Stanford Health Care People - Fall 2014

STANFORD HEALTH CARE

A PUBLICATION PUBLICATIONFOR FOREMPLOYEES EMPLOYEESOFOF STANFORD STANFORD HOSPITAL HEALTH& CARE CLINICS

ISSUE ISSUESIX NINE / WINTER / FALL 2014

HUMAN RESOURCES EMPLOYEE AWARDS SPIRITUAL CARE

from the CEO

PAGE TWO News and Notes From Around SHC...

Dear Colleagues, As Stanford Health Care continues to reach out to serve in more locations and in new ways, our commitment to care and to C-I-CARE is driven by our outstanding team members.

In this issue you will read about approaches our Human Resources team is deploying to provide outstanding support to all of us. For example, 90 percent of all employee telephone inquiries in August to our Human Resources answer center were resolved on the first phone call.

On the back cover of this issue we feature an impactful

Have you joined the @stanfordhealthcare.org family? We encourage you to begin using the new address on business cards, email signatures, and other documents and communications.

Go to the Brand Standards link on SHC Connect to see our new templates … This year marks the 25th anniversary of the Stanford Health Library, which continues to provide evidence-based medical information and research to the public. The library opened in 1989 with its first location at the Stanford Shopping Center. Today, there are four locations and one affiliated library throughout the community. In FY14, the Health Library served more than 13,000 walk-ins and 360,000 online visitors … According to Press Ganey surveys, SHC now ranks in the 94th percentile nationally in terms of “Likelihood to Recommend” our inpatient care.

This score has risen dramatically from the 45th percentile level experienced just a few years ago.

For Emergency Department care, SHC ranked in the 78th percentile, up from the 28th percentile a few years ago. Ambulatory Care patients rank SHC in the 69th percentile, which is up significantly from the 12th percentile level experienced several years ago. The Cancer Center, which had been in the fifth percentile several years ago, most recently ranked in the 94th percentile … The MyHealth patient portal continues to see steady growth, with the number of active users increasing to more than 135,000 accounts. This places Stanford Health Care in the top four among the nation’s 100 academic medical centers using Epic.

MyHealth provides SHC patients with secure access to their health records, and enables communications and virtual visits with their physicians … Did you know: Stanford Health Care is the first hospital in the country to offer GMO-free certified beef from a local rancher to more than 6,000 patients and employees each day.

story on leading edge and coordinated care from one of our patients. She truly is an inspiration and a wonderful reminder of why we are all here.

As always, I wish to extend my sincere thanks for everything you do to help heal humanity through science and compassion, one patient at a time.

STANFORD HEALTH CARE PEOPLE IS PUBLISHED BY

SHC OFFICE OF COMMUNICATIONS GARY MIGDOL EDITOR, DIRECTOR OF INTERNAL COMMUNICATIONS KATIE LIPOVSKY, COMMUNICATIONS SPECIALIST GRACE HAMMERSTROM CONTRIBUTING WRITER JAMES LARKIN DIRECTOR OF CORPORATE COMMUNICATIONS/PR SARA WYKES CLINICAL AFFAIRS WRITER NORBERT VON DER GROEBEN PHOTOGRAPHY

Sincerely, AMIR DAN RUBIN PRESIDENT & CEO

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STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

Send comments and story ideas to communications@stanfordmed.org

ON THE COVER: Members of SHC’s Human Resources Team

PUTTING A

HUMAN TOUCH

ON HUMAN RESOURCES

New Programs and Philosophies Reinventing HR

O

NE OF THE FIRST THINGS KETY DURON DID WHEN SHE ARRIVED IN JANUARY AS SHC’S NEW VICE PRESIDENT OF HUMAN

RESOURCES WAS TO OPEN ITS PREVIOUSLY CLOSED FRONT

DOOR AND TO END ITS PREVIOUSLY AUTOMATED TELEPHONE MENU.

It was symbolic of many changes Duron has directed, all aimed at endowing HR with greater transparency, responsiveness, and effectiveness to make SHC “the employer of choice in Northern California,” she said.

