Healthy Heart

Healthy Heart 5 Simple Strategies for Healthier Holidays

By The American Heart Association

American Heart Association’s Healthy for Good™ movement offers simple tips for self-care this season Nourishing yourself is smart for your heart and an effective way to take control of your health during the holidays. During Eat Smart Month this November, the American Heart Association, the leading voluntary health organization devoted to a world of longer, healthier lives, offers its latest recipes and science-backed tips to help you be Healthy for Good™. “The holidays can present nutrition challenges and additional stressors, but simple changes and investments in your own health can make an impact on your well-being and help you enjoy the season even more,” said Jo Ann Carson, PhD, RD, retired professor of clinical nutrition in Dallas and past volunteer chair of the nutrition committee of the American Heart Association. “Start small by making one more healthy choice today and build on it tomorrow.” Focus on small, consistent steps. The American Heart Association’s Healthy for Good Eat Smart Initiative offers five tips for nourishing yourself this holiday season: 1. Get creative with swaps: Cooking at home is a great way to take control of your diet and tweak favorite seasonal dishes. Reduce sodium by replacing salt with herbs and spices, adding more fruits and vegetables to dishes, and using lower-sodium canned and frozen products. 2. Snack smart: To avoid overindulging during the holiday season, prep with nutrient-rich foods that don’t sacrifice taste. Look for snacks that will keep you feeling full and less tempted by those unhealthy choices. 3.

4.

5. Take your time: Don’t rush through meals. Enjoy mealtime by pausing between bites and savoring your food. Use time-saving technology: Many grocers make it easy to shop deals and save time with online ordering and pick-up and delivery options. Plus, it’s easier to resist that candy bar in the checkout line if you aren’t in a staring contest with it. Practice gratitude: It can help lower blood pressure, improve your immune system, and spur you to eat better and exercise more. Write down five things you’re grateful for and share them with your family and friends. Gratitude is the gift that keeps on giving.

For more healthy tips and recipes

visit heart.org/eatsmartmonth. Another tenet of the Heart Association’s Healthy For Good movement is Move More. A great way to get moving this month is to participate in one of the five Greater Houston Heart Walks, held November 5th and November 12th on Facebook (@AmericanHeartTX), that encourage participants to #walkwhereyouare. Tom Stewart, Vice President of Southeast Region Sales and Account Management of Blue Cross Blue Shield of Texas, said, “As a long-time supporter of the American Heart Association in Houston, Blue Cross Blue Shield is proud to sponsor the Houston Heart Walk and continue to make strides toward ending heart disease and stroke. Houston is our home and we want our families, friends and neighbors to move more and be well, especially now, when you can walk and be active wherever you are.”

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Texas Heart Institute Debuts Clinical Cardiology Practice Cardiovascular Research Center Will Harness the Full Breadth Of Its Storied History, Ushering In New Era With The Opening of Texas Heart Medical Group Houston, TX

Texas Heart Institute (THI) – the internationally lauded research and educational center dedicated to the prevention and care of heart disease – is once again raising the bar with the long-planned official debut of Texas Heart Medical Group (THMG). THMG represents a significant step into the future for the institution, which has played a critical role in major cardiovascular breakthroughs since its founding in 1962 by legendary heart surgeon Dr. Denton Cooley.

When Dr. Cooley established THI nearly 60 years ago, his mission statement for the non-profit at Texas Medical Center was simultaneously simple and bold: namely, reduce the devastating toll of cardiovascular disease through innovative programs in research, education and improved patient care. Texas Heart Institute is now breathing new life into Dr. Cooley’s original vision as the institution readies to open its clinical practice specializing in cardiovascular care with the singular mission to provide the highest-quality medical care in a sophisticated and welcoming patient-oriented atmosphere. They started seeing new and existing patients on October 1, Texas Heart Medical Group will serve as home

Texas Heart Medical Group

base for twelve outstanding cardiologists who are also leaders in the subspecialty fields of Cardiac Imaging, Interventional Cardiology, Peripheral Vascular Disease, and Electrophysiology. Texas Heart Medical Group will embody the totality of Texas Heart Institute as a fully integrated clinical cardiology practice encompassing the areas of education, research and direct patient care.

