Hospital News - 1st Quarter 2007

PHG joins campaign to take medication safety to consumers
‘Educate Before You Medicate’ Gathers Community-wide Support

March 20, 2007 - One morning Jane Harding took her first dose of a new prescription medication. Less than an hour later she lay comatose on her bedroom floor.

The cause: Unbeknown to both Jane and her physician, she had taken a drug that reacted badly to an over-the-counter medication she was already using.

Medication errors of various kinds happen at least 1.5 million times a year across the nation to adults taking prescription drugs, over-the-counter medications and herbal supplements. Undoubtedly, these medicines are usually beneficial. Yet medication errors like this one can cause serious harm or even be fatal.

Now the Dallas-Fort Worth Hospital Council, in partnership with the Dallas County Medical Society, hospitals in surrounding counties, including Presbyterian Hospitals of Greenville and Commerce, and a coalition of area corporations and associations, is leading an “Educate Before You Medicate” campaign to teach consumers what they can do to prevent medication errors.

Part of the solution lies in the hands of an educated consumer, according to Hospital Council President and CEO John Gavras. DFWHC and its volunteer partners are providing easy-to-access forms and wallet cards where consumers can maintain a complete list of their current medications.

“Medication errors are preventable when patients work with their physicians, pharmacists and other healthcare providers to keep a record of what medications they’re taking and take responsibility to know why they’re taking them,” Gavras explained. “We want consumers to have a list of what they’re taking and be able to provide that list whenever they receive healthcare.”

Beginning this month, consumers can go to www.dfwhc.org, fill in their list of medications on free forms and wallet cards, and download them for easy access.

Kids' Safety

March 20, 2007 - Kid safety is taken very seriously around Presbyterian Hospital of Greenville. One of the most successful community service programs offered is the Child Seat Safety Check.

The most recent event came in February during Child Safety Week in which 42 child restraint systems were checked by four certified technicians, Out of those checks, eight booster seats were distributed and 12 child restraint systems were replaced, demonstrating the thoroughness of the checks and the need for this service, said Bret Freeman, director of the Trauma Department at PHG.

Of the child restraint systems that came through the check at the Crossroads Mall location, only 28 percent were installed correctly, he said. “Unfortunately, it is normal for us to see at least one area of misuse during each car seat check,” he said. “The whole purpose of the program is to identify misuse, educate the parents while encouraging their participation with the installation, and, of course, correcting the misuse.”

According to a recent study published by National Highway Traffic Safety Administration, in 2003 motor vehicle crashes were the leading cause of death for the age group 4 through 34. Because of the young lives consumed, motor vehicle traffic crashes ranked third overall in terms of the years of life lost, third only to cancer and diseases of the heart. Many of these lost years can be blamed on incorrect use of child safety seats, NHTSA says.

Representatives from Presbyterian Hospital of Greenville, Hunt County EMS, and Greenville Police Department participated in the safety check at Crossroads Mall.
Volunteer help was provided by the Greenville Police Department Explorer Program and Paris Junior College nursing students.

Education material was distributed to the parents along with giveaways provided by PHG and the North Central Texas Trauma Regional Advisory Council. The material reminded parents when their child should graduate to a different child restraint system, which direction they should face, and how long they need to be in booster seats.

“Parents do not realize that their child should remain in a belt positioning booster seat up until they are 4 feet 9 inches or 57 inches tall,” Freeman said.

After children graduate from forward facing harness restraint systems they are not tall enough to sit directly in a vehicle seat with just a lap/shoulder belt. Belt positioning booster seats allow the lap/shoulder belt to cross the child in the correct anatomical positions, he said.

Abdominal and neck injuries are common in motor vehicle crashes in which children were not restrained appropriately in booster seats.

“The Hunt County Coalition’s goal is to keep children safe in the county by educating the parents and encouraging their help during installation. Please take a few minutes to make sure your child is restrained appropriately in your vehicle,” Freeman said.

If you have any questions or concerns please contact the PHG Trauma Department at 903-408-1412. Parents can also make an appointment for a routine checkup on the second Tuesday of every month by calling that number.