Much has been accomplished in a short time, Duron said, “and there is much more to be done. We are looking at every process, questioning why CONTINUED ON PAGE 4

HELPING TO REINVENT HUMAN RESOURCES ARE BRITTANY NG (TOP LEFT), AND SUSANNE OGI (TOP RIGHT), FROM THE HR OPERATIONS TEAM, PATRICK ALVAREZ (MIDDLE) FROM EMPLOYEE & LABOR RELATIONS, AND KETY DURON, HR’S VICE PRESIDENT (ABOVE).

STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

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CONTINUED FROM PAGE 3

to make it easier and faster for

we have done it the way we have and looking for ways to do it better. What keeps me up at night is how we attract and recruit talent and how to retain

employees to get answers to

DID YOU KNOW?

questions, it is now a point of pride for the HR team. It includes tool kits for employees and managers that include

our employees.”

For new employees, she built a new onboarding process.

“First impressions make lasting impressions,” Duron said. “Early on we focused on creating a seamless

SHC RECEIVED

86,821 APPLICATIONS IN FY14 FOR JOB OPENINGS. OF THOSE,

2,250 POSITIONS WERE FILLED.

often-requested information and a special section for new employees.

Employees will also notice that HR’s organizational structure is visible on its webpage with contact

onboarding process for our new hires,

information for each person. Rallying

by adding new hire sessions and

all of HR’s group leaders to conduct

revamping the new employee and

daily staff huddles and active daily management was another important step.

leader sessions.”

For current employees, one of the most easily visible differences is HR’s webpage. Revamped and redesigned

Learn more by visiting Human Resources on SHC Connect.

Here’s a Quick Look at Other Changes in HR’s Territories

Training and Organizational Development For frontline staff, said director Todd Prigge, “we’ll be working with Performance Excellence to provide training in the Stanford Operating System and in the tools and methodologies of being problem-solvers. We want an organization that has a culture of problemsolving.” Redesigned orientations for new employees and leaders have been crafted “to set our new hires up for success,” Prigge said. Another priority is the development of new leaders from within SHC, he said. “Our goal is to leverage employees’ strengths.”

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STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

Employee and Labor Relations Director Mary Gaines is responsible not only for negotiation of union contracts with major employee groups, but also for those daily requests that cover a wide array of questions about everything from harassment to compliance with policies, labor laws and other regulations.

A new goal is to find new ways for managers to learn best practices for working with their teams.

Compensation This program has a trio of goals: to attract and retain a talented workforce, to provide a competitive mix of pay and benefits, and to align pay with contributions and competency. What may be appreciated already is a beefedup system of answering calls about benefits. This year, SHC hired a new vendor to assist with those calls, and those extra hands have enabled Compensation’s team to resolve 80 to 85 percent of those calls in that first phone call.

PICTURED ABOVE: HR TEAM MEMBERS TERRI DAY-RITTER (LEFT), LAURA GRUBB (MIDDLE) AND MARGARET WILSON (FAR RIGHT).

Talent Acquisition

Operations

Occupational Health

Manager Teresa Wei has been at SHC for a decade and appreciates how much there is to do. In 2008, SHC had about 7,000 employees; now it has nearly 10,000. “The external market,” she said, “is much more dynamic and competitive. The demand for good, experienced talent far exceeds supply in many cases, so we are doing more to build our own pipeline of talent.” That includes recruiting new graduates for training programs and internships—and working with local workforce agencies to build training programs for medical assistant and other jobs.

Manager Mylien Yuan must take a very big-picture view of HR, because operations touches many aspects of HR. One major renovation under way is a dedicated team assigned to each major SHC department. That core team will include a representative from each of HR’s disciplines to build closer connections to departmental needs and a quicker response. The new-hire onboarding process now includes providing ID and parking permits at orientation so employees can arrive for work their first day ready to go. Yuan and her team are also working with the IT team to deliver computer information to new hires so they will have that, too, on their first day.

Director Mary Spangler and Duron’s goals for this team include a stronger integration of OHS services into all aspects of work life at SHC. The Healthy Steps program, already part of Occupational Health, supports many of the early employee health tasks, including the post-offer physical, TB screening, and blood draws and ergonomics. “We are looking forward to more collaboration and more sharing,” Spangler said, “to help people navigate all our services.”

