SPRING 2014

Providence Health & Services, Southern California is proud to announce that we are the first and only health system in California to have all our eligible hospitals recognized with the Healthgrades® Distinguished Hospital Award for Clinical Excellence in 2014. Our hospitals rank in the top 5 percent of all hospitals nationwide for clinical excellence which means better outcomes for patients.  Providence Holy Cross Medical Center, Mission Hills  Providence Little Company of Mary Medical Center, Torrance  Providence Saint John’s Health Center, Santa Monica  Providence Saint Joseph Medical Center, Burbank  Providence Tarzana Medical Center, Tarzana As the second largest health system in Los Angeles County, we’re dedicated to quality, compassionate care. Together, we’re creating healthier communities.

*Based on risk adjusted, in-hospital data. Providence Little Company of Mary Medical Center San Pedro was not eligible for consideration for this award.

1-888-HEALING (432-5464) california.providence.org Providence Holy Cross Medical Center Providence Little Company of Mary Medical Center San Pedro Providence Little Company of Mary Medical Center Torrance Providence Saint John’s Health Center Providence Saint Joseph Medical Center Providence Tarzana Medical Center Providence TrinityCare Hospice Providence Affiliated Medical Groups

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