 

Among those assisting with the safety check from the Presbyterian Hospital of Greenville Trauma Department were Bret Freeman, Megan Brown, and Nickie Lyons; Michael Sanchez from the Hunt County Emergency Medical Services; Officer Philip Spencer, Greenville Police Department; and, Paris Junior College nursing student volunteers Brian Huff, Kelly Peters, and Dustin Wilson.

 

It looked almost like a traffic stop at Crossroads Mall recently as vehicles drove up for an inspection of their kid’s safety seats.

 

Dr. Thurmond named Physician of the Year
by Melva Geyer

Dr. Frederick Thurmond, a hospitalist at Presbyterian Hospital of Greenville since 2001, has been named 2006 Physician of the Year for the Hunt Memorial Hospital District.

Dr. Thurmond was chosen from a field of physicians who had been selected during the four quarters of 2006 by the Physician Satisfaction Service Excellence Team. Besides Dr. Thurmond, they included Dr. Min-Sheng Wu, PHG anesthesiologist; Dr .Joseph Bleier, medical director of the Emergency Department, and Dr. Mohan Philip, Greenville Pulmonology Associates.

Dr. Thurmond has served as chairman of the Medicine Department and the Utilization Management Medical Records Committee and is a member of the Medical Executive Committee.

As a hospitalist, he is a fully certified physician who, like his five contemporaries at PHG, focuses on inpatient care within the hospital as an acute care specialist. The hospitalists do not have their own private practices and do not see patients outside of the hospital, but work closely with primary care physicians, surgeons or specialists to provide total care for the patient throughout his or her hospitalization.

Dr. Thurmond was trained in internal medicine at Parkland Hospital in Dallas. He had graduated from college in his hometown of Albuquerque, N.M., receiving his medical degree from the University of New Mexico.

He did his residency at Parkland Hospital of Dallas after a friend encouraged him to come to Dallas. He also did his internship at Parkland Memorial Hospital and is certified by the American Board of Internal Medicine.

Finding it necessary during his training to help make ends meet, Dr. Thurmond took a job part time at the Greenville hospital with which he was very impressed. He and his new bride, Suzanne, whom he had met in Dallas where she was a student at Southern Methodist University, liked Greenville and decided it would be the area where they would live and raise a family.

The Thurmond family has since grown to four including six-year-old Pierce and one-year-old Mary. Dr. Thurmond said they have purchased land in Hunt County where they will build a new home. He says the whole family likes going camping and he loves to fish.

Dr. Thurmond said he was pleasantly surprised at being selected for the physician honor and said it meant a lot because it also reflected well on the hospital and the professional staff he works with.

“I look forward to working with them every day,” Thurmond said.

In the numerous nominations for the honor Thurmond was cited for his knowledge, compassion for the patients, respect for and interaction with staff, and being timely in communicating with patients and their families.

The physician recognition program was initiated this year by the Physician Satisfaction Service Excellence team as part of the ongoing Service Excellence Initiative at PHG. Those selected are pictured in the “Hall of Honor” on the second floor of the hospital between the main tower and the Emergency Department.

Dr. Thurmond, along with all the active staff members will be honored this month at a special event observing Doctors’ Day at PHG.

Geyer is Marketing Communications Coordinator for the Hunt Memorial Hospital District. She can be reached at 903-408-1613 or at mgeyer@hmhd.org

Alcohol Awareness

March 20, 2007 - Students at New Horizons School in the Greenville Independent School District listen to nursing students from Paris Junior College and team members of the Presbyterian Hospital of Greenville Trauma Department discuss the dangers of drinking and driving.

The guests were invited to participate in the “Dare to Care” project at the school with the Trauma Department’s education program on Alcohol Awareness.

At right, PJC nursing student Brian Huff talks about the personal tragedies that result from mixing alcohol and drugs with driving.

Adopt a "Fad-Free" Diet for Nutrition Month
by Richard Carter

“Lose 30 pounds in 30 days!”
“Eat as much as you want and still lose weight!”
“Try the thigh buster and lose inches fast!”

March 19, 2007 - I don’t know if you’ve watched much television lately, but recently I’ve been hearing people complain about all the commercials for different kinds of diets – or, I’m hearing people talk about the recent diet they are trying in order to lose weight.

I’ve never given much credence to diets that don’t require simply cutting back on your eating while increasing your physical activity. (OK, I know there is nothing really simple about it, but it is a simple solution.)

