wellness matters Caring for the Person in Each Patient

In the right place at the right time

In late July of last year, Mary Yoder, patient over 60 with belly pain, one of the The wall of the vessel had weakened and of Harrisonville, hadn’t felt well for a causes you commonly look out for is an bulged to the point that it was two times few days. Her family urged her to go to abdominal aortic aneurysm.” its normal size. the doctor, but she kept putting it off, Dr. Lienhop immediately ordered a thinking she’d start to feel better. However, computed tomography (CT) scan to check Excellent teamwork she continued to worsen, and finally one Mary’s abdominal aorta. Dr. Lienhop knew that Mary would morning she knew she needed help. She By the time Harry came back from quickly need surgery to fix her aorta. woke her husband of 53 years, Harry, parking the car, Mary had been evaluated He arranged for her to be transported and told him he needed to take her to the and taken to the Medical Imaging by ambulance to a hospital in Kansas Emergency Department (ED). Department for the CT. City, where a vascular surgeon (one Mary doesn’t remember much about her “I couldn’t believe how quickly the who operates on blood vessels) would time in the ED at Cass Regional Medical doctor moved,” Harry remembers. “It was repair the aorta. Mary was admitted to Center, but her care team does. Terry amazing to me how fast they worked.” the cardiovascular ICU, and while the Lienhop, DO, was her doctor. The CT results confirmed Dr. Lienhop’s surgical team was discussing her care plan, suspicions. The test revealed a weak, the aneurysm ruptured. She was rushed Quick action bulging area—called an aneurysm—in to surgery, where the team successfully “Though Mary’s blood pressure and heart Mary’s abdominal aorta. The aorta is the completed the repair. rate were within normal limits, and there vessel that carries oxygenated blood from “The fact that Mary was in the were no other red flags in her initial exam, the heart to the rest of the body, and its hospital when her aorta ruptured made the fact that she was complaining of main branch travels from the heart down the difference,” Dr. Lienhop says. “The abdominal pain was certainly a concern,” through the abdomen, which is where the chances of survival are almost nil if the Dr. Lienhop says. “Any time you have a weak spot in Mary’s aorta was located. Continued on back page

INSIDE SPRING 2016 Lend a helping hand pg 3 Meet our general surgeons pg 6 Wellness Safe spring Matters cleaning | Summer pg 2015 7 1 Spring 2016

SEARCHING FOR DR. RIGHT? wellness Calendar Try our physician directory at www.cassregional.org. SUN SAFETY Tips to beat the burn

SEEK SHADE

Choose a broad-spectrum, water-resistant sunscreen with a sun protection factor (SPF) of 30 or more. Apply it generously. Reapply at least every two hours and after swimming or sweating.

