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Report to Our Community CONTENTSTABLE OF Click on any title to instantly advance to the article. REPORT TO OUR COMMUNITY

Leadership Perspective Nursing Strategic Plan Singing Sensation Makes A Visit - Judy Rich Canyon Ranch Institute Race Car Driver Charlie Kimball Leadership Perspective - Louise Francesconi A Gluten-Free Population 2013 Community Affairs Recipients

Leadership Perspective Tucson Medical Center Volunteers 2013 Community Benefit - J. Manuel Arreguin, M.D. - Community Benefit Trends Your Life, Your Plan, Your Choice Tucson Medical Center 2013 Community Benefit Report To Our Community Video Optimal Results - Community Benefit Trends (continued)

Biotech Collaboration Purple Heart Dog TMC Senior Services Year At A Glance - Healthy Living Connections Ventana Builds Up Pediatrics’ Lego® Stash Diaper Bank Sources Of Funds/Data Healing Children News Briefs

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From The Vice President & Chief Development Officer Paying It Forward - Michael J. Duran, J.D. Dementia Care From The TMC Foundation Chairwoman - Anne Fulton-Cavett, J.D. Erickson Legacy Society - Spotlight On Hope And Alan Green Helping Patients Deal With Chronic Disease “A Real Raffle For Real People!” The NICU After Care Program Committed To TMC Cardiac Rehab Superb Care At TMC Unlikely Stroke Therapy Making A Difference Volunteer Standout Now Hear This Healing From The Art TMC Foundation Events OUR Tucson Medical Center delivers caring, personalized, quality health care to patients MISSION and their families in an environment that is supportive and compassionate. VALUES OUR

COMPASSION COMMUNITY DEDICATION INTEGRITY We have heart We are welcoming and friendly We work hard for our patients We tell the truth We respect diversity and We practice kindness in all and each other We are responsible in how we individuality our relationships We are committed to use our resources We honor body, mind We reach out as teachers and professionalism and We have the courage to uphold and spirit as leaders excellence our values We listen, we learn, we grow In last year’s Report to Our Community, we introduced you to our LEADERSHIP journey of continuous quality improvement utilizing “Lean” thinking PERSPECTIVE to improve the care we provide and a change in how we work to more effectively put the patient at the center of what we do. In this year’s JUDY RICH report, you will read about how we have endeavored to allow this patient-centeredness to define how we work and who we are, and we have established what we call True North principles to keep us on course moving forward. In scientific terms, “true north” is the direction from any point along a meridian toward the North Pole. Interestingly, a traditional magnetic compass is not the most reliable way to define true north because other magnetic forces can interfere and pull you off course. Similarly, as we go through our daily work at Tucson’s community hospital, it’s easy to get off course if we do not have our direction clear: Patient Experience, People, Quality/Safety and Profitability. While a captain of a ship looks to set a course across the sea, our True North TRUE NORTH DIRECTION: principles provide us the map giving us a vision for what success looks like from the standpoint of our patients, our colleagues and our community. PATIENT As we go about our work, we look to involve our patients and our EXPERIENCE community to help direct our course. We are committed to addressing PEOPLE what matters to our patients, not simply what is the matter. QUALTIY/SAFETY PROFITABILITY We have done this by including members of our patient and family These are two examples highlighted in this report that are reflective of advisory councils on quality improvement teams and in program listening to the voice of our stakeholders, aligning their needs with our development work groups. True North principles to allow us to continue to improve the health and well-being of the people of Southern Arizona. Often, it’s one voice, As we go about our work, we look to involve our patients and our one idea, one challenge that drives us. We endeavor to listen, learn community to help direct our course. We are committed to addressing and improve everyday to be better for the patients we served and our what matters to our patients, not simply what is the matter. We have broader community. done this by including members of our patient and family advisory councils on quality improvement teams and in program development work groups. We asked what our patients thought of the food (they didn’t always like it, and for some we didn’t address their specific allergies and needs) – and so we worked hard to change our processes. We began testing out how to provide room service to all of our patients, and we set up an area of the kitchen that is able to prepare gluten-free meals to those patients who require this special diet. We also listened to our employees (embodied in the People of our True North principles) and their interest in improving their overall health and well-being. To that end, we expanded our employee wellness program and opened Optimal Results Fitness and Wellness Center, a 5,000 https://www.youtube.com/watch?v=mlB7Q0x0dqQ square-foot gym available to our employees, physicians and staff. Health care is transforming, this much we know. But in many ways, we do LEADERSHIP not know exactly how health care will look down the road. As leaders, it’s PERSPECTIVE natural to focus on the work of running an acute-care hospital. And while we must run an efficient and effective hospital operation, it is limiting to LOUISE ignore the broader picture of health and well-being for our region. FRANCESCONI As a nonprofit hospital, we have invested in our hospital campus and those investments are paying off as our community recognizes TMC as the highest quality health care facility in the community. Likewise, we have implemented continuous improvement processes that have put structure around the work we do so we can be more effective. We also have learned to recognize when parts of our business would thrive better in a different environment. An example of this, is the decision to sell our behavioral health care business, Palo Verde Behavioral Health, to United Health Services. This strategic decision will allow that business to grow and expand with leadership and investment from a company that OUR specializes in behavioral health services. VISION IS TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. While our focus on the hospital is imperative, we must also focus on health care system for the future. We may not know exactly how health meeting the community’s broader and more holistic health care needs. care transforms, but we do know that TMC will be actively engaged in We need to look at way to bring health and wellness closer to where shaping this transformation to the benefit of our community. people live. Our challenge is to make healthcare more than annual visits to the physician’s office or unexpected trip to the emergency room, but instead to make taking care of our health part of our daily activities. As individuals are more empowered to take charge of their personal health and wellness, Tucson’s community hospital must find new ways to support their efforts and address our community’s well-being. We can do this both through community programs and investments in physical activity and wellness education and also through the work we do in the hospital. In health care, we spend a lot of time talking about clinical quality outcomes – and that focus is important for the hospital to understand. But, it’s the patients who are experiencing the activities that lead to the outcome that matter most. Our vision is to improve the health and well-being of our community. And we will continue to challenge ourselves to build robust programs that impact the broader concept of well-being as we build a community As an obstetrician gynecologist I have attended well over 10,000 LEADERSHIP deliveries in my 20-plus year career. After these many deliveries, one PERSPECTIVE would think that the novelty of seeing a baby born would soon fade. Surprisingly, it just doesn’t. Whether it’s the look of satisfaction in the J. MANUEL face of an exhausted, newly delivered mother, or the look of relief on the ARREGUIN, M.D. father’s face to see his baby come out of such a small space, I share no greater culmination in handing over a cherished newborn. MY VISION IS TO We are at the cusp of experiencing a new birth in medicine. PROVIDE THE RIGHT For years, volume and independent thinking were part of physician’s

armamentarium. Today, we are witnessing a paradigm shift that now CULTURE incorporates terms such as quality, transparency and value-based care. THAT ENABLES THIS NEW Giving patients an opportunity to tell us what matters most to them is very PARADIGM different from the old practice of simply asking, “What’s the matter?” SHIFT. As chief of staff, my vision is to provide the right culture that enables this new paradigm shift. Helping the cause starts by intentionally listening to the concerns that my colleagues face day in and day out. Working expectantly and mutually with our administration to help stay the course of verifiable improvements is paramount. Finally, focusing on the younger generations, through targeted outreach programs, will assure that we continue to bring the best and the brightest to our time- honored profession. https://www.youtube.com/watch?v=pLxtlIjWAYU BIOTECH TMC Lab advances with support from COLLABORATION Ventana Medical Systems TMC upgraded its laboratory in 2013 in collaboration with Ventana Medical Systems, a global leader in tissue diagnostics. A number of state-of-the-art technologies were connected to create processes to get the most accurate and timely results possible for our patients. “This collaboration with Ventana is critical to ensuring our patients receive world-class accuracy and precision from TMC’s highly Mara Aspinall with Judy Rich efficient laboratory,” said Judy Rich, TMC president and CEO.” This equipment is key to enhancing patient safety and improving quality. At TMC, we focus on delivering the best diagnostic results for every patient we serve, and this is a giant leap forward.” Judy Rich and Michael J. Duran, J.D., with TMC’s director of Lab Services, John Allen The new equipment, which includes four instruments and the accompanying software, allows the hospital to perform more in-house tests, reducing the need to send samples to outside laboratories adding to turnaround times. The automation also allows for stronger management of patient identification through the process. This reduces the opportunity for misdiagnosis and mislabeling. Since a single technologist or pathologist works with one patient at a time through the entire process, there is greater continuity of care. TMC and Ventana celebrated the results at a June ribbon- MORE IN-HOUSE TESTS cutting ceremony. STRONGER “The strength of our confidence in each other across these two MANAGEMENT OF PATIENT corporations was palpable,” said John Allen, director of TMC IDENTIFICATION Laboratory Services. “We are two organizations with a vision of the THROUGH THE PROCESS future of pathology, cancer diagnosis and treatment, and a commitment to our community that is unified, thoughtful and creative.” GREATER CONTINUITY OF CARE COMPANY TMC for Children patients thankful for BUILDS UP having the pick of a tower of toys KIDS MORALE During the hustle and bustle of Thanksgiving week, employees from Ventana Medical Systems carved out an afternoon to bring more than 200 Lego® sets to deserving little patients in TMC for Children as part of Children’s Miracle Network. It didn’t take long for kids to emerge from their hospital rooms, and gaze at the stash of Lego® sets before picking the “perfect” one that they could take home.

Cody Warren Ventana employees collected Lego® sets since the beginning of October. Ventana President and CEO Mara G. Aspinall personally helped with the delivery, and TMC President and CEO Judy Rich accepted the donation. But it was 4-year-old Cody Warren who stole the show. He picked out a Lego® Star Wars set for himself, and a Lego® Friends Selena Gilley (in pink) plays with her new Lego® set set for his sister, who was sleeping in her hospital room. “We were thrilled when we learned about the Lego® drive that was organized for TMC for Children, Children’s Miracle Network,” said Rich. “Visits like this helps lift our patients’ spirits, which aids the healing process, and having a new toy to play with provides a distraction that helps them focus on something other than the reason VENTANA MEDICAL SYSTEMS they’re here.” DELIVERED MORE THAN That was evidenced just a few minutes after the event, when 8-year-old ® patient Selena Gilley was hard at work in her hospital room diligently 200 LEGO SETS following the directions to create her masterpiece. TO DESERVING LITTLE PATIENTS IN TMC FOR CHILDREN AS PART OF “Ventana prides itself on being true to our mission to improve the lives of patients,” said Aspinall. “Having the opportunity to meet these CHILDREN’S young patients in our community and share a toy to help lift their MIRACLE thoughts and spirits, gives me and all Ventana employees great joy.” NETWORK. HEALING Coming together to provide Honduran girl Dr. Luis Piedrahita with Silvia Cross CHILDREN with life-changing spine surgery in Tucson They say ‘laughter is the best medicine.’ So it’s no wonder 14-year-old Silvia Cross was doing remarkably well as she recovered from major spine surgery she had at Tucson Medical Center. The Honduras native is described as “the most energetic, outgoing person you will ever meet.” She has an infectious giggle that fills the house of her host family – a house that was her home for more than three months. Silvia suffered