This is why I had to smile a couple of weeks ago when our Nutrition Department began its “100% Fad Free Diet” campaign as part of National Nutrition Month. There are reminders all over the place about eating “Fad Free.”

They’ve even got little messages in the stairwells reminding us about the importance of physical exercise and eating smart.

Now, I have a few questions for you, thanks to the help of the American Dietitic Association. They might just lead to some better eating habits and keep you away from the hospital, except as a visitor.

1. What is a fad?

A. Bellbottoms and polyester
B. Pet rocks
C. Low carb/high protein diets
D. All of the above

Answer: D. We all make mistakes. And if you’ve followed any of the fads —A, B or C — you’ve had lots of company. Fads are trends that seem like a good idea at the time, but often in hindsight are just the opposite. The most important lesson about fads is to avoid repeating them!

2. Following a diet fad is bad for your health…

A. Always
B. Sometimes
C. Never

Answer: A. While you may lose weight with fad diets, they are potentially harmful to your health. A diet fad that excludes many foods or an entire food group eliminates key nutrients that are essential for health. Learn how to spot a fad diet. Don’t get caught in a diet plan that doesn’t allow foods you enjoy, promises fast weight loss or sounds too good to be true.

3. Which fad diet was originally published in 1825 but is still popular today?

A. Cabbage Soup Diet
B. Grapefruit Diet
C. Low-Carbohydrate Diet
D. Banana and Skim Milk Diet

Answer: C. The low-carbohydrate diet has been around since 1825 when Jean Brillat-Savarin introduced it as the key to weight loss in his book The Physiology of Taste. Many decades and several variations later, low-carb diets are still among the most popular fad diets. Giving this diet another chance has never been shown to improve long-term health.

4. A diet that recommends the following should raise a red flag:

A. Special food or drink to detoxify the body
B. Eating a specific food with all meals
C. Eating protein and carbohydrates at separate meals
D. All of the above

Answer: D. Requiring a specific food or beverage to be included with each meal or eating certain types of foods separately are clues to spotting a fad diet. There are no miracle foods or beverages that can lead to quick weight loss or stop you from aging.

5. It’s not a diet fad if it’s endorsed by a celebrity.

True / False

Answer: False. Celebrity endorsements shouldn’t replace sound science. Make sure your weight-loss plan is based on research studies that support effectiveness and safety. And be sure to talk with your physician and a registered dietitian about your weight-loss goals, especially if you have a health problem.

6. Some diet fads work.

True / False

Answer: True. But only for the short-term. You may lose some pounds quickly; however, long-term maintenance of that loss is unlikely. Dieters often return to old eating habits and regain the weight they lost. Developing an eating plan for lifelong health, combined with regular physical activity, is the best way to reach and maintain a healthy weight.

7. What popular cracker was originally created as part of a health-food diet?

A. Cheese crackers
B. Saltine crackers
C. Graham crackers
D. Animal crackers

Answer: C. Sylvester Graham may be the originator of food fads in the U.S. Beginning in 1830, he promoted a bland, meat-free diet and avoidance of rich pastries, alcohol, coffee and tea. Eating his whole wheat Graham bread was best. Graham crackers are his contribution to healthy eating.

8. Adding physical activity to your day can help give you:

A. A healthy heart
B. Stronger bones
C. Less emotional stress
D. All of the above

8. Answer: D. Regular physical activity is important for your overall health and fitness — plus it helps control body weight, promotes a feeling of well-being and reduces your risk of chronic diseases.

9. If you eat 100 more food calories a day than you burn, you will gain how
many pounds in a month?

A. 1/2 pound
B. 1 pound
C. 2 pounds
D. 10 pounds

Answer: B. You will gain about 1 pound in a month. That’s about 10 pounds in a year. The bottom line is that to lose weight, it’s important to reduce calories and increase physical activity. Find your balance between food and physical activity.

10. For the most reliable, fad-free, science-based nutrition information,
consulting a registered dietitian is the best approach.

True / False

Answer: True. Registered dietitians are your most valuable and credible source of timely, science-based food and nutrition information. RDs specialize in taking a personalized approach to weight management because one size does not fit all. RDs help individuals understand how healthy eating and physical activity are important in maintaining a healthy lifestyle.

