Published by Kettering Health Network Q1/2 : 2015

PHYSICIANQuarterly

Minimally-invasive Brain Surgery Smart Rx New Cancer Center Family Medicine Broke ground in May For America’s health

Kettering | Grandview | Sycamore | Southview | Greene | Fort Hamilton | Soin | Kettering Behavioral NETWORK 3

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Outstanding Q Kettering Health Network Kettering Health Network for orthopedic care Center Kettering Medical and major for trauma care (p. 36) surgery cardiac #1 by The rank in Ohio held • • 72% of U.S. hospitals used hospitalists in 2014— a significant rise from 50% in 2007 (p. 28) 95th ranking The percentile Fort Hamilton Hospital holds for quality care, to Truven according Health Analytics (p. 30) 6 The number of mission trip opportunities (p. 12) featured 75% costs are of U.S. healthcare preventable spent on treating disease (p. 22) ”

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” the right care to the right patient in the right to the right patient the right care an requires coordination location… Care care, focus on patient-centered increased management. rather than disease-centered in delivering innovative, compassionate care (p. 20) compassionate care (p. in delivering innovative, on the mentality that is integral Underwood Jody 26) to the pursuit of care coordination (p. DO, on the marked increase Lytle, Patrick 30) in cardiac cath lab volumes (p. Fred Manchur, CEO of Kettering Health Network, on the Health Network, of Kettering CEO Manchur, Fred 5) care (p. access to emergency focus on expanding network’s time MD, on the quick recovery Schwartz, Brian 6) Replacement (p. Valve Aortic of Transcatheter of the entire team DO, on the importance Porcelli, Phillip DO, on the vital role of primary care providers Martin, Paul 22) (p. the U.S. to improve the health of people in The goal of care coordination is to provide coordination The goal of care amount of trust for a patient It takes a great With these freestanding Emergency Centers, Emergency freestanding these With are procedure have the TAVR Patients who here lucky to have such a dedicated team We’re the health is the path to putting Primary care to put their health in the hands of a physician, nurse, technician, or—on a larger scale—a hospital or network. As a testament to that coming to Fort are trust, Hamilton residents their heart care. Hamilton Hospital to receive residents will have better access to quality better access will have residents closer to home. care emergency four hours later their hospital rooms sitting up in family and friends. and talking to when it comes to theat Kettering Medical Center part of it. It’s The surgery is only neurosciences. an innovative It’s the therapy. it’s the after care, feel. with a community hospital atmosphere back in health care. “ “ “ “ “ “

Experts! Physician

Author Quarterly articles Serve as media spokesperson Speak at community events • • Contribute content ideas •  •  Are you willing to volunteer you Are your expertise in any of the following areas? Email: [email protected] or call (937) 752-2053 Kerry Lange, Tara Pettit, Kendra Silvis, Kerry Lange, Tara Leigh Wilkins Michelle Wesney, Cover Photography: AGI Studios Managing Editor: Emily Syvertson Design & Layout: Christie Mildon Cheryl Kennison, Additional Writing: Physician Quarterly is published by Kettering Health Network to support communications fellows, alumni, between physicians, residents, and hospital administration. We need PHYSICIAN

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...... for quality care top docs...... as Cincinnati’s disability available...... welcomes new docs...... Soin launches new joint program Communication is key with hospitalists...... Soin medical staff & Greene Fort Hamilton ranks top 5% Advances in lung cancer Physicians recognized Fort Hamilton medical staff Kettering Physician Network Leadership changes...... grows in Springboro Primary care ..... New employee assistance program Supplemental long-term Kettering Physician Network ...... care Coordinated welcomes new docs...... Fort Hamilton lab volumes climb...... cath Cardiac diagnosis and therapy...... welcomes new docs...... Family medicine for America’s health... for America’s Family medicine joint surgery Grandview’s Soin/Greene Grandview/Southview ...... care patient seeks improved welcomes new docs...... staff Grandview provisional Level III Grandview provisional ...... improved health services Women’s expand...... Local health centers medicalGrandview & Southview Trauma Center...... Trauma 4 5 6 7 8 9

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Comments of encouragement...... Kettering & Sycamore Hospitals...... named 100 Top Kettering College opens Minimally-invasive brain surgery for “inoperable” tumors...... MRI...... new wide-bore Sycamore’s medical staff Kettering & Sycamore welcomes new docs...... Kettering/Sycamore Pursue personal goals ...... resolve with year-long ...... OTD program cardiac therapies...... cardiac Emergency expands...... Emergency patients...... Heart surgery for high-risk Genetically personalized ...... Anterior hip replacement ...... Patient advisory councils ...... Become a better communicator ...... Mission trip opportunities InstitutePhysician Leadership ...... starts second cohort Physician Hospital Alliance tools ...... assist providers Leadership changes support alignment...... Epic updates...... Network partners ...... telemedicine to provide as CME...... Smart Rx offered New Cancer Center...... New Cancer Phillip Porcelli, DO, Phillip Porcelli, at Kettering neurosurgeon destroys Medical Center, a brain tumor with a laser This minimally- via computer. offers invasive procedure a game-changing alternative for patients with “inoperable” brain tumors (p. 20). On Our Cover

Network Ta NETWORK 5 Fort Hamilton Hamilton Fort Franklin Grandview Greene Huber Kettering (opening Preble 2015) 24, August Soin Southview Sycamore • • • • • • • • • • Kettering Health Network Locations Emergency

Kettering Health Network Emergency Center, Franklin Kettering Health Network Emergency Center, Preble will Center that The Emergency County is located serve Preble network’s in Eaton next to the County Medical existing Preble It will have eight to Center. and is expected 12 rooms, 25 to 30 new jobs. to create certified emergency Four board be on staff. physicians will also It is scheduled to open August 24, 2015. Soin After only two years of operation, the Soin Emergency Department needed to expand. In 2014, the to add ground network broke a nurses 12 new exam rooms, station, an EMS suite, and supply The expansion will be open areas. for patients in the summer of 2015. Network ContinuesNetwork Care Emergency to Expand minutes Because an emergency, count in Kettering Health been Network has to bring on a mission emergency services people closer to where live and work. The journey in 2011 when began its first the network opened Emergency Center in freestanding the Huber Heights. Most recently Warren network identified northern in counties as areas and Preble need of better and faster access to emergency services. In 2014, on two ground the network broke new Emergency Centers to serve these areas. “With these freestanding will Emergency Centers, residents have better and faster access to closer to quality emergency care CEO Manchur, home,” says Fred of Kettering Health Network. Franklin The Kettering Health Network Emergency Center serving County residents northern Warren I-75 at the Franklin/ is located off exit on State Route Springboro 73, next to the southbound 75 which entrance ramp. The facility, Sycamore through is accredited is 12,000 square Medical Center, It has feet and has 12 rooms. new jobs, including 40 created nurses, respiratory registered therapists, imaging and lab technicians, and support staff. certified emergency Four board also on staff. physicians are After the ribbon cutting on February 3, the center held an open house on February 22. opened for patients on It officially February 23, 2015.

Colleen Pike, Criswell Davis, and Amber Best, members of the patient advisory council for the cancer center. Cutting-edge cancer care care cancer Cutting-edge home close to Kettering Health Network is committed to providing close cancer care comprehensive can focus on to home, so patients of the stress their health without extensive traveling. have the most sophisticated “We technology cancer treatment do not available so that patients the region have to travel out of We their cancer care. to receive also have the expertise required to help patients and their families navigate the journey through says Elizabeth cancer treatment,” of the oncology director Koelker, service line for Kettering Health Network. “This cancer center is the being designed to provide most advanced patient-centered that in an environment care focuses on healing the mind, and spirit.” body, As the only network of hospitals in to receive Dayton area the Greater the Outstanding Achievement the Commission on from Award Kettering Health Network Cancer, is taking the next step in delivering quality cancer care. A café that focuses on the A café that focuses tastes nutritional needs and of patients with cancer Complimentary holistic medicines, such as medical massage spa-like A boutique in a serene, post-surgical setting that offers and other products apparel their that help patients through cancer journey Designed for patients, by patients the very beginning of the From the network has sought project, and former the input of current cancer patients. “Our patients’ voices have been the planning our guide throughout says of this cancer center,” CEO of Kettering Manchur, Fred formed a Health Network. “We patient advisory council to provide for our decisions on direction the building and everything from interior design to the kind of food The cancer center and furniture. is designed for patients by our patients.” are tailored to patients’ tailored are needs, including: • • •

Tailored amenities Tailored a full menu The center will provide amenities that of cancer-specific The cancer center will offer The cancer center will offer to patients in complete care with a caring environment, dedicated patient-centric services to fight and specialized treatments The center will serve as cancer. a single touch point for patients, them with a wide range providing of services. The 120,000-square- foot, five-story facility will cost $49 million. approximately on Kettering Medical Center Campus Center Medical on Kettering In order to advance the to advance In order in health care level of Health Ohio, Kettering a Network is building cancer comprehensive center on the care campus of Kettering The Medical Center. ground network broke May 14, on Thursday, 2015. Construction is expected to be completed in late 2016. New Cancer Center to be Built be to Center Cancer New NETWORK 4 NETWORK 7 “This is one way that we are way that we are “This is one to be and tailoring care advancing says Suzanne patient-specific,” of Innovation, Coleman, director & Grants. Research of Located on the campus the Center, Kettering Medical & of Innovation, Research office development Grants supports the clinical of innovative solutions, studies, and new research the technologies throughout network. It facilitates several grant initiatives, including Grandview’s Center, Breast Comprehensive requirements supporting research for the new occupational therapy at Kettering doctorate program College, and conducting studies FDA-regulated numerous for the development of new drugs and devices.

The majority of prescription drugs only The majority of prescription work in 30-50% of the people taking them Funding for this genetic testing is this genetic testing Funding for by Medicare. supported “By performing pharmogenomic the best testing, we can tailor a patient medical therapy for agents by determining which most beneficial and doses are condition,” says for a patient’s , director Franklin Handel, MD at Research of Cardiovascular Center. Kettering Medical genetic Understanding patients’ prior to starting therapies profiles can help physicians minimize risks responders by pre-identifying as well as and non-responders, avoiding potentially life-threatening adverse events. “For example,” Handel, “certain patients says Dr. have an taking Plavix (clopidogrel) allele which makes the breakdown to its active of clopidogrel metabolite less likely to occur in therapeutic blood levels. This would make the drug less likely to benefit the patient. By knowing hepatic P450 2C19 the patient’s we can prescribe activity, antiplatelet agent the proper for the patient.” of office visits of office Two-thirds in to physicians result drug therapy prescription $ $ Did you know? About $350 billion is spent annually on medicine ineffective Personalizes Cardiac Therapies Cardiac Personalizes Pharmacogenomic Testing Testing Pharmacogenomic of Innovation, The office is conducting & Grants Research testing— pharmacogenomic study of which extends the pharmacology to modern cardiac genetics—to reveal side patients’ risks of serious drug and reduced effects This insight will effectiveness. make clinical allow physicians to therapeutic decisions that improve initiation outcomes prior to of therapy. with Schuster Cardiology Working Associates and Southwest the studies include Cardiology, at patients who have reported with their least one problem medications. cardiac cheek After the patient’s is swabbed, the DNA is sent to Companion Dx™, a health-focused comprehensive, of genetic analysis provider services, to run a genetic test. The drug each patient’s reveal results metabolism, information that is especially helpful for medications therapeutic that have a narrow also offers The report window. recommendations. treatment Dr. Pavlina Dr. Dr. Merle Dr. Dr. Schwartz Dr. Nazir Dr. *Otto CM. Timing of aortic valve surgery. of aortic valve surgery. *Otto CM. Timing Heart. 2000;84:211-218. ** Goldbarg SH, Elmariah S, Miller MA, into degenerative Insights Fuster V. aortic valve disease. J Am Coll Cardiol. 2007;50(13):1205-13. The Kettering Medical Center $48,000 in Foundation provided funds to make donor-designated equipment adjustments to one suites operating of Kettering’s to accommodate the in order procedure. TAVR