This year, employee safety is a priority, and Spangler is working closely with a number of groups to support this initiative.

STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

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FOCUS ON Employee Safety As part of its annual goal setting, Stanford Health Care has prioritized employee safety as a top initiative for the new fiscal year, with the goal of reducing the injury rate to at or below the industry benchmark.

“We have the best employees in health care, and they deserve the safest possible environment to work in,” says James Hereford, Chief Operating Officer. “Our data suggests that hasn’t been the case.”

“As an organization, we have done an amazing job of focusing on patient safety,” adds Kety Duron, Vice President of Human Resources. “We want to bring that same focus to the health and safety of our employees.”

SHC is addressing employee safety from a number of angles. “The first

MINAL MOHARIR, MD (RIGHT), AND OCCUPATIONAL HEALTH STAFF, TREAT EMPLOYEES WHO ARE INJURED IN THE WORKPLACE.

thing we’re doing is getting more data out to our managers and directors in the form of dashboards so injury rates are more visible,” says Duron. “We are also asking our front line managers and supervisors to become ambassadors of employee safety—to talk about safety in their daily huddles, look for 6

STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

PATIENT-LIFTING DEVICES HELP MINIMIZE EMPLOYEE INJURIES. ABOVE, AARON TOSCH, RN, AND BRENDA VALENCIA FROM DI DEMONSTRATE HOW TO LIFT A PATIENT FROM A BED.

“As an organization, we have done an amazing job of focusing on patient safety. We want to bring that same focus to the health and safety of our employees.” hazards in the workplace, and ask for improvement ideas from their teams,” she says.

“We want to use employee safety as a key driver of operational excellence” says Hereford. “If an employee gets injured or comes close to being injured, that is an opportunity to improve our processes and make the organization safer for everyone.”

The primary sources of injuries at SHC come from the push/pull/manipulate motion; being struck, injured or hit by something; slips, trips and falls; and repetitive motion. To address these risks, the organization conducts targeted safety training, job hazards assessments, ergonomic evaluations, and workspace improvements.

Employees who are injured at work are assessed and treated by Occupational Health Services. “Our

goal is to get the employee back to work in the same job or in a modified role,” says Mary Spangler, director of the department. “We also look at injury causation factors,” she says. “Is this something that can be prevented in the future?” Injury prevention often involves changing long-established habits and procedures. “The key for employees is to understand that they are part of the process,” says Spangler.

“We need their input and engagement around safety.”

ERGONOMIC EVALUATIONS AND ADAPTIVE WORKPLACES SUCH AS STANDING DESKS HELP EMPLOYEES LIKE DEMETRIUS PERRY AVOID INJURY.

FOCUS ON Spiritual Care Services

“Religious zip codes don’t matter. It’s your presence that says, I’m here with you and you’re not alone. I’m here with you because I care about you. That, to me, is the essence of our work.”

Some of SHC’s most valuable care comes from a special group not easily recognizable by traditional uniform of white coats or scrubs. Without surgery or medication, the members of Stanford’s Spiritual Care Service team quietly tend to the religious and spiritual needs of patients, families and staff, providing them with profound comfort and support.

The team members represent many faiths, but are united in their contribution to healing at SHC. They are good listeners.

They pray with patients and staff. They help families grieve. They perform critical sacraments and rites to honor the rituals of every faith tradition. They provide comfort at the end of life. They help staff cope with personal or work difficulties or with the

sadness that comes from losing a patient.

They perform weddings for patients and renew their vows. They’ve even been known to sneak a beloved family dog to a patient’s bedside at the end of life.

The Spiritual Care Service team is composed of staff chaplains, Clinical Pastoral Education (CPE) residents and more than 160 volunteers. Together, this diverse group serves patients from every faith, including Christians, Muslims, Jews, Catholics, Hindus, Buddhists and Sikhs, as well humanists, atheists and individuals of no particular faith.

“We are committed to providing compassionate care, to listening, and to honoring religious, spiritual and cultural preferences,” says Rabbi Lori Klein,

director of Spiritual Care Service. The goal of the department, she adds, is for virtually every patient who is in the hospital for longer than a day to get a spiritual care visit if they want one.