I hope there has been some inspiration here to cause you to take your diet more sensibly and remember to use common sense in making food consumption decisions.

There are some remaining activities this month here at the hospital in observance of NNM and you are more than welcome to join in. On Wednesday (March 21) our very own dietitians will be on hand to offer advice on good eating habits and there will be signups for drawings and some give-aways. Come see us on the second floor mezzanine. (Take the steps if you’re able.)

Carter is Chief Executive Officer of the Hunt Memorial Hospital District which includes Presbyterian Hospitals of Greenville and Commerce.

Hospital Celebrates National Nutrition Month

March 12, 2007 - The Nutrition Department at Presbyterian Hospital of Greenville is inviting the public to join in celebrating National Nutrition Month by striving to eat “100 Percent Fad Free.”

Part of the March activities includes encouraging everyone to eat sensibly by balancing meals that are basic and healthy.

“It’s easier than you might think,” says PHG Nutritionist Sheri Harmeier. “Sometimes just sticking with basic diets and eating smaller portions, while exercising a little bit more, is all it takes,” she said.

On each Wednesday of the month, Harmeier’s department is offering a lot of information on healthy eating with fliers on recipes, tips and samples available. Nutrition tips and trivia will be displayed in the cafeteria and stairwell.

On March 21 from 1-4 p.m. dietitians Melissa Allen and Celize Murray will be on the second floor mezzanine offering advice and information on healthy eating concerns, Harmeier said. Also assisting with the “Fad Free” observance will be Staff Dietitian Jennifer Lincicum.

The public will also be eligible for the prizes being given away during the month.

A new wrinkle to this year’s observance is a food drive throughout the month with the collection of canned and other non-perishables going to the local food banks.

Respiratory illness keeps ER busy
by Richard Carter

February 27, 2007 - If you’re one of those people who have had to visit our Emergency Department in the past few weeks, I don’t have to tell you we’ve been busy and you have had some lengthy wait times.

It seems as if everyone in Hunt County has come down with the flu or respiratory illness this month, creating a real crunch for our emergency room personnel (not to mention all the other departments that offer support services such as the Laboratory and Radiology).

The last time we were under our average daily visits of around 95 was on February 1, when we had 75 visits.

This month, as of February 21, there have been 2,422 people go through the emergency department, the past week seeing the biggest numbers of more than 124 per day.

This means there have been long waits for some folks, because, unfortunately, critical care needs don’t take a holiday during the flu season. There are still accident victims and those suffering from heart attacks or other acute injuries that need our immediate attention.

That is not to say we don’t want to treat you when you are not feeling well. Most citizens understand our need to “triage” (assess the illness) before seeing patients that come through the ER, making sure that the more critically ill are rushed into treatment rooms. Certainly you wouldn’t want to wait on a doctor to attend to you if you had been in a car wreck or the victim of a violent crime.

Our Emergency Department Director, Kim Mulder, says she has anticipated and prepared for a flu “rush” this season, but says it has not been as bad as it could have been, although it has kept everyone running. Even doctors’ offices can’t see all the patients and therefore we see them turn up in the ER.

Emergency departments all over the country are facing critical overcrowding conditions. Try as they might, administrations are having a tough go of cutting waiting times both in seeing patients and getting patients into hospital rooms, even though they have made deliberate strides to see and move patients faster.

We hope to alleviate some of the “congestion” in ER when we complete our West Wing addition, which will add more patient rooms. We are also working on a plan to expand our Emergency Department for the future, although it will mostly fill the needs that already exist.

In the meantime, I do hope people understand that we don’t like seeing them have to wait for treatment or end up lying in a hall bed for a long period of time. The patient is our most important focus and we pledge to do everything we can to take care of them.

Patients do have the opportunity to provide feedback through patient surveys. This is our way of finding out how you were treated and if you have any suggestions for improvement.

Carter is Chief Executive Officer of the Hunt Memorial Hospital District which includes Presbyterian Hospitals of Greenville and Commerce.

Babies - and more babies!

Cheryl Vasquez, Patient Care Associate in the Maternity Center, shows off new arrivals who seemed to be everywhere.

On the morning of February 1, when she arrived for work in the obstetrics department there were 16 newborns and two more on the way.