traditional heart surgery, for traditional heart surgery, considered which they may be inoperable. Without aortic valve severe patients with replacement, a survival rate aortic stenosis have years after as low as 50% at two the onset of symptoms*. also offers This new procedure hospital stay and reduced traditional time; whereas recovery aortic heart valve surgery requires about a five-to-six-day stay in the months hospital followed by three patients who undergo of recovery, typically procedure the TAVR in the hospital for two to recover most days and can resume three activities within a week. “Patients who have the TAVR sitting up in their are procedure four hours later hospital rooms and talking to family and friends,” explains Brian Schwartz, MD, who along with Peter Pavlina, MD, is co-medical director of Kettering Medical Center’s “After having program. TAVR feel patients this procedure, dramatically better almost is a game- TAVR immediately. changer in the treatment of valvular disease.” The team performed their first on November 24, two procedures Drs. Schwartz and Pavlina 2014. performed the first, and Thomas MD, and Raja Nazir, Merle, MD, performed the second procedure. Aortic valve valve Aortic Aortic stenosis stenosis Aortic disease is disease affects up to 7% 7% up to affects responsible for for responsible of the population of A team of interventional A team of interventional and cardiac cardiologists surgeons is performing valve transcatheter aortic procedures (TAVR) replacement Center for at Kettering Medical stenosis. patients with aortic is a procedure The TAVR alternativeminimally-invasive to surgeons heart surgery in which the replace and cardiologists a catheter. aortic valve through can be performed The procedure approaches: three through transfemoral, transapical, and transaortic. The procedure in 2011 for was first approved the “inoperable” patients before extended to high- and approval surgical patients. greater-risk high- or greater-risk offers TAVR surgical patients–such as people with diabetes, lung disease, or the elderly–an alternative to Transcatheter Aortic Valve Replacement Valve Aortic Transcatheter Alternative High-risk for Provides Patients Surgical

more than 25,000 than 25,000 more over the age of 65* the age of over

NETWORK 7% 6 deaths annually** deaths 25,000 Anterior Hip Replacement Offers Listening to the Patient’s Voice a Speedy Recovery for Patients Network develops patient advisory councils It is estimated that more than 285,000 total hip Kettering Health Initial changes council at each facility, some Surgeons performing make impact service line based, while others replacements are performed each year in the United anterior hip replacement Network has begun to The January 2015 perioperative serving more as general care more intentionally seek NETWORK States. Kettering Health Network surgeons perform physician meeting incorporated councils, according to Johnson. the highest volume in the Greater Dayton area. Kettering & Sycamore the voice of the patient ideas from the previous patient The network has an active council as the key to unlocking and family advisory council. in Kettering Medical Center’s Getting patients back to their normal activities as soon as possible is medical, administrative, For example, since designating OR, the initial formation of a the primary goal of any joint replacement surgery. Some of the joint expert IV staff for difficult-to-start general care council at Sycamore NETWORK surgeons from Kettering Health Network are performing hip replacement and primary care-based patients, the patient survey score Medical Center, and several procedures using an anterior approach, as opposed to the more process improvements for IV starts has already improved, other preliminary formations of traditional posterior approach. that help to achieve Dr. Wang notes. informational meetings in various Advantages of anterior approach goals for quality, safety, The simple change for IV starts departments at each network 8 has the potential to improve facility, Johnson states. 9 Anterior approach hip replacement differs from other surgical techniques Michael Welker, MD and service. patients’ overall experience. “One “When patients defined what in that the surgeon can replace the joint without cutting muscles or Far Oaks Orthopedists “Partnering with patients and of the patients asked, ‘If you can’t quality of care really means to tendons from the bone, causing less tissue damage. This less-invasive families as advisors is a significant method results in quicker recovery times, less pain, and improved start my IV, how do I know you them, the phrase that surfaced way to move toward our goal to can do my surgery well?’” says was, ‘If it matters to us, it should mobility. Another advantage of the anterior hip replacement is that be a patient- and family-centered patients will not need to follow routine hip precautions post-operatively. Carol Applegeet, vice-president matter to you,’” says Jeanette culture—an organization that for Patient Care at Fort Hamilton Little, Kettering Medical Center’s “The direct anterior approach allows patients to return to activities listens to and partners with those Hospital, previous director of manager of Patient Experience. earlier than with the posterior approach secondary to decreased muscle we serve so that the patient’s Surgical Services at Kettering “We’re looking at how we can damage during surgery,” says Jerry Ahluwalia, MD. “There are also experience can help drive our Medical Center, and one of the really bring that slogan to life.” lower dislocation rates and fewer post-operative restrictions in regard improvements,” says Sandy founding leaders of the Surgical to bending and squatting.” Johnson, network director for Services patient and family Each voice matters Gurpal (Jerry) Ahluwalia, MD Patient and Family Experience. The anterior approach requires specialized instrumentation and Far Oaks Orthopedists advisory council at Kettering “Every life counts, and every a customized operating room table. The table’s design allows extension Kettering Health Network’s first Medical Center. voice matters,” says Johnson. of a patient’s leg downward, which gives access to the front of the hip official patient and family advisory “There’s a reverence for life that is not possible with conventional tables. council formed last November Patient-focused future in the work we do, including in Kettering Medical Center’s The development of these listening to and learning from “Because of the shorter recovery time, the anterior approach for hip Surgical Services, where people councils is a priority for network the people we serve.” replacements is optimal,” says Michael Welker, MD, from Far Oaks constructively share feedback leadership, who have established Orthopedists. “However, not everyone is a candidate.” Amidst goals for quality standards on hospital experiences, how care the goal of creating at least one and process improvement, the Best practices is delivered, distributed materials, patient’s voice is a guiding light. and facility design. Another key component to a speedy recovery at any network hospital John Lochner III, MD Little says, “Through these is a highly-specialized orthopedic team that educates the patient prior “The council has pointed out very Far Oaks Orthopedists councils, patients are engaging to surgery, and assists the patient and family every step of the way tangible things,” says Rebekah with and investing in us on their road to recovery. Wang, MD, medical director of as an organization, and Grandview Clinical Quality. “There were very Whatever approach is used, the experience and skill of the surgeon is we are doing the same practical ideas for how we can key to a successful outcome. Since every approach to hip surgery has with them.” improve communication about specific pros and cons, it is the surgeon’s responsibility to discuss each starting an IV, discharging, and individual patient’s needs and match them to the best-suited approach. allergies. These came to light through the eyes of the patient.” Kettering Health Network has been recognized in 2015 as #1 in Ohio for Chad Weber, DO Orthopedic Associates of SW Ohio Medical Excellence in Orthopedic Care ® ® Anterior approach hip by CareChex —a division of Comparion . replacement surgery will be available at Soin Medical Center in the near future. NETWORK 11

G G F F E E D D C C B B A A -Rachel Naomi Remen, MD “Who we are and what we bring within us that strengthens life may have more“Who we are and what we bring within us that strengthens to do with healing that what we know or what we do.” BEST PRACTICES IN PHYSICIAN COMMUNICATION IN PHYSICIAN PRACTICES BEST I acknowledge my patients’ feelings in an empathetic way my patients’ feelings in I acknowledge my patient breath and focus before approaching I take a deep positive rapport first warmly and establish I greet my patients I tryfrom them insight about the patient them and gain more to acknowledge are present, When family members I address it directly with that person action, a colleague’s When I have an issue with feelings and perspective legitimacy of the patient’s I validate and confirm the I raise the issue in a caring way If I have an issue with a co-worker, show my interest and knowledge of the patient so I can immediately I prepare, Before I sit down with a patient, receptive posture and adopt an open, lean in, level, I sit at eye When I am visiting with a patient, feelings for the other person’s I communicate empathy In difficult conversations, to set priorities for the time we have together I work together with the patient and give enough time for them to do so their feelings, I encourage patients to share taking notes, typing, of shuffling papers, I give my undivided attention instead When the patient is speaking to me, or looking at the computer and I honor their preference I ask the patient how much they want to know, when they disagree with mine even the care team, I open my mind to ideas and opinions from others on view without being defensive I listen and consider their point of If a colleague has an issue with me, me so patients can easily understand I avoid using acronyms and medical jargon, before I interveneI encourage the patient to speak freely about their concerns ideas and viewpoints before making suggestions I invite the patient’s I act as a positive role model for collaboration and teamwork or instruction I encourage questions as I proceed with an explanation and staying attentive and concerned I show empathy in my non-verbal behavior by nodding they have understood me I find out what people have understood instead of assuming a partner in decisions I make an intentional effort to engage the patient as ending the visit understanding and comfort with next steps before (and family’s) I check the patient’s am more likely to be effective and therapeutic I plan my approach so I When I have difficult news to share with a patient, really tune in to what the patient is saying, I am able to stop my mind from racing and When I am with a patient, and hear the story behind the story care I regularly acknowledge and appreciate co-workers who are involved in the patient’s I show empathy for their feelings If family members are present, I make the last six seconds of my interaction with a patient a positive memory for them I invite their questions and address their concerns When family members are present, point of view I listen with an open mind to the other person’s In a difficult conversation with a colleague, I find out from the patient what they already know so I can build on it and address any misinformation respectfully care plan so we will have a coordinated effort I communicate well with co-workers about the patient’s and not confuse the patient I make an intentional effort to resist verbally interrupting or allowing interruptions When I am with a patient, NUMBER OF CHECKS IN EACH COLUMN TOTAL YOUR SCORE YOUR interest in the wellbeing of those in the wellbeing interest we know that effective we serve, health, is linked to communication and quality outcomes, as safety, in a provider. well as confidence not something Communication is that can be done “soft and fluffy” Effective well if one has “time.” a critical clinical communication is naturally more skill that may come be learnedfor some, but can and by all with practice. retained have the power to impact You healing in non-technical, non- pharmaceutical ways that will keep your passion alive for this work, as well as build sacred with your trusting relationships patients and their families. Thank you for all of the ways you the quality of life for the improve communities we serve. Mindful practice Collaboration and teamwork Effective openings and closings Communicating with empathy Effective explanations Engaging patients and families as partners Hard conversations COMPETENCY AREA F E A B C D G COLUMN TOTAL OF ALL COLUMNS (out of 35 possible) TOTAL perception of care—cannot of care—cannot perception by only one clinician. be driven of us building a It takes all and consistently coordinated compassionate, patient-centric delivery system. And it care physicians to reevaluate requires traditional approaches more older, such as telling to delivering care, what is best the patient, “I know patients were for you.” In the past, asked what they needed, rarely approach and a one size-fits-all was common, albeit with good intentions. Clinical competency is imperative, work also hinges yet our sacred competencies. We on relational heal, understand that relationships and intentionally honing our ability a healing presence to create our work with joy. re-infuses Building on a foundation of compassion and a genuine network director of Patient and Family Experience and Family Experience of Patient network director