Alzheimer’s Support Group Diabetes Support Group Tuesdays, April 12, May 10, June 14, Thursdays, April 21, May 19, 6:30 p.m. July 12, 6:30 p.m. Conference Rooms 2 and 3 Conference Room 1 Join us in April for information on new Contact Jeanne Reeder at diabetes medications and in May for COVER UP [email protected], or call the A1C Champions program with a 800-272-3900. motivational presentation by a national Cover as much of your skin as speaker. Contact Liz Whelan, RN, MSN, CDE, possible. Choose a hat that shades COPD Support Group at 816-380-5888, ext. 6010, or email your face, ears and neck—and wear sunglasses that block [email protected]. Wednesdays, April 13, June 8, 11:30 a.m. 99% to 100% of UV rays. Conference Rooms 1, 2 and 3 Contact Gary Skiles, RRT, at Free 816-380-5888, ext. 4160, or email Community Health Screening [email protected]. Fridays, 9 to 11:30 a.m. Rotating locations around Cass County, Community Blood including Archie, Drexel, Garden City, Center Blood Drive Harrisonville and Peculiar USE SUNSCREEN Friday, July 22, 2 to 5 p.m. Blood sugar, cholesterol and blood Conference Rooms 1, 2 and 3 pressure screening. Contact Kacee Take extra care near reflective surfaces Appointments welcome but not Baldwin, MA, at 816-619-3000 or email like water, sand and snow. They [email protected]. increase the likelihood necessary. To schedule an appointment, of sunburn. go to www.savealifenow.org. Free High School Sports Physicals Archie Medical Clinic—Wednesday, April 13 Drexel Medical Clinic—Wednesday, April 27 Garden City Medical Clinic—Thursday, wellnessmatters April 28 Information in WELLNESS MATTERS 4 to 6 p.m. comes from a wide range of medical Contact John Hoffman, PT, at experts. If you have any concerns or questions about specific content that 816-380-5888, ext. 4230, or email may affect your health, please contact [email protected]. your health care provider. Models may be used in photos and illustrations. 2016 © Coffey Communications, Inc. All rights reserved. Sources: American Academy of Dermatology; 2 www.cassregional.org | 816-380-3474 | Spring 2016 American Cancer Society SUN SAFETY Tips to beat the burn HELPING HANDS PROJECT Providing TLC SEEK SHADE to patients Jeff Hibschle, RN, chats with one Choose a broad-spectrum, of the infusion therapy patients water-resistant sunscreen with Handmade goods keep a sun protection factor (SPF) of 30 or who received a shawl made by the more. Apply it generously. Reapply at Cass Regional patients Helping Hands Project volunteers. least every two hours and after comfortable swimming or sweating. The Helping Hands Project started in hands have included the Harrisonville A total of 1,330 comfort items were the fall of 2012 to provide special TLC United Methodist Women, the American given to patients last year, which is (tender loving care) items to patients at Sewing Guild, the First Baptist Church more than double the amount that was Cass Regional Medical Center. The idea of Archie sewing group, the Garden City distributed in 2014. Items are provided for the project began when the Patient sewing group, and individuals who have free of charge to patients in the Emergency COVER UP Experience Team at Cass Regional been patients themselves or have had Department, Intensive Care Unit, Medical/ identified certain items that would be family members treated at Cass Regional. Surgical Unit, Surgery Department, Cover as much of your skin as helpful and comforting to patients during Several of these helpers, along with area Behavioral Health Unit, and the Physical possible. Choose a hat that shades their treatment and recovery. businesses, have also donated thousands and Occupational Therapy Department. your face, ears and neck—and wear sunglasses that block The effort was soon adopted by the of dollars in materials to create the TLC They are also given to infusion therapy and 99% to 100% of UV rays. Cass Regional Auxiliary, and volunteers items. oncology patients in the Specialists Clinic. from across the region were recruited to In 2015, the Helping Hands Project create the handmade items. Using their provided the following items to patients at WANT TO GET INVOLVED? sewing, crocheting, knitting and quilting Cass Regional: If you are interested in supporting this skills, several groups and individuals from ww 809 comfort pillows. project by producing handiwork or donating goods across the area have since made hundreds ww 118 rice bags. needed (fabric, Poly-Fil, yarn, etc.) or know a person of items for patients. ww 117 walker caddies/utility bags. or group who would like to participate, please USE SUNSCREEN In addition to some of the Cass ww 70 knitted caps. contact Martha Sims, project chair, at 816-210-3554 Regional Auxiliary members, the helping ww 216 lap throws and shawls. or via email at [email protected]. Take extra care near reflective surfaces like water, sand and snow. They increase the likelihood of sunburn. Welcome, Dr. Connett Cass Regional Medical Center is pleased to Louisville affiliated hospitals. He is certified by the announce that urologist Bradley D. Connett, MD, American Board of Urology. has joined the medical staff. He sees patients on Dr. Connett treats urological conditions, such as Tuesdays at Rock Haven Specialty Clinic, which is incontinence and bedwetting, as well as diseases located at 2820 E. Rock Haven Road, Suite 150, in of the male reproductive system. He succeeds Harrisonville. urologist Keith J. Abercrombie, MD, who retired at A graduate of the University of Louisville School the end of 2015. of Medicine in Kentucky, Dr. Connett completed a urology residency as well as an internship and NEED AN APPOINTMENT? Bradley D. Connett, MD residency in general surgery at the University of Call 877-790-4730 for an appointment or more information.