Silvia Cross from a severe case of scoliosis and required a spinal fusion with a rod placement, but didn’t have access to the treatment in Honduras. Her widowed mother, who sells bread for a living, didn’t have the money or access to seek out the medical attention her daughter so “EVERYONE AT TMC WAS desperately needed. EXTRAORDINARILY Healing the Children is a nonprofit charitable organization that helps WELCOMING. underserved children throughout the world secure urgently needed THEY DID EVERYTHING medical assistance they otherwise are unable to obtain. As part of the THEY COULD program, Silvia was flown to Arizona in October 2013 along with TO MAKE SILVIA another little girl named Doris who underwent a similar surgery at a Phoenix area hospital. The girls bonded with their host family, the COMFORTABLE,” Shoemakers, for a few weeks before their operations. LEAH SHOEMAKER. Leah and Dave Shoemaker both work full time in addition to raising Silvia was in TMC for Children’s Pediatric Intensive Care Unit for five their three young children, 9-year-old Aston, 4-year-old Bryton, and days following her surgery – something that was tough to prepare her 2-year-old Caelyn. As you can imagine, it was a huge adjustment for for. “Despite telling her ‘it’s going to hurt, you’re going to be sick’ – all involved. The dynamics of the house changed instantly. “When they there really was no way to prepare her for that,” said Leah. first came into our house, it was unbelievably difficult. You want to do Silvia was fortunate to be under the care of Dr. Luis Piedrahita, a everything you can to make them feel welcome. But it’s amazing how surgeon with Tucson Orthopaedic Institute. “We are very fortunate to quickly everyone adjusts,” said Leah. have one of the most advanced health care systems in the world,” he “Silvia lives with her 1-year-old niece and 3-year-old nephew in said. “The great majority of the world population has access only to Honduras, so she was used to having little kids around, and was very basic medical care. Complex musculoskeletal problems are not treated helpful around the house. She was very eager to blend in with our and even ignored. Usually very complex surgeries like this one can only family,” said Leah. One little problem, however – was the language be performed here because of the limitations of instrumentation and lack barrier. Silvia speaks Spanish, and speaks very fast. Leah admits her of postoperative care. Bringing the patients here is the ideal thing to do, Spanish is rusty at best. “My Spanish has gotten better, and she has but requires a lot of non-medical work. I was very pleased with how learned to speak slower, so we’re finally at a point where she finishes Healing the Children was able to accomplish this efficiently, and I look my sentences,” she laughed. “Silvia has become part of our family.” forward to continuing to provide my support in any way I can.” Leading up to surgery day, Silvia was fearless – and incredibly grateful, almost as if she was on a mission to get better. “The face-to- face medical interpreter at TMC was absolutely amazing and made all the difference for Silvia. Everyone at TMC was extraordinarily welcoming. They did everything they could to make Silvia comfortable, and they treated me as her mom,” said Leah. Anesthesiologist Dr. Luis Esparza from Old Pueblo Anesthesia was Silvia headed back to Honduras in January, but not without leaving asked to participate since he speaks Spanish, and could therefore her mark in the States. “We will keep in touch with her forever,” said help her feel a little more comfortable so far from home. “I had the Leah. “These kids become part of your family, and we will never opportunity to be involved in providing care for her that she could forget them.” never have obtained at home. I think that we sometimes lose sight of the fact that what seems routine to us can have such a huge impact on others. Being involved in cases like hers helps to remind me of that. I was happy to be part of the team that cared for her.” A BRIGHT FUTURE AHEAD The experience led to the creation of some big goals for Silvia. She wants to learn English, move to America, become a nurse and be able to support her family back home. She knows that the one way to get there is through education. Silvia goes to school in Honduras, whereas most children do not. During the three short months she was here, she made it clear – she wanted to go to school. The Shoemakers enrolled her in Emily Gray https://www.youtube.com/watch?v=iqJlLgF9GSY Junior High. “She found a bilingual student who helped her quite a bit,” said Leah. “She has really embraced this experience and wants to see everything America has to offer.” At night, Silvia would spend three to four hours figuring out her homework. Family Opens Heart - And Home Leah Shoemaker’s inspiration to help children like Silvia stems from “I’m not part of bringing these kids here. I’m not on the surgical team. an experience involving one of her sons. When Aston, who’s now 9 But I know the pain the mom goes through, and I know the pain the years old, was a toddler, he suffered his first seizure. He was eventually child goes through. And my family can help with that.” diagnosed with a rare brain malformation and has since undergone Many years ago, she read an article in People Magazine about three brain surgeries. organizations that help children like this. It prompted her to do a little “When something is wrong with your child, one of the things you want research and make it happen. She discovered the Arizona chapter of is control over the situation. And you have none. The other thing you HTC, which is based out of Scottsdale. Three years ago, they opened really want is help,” she said. “Throughout that process, I was just very up their hearts and their home to a little girl from the Philippines who happy that we have the care that we do in America.” needed open heart surgery. Hosting Silvia and Doris was a positive Reflecting on her experience she realized a lot of parents don’t have experience for their family, and they say they will without a doubt – the ability to help their child. do it again. “The family thought it would be comforting for the girls to be together. They are truly an incredible, loving family who have a “I couldn’t imagine anything worse than being in a country, having a special place in their hearts for our children,” said Kristin Matthews, sick child, and not being able to help them,” she said. president and co-director of HTC Arizona. Since everything is charity- She found a way to help. based, host families don’t receive any reimbursement, making their commitment even more extraordinary. Medical Interpretation Dozens of bilingual staff members at Tucson Medical Center are receiving “Up to now, we did not know the language competency of our special training in medical interpretation skills under a partnership with the bilingual employees, especially in a medical setting,” Frisbie-Garcia University of Arizona National Center for Interpretation. said. “This is important because ineffective communication can result in a number of medical mishaps including incorrect diagnoses or “This project focuses on patient safety by reducing the risk of clinical treatment by a health care provider, unnecessary return visits to the ED errors due to language barriers,” said Monica Frisbie-Garcia, manager or hospital readmissions due to patients misunderstanding medication of TMC International & Language Services. or discharge instructions, or patient non-compliance of a treatment According to U.S. census data, more than 31 percent of Arizona’s plan due to language barriers.” Increasing the language competency of population is Hispanic – about 2 million people. Nationwide, more Spanish bilingual staff can lower these risks. than 25 million people have limited English proficiency, a majority of Through the Spanish Medical Interpretation Training, or MIT, them speaking Spanish. workshops that began in the fall of 2012, TMC now has 30 “Spanish TMC is the only hospital in Southern Arizona staffed with certified language assistants” representing 20 different units and departments. Spanish medical interpreters. The International & Language Services The four-day workshops cover interpretation ethics and protocol, department also oversees the provision of language assistance for other medical terminology, and several hours of rigorous interpretation languages through outside contractors such as CyraCom. Interpretation practicum to refine language skills. is offered face-to-face, by telephone or through Internet video remote services. And as a reflection of Tucson’s cultural diversity, TMC also has many Spanish bilingual employees. Reaching language competency as a Spanish language assistant allows bilingual employees to support language needs on their units in a much safer manner. “Having the opportunity to take the MIT workshop at TMC is very beneficial for patients,” said MIT grad Angelica Hibbs, a nurse on the Mother/Baby unit. “They now have a qualified professional individual on the unit to provide correct interpretation. As a Spanish language assistant, I’ve learned to gauge the patient’s comprehension level and cultural background and interpret accordingly. Yet another successful patient safety initiative at TMC.” EMERGENCY ED teamwork positively impacts SERVICES patient care Last spring, John Hall was visiting Tucson when a medical emergency landed him in the TMC Emergency Department. Himself an emergency room physician, Dr. Hall was impressed. “To a person - receptionist, triage personnel, patient care technicians, radiography technician, administrative clerk, scribe, nurses and physician - I was treated with both kindness and respect,” he wrote in a Melissa Ritchey, R.N. thank you email that he gave permission to share. Dr. Hall wondered if he was getting preferential treatment as a professional courtesy, but he realized he wasn’t. “I saw/heard the same caring and professionalism given to the several other patients in the curtained ward.” Last spring, John Hall was visiting Tucson when a medical emergency Emergency Department staff landed him in the TMC Emergency Department. Himself an emergency room physician, Dr. Hall was impressed. “To a person - receptionist, triage personnel, patient care technicians, radiography technician, administrative clerk, scribe, nurses and physician - I was treated with both kindness and respect,” he wrote in a thank-you email that he gave permission to share. Dr. Hall wondered if he was getting preferential treatment as a professional With basic education on Lean principles and the leeway to try out their courtesy, but he realized he wasn’t. “I saw/heard the same caring and own ideas for improvements, staff members have been more engaged professionalism given to the several other patients in the curtained ward.” in their processes and outcomes. At daily stand up meetings, they review metrics and share challenges for the day; idea boards provide His care wasn’t a surprise to Melissa Ritchey, director of Emergency a visual mechanism to implement employee suggestions; and rapid Services. In fact, his remarks are indicative of a department that spent improvement events, called kaizens, bring staff together for four or 2013 working to remake itself into an emergency department where five days to drill down into problems, determine root causes and pilot anyone would want to take their loved ones. measures to improve processes. “I am most proud of the culture change,” Ritchey said. “The staff is In the Emergency Department, one measure that is tracked is length of engaged; they take a lot of pride in the department. It’s not just a job – stay – the time it takes from a patient’s arrival to departure. In 2013, TMC it’s a profession for them all.” treated 84,920 patients in the Emergency Department, an average of more Throughout 2013, the Emergency Department incorporated Lean than 230 each and every day. About two-thirds were treated in the main strategies into its work. A manufacturing concept originally developed ED and a third in the pediatric ED. The majority of ED patients, some 80 by the Toyota Motor Co., Lean has been embraced by health care percent, are treated and released without an inpatient stay. organizations over the last decade. Throughout the year, the median length of stay for these patients was under 3 hours. In the Pediatric Emergency Department, the median length Lean teaches staff to see their work through the eyes of the patient as well of stay was under 2 hours from May through the rest of the year. as providing a set of tools to improve the work. Leaders in an area learn to see the work from the eyes of their staff as well as tools to coach and Not only is a shorter length of stay appreciated by these patients whose engage staff to root out and eliminate waste. In this way, TMC can make conditions allow them to go home, but it ensures that everyone going the patient experience safer and more satisfying for all involved. through the department will be attended to in a more timely manner. This timeliness shows up in another measure that is tracked in real “They care about what’s happening in the department,” Ritchey said. time, and that is patients who leave without being seen, also called “They call on their days off to see how things are shaping up.” They LWOBS. These patients become a safety concern. want to know if they hit the targets, if there were any outliers and what can be done to address them. “If a doctor hasn’t seen them, we worry that something bad can happen,” Ritchey said, explaining that the patient felt the medical need And they don’t do it alone. The ED partners with areas that are was sufficient to go to an emergency department but yet left without essential to the emergency visit, such as CT, X-ray, Ultrasound, being assessed. Transportation and Lab, to make sure these areas don’t become the bottleneck that slows down everything. At TMC, the goal is to have a doctor or mid-level provider, such as a physician’s assistant or nurse practitioner, evaluate the patient in a “We’re also better able to communicate with patients to manage their timely manner so treatment can begin and the patient won’t be as likely expectations,” Ritchey said, “We have a pretty good idea how long it’s to leave without receiving care. going to take for labs or results.” Last year was one of steady improvement in this measure. Five of the It might be a while before Tucson’s busiest Emergency Department last six months of 2013 saw the ED beat its LWOBS goal of 1.5 percent. can completely eliminate wasteful waiting, but that is the vision, and Through the entire month of December, the Pediatric Emergency everyone is on board to help make it happen. Department had only a single patient leave without being seen. “The staff is engaged and want to be a part of the process And if you asked the staff, anyone who was on that day would be able to improvements,” Ritchey said, noting that 2013 also saw less turnover share the reason the parent and child left. By tracking and discussing these of core staff and the need for fewer traveling nurses. measures daily, the staff can look for trends and for ways to improve. Dr. Hall might not have known about Lean tools and methods, but that doesn’t matter. Instead, that he had a positive experience and was moved to send an email is evidence of the hard work and thoughtful care taken by all in the department.