For each competency area, the lowest For each competency area, is 0, meaning that you possible score employ any of the best regularly don’t The practices for that competency area. is a 5, indicating highest possible score that you see yourself as employing all five best practices in that area The lower your score, of competency. opportunities you have the more for improvement. Personal communication assessment EdD, Leebov, communication assessment developed by Wendy Please spend a moment with the personal Communication book, “The Language of Caring Guide for Physicians: and Carla Rotering, MD, found in their Essentials for Patient-Centered Care.” Directions orange in the column to the right. put an “x” in the box that is shaded For each item, if you do it consistently, your profile How to score below the in the shaded boxes in each column and write the total Count the number of checks you entered line. letter in the TOTAL column’s What does it mean? demonstrate best practices the extent to which you regularly represent totals in each column Your these key physician communication competencies: to related Sandy Johnson, Sandy Johnson, care, world of health In our “new” volume- from we have moved value-based incentives based to episodic to and payment, from of providers. roles care-continuum of The competing natures and compassionate care providing puts goals meeting productivity position. physicians in a complex of the modern Regardless one thing environment, healthcare Physicians will always be true: of the patient at the core are and their behaviors encounter, and human-connection skills impact not only the current of but also the myriad encounter, ways the patient will engage in his in the future. or her plan of care trained While physicians are on and often measured individual performance, patients’ experiences and outcomes— and their quality, safety, The Patient Will Hear You Now You Hear Will Patient The NETWORK 10 NETWORK 13

Professional growth Professional a critical Physician leaders play in advancing network role who strategies. Physicians are complete the program to issues that introduced facing leaders are healthcare on a daily basis. The program also helps each physician to better understand their individual leadership strengths and opportunities for further development. Physicians who successfully complete will be eligible to the program participate in advanced physician leadership development initiatives. in future Physicians interested leadership training programs should contact me at [email protected] program alongside Kettering alongside program Health Network strategy champions. cost-saving services; and providing cost-saving services; and providing educational opportunities to PHA related members and their staffs to the local delivery of health care options. purchasing and group in PHA, call Kim enroll To Kristian at (937) 752-2164. Questions? Email [email protected] Physicianhospitalalliance.com The PHA is a resource for facilitating practices to be financially viable, quality driven, and patient centered. Coordinated managed care managed care Coordinated contracting of group The continued growth opportunities purchasing service A referral An online employee recruitment service A fringe benefits program for members and their staffs Designed Designed for Quality. The Quest focus to to bring clarity and this class quality, healthcare to mobilize enables physicians the best providing toward staff possible care. Data-driven Leadership. their data Participants hone learnanalysis skills and to better leverage data for management, and performance improvement, decision-making. Leading Change. This course physicians to effectively prepares lead change initiatives that renew the organization. of this One of the unique features curriculum is an online discussion can physicians where board continue to develop the concepts in their classes. presented by national presented Courses are Advisory Board the faculty from leader development Company’s PHA programs and initiatives PHA programs include: • • • • • physicians continue to prepare To the and the network for the future, managed PHA is re-negotiating which meet PHA contracts care contracting criteria; expanding Chief Learning Officer of Kettering Health Network of Kettering Chief Learning Officer president of the Physician Hospital Alliance president Troy Tyner, DO, Tyner, Troy As a physician, it is all too easy to get caught up in managing the details of modern This health care. Joseph Nicosia, Joseph The Physician Leadership Institute is a Starts Second Cohort Second Starts diverts time, energy, and focus diverts time, energy, caring for patients. away from As a physician-led, physician- driven organization, the Physician Hospital Alliance (PHA) provides that attend to the products business side of a medical practice so physicians can focus on what they do best: providing high-quality care. physician-designed program built program physician-designed with leadershipto equip physicians for effective and business skills network.leadership within the the Physician This January, second Leadership Institute’s begancohort of 38 physicians now have two courses. We cohorts of physicians receiving state-of-the-art leadership development resources. with PHA Tools Physician Leadership Institute Leadership Physician Customized courses Physicians involved attend four half-day sessions a year for two years. Some courses include: Leadership. This Breakthrough leadership class emphasizes three imperatives: setting clear direction, making sounds choices, and to managing and motivating staff execute on goals. on Care Can Focus Providers 752-2063

(937) Get involved! Papua New Guinea Guinea New Papua June 9-23 Belize July 20-29 Albania 13 July 29-August Honduras 15-22 August Kenya 2-14 September India 2 18-December November 2015 TRIPS MISSION Contact Missions Outreach Missions Contact A team is

Both clinical and non- Allegheny West Allegheny West

Sonographer Nurses Physicians Anesthesia Nurse assistant Respiratory therapists Optometrists Advanced practice clinicians Non-clinical personnel Conference is hosting this medical this hosting is Conference in mission trip to India. They are need of physicians, nurses, and other clinical help. INDIA Seeking medical and nonmedical specialists • • • • • • • • • KENYA forming for a trip to Adventist forming for a trip to Health International/Hospital de Angeles, Adventista Valle which is located in the mountains 30 minutes outside the capital, Both non-clinical Tegucigalpa. needed and clinical volunteers are to help conduct medical clinics at various villages. HONDURAS clinical volunteers are needed to clinical volunteers are help conduct medical clinics in various villages in Kenya, Africa. Robert

Allegheny West Allegheny West Kettering College’s Kettering College’s

ALBANIA BELIZE PAPUA NEW GUINEA PAPUA Each year Kettering Health Network employees, employees, Health Network Kettering Each year volunteer affiliates and other physicians, bring physical the globe to across to travel Our teams perform and spiritual healing. and eye care, care, surgeries, dental education to villages personal health access to health care. that do not have various hospitals assistance to Providing of our calling. the world is part around Opportunities to Live with a Mission a with Live to Opportunities , OB/GYN from Fort MD, OB/GYN from Arrom, is putting Hamilton Hospital together a team to work at Kudjip Hospital in Papua Nazarene in need of New Guinea. They are including providers, healthcare therapists, nurses, respiratory and physicians. Conference is hosting a medical Conference mission trip to Albania. They are need of nurses and nurse in great assistants. Health Science Division will take a mission trip to Belize. Anyone is welcome to join them, though is a specific need for family there practice and pediatric healthcare providers. NETWORK 12 NETWORK 15 GO-LIVE

Visit the Physician and intranet ICD-10 Project pages for additional and resources information.

ICD-10 ICD-10 compliance, ICD-10, and compliance, ICD-10, quality parameters. recognized while not Use of these templates, physicians will provide required, with easy-to-use note options that note elements. include required Questions? Email me at [email protected], call (937) 914-7361, or contact me via Sp¯ok. who will offer medical advice and who will offer if remotely write prescriptions indicated. HealthSpot visits will into Epic, ensuring also be entered continuity of care. The kiosks will initially be open at eight Rite Aid locations throughout with HealthSpot the region, planning to open 100 locations the state of Ohio by throughout the end of 2015. Several health insurance companies currently cover telehealth sessions as a visit. Patients can office regular also self-pay for their visit. implementation date implementation 2015 OCTOBER Chief Medical Information Officer at Kettering Health Network at Kettering Information Officer Chief Medical Inpatient Epic Problem Problem Inpatient Epic List Calculator the end of the toward Available the Epic Problem second quarter, to patients’ is crucial List feature The Problem continuing care. List Calculator assists inpatient the physicians by providing specificity needed for greater diagnoses with ICD-10. Note templates to come has begun on network Work documentation templates which will contain elements to construct various notes (H&Ps, Progress Notes, etc.) that meet regulatory Patients can visit the station without scheduling an appointment for treatment and can receive conditions, common health minor, including cold and flu, rashes and skin conditions, eye conditions, ear sinus infections, throat, aches, sore infections, and upper respiratory seasonal allergies. Kettering Health Network is the in the exclusive local provider Patients who select a Dayton area. Kettering Health Network provider will be connected to a Kettering Physician Network physician or advanced practice provider Chuck Watson, DO, DO, Chuck Watson, Following ofcompletion the Epic upgrade on January 18, attention is being turned Epic for end to optimizing for the ICD-10 users and preparing 1, 2015. As yougo-live on October was the ICD-10 go-live may recall by the federalpostponed one year government. Kettering Health Network and HealthSpot have partnered access to high- to increase healthcare affordable quality, stations. HealthSpot through The telemedicine stations are private, walk-in medical kiosks an attendant. Inside, by staffed patients connect to a healthcare via a high-definition video- provider system and a suite of conferencing interactive digital medical devices biomedical information that stream to the provider. Epic Updates Epic your ICD-10 Refresh knowledge The physician eLearning for ICD-10 will again be available and campus in HealthStream, will begin in the presentations For second quarter of this year. and details, please resources more to the ICD-10 newsletter for refer quarter 1 2015, which is available in the physician lounges, as well as on the Physician and ICD-10 intranet pages. Network to beKettering Health the Exclusive Local Providerthe Exclusive HealthSpot Kiosks for Dayton Area Business Development for Kettering network He joins the Medical Center. North Pinellas Florida Hospital’s from he successfully campus, where volumes and developed increased markets as the senior leader core of Business Development. of Business Development for Greene and Soin, developing mutually with area relationships beneficial physicians and aligning the services by the network with the offered of the community. needs healthcare than 14 years Campbell has more Business Development at Sycamore he In this role, Medical Center. identifies and develops growth by opportunities for services provided and Kettering Behavioral Sycamore Medicine Center. was an Brown Prior to this role, president of Physician Recruitment of Physician Recruitment president Network. As an for Kettering Health with builder excellent relationship physicians and medical residents, he will focus his full attention on identifying and cultivating potential physicians for our network and was named director of Paul Hoover was named director David Campbell was named director was named manager of Jason Brown transitioned to vice Jon Larrabee transitioned to vice

of experience in the healthcare field, and more than field, and more of experience in the healthcare half of that time was as a physician liaison manager for Kettering Health Network. acquisition liaison with Kettering Physician Network for development coordinator and an outreach Kettering Behavioral Medicine Center. Under her leadership, all network hospitals have hospitals have leadership, all network Under her surveys, and the HFAP had successful recently the top national decile for quality network ranked in Health Analytics. to Truven and safety according quest leading the organization’s Sholder will continue in quality and patient safety. for the best outcomes business development Physician and Kettering Physician Network. role capacity to focus solely on her capacity role As duties as Chief Quality Officer. vice Kettering Medical Center’s for Quality since 2013, president Sholder successfully developed clinical and implemented standardized and operational practices across the network. to vice president of Clinical Services to vice president at Grandview Medical Center. During her past year at Grandview, Brandstater has demonstrated outstanding skills in improving patient, employee, and physician more collaboration. Drawing from vice president of Patient Care Services of Patient Care vice president assuming at Kettering Medical Center, held by previously the responsibilities Kuhn. former Center’s Medical As Sycamore of Clinical Services, vice president Sisson excelled in implementing transitioned from a dual Sholder transitioned from Teri Ronda Brandstater was promoted Deanette Sisson has been named into her role as Kettering Health into her role Officer. Network Chief Nursing network Kuhn has served the seven as vice for 15 years, the past Services of Patient Care president Center. at Kettering Medical her daily She relinquished transitioned full-time Kuhn transitioned Brenda