The Spiritual Care team also serves SHC staff with private support and group activities such as Tea for the Soul. During Spiritual Care Week in November, chaplains offer to bless the hands of care providers and staff to recognize the work they do to heal and care for patients with compassion.

“Religious zip codes don’t matter,” says Rev. John Hester, a Catholic priest who is retiring in January after 39 years as a Spiritual Care chaplain at Stanford.

“It’s your presence that says, I’m here with you and you’re not alone. I’m here with you because I care about you. That, to me, is the essence of our work.”

LED BY RABBI LORI KLEIN, STANFORD’S SPIRITUAL CARE TEAM TENDS TO THE RELIGIOUS AND SPIRITUAL NEEDS OF PATIENTS, FAMILIES AND STAFF. CHAPLAINS BLESS THE HANDS OF CARE PROVIDERS AND STAFF DURING SPIRITUAL CARE WEEK.

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KUDOS July Service Spotlight Award ADRIANA EL CALAMAWY While visiting a patient in his room, Special Patient Services Advocate Adriana El Calamawy learned that he was a pianist and missed playing the piano. The patient was delighted when El Calamawy arranged for him to be able to play the piano in the Atrium during his stay. After he was discharged, the patient returned to perform a concert to show his appreciation.

July Patient Safety STAR Award BEVLIN PRASAD D-Ground unit secretary Bevlin Prasad received the July Patient Safety STAR award for her keen observation and quick action. A refrigerator in the patients’ nutrition room was moved from one side of the room to the other so the room door would no longer bang into the refrigerator. After the move, however, Prasad noticed an unexpected hazard: If the refrigerator door and the room door were opened at the same time, anyone standing between the doors would be hit by both doors and injured. She immediately placed a high injury caution sign on the room door and asked facilities maintenance to move the refrigerator as soon as possible.

August Service Spotlight Award JULIE MUCCINI Occupational therapist Julie Muccini was working with a local college senior who had multiple sclerosis. The patient was struggling in her current dorm and 8

STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

was having a hard time getting around her college campus. After Muccini demonstrated medical necessity and financial need, a medical equipment vendor graciously donated an electric scooter to the patient. Muccini also worked with student housing to arrange for the patient to be moved to an accessible dorm. The student was able to continue to stay on campus and was a proud graduate of the class of 2014.

August Safety STAR Award CAROLYN HOOD As a Surgery Admission Unit (SAU) office assistant, Carolyn Hood prepares patients’ charts after they check in for surgery. While preparing a patient’s chart, she noticed that the patient had a history of drug use, but no drug toxicology screening had been ordered.

She immediately reported her findings to the SAU Resource Nurse (RSN). The anesthesia team was notified, and a toxicology screen was ordered, which came back positive for drugs.

Surgery was canceled because the combination of street drugs and anesthesia could have been fatal. Carolyn Hood went beyond the scope of her job to ensure the safety of the patient.

September Service Spotlight Award ERIN BISETTI, BSN, RN, AND LAURA DEBENNING, RN, OCN With the help of Guest Services and two security officers who are also military veterans, E1 nurses Erin Bisetti, BSN, RN (below, right), and Laura DeBenning, RN, OCN (below, left), organized a send-off to honor a patient’s service to his country. Bisetti and DeBenning did not want the

highly decorated veteran’s last journey to be without special honors. His gurney was covered with Stanford red VIP blankets and topped with a single white orchid. Doctors, nurses and other staff lined E1’s hallways, with hospital security guards acting as a form of honor guard. At its final stop, the security officers lined up and raised their hands to their foreheads in a respectful salute.

Two friends of the soldier joined that gesture. The red blankets were later folded and presented to the two friends by E1 nurses.

SHC BOARD AWARDS Each year, the Stanford Health Care Board of Directors honors individuals who exemplify the highest standards of Stanford Health Care with two awards: The Isaac Stein Award for Compassionate Care and the Denise O’Leary Award for Clinical Excellence.

