Summer 2020
MARSHALLTOWN
‘LIFE AND DEATH WAS A MATTER OF MINUTES’ EMS UPDATING & GROWING ITS AMBULANCE FLEET MARSHALLTOWN MAN THANKS ER FOR SAVING HIS LIFE MYTHS ABOUT MIDWIVES Q&A WITH DR. LANCE VANGUNDY
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WHAT’S INSIDE 1…A Note From Jenni Regional Chief Operating Officer, UnityPoint Health – Marshalltown 2… Returning Providers Dispel Myths About Midwifery 3… Welcome back, Autumn and Melissa! 4…‘ Life and Death was a Matter of Minutes’ 5…Urgent Care vs. ER 6… Patient Grateful for Care After Beating COVID-19 7… Q & A with Dr. Lance VanGundy 8… Marshalltown Man Thanks ER for Saving His Life 9… Marshalltown Ambulance Service Expands to Grinnell
Our Medical Park is undergoing a $38.4 million expansion
We’re Consolidating to an Expanded South Campus Over the past three years, UnityPoint Health – Marshalltown has been on a journey to redesign the healthcare services that are needed and supported in Marshalltown. We’ve made a commitment to remain in the community and have adapted our services around what the community actually uses and needs. In December 2019, we announced exciting plans to consolidate all our services from the hospital downtown (North Campus) to the Medical Park (South Campus), which will be expanded. It’s a $38.4 million project that will add 65,000 square feet to the existing Medical Park, which is located just south of where Highways 20 and 14 intersect. When finished, the expanded Medical Park will be 137,000 square feet. Planning has begun, we’re anticipating a groundbreaking in fall 2020 and full completion by 2022.
Summer 2020 LiveWell magazine is produced by UnityPoint Health®. 3 S. 4th Ave. | Marshalltown, IA 50158 (641) 754-5151 | unitypoint.org Copyright ® 2020 UnityPoint Health. All Rights Reserved. ® SM trademarks of UnityPoint Health.
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This is a significant enhancement and investment for the Marshalltown community. UnityPoint Health is committed to the health and well-being of this community, and we’re proud to offer quality, local health care. Now more than ever, we need the support of our community to keep health care local – from laboratory testing, to physical therapy, to urgent care.
A NOTE FROM JENNI
A NOTE FROM JENNI … It’s been said that nothing worth having comes easily. If that’s the case, we have more reason than ever to get excited about the future of health care in Marshalltown. In the three years since UnityPoint Health stepped in to take over this town’s struggling health system, we’ve made tremendous strides, tough decisions, and experienced growing pains. All the while, we made many improvements to the care we provide, strengthened our team, and put ourselves in a position to be here for the long term. We were ecstatic in December when we announced exhilarating news – approval of a $38.4 consolidation to an expanded south campus, which is our beautiful Medical Park conveniently located where highways 30 and 14 intersect. When I received the news of the approval, I cried. Fate wasn’t as sentimental, though. Before we could firm up blueprints or break ground, COVID-19 came along, and it put our plans on pause for a few months. Still, the pandemic brought out the best in people. Our healthcare workers were heroes as they battled the virus around the clock for months. The community was amazing, too, as they supported us with supplies, donations and so much encouragement. Now, with summer here and the pandemic seemingly shrinking, it’s time for all of us get excited again. After all, having our healthcare operations consolidated into a modern facility has obvious benefits for both our team and the patients who come to see us. In addition, I hope the decision to invest this much into the project shows Marshalltown that our commitment to the community is as strong as ever. We want to keep health care local, and the community can help us do that as we build on some of our recent achievements. • We announced a significant financial turnaround in the past year – reversing a reported $7 million loss. We planned on being profitable in 2020 before the pandemic arrived. • Despite a national shortage of providers, our emergency department is fully staffed with five excellent providers. • We successfully launched a new electronic medical record system. At the touch of a button, patients can view their medical record, schedule an appointment or send a message directly to their provider. • Our patient satisfaction scores are climbing across the board. Overall, we’re well above average nationally at 64% (compared to 21% in 2017). Specifically, mammography ranks in the 99th percentile nationally! • We’ve developed a plan for sustainable health care to serve our community. • We’ve embedded local leadership, who live in Marshalltown, to guide us into the future Finally, know that we’re grateful for your continued support and patience as we make this journey together.
The leadership team at UnityPoint Health – Marshalltown is Shari King, Hospital Administrator; Jenni Friedly, Regional Chief Operating Officer; and Jen Arneson, Director of Nursing.