Quality focus than a decade of nursing leadership, her experience positions Grandview for continued growth. innovative strategies resulting in improved patient in improved innovative strategies resulting She deployed excellent tools for nursing care. the communication and alignment to enhance patient experience. Nursing leadership Nursing Medical Center to focus at Kettering responsibilities ensuring mission and culture, on One Best Practice, and performance service safety, optimal quality, deployed throughout successfully outcomes are each facility. Leadership Changes Leadership Alignment Network Support NETWORK 14 Network Offers CME on Responsible Turn Resolutions into Year-long Resolve Prescribing Practices Robert Smith, MD, vice president of Medical Affairs, Chief Medical Officer

of Kettering and Sycamore medical centers KETTERING • SYCAMORE Excerpts taken from Ohio State Medical Association’s quarterly magazine, Ohio Medicine What are your resolutions this year—both personal and professional? On January 1, perhaps Kettering Health Network, in you vowed to spend more quality time with your family or study for a recertification exam. partnership with the Ohio State Medical Association (OSMA) and I am writing this at the time when most well-meaning intentions have waned. Personal goals other major hospital systems such as “losing 10 pounds” and “eating more vegetables” are said to fall by the wayside on an across the state, began rolling average of just three weeks into the New Year. out an innovative new educational With numerous goals and to-dos on your list, consider refocusing on one or two resolutions that will span the initiative this March called personal and professional, making them essential to every part of your life. Here are a couple suggestions: NETWORK Smart Rx—Smart Medicine and Responsible Treatment. “This program offers information Listen attentively Practice patience on crucial compliance issues in a 16 format that is concise, engaging, As professionals we interrupt our patients When the pressures of the day pursue us at and accessible from many digital on an average of 15-20 seconds after they work, at home, and all weekend long, how do 17 devices,” says Robert Patterson, start speaking. Are we doing the same to we respond to the next page, call, or question? vice president of Corporate our families? Feeling constantly “on call”—whether for work Integrity and Ethics Practicing the art or in demand at home—can lead to clipped, at Kettering Health Network. of listening impatient interactions. for two Unplug for a time and enjoy a Staying up to speed minutes before pleasant discussion with a family Considering prescribing issues Smart Rx will fill a key role to help doctors we speak member or friend. Practicing patience now account for more than one understand what they must do to protect may open up in a clinical setting can result in both of every five disciplinary actions conversations you and your patients feeling before the state medical board, patients and themselves. that otherwise more fulfilled. Having it is imperative that doctors are might not interactions at home when aware of current prescription Digital, experts in unpacking across Ohio, as well state occur. refreshed can lead to more drug laws and other regulatory complex information through lawmakers, who share advice and quality time with your family changes. online courses. insights. and friends, which plays an essential role in maintaining your In the past year alone, lawmakers “Today’s professional has an Making people safer work-life balance. have sponsored more than a attention span of eight seconds,” dozen bills that attempt to end said Mindset Digital CEO and “Kettering Health Network abuse and reduce overdose founder Debra Jasper, PhD. “It physicians and allied health deaths, which have jumped more doesn’t mean they won’t tune in professionals should embrace this unique interactive online than 440 percent between 1999 longer. But they are making a snap Your turn and 2012. In fact, more Ohioans decision about whether these programming to review their now die from prescription drug courses are worth their time.” evaluation and prescribing Choose one area you wish to improve in both your personal and abuse than car crashes. patterns for opioids and, in turn, professional life. Write it down, including a Physicians earn Continuing provide the highest safety and Smart Rx will fill a key role to help specific approach toward improvement. Medical Education credits quality of care for their patients,” doctors understand what they Review this area as the year for completing the sessions, says Paul Martin, DO, Chief must do to protect patients and progresses and adjust your plan which cover: Medical Officer of Grandview and themselves. as needed. • New and pending laws that Southview medical centers. Together we can take an Short and engaging affect opioid prescription and To enroll, visit courses reporting active approach in achieving mindsetdigital.com/ the goals we have set. Smart Rx provides highly-visual, • Strategies to help identify smartrx-kettering Enjoy this year with your family interactive online courses that patients who might be abusing Log in using your email and friends, and in your careers. doctors and nurses can take in painkillers address and the temporary 15- or 20-minute modules from • Alternatives to prescription password: rxtraining their laptops, tablets, or phones. painkillers for chronic pain Questions? Contact Robert To develop the four-part The series also includes videos Patterson at robert.patterson@ curriculum, OSMA worked with from top medical professionals khnetwork.org next-gen training firm Mindset KETTERING • SYCAMORE 19

For more info For more visit kc.edu/otd Responding to demand The American Occupational has Therapy Association institutions been encouraging entry-level nationwide to develop like Kettering doctoral programs College’s. is a “Occupational therapy field and is demanding growing who have professionals more explains post-graduate degrees,” of president Nate Brandstater, Kettering College. “The Ollie Davis Center is a first-class setting in and which to start this program, our footprint into to broaden County.” Greene An advantage of the doctoral for occupational program Anderson, says Dr. therapy, “extensive is that it provides participation training to improve will which in clinical research, help students gain a better ability evidence-based care. to provide Occupational therapists need a deal of didactic instruction great and clinical experience to become to fit all and it is difficult proficient, program.” of that into a master’s were there Anderson reports Dr. 206 applicants for the first 18-seat includes cohort. The program five semesters of classroom instruction; two semesters of field work; and four months in a doctoral experience, which can include clinical practice, administration, program research, development, and other areas of training. Network collaboration with the “Our close connection 140 occupational therapists Health who work at Kettering will make this Network hospitals stand out,” says Dr. program big draw is Anderson. “Another values that Kettering College’s innovation, of trustworthiness, and caring, competence, collaboration mesh well with the occupational by values shared therapy practitioners.” an opportunity offers This program the network for clinicians across to become involved in a variety of aspects of student learning and clinical experience. “The dynamic interaction between of Anderson and the staff Dr. raises the bar the OTD program for us as clinicians to integrate innovation and clinical research into our daily work with our patients and their families,” says Cox, OTR/L, clinical Marcia specialist. Kettering Health Network rehab and managers, rehab directors, occupational therapists formed to assist an OTD advisory board with the Kettering College staff needs analysis and business case for why an occupational therapy would benefit doctorate program the region. a shortage of have “We occupational therapists in Ohio will help fill and this program the need for positions within the and Ohio in area Dayton Greater general,” says Diane Ryckman, MA, OTR/L, administrative medicine and rehab of director the orthopedic service line at Soin, Kettering, Sycamore, and Greene. Kettering College Prepares To Open To Prepares College Kettering Doctoral Therapy Occupational Fall 2015 In Program Responding to demand for growing therapy occupational of and a shortage therapists nationwide, Kettering College, a health sciences campus college on the of Kettering Medical is in the final Center, stages of preparation to launch its doctoral in occupational program therapy. It will be one of only 18 such in the United States, programs says its founding director Anderson, OTD, Terrance who joined Kettering College in November 2013. An experienced educator and clinician, Dr. Anderson has led curriculum development, accreditation and faculty recruitment. efforts, Classes for the OTD program, first which is Kettering College’s will be held at doctoral program, the Ollie Davis Medical Arts and located Education Center, Ohio. in Beavercreek, pleased to welcome are “We Kettering College to the Ollie Davis Medical Arts and Education president Brock, Jeff says Center,” Medical Foundation. of the Greene “Ollie Davis gave this facility to our Foundation in 2012 with the continue her medical to desire and especially medical interests, County.” education, in Greene 85 percent of our doctors are doctors are of our 85 percent or aligned with either engaged Health Network. Kettering to thank my Once again, I want administrative many medical and so well colleagues who work of our together for the benefit our medical patients. Much of from committee work results staff of our the outstanding integrity doctors, nurses, hard-working Your and executive leaders. year will help ongoing support this me lead our dedicated physicians of providing mission on our sacred our patients with the best care possible at every single one of our facilities, every single time. “This award reflects the the reflects “This award commitment of our hospital’s to physicians, nurses, and staff an exceptional experience provide for every patient who comes doors for treatment,” our through Sackett, senior vice says Walter Medical of Sycamore president to honored are “We Center. distinction.” this receive Study details Top Health 100 The Truven Hospitals® study evaluates performance in 11 areas: mortality; medical complications; patient safety; average patient stay; expenses; profitability; to patient satisfaction; adherence post- of care; clinical standards discharge mortality; readmission rates for acute myocardial and heart failure, infarction, Spend pneumonia; and Medicare per Beneficiary (new this year). Chief of Staff at Kettering and Sycamore medical centers medical and Sycamore at Kettering Chief of Staff Truven Health Analytics has Truven named Kettering and Sycamore medical centers two of the Hospitals. 100 Top nation’s Health Analytics is a Truven of information leading provider the cost and solutions to improve This is and quality of health care. the 11th time Kettering Medical with Center has been recognized and the seventh time this honor, Medical Center. for Sycamore of this proud extremely are “We achievement,” says remarkable of Kettering president Roy Chew, “Kettering is one Medical Center. of only six hospitals in the country that has been named a 100 Top Hospital at least ten times and consecutively for at least the past grateful to be are We years. three as one of consistently recognized the best hospitals in the country.” Kettering and SycamoreKettering and of Nation’s Named Two Hospitals Top Working together Working and My focus on quality continue to communication will doctors” emphasize the “right the “right trains” on boarding congruent tracks traveling accountable, physician- towards driven clinical leadership. Thankfully—and by no accident— physician survey has our recent confirmed my suspicion that over motivation for serving his patients: for serving his patients: motivation hands, talent, gave me “The Lord it; And I cannot refuse and insight. the worst I have to use it because advantage thing is to not take These are of what He gave you.” to guide each very inspiring words our staffs. one of us and all of In 2015 the In 2015 the change winds of to affect continue the healthcare The environment. William McCullough, MD, William

future will require aircraft engines aircraft will require future leadership to navigate of great physician dynamic skies. Both leadership and medical staff leadership administrative business focusing plan to collaborate, and on our triple aim directives our One Best striving to achieve Practice model. During my final year as Chief pleasure I find great of Staff, in leading our medical staff’s continuing journey which seeks improvement process relentless on behalf of our patients. Our mission helps to sustain sacred and accolades the many awards we have earned for outstanding patient experience and our HFAP evaluations. I extend accreditation many heartfelt thank-yous to my fellow physicians and executive colleagues who have worked together to make our innovative a reality. process care Words of inspiration Words 2014 is the A highlight from positive feedback medical staff our regarding has received meeting for holiday medical staff Kettering Medical Center at the Our elegant Schuster Center. 50th “Golden Anniversary”— 1964 through spanning from with a 2014—was capped off DVD depicting 50 years of caring and innovation. It was a true blessing to participate in this depicted many of which feature, my distinguished former leaders colleagues who all and present have served their patients with a loving spirit, professionalism, trust, and empathy. In this DVD, Ken Pohl, MD, heartwarmingly describes his Comments of Encouragement Comments KETTERING • SYCAMORE • KETTERING 18 KETTERING • SYCAMORE 21 (Sept 2014 – Jan 2015) (Sept 2014 RADIOLOGY Swain, MD Freddie MD Anuj Tewari, DO Matthew Tommack, Kettering Network Radiologists, Inc. (937) 297-6306 REPRODUCTIVE ENDOCRINOLOGY Nastaran MD Foyouzi-Yousefi, Kettering Reproductive Medicine (937) 395-8444 PEDIATRICS MD Timothy Freeman, Ohio Pediatrics, Inc. (937) 299-2339 MD Audey Veach, Hospital Children’s Newborn Associates Care (513) 636-7216 patients with total joint to have accurate MRI exams. information, contact For more Sycamore’s Sandra Chubner, Radiology manager at (937) schedule an 914-6229. To appointment contact Central Scheduling at (937) 384-3888.