An exciting day in the history of the Texas Heart Institute. With the launch of Texas Heart Medical Group, THI will usher in a dynamic new era as it enters into the clinical care arena,” stated Texas Heart Institute Board Chair Eric Wade. He added, “Texas Heart Medical Group will tap into Texas Heart Institute’s longstanding and relentless pursuit of excellence that began with the historic breakthroughs under Dr. Cooley’s leadership and vision. I am confident in saying that he would be proud of and excited for this new chapter in THI’s dramatic story.”

To date, Texas Heart Institute has focused solely on research and education in affiliation with St. Luke’s Episcopal Health (now CHI St. Luke’s Health - Baylor St. Luke’s Medical Center). From the outset,

see THI...page 12

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Harris Health System’s LBJ Hospital Earns More National Nursing Recognition

Harris Health System’s Lyndon B. Johnson Hospital has earned its re-designation as a Pathway to Excellence® hospital, its second national nursing recognition in less than a month. It comes on the heels of LBJ Hospital achieving Magnet recognition in September, the acknowledged gold standard for nursing excellence. Both recognitions are given by the American Nurses Credentialing Center to hospitals that promote high-quality patient outcomes through a robust nursing program that works in coordination and collaboration with all aspects of hospital staff to provide evidence-based patient care. “This has been a remarkable year for LBJ Hospital,” says Derek L. Curtis Sr., DNP, MA, RN, NEA-BC, chief nursing officer, LBJ Hospital. “We are thrilled to receive two American Nurses Credentialing Center designations in the same year. This accomplishment reflects our continuous pursuit of excellence. We are committed to creating a positive practice environment that empowers and engages staff as we light the way for excellence in patient care.” LBJ Hospital is one of 192 Pathway designated hospitals in the nation and the fourth hospital in 2020 to achieve Magnet recognition from the ANCC Magnet Recognition Program®. LBJ Hospital joins the exclusive lists of 43 Pathway and 51 Magnet hospitals in Texas. “Each day, the LBJ Hospital team inspires me with their unwavering commitment to excellence in patient care, even when the work we do is framed by a global pandemic,” says Patricia Darnauer, executive vice president and administrator, LBJ Hospital. I’m proud of what we do here every single day and these recognitions highlight why we are an invaluable resource for Harris County residents.”

Derek Curtis & Patricia Darnauer

Pathway to Excellence® is awarded after an organization successfully undergoes a rigorous review that documents foundational steps taken to create a positive work environment as defined by nurses and supported by research. These initiatives must be present in the facility’s practices, policies and culture. Nurses in the organization verify a supportive work

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environment through a confidential online survey. According to the Pathway to Excellence® web site, the program recognizes healthcare and long-term care organizations for positive practice environments where nurses excel. Pathway organizations foster supportive leadership, inter-professional collaboration, nurse development and work-life effectiveness. To achieve Pathway designation, organizations must meet the six essential standards to an ideal nursing practice environment. Applicants undergo a vigorous review to fully document the integration of those standards in the organization’s practices, policies and culture. Hospitals designated as Pathway to Excellence are recognized for their outstanding patient care and outcomes, as well as nursing measures such as: • Improved nurse satisfaction • Retention of highly-qualified nursing staff and leaders • Champions of high-quality nursing practices 

Legal Matters Continued from page 3

enforcement actions to shut down more than 300 websites that fraudulently purported to sell products that became scarce during the pandemic, including hand sanitizer and disinfectant wipes. Thousands of victims throughout the United States paid for items through these websites but never received them. The DOJ also reported having received more than 3,600 complaints

Mental Health

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traffic on the roads (while it lasts), and taking on old or new hobbies and activities. 4. Happiness Promotion How we choose to respond to the world can determine our degree

THI

Continued from page 10

Dr. Cooley designed an organizational structure which coordinated care at the THI-affiliated hospital partners. Texas Heart Institute did not directly treat patients under the THI umbrella, about COVID-related online scams less than two months into the declared pandemic, which will certainly result in additional civil enforcement actions.