Sources: American Academy of Dermatology; American Cancer Society Wellness Matters | Spring 2016 3 Community Benefit WANT TO LEARN MORE? Call 816-380-5888, ext. 4650, during regular business hours, Monday through Friday, or email Report [email protected]. This Community Benefit Report highlights some of the advancements Cass Regional Medical Center made last year under our five operational Pillars of Quality Success: People, Quality, Customer Service, Growth and Financial Strength. ww No hospital-acquired conditions or infections were experienced by our patients in 2015. ww We earned accreditation by the American College of Radiology for our 16-slice CT scanner and had People successful accreditation surveys of our laboratory as well as our mammography, nuclear medicine and diabetes ww For the second year in a row, we saw improvement education services. in our employee engagement scores, which again ww We attained Stage II Meaningful Use certification for placed Cass Regional in the top 10 percent within our both the hospital and clinic information systems, which benchmarking group. included the addition of a patient portal. ww We continued to add new staff positions and now ww We purchased equipment to improve patient care employ approximately 470 individuals, the majority safety and quality, including a radiation and contrast of whom live in Cass County. These jobs result in dose management software; the Novadaq PINPOINT approximately $28 million in salaries and benefits that Imaging System that allows better visualization of are re-invested locally through the residents who live and structures, especially blood flow, during laparoscopic shop in our area communities. surgery; an upgrade to our CT equipment to improve ww We added a discretionary retirement distribution to imaging acquisition speed in support of our trauma reward employee tenure within the organization, and program; and the replacement of the nurse call system. we increased our minimum starting wage from $9.14 to $10.50 per hour (effective February 2016). ww We completed the Patient Care Simulation Lab, which will enhance clinical education opportunities for Cass Regional staff and other members of the Cass County Customer Service health care community, including nursing students from ww We improved in Emergency Department patient Cass Career Center. satisfaction over the last year, with an overall ranking in the top quartile of facilities within the national Press Ganey survey database. ww We saw trending improvement in our inpatient satisfaction scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey, with an overall ranking in the top 10 percent nationally for the fourth quarter of 2015.

4 www.cassregional.org | 816-380-3474 | Spring 2016 COMMUNITY

Growth ww We completed a remodeling project that allowed expansion of our pain management and infusion therapy services while increasing capacity within our GI Lab. ww We added 3-D mammography services to improve the detection of breast cancer and reduce the number of callbacks for further testing. ww We improved access to primary care with the additions of Dylan Werth, MD, to the Pleasant Hill Medical Financial Strength Clinic staff; Alberto Suarez, MD, to the Peculiar Medical Clinic staff; and Darya Collins, RN, BSN, ARNP, to ww We refinanced the hospital revenue bonds that were the Archie Medical Clinic staff; and with the transfer of issued in 2007 to construct our new facility. This Jackie Kumm, RN, FNP-BC, to the staffs of Peculiar transaction will close in November 2016, and it will save Medical Clinic and Harrisonville Medical Clinic. the organization $11 million over the life of the bond ww We expanded podiatry coverage with the employment of and take six years off its term. William Cruce, DPM. ww We again exceeded budgeted expectations related to ww We provided economic and facility support to the Cass operating margin and days of cash on hand. County Dental Clinic, which allowed the organization ww We were recognized by iVantage Health Analytics and to open a second location within Cass County. The the National Organization of State Offices of Rural new clinic, which is located in Harrisonville, improves Health for overall excellence in outcomes and financial access to dental care for children who are without dental strength, reflecting top quartile performance among all coverage or who are enrolled in Medicaid. acute care hospitals in the nation.