HOSPITALIST MD Parasram Ramdeo, KHN IP Med (937) 395-6665 INTERNAL MEDICINE MD Sheila Cheruvelil, Commons Beavercreek Family Practice (937) 427-3333 OPHTHALMOLOGY Jennifer Jaworski, MD Dayton Eye Associates (937) 320-2020 ORTHOPEDICS James Martens, MD Orthopedic Institute of Dayton (937) 298-4417 OTOLARYNGOLOGY Stewart Adam III, MD Southwest Ohio ENT Specialists, Inc. (937) 496-2600 and in most cases, the need for anesthesia when compared to conventional MRI systems. MRI also allows The wide-bore Medical Center to Sycamore better accommodate patients MRIs with special needs. Cardiac can often be performed without a non-invasive contrast, offering option for patients with renal or a dye allergy. compromise This new technology also offers the ability to see soft tissue against a piece of metal, allowing EMERGENCY EMERGENCY MEDICINE MD Alan Dupre, (937) 395-8659 MEDICINE FAMILY Eva Campbell, MD Park Family Congress Practice (937) 435-9013 Alan Fark, MD Xenia Urgent Care (937) 352-2850 GASTROENTEROLOGY Rosanne Danielson, MD Digestive Specialists, Inc. (937) 534-7330 Ben Thomas, DO Specialty Medicine LLC Care, (937) 429-0607 GENERAL SURGERY Jonathan Saxe, MD State Surgery Wright (937) 208-2552 Kettering • Sycamore Medical Staff Medical • Sycamore Kettering Docs New Welcomes ANESTHESIOLOGY DO David Kaffenberger, Kettering Anesthesia Associates, Inc. (937) 293-8228 CARDIOLOGY Josephine Randazzo, DO Specialists Cardiology of Dayton, Inc. (937) 454-9527 COLON & RECTAL SURGERY Michael Johnson, MD Dayton Colon & Rectal Center (937) 435-8663 DERMATOLOGY Joseph Blackmon, MD Dayton Skin Surgery Inc. Center, (937) 293-5567 Sycamore Installs Large, Wide-Bore MRI Installs Large, Wide-Bore Sycamore Medical Center now Sycamore MRI latest wide-bore the offers system, with This MRI technology. its wider opening (70 cm), noise package, and faster, reduction offers ability, scanning clearer comfortable patients a more exam experience. With the ability to place the feet first, many patient’s can now be procedures head performed with the patient’s outside of the bore. remaining patient reduce These features anxiety and claustrophobia, Phillip Porcelli, DO, prepares a DO, prepares Phillip Porcelli, patient for NeuroBlate surgery. patient for NeuroBlate Offering this procedure is just one is just one this procedure Offering way in which Kettering Health state-of-the-art Network offers to the close care neurosurgical homes of the communities it serves. lucky to have such a “We’re when it dedicated team here comes to the neurosciences,” “The surgery is Porcelli. says Dr. care, the after only part of it. It’s an innovative It’s the therapy. it’s a community with atmosphere hospital feel.” Quality neurosurgery Quality neurosurgery close to home generally involves less pain, generally involves than discomfort, and scarring and allows traditional surgery and resume patients to go home normal activity sooner. isn’t therapy “While NeuroBlate it gives for every type of tumor, an a certain patient population allows them to option, and it also risk,” faster with minimal recover a patient “To Porcelli. says Dr. sorry, who has been told, ‘We’re that can be nothing more there’s done,’ this gives them hope.”

Benefits this between “The big difference and traditional brain surgery is It and length of stay. recovery also limits blood loss significantly, post-operative pain, and reduces faster allows patients to recover and get back to their lives,” says Porcelli. Dr. Post-operative NeuroBlate in the hospital patients remain for one to two days, as opposed to the 8.8 day hospital recovery length of stay for open-cranial surgery patients. Considered minimally invasive, the procedure The NeuroBlate System is used in System The NeuroBlate MRI scanner, conjunction with an to view which allows physicians progress and guide the real-time offering of tumor destruction, that the patients better odds treated. tumor will be completely the NeuroBlate The integration of the and MRI devices allows direct to precisely neurosurgeon gas-cooled an MRI-compatible, to burr-holes through laser probe target, administer laser a desired interstitial thermal therapy (LITT), and monitor thermal dose using MRI thermometry data. real-time laser therapy ®

“The procedure is done while is done “The procedure the patient is in an MRI machine so the doctor can see the tumor healthy tissue and surrounding it to apply laser energy where is needed,” says neurosurgeon DO, of Kettering Phillip Porcelli, “The temperature Medical Center. of nearby healthy tissue is that it is to help ensure monitored as much as possible. protected Kettering Medical Center is the only hospital in Ohio to have this advanced technology, besides the Cleveland Clinic and University Hospital in Cleveland.” with Inoperable Brain Tumors Brain Inoperable with NeuroBlate Minimally-Invasive Laser Brain Surgery Brain Laser Minimally-Invasive People for Hope Provides is now offered at The is now offered Institute at Neuroscience Network.Kettering Health as a potentially Offered tolife-extending option withpatients diagnosed “inoperable” tumors or tumors considered unsuitable for traditional NeuroBlate brain surgery, technology allows more surgeons to reach brain with a in the areas risk of harming reduced healthy tissue. surrounding KETTERING • SYCAMORE • KETTERING Kettering Medical Center Medical Kettering Richard Gorman, DO Raymond Poelstra, MD Phillip Porcelli, DO Jamal Taha, MD Surgeons performing the performing Surgeons procedure NeuroBlate 20 GRANDVIEW • SOUTHVIEW 23

New pain medication protocols medication protocols New pain comfort patient to increase resuscitation protocols New fluid hydration, to achieve optimal is a failure since acute renal of joint common complication surgery replacement home health frequent More first two visits during patients’ weeks following discharge readmission to reduce focus on customer Increased service and patient-centered medical care Reduced length of stay by .37 days 98% of joint replacement patients surveyed September – November 2014 ranked their satisfaction level as excellent testing Reduced pre-admission six and education wait times from hours to an average four hours, a 33% improvement • • • • indicate that these Early results an impact. making changes are Early Results • • • Greater utilization of regional utilization of regional Greater anesthesia, such as spinal and adductor canal blocks, which the risk of deep can reduce and other vein thrombosis complications Utilization of perioperative medication (such as tranexamic acid) to limit blood loss and the need for transfusions Grandview Provisional Center Level III Trauma In late quarter 3 of 2014, Grandview Medical Center was designated Center. Level III Trauma a Provisional this additional the need for the hospital to offer saw “We lifesaving, highly-specialized service to our patients,” of says Paul Martin, DO, Chief Medical Officer Grandview Medical Center. Grandview is the fourth network hospital to joining Kettering (verified open a trauma center, (verified Level III), and Soin Level II), Greene (verified Level III). The team also tackled pre- The team education, surgery patient class with the four-hour replacing that walks a 20-minute video of the process patients through surgery total joint replacement questions. and answers common the DVD and a Patients receive when they are detailed handbook scheduled for surgery. found that only 10 percent “We attending the of patients were Heckler class,” Dr. pre-surgery of 100 percent says. “Now, watching the patients report DVD, making them much better for surgery.” prepared Clinical improvements The team made significant clinical as well, including: improvements • • Streamlined preadmission preadmission Streamlined testing and education early findings One of the team’s testing the pre-admission that was was time-consuming and process multiple inconsistent, requiring doctor appointments and testing takes process the days. Now, start to about four hours from finish: patients undergo lab tests then and imaging at Grandview, meet with an internist to review The same internist test results. follows them during their hospital stay and post-discharge. Grandview’s Joint Surgery Program Surgery Joint Grandview’s Care Patient to Improve Seeks joint Medical Center’s Grandview program surgery replacement a team of called together orthopedic surgery, people from internal anesthesia, medicine, information nursing, social work, pre- registration, technology, billing, home admission testing, hospital health, and every other in joint department engaged Their surgery care. replacement clinical mission: to achieve satisfaction outcomes and patient that place Grandview scores Medical Center in the top five in the nation for joint percent surgery. replacement The team met every two weeks during most of 2014, working to analyze every aspect of the patient experience, identify establish for improvement, areas progress, metrics to measure solutions. Leading and create was Deby Moore, the effort of operational design at director Grandview and Southview; Todd of Anderson, senior vice president market strategies; Matt Heckler, DO, orthopedic surgery; Troy DO, internal medicine, Tyner, improvement network process and Robert medical director; Melashenko, MD, and Rodney White, CRNA, anesthesiology. For more info visit For more fmahealth.org or healthisprimary.org relationship between doctors between relationship and patients. has access to a Everyone primary care patient-centered most, medical home where if not all, of their healthcare in needs can be met medical a coordinated provides neighborhood that and care additional consultative needed. management when and health Prevention as important are promotion disease. as treating Doctors will engage employers, policymakers, health advocates, and civic leaders to address individual and population health as well as accelerate and expand access to primary care. reduced Health disparities are access to by increasing primary care. fully Financial incentives are and aligned with quality care better health outcomes. • • • • • this end, the specialty of To family medicine has launched a five-year initiative titled “Family Health,” Medicine for America’s which places emphasis on practice transformation, workforce development, payment review, technology, research, primary care and medical school education to transform itself and the healthcare that family system to ensure medicine can meet the nation’s needs. healthcare communications A three-year campaign titled “Health is Primary” was also launched to advocate for the values demonstrate of primary care, the benefits of family medicine, and drive patient activation. Access to primary Access to primary Doctors and patients work together in a true partnership on important health issues, including smoking cessation nutrition and and prevention, immunizations, fitness, obesity, disease and chronic management. Doctors have long-term with their patients relationships the and evaluate and treat patient holistically. through Technology computerized interoperability supports and fosters the Primary care is the path to putting is the path Primary care back in health care. the health care based on primary A system on the Triple can help to deliver better care, Aim: better health, and lower costs. Better Health– can help patients live longer, care of the healthier lives. In areas more are there country where person, per providers care primary heart death rates for cancer, lower. are disease, and stroke in An increase Better Care– doctor per one primary care 10,000 people can decrease costly and unnecessary care. Evidence also shows that primary is associated with a more care equitable distribution of health in populations, a statistical finding and that holds both cross-national within-national studies. Lower Costs– U.S. adults who physician have a primary care lower healthcare have 33 percent spending is less costs. Medicare primary care for states with more physicians, and these states have care. higher-quality effective, system based on A primary care the values of family medicine can Family make America healthier. that medicine wants to ensure health America is a place where A place where: is primary. • • • Chief Medical Officer of Grandview and Southview medical centers of Grandview and Officer Chief Medical For too long, For too the United States healthcare system has Paul Martin, DO, Paul Martin,

Family Medicine for America’s Health: Why? Health: America’s for Medicine Family been out of balance. been out of balance. treatment Spending on far exceeds spending Our on prevention. payment system current for volume rewards by ordered of care physicians rather than value derived from And, at times, care. system the healthcare can lose focus on the patient. and uncoordinated.

receive is fragmented is fragmented receive

an episodic rather than rather an episodic

disease, not patients, in patients, not disease,

to prevention and public prevention to GRANDVIEW • SOUTHVIEW • GRANDVIEW U.S. of percent health—75 world, yet it ranks almost almost it ranks yet world, last among industrialized among industrialized last Only three percent of U.S. U.S. of percent Only three longitudinal manner from manner from longitudinal is treating conditions and conditions is treating much of the care patients patients the care much of

The U.S. healthcare system system healthcare U.S. The The U.S. healthcare system system healthcare U.S. The countries in patient health. countries healthcare spending is tied healthcare birth to death. Additionally, Additionally, death. birth to is the most expensive in the expensive is the most 22

treating preventable disease. preventable treating healthcare costs are spent on are costs healthcare GRANDVIEW • SOUTHVIEW 25 (Sept 2014 – Jan 2015) The Englewood Health Center, Health Center, The Englewood base serving care a primary Clayton the Englewood and its communities, is expanding to the needs services in response include: of local patients to orthopedic general surgery, physical and cardiology, surgery, CT, X-ray, occupational therapy, ultrasound, and lab. is experiencing growth, “The area and this site is conveniently located on the same campus as one of the busiest YMCAs in the as well as Dayton region, Greater a branch of Sinclair Community “We College,” says Bowshier. feel that this facility provides options in convenient healthcare the vicinity.” PULMONOLOGY Mohammed Zeitouni, MD Grandview Hospital (937) 223-6837 Ehab Hussein, DO Pulmonary Medicine of Dayton, Inc. (937) 439-3600 RADIOLOGY Swain, MD Freddie MD Anuj Tewari, DO Matthew Tommack, Kettering Network Radiologists, Inc. (937) 297-6306 THORACIC-CARDIOVASCULAR Buup Kim, MD Cardiothoracic/Vascular Premier Surgeons (937) 278-5100

