SUMMER 2022
MARSHALLTOWN
REUNITED AND IT FEELS SO GOOD
Patient Meets Ambulance Crew That Saved His Life
TAKE A PEEK INSIDE YOUR NEW HOSPITAL PROACTIVE RESPONSE TO STROKE KEY TO PATIENT’S RECOVERY
unitypoint.org/marshalltown
WHAT’S INSIDE
EXTERIOR CAMPUS
1 A Note from Shari Administrator, UnityPoint Health – Marshalltown 2 Patient Reunited with Ambulance Crew That Saved His Life
A Note from Shari
4 Take a Peek Inside Your New Hospital
Friends, This is my first note to you since we moved into our new hospital. As you can imagine, things look very different now.
6 Proactive Response to Stroke Helps Patient Avoid Major Damage
If you didn’t make it to our open house, or haven’t been here to receive care yet, it’s a state-of-theart facility. And, as we said for months leading up to the move, the benefits go beyond curb appeal. You’ll find the facility was designed with our patients and families in mind. Parking is convenient, entry ways are clearly marked and handicapped accessible, and the floorplan greatly helps our workflows so we are more efficient in caring for patients.
8 Growing Family Medicine Clinic Adding Two Providers 9 Q&A with Lisa Spitzli, Med/Surg Floor Manager
Of course, we also opened a new urgent care facility a year ago with the UnityPoint Clinic – Express location at the intersection of Olive and South Center and recently remodeled the family medicine clinic at 303 Nicholas Drive to allow us to care for more patients. There’s no doubt the new facilities have made our workspace more efficient, but our true work remains – fine-tuning the patient experience. At UnityPoint Health, we want you to know how much you matter to this world, and every one of our team members realizes new facilities aren’t the best way to do that.
Nominate a Nurse for a DAISY Award UnityPoint Health – Marshalltown participates in the national DAISY Foundation, which was established in 1999. The goal is to recognize exceptional nursing around the country.
Summer 2022 LiveWell magazine is produced by UnityPoint Health®. 55 UnityPoint Way | Marshalltown, IA 50158 (641) 754-5151 | unitypoint.org/marshalltown Copyright ® 2022 UnityPoint Health. All Rights Reserved. ® SM trademarks of UnityPoint Health.
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If you witness remarkable care from one of our nurses, we encourage you to nominate that nurse for a DAISY Award. Ask for a nomination form from any nursing unit in the hospital or complete the online form at unitypoint.org/marshalltown/daisy-award.
For instance, we closely monitor your patient experiences. If you’ve visited us recently, you received a survey via text or email. And while these surveys are automated, please know they aren’t a matter of us going through the motions. We track every score you assign, and we see the comments (both the good and the bad). When a patient experience doesn’t meet expectations, we respond – sometimes with a message to learn more and sometimes by taking action to avoid future missteps. It’s the same process utilized by all UnityPoint Health hospitals. We’ve been in Marshalltown for five years now, and I believe we’ve done a great job of putting the UnityPoint Health DNA into our teams and processes. The proof is in the pages that follow. Check out Jon Brones’ amazing story on page 2, and you’ll agree that our ambulance service is amazing. Or read Kathy Smith’s stroke article on page 6, and you’ll see that our ER is ready for emergencies large and small. Join me in stepping back and reflecting for a moment on the amazing progress we’ve made together. Five years ago, Marshalltown was troubled with a bankrupt hospital. Now, our community has new facilities and we’re focused on our patients and families, while enjoying the backing of the state’s strongest health system. Needless to say, I’m very proud of our team and so encouraged about our future. Sincerely,
Shari King Administrator, UnityPoint Health – Marshalltown
AMBULANCE CREW
Patient Reunited with Ambulance Crew That Saved His Life
with a dangerously low oxygen level in the 40s. He initially didn’t want to go, but the team convinced him otherwise. So, they quickly transported him to the emergency department in Marshalltown, where an ER team got him stabilized. Fortunately – and frankly surprisingly, considering it was fall 2021 – there was a bed available at a nearby hospital, so the ambulance service rushed him there. “I’m glad they drove 80 instead of 75, because it sounds like I didn’t have 5 minutes to play with,” Brones reasons now. One provider told him his oxygen level was at 40 when he arrived, and they couldn’t find a pulse. Near the end of his stay, another doctor told Brones how special he was to survive. “He said, ‘I only had one other patient other than you who walked out of here,’” Brones says. “So, like a dummy, I asked him what happened to the rest of them. Where did they go? He said, ‘They died.’”