MARTHA BERRIER Martha Berrier, D1 Patient Care Manager, was presented the Isaac Stein Award for Compassionate Care for the extraordinary care she provides to her patients. She is known throughout the hospital for her ability to be consistently cheerful and positive even under difficult circumstances.

“Martha sees what happens from all perspectives—including patients, nurses and physicians,” said Randy Vagelos, MD. “This eliminates the barriers that can keep health care teams from achieving their ultimate goals.”

GLENN CHERTOW, MD Glenn Chertow, MD, was honored as winner of the Denise O’Leary Award for Clinical Excellence for his deep commitment to patient care and for modeling a combination that sets the highest standard for faculty—a reeminent clinical researcher and an outstanding clinician. In addition to being a tireless advocate for patients, he also advocates for the well-being of the physicians in his division.

56th Annual Employee Awards Banquet SEVERAL EMPLOYEES WERE RECOGNIZED FOR THEIR OUTSTANDING WORK AT STANFORD HEALTH CARE AS PART OF THE 56TH ANNUAL EMPLOYEE AWARDS BANQUET ON OCTOBER 30.

MEMBERS OF THE D GROUND ORTHOPEDICS TEAM

THOMAS A. GONDA AWARDS The Thomas A. Gonda awards are the highest honor a SHC employee can receive. They are given annually to employees who are nominated by coworkers and selected by a committee based on their ongoing and outstanding contributions to Stanford Health Care. The awards were named in honor of Thomas Gonda, MD, a former Stanford Hospital director.

Thomas A. Gonda Employee of the Year Award

leader,” said Linda Green, Pulmonary Clinic Manager. “He effectively delegates, is inclusive in his style, and utilizes C-I-CARE and humor successfully in his work.”

MALINDA S. MITCHELL QUALITY AND SERVICE AWARDS

D GROUND ORTHOPEDICS

Justin Ellsworth was honored for his role in making sure that SHC buildings are safe and ready for patient care.

“We are fortunate to attract a group of people that strive for the best and expect only the best from their team and from their leaders,” said Helen Wilmot, Vice President, Facilities Services & Planning. “Ellsworth is one of those people.”

STANFORD FAMILY MEDICINE

The D Ground Orthopedics team was honored for achieving and sustaining goals for pain management.

The team continues to demonstrate best practices around pain management at the bedside.

The Stanford Family Medicine (SFM) team helped to reduce the number of e-Prescribe errors by 85% at the SFM clinic. The outcomes show the outstanding results that a multidisciplinary team can produce to impact quality and service for our patients.

JACK O’MALLEY, CLINIC MANAGER FOR ORTHOPAEDIC SURGERY Jack O’Malley is celebrating 40 years at SHC. Known for managing each and every interaction with respect and kindness, O’Malley has developed tools that have become best practices within Ambulatory Care. “Jack is an inspired

Four special awards for outstanding contribution and achievement were also presented.

LINDA GOJENOLA, SOPHIA LOO, DEBBIE VALDEZ BARRAGAN, KEVIN WARD Linda Gojenola, a 25 year employee, is a supervisor in the Molecular Pathology Laboratory. She received the award for being a compassionate, patient-centered

The Malinda S. Mitchell Quality and Service Award, named in honor of SHC’s former chief operating officer, are given annually to programs that have demonstrated exceptional quality and teamwork.

JUSTIN ELLSWORTH, MASTER ELECTRICIAN

Thomas A. Gonda Award for Management

SPECIAL AWARDS

MEMBERS OF THE STANFORD FAMILY MEDICINE TEAM

leader. Sophia Loo is a nurse coordinator in D3 IICU. She has been at SHC for 13 years and was honored for the compassion and dedication she has for her patients. Debbie Valdez Barragan has been at SHC for 6 years and is an administrative coordinator in the Department of Graduate Medical Education. She was recognized for being a dedicated, consistent, and committed team member. Kevin Ward was honored for providing outstanding customer service. Ward has been at SHC for 9 years and he works in the Ambulatory Care Services Call Center.

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GOOD WORKS At SHC Team Tackles CT Efficiency Because the contrast used for CT scans is thick and must be injected at a high rate of pressure, it can cause IV lines to leak or detach. When this occurs, radiology staff must repair or start a new line or send patients back to the floor. Two years ago, 8 percent of patients had defects in their IV lines, which caused scheduling delays, idle machines, and frustrated patients and staff.