City and Troy areas can see these can see areas City and Troy near home.” specialists in facility is located The renovated as Upper Valley the same building a longstanding, Family Care, practice. multi-physician family Expansion at Englewood Expansion at Englewood Health Center new family medicine Three Kettering physicians have joined Primary Care Physician Network in Englewood. Lewis Mahran, DO, and Kattie MD, began to see Amegatcher, patients at the center earlier this MD, will join Ryan Foster, year. Amegatcher Mahran and Dr. Dr. following the completion of his sports medicine fellowship in August. PATHOLOGY MD Ersie Pouagare, Grandview Hospital (937) 723-3889 Jill Rosset, MD Phoenix Pathology LLC (937) 660-8750 PEDIATRICS MD Audey Veach, Hospital Newborn Children’s Associates Care (513) 636-7216 PLASTIC & RECONSTRUCTIVE Salim Mancho, DO State Physicians Wright (937) 208-4955 Grandview • Southview Medical Staff Grandview • Southview New Docs Welcomes to Welcome More Patients More to Welcome Health Centers Expand Centers Health Health Center Troy now open Center opened its Health The Troy the Tippdoors to patients in City February. in early areas and Troy center care The small ambulatory additional medical now offers including specialties in areas vascular surgery, general surgery, orthopedics, gastroenterology, pain medicine, internal medicine, In the and pulmonary medicine. the facility also plans to future, x-ray services. offer “It is our goal to continue to the community with provide 10-minute access to quality says Calen physician care,” of Business director Bowshier, Development at Grandview and in the Tipp “Patients Southview. INTERNAL MEDICINE MD Kevin Volt, Inc. Internal Medicine Care, (937) 429-0607 NEONATOLOGY Nostrand, DO Sarah Van of Ohio Pediatrix Medical Group (937) 243-3839 OBSTETRICS & GYNECOLOGY Misty Dickerson, DO Contemporary OB-GYN, Inc. (937) 433-4325 OTOLARYNGOLOGY Stewart Adam III, MD Southwest Ohio ENT Specialist, Inc. (937) 496-2600

Save the date: August 17 than half of the money More health raised for these women’s the Grandview came from projects Golf Eagle Seekers Foundation’s in 2013 and 2014. Tournaments The 2015 Eagle Seekers tournament will be held August 17 at the Dayton Country Club. The event will raise funds to and community enhance resident and fund education efforts, updates to the Ohio University campus. building on Grandview’s covering all facets of breast care,” care,” all facets of breast covering training explains. “This Elrod Dr. in that residents will help ensure general obstetrics/gynecology, family practice, radiology, surgery, and internal will be able medicine care excellent breast to provide also plan to to their patients. We and radiology train general surgery to perform stereotactic residents breast and ultrasound-guided biopsies.” As part of the hospital’s for medically commitment to care underserved people, the new a new community center will offer program education and outreach cancer breast to increase and mammograms. screenings Kellen Patten, DO; Kristen Caldwell, DO; Mark Day, DO, program director director DO, program Kellen Patten, DO; Kristen Caldwell, DO; Mark Day, for the MD, medical director Frasier, Percy for the OB/GYN residency; DO; Ashby, DO; Molly Center; Robert Fresch, Southview Women’s Center. Courtney Graybeal, DO, at the Southview Women’s New technology, New technology, training opportunities at Grandview 2014 campaign The foundation’s breast a comprehensive created which brings center at Grandview, care breast the medical center’s one place. Theservices together in center opened in October 2014. The most exciting aspect of the patient a from $350,000 project of standpoint is the purchase care a digital mammography unit, says DO, general surgery Mike Elrod, at Grandview. director program “Digital mammograms have been shown to be about 15-28 percent than standard effective more mammograms in detecting tumors in women under age 50 and tissue,” those with dense breast explains. “They are Elrod Dr. accurate more also considered and peri-menopausal for pre- women. This technology will help us catch cancers earlier.” new training The center offers as well. opportunities for residents developing a curriculum are “We that includes a didactic series and multi-specialty conferences programs nationally. Also, it’s it’s Also, nationally. programs ultrasound to offer great of sending on site, instead patients elsewhere.”

Purchasing a 3-D ultrasound unit a 3-D Purchasing and a digital colposcopy unit a Adding two exam rooms, a private larger charting room, and an patient education area, room updated break a new conference Creating with high-tech audiovisual room capabilities Developing new educational materials for patients Updating carpet, paint, artwork, throughout and furniture A major upgrade A major upgrade at Southview Center Women’s In 2013, Grandview Foundation raised funds to expand and Southview Women’s renovate training clinic a resident Center, adjacent to Southview Medical a full range Center that offers of obstetric and gynecologic The $250,000 project care. was completed in February 2015, and included: • • • • • “This is a very busy outpatient clinic, and the extra space makes for our patients, a big difference medical students, residents, clinical and additional faculty, DO, an Mark Day, says staff,” obstetrician/gynecologist who for the OB/ serves as director “We program. GYN residency about training our excited are on the digital ultrasound residents and colposcopy technologies—it puts us ahead of the game in comparison to other residency Two very successful fundraising successful fundraising very Two by Grandview campaigns enhancing are Foundation services healthcare women’s Center at Grandview Medical and Southview Women’s Center—and providing training opportunities great for medical residents. Grandview Foundation Gives Foundation Grandview Women’s Health Services a Boost a Services Health Women’s GRANDVIEW • SOUTHVIEW • GRANDVIEW 24 GREENE • SOIN 27 After surgery, patients stay on a After surgery, dedicated unit on the fourth floor of the new inpatient gym hospital. The unit’s practice stairs, a car simulator, features and other amenities. medical management during their during medical management inpatient stay. this program, Prior to launching Wells— only one surgeon—Dr. knee, and performed total hip, at Soin. Now, shoulder surgeries doing so. surgeons are all three on gets everyone “This program I feel like I the same page, and during, support before, have more says. Wells Dr. and after surgery,” we have a “For example, now dedicated team, whose members familiar with newer techniques, are such as the use of tranexamic loss. blood post-op reduce to acid This familiarity allows us to work efficiently.” together more Ron Connovich, vice president of finance and operations for and Soin, says that Greene is part of this new program in the the natural progression and development of Soin growth “Orthopedic Medical Center. surgery is one of many service lines that is coming into maturity as a full-service as Soin grows hospital,” he says. “It is part of the our commitment to providing with County of Greene residents close to home.” high-quality care

Coordinated care care Coordinated day one from One convenient aspect of the is that patients can program testing, pre-op undergo pre-op physical education, and a thorough exam all in one day at the Ollie Davis Pavilion, which is attached to Clinical Nurse Soin Medical Center. Specialist Lisa Meiring coordinates education and patients’ pre-op and follows them preparation, post-surgically until discharge. internal medicine specialists, Two Sven Raymond, MD, and Priyanka Edara, MD, also play seeing patients a critical role, and providing pre-operatively and did an outstanding job of outstanding job and did an practice goals for setting best says of patient care,” every phase Ryckman. “They used Kettering protocols Medical Center care as a guide, and quality processes for Soin staff customizing them and patients.” will expect that this program “We outcomes have the same strong in Center’s as Kettering Medical post- such as length of stay, areas and patient operative pain control, says. Donigian satisfaction,” Dr.

Adapting the program Adapting the program to Soin members spent time with Team their counterparts at Kettering medical centers, and Sycamore which have busy joint replacement Nurses and surgery programs. therapists attended in-services joint replacement and a pre-op surgery class, and received training on pain management; the surgical team observed surgeries joint replacement at Sycamore. team worked “The interdisciplinary together quickly and efficiently, Orthopedic Surgeons Help Launch Soin’s Soin’s Launch Help Surgeons Orthopedic Program Surgery Replacement Joint New Center recently Soin Medical a comprehensive launched surgery joint replacement with leadership program Aram Donigian, MD, from and Matthew Hess, MD, MD. These Britton Wells, worked orthopedic surgeons team at with an interdisciplinary new program Soin, modeling the Center’s after Kettering Medical surgery joint replacement among considered program, the best in the country. Hess, Donigian, Dr. Dr. and Diane Ryckman, Wells, Dr. of MA, administrative director the orthopedic service line for Soin, and Kettering, Sycamore, started meeting with the Greene, team in October 2014. “The surgery itself is very important, of course, but so is education, pre-operative great and post- peri-operative care, discharge follow up,” says that staff made sure Hess. “We Dr. in every department that interacts surgery with joint replacement That’s patients was on board. important, because we know that a collaborative, team approach surgery leads to joint replacement to a high level of success.” RIGHT LOCATION Your input is crucial input is Your on the are you As a physician, and care, patient line of front observations your welcome we If you and recommendations. in improvement for an area see provide to efforts the network’s share please care, coordinated a senior with me, concerns your director or the quality leader, I can hospital. network at any or at 937-702-4141 be reached [email protected] Another objective is to provide is to provide Another objective post-discharge aggressive more nurses follow up. Perhaps at home could call patients looking after a hospital stay, such as missed for problems follow-up appointments, and non- unfilled prescriptions, therapy. compliance with home a patient’s All of these can affect for readmission health status, risk and overall satisfaction. RIGHT PATIENT RIGHT CARE Care Coordination Communication is key Communication communication between Effective is essential, providers care one from especially in “hand-offs” The team setting to another. care is finding ways to inform primary physicians, specialists, post- care facilities, and home acute care about a patient’s providers care post-discharge needs so that no delays or gaps are there working are We in care. with information technology experts at Kettering Health better Network to create communication mechanisms within Epic and other electronic systems. medical records get to follow-up appointments? appointments? get to follow-up for the Can the patient pay family medication? Are prescribed to provide members available support as needed? Director of Clinical Quality at Greene Memorial Hospital and Soin Medical Center and Soin Medical Memorial Hospital Quality at Greene of Clinical Director Jody Underwood, Jody Underwood, A network- wide effort to establish care

coordination protocols protocols coordination is gaining momentum. What is care What is care coordination? is coordination The goal of care to the the right care to provide right patient in the right location. is essential coordination Care for all patients, but especially at highest risk for those who are and for hospital readmission utilization of emergency increased department services, and those at an advanced stage who are of illness. an requires coordination Care focus on patient- increased rather than care, centered management. disease-centered One important goal is to identify post-discharge a patient’s needs early in the hospital stay, any potential barriers addressing to success. For example, does the patient have transportation to Leading the charge is the Leading the charge and mortality, readmission, area result advanced illness key team. This large, interdisciplinary, multi-facility team started meeting and will have key in January, in place by the end processes of 2015. I serve as team leader, support and the team has great executive sponsor Deanette from of patient Sisson, vice president services at Kettering Medical care David Small, MD, chief Center. and at Greene medical officer Soin, is on the team as well, perspective adding a physician’s to all we do. Working Together to Ensure to Together Working Care Seamless Coordinated, GREENE • SOIN • GREENE 26 GREENE • SOIN 29 (Sept 2014 – Jan 2015) (Sept 2014 PEDIATRICS MD Audey Veach, Hospital Children’s Newborn Assoc. Care (513) 636-7216 Nostrand, DO Sarah Van Pediatrix Medical Group of Ohio (800) 243-3839 PHYSICAL MEDICINE & REHAB Ryan Hinman, MD Kettering Physiatrists & Rehabilitation (937) 395-8666 RADIOLOGY Swain, MD Freddie MD Anuj Tewari, DO Matthew Tommack, Kettering Network Radiologists, Inc. (937) 297-6306 Omar Majid, MD KMC Radiation Oncology (937) 395-8646 RADIATION ONCOLOGY Carl Jueng, MD Stella Ling, MD Memorial Hospital Greene Radiation Oncology (937) 352-2146 UROLOGY James Colombo, MD Eric Espinosa, MD MD Vlada Mardovin, Springfield Urology (937) 342-9260 ORTHOPEDICS James Martens, MD Orthopedic Institute of Dayton (937) 298-4417 Paul Peters, MD Bone & Joint Surgeons, Inc. (937) 836-3118 INTERNAL MEDICINE Sheila Cheruvelil, MD Commons Beavercreek Family Practice (937) 427-3333 Gurjeet Kahlon, MD Medical Valley Primary Care (937) 208-8282 Patrick Mezu, MD Pulmonary Medicine of Dayton, Inc. (937) 439-1884 Neha Patel, DO Community Physicians Springs of Yellow (937) 767-7291 HOSPITALIST MD Matthew Brockman, South Dayton Acute Care Consultants, Inc. (937) 433-8990 MD Rebecca Ramirez, Primary Sycamore Group Care (937) 384-6800 Syed Ali, MD Syed Ali, Appalaneni, MD Vasu Beck, MD Gregory Steven Dellon, MD Rupa Fritz, MD MD Michael Gorsky, Piush Gupta, MD DO Ilyas Ikramuddin, Rizwan Kibria, MD MD Knoll, Aaron MD Donald Lutter, Pallavi Rao, MD David Romeo, MD Giti Rostami, MD MD Sanjay Sandhir, Jonathan Saxe, MD Lisa Stone, MD Niaz Usman, MD MD Mark Walsh, MD Larry Weprin, Robert Wille, MD William Wilson, MD Dayton Gastroenterology, Inc. (937) 320-5050