“It’s not very often that this happens where people actually come back and thank us for what we did,” said Colin, an EMT who drove the ambulance that took Brones to the ER in Marshalltown. “It makes the job worth it.” “That’s true, it’s not something you hear every day,” echoed Turner, a clinical care attendant who was with Brones in the back of that ambulance ride. “It’s rewarding. I mean, it’s nice just to be able to go out and make a difference any way you can.” “You can’t believe how thankful I am for you guys,” Brones summed up in front of the ambulance team while fighting back tears. “You’re all responsible for me being here today.” “We understand that people do feel thankful for what we do and don’t necessarily take the time to come back and tell us,” said Sinnwell, the paramedic who rushed Brones to the hospital. “We don’t expect them to, but it’s very nice when they do.”
Brones saw many others struggling with COVID-19 and most didn’t make it, including another man from Marshalltown who lasted 13 days before succumbing. “He was much younger, bigger and stronger than I am,” Brones says. “I asked them what causes me to make it when that guy didn’t, and they said my will to live was strong.”
Jon Brones flanked (left to right) by UnityPoint Health’s Shayne Turner, Bobby Colin and Steven Sinnwell.
While driving on other calls, Bobby Colin has passed by Jon Brones’ home many times since last fall and wondered how the Marshalltown man was doing. Or if he even survived. On a sunny summer day nearly a year later, he finally got his answer. Brones, who nearly died from COVID-19, was reunited with the UnityPoint Health – Marshalltown ambulance service team that saved his life. In a conversation that often grew emotional, he asked questions about that night and expressed his gratitude for the group’s life-saving work. “I wanted to thank you guys for what you did to help me that day,” a tearful Brones told a roomful that included Colin, Steven Sinnwell and Shayne Turner, as well as their regional manager Nick Heintz. “You probably do that every day and it’s probably no big deal to you, but it was a big deal to me.”
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Brones has one amazing story to share – at least the parts he remembers. He remembers going to bed the night of August 27, 2021. The next thing he can recall is waking up in an ICU in Ames. It was now September 27. Thirty-one days had passed. “I told people, ‘No, it’s August,’” Brones retells. “So, my girlfriend took a picture of me and a beard that I didn’t have before and showed it to me.” Brones’ girlfriend, Phillis Booth, played huge role in his story. When she found him unresponsive, she called 911, which summoned the UnityPoint Health ambulance from Marshalltown. Then she visited Jon every day he was in the hospital, held his hand and talked to him. Brones was alert when the ambulance got to his home, but he doesn’t remember it. The first responders found him
All told, Brones spent 49 days in the hospital, including 31 in the ICU. When he finally woke up, he could barely utter a whisper. Along the way, he contracted pneumonia and was tested for brain damage. His family was even prepared by the hospital in the event of his imminent death. “We had gone on a 3,000-mile motorcycle trip with friends just before the whole thing,” Brones says. “My girlfriend was vaccinated and nobody else was, and she’s the only one who didn’t get sick. It kind of made a believer of me that I should’ve gotten vaccinated.” It’s been a slow but steady recovery since his discharge. Brones was on oxygen until the middle of February, he had to use a walker for a while and his stamina hadn’t fully returned nine months later. However, he’s moving reasonably well on his own and recently returned to full-time work. That made it a great time to stop by the new UnityPoint Health hospital and enjoy a reunion with the EMS team that came to his rescue in August.
LiveWell Summer 2022 | 3
NEW HOSPITAL
MEDICAL/SURGICAL UNIT This inpatient unit consists of 16 large rooms with private, walk-in showers and beautiful views of the countryside. Each room has a bedside monitor for increased monitoring of higher-acuity patients and a state-of-the-art call light system. There’s also an inpatient therapy room in the southeast corner of the unit.
We’re Open!