“A 15-minute exam would turn into a 30-minute exam,” says Daisha Marsh, CT Technical Supervisor. With only three

(RPIW) that included radiology technologists, transport personnel, and nurses from radiology, inpatient units and the Emergency Department.

The team created new standard work for the patient hand-over process, and radiology staff began educating floor nurses on securing IV lines. To sustain the learning, radiology staff regularly attends huddles on the floors, and Marsh distributes an IV defect report to all stakeholders each week.

As a result of these improvements, the IV defect rate dropped from 8 percent to between 2 and 3 percent one year after the RPIW. Today, two years later, that defect rate is near zero.

Madra attributes this success to both the sustained process improvement work and a new closed-system catheter that was recently implemented hospital-wide.

In the Community Stanford Leads Bicycle Safety Coalition

HARM MADRA AND DAISHA MARSH LED A PROJECT IMPROVEMENT EFFORT TO IMPROVE CT EXAM EFFICIENCY.

scanners for up to 95 patients a day, including interventional radiology exams, it was critical to improve efficiency of this limited resource, she adds.

To remedy this situation, Marsh, together with Harm Madra, nursing manager in radiology, led a Rapid Process Improvement Workshop 10

STANFORD HEALTH CARE PEOPLE / ISSUE NINE 2014

Cycling crashes are the third most common cause of admits to Stanford Trauma. Each week, about 11 cyclists are seen at the Stanford Emergency Department. When Chief of Staff Mark Welton was struck and injured on his bicycle in 2011, trauma surgeon David Gregg, MD, had seen enough. He sought out Welton’s wife, Cindy, and urged her to organize a bicycle safety summit to address the issue.

From that original mission, the Roadways Safety Solutions Team (RSST) was born. Led by the Stanford Trauma Center and the Silicon Valley Bicycle Coalition, the group brings together public works staff, law enforcement, health agency officials, cycling clubs, the DMV, Caltrans and elected officials to address bicycling safety in Silicon Valley.

The group is focusing its efforts on two key areas—infrastructure improvements and cyclist and motorist behavior, says Ellen Corman, supervisor of Stanford’s Community Outreach and Injury Prevention Program. Recently, it held a design challenge to create new messaging about sharing the road and is close to getting a number of dangerous intersections repainted.

“When David Gregg tasked my wife with organizing a bike safety summit to make the roads safer, he unleashed a force.”

In June of this year, the group was honored with the Community Partnership Award, presented by the Stanford University Office of Public Affairs. “When David Gregg tasked my wife with organizing a bike safety summit to make the roads safer, he unleashed a force,” says Mark Welton.

“I would never want anybody to be on either side of the incident that happened to our family,” adds Cindy Welton. “If I’m in a position to do something about it, I need to.”

CINDY WELTON WAS INSPIRED TO DEVELOP A BIKE SAFETY PROGRAM AFTER HER HUSBAND MARK’S BICYCLING ACCIDENT IN 2011.

BUILDING STANFORD HEALTH CARE Hospital and Outpatient Center expansion reach new heights— literally—in 2015

M

ultistory steel frames, the skeletons of Stanford Health Care’s modern medical facilities, are gradually taking shape after years of planning—both on campus and 25 miles to the south—to address the increasing health care needs of the surrounding communities.

“With the addition of three new facilities, Stanford Health Care is expanding its footprint by more than a million square feet to better serve its patients,” says Bert Hurlbut, Vice President of Construction. “The next year will culminate with the opening of the South Bay Cancer Center, the completion of the Neuroscience Health Center, and the completion of the new hospital’s seven-story steel frame.”

The first of these three projects is the South Bay Cancer Center (SBCC), which is scheduled to open for patient care in summer 2015. When Stanford started the project, the four-story building was a warm shell with a minimally finished interior, says Katie Abbott, Senior Program Manager of Business Operations.