“I have practiced emergency medicine for 35 years and I only hope TMC TREATED that most of the time I help deliver the type of service that I received at your emergency department,” Dr. Hall wrote. “My hat is off to you all 84,920 and kudos need to be shared! If you are ever in Anchorage and (God PATIENTS IN THE forbid) need an ER I hope we at Providence Alaska Medical Center EMERGENCY can serve you as well.” DEPARTMENT, AN AVERAGE OF MORE THAN 230 EACH AND EVERY DAY. NURSING Nursing Strategic Plan focuses on evidence- STRATEGIC based practices – for patients and their nurses PLAN When TMC Vice President and Chief Nursing Officer Elizabeth Maish returned to TMC in late 2012, she wanted to raise the bar for nursing. But to compete with the likes of The Mayo Clinic, Cleveland Clinic or Johns Hopkins– TMC would have to be more rigorous in its approach to nursing care practice. “The professional nursing field is continually developing,” explained Maish, whose nursing career as a chief nurse executive and quality director spans 30 years. When TMC Vice President and Chief Nursing Officer Elizabeth Maish returned to TMC in late 2012, she wanted to raise the bar for nursing. But to compete with the likes of The Mayo Clinic, Cleveland Clinic or Johns Hopkins– TMC would have to be more rigorous in its approach to nursing care practice. “The professional nursing field is continually developing,” explained Maish, whose nursing career as a chief nurse executive and quality director spans 30 years. “We need to pull everything up. There’s a lot of work to be done.” Maish took the first part of 2013 scouring the literature, delving into the Under each pillar are four to nine components touching all areas of nursing nursing theories around caring, empathy, safety and team. She thought about – from patient safety and staff fatigue mitigation to patient placement and nursing strategy as a way to support and define where TMC needed to be. health care literacy. One thing she found was that all of the pre-eminent health care organizations had rigorous strategic planning efforts around the nursing workforce. “We want to keep it simple. Use evidence-based and best practices. It’s really straight forward,” Maish said. A nursing strategic plan allows TMC to approach the future in an orderly and systematic way, ensuring the hospital remains relevant and responsive For example, under Workforce Management comes the topic of “Fatigue to patient and community needs. It provides a clear and consistent Mitigation.” Maish points out that there is irrefutable evidence that extreme organizational focus. nursing fatigue can be tied to negative patient outcomes. After synthesizing the material, she spent the next few months, with As a result, nursing work schedules require a lot of attention, management input from the director of Nursing Practices, putting together the 2014- and innovation. “The days of the 60 hour nursing work week are over at 16 Nursing Strategic Plan. The plan addresses the many facets of TMC’s TMC,” she said. While she will take the pushback, she knows that it’s the relationship-based care model, with a focus on evidence-based practices. right thing to do. “We want to circle the wagons around five pillars that we know impact “To better focus on our patients, our staff needs to be healthier in terms of patient and workforce health,” she said. The pillars include: being mentally, emotionally and more physically fit,” she said the focus should be on promoting wellness, not “getting by.” And that’s just a single • Safety component of an overall strategy. • Competency • Workforce Management After the plan was put together, Maish took it on the road, presenting to • Operations Improvement nursing staff and leadership. The plan has been endorsed by the Executive • Patient Experience Team and sanctioned by the TMC Board of Trustees. “These weave into our True North principles, it all ties together,” said “There are action plans behind each of the components; and we will tie all Maish, referring to TMC’s guiding principles of Patient Experience, People, the work we’re doing over the next three years to an approved strategy,” Quality/Safety and Profitability. she said. “We’ve set our course.” SAFETY COMPETENCY WORKFORCE OPERATIONS PATIENT • National Patient • Clinical Excellence MANAGEMENT IMPROVEMENT EXPERIENCE Safety Goals - Care Standards • Integrated Nursing • Throughput • “Nothing to you • Medication - Professional Workforce • Communication without you” Management - Growth • Bedside Leadership Structures • “What matters to • Care Transitions • Skill Development • Resource Stewardship you?” • Hand-off - Specialization • Fatigue Mitigation • Lean Management • Navigation Communication - Evidence-based • Innovative Scheduling System • Health Literacy • Hourly Rounds Practice & Care Models • Optimized IT Platform • Bedside Report • Emotional Intelligence • Patient Placement - Self Awareness • Communication • Daily Staffing Review - Compassion & - Patient • Ops Huddle Empathy - Family • Practice Alerts - Medical Staff • Principles of - Peers Informatics - Information access • Top-of-License Work • Accreditation/ - Delegation Regulatory Compliance CANYON Making hopes of becoming CRI LEP participant RANCH healthier ‘a reality’: INSTITUTE Canyon Ranch Institute, Healthy Living Connections bring life enhancement program to the community. Gone are the days when older adults sit back and wait for disease to take its toll in an inevitable journey of decline. Instead, one of the major Julie Ward, R.N., health trends amongst older adults is proactively seeking community Chest & Pain Coordinator resources to help stay healthy and prevent or manage conditions. TMC launched Healthy Living Connections seven years ago and its wellness programs this past year to respond to the growing trend of healthy lifestyles. And what better partner for the community than Canyon Ranch Institute, a 501(c)3 non-profit public charity led by the wellness leaders who founded Canyon Ranch. LASTING CHANGE IS NOT A ONE-SIZE FITS-ALL PROPOSITION Gone are the days when older adults sit back and wait for dis-ease At the core of the program is the philosophy that lasting change is to take its toll in an inevitable journey of decline. Instead, one of not a one-size-fits-all proposition. It is very important for people to the major health trends amongst older adults is proactively seeking create a vision for their health that fits their needs and their lifestyles. community resources to help stay healthy and prevent or manage “Having participants set their own realistic goals and then celebrating conditions. TMC launched Healthy Living Connections seven years each success that comes during the journey is very fulfilling,” said ago and its wellness programs this past year to respond to the growing Mary Atkinson, RD, TMC director of wellness. “We are trying to shift trend of healthy lifestyles. And what better partner for the community people’s thinking from what they can’t do to what they can do.” For than Canyon Ranch Institute, a 501(c)3 non-profit public charity led by more information about this program, email [email protected]. the wellness leaders who founded Canyon Ranch Institute. Below one participant shares what she is doing now to take control of Last year, TMC and Canyon Ranch Institute teamed up to provide the her health: Canyon Ranch Institute Life Enhancement Program to members of our The CRI LEP connected me to people who care about my health, community at no cost. The CRI Life Enhancement Program, also known Michaela Johnson as the CRI LEP, focuses on self-discovery, preventive care and positive lifestyle habits that enable the participants to experience a healthy Before I joined the CRI Life Enhancement Program, I thought I knew transformation through personal empowerment and behavioral changes. what it takes to live a healthy life – what’s good for you, what’s not. What I really lacked was motivation. The CRI LEP is a 12-week program delivered by a core team of TMC health professionals with expertise in behavioral health, integrative I expected that the structure of the program and classes would help me health, nutrition, physical activity and pharmacology. The program find that motivation. What I found was that the dedication of the other includes weekly classes as well as one-on-one appointments with participants and the health professionals from Tucson Medical Center members of the core team. motivated me to reconnect to health and wellness in my life. As someone who lives alone and has gotten pretty isolated in life, the group support, caring, and shared values was incredibly important to me. Embedding myself amidst such a dedicated health team who strives to go the extra mile with every individual – regardless of someone’s particular challenges – allowed me to make my hopes of becoming healthier a reality, instead of just another “good idea.” The CRI LEP created an environment of such strong values, that I knew I could absorb and embrace them simply by participating. It now matters to me and other people how well I’m doing. The sense that someone cares about me improving my health gave me the “jump start” that I needed to lead a healthier life. Today, I’m working to maintain my healthy habits. I continue to make better food choices, having more fruits and vegetables and overall fewer calories. The program’s emphasis on meditation also helped me to reconnect with myself and my goals. Daily meditation has made the biggest impact in helping me to stick to my healthy new habits. When the program was ending, I asked if I could volunteer for the next program at Tucson Medical Center. I figure staying connected with the program will help me, and maybe I can help other people. A Meeting the needs of the GLUTEN-FREE gluten-free population POPULATION Tucson Medical Center is committed to creating a safe environment for those with celiac disease, wheat allergies or gluten-intolerance issues. On a Sunday in November, more than 1,200 community members descended upon the TMC campus for the first Gluten-Free Awareness Expo. The expo, sponsored by TMC and organized by the University of Arizona Gluten-Free Club, consisted of workshops, networking, education and support systems for those living gluten-free and their medical providers. Tucson Medical Center is committed to creating a safe environment for those with celiac disease, wheat allergies or gluten-intolerance issues. On a Sunday in November, more than 1,200 community members descended upon the TMC campus for the first Gluten-Free Awareness Expo. The expo, sponsored by TMC and organized by the University of Arizona Gluten-Free Club, consisted of workshops, networking, education and support systems for those living gluten-free and their medical providers. Attendees included those with celiac disease, which damages the lining of the small intestine and prevents absorption of nutrients; those with wheat allergies or gluten intolerances; and medical professionals seeking https://www.youtube.com/watch?v=aA70jo-ux7E education about these conditions. Lectures by Dr. Lucinda Harris, associate professor at Mayo Clinic • Food choices include a variety of fresh products and specialty gluten- Scottsdale, and Nina Spitzer, president and founder of the Celiac free items such as breads, crackers, pizzas, pastas, cookies, dressings, Disease Foundation, Greater Phoenix Chapter and creator of the even brownies! School Nurse Awareness Program, addressed the difference between celiac disease and wheat allergies as well as how to address the Upon request TMC will provide patients with the details of these diagnosis of celiac disease for school-age children. procedures and product labels as well as consultation with a dietitian. The interest in the expo reflects a growing need within the community When patients arrive at admission and inform us of their gluten-free for awareness and accommodation of those with celiac disease, wheat status, this is recorded in their medical record as an allergy. This allows allergies and gluten intolerances. As rates of celiac disease increase within their diet order to be directed to reflect the gluten-free need. our population (quadrupling in the past 60 years) and awareness of wheat A manager or dietician from Food & Nutrition Services is available allergies and intolerances increases, Tucson Medical Center is responding. to speak with a patient prior to a planned stay to discuss the hospital’s In the summer of 2013, TMC adopted new procedures to ensure the gluten-free process. safety of those who are gluten-free, providing gluten-free patients with a variety of fresh, safe and nourishing gluten-free options. TMC ADOPTED NEW PROCEDURES In the kitchen and in transport Tucson Medical Center: TO START PROVIDING • Follows specific gluten-free storage, handling and production GLUTEN-FREE PATIENTS procedures to assure gluten-free status. WITH A VARIETY OF FRESH, • Follows specific food-handling procedures to ensure the gluten-free SAFE AND NOURISHING integrity of the meals served to patients. These procedures include dedicated cutting