GASTROENTEROLOGY Patrick, MD Teressa Narayan Peddanna, MD MD Jigna Thakore, Digestive Specialists, Inc.- Dayton (937) 534-7330 Salma Akram, MD MD David Arner, MD Christopher Barde, Rosanne Danielson, MD Houston, MD Richard Rajkamal Jit, MD MD Anjali Morey, David Novick, MD Nagaraja Oruganti, MD MD Marios Pouagare, Kanan Sharma, MD Urmee Siraj, MD Ansil, MD Bikram Verma Digestive Specialists, Inc.- Kettering (937) 293-2169 MD Malay Dey, Digestive Specialists, Inc.- Springboro (937) 534-7330 Saurabh Basundhra, MD Saurabh Aleena Slone, MD MD, Askew, Gail T. Family Practice (937) 458-4650 MD Parasram Ramdeo, KHN IP Med (937) 395-6665 Greene • Soin Medical Staff Medical • Soin Greene Docs New Welcomes Andrew Bohn, MD Andrew MD Alan Dupre, MEDICINE FAMILY Caleb Molokwu, DO Community Urgent Care (937) 399-5303 DO Christina Bereda, Alan Fark, MD API Xenia Urgent Care- (937) 352-2850 ANESTHESIOLOGY ANESTHESIOLOGY MD Kerry Christensen, DO David Kaffenberger, Seong Bae Kim, MD Kettering Anesthesia Associates, Inc. (937) 293-8228 Adam Montoya, MD Wright-Patterson Medical Center (937) 257-1942 CARDIOVASCULAR DISEASE Josephine Randazzo, DO Specialists Cardiology of Dayton, Inc. (937) 454-9527 & CARDIOVASCULAR THORACIC Mohey Saleh, MD Advanced Heart and Lung Surgeons, Inc. (937) 279-9777 COLON & RECTAL Michael Johnson, MD Dayton Colon & Rectal Center (937) 435-8663 EMERGENCY MEDICINE “We want to keep on top “We needs of each patient’s and make effective use of our resources as we work toward hospital discharge.” Monthly strategy Monthly meetings Small, Dr. Once a month, Dr. Raymond, and Underwood , who is meet with Indu Rao, MD for South hospitalist coordinator Consultants. Dayton Acute Care more These meetings are as participants strategic in nature, to quality, discuss issues related and physician communication, at Greene coordination care Small and others and Soin. Dr. also work closely with Rebecca MD, Kettering Health Ramirez, Network hospitalist coordinator, and efficiency to improve One Best Practice coordinate for all hospitalist services across all network hospitals. scheduled regularly Frequent, meetings have become indispensable in helping Greene and Soin team members improve and address coordination care any issues early. the tendency was “Before, to communicate only when Dr. something went wrong,” Small says. “In the year or so that these meetings have been in place, we’ve made some positive changes and have in patient seen improvements as well.” satisfaction scores contracted through South Dayton South through contracted a private Consultants, Acute Care with also contracts practice that medical Kettering and Sycamore care. centers for hospitalist Weekly conferences conferences Weekly Small meets Each week, Dr. with Sven Raymond, MD, head and Soin, hospitalist for Greene and Jody Underwood, director and Greene of Clinical Quality, Soin, to focus on hospital- and network-wide issues that may care. inpatient affect “Something we’ve been tackling the fact that on any is recently of about one-third given day, Soin inpatients are and Greene in observation status—a much higher rate than other network hospitals,” Underwood says. “We a at that situation from looking are angles, and finding lot of different ways to manage observation aggressively.” patients more The daily “huddle” Every morning,hospitalists and Soin lead an at Greene on team meeting interdisciplinary medical/ each unit to talk about Care surgical and ICU patients. how team members discuss to each patient is doing in relation social/ such as clinical care, areas psychosocial issues, barriers to risk. discharge, and readmission want to keep on top of “We make needs and each patient’s use of our resources effective hospital as we work toward discharge,” explains David Small, at MD, chief medical officer and Soin. Greene The number of Hospitalists work in hospitals, skilled nursing facilities, rehabilitation units, and other types of facilities.

percentage of The percentage When it comes to improving the inpatient experience, there is no substitute there experience, the inpatient improving it comes to When tend to get a bad Meetings Memorial Greene rap. But at Soin Medical Center, Hospital and helping hospitalists they are with effectively work more and other administrators, nurses, the to improve providers care and reduce inpatient experience time that can cost inefficiencies Hospitalists play a and money. which in these meetings, key role once a day, take place once a month. week, and once a and Soin Hospitalists at Greene “quarterback” the inpatient care teams on medical/surgical floors Unit. and in the Intensive Care Also, they admit patients who hospitalized following a visit are to the Emergency Department of (which accounts for 80 percent and Soin). all inpatients at Greene The 10 hospitalists who work and Soin are primarily at Greene Communication Counts Communication

GREENE • SOIN • GREENE Source: HealthleadersMedia 44,000 72% Hospitalists are the fastest the Hospitalists are specialty in the growing history of medicine. hospitals using hospitalists has 29% in 2003 to 50% in risen from 2007 to 72% in 2014. U.S. hospitalists has quadrupled, in 2003 to 44,000 11,000 from in 2014. 28 FORT HAMILTON 31

planning. At The Gebhart Cancerplanning. At The Gebhart we use 4-D CT scans Center, and tumor to assess respiratory breathing. motion during normal scans also use cone-beam CT We the through (a limited CT scan tumor to localize the targeted area) of eachtarget prior to the delivery Respiratory radiation treatment. and precise motion management target localization allow us to target tumors with minimal variation and deliver high doses of radiation to while sparing the a focused area maximum amount of surrounding normal tissue. (OHC) Ohio Hematology Care radiation oncology and medical oncology work collaboratively to cutting- patients receive ensure OHC has one of edge treatment. the largest clinical trial menus in which allows patients the Tri-State the newest the ability to receive drugs targeted for lung cancer. the I want to again stress high-risk importance of screening treatment patients, as effective options exist for both surgical and non-surgical candidates Also with stage 1 lung cancer. is not a that screening remember substitute for smoking cessation and thus all patients should be counseled appropriately. at the patients Barriger sees Dr. at Center Gebhart Cancer The Hospital. Hamilton Fort an appointment schedule To call please Barriger, with Dr. 1-844-424-6673. Other Radiation Oncologist at Fort Hamilton Hospital Oncologist at Fort Hamilton Radiation Various national societies interpret national societies interpret Various the data slightly differently. cell lungEarly stage non-small typicallycancer (Stage 1) is in medically surgically treated For patientsoperable patients. not surgical candidates who are ordue to medical comorbidities highlypoor pulmonary function, radiationfocused and high-dose body radiation stereotactic therapy, therapy (SBRT), or stereotactic ablative radiotherapy (SABR) yield local than 90 percent greater tumor with of the primary control This high few if any side effects. compares rate favorably control local control to the 30 percent of conventionally fractionated radiation for early stage lung cancers. Suitable candidates for those primary SBRT/SABR are with tumors <= 5cm and no lymph node involvement. pulmonary tumors Targeting needed for with the precision specialized SBRT/SABR requires radiation equipment and treatment Current smoker or quit within the past 15 years or quit within the past smoker Current No prior history of lung cancer of No prior history 15 years or quit within the past smoker Current therapy curative that preclude No comorbidities With an additional 5% risk of developing developing risk of an additional 5% With 5 years in the next lung cancer With one other risk factor other than other risk factor one other With hand smoke second

30 30 30 30 30 20 20 (pack-years) Smoking History Smoking History Robert B. Barriger, MD, B. Barriger, Robert Lung cancer is the second most frequently diagnosed cancer but Age >=50 >= 55 >= 50 55 – 74 55 – 74 55 55 – 79 55 55 – 80 55 Patient Patient 1 3 5 2 4 Group AATS NCCN NCCN AATS USPSTF ALA ACS US Preventative Services Task Force: http://www.uspreventiveservicestaskforce.org/Page/Document/ US Preventative Services Task RecommendationStatementFinal/lung-cancer-screening American Lung Association: http://www.lung.org National Comprehensive Care Network: http://www.nccn.org/patients/guidelines/lung_screening/ American Cancer Society: http://www.cancer.org/healthy/informationforhealthcareprofessionals/ acsguidelines/lungcancerscreeningguidelines/index American Association for Thoracic Surgery: http://aats.org/multimedia/files/Guidelines/Lung-Cancer- Screening-Using-low-dose-computed-tomography-scans.pdf 1 2 3 4 5 Advances in Lung Cancer DiagnosisCancer Lung in Advances Therapy and remains the leading cause of the leading cause remains and women. cancer death in men diagnosed at Many cases are treatment advanced stages when However, is less effective. advancements in diagnosis the and therapy have increased number of available therapies in the fight against this disease. have been made Recent efforts lung cancer mortality to reduce earlier diagnosis. In 2011 through a randomized trial showed a 20 cancer- in lung reduction percent specific mortality when low-dose to screen used CT scans are high-risk patient populations with chest to screening compared with x-rays. In general, screening for low-dose CT is recommended patients between the ages of 55 and 74 with at least a 30-pack- year smoking history who quit no later than the past 15 years.