There were 95 babies born at Presbyterian Hospital of Greenville in January.

Cardiac Rehabilitation Center Health Fair

 

Two-year-old Akash Gupta is ready for some veggies as his 10-year-old sister, Shelly, prepares a plate for him. They were waiting for their parents, Vikas and Neelam Gupta, who were getting their blood pressure, glucose and cholesterol checked at the annual Cardiac Rehabilitation Center Health Fair on February 8.

More than 80 people went through the checkups during the four-hour fair

Hunt County’s response teams make a difference
By Susan Spoonemore
Development and Communications

February 21, 2007 - With about 10,000 emergency calls made each year, the Hunt Memorial Hospital District relies heavily on the First Response Teams that provide life-saving services to Hunt County residents.

Thirteen first responder teams throughout Hunt County (known to most in their communities as their fire departments) are standing ready 24 hours a day awaiting calls from those needing emergency care.

Most of the responders are volunteers. Cash, Caddo Mills, Celeste the Commerce Emergency Corps departments have rescue status. The Emergency Corps is classified as a volunteer Emergency Medical Service.

Other departments in the county include Wolfe City, Lone Oak, Merit, Commerce FD, Greenville, Quinlan, Tawakoni South, Union Valley and West Tawakoni

According to Patrick Schooler, director of Hunt County EMS, all first responders undergo extensive training. “We provide Emergency Medical Technician (EMT) and continuing education classes every quarter,” he said.

Most First Response teams have the ability to provide services that are critical in the first moments of a medical emergency, whether it’s a vehicle accident, injuries from violence, fire or water-related accident. The teams can provide Rapid Sequence Induction, which is the process of giving patients drugs to anesthetize them to insert a breathing tube. Also, the teams have transportable ventilators, called Critical Care Transfer Medics.

The process of an emergency rescue is fairly complicated. Once a call is made for help, it goes to a local 911 center, such as the Hunt County Sheriff’s office or the Greenville or Commerce Police Departments. That center will then transfer the emergency situation to American Medical Response in Dallas. Then, certified EMD dispatchers will contact the needed department by a generating specific tone. After the tone is received, the team will respond to the emergency. Paramedics then make the decision of whether to transport the patient to a Hunt County hospital or to a larger facility in Dallas.

Dr. Joe Bleier, the medical director for Presbyterian Hospital of Greenville’s Emergency Department, emphasizes that first responders of Hunt County provide a major service to the county. “Two treatment modalities are proven by researchers to save lives in hospital care: Defibrillation and early arrival. You cannot underestimate the value of our volunteer first responders delivering those therapies at a significant savings to the county taxpayers.”

The services of first responders have not gone unnoticed. In recent years, the Caddo Mills Volunteer Fire Department and the Commerce Emergency Corps have been named the First Responder of the Year by the Texas Department of State Health Services.

“The dedication of volunteers in the past has resulted in those awards, but lessons learned from Hurricane Katrina and other multi-causality incidents has given us a direction in which to grow,” said Bleier.

Despite their training and expertise, most of the team members are not paid for their services. The communities and rural areas in the county receive hospital funding to support the EMS and teams through purchase of equipment and facility use. The money comes from taxes collected by HMHD which is deliberately put back into the protection of the entire county.

Assistant EMS Coordinator Michael Sanchez, also a certified EMT, considers the teams valuable assets to the communities of Hunt County.

“Given that they volunteer their services and time, they save the county taxpayers millions of dollars,” he said.

The volunteer units don’t stop at just protecting the communities’ residents. Most of them also contribute to the quality of life by spearheading community events, celebrations, fund-raising efforts and charitable causes.

The training and education of the teams of Hunt County continues later this month when EMTs will attend a Continuing Education Conference, in which they will break up in teams and be assessed on their skills and knowledge of emergency medical care.

“Education and the acceptance of the responsibility of a First Responder is literally a matter of life and death,” says HMHD Chief Executive Officer Richard Carter. “We are extremely proud of the group of men and women who help the hospital district in serving the Hunt County area with their life-saving efforts.”

Cardiac Rehab Center named for Mary Rich Lynch

February 14, 2007 - The Mary Rich Lynch Cardiac Rehabilitation Center was officially dedicated Wednesday at Presbyterian Hospital of Greenville as part of Heart Health Week and the observance of Valentine’s Day.