boards, knives, microwave, toaster, fridge and GLUTEN-FREE disposable aprons; gluten-free labeling and use of gloves. OPTIONS. TUCSON Volunteers with a can-do attitude greet all MEDICAL with a concierge mindset CENTER Coming to an unfamiliar place, sometimes before the crack of dawn, can be daunting to patients and families already anxious about a surgery or VOLUNTEERS procedure. Oftentimes it takes just a smile, an encouraging word and someone to point the way to help set minds at ease. With the introduction of the TMC Orthopaedic and Surgical Tower in May 2013, TMC Volunteer Services has focused on providing concierge-style service to help make people’s experience a positive one from the start. Coming to an unfamiliar place, sometimes before the crack of dawn, can be daunting to patients and families already anxious about a surgery or procedure. Oftentimes it takes just is a smile, an encouraging word and someone to point the way to help set minds at ease. With the introduction of the TMC Orthopaedic and Surgical Tower in May 2013, TMC Volunteer Services has focused on providing concierge-style service to help make people’s experience a positive one from the start. “Our TMC volunteers can let patients and visitors know from the get-go that TMC is ready to take care of their needs,” said Ginny Robbins, chair of TMC Volunteer Services. The desk is staffed by a special group of TMC volunteers, who “It’s our honor and privilege to care for the community and all who have been trained to go above and beyond. These volunteers help choose Tucson Medical Center,” Robbins said. “The concierge ensure all patients are greeted and assisted in a warm and welcoming volunteers’ can-do attitude is what makes us the best.” environment that mirrors the hospital’s values of compassion, integrity, dedication and integrity. “The concierge volunteers just say ‘Yes – yes, I can do that!’” Robbins See page 78 to read more about the volunteer standout, Ginny Robbins. said, adding that “no request goes unanswered and all patients and visitors are welcomed and their needs are met immediately by volunteers committed to exceptional service.” Robbins sets the bar high with the expectation of a full five hours of smiles during a shift. These concierge volunteers help with hospital way-finding often a challenge with TMC’s 15 miles of interior hallways. They guide patients to the appropriate surgical floor, inpatient unit, procedural area, cafeteria, and even to physician USING A practices across the street in TMC’s medical park. WEB-BASED TOOL CREATED Using a web-based tool created for the desk, concierge volunteers have FOR THE DESK, CONCIERGE information at their fingertips, so they can provide contact information VOLUNTEERS HAVE to nearby amenities including restaurants, grocery stores, hotels and INFORMATION medical offices … just like a top-rated hotel. AT THEIR FINGERTIPS. YOUR LIFE, End-of-life dialogue helpful, YOUR PLAN, not heartbreaking YOUR “I wonder how it will happen…” CHOICE That’s what Jackie Isaac said to her daughter Dory Martin as the two were having breakfast about a month before Jackie passed away. Jackie Isaac in May “‘How will I die?’ is what she meant,” Martin said. 2012, less than a year before she passed away. For many of us, just the thought of a loved one dying is enough to force us to think of something else – ANYTHING else – instantly. Having a conversation with a loved one about her wishes surrounding death? Forget it. But that conversation doesn’t have to be so uncomfortable that it is too much to bear. “I wonder how it will happen…” That’s what Jackie Isaac said to her daughter Dory Martin as the two were having breakfast about a month before Jackie passed away. “’How will I die’ is what she meant,” Martin said.. For many of us, just the thought of a loved one dying is enough to Understanding those wishes is a big part of palliative care. The term force us to think of something else – ANYTHING else – instantly. “palliative care” is often confused with hospice care. Palliative care Having a conversation with a loved one about her wishes surrounding is family-centered care that optimizes quality of life by anticipating, death? Forget it. But that conversation doesn’t have to be so preventing and treating suffering. uncomfortable that it is too much to bear. Throughout the continuum of illness, palliative care involves addressing In fact, having that talk, and knowing what your loved one wants, will physical, intellectual, emotional, social and spiritual needs and helps make aspects of what’s an incredibly painful time a little bit easier. facilitate patient autonomy, access to information, and choice. At the People who have experienced death firsthand shared their perspective base of palliative care: What are the patient’s desires and wishes? at a TMC workshop devoted to critical health care decisions called “Quite often we get so hung up on what we can do for someone Your Life, Your Plan, Your Choice. About 70 people attended. medically that we don’t ask who the people are and what they would Martin spoke about her mother’s life – a life well-lived – and really want. And that, I feel, is the more important question,” said about having that conversation prior to her mom’s death from a Kathy Kennel, NP, a TMC palliative-care coordinator. Kennel also neurologically based illness at the age of 85. Before the illness spoke at the workshop, opening her talk with a flashback to her consumed her, Jackie made her health care wishes known, and also mother’s dying days, and how she vowed to do whatever she could to wrote out an ethical will – a personal letter in which she expressed her help families at the end of life. values, experience, wisdom and end-of-life wishes. Dr. Larry Lincoln, medical director of TMC Hospice, also shared Having the conversations and the documents that spelled things out gave a personal story about his mother, who lived in a care home with her children clear cut instructions…and left few decisions up for debate. dementia and heart failure toward the end of her life. “She told me she did not want to go on living for a year prior to her death,” he said. He vividly remembers receiving a call from the care home. His if you become unable to make decisions. Through advance directives, mother had a medical crisis in which she could have been treated such as living wills and durable powers of attorney for health care, you and potentially moved back to the care home. He thought about his can make legally valid decisions about your future medical treatment. mother’s words and made the decision not to have her treated. Another resource is the Arizona Attorney General’s Office, which provides She was transferred to Peppi’s House where she was kept comfortable a Life Care Planning packet online in both English and Spanish. until her death. For a calendar of events or for more information about the TMC Senior Even though he knew that he was following hias mother’s wishes, he Resource Center, click Healthy Living Connections. still struggled with being responsible for her death. He explained that many people have this initial reaction when faced with these important decisions. He knows he did not kill his mother; he was simply carrying out her wishes. He took comfort in what she expressed to him before the ABOUT dementia got severe. 70 Making your wishes known PEOPLE Having a meaningful, open dialogue about end-of-life wishes is not ATTENDED THE TMC WORKSHOP easy, but The Conversation Project is a good place to start. Advance DEVOTED TO CRITICAL directives are another way to provide some direction. Formal advance HEALTH CARE DECISIONS CALLED directives are documents written in advance of serious illness that state YOUR LIFE, YOUR PLAN, your choices for health care, or name someone to make those choices, YOUR CHOICE. OPTIMAL A promise made to TMC employees leads RESULTS to an on-site investment in their health You could consider a new place a success when it’s barely been broken in, and your customers are clamoring to tell you what a difference it already has made in their lives. That’s exactly what’s happening at the Tucson Medical Center Optimal Results Fitness and Wellness Center. The Optimal Results gym is where the hospital’s operating rooms were located before they moved to the new TMC Orthopaedic and Surgical Tower. You could consider a new place a success when it’s barely been broken in, and your customers are clamoring to tell you what a difference it already has made in their lives. That’s exactly what’s happening at the Tucson Medical Center Optimal Results Fitness and Wellness Center. The Optimal Results gym is where the hospital’s operating rooms were located before they moved to the new TMC Orthopaedic and Surgical Tower. OVER TMC President & CEO Judy Rich challenged staff at an employee 700 forum early in the year that if they could reduce their health care claims by $500,000, she would build them a gym. EMPLOYEES BECAME MEMBERS IN THE FIRST YEAR Employees reduced their claims, and Rich made good on her promise. Speaking of convenience, Optimal Results is open 24/7 – perfect for But that’s just where the story begins. staff who work early morning, night or overnight hours. For Judy Lesson, a lead transcriptionist who’s been with TMC for 20 years, it When the TMC Surgical and Orthopaedic Tower opened up in May could not be any easier to incorporate exercise into her day. 2013, the newly vacated operating suites in the main part of the hospital sat empty, providing ample space for the project: 5,000 square feet. A “The gym is about two feet from where I work, so I really don’t have an group of about two dozen employees formed a Gym Committee to tackle excuse not to go,” she laughed. Lesson’s lunch hour is now spent on the details such as membership, equipment, and policy and procedures. treadmill, doing strength training, or taking a group exercise class. Renovations began in June, and by September, Optimal Results was “I’ve done Jazzercise for 30 years. I’ve never been part of a traditional open for business, with an employee membership of just $12 a month. gym, so this is all new for me,” she said. “I love doing different things. It’s truly a win-win for everyone.” TMC Employee Wellness Specialist Amy Mattox was brought on board to make sure the place was comfortable – yet inspiring – for all employees. Lesson is one of more than 700 employees who became members in It’s a role she embraces with an extensive personal training background 2013, Mattox said. “To have 700 employees sign on to swipe their and experience working with people of all ages and fitness levels. badge, and get ready to sweat – it’s fantastic.” “We’re targeting a lot of people who haven’t been in an exercise facility The gym opened with two cardio rooms including treadmills, elliptical for a very long time,” Mattox said. “We’re trying to encourage these machines and bikes, as well as a full free-weight area. Plate-loaded people to take control of their wellness and try fitness again. At the same weights are available for strength training, as well as a room with time, we’re trying to provide regular gym-goers with a clean place that stacked weights – in order to accommodate everyone. features state-of-the-art equipment in which they can continue to challenge themselves. We want to make getting in shape convenient for everyone.” A roomy multipurpose area hosts group classes, including yoga, Zumba, core and spin. Another room has a large synergy machine. “We’ve started a circuit class using this machine in which people get a CrossFit type workout,” said Mattox. Another weight lifting area with an additional 700 square feet is planned to be built out in 2014. “The best part is seeing so many people come in who haven’t used a fitness facility in many years, and being inspired to try exercise again,” said Mattox. “These are people who – if this gym wasn’t right here for them, they would never go down the street and sign up at a traditional gym. By providing this, and making it a perk of employment, we’re encouraging them to step outside the box a little bit. They’re now making physical activity part of their daily routine, they’re healthier and happier for it, and they’re having a blast.” https://www.youtube.com/watch?v=LHyCSlzUPoc It’s that enthusiasm that Mattox and other TMC leadership hope will spread like wildfire across the Tucson community. They’re optimistic that by leading the way, and encouraging wellness among the more than 3,000 employees at TMC, it will inspire Southern Arizonans to take control of their health, focus on preventative care, and get moving. PURPLE What seemed an ordinary visit ends up an HEART DOG extraordinary honor for TMC therapy dog A 70-pound golden retriever with silky blond fur, a friendly face and a sweet demeanor undoubtedly attracts a lot of attention wherever she goes, and when Spencer Harman takes his dog Jamie out in public, that’s exactly Spencer Harman with Jamie what happens. Spencer knew Jamie was an exceptional dog from day one. “As a puppy, she tried to jump on the sofa. I took her ‘down’ and told her ‘no’ one time