INPATIENT PHARMACY & RESPIRATORY CARE An inpatient pharmacy and respiratory care are conveniently located just down the hall from the med/surg rooms. The pharmacy features updated equipment and three new compounding hoods, while the latter was built to allow enhance cleaning/sterilizing of respiratory equipment, as well as nearby storage for all respiratory equipment.
Our New Hospital is Here. Take a Peek Inside.
IMAGING Our acclaimed imaging department didn’t move throughout the build and continues to offer MRI, CT, nuclear medicine, mammography, ultrasound, general X-ray and more. There is also a mobile PET service that comes every other week.
The new UnityPoint Health hospital in Marshalltown is open and ready for business. Two years of preparation and construction came to fruition in late April as the hospital’s operations were officially moved from the 106-year-old hospital downtown to a newly expanded facility just south of where Highways 30 and 14 intersect. The move marked the completion of a $38.4 million expansion of the medical park. It also served as a mile marker for UnityPoint Health, which was celebrating its five-year anniversary in Marshalltown after taking the reins from a bankrupt organization. But what does all this really mean for Marshalltown? Plenty. The facility was designed with patients and families in mind – parking is convenient, entrances are clearly defined and handicapped accessible and the floorplan allows us to be more efficient in caring for patients. All this works together to enhance the patient experience. The future of healthcare is already here in Marshalltown, and here’s what it looks like for many of our service lines.
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EMERGENCY DEPARTMENT The 16-bed ER consists of 10 standard treatment rooms, two large trauma-specific rooms and a triage room. There are also four observation rooms designed to accommodate our behavioral health patients (protective covers over medical devices and TVs). The rooms in the new ER are far more spacious than those at the old hospital. The Marshalltown emergency department is an especially busy one as it averages 47 patients daily. For the sake of patient experience and efficiency, there’s an attached twobay EMS garage next to the trauma rooms and an X-ray room in the back. In addition, the ER is strategically located close to the lab, imaging and security, while the medical/surgical unit is situated directly above it on the second floor.
LAB The lab is more accessible than ever for the people who need it. Outpatients requiring service are greeted inside the main entrance and a draw station is nearby. Internally, the main lab is situated much closer to the emergency department, which enables a better workflow when time is critical. Finally, new chemistry analyzers (medical devices that examine samples of serum, plasma, urine and other body fluids) have allowed the local lab to standardize care with the rest of the UnityPoint Health system. CARDIAC REHAB & OUTPATIENT RESPIRATORY THERAPY Cardiac rehab is convenient located just inside the main entrance and operates in a bright, open beautiful space with high ceilings. It features advanced equipment with the latest technology for a heart-healthy workout, including a cardiac monitoring system. In addition, there’s an education room for classes to promote lifestyle changes and a separate Pulmonary Function Test lab and EKG room.
CAFETERIA Conveniently located on the first floor between the ER and the main lobby, the café is open to the public from 7 a.m. to 6 p.m. with a variety of home-cooked and grab-n-go options depending on the time of day. At the old facility, the cafeteria was in the basement of a four-story hospital. MULTI-SPECIALTY CLINIC This is a dedicated space in the clinic addition that allows specialists to see patients in the areas of cardiology, nephrology, podiatry, urology, neurosurgery and vascular surgery. There’s a large nurses station behind the reception area, numerous exam rooms and special offices to accommodate the visiting providers. WOUND CLINIC AND SELECT THERAPY These clinics remained where they were throughout the expansion of the medical park. The wound clinic was recently named the top Healogics clinic in the western part of the country. It offers a variety of advanced wound treatments, including skin grafting, wound vacuum therapy, total contact casting and hyperbaric oxygen therapy. Select Therapy, meanwhile, offers physical, occupational and speech therapy care, plus comprehensive pediatric and orthopedic programs along with aquatic therapy and concussion rehabilitation. SLEEP CENTER The sleep center is located in the back of the clinic addition and offers convenient after-hours access from a parking lot in the rear. It primarily tests and treats patients for suspected sleep apnea during days and nights through brand-new state-of-the-art digital technology, while also providing home sleep testing.
EMS GARAGE In addition to the two-bay attached garage, there is a fivebay, free-standing EMS garage just south of the ER. This building resembles a fire station, as it features a kitchen, showers and sleep rooms for crews who typically work 24hour shifts.