Lynch, seated next to accountant Mike Taylor, listens as Dr. Michael Sills keynotes the event with the history of cardiac rehabilitation and how it has revolutionized care and recovery for patients who have suffered heart attacks and heart disease.

Lynch made a $200,000 gift to the Hunt Memorial Hospital District Foundation in 2006 to upgrade and expand services for the Cardiac Rehab Center which is located on the second floor of the Professional Building. Taylor and the late Harold Curtis assisted Lynch with details of making the gift. Hers was the first major donation to the Foundation, which raised almost $1.4 million in 2006.

HMHD board and foundation members, hospital administrative staff, Rehab staff members and friends were among those present to honor Lynch.

 

In this photo, Lynch is pictured with Hunt Memorial Hospital District CEO Richard Carter, HMHD Board Chairman Ron Wensel and Foundation Chairman Dee Hilton following the unveiling of her photo and the plaque that will be placed outside the Center located on the second floor of the professional building.

HMHD names new hospital administrator

February 12, 2007 - Michael R. Klepin, a healthcare executive for 20 years, has been named administrator of Presbyterian Hospitals of Greenville and Commerce.

Klepin, who will join the Hunt Memorial Hospital District on March 26, comes to Greenville from Reno, Nev., where he has served with the Renown Health since 2001, holding a number of positions and responsibilities.

“This has concluded a long and very diligent search for the right person to step into this position,” said Hunt Memorial Hospital District Chief Executive Officer Richard Carter. Carter currently holds the position of CEO and Administrator, but will assume the duties of CEO full time as soon as Klepin comes on board, he said.

“This is not an additional position to the management team, but it is a new position,” Carter explained. When Assistant Administrator Patsy Youngs left to accept the presidency of Presbyterian Hospital of Kaufman, Carter temporarily reassigned her responsibilities until the administrator’s post was filled.

Klepin will assume the day-to-day business of both hospitals while Carter will turn his focus on strategic initiatives, organizational growth, physician recruitment, and community and Foundation activities.

“To prepare for the growing number of residents and businesses, we have formulated plans to build new facilities, and now we’re adding new management who will augment those plans,” said Carter, who will relocate his office to the HMHD Annex on Ridgecrest across from the hospital.

Klepin, 45, received his master’s degree from the University of Cincinnati, and his bachelor’s degree from Youngstown State University. He is a native of Poland, Ohio, near Youngstown.

“Mr. Klepin has been working in various executive roles within healthcare administration since his first job in 1986 with the Harris Methodist System in Fort Worth.

He has also held positions as CEO of Plano Rehabilitation Hospital in Plano and Rio Vista Rehabilitation Hospital in El Paso, as a senior business consultant for CIGNA Healthcare of Arizona, administrator of Vencor Northwest facility in Houston, and chief operating officer of Greenbrier Valley-Medical Center in Lewisburg, W.V.

He is a member of the American College of Healthcare Executives and the American Cancer Society and has been actively involved in volunteer work.

He will be moving his family to Hunt County as soon as the school year is finished. He and his wife Dianne, a Fort Worth native, have two children, Nicholas 12, and Francesca, 8.

“I am very excited to be coming back to Texas. We’ve found Greenville to be the kind of place we want to live in and finish raising our children,” Klepin said. “There is a real sense of community within the hospital and the county,” he said.

Cardiac Rehab Center to be dedicated on 10th anniversary

January 24, 2007 - An important week is coming up for Presbyterian Hospital of Greenville as its Cardiac Rehabilitation Center celebrates its 10th anniversary – and gets a new name.

As part of Heart Health Month and National Cardiac Rehabilitation Week (Feb. 11-17), the Center has set aside Feb. 12-16 for some special events, including its annual health fair on Tuesday, Feb. 13 on the Mezzanine from 10 a.m. until 2 p.m.

The week will kick off on Monday, Feb. 12, with a display on the Mezzanine of the history and vision of cardiac rehabilitation.