Jamie, Purple Heart Therapy Dog – and that’s all it took. She hasn’t jumped on the furniture since.” A 70-pound golden retriever with silky blond fur, a friendly face and a sweet demeanor undoubtedly attracts a lot of attention wherever she goes, and when Spencer Harman takes his dog Jamie out in public, that’s exactly what happens. Spencer knew Jamie was an exceptional dog from day one. “As a puppy, she tried to jump on the sofa. I took her ‘down’ and told her ‘no’ one time – and that’s all it took. She hasn’t jumped on the furniture since.”

Visit the link below to learn more www.tmcaz.com/Community/SeniorServices/Pet_Therapy Fast forward a few years. Harman enrolled his loving, furry friend in A twist of fate training class to become a certified therapy dog. Jamie passed with Harman and Jamie’s morning tradition includes a walk to Starbucks flying colors and joined the TMC Pet Therapy team two years ago. The so that he can drink his coffee while she visits with customers. On 8-year-old is a welcome sight to patients. an ordinary day in January, something extraordinary happened. “A “Jamie greets a lot of people everywhere she goes,” Harman said. woman named Karen came up to me and reminded me that Jamie and I “People are especially happy to see her in the surgical waiting area. had visited her father in TMC on Christmas Day. Her father, a Vietnam She brings a little sunshine to folks who are anxiously awaiting veteran, was discharged around New Year’s, and passed away a week word on their loved one.” later. Before he passed, he asked his daughter to find Jamie and give her his Purple Heart medal.” Christmas Day 2012 As she told the story to Harman, Karen pulled a little cloth Last Christmas, Spencer didn’t have much going on at his house and handkerchief out of her purse, and presented him with the medal. He thought maybe some patients would enjoy a visit from Jamie. He brushed admitted that it took a while for everything to soak in. “I took it home, her out, put on her vest and headed over to TMC where they spent some and when I pinned it on Jamie’s vest, I was so proud that she had time in unit 700. A woman came up to him and asked if he could please impressed somebody like that. All I know is that she brought smiles bring Jamie to her father’s room, which he did. “I remember he was an and a few minutes of peace to the man in that bed that day,” he said. older gentleman,” recalled Harman. “He was just taken by Jamie. He reached over the side of the bed and just kept petting her and smiling. We Karen had tracked them down with the help of TMC nurses, who visited him for a few minutes, and then we went on our way.” knew where the two typically spent their mornings. “When Karen approached me that morning, I thought she was just coming to say Little did Harman know that those few minutes impacted that patient in hello to Jamie. I never expected this to happen,” he said. a way he never imagined. Harman tried to get the woman’s contact information, but in a hurry and late for her flight back to Chicago, she took down his information instead and said she would send him some pictures of her father in the service. Harman has yet to hear from her, but holds out hope that one day he’ll learn more about the man who earned the medal his pup wears now. “I’ve got a proud little gal here, and I’m proud of her,” he boasted. HE LOOKED OVER AND WHEN HE SAW JAMIE, Harman recalled a day a while back when a man was walking his dog in the opposite direction in the Starbucks parking lot. “He looked over HE SALUTED ME. “CHILLS and when he saw Jamie, he saluted me. Chills came over my body. He CAME OVER MY BODY. was saluting the dog with the Purple Heart.” HE WAS SALUTING THE DOG WITH THE PURPLE HEART.” DIAPER Helping the community to bank BANK 300K diapers Sometimes all it takes is a little space to help out the community. This past fall, the Diaper Bank of Southern Arizona issued an urgent call to warehouse more than 300,000 diapers shipped into Tucson on short notice from Kansas. Tucson Medical Center and the Community Food Bank of Southern Arizona answered the call to store the booty bounty, which was part of a 2013 grant award of 2 million diapers over a two-year period from Huggies® and the National Diaper Bank Network. This was the second installment of 1 million diapers allotted for the year. Sometimes all it takes is a little space to help out the community. This past fall, The Diaper Bank of Southern Arizona issued an urgent call to warehouse more than 300,000 diapers shipped into Tucson on short notice from Kansas. Visit the link below to learn more

www.diaperbank.org/ Tucson Medical Center and the Community Food Bank of Southern there were 1.5 million requests for these supplies and the Diaper Bank Arizona answered the call to store the booty bounty, which was part of was able to distribute only 600,000. a 2013 grant award of 2 million diapers over a two-year period from Founded in 1994 the Diaper Bank of Southern Arizona was the Huggies® and the National Diaper Bank Network. This was the second nation’s first diaper bank partnering with more than 50 agencies in installment of 1 million diapers allotted for the year. Pima and six other Arizona counties. The Diaper Bank seeks to not On a Monday, the call came that two semitrailers carrying the only provide a much needed product but to address the root causes of 30,000-pound cargo stacked on 77 pallets were due in on that Thursday, poverty through its relationships with area nonprofits, each of which according to Lindsey Jones, executive director of the diaper bank. provides ongoing case work with its clients. “TMC’s support made all the difference in our being able to accept this shipment and provide these supplies to residents in Southern Arizona,” TMC WAS ABLE TO OFFER Jones said. “These community partnerships are the heart of the Diaper WAREHOUSE SPACE ON THE EL Bank’s operations.” DORADO HEALTH CAMPUS TO STORE TMC was able to offer warehouse space on the El Dorado Health Campus to store 145 pallets with 112,000 diapers, saving the 145 PALLETS organization an estimated $750 a month. WITH While the large donation makes a dent in some of the area’s severe 112,000 diaper need, the sizes provided are very limited. The Diaper Bank not DIAPERS only provides supplies for infants and babies but also for older children SAVING THE ORGANIZATION AN with special needs, disabled adults and the elderly. Last year alone ESTIMATED $750 A MONTH NEWS Happiness: The Series BRIEFS Happiness has been found to be strongly linked to improved health. For this reason, TMC was pleased to sponsor the University of Arizona College of Social and Behavioral Science’s Downtown Happiness Lecture Series at the Fox Theater. The annual series aims to explore a subject that shapes our daily well- being, with “happiness” selected for this first year. UA faculty members explored the complexity of happiness by sharing insights from their diverse fields of study, including psychiatry, sociology, anthropology, philosophy and integrative medicine. The series was a huge success with overflow seating required at all five of the lectures. Lectures covered the differences in happiness as we age or within social groups, compassion, our environment, physical activity and how happiness is viewed today compared with centuries ago. Podcasts of the individual lectures are available from Arizona Public Media www.education.azpm.org/azconnection/ OPERATION Tucson Orthopaedic Institute surgeons team WALK up with Operation Walk USA to change lives Recovering from major surgery isn’t something anyone looks forward to – unless you’re 49-year-old Carlos Lopez. Lopez is home after spending a few days in December at the TMC Orthopaedic and Surgical Tower. For him, the recovery process means he’s finally received something he’s dreamed of for years – a new hip. Carlos Lopez, Operation Walk USA patient Lopez had been in excruciating pain since August 2009 when the father of four suffered an on-the-job injury. He was on Interstate 10 when a car slammed into his food-service truck causing it to roll. Lopez’s legs were pinned beneath the steering wheel, and he was trapped for about “I TRULY CONSIDER IT A half an hour until emergency medical services could cut him out of the MIRACLE wreckage. THAT I WAS SELECTED. I KNOW Recovering from major surgery isn’t something anyone looks THE RECOVERY PROCESS WILL BE forward to – unless you’re 49-year-old Carlos Lopez. Lopez is home

after spending a few days in December at the TMC Orthopaedic and CHALLENGING, Surgical Tower. For him, the recovery process means he’s finally BUT I’M READY FOR IT” received something he’s dreamed of for years – a new hip. SAID LOPEZ. Lopez had been in excruciating pain since August 2009 when the The program was brought to TMC by orthopaedic surgeon Dr. Russell father of four suffered an on-the-job injury. He was on Interstate 10 Cohen, who was inspired by a trip to Vietnam as part of Operation when a car slammed into his food-service truck causing it to roll. Walk International. “It’s a true honor to take care of those with no Lopez’s legs were pinned beneath the steering wheel, and he was means to otherwise be helped,” Dr. Cohen said. “I wanted to help those trapped for about half an hour until emergency medical services could in need who live in our community.” cut him out of the wreckage. Four Tucson Orthopaedic Institute surgeons, including Drs. Cohen, Lopez underwent therapy, but when he returned to work a month later, Andrew Mahoney, John Wild and Larry Housman, performed the the pain continued. He endured it for years until it finally forced him surgeries on these patients in one day. to quit in January 2012. “The pain was unbearable. I would fall off the ramp at work and injure myself. I was physically not able to do my job The surgeons donated their time, as did anesthesiologists from Old anymore. Since my case had been closed, I was not eligible to receive Pueblo Anesthesia. Hospitalists volunteered their time to care for these any more help under workers’ comp,” Lopez said before his surgery. patients after their surgery. Tucson Medical Center donated the space His legs were uneven because of the problem with his right hip, forcing and necessary prescription medications. Stryker Orthopaedics provided his left leg to compensate, and he developed a hernia as well as a back the joints, and Gentiva provided home health services to assist these problem. Before his surgery, he walked with double canes for support. patients during their recovery. Lopez was one of 10 patients from around Southern Arizona who For patients like Lopez, this is just the beginning of a drastically received the joint replacement surgery they so desperately needed, but improved quality of life. were unable to afford. The care was provided through a partnership “I feel so overwhelmed and blessed,” Lopez said about being part of between Tucson Medical Center, Tucson Orthopaedic Institute, Old the program. “I truly consider it a miracle that I was selected. I know Pueblo Anesthesia and Operation Walk, a private, nonprofit, volunteer medical services organization that provides free surgical treatment for the recovery process will be challenging, but I’m ready for it. I will do patients who do not have access to life-improving care for debilitating whatever it takes to get back on my feet without my double canes.” bone and joint conditions. SINGING Pint-sized patients receive inspirational SENSATION visit from singing sensation MAKES TMC for Children had a warm welcome for singing sensation Pia Toscano, who was in Tucson to perform with Jennifer Hudson and A VISIT Jordin Sparks at Divas in the Desert, the 2013 Gala held by the American Cancer Society and sponsored by TMC. “I’m so in awe of both of them. I’m thrilled and humbled to be a part of this event,” Toscano said when she visited in the spring. “They are two very powerful women who have been through so much, yet are incredible.” Pia Toscano with patient Toscano made a name for herself as one of American Idol’s Season 10 frontrunners thanks to her powerhouse vocal ability. Pia Toscano visiting with patients See more photos on the Divas in the Desert page on Facebook www.facebook.com/DivasintheDesert “CHILDREN ARE SO INSPIRING,” SHE SAID. “THEY’RE SMILING AND HAPPY, NO MATTER WHAT’S GOING ON IN THEIR LIFE.” TMC for Children had a warm welcome for singing sensation Pia Toscano enjoyed visiting with patients and their families – chatting, Toscano, who was in Tucson to perform with Jennifer Hudson and laughing and reading books. “Children are so inspiring,” she said. Jordin Sparks at Divas in the Desert, the 2013 Gala held by the “They’re smiling and happy, no matter what’s going on in their life. American Cancer Society and sponsored by TMC. “I’m so in awe It really puts your life into perspective. I know that just making them of both of them. I’m thrilled and humbled to be a part of this event,” smile is such an important part of the healing process. ” Toscano said when she visited in the spring. “They are two very powerful women who have been through so much, yet are incredible.” Toscano made a name for herself as one of American Idol’s Season 10 frontrunners thanks to her powerhouse vocal ability. She secured a spot in the Top 9, when she was suddenly eliminated – a move that shocked many fans. Toscano said she jumped at the opportunity to perform at Divas in the Desert because she’s always been passionate about the American Cancer Society. “This is something that’s very close to home for me,” she said. “Some of my family members have had cancer, and one of my mentors passed away from cancer. It has deeply affected my life. I try to be a part of the American Cancer Society in any way possible.” RACE Race car driver Charlie Kimball shares his CAR DRIVER diabetes story with kids CHARLIE Charlie Kimball, the first driver with diabetes to race at the highest level of IndyCar, visited TMC to spread his message about how he has managed KIMBALL his diabetes while pursuing his dream of living life in the fast lane. The 28-year-old Kimball was the first driver with diabetes to qualify for, complete and lead laps at the famed Indianapolis 500. In 2012, he achieved six top 10 finishes and received IndyCar’s Tony Renna Rising