To care for the community how for the community care To are they need it, we and where line that expanding a service of encompasses all aspects the medicine, with cardiovascular surgery. exception of open-heart than This means that more of Hamilton-area 90 percent top- can receive residents at their own care notch cardiac community hospital. dedication the reflects This growth of the physicians, nurses, ancillary and administration of Fort staff, Hamilton and Kettering Health and hard Network. Their desire the ultimate patient work to create experience is paying off. for Quality Care in 95th Percentile Fort Hamilton RanksFort Hamilton comparing quality Health Analytics publishes a report Truven Each year, ranked Hospitals are the country. of hospitals across and efficiency including of quality and safety, measures on performance in the relevant readmissions, measures, core patient safety, length of stay, mortality, and patient experience. cost of care, report in the 2015 Fort Hamilton Hospital ranked in the 95th percentile with 959 hospitals of similar (based on 2013 performance) compared at Fort Hamilton is This means the quality of care the country. size across similarly sized hospitals and has of the country’s better than 95 percent the exceeded top decile performance. Hospitals that rank this high are best in the country because they demonstrate a commitment outstanding performance in patient care, to excellence through and financial stability. operational efficiency, and dedication of the This achievement was driven by the skill, effort, to the patients they serve. medical staff What makes this impressive is this impressive What makes cath volumes that, nationally, But we are peaked in 2008-2009. from still experiencing increases 738 cardiac our 2008 volume of procedures. in volume can be This increase factors. traced back to several have always Our cardiologists pride in delivering taken great to our patients. high-quality care works hard Our nursing staff a positive patient to create experience. In addition, under leadership, the hospital’s current capital within the reputational community has increased. I believe our surrounding this, community perceives to our entrusting their care cardiologists. Medical Director of Cardiology at Fort Hamilton Hospital Cardiology of Medical Director Patrick Lytle, DO, Lytle, Patrick great It takes a amount of trust for a patient to put their health in the hands of a physician,

Fort Hamilton’s Cardiac Cath Lab Cath Cardiac Hamilton’s Fort Climbs Volume nurse, technician, or—on a larger nurse, technician, network. As a scale—a hospital or Hamilton testament to that trust, coming to Fort are residents their to receive Hamilton Hospital heart care. see the evidence of this in We our cath lab volumes: In 2014, a total of the cath lab reported 32 procedures—a 905 cardiac 2013. We from increase percent also performed 175 coronary interventions, which is up 39 2013. from percent FORT HAMILTON FORT 30 KETTERING PHYSICIAN NETWORK 33 Matt Dabbelt was Matt Dabbelt of named director Business Development. with Working physicians and hospital administration,

“Patients appreciate that we “Patients appreciate with want to build relationships on trust based them that are Dunn. says Dr. and respect,” take keep wait times low, “We time to listen to what patients tell us during appointments, and investigate the underlying causes of their symptoms. I think people to this type of high- drawn are getting the and are quality care to our community.” out word The practice is located at 52 Remick Boulevard in Springboro. he establishes new physician he establishes new physician partnerships, enhances on-boarding and medical practice and implements processes, and retention physician relations strategies. Dan Morris was to promoted executive director of Specialty Services for KPN. He oversees the cardiac, network’s orthopedic, Dayton, Ohio area to practice in Dayton, Ohio area Blair has served Dr. Springboro. the community for 16 years and is certified in family medicine. board Blair joins Michael Buch, DO, Dr. since the who has been on staff practice opened, and Kassandra Bond, DO, and Thomas Dunn, DO, who began last August. Drs. Buch, Bond, and Dunn completed the family medicine residency at Grandview Medical program Center. extensive knowledge to extensive best practices implement contracting, in physician compensation models, and compliance. service surgical, and neurosurgical lines, and facilitates collaboration and measurable outcomes for specialty practices. “I think people are drawn to this type of high-quality care, and are getting the word out to our community”

Dan Haibach is now the executive of director Physician Partnership Services. He collaborates with network-employed The practice welcomed its newest MD, Blair, Ward F. team member, Blair in December 2014. Dr. the graduated with honors from University of Cincinnati College of Medicine and completed his while serving in the residency In Va. U.S. Army at Fort Belvoir, wife and Blair and his 1998, Dr. moved back to the six children Primary Care in Springboro Hires Fourth Hires in Springboro Primary Care Up with Rapid Growth Physician to Keep Since opening its doors in August 2013, Kettering Physician Network Primary Care expanded in Springboro one family from medicine physician and recently to four, added new clinical space to accommodate patient volume. Makes Key Leadership Changes Leadership Key Makes Kettering Physician Network Physician Kettering Physician Network As Kettering to align strategic (KPN) continues its processes, improve goals and continues leadership structure and to evolve to best support these initiatives. strengthen and independent physicians to their partnerships with strengthen KPN, while continuing to tap

(Sept 2014 – Jan 2015) Ophthalmology MD Daniel Love, Orthopedic Surgery DO Joseph S. Scheidler, Psychiatry Quinton Moss, MD Pulmonology MDMichael Gabrilovich, Sternberg,Richard DO Radiation Oncology Sacco, MD John F. Radiology Linda Reilman, MD Raymond Rost, MD Adam Mussman, MD Bulas, MD Robert V. Robert Ernst, MD Surgery Vascular MD Girish Nagesetty, PHYSICAL MEDICINE & REHABILITATION Ashok Poluri, MD LLC Medicine Inpatient Group, (513) 618-7430 PODIATRY DPM Nicholas Woebkenberg, Podiatry Associates of Cincinnati (513) 474-4450 ORTHOPEDICS James Martens, MD Orthopedic Institute of Dayton (937) 298-4417 PEDIATRICS Steve Milligan, MD Hospital - Cincinnati Children’s Newborn Associates Care (513) 636-7216

Congratulations to the following to the following Congratulations at Fort Hamilton physicians made Cincinnati Hospital who Doctors Top Magazine’s 2015 List: Cardiology Faisal Khan, MD Emergency Romanello, MD Marcus General Surgery MD Douglas Hingsbergen, Gastroenterology Robert Cucinotta, MD Hematology Evan Z. Lang, MD MD Paula Weisenberger, Internal Medicine Manish Sachdeva, MD Nephrology Ritche Chiu, MD Bhupendra Mahida, MD HOSPITALIST MD Rebecca Ramirez, Group Primary Care Sycamore (937) 384-6800 MEDICAL ONCOLOGY Colleen Darnell, MD Inc. Oncology/Hematology Care, (513) 682-4800 NEONATOLOGY Hitesh Deshmukh, MD Hospital Medical Center Children’s (513) 636-3874 GASTROENTEROLOGY MD Dilip Bearelly, Kettering Surgical Associates (513) 829-7133

Fort Hamilton Medical Staff Fort Hamilton Medical New Docs Welcomes Recognized As Top Doctors As Top Recognized than more After asking physicians— 5,000 and including MDs would DOs—who they seek out for medical of friends, family, care and even themselves, Cincinnati Magazine Top compiled the List. Nine Doctors 2015 physicians in hundred 50 specialties made the list, each having at least five received their peers. votes from Fort Hamilton Physicians Hamilton Fort EMERGENCY MEDICINE Selvarajah, MD Andrew Health Team (856) 686-4322 MEDICINE FAMILY Alan Fark, MD Xenia Urgent Care (937) 352-2850 MD Suzanne Hardacre, Jason Hoke, MD Family Health Indian Creek Oxford Center- (513) 523-2340 Sherif Zihni, MD of Hamilton Urgent Care (513) 896-9700 FORT HAMILTON FORT 32 KETTERING PHYSICIAN NETWORK 35 (Sept 2014 – Jan 2015)

RADIOLOGY Stella Ling, MD Radiation Oncology Greene (937) 352-2146 SURGERY Gary Anderson, DO Muth, MD Warren MD Sawmiller, Carol South Dayton Surgeons (937) 534-0330 TRAUMA Steven Santanello, DO Kettering Medical Center Trauma (937) 395-8556 OBSTETRICS/GYNECOLOGY MD Phillip Carr, Kettering OB/GYN Services- Hamilton (513) 867-1200

Individual non-cancellable disability insurance with own-occupation disability insurance with own-occupation Individual non-cancellable protection rates standard discount from A 30 percent $15,000 per month with financial underwriting Issue limit of up to working of up to $5,000 per month if currently Guaranteed issue security benefits Retirement at [email protected] or (937) 449-0031. or (937) at [email protected] If you want additional security, Principal Financial Group and Kettering Group Principal Financial additional security, If you want offers Davis Keith P. Income Advisor Individual Disability Health Network a disability plan on long-term physicians a supplemental employed basis. This plan includes: voluntary • • • • • the network and and commitment you contribute to Because of the skill the lifestyle those skills Principal want to help protect patients, KPN and you and your family. provide Keith contact or consultation, a quote For F. Ward Blair, MD Blair, Ward F. Primary Care Springboro (937) 531-0120 DO Jon Baker, DO Kelly Baker, MD Julie Broering, Chad Fogt, MD Family Health- Ross Indian Creek (513) 737-6068 MD Suzanne Hardacre, Jason Hoke, MD Family Health- Oxford Indian Creek (513) 523-2340 MD James Foster, MD Lisa Heinemeyer-Foster, Ollie Davis Kettering Primary Care- (937) 531-0132 MD Kattie Amegatcher, Lewis Mahran, DO Kettering Physician Network - Englewood Primary Care (937) 836-2424 Souyma Nadella, MD InternalSycamore Medicine (937) 866-6655 Kettering Physician Network New Docs Welcomes CARDIOLOGY Josephine Randazzo, DO Specialists of Dayton Cardiology (937) 454-9527 MEDICINE FAMILY Eva Campbell, MD Park Family Practice Congress (937) 435-9013 Saurabh Basundhra, MD Alenna Slone, MD MD, Family Practice Askew, Gail T. (937) 458-4650 Kerri Gibson, MD Xenia Primary Care (937) 562-2280 Supplemental Long-term Disability Long-term Supplemental can insurance Disability of part be an important income a physician’s long- plans. The security plan (LTD) term disability by Kettering provided is a Physician Network foundation. strong ADMINISTRATION Paul Martin, DO Chief Medical Officer- Grandview Medical Center (937) 723-3413 MD Rebecca Ramirez, of Hospital Medical Director Medicine (937) 384-6800

The easy-to-access Work Life Work The easy-to-access vetted articles, website hosts features and interactive resources, issues physicians that address every day. and families deal with Coming soon Later in 2015, physician-centered educational opportunities such as that focus on topics burnout, balancing preventing and dealing work and family life, will be with adverse patients available. Specialized services, such as physician peer coaching (for an additional fee), are on the horizon. immediate live, for 24/7 Call 1-800-227-6007. assistance: myimpactsolution.com (login: KHN) Work-life balance Work-life work-life resource A free available online or by and referral, phone, can save time and assist with daily living demands such as finding childcare, traveling, finding eldercare, and connecting to relocating, other community resources. Financial and legal Financial services have access Employed physicians financial counseling. to free and Identity theft prevention services include free recovery through identity theft monitoring ID. Your Control a Legal assistance includes as complimentary consultation, discount well as a 25 percent on most legal services.

Mental health services designed are services These free to help physicians manage to burnout, marital related stress or and family concerns, anxiety, Clinicians provide depression. confidential, 24/7 support. Employed physicians have access to an extensive local network of licensed mental health who participate in professionals plan. the UnitedHealthcare save time, appointments To and same-day expedited, are appointments can be arranged if the situation is urgent. professional Off-site counseling, with up to three face-to- to three face counseling sessions for each concern, is available. The network worked with IMPACT The network worked with IMPACT Solutions, a behavioral health and people development consulting firm, to develop these services, also available to which are physicians’ families. In response to the to the In response employee annual survey, engagement Kettering Health Network expanded Employee Assistance (EAP) Program for employed offerings to physicians. Designed lives make physicians’ easier by supporting the unique challenges physicians and their families face, these new a wider benefits provide range of assistance. New Employee Assistance Program Assistance Employee New of Physicians Needs Supports KETTERING PHYSICIAN NETWORK PHYSICIAN KETTERING 34 36 NETWORK TP15KHN0008-0070 Kettering OH,45429 Blvd 3535 Southern in Physician Quarterly , [email protected] orcall ( If you would like to submit an article or have information you would like to see If youwould like tosubmitanarticleor haveinformationyouwould liketosee Because of you, ourpatients can continue to Providing excellent care isonlypossible withouroutstanding physicians. We are extremely grateful for your ability to care City, StateZipCode Address 2 Address 1 Office Name First NameLastName,Degree for patients insuchanexceptional manner. 937) ©2015 Kettering Health Network, AllRights Reserved. 752-2053.

PERMIT No. ORGANIZATION US POSTAGE Dayton, OH NONPROFIT PAID 45