Sincerely,
Jenni Friedly Regional Chief Operating Officer LiveWell Summer 2020 | 1
MIDWIFERY
Returning Providers Hoping to Dispel Myths About Midwifery There’s a myth about the kind of care that midwives provide, and Melissa Koch would like nothing more than to dispel it. As announced in January, a new Women’s Health Outreach Clinic opened at UnityPoint Health – Marshalltown. That allowed Koch and Autumn Schmoker, who are certified nursing midwives, to return to Marshalltown to provide women’s health services. Koch believes it’s never been more important for the community to understand the type of care a midwife helps manage. “Midwives are not just here to provide care for pregnant women,” Koch said. “We’re here to address any concerns related to women’s health, including preventative care, birth control support, or any problems or questions women might have about their health. “When I first started practicing as a midwife in Marshalltown, a lot of patients didn’t feel they could benefit from a midwife because they weren’t pregnant. So, I want women to know that’s a myth. We provide care to women through all stages of their life, and it’s not just specific to pregnancy.” The clinic is the result of a partnership with UnityPoint Health facilities in Des Moines and Waterloo. Initially, the clinic will be open 9 a.m. to 3 p.m. every Monday, and it’s anticipated the clinic will add additional days of operation in the future. 2 | unitypoint.org
Melissa Koch (left) believes it’s never been more important for the community to understand the care that midwives provide
Specifically, the midwives at the clinic will provide women’s health services such as initial OB visits, routine prenatal care, gynecological exams, screenings and vaccinations, fertility counseling, family planning and menopausal care. Babies will not be delivered locally, but the midwives will be instrumental in transitioning care to birthing centers in surrounding cities and connecting families with pediatric providers at UnityPoint Health – Marshalltown. “I can say with complete confidence that any person who decides to come see us will be pleased and happy with the care they receive,” Schmoker said. “I’m truly blessed to work with the group of women I do. They are all amazing and so caring. When someone is passionate about what they do, it really shows.”
“It’s important for this community to have this service.” Koch said, “And it feels good to be able to bring it back.” To schedule an appointment in the Women’s Health Outreach Clinic, call (515) 309-6011 or contact the MultiSpecialty Clinic in Marshalltown at (641) 844-6259.
Welcome back, Autumn and Melissa! AUTUMN SCHMOKER, CNM, ARNP
Education Earned nursing degree from Iowa Central Community College, then bachelor’s degree at University of Iowa. Graduated from the University of Cincinnati’s Midwifery Program. Background Autumn was a labor and delivery nurse for 10 years prior to becoming a midwife. She then provided women’s health care in Marshalltown for 3½ years before transitioning to Des Moines in September 2019. On returning to Marshalltown “I’m hopeful I’ll be able to serve some of my past patients again. I had seen a lot of the women for their annual exams over the past three years, so they became a part of my life. I miss seeing them yearly, and I hope they will start seeing me again so we can catch up!”
MELISSA KOCH, CNM, ARNP Education Earned nursing degree from University of Iowa, then graduated from the University of Cincinnati’s Midwifery Program. Background Melissa, who is born and raised in Marshalltown, worked at the hospital for more than 12 years. She practiced as a registered nurse in labor and delivery, nursing education and nurse manager, then spent one year as a midwife before transitioning to Des Moines. On returning to Marshalltown “It wasn’t an easy decision for me to leave the Marshalltown area, I have always taken pride in the fact that I was able to provide care locally to women. To be able to return to my hometown and bring services that are needed excites me.”