Indy race car driver Charlie Kimball Star award. Charlie Kimball, the first driver with diabetes to race at the highest level of IndyCar, visited TMC to spread his message about how he has managed his diabetes while pursuing his dream of living life in the fast lane. The 28-year-old Kimball was the first driver with diabetes to qualify for, complete and lead laps at the famed Indianapolis 500. In 2012, he Judy Rich with Indy race car driver Charlie Kimball achieved six top 10 finishes and received IndyCar’s Tony Renna Rising Star award. Kimball, who began racing go karts at age 9, deferred admission to Stanford University’s engineering program to pursue his dream of racing. He was abruptly forced to abandon his racing program mid-season when he was diagnosed with diabetes in 2007 during a routine physician’s visit. At that time, he was not sure how it would affect his racing. Determined to get back behind the wheel, Kimball worked with his HE WAS ABRUPTLY FORCED TO doctor and team to initiate a diabetes treatment plan that included some ABANDON creative precautionary tools to help him manage his condition while HIS RACING PROGRAM MID-SEASON driving. Six months later, he was behind the wheel again claiming a podium finish in his first race back after his diagnosis. WHEN HE WAS DIAGNOSED WITH Off the track, Kimball is committed to raising the awareness of people DIABETES living with diabetes and his visit to TMC is a part of a tour to motivate IN 2007 DURING A ROUTINE and inspire people with diabetes – or any other chronic condition – to PHYSICIAN’S VISIT. take control and create as full a life as possible for themselves. His story is important and his message is inspiring. His appearance was a joint effort by Arizona Connected Care (Southern Arizona’s only accountable care organization), Tucson Medical Center, and his race sponsor, Novo Nordisk. 2013 Below is a list of some of the organizations receiving financial COMMUNITY support from TMC Alzheimer’s Association Emerge! Center Against Domestic Abuse Southeast Arizona EMS Council AFFAIRS American Cancer Society Girl Scouts of Southern Arizona Southern Arizona Affiliate of RECIPIENTS American Diabetes Association Handi-Dogs Susan G. Komen American Heart Association Handmaker Foundation Southern Arizona AIDS Foundation Southern Arizona Network for American Red Cross Jewish Family & Children’s Services of Southern AZ Down Syndrome Angel Charity for Children Junior Achievement Supporting Academic Trauma Foundation Ara Parseghian Medical Research Foundation Juvenile Diabetes Research Foundation Tu Nidito Arizona Oncology Foundation Leukemia & Lymphoma Society Tucson Festival of Books Beat Cancer Boot Camp Living Streets Alliance Tucson Jewish Community Center Ben’s Bells Marana Healthcare Foundation Tucson Hospitals Medical Education Program Big Brothers Big Sisters of Tucson March of Dimes Tucson Meet Yourself Blair Charity Group Mobile Meals of Tucson Tucson Metro Chamber Boys & Girls Clubs of Tucson Mothers Against Drunk Driving Tucson Police Foundation Caregiver Consortium National Alliance on Mental Illness Tucson Regional Economic Organization Casa de los Niños National Fallen Firefighters Foundation Tucson Stroke Leadership Group Child & Family Resources National Ovarian Cancer Coalition Tucson Values Teachers Children’s Museum Tucson Old Fort Lowell Live-At-Home Program Inc. UA College of Social & Behavioral Sciences City of Tucson Moves a Million Miles Old Fort Lowell Neighborhood Association UA Presents/UA Foundation Community Food Bank of Southern Arizona Perimeter Bicycling Association United Way of Tucson & Southern Arizona Copper Queen Community Hospital Pima Community College Foundation Women’s Foundation of Southern Arizona Cystic Fibrosis Foundation Pima Council on Aging YMCA of Southern Arizona Diaper Bank of Southern Arizona Pima County Medical Society YWCA Tucson Educational Enrichment Foundation Reid Park Zoological Society El Rio Health Center Foundation Ronald McDonald House Charities 2013 Community Benefit Trends 2013 - 12.6% Percent of Net Revenue COMMUNITY 2012 - 11.4% BENEFIT 2011 - 9.7% $53 47.9% MILLION Uncompensated Care $48 (Charity Care & Bad Debt) $38 MILLION MILLION $25,634,000 43.1% Unpaid Costs $23,056,000 WHAT MAKES UP THIS NUMBER? 9.0% Unpaid Costs: TMC provides services to patients covered by AHCCCS Care program. For purposes of community benefit reporting, charity care, Outreach & Education and other public programs for people with low incomes. This is the bad debt and uninsured discounts are reported in terms of costs, not charges. shortfall created when a facility receives payments that are less than the For more information about TMC’s charity care policy, visit www.tmcaz.com. $4,833,000 cost of caring for public-program beneficiaries. Outreach & Education: This figure includes community benefit Uncompensated Cost of Care for Charity Care, Bad Debt & programs and activities that provide treatment or promote health and Total of Discounts for the Uninsured: Charity care is free or discounted health healing as a response to identified community needs. These programs $53,523,000 services provided to people who can demonstrate that they do not have and activities help improve access to health care services, enhance the the means to pay the full cost of care and who meet the organization’s health of the community and advance medical knowledge. Community Benefit = 12.6% of net revenue financial-assistance policy criteria. Bad debt consists of services for DISCOUNTS FOR UNINSURED PATIENTS. TMC will report more than $53 million in community benefit which the hospital anticipated but did not receive payment. Recognizing Self-pay patients who do not have health insurance are not in the same and charity care for 2013, or about 12.6 percent of net revenues. that self-pay patients who do not have health insurance are not in the position as insurance companies to negotiate reduced rates. In an effort to Last year, TMC reported a community benefit of 11.4 percent same position as insurance companies to negotiate reduced rates, TMC address this disparity, TMC reduces a patient’s bill by half if the patient is of net revenues. TMC calculates community benefit using discounts these patients’ bills by half; and, depending on a patient’s without any insurance coverage. Depending on a patient’s income, other standards endorsed by the American Hospital Association. income, other discounts may apply as part of TMC’s Community discounts may apply as part of the TMC Community Care program. 2013 Community Benefit Trends(continued)

COMMUNITY NUMBER OF LICENSED 2013 EMERGENCY VISITS: TOTAL ADMISSIONS BENEFIT BEDS IN 2013: 84,920 30,654 631 Adult, pediatric and psychiatric Mom/Baby: 60 Pediatric 28,393 NICU: 42 Pediatric Adult Pediatric: 44 PICU: 12 Inpatient surgeries: 8,997 364

Medical-Surgical: Pediatric ICU: 45 Adult Psychiatric: 48 56,527 Inpatient Hospice: 16 Adult Outpatient surgeries: 12,356

Babies delivered: 5,602 TMC SENIOR Healthy Living Connections

SERVICES YEAR ATTENDEES IN 2013 CLASSES AND EVENTS: PRIMARY REASON FOR CONTACTS OR VISITS: AT A GLANCE 5,348 Medicare Counseling: Outreach events & educational classes: 55 205 Alzheimer’s Disease Information, Support: Volunteers: 1,2 87 56 Volunteer Care Coach: Volunteer hours: 235 6,512 Health Resource Center: 881 Seniors Helping Seniors community support (includes phone, in-person visits): 75 4

Other Notables – provided space to American Parkinson Disease Association and Eastside Congregate Meals Program. SOURCES OF FUNDS/DATA GRANTS AWARDED BY THE TMC FOUNDATION TMC FOR CHILDREN, PEDIATRIC EXPANSION PROJECT 53%

CHILDRENS 34% TMC FOUNDATION GIFT SOURCE GENERAL PURPOSE 6% 1 2 3 HOSPICE 3% 4 5 WOMENS 3% DONOR DESIGNATION OF FUNDS

OTHER 3% CHILDREN’S 41%

OTHER 4%

GENERAL PURPOSE 4%

HOSPICE 10%

CORPORATIONS INDIVIDUALS OTHER WOMEN’S 41% 41% 36% 23% CENTER ON Every year at this time I look forward to sharing with you highlights of FROM THE the past year. It is extremely gratifying to know that each and every one VICE PRESIDENT of you are making a difference in the lives of patients and families we care for. In this edition of On Center you will read about the immediate & CHIEF impact of your gifts to TMC. DEVELOPMENT Your generosity creates opportunities for our patients to heal in so OFFICER many ways. Whether you help TMC purchase life saving equipment, invest in programs and services that better the health of our community, MICHAEL J. or create opportunities for our employees to achieve nursing degrees, DURAN, J.D. you touch the future in health care. Every year at this time I look forward to sharing with you highlights of the past year. It is extremely gratifying to know that each and every one of you are making a difference in the lives of patients and families we