Wednesday will be a special day as the Hunt Memorial Hospital District Charitable Health Foundation dedicates the naming of the Center as the Mary Rich Lynch Cardiac Rehabilitation Center. The event is in honor of the long-time Hunt County resident who last year presented a gift of $200,000 to the Foundation to continue its work in supporting enhance the efforts of the Center. A large wall plaque will be placed at the entrance to the Center which is located on the second floor of the East Wing.

On Thursday a walking event is being scheduled.

Open Mondays, Wednesdays and Fridays, the Center provides a comprehensive program as an outpatient process that includes physician supervision. It all begins while the patient is still in the hospital or with a referral from the primary care physician who has determined that a change of lifestyle is needed.

The rehab team performs an orientation and clinical evaluation with continuous monitoring for four to six weeks. This is done after the patient leaves the hospital and includes physician supervision.

The next phase offers both a regimen for physical exercise and lifestyle education.

“Education is the key to making lifestyle changes regarding the role of good nutrition, stress control, knowledge of your medicine and the importance of exercise,” said Kathy McKinney, coordinator. McKinney and RN Arlene Cannon have been with the program since the center opened in 1997. Mary Kay Ross is director of Cardiac Rehabilitation.

The education and exercise goes on for six to eight weeks after which an exit evaluation is made and results forwarded to the referring physician.

When the entire 12-week program is concluded, the patient is given the opportunity to continue the exercise program at the Center and will be provided with ongoing cardiovascular maintenance exercises, McKinney says.

Physician involvement is also a key to the success of the Cardiac Rehab Center. McKinney says most local doctors and Hunt County-area cardiologists do a good job of referring their patients who have undergone cardiac surgery, suffered heart attacks or have just been diagnosed with heart disease. And, the number of patients using the Center has steadily risen over the years.

Nationwide, however, the American Heart Association has taken notice in its updated scientific statement on cardiac rehab and secondary prevention of coronary heart disease, that not nearly enough physicians are encouraging patients to rehab and follow prevention protocols.

“Cardiac rehabilitation programs remain underused in this country, with only 10 to 20 percent of the 2 million eligible patients a year who experienced heart attack or underwent cardiac revascularization procedures participating,” said Arthur Leon, M.D., chairman of the AHA writing group.

“In addition to a low physician referral rate, factors contributing to underuse of the services include poor patient motivation and inadequate third-party reimbursement. We need to motivate physicians to be more progressive in educating and referring patients to the programs and encouraging insurance companies to re-evaluate their coverage.”

Statistics, they say, support this emphasis of the benefits of exercise-based rehabilitation. They show that the average cardiac death was 26 percent lower in rehabilitation patients who were exercise-trained compared with those who received “usual care.” There were also 21 percent fewer nonfatal heart attacks, 13 percent fewer bypass surgeries and 19 percent fewer angioplasties in the exercise-trained people.

Leon said the specific benefits of the exercise training component are improved functional capacity for the patient, improved blood vessel function, improvement in cardiovascular risk factors, improved coronary blood flow, improved electrical stability of the heart muscle (thus reducing the risk of a fatal heart rhythm disturbance), reduced risk of blood clots and reduced cardiac work and oxygen requirements.

The American Heart Association Writing Group contributed to this article.

Safety tips:
Out of control on bad roads

January 24, 2007 - Bret Freeman, trauma department coordinator at Presbyterian Hospital of Greenville, recently came across some information that is useful to motorists during this time of the year.

He read about a 36-year-old woman who had an accident late last year and totaled her car. A resident of Kilgore, she was traveling between Gladewater and Kilgore. It was raining, though not excessively, when her car suddenly began to hydro-plane and literally flew through the air. She was not seriously injured but very stunned at the sudden occurrence.

When she explained to the highway patrolman what had happened he told her something that every driver should know: Never use the cruise control when the pavement is wet or icy.

She had thought she was being cautious by setting the cruise control and maintaining a safe consistent speed in the rain. But the highway patrolman told her that if the cruise control is on and your car begins to hydro-plane, that is, when your tires lose contact with the pavement, your car will accelerate to a higher rate of speed and you take off like an airplane. She told the patrolman that was exactly what had occurred.

The patrolman said a warning sign about the cruise control should be placed on the sun visor next to the air bag warning.

We tell our teenagers to set the cruise control and drive a safe speed, but we also need to tell them to turn it off if the pavement is wet.

 

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