Marshalltown Multi-Specialty Clinic SPECIALTIES Multi-Specialty Clinic (641) 844-6259 | 407 E. Main St., 3rd floor • Urology • Orthopedics • Pain Clinic • Nephrology • Women’s Health Cardiology Clinic (641) 854-6001 | 407 E. Main St., 2nd floor • Dr. Antezano and Dr. Stark
FAMILY MEDICINE Marshalltown (641) 753-2752 | 405 E. Main St., 1st floor • Jaime Hooley, PA, Maemie Miller, PA, and Tracy Schiller, PA • Pediatrics: Lisa Glantz, ARNP, and Callie Williams, ARNP Conrad (641) 366-2123 • Dr. Steve Scurr and Tim Cooper, PA State Center (641) 844-2970 • Amanda Konz, ARNP Tama-Toledo | (641) 484-5445 • Dr. Polly Hineman and Sherry Parks, PA
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EMERGENCY CARE
Carolyn and Ken Anderson
‘Life and Death was a Matter of Minutes’ When a person’s health can change at a moment’s notice, it’s critical to have an emergency room just a few minutes away. Ken and Carolyn Anderson didn’t need that kind of reminder, but life provided one anyway on October 18, 2019. It was a beautiful Friday afternoon and Ken, longtime president and CEO of Marshalltown’s Chamber of Commerce, was working in his yard. Inside, Carolyn was entertaining a guest. Suddenly, Ken stumbled into the house and told Carolyn he didn’t feel well at all. They got into their car and sped toward the ER at UnityPoint Health – Marshalltown. However, they couldn’t get there fast enough. Ken passed out around the 3rd Avenue viaduct. By the time Carolyn reached the ER, Ken was unresponsive, had no pulse and wasn’t breathing. Seconds later, emergency personnel started chest compressions. “I’m proud of our nurses for their sense of urgency,” recalled Dr. Blaine Westemeyer, ER physician at UnityPoint Health –
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Marshalltown. “Our team members started CPR immediately once Ken was removed from his vehicle. One of our nurses literally got on top of Ken on the transport cot in order to do chest compressions while he was being wheeled into the emergency room.” Meanwhile, Carolyn was walked to the family room and an employee offered to park her car. The team at UnityPoint Health – Marshalltown, which included Dr. Westemeyer and nurses Jamie Kadner, RN, and Megan Heise, RN, stabilized Ken. After family arrived, they speculated this was related to pain he’d experienced recently. They had been affectionately referring to it as “gallbladder pain.” Unfortunately, they were wrong. This was something much bigger. “Within a couple of minutes, we recognized that Ken’s heart was in a dangerous rhythm called ventricular fibrillation,” Dr. Westemeyer said. “He received an electrical cardioversion
to revert his heart back into a normal, safe rhythm. But it was evident based on Ken’s arrhythmia and his symptoms that he was likely suffering from a heart attack.”
Urgent Care vs. ER
And a massive heart attack, at that. Ken was quickly airlifted to UnityPoint Health – Iowa Methodist in Des Moines, where physicians discovered Ken had an artery that was 100 percent blocked. They put in four stents, then met with Carolyn and her daughter in the hallway. The physicians said they wouldn’t sugarcoat things. They told Carolyn to call family and have them come as soon as possible because there were no guarantees Ken would survive the night. “Frankly, I thought maybe they were going to tell me there was brain damage or something,” Carolyn recalled. “That was the toughest thing I think I’ve ever had to go through.” However, to everyone’s amazement, Ken did survive. His blood pressure, which was nonexistent at one juncture, started to climb on Saturday. By the wee hours on Sunday morning, Ken opened his eyes. And by Monday, as Ken was eased off sedatives, he became fully alert.
URGENT/EXPRESS CARE Open days, evenings, weekends and holidays. Treat injuries and illnesses that aren’t life-threatening but need immediate attention. • Upper respiratory problems • Sinus infection, sore throat or ear infection • Minor injuries, including small cuts and burns • Non-life-threatening allergic reactions
Just one month later, Ken is in remarkable shape. He tells people he doesn’t even feel residual effects of the heart attack. In fact, he doesn’t remember much from the ordeal, but he won’t forget an interaction he had with his cardiologist, who patted him on the arm and said, “You realize you probably shouldn’t be here, right?” “You can’t go through something like that without having a perspective altered,” Ken says. “Mortality sort of becomes real.” Carolyn is still amazed at the care and compassion shown by everyone associated with UnityPoint Health. “It’s almost as if they had all just come from a training class on customer service,” she says. “It was absolutely great.” “I think the care we got, they did all the right things … and I’m sitting here talking to you today because of it,” said Ken. “We’d give them two thumbs up. It was excellent.”
“I’m grateful this community has an emergency department like this, which has an amazing and talented staff ready to serve patients like Ken,” said Dr. Westemeyer. “In his case, life and death was a matter of minutes.”
EMERGENCY ROOM 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 • Open, broken bones
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COVID-19
Patient Grateful for Care After Beating COVID-19 Fred Ohrt had COVID-19, and there were a few nights where the shortness of breath seemed to be getting the best of him. Sensing the worst one evening, he told his wife, Jackie, he didn’t think he was going to make it. Fortunately, Fred’s story has a happy ending. After nearly a week at UnityPoint Health – Marshalltown, the 77-year-old is back home and well on his way to recovery. Looking back, there are many things that come to Fred’s mind – when he learned he was positive for the virus, when his wife rushed him to the ER, and several long nights where sleep was impossible because of shortness of breath. One memory seems to override the rest, though – how well he was received by his caregivers at the hospital. “They are the nicest people, and I don’t know where I’d be without them,” said Fred. “You know, I don’t go to the hospital very often, and I don’t expect to be treated like a king, but they were very sympathetic. I would recommend that place to anybody.” At that point, Fred had already tested positive for COVID-19 and was doing his best to self-isolate and recover. However, it was a pulse oximeter that ultimately sent him to the ER. Blood oxygen levels under 90 are a key measurement for determining when to go to the ER. Fred’s kept coming up 88.