care for. In this edition of On Center you will read about the immediate Orthopaedics Manager Sandi Triplett welcomes patient impact of your gifts to TMC. Sharon Seekins Your generosity creates opportunities for our patients to heal in so many ways. Whether you help TMC purchase life saving equipment, invest in programs and services that better the health of our community, or create opportunities for our employees to achieve nursing degrees, you touch the future in health care. What is most impressive about your support is that whenever we ask, their prizes but they were equally excited to have given back to TMC you are there to support TMC’s charitable mission of improving the through the Mega Raffle. health of our community. Whether it’s TMC for Children & Children’s We had a record-breaking fundraising year for Children’s Miracle Miracle Network, Peppi’s House, TMC for Women, Cardiac Rehab Network with a 10 percent increase in our national sponsors and so many more causes, you always step up to the plate with support. fundraising efforts. And all of Southern Arizona’s kids benefit from the Last year was a monumental year with the opening of the Orthopaedic impressive efforts of the nation’s top fund-raising Walmart -- the store and Surgical Tower. When we ushered our first surgical patient from at East Speedway Boulevard and North Kolb Road raised more than her third-floor surgical suite the fourth-floor orthopaedic inpatient unit, $100,000 last year! it was an historic moment that was literally years in the making. Anticipating our 30th anniversary in 2014, I look forward to It was also a banner year that saw the launch of the TMC Foundation’s celebrating another banner year with you. Healing Art Program, which was made possible by generous donations of art from our community. Patients, visitors and staff all will benefit from the improvement in the hospital environment provided by the presence of art and color. CHILDREN’S MIRACLE NEWORKD HAD A Last year witnessed the introduction of a new and innovative way to support TMC. The TMC Mega Raffle was a great success in its 10% first year. Not only did we provide a boost to Tucson’s economy and INCREASE IN OUR NATIONAL SPONSORS make money on the effort, but many of the prize winners shared their FUND-RAISING EFFORTS. WALMART personal stories of the care they received at TMC. Not only were the RAISED MORE THAN winners excited about $100,000! FROM In many ways, 2013 was a year of building. We saw the completion of the stunning four-story Orthopaedic and THE TMC Surgical Tower that has completely transformed TMC’s campus. FOUNDATION Our physician community came together to build quality, with a CHAIRWOMAN renewed focus on how to improve the experience for patients when they’re in the hospital, how to safely transition these patients home and ANNE how to best keep them from needing readmission. FULTON-CAVETT, J.D. We established a culture that stresses the importance of education with a vow not to simply hand out safety equipment without also providing the knowledge about how to use it properly, and why it’s so vital. In many ways, 2013 was a year of building. We saw the completion of the stunning four-story Orthopaedic and Surgical Tower that has completely transformed TMC’s campus. Firefighters from the Old Pueblo Firefighting Our physician community came together to build quality, with a Association visit with Eduardo Armenta renewed focus on how to improve the experience for patients when they’re in the hospital, how to safely transition these patients home and how to best keep them from needing readmission. We established a culture that stresses the importance of education with Job Corps and TMC that will help underserved young adults gain a vow not to simply hand out safety equipment without also providing valuable vocational training. the knowledge about how to use it properly, and why it’s so vital. TMC is fortunate to be on the receiving end of some extraordinary And we continued to build on our commitment to Southern Arizona community contributions. Our TMC Foundation is hard at work trying by furthering our reach of the people we help each and every day – to bring dollars into the hospital to fund services that otherwise our whether it’s patients, their families or those who provide care. patients may have to go without. Visit TMC for Children on any given day, and you’ll likely see a special group or individual taking their A specialized team of our cardiac and stroke nurses, for example, precious time to visit our precious patients and lift their spirits. We routinely heads to rural areas to educate first responders on the most continue to be blessed by many generous groups, whether they provide current best practices for pre-hospital care. Our NICU flight team is their time, talents or treasure. another example of the extraordinary community-building work that takes place. On-call nurses will board a chopper as soon as they get the Our first-ever Mega Raffle was an exceptionally fun way to build call that there is a child in desperate need of medical services, with no community support for TMC. Hearing the stories about what time to transport them by ambulance. compelled people to buy tickets, their connection to TMC and of course learning about the lucky winners - was both fascinating and We have employees who apply the hospital’s mission to their personal heart-warming. lives. Like the TMC Orthopaedics manager who used her vacation time to escort a group of World War II veterans to the National WWII Stories from the annual Children’s Miracle Network Radiothon for Memorial as part of Honor Flight. Or the TMC power plant operator TMC for Children not only warmed our hearts, but also tugged at who was so profoundly impacted by his positive experience with the our heart strings. The Tucson community stepped up in a big way Fred G. Acosta Job Corps Center that he sparked a partnership between to support one another after hearing personal stories about medical challenges no child should have to experience. The annual TMC Foundation Gala, which took us back to Old Hollywood, is a dynamic example of how the business community supported the efforts of TMC once again. Their ongoing support makes a difference in the lives of Southern Arizonans who many of us will never meet, but who will undoubtedly have their lives changed for the better. With a spotlight on TMC for Women, we focus on those WE CONTINUED TO BUILD who make most of the medical decisions for their entire family, yet ON OUR COMMITMENT TO often are so busy taking care of everyone else, that they inadvertently neglect themselves. SOUTHERN ARIZONA BY We are constantly working to maintain growth while we continue to FURTHERING deal with the uncertainty of fiscally challenging times. Your steadfast OUR REACH support allows us to continue building – building services in a hospital OF THE PEOPLE WE HELP EACH people know they can count on for exceptional, compassionate care. AND EVERY DAY. Please know how much your support means to us, and how vital it is to the health of the community we live in. In reading On Center, I think you will agree that 2013 was a community building year, and one we can be proud of. Meet the incoming chairwoman, Christine Aronoff Christine Aronoff, a senior Vice President and wealth manager at Wells Fargo Bank, has been named chairwoman of the TMC Foundation. her leadership,” he said. Anne Fulton-Cavett, who wrapped up her two- Aronoff has been on the TMC Foundation Board since 2009. This year term as chairwoman in 2013, is equally excited about Aronoff’s certified public accountant has a strong background in accounting, new role. commercial lending, brokerage and management, but her niche is the financial management and coordination of high net-worth “It has been my honor and privilege to serve as chairwoman. The family relationships, which makes her a valuable asset to the TMC Foundation staff is an incredible team and I already miss not speaking Foundation Board of Trustees. with them weekly, if not daily! I am passionate about the care our superb community hospital provides and fundraising for TMC has “During my time as chairwoman, I hope for successful fundraising been rewarding. I am proud of what we accomplished and I look as well as continuing to enhance TMC’s already strong reputation in forward to Christine’s capable leadership as I pass the torch,” she said. the Southern Arizona community. I am proud to be involved with a hospital that is so invested in the community,” she said. Michael Duran, vice president & chief development officer with the TMC Foundation, said Aronoff’s enthusiasm and tireless support for TMC will serve her well. “I know I speak for everyone at TMC when I say how excited we are to have her as chair and we look forward to Transitional Care Manager Louisa HELPING Compassionate support focuses on quality, Liguori with James Whitney PATIENTS DEAL empower patients with chronic disease WITH Living with a chronic disease is challenging enough. Living well? Some patients say it’s more effort than they can handle. But TMC’s CHRONIC chronic disease coordinators are engaging these patients with DISEASE conversations and tools that support quality of life and patient choices. A program called Living Well with Chronic Disease received a grant from the TMC Foundation and is another example of how donated Transitional Care Coordinator Brenda Carle with Donna Drulard dollars are making a positive impact on the health of our community. Living with a chronic disease is challenging enough. Living well? Some patients say it’s more effort than they can handle. But TMC’s chronic disease coordinators are engaging these patients with conversations and tools that support quality of life and patient choices. A program called Living Well with Chronic Disease received a grant from the TMC Foundation and is another example of how donated dollars are making a positive impact on the health of our community. DONATED DOLLARS MAKE See page 35 for the RTOC Decisions at end of life story POSITIVE IMPACT. Every day, TMC’s Transitional Care team is identifying high-risk The TMC Foundation funding is helping support the growth and hospitalized patients with chronic diseases who could benefit from learning of a caring community to be able to provide diligent symptom the resources this grant provides. Patients may be independent and management. Additionally, it supports the best quality of life for need guidance about preventing further disease progression; they patients who have a serious, potentially life-limiting illness at any may be struggling with symptom management; or they may need stage of the disease process. compassionate discussions about their health care options and end- The grant also allowed for training at a valuable End of Life Nursing of-life planning, and could benefit from information about palliative Education Consortium, and these care coordinators are now sharing care. The goal is to not only provide the resources for these patients, their new knowledge with patients, staff and community partners. but empower them with improved support. “We work on making the “This program directly ties our community outreach efforts to post- patient part of the team,” said Brenda Carle, TMC transitional care acute-care providers. It also ties resources to patient empowerment and coordinator. “We want them to know that what they have to say is just outcomes,” said Carle. as important as what the physician has to prescribe. Instead of telling these patients what not to do, we’re helping them think about the Those outcomes include some impressive feats. The likelihood the consequences of making good choices.” patients in this program will return to the hospital within 30 days of being discharged is decreasing. Patient satisfaction scores related Guides including Managing High Cholesterol, How to Eat to their transition of care have soared. Patients report they feel their Healthy, Managing High Blood Pressure and My Plan for an preferences are respected, and they have the resources in place to Active Life can benefit anyone battling a chronic disease at any truly understand the purpose of interventions. As for living well? stage. These guides allow for reflection and encouragement after These patients now have a network of support to assist them with their the acute phase of hospitalization. personal responsibility of making healthy choices for living well with a chronic disease. THE NICU New TMC prevention program helps The Debbault triplets: Victoria, Sophia & Cecelia AFTER CARE young patients get on the right track PROGRAM The 12 month old who wasn’t eating solid foods. The 18 month old who wasn’t walking and didn’t know how to play with toys. The 2½ year old who wasn’t talking. The 3 year old who couldn’t follow directions. Speech/Language Pathologist Brenda Abbey with the Debbault triplets Toddlers and young children like this were filling up TMC Pediatric Outpatient Therapist Brenda Abbey’s schedule. Something with their development wasn’t quite right. Their parents were concerned. These children needed help. Like she does with all new patients, Abbey started reviewing their medical histories and was stunned when she found a common thread: Many of these kids were either born premature or spent time in the USING THEIR COMBINED newborn intensive care unit. “It was happening too often,” she said. “I thought to myself, ‘what 46 YEARS OF is falling apart for this population, and how can we catch these EXPERIENCE, developmental problems sooner rather than later so that these kids THEY CREATED THE NICU don’t need therapy?’ There had to be something better than the ‘wait and see’ approach.” AFTER CARE PROGRAM Abbey started digging. She looked closer at the records of children that if we could offer this program to families free of charge, it would who spent time in the NICU – at TMC, as well as other hospitals in help improve the outcomes for these children,” explained Abbey. The Southern Arizona. She reached out to her counterparts in occupational two turned to the TMC Foundation and Children’s Miracle Network and physical therapy - how many children were they currently helping for support. who had also been born premature or were NICU graduates? “When Brenda and Julie approached the TMC Foundation about The connection she found – was alarming. funding this program, their research painted a picture of a serious need for this population. We believe this will be a pivotal program for the Abbey, along with TMC Developmental Nurse Specialist Julie development of these children,” said Erika Grasse, TMC Children’s Seidl, knew what had to be done. Using their combined 46 years of Miracle Network Director. “We applaud the efforts of these therapists, experience, they created the NICU After Care Program. The pair works and all TMC staff who are able to identify problems or trends when it together to identify babies who are about to be discharged from the comes to our patients, and then offer a solution. We felt compelled to NICU and who qualify for the program. These included babies who are do what we could to help these therapists, in turn, help these children having a hard time feeding or had been drug exposed, as well as babies and their families. It’s the right thing to do, and we couldn’t have born before 35 weeks gestation. “Research shows that babies born funded the NICU After Care program without CMN dollars.” before 35 weeks gestation are at a higher risk for having language and cognition delays later in life,” Abbey explained. The voluntary program requires the baby to return to TMC about two weeks after discharge. Abbey and Seidl will examine the infant’s “Our program is essentially developmental follow-up,” said Seidl. “It’s feeding and do a developmental screening. Behaviors and tendencies not a new concept, but historically it’s been an expensive model.” Seidl that may seem like “no big deal” to mom and dad can signal red flags cited a similar program that lost state funding a number of years ago. for the child’s speech, hearing or gross motor development. “This tracking is so important, and we didn’t want any family to shy away from receiving this help because they couldn’t afford it. We knew “We are able to identify problems in children this young. If the child behaviors mean. They’ll tell them what to expect in the coming weeks prefers to move their head to one side, for example, we’re able to and what to do if they don’t see their child doing certain things. diagnose torticollis, a stiff neck that results from a child having a The two started tracking the first babies as part of this program in side preference. We’re also able