LiveWell Summer 2022 | 5
EARLY STROKE DETECTION
Proactive Response to Stroke Helps Patient Avoid Major Damage
When a stroke occurs, ER doctors like to say, “time is brain.” That fact was underscored when Kathy Smith arrived by ambulance at UnityPoint Health – Marshalltown.
delivered within a narrow window beginning with the onset of stroke symptoms.
Smith, a 64-year-old paraeducator at Marshalltown High School, was operating a copy machine when her body started to fail her.
“According to all the science, we know that any thrombolysis medicine we give shows the greatest benefit the earlier we give it,” says Dr. Toulouse. “We also know from that same science the dreaded Kathy Smith complications of unwanted or even deadly unexpected bleeding increases considerably if we give this medication too late in the natural process – or if we give it to the wrong patient.
“My arm, on the right side, just started to act up, and I knew something was wrong,” recalls Kathy. “I couldn’t push the button to shut off the copier, and my right leg wouldn’t move. So, I had to get to the nearest person, they got me help, and I was rushed to the hospital.” Kathy’s suspicion was correct – she was experiencing a stroke, and the clock was ticking. Her estimated time of arrival was announced inside the emergency room and Dr. Joseph Toulouse soon met Kathy on a gurney after she arrived by ambulance. “After confirming from her what time her symptoms began and that she indeed had the neurological deficits reported over the radio, I ordered the medics to take her straight to the CT scanner so we wouldn’t lose a moment,” recalled Dr. Toulouse. The good news with a stroke is that patients can often be given tPA (thrombolysis medication) that breaks up blood clots in the body. However, the medication must be
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“We have to accurately, clearly and plainly learn a lot about the patient’s medical history, medications taken and the exact sequence and timing of when the stroke symptoms appeared within just a few minutes of their arrival. We know far too well the stakes are high. We have to think and move fast.” Within about 20 minutes after arriving, Dr. Toulouse received a favorable report from the radiologist, which made it safe to consider a tPA for Kathy. After another 20 minutes at her bedside verifying the aspects of Kathy’s story, he approved the treatment.
“I appreciated him being very straightforward on everything. I told him, ‘I’m 64, and I’ve got 36 more years to go, because I’m not dying until I’m 100, so let’s move on this,’” Kathy said with a smile.
The tPA worked well. After it was given, Kathy was transferred to the hospital of her choice – Allen Hospital in Waterloo – where she was monitored for a few days. She didn’t require physical or speech therapy and was soon released.
“We had a very truthful discussion regarding the possible benefits and very real risks of a powerful medical treatment like tPA,” Dr. Toulouse recalled. “This is a medication that can dissolve any and perhaps all blood clots anywhere in your body. We hope more than anything else that it dissolves the blood clot that we assume caused the stroke. We cannot guarantee that it will not cause deadly bleeding elsewhere in your body or even in your brain, causing an even worse hemorrhagic stroke. However, all of our research to date says that by giving it within the first 3 or 4½ hours to the right patients with all the right characteristics we are more likely to help you clear some of these stroke deficits rather than cause you any harm.”
Kathy is back to work, although it’s part-time for now. She’s expected to make a full recovery but must learn to manage her migraine headaches, which her medical team suspects triggered the stroke. Still, she’s grateful for the care she received at the ER in Marshalltown.
Assured that Kathy was a good candidate, Dr. Toulouse gave the orders for the tPA and nurses were administering the medication by 4 p.m. This was just a little more than an hour after Kathy arrived.
BALANCE EYES Lost
Blurry
FACE
Drooping
“I’ve been really impressed with them,” Kathy says. “I mean, most of the time when I’ve gone to the ER, you expect to wait a while, but the last few times I haven’t had to wait. Plus, the nurses were really helpful and very friendly.” “It is really no exaggeration to say we’re under the gun when a stroke patient with symptoms that just came on in the last hour or two hits our doors,” Dr. Toulouse says. “Kathy started with strange and, at first, vague and mild strokelike symptoms at 2:15 while she was at work. Within a few minutes, someone figured out that she could be having a stroke. That’s when someone acted quickly and called 911. “Whoever it was that first had that thought that this could be a stroke probably saved Kathy a lot of future neurologic disability. We and Kathy can never thank that person enough.”