Cass Regional Medical Center key operating statistics

2013 2014 2015 Inpatient admissions 3,169 2,974 2,846 Outpatient visits 22,193 22,680 22,981 Emergency Department visits 14,596 14,604 15,564 Family Practice Clinic/General Surgery Clinic visits50,820 51,935 55,438

Balance sheet (Consolidated with Cass Regional Medical Center Foundation and Cass Medical Center Improvement Corporation) 2013 2014 2015* Assets $107,985,577 $112,283,454 $114,085,541 Liabilities $54,960,141 $54,544,046 $51,455,523 Fund balance $53,025,436$57,739,408 $62,630,018

Payer mix 2015 Medicare and MCR HMO: 48.2% County maintenance tax appropriation received: $2,009,585 Medicaid and MCD HMO: 11.4% Bad debt expense: $11,628,461* HMO/PPO: 31.5% Charity care: $890,810* Self-pay: 7.2% Total charity care and bad debt expense: $12,519,271* Other: 1.7% *Unaudited figures

Wellness Matters | Spring 2016 5 Our general surgeons

Walter W. Costner, MD, FACS, holds a bachelor’s degree in psychology from Samford University and a Master of Health Services Administration degree from the University of Central Florida. He is a graduate of Saba University School of Medicine and served his residency in general surgery at the University of Missouri–Kansas City. He is certified by the American What is Board of Surgery and is a Fellow of the a general American College of Surgeons. Jack Hudkins, MD, FACS, holds surgeon? a Bachelor of Science degree in biology from A diseased gallbladder. A breast tumor. Education and training Oklahoma Christian An obstructed bowel. All of these diverse To become a general surgeon, a person University and conditions often require surgery to treat must complete four years of medical received his them, and chances are the doctor who school and then a five-year residency medical degree from the University is going to perform those operations is a in general surgery. If he or she wants to of Oklahoma. His residency in general surgeon. further specialize, two or more years of general surgery was performed at training are needed. the University of Kansas School of What they do Some of the areas in which a general Medicine–Wichita. Dr. Hudkins is General surgeons are trained to diagnose surgeon can specialize include: certified by the American Board and manage a wide range of diseases ww Surgical critical care. of Surgery and is a Fellow of the and disorders that may require surgical ww Pediatric surgery. American College of Surgeons. treatment. Their area of expertise is, ww End-of-life care. essentially, the entire body. It includes: ww Bariatric surgery. Michael Kohlman, ww The head and neck. ww Minimally invasive surgery. MD, received ww The endocrine system, including the A general surgeon may seek board a Bachelor of pancreas and thyroid gland. certification from an organization such Science degree ww Breasts. as the American Board of Surgery. in biochemistry ww All parts of the digestive tract, Certification is voluntary. To obtain from the University including the intestines and rectum. it, a surgeon must pass extensive written of Washington ww The abdominal organs, such as the and oral tests to show mastery in the and his medical stomach and liver. field. degree from St. Christopher’s College ww Skin and soft tissues. When a surgeon is board-certified, of Medicine. His surgical residency was General surgeons are also trained in it means he or she has met the highest performed at Atlanta Medical Center the care of pediatric and cancer patients standards for education, training and and the University of Missouri–Kansas and the treatment of patients who are knowledge. City. Dr. Kohlman is certified by the injured or critically ill. Additional source: American College of Surgeons American Board of Surgery.

6 www.cassregional.org | 816-380-3474 | Spring 2016 SPRING YARDWORK Don’t let safety Never use electric pruners when it’s slip raining or wet.