Construction crews are now on site, building out interior framing, installing drywall, and beginning some interior

2015 WILL SEE THE COMPLETION OF STEEL BEAM INSTALLATION FOR THE NEW HOSPITAL (ABOVE), THE OPENING OF THE SOUTH BAY CANCER CENTER (RIGHT, BOTTOM) AND COMPLETION OF CONSTRUCTION FOR THE NEW NEUROSCIENCE HEALTH CENTER (RIGHT).

finishes. In the next few months, major medical equipment installation will begin.

The project team is also beginning the transition-planning phase and continues to design future processes that will allow us to deliver coordinated care in a patient and family-centered way, Abbott adds.

Closer to campus, crews at the Stanford Neuroscience Health Center have completed the steel framing, installed metal decking on each floor, and begun pouring concrete, says Rachel de Guzman, Senior Project Manager, Planning, Design & Construction. The steel system was installed in just four weeks due in part to Stanford’s use of a modular, prefabricated steel building system that automates welding and machining processes. Later this month, the crew will begin erecting the exterior glass skin of the building, and that work will continue through the spring. Construction is scheduled to be complete in July 2015.

A mile down the road, the new Stanford Hospital is rising out of the ground, one floor of steel at a time.

“For the last year and a half, we have been going down,” says Kevin Curran, Director of Construction. “And now

we’re really going up.” Steel beam installation started in late June and will continue through February 2015, Curran says. “We’re currently at the third level, with five or six more to go.” The hospital will celebrate the completion of steel with a “topping off ceremony,” fitting the final steel beam into place amid a celebration.

Once the frame is complete, the number of laborers onsite will increase from about 200 to 600 per day, says Curran, as various trades work side by side on the interior. Early next year, a giant tower crane will be brought on site to hoist the exterior materials needed to enclose the building. The new hospital is scheduled for completion in 2017.

Learn more about the Stanford University Medical Center Renewal Project at sumcrenewal.org.

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OUR PATIENTS NOW

Diving

FOR THE AGES Five years ago, not too long after Viki Tamaradze had celebrated her 80th birthday, she arrived at SHC with a long-standing complaint—cramping in her lower legs so painful that she could barely walk more than a block at a time.

Her first clinic visit was with Ron Dalman, MD, Chief of Stanford’s Division of Vascular Surgery.

Her problem, he said, was a blood flow condition called claudication. He could prescribe her a medication that might work, he said, or she could try another approach that many studies showed would work—walking.

She started on a regular routine of treadmill work. She also decided she wanted to do something else. “I hadn’t jumped in probably 70 years,” she said, “and I had been a swimmer.” She’d been watching the college-age divers practicing at the UC Berkeley gym, and something about the activity grabbed her. “I decided I would love to have that kind of control and grace,” she said.

It took a couple of rejections from coaches “who didn’t want to teach someone so old,” she said, until she heard a yes from Todd Mulzet, a veteran diving coach who had just started as the head diving coach at UC Berkeley. “When he said, ‘Sure,’ I nearly fell over,” Tamaradze said.

“What it really comes down to is that she wanted to do this,” said Eric Holzheimer, who now coaches Tamaradze as part of the Cal Diving Club.

“There’s that old saying that you can’t teach an old dog new tricks, but the greatest physical asset anyone has is the five inches between your ears.”

Her age made her an ad hoc mascot for the UC Berkeley diving team. She also is not immune to competitive spirit: She participates in U.S. Diving Association diving meets—in her age category, of course. “Sometimes, I’m the only one.”

Others have told her she’s also unusual because she began so late—that most masters level divers had collegiate diving experience.

Dry-land conditioning helped her, Holzheimer said, and so did swimming and stretching. “She’s always exercising.” She kept on going even after she tore a rotator cuff in her shoulder while trying a dive and after surgery Dalman did to clear out a blockage in her carotid artery.

Tamaradze’s diving has transformed her body.

“Her posture, her balance—and try to find another woman her age who would take this on!” Dalman said. “It shows how functional maintenance can extend your life.”

“The first time I showed up at a meet,” Tamaradze said, “I thought, ‘I can’t dive in front of all these people.’ But once you get on the board, the total concentration you need is absorbing. I love that kind of experience—and I have never felt better in my life!”

Find more patient stories at stanfordhealthcare.org/now.