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“They are the nicest people, and I don’t know where I’d be without them. You know, I don’t go to the hospital very often, and I don’t expect to be treated like a king, but they were very sympathetic. I would recommend that place to anybody.”
Once admitted, he leaned on the encouragement of the employees and his family, who visited by phone (as routine visitors were not allowed). “Even though he wasn’t feeling well, he was always kind and tried to maintain a sense of humor,” recalled Karrie Lisboa, ARNP. “He didn’t have much of an appetite and mentioned that a candy bar sounded good, so I happily supplied him with some candy and a slice of my birthday cake.” “What a blessing she was,” Fred said of Lisboa and his other caregivers. “I can’t imagine what it must be like to be so sick and not have your family or friends by your side,” Lisboa said. “On the day of his discharge, Fred was so relieved to be going home he teared up, and I gave him a hug in full PPE. COVID-19 has been tough on all of us, but Fred absolutely made my week.” Fred has been recovering at home since his discharge on May 8. Family and friends even celebrated his homecoming in a socialdistancing-kind-of-way. Fred took a seat in his driveway while everyone drove by the house, honked and stopped to talk from the street. “So that was pretty good encouragement right there,” Fred said.
Q&A
Q. WHERE ARE YOU FROM ORIGINALLY? A. I moved to Marshalltown in the first grade and graduated Marshalltown High School, married a Marshalltown gal and returned here to practice in 1998.
Q. WHY DID YOU BECOME A PROVIDER? A. M y dad was a family doctor who sewed up my foot laceration two hours before a football game, and I still got to play. I wanted to be able to do the same thing for my family and friends.
Q&A with Dr. Lance VanGundy ER Medical Director
Dr. Lance VanGundy, Dr. Blaine Westemeyer and Brandy Reints, ARNP, from the ER at UnityPoint Health – Marshalltown
• Graduated from Cornell College in Mt. Vernon in 1991 with a double major in biology and anthropology, cum laude. • Graduated University of Iowa Medical School in 1995. • Attended North Iowa Mercy Health Center Family Medicine residency in Mason City, and subsequently sought ER training through the American Board of Physician Specialists in Emergency Medicine in 2014 • Certifications include ACLS, ATLS, PALS certified.
Q. WHAT QUALITIES BEST DESCRIBE THE CARE YOU PROVIDE TO PATIENTS? A. I try to be humble and listen, and I try to check my assumptions at the door and meet every patient right where they are without judgment.
Q. ARE THERE ANY FUN FACTS ABOUT YOU? A. I ’m a sci-fi/fantasy geek and I’m active in the fantasy novel-writing community. I want to be buried with used Zeno’s Pizza boxes – to take that deliciousness with me to the afterworld! If my fantasy novel sells a million, I told my daughter (who is a graphic designer and the book’s cover artist) that I would get the cover in a sleeve tattoo!
Q. WHAT ARE YOUR HOBBIES AND PERSONAL INTERESTS? A. F antasy novel writing, landscaping, travel and experiencing other cultures. I am a total foodie, but I consider pineapple and other sweet fruit on pizza somewhat of a heretical crime.
• Medical Director of the ER in Marshalltown and the surrounding EMS communities for nearly 20 years.
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ALLERGIC REACTION Phil (far left) and his wife, Kellie (far right), with their son, Austen, and his wife, Alicia.
MARSHALLTOWN MAN THANKS ER FOR SAVING HIS LIFE Phil DeRuiter doesn’t remember much after being rushed into the emergency room at UnityPoint Health – Marshalltown.
“I was very scared at that point,” says Phil. “I thought I was leaving this Earth.”
Really, it’s just a series of images and brief instances. A room full of providers and nurses. A lot of activity. Reassuring words. And pain – severe pain.
Somehow, Kellie got Phil into the car and to the ER at UnityPoint Health – Marshalltown. A team, including Dr. Blaine Westemeyer, RNs Jeff Gilchrist and Jamie Kadner, rushed out to get him into a wheelchair and took him inside.
“At one point, I recall saying, ‘Just let me die,’ and I remember the nurse saying that wasn’t an option,” recalls Phil. Phil, a 55-year-old Marshalltown resident who works at Sika Corporation, was suffering from a bleeding ulcer, and it was a severe, life-threatening situation. His condition arose quickly one weekend in March, when he started to feel ill on a Saturday. By Sunday, things were worse, and his wife, Kellie, returned home from shopping to find him in the bathroom, very weak, sweating profusely and nearly unconscious.