Pruning and mowing and weeding— pointed down. ww Teach kids to stay away from all oh yes! With spring’s arrival, it’s time ww Never use electric pruners when it’s running mowers. to spruce up your yard and tackle some raining or wet. Using ladders to clean gutters and outdoor chores. ww Don’t try to cut branches larger than windows: But as eager as you may be to tidy up, your pruner is designed for. ww Always place the ladder on a steady, don’t set safety aside. Every year, thousands Mowing your lawn: level surface. of people nationwide get hurt—sometimes ww Always clear away stones, sticks and ww See that the ladder is fully open and its seriously—doing yardwork and outside other objects before starting. braces are locked. cleaning. Here are a few tips to remember. ww Never mow barefoot or in sandals. Opt ww Don’t stand on the top rung of any Pruning hedges: for sturdy, closed-toe shoes. ladder or lean too far to the side—when ww Before cutting, make sure hands and ww Use a stick or broom handle to remove leaning, your belly button should not go fingers are well out of the way. debris in blades—never your hands or past the right or left side of the ladder. ww Carry pruning tools with the sharp end feet, even if the engine is off. University of California Agriculture and Natural Resources

How old kids should be THE before they operate a push mower and a riding 4-1 12AND RULE mower, respectively. Remember this Source: American Academy of Orthopaedic Surgeons when leaning a 16 ladder against your house or a wall: Make sure EVERY the base is 1 foot This is how often you should get a tetanus away from the vaccination—especially if you work in your wall for every yard or garden. Tetanus lives in the soil and can 4 feet of ladder. 10 get into your body through a break in the skin. Source: American Academy YEARS Source: Centers for Disease Control and Prevention of Orthopaedic Surgeons

Wellness Matters | Spring 2016 7 Standard U.S. Postage PAID Cass Regional Medical Center

2800 E. Rock Haven Road Harrisonville, MO 64701 816-380-3474

Three reasons to trust Cass Regional. Meet them on page 6.

Herbed spinach quiche portobello caps Mary Yoder survived the rupture of her abdominal aorta thanks to the quick actions of Cass Regional’s Emergency Department team.

Continued from front page Makes 4 servings. mushroom caps on baking sheet. Ingredients patient is not within five minutes of a surgical ww In a mixing bowl, whisk together team when a rupture occurs.” 4 portobello mushrooms, all remaining ingredients, except Mary has had a long road to recovery. She spent 3-inch diameter 1 tablespoon Parmesan cheese. a month in the hospital after surgery and then Cooking spray ww Coat 10-inch nonstick pan with two more months in two different rehabilitation 3 large eggs cooking spray, and heat over facilities. Shortly after she was discharged, she Egg whites from 6 eggs medium heat. experienced some additional problems, which led ½ cup whole-wheat grated ww Cook and scramble egg mixture to another ICU stay, followed by another inpatient bread crumbs (panko) until it just starts to thicken. rehabilitation stay. After a short trip home to ¼ cup nonfat milk ww Remove from heat. celebrate Thanksgiving, she returned to the 1 teaspoon low-sodium driedw w Using a large spoon, scoop rehabilitation facility and was finally able to come garlic and herb blend partially-cooked hot egg home for good on Dec. 19. 1 cup cooked and drained, mixture into portobello caps. Dr. Lienhop credits the ED and Medical chopped, frozen spinach ww Sprinkle tops with remaining Imaging staff for working together as a team ¼ cup reduced-fat Parmesan Parmesan cheese. to diagnose Mary and to get her transferred to cheese, divided ww Bake about 20 minutes. Serve Kansas City for surgery. immediately. “Teamwork has to happen for good patient Directions Nutrition information care,” he says. “I love our group here. All of the ww Place oven rack in center emergency nurses are some of my favorite people, of oven; preheat oven to Amount per serving: 190 calories, and it is a joy to work with them.” 375 degrees. 6g total fat (2g saturated The Yoders are grateful for the quick response ww Remove portobello stems. Wipe fat), 145mg cholesterol, by the ED staff at Cass Regional. caps clean with damp paper 14g carbohydrates, 17g protein, “They got on the ball and did the right thing,” towel. 4g dietary fiber, 330mg sodium. Harry says. “They saved her life, and I will be ww Spray baking sheet with Source: Produce for Better Health Foundation forever grateful for the care she received.” cooking spray, and place