The broad array of investigative agencies involved in the cases brought thus far demonstrates the vast resources available to the Fraud Section in conducting these investigations. These investigations are not just run by the well-known federal investigative agencies, such as the FBI, Secret Service, and IRS, but also include lesser-known, but equally of happiness. Humor seems to demonstrate how “happiness comes from within.” Multiple studies have shown that adults who use certain styles of humor tend to be happier. In particular, affiliative humor makes us more empathetic while enriching the quality of our social relationships. Self-enhancing humor though it quickly blossomed into “the most prolific heart surgery center in the United States and possibly the world,” as the iconic surgeon wrote in his own words.

“The leading physicians in the Texas Heart Medical Group who are members of the THI Professional Staff, are eager to blaze a new trail aggressive investigative agencies like the FDIC-OIG, Board of Governors of the Federal Reserve, Small Business Administration OIG, Bureau of Consumer Financial Protection OIG, the Federal Housing Finance Agency OIG, and the U.S. Treasury Inspector for Tax Administration. The participation of such a large number of investigative agencies is reminiscent of the federal government’s response to prior crises, such as the financial crisis of 2008, and portends significant

enforcement activity by the Fraud helps us maintain or enhance our positive psychological well-being while distancing ourselves from adversity. It helps us manage reality by reflecting and responding to threats rather than feeling utterly out of control. Sharing humor is, in some ways, akin to sharing happiness. Humor Is No Laughing Matter

and practice top tier cardiovascular medicine through this clinical group,” emphasized Dr. Emerson Perin, Texas Heart Institute’s Medical Director.

He added, “The founding physicians at THMG have upheld the same standards of excellence set forth by Dr. Cooley, spanning decades of collective experience in the practice of Section.

With the continued distribution of CARES Act funding as a part of the response to COVID-19, the number and scope of investigations conducted by this newly formed Strike Force will undoubtedly grow. All recipients of CARES Act or other COVID-19 relief funds should be aware of the increasing focus of the DOJ on COVID-related fraud, and should be aware of the requirements for compliance in properly utilizing these funds.

It is no wonder that we keep on watching funny TV shows or movies, stand-up comedians, and late-night political satire. It makes us feel better. With all the evidence on how humor can be beneficial, a more appropriate question then is not, “Is it OK to laugh?” but instead, “What are you waiting for?”

cardiovascular medicine and clinical investigation. In the spirit of the Cooley legacy, we are joining together as a body of clinicians, surgeons and scientists with a unified ethos to take Dr. Cooley’s core mission far into the 21st Century.” 

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Liability Risks

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as some do not have sufficient internet bandwidth for video visits. Moreover, circumstances have forced physicians to use telemedicine in ways they usually might not. Telemedicine is ideally an adjunct to in-person care, and therefore not the best option for a first visit with a new patient, but during peak infection risk, exceptions had to be made. Among our infrequent telemedicine claims pre-COVID-19, misdiagnosis of cancer was the top allegation, and I can’t imagine that risk of misdiagnosis has decreased, given the spike in telemedicine usage under nonoptimal conditions. Also, I anticipate that some COVID-19-related cases will focus on shortages of personal protective equipment (PPE)—those claims may come from patients or employees. • As you’ve said, providers are delivering care differently during

COVID-19. How do these changes diminish or increase risks? • In the crush of managing a public health crisis, many hospitals and practices have had to take temporary measures that impact patient safety:

Some of these measures mitigate certain risks but may amplify others. Healthcare providers in hard-hit areas are working longer hours, sometimes with insufficient PPE, sometimes in large tents put up in parking lots or other overflow sites. In surge locations, staff from other departments may be covering in the emergency department (ED) or intensive care unit (ICU)—this is could increase the risk of communication gaps. All of these resource-stretching measures, taken together, may add up to a risk profile that is more than the sum of their parts. While responding to health COVID-19 Study