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“He rolled into our department looking awfully sick and worrisome for shock due to massive blood loss,” recalled Dr. Westemeyer. “He was pale as a ghost, sweaty and clammy with thready pulses (indicating decreased pulse pressure). Our team quickly identified the life-threatening nature of the situation and orchestrated stabilizing this patient.” Phil had a central line catheter placed and was given blood products in the emergency department to help stabilize his blood flow. He was experiencing severe bleeding in his digestive tract and hypovolemic shock (a life-threatening condition when your body loses more than 20 percent of its blood). With his vital signs especially unstable, it took significant time for his care team to get him stabilized.
“This group steps up to the plate every day, and they quickly triage and prioritize every patient’s needs,” said Sheila Brown, manager of the emergency department. “Jamie, Jeff, and Dr. Westemeyer immediately recognized Phil’s acuity and intervened with life-saving measures.” “Everyone was very reassuring that they were doing everything they could to help him,” Kellie said. “I was scared, too, and concerned for his life, but Phil received excellent care.” However, Phil wasn’t out of the woods yet. Paramedic Brynn Oliver and EMT Stephan Burk transferred Phil by ambulance to Iowa Methodist Medical Center, where he underwent emergency surgery by gastroenterologist Dr. Archana Verma. Phil was quickly on the road to recovery, yet he remained at Methodist for a week and took another week to rest at home before returning to full strength. “Dr. Verma did say I was lucky,” Phil recalled. Once Phil’s health was in the clear, his son, Austen, expressed his gratitude on Facebook, and Kellie gratefully shared it with friends. And to show his thanks for the ER team in Marshalltown, Phil has taken them lunch twice – Taylor’s Maid Rites on one occasion and Domino’s pizza and breadsticks on the other. “It’s amazing to see patients, after being transferred from our ED in critical condition, walk back in weeks later with a happy story to share,” said Brown. “Phil and Kellie’s kindness and generosity was appreciated by our team, but it’s not necessary.”
“I love them and owe them my life, and I believe that is due to the people of the Marshalltown ER,” Phil said. “They need to keep doing what they’re doing because they are appreciated.”
UnityPoint Health – Marshalltown EMS Updating and Growing Its Fleet These days, it isn’t just patients who are getting healthier and stronger at UnityPoint Health – Marshalltown. The EMS service is on quite a roll, as well. When UnityPoint Health took over the bankrupt Marshalltown hospital in 2017, they inherited four notably depreciated ambulances. Fast forward to today, when the hospital has purchased and received three new ambulances with $750,000 in capital funds, bringing its fleet to eight, including five being active during peak periods. Along the way, the community also came forward and contributed over $400,000 for two new ambulances in 2018-2019. “With the increase of heart attacks, strokes and other medical emergencies, having a bigger fleet of ambulances is crucial,” said Nick Heintz, Manager of Emergency Management Services for UnityPoint Health – Marshalltown. “With five vehicles active, we can be more efficient in routing our ambulances and stretching the regions we support, like Marshalltown, Conrad and Grinnell.” The three new ambulances will look the same as the previous two ambulances, which were purchased by the community through a UnityPoint Health – Marshalltown Foundation project in 2018. The three new ambulances: • Are larger than previous models, and they feature a liquid-air ride system, which increases the comfort for patients in the back • Include all-wheel drive, which provides more safety and improves service during Iowa winters • Contain DVD players mounted to the ceiling to provide calming entertainment for patients during transports, especially children • Feature the same interior design as previous ambulances, which reflects preferences of EMS providers “We’re so grateful for the addition of these ambulances,” said Heintz. “They’re expensive, but they’re needed, and they represent a significant investment in the healthcare of Marshalltown and its surrounding communities.” LiveWell Summer 2020 | 9
3 S. 4th Ave. | Marshalltown, IA 50158
We apologize for mailing problems such as duplicate copies. If you have questions or concerns about LiveWell magazine, please email MT_ Marshalltown@unitypoint.org. Copyright ® 2020 UnityPoint Health. All Rights Reserved. ® SM trademarks of UnityPoint Health.
HEALTH CARE
HEROES During these extraordinary times, UnityPoint Health – Marshalltown wants to show our appreciation and support to all healthcare workers. As the COVID-19 pandemic continues to evolve, there are many incredibly talented, dedicated and courageous healthcare workers who are making a difference every day to patients and our community.