ARM
Weakness
SPEECH
Difficulty
? Does the person have a sudden loss of balance, coordination or dizziness?
Have they lost vision in one or both eyes?
Every 40 seconds, someone in the United States has a stroke.
Does one side of the face droop or look uneven?
Is one arm weak or numb?
Every 4 minutes, someone dies from a stroke.
Speech slurred or mumbled?
TIME
To Call 911
9-1-1
Call 911 immediately if you see any of these symptoms!
Stroke is the leading cause of serious long-term disability.
TIME LOST IS BRAIN LOST. Know the warning signs of stroke and B.E.F.A.S.T
LiveWell Summer 2022 | 7
Urgent Care vs ER
Q&A with Lisa Spitzli RN, MEDICAL/SURGICAL MANAGER
URGENT/EXPRESS CARE 1704 S. Center St.
Family Medicine
Open days, evenings, weekends and holidays. Treat injuries and illnesses that aren’t life-threatening but need immediate attention. • Upper respiratory problems
Q A Q A
• Sinus infection, sore throat or ear infection • Minor injuries, including small cuts and burns • Non-life-threatening allergic reactions
Q Our newly remodeled clinic at 303 Nicholas Drive is just a mile north of the new hospital.
A
MARSHALLTOWN (641) 753-2752 | 303 Nicholas Dr. NEW Jaime Hooley, PA-C | Abbie Sharp, ARNP | Sherri Stebniski, PA-C COMING SOON: Thai Nguyen, MD, and India Chapman, PA CONRAD (641) 366-2123 | 105 N. Church St. Tim Cooper, PA-C | Steve Scurr, DO STATE CENTER (641) 844-2970 | 503 3rd Ave. SW Amanda Konz, ARNP TAMA-TOLEDO (641) 484-5445 | 1307 S. Broadway St. Mark Atcher, ARNP | Sherry Parks, PA-C
Where are you from originally? I was born and raised in Whitewater, Wis. I lived in several areas around the state and moved to Iowa in 2005.
Q A
Why did you get into healthcare? I began working as a CNA in high school. I really loved building relationships with my patients and their families. I also enjoy learning and teaching about medical treatments and diagnoses. A career in nursing provides so many opportunities for me to make a difference and do the things I enjoy. What qualities best describe the care you and/or your team provide to patients?
Q A Q A
What will the new hospital mean to you and the care your team provides? The new hospital has refreshed my love for healthcare. I am very excited to have the opportunity to care for my community in a new facility. Are there any fun facts about you or your background? I have a love for powerlifting, and I am a certified Crossfit Level 1 Trainer. What do you like to do in your free time? I enjoy spending time with my family, any outdoor activities, traveling and exploring new foods/cuisines.
I believe that empathy and patience are very important while providing care to our patients. It is important to communicate clearly with patients and families to help them understand the plan of care and discharge process, etc. Our caregivers work well as a team and adapt to new challenges that arise each day. This helps to provide comfort and a sense of security to our patients who are in a very vulnerable situation.
THE LISA SPITZLI FILE EMERGENCY ROOM 55 UnityPoint Way
For serious or life-threatening health issues, call 911 or go to the emergency room. • Chest pain or heart attack symptoms • Stroke symptoms • Car accident injuries • Head pain (sudden or severe) or head injury • Loss of consciousness • Severe cuts
Resides in: Marshalltown Schooling: Associate Degree in Nursing Other education/certifications: Certified in ACLS and PALS
Previous roles/positions: For the last 8 years I have been in the role of house supervisor here at UnityPoint Health – Marshalltown. I spent 5 years as charge nurse on Med/Surg. I also have experience managing a residential care facility for disabled adults. Favorite quote: “Keep a good heart. That’s the most important thing in life. It’s not how much money you make or what you can acquire. The art of it is to keep a good heart.” – Joni Mitchell
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55 UnityPoint Way | Marshalltown, IA 50158
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Multi-Specialty Clinic Multiple specialties, all under one roof. This clinic gives you easy access to providers from some of the leading practices in the state.
(641) 844-6259 51 UnityPoint Way • Cardiology • Dermatology NEW • Nephrology • Neurosurgery Outreach NEW • Podiatry • Urology • Vascular Surgery Outreach NEW
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