Continued from page 1

further development of the pandemic and the impact that vaccination and improvements in therapy will have on our populations,” said Dr. Chris Amos, principal investigator of the Baylor study, director of Baylor’s Institute for Clinical and Translational Research and associate director of population and quantitative science at the Dan L Duncan Comprehensive Cancer Center at Baylor. In addition to prevalence, researchers also will study demographic and social risk factors and medical directives from state and local governments, as well as advisories from the Centers for Disease Control and Prevention (CDC) and other trusted sources, hospitals and practices will continue to experience unavoidable delays in treatment to all patients. Testing delays do not help. In addition, by patient preference, many routine checkups and tests have been delayed, not to mention routine procedures. Adverse events linked to these delays could affect physician liability. • What can physicians and practices do to protect themselves during the pandemic? • Conscientious documentation becomes a witness for the physician in the courtroom. In the COVID-19 era, practices may benefit from documenting not only individual patient interactions, but how the practice is following CDC infection control guidelines and recommendations from state and local health authorities at particular points in time. This could be as simple as jotting a daily note in an electronic calendar. • How are courtroom changes during the pandemic challenging defense teams? • In a recent medical malpractice suit, a physician member of The Doctors

Company, with assistance of counsel and The Doctors Company’s support, secured a defense verdict despite many changes in the courtroom environment that could have posed problems if we had not been prepared to adjust. We’ve seen firsthand how physicians facing a court hearing during COVID-19 need a legal team that is prepared for changes in depositions, jury selection, and the trial itself. For instance, depositions may be completed by video, with multiple screens for the attorneys, parties and exhibits, and jury selection may take place partly co-morbidities associated with infection. Data collected in the study will be used to inform mathematical models of disease progression and projections of future disease risk. COMPASS organizers will recruit a diverse group of participants that reflects the ethnic, age and gender make-up of the U.S. population. Nationwide, the study will collect samples from about 70,000 individuals, with about 4,000 of those participants coming from the Houston area. Participants will be recruited at community gathering spots like grocery stores, churches and parks as well as nursing homes and healthcare centers. In order to ensure selected individuals via written communication. During trial, showing evidence must be done differently, so defense teams need solid technology skills in settings where counsel can publish exhibits to the jury using large screens. Some courts are taking 15-minute breaks every hour for better ventilation and cleaning. This breaks the momentum when an attorney is speaking with a witness, reduces the overall trial time per day, and prolongs the trial duration. Taking time out of a practice to participate in an extended trial can further stress a stretched practice. • Litigation stress places a burden on physicians at any time. How is this different during the pandemic? • Individual trials are taking longer, compounding delays from the existing backlog. This keeps physicians in limbo—and could even affect their credentialing. As previously reported by RAND, pre-pandemic, on average, physicians were already spending more than 10 percent of their careers living under the shadow of an open malpractice claim. It is true that at any time, even the best of physicians could find themselves facing an unexpected lawsuit. And states around the country handle cases differently. That’s why our members are supported by legal teams with deep roots and expertise in members’ local venues. In addition, knowing that the stress of malpractice litigation affects physicians deeply, and knowing that preparation is the key to victory, we support our members through in-depth litigation preparation. Like the COVID-19 pandemic itself, pandemic-related risk exposures are fluid. Physicians, practices, hospitals, and systems are facing rapid changes in liability exposures at the same time as changing under their feet.

the day-to-day business of healthcare is are similar to their community, the study will set up facilities at the different sites and randomly ask individuals to participate in testing and sample collection. The study is part of a $20 million initiative by the National Institutes of Health to understand the prevalence of COVID-19 infection. Results will allow researchers to estimate how many members of the Houston population have already been infected by COVID-19 and determine the current burden of COVID-19 infection. For more information on the study, contact Amos at chris.amos@ bcm.edu

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