to tell if a baby’s head is becoming November 2012. Already, they’ve seen their work – and their push misshapen. If we are able to catch these things early and educate for prevention – pay off. “We’ve had families who need to bring their the parents, we may be able to get that child on a preventative track babies in once a month because of the education they’ve received as opposed to waiting until they’re a toddler when the problem rather than having to bring their child in for therapy once or even twice becomes much more prevalent, and the therapy track is much more a week when the child is older,” said Abbey. complicated,” explained Seidl. In November 2014, the first babies turn 2 and the team will have hard Parents are asked to bring the child back at 4-6 months of age, at the first data on how this program is making a difference. Until then, the NICU birthday, at 18 months and finally – around the second birthday. Four to After Care Team will continue to advocate for these children, and serve six months of age is a big transitional time for a child’s feeding, motor as a lifeline for their parents. and developmental skills. “At that age, I can’t tell if a child is going to have a speech and language delay later in life – but research tells me they are at higher risk. So I want to see them,” said Abbey. ONE STOP SHOP The 2-year mark is also an important milestone because, as Abbey TMC’s Pediatric Outpatient Therapy, which receives support from explains, premature babies should have caught up with their age- CMN dollars, is the only place in Southern Arizona that offers a “one matched peers by age 2. That’s when “the playing field is leveled.” stop shop” for audiology, speech, physical, and occupational therapy with a pediatric focus. In 2013, TMC’s pediatric outpatient therapists At each visit, the NICU After Care team emphasizes education. They performed 2,000 therapy evaluations, and had 17,400 therapy visits. teach these families what to look for and help them learn what certain CARDIAC Friends of Cardiac Rehab address the heart REHAB of the matter with scholarship program When Tucson resident Peg Doherty suffered a heart attack in the fall of 2012, it may have been a blessing in disguise. She was stunned to learn that one of her arteries was 90 percent blocked. She recovered, but was soon faced with an equally frightening thought: her doctor said she needed to start cardiac rehabilitation. It’s a supervised exercise program that helps cardiac patients strengthen their heart muscle in a safe environment. “I was terrified to go to cardiac rehab because I thought Peg Doherty any kind of exercise may trigger another heart attack,” she said. When Tucson resident Peg Doherty suffered a heart attack in the fall of 2012, it may have been a blessing in disguise. She was stunned to learn that one of her arteries was 90 percent blocked. She recovered, but was soon faced with an equally frightening thought: her doctor said she needed to start cardiac rehabilitation. It’s a supervised exercise program The Cardiac Rehab volunteers at the bowling event: Anthony Mastrangelo & Dominic Dominice that helps cardiac patients strengthen their heart muscle in a safe environment. “I was terrified to go to cardiac rehab because I thought any kind of exercise may trigger another heart attack,” she said. But that was just one part of her hesitation. The other part was the price. support and generosity of TMC immediately because we tell them, Each visit costs upwards of $200 for cash-paying patients. It’s covered ‘we can help you financially,’” said Mark Gaxiola, TMC Outpatient under most of the big insurance companies, but oftentimes patients are Cardiac Rehab supervisor. “This scholarship fund helps these patients still required to fork over a hefty co-payment. That was the case for receive the assistance and direction in improving the functionality of Doherty. Under her insurance plan, she had to come up with $45 for their hearts while building their endurance and providing that social each visit. Most patients need 36 visits. Do the math, and that’s more network piece that helps improve their overall emotional state.” than $1,600 she would have to come up with in order to complete the FOCR organizes various fundraisers throughout the year, including program. At 83 years old and on a fixed income, it just wasn’t feasible. a bowling tournament which helped bring in $2,000. A generous Luckily for Doherty, there is a scholarship program in place that she contribution of $7,500 was also made to the fund by the TMC qualified for to help lessen the blow. The idea of offering financial Auxiliary. Since the scholarship program started, FOCR has donated assistance to patients in need started a few years ago with Friends of $12,500 to the TMC Foundation, which in turn, has awarded Cardiac Rehab, or FOCR, a team of former cardiac rehab patients who scholarships to patients like Doherty. are described as a “small group, with big hearts.” On average, about two dozen patients who receive financial assistance They believe in the program whole-heartedly and work to raise come through the program each year. “There are not many outpatient awareness about its benefits. The group worked with the TMC cardiac rehab programs that have a scholarship fund in place like we Foundation to establish the scholarship program for patients who don’t do,” said Gaxiola. “It’s a unique program offered through FOCR. have insurance, those who have high co-pays, or anyone who needs Many people who need cardiac rehab don’t enroll because they look this life-saving therapy and simply can’t afford it. at their budgets. It’s a financial decision, not a health decision. FOCR eliminates that from the equation and gives these patients the choice to “The cost of the program is often a patient’s biggest concern. When improve their quality of life through outpatient cardiac rehab. Our goal they hear about the scholarship program, they’re elated. They feel the is to keep these patients out of the hospital.” With the help of this scholarship fund, and assistance she received from her children, Doherty signed up for the program. The burden of how to pay for the program was lifted, but she was still resistant. What if starting an exercise program caused another heart attack? She says that issue was cleared up within the first couple of minutes in her initial visit. “They showed me the equipment. I met all of the health professionals who were there to help me. The nurses are extraordinary, ON AVERAGE, ABOUT and since there is a doctor there, I feel safe exercising,” she said. TWO Doherty has graduated to phase three, a maintenance plan in which patients can come in as much as five times a week for $55 a month. DOZEN PATIENTS She’s committed, and says she’ll never stop going to TMC’s cardiac WHO RECEIVE FINANCIAL rehab. “It has definitely changed my life. I have such a better outlook ASSISTANCE COME THROUGH on life now. Before I started cardiac rehab, I was happy just staying at THE PROGRAM EACH YEAR home. Cardiac rehab has pumped new life into me. I feel absolutely wonderful, and my entire life has turned around. I am so grateful for the assistance of the scholarship program.” On Center Auxiliary story about Ginny Robbins Robbins is one of 500 active volunteers who graciously give their time to • Gift Shop Improvements: $22,000 TMC on a regular basis. An incredible force that, she said, is a testament • Shared cost between TMC and the Auxiliary for a much-needed to the good work TMC does for the community day in and day out. While renovation to the main Gift Shop. helping others by giving their time is one of the main roles of the TMC • Employee purchases represent 85 percent of the shop’s total sales. Auxiliary, another responsibility is fundraising for • TMC’s community programs. • Cardiac Rehab: $7,500 • Total Volunteer Hours: 79,000 • For the Friends of Cardiac Rehab scholarship program that allows cardiac patients to receive the rehabilitation they otherwise would • Full-time Equivalent Positions: 41.1 not be able to afford. • Average number of volunteers working each day: 78 • Hospice: $5,000< • Total Contributions: $184,900 • Supports families’ needs including hotel rooms, rental cars, food and • Joel. M. Childers, M.D. Women’s Center Capital Campaign Pledge general assistance. Payment: $50,000 • TMC Foundation Events: $4,000 • First installment of a five-year building pledge. • Annual Gala tables and Rock ‘N Rodeo. • Breast Screening: $50,000 • Auxiliary Programs: $45,900 • Hospital-based program that provides life-saving mammograms to • Associated costs for Auxiliary-run programs. underserved women. UNLIKELY Stroke survivor gains mobility, gives back to STROKE CMN using unlikely therapy tool THERAPY Maria Hinton was just 42 when it happened. “I’m still alive, and I do have “I was in a store, walking over to meet my friend when suddenly everything a heart, and I refuse to just looked hazy. I couldn’t hear anything. I couldn’t say anything,” she recalled. sit here in this wheelchair and feel sorry for myself.” Maria collapsed. Maria Hinton Fortunately a stranger close by was able to catch her. Kevin & Maria Hinton Maria had suffered a stroke. “The left side of her body was affected,” explained Maria’s husband, Kevin. “Doctors didn’t expect her to have much mobility afterwards or be able to speak again.” But Maria surprised everyone. Over the next year, she learned how to talk again with the help of a dedicated speech therapist. Unfortunately, the stroke wiped out all of her basic knowledge. Things like simple math and English – were foreign to her. “All of the things most people take for granted, she had to re-learn,” said Kevin. While Maria made remarkable strides with speech therapy, her physical rehabilitation didn’t produce the same results. “I felt like I had to do something to try and help myself,” said Maria. “I She kept playing and kept winning. She developed quite the collection couldn’t just sit there in my wheelchair and give up on myself. I know – and kept adding to it. “People started asking me, ‘what are you going God is always with me, and I had to do something to try to get my to do with all those toys?,’” she said. At first, she would take them mobility where I wanted to be.” around the store and give them to children – just to brighten their day. She gave a bunch to local firefighters so that they could help comfort That ‘something’ popped in her head one day when she saw people children during tragedies. But even still - she had more plush toys than winning plush toys out of a claw machine at Sam’s Club. The machines she knew what to do with. are commonly found in video arcades, supermarkets, shopping malls and the like. The player inserts a couple of coins into the machine and She was in Sam’s Club again when another idea came to her. manipulates a joystick that controls the claw before it descends down and makes an attempt to grip a toy. The store was fundraising for TMC for Children, Children’s Miracle Network. Perhaps she could sell these toys and donate the proceeds “I told her, ‘that would be good therapy for you,’” said Kevin. “Let’s to CMN? After all, she and Kevin were familiar with the good work try it. It’ll be good for your coordination and who knows – someday, CMN does – they had donated to the organization before. The store’s you might just win something.” associates set up a table for her, and Maria started selling while becoming an advocate for Southern Arizona’s children. Maria discovered that the machine helped her right away. “I couldn’t stand very well, but by holding on to the joystick, I was able to stand,” When sales started to slow down, they switched tactics. Instead of she said. selling these toys, what if they simply asked for donations, and then – no matter the amount – handed over a plush toy? It made perfect At first, she would burn through about $200 in quarters every month – sense. “If someone makes a donation, I give them a toy as a token money well spent since it was great therapy for her. She eventually got the of appreciation,” explained Maria. “I like to surprise them and say, knack of the machine, and it wasn’t long before she started winning toys. ‘would you like to take a toy home?’ They always get a kick out of it. I Lots of them. tell them it’s a thank you gift,” she laughed. While she hasn’t kept track of how many animals she’s won or handed out, or exactly how much money she’s donated to CMN, she says in A Letter From Maria the 10 years she’s been doing this, it’s well into the thousands. But she can’t put a price on how much those claw machines have helped her mobility. “She’s surprised me quite a bit,” said Kevin. “After her stroke, doctors didn’t expect her to be able to move her left arm or left hand at all. She is now using her right hand to help her left hand function.” The couple –married for 27 years – is outside Sam’s Club every weekend when the store is fundraising for charity. It’s for Southern Arizona’s children. It’s their chance to give back. And it’s an opportunity to meet others. “People always ask me why I do this, and my answer is always the same,” said Maria. “This is the body the Lord gave me. There are people who are worse off than me and I’m here to support them.” Maybe she’ll inspire someone to look at their life a little differently – maybe they’ll act a little more selfless. “Just because something bad happened to you, you can’t give up. You can make something of yourself. I can’t use half of my body, but I can do something that will help somebody else and try to make them feel good,” she said. Children’s Miracle Network and 94.9 MIXFM TMC for Children, Children’s Miracle Network was proud to partner again with 94.9 MIXfm for the annual Mix Miracles CMN Radiothon. Bobby Rich, Mrs. Grant and Greg Curtis powered on for two solid days, broadcasting live from the lobby of the Pediatric Emergency Department to help raise $263,709 for local children. Every penny stays here in our community, providing life-saving equipment and therapy to children who depend on it. VOLUNTEER Life, love and longevity: why a standout STANDOUT volunteer continues to value service When Ginny Robbins signed on to volunteer at TMC in the Ambulatory Surgery department back in 1993, she made a commitment to the hospital that she had long considered home. “To me, it was a job,” she TMC volunteers said with a smile. It was two years into her retirement from Tucson Unified School District, and she was looking for something to fill her days. “I love everything about this hospital,” she said. “I love how people are treated. I love what TMC does for the community, and I TMC volunteer Ginny Robbins completely agree with its values.” When Ginny Robbins signed on to volunteer at TMC in the Ambulatory Surgery department back in 1993, she made a commitment to the hospital that she had long considered home. “To me, it was a job,” she said with a smile. It was two years into her retirement from TUSD, and she was looking for something to fill her days. “I love everything about this hospital,” she said. “I love how people are treated. I love what TMC does for the community, and I completely agree with its values.” For Robbins, TMC is full of good memories – the births of her son and granddaughter – and also some painful ones – like the weeks she spent with her husband, Jim, as he battled illnesses and underwent serious operations until his death in 1998. “A few months after he passed away, I was invited by Kate in the employee grievances for TUSD serves her well in this role. “It may be Volunteer Office to attend a volunteer luncheon, and I was seated somebody’s bad day. But the most important thing to me in that moment with those who work in the surgery lobby. They were encouraging is making sure they leave TMC happy. I express empathy for what these me to come join them. At first, I told them I absolutely could not do people are going through, and I feel for them. I do my best to solve it. I had spent way too much time in that lobby worrying about Jim. I their problems, and when I’m able to, their thanks is what makes it all had bad memories there, and it just hit too close to home. But I found worthwhile. I do everything I can to make sure their hospital experience the strength, and I did it.” Volunteering allowed her to channel that was good,” she said. heartbreak into help for others who were in a similar situation. Caring for others is a fundamental part of who Robbins is. Over the course Robbins realizes now that the move was as good for her as she was of more than 25 years, including time she was still working, she was a for others. “I knew exactly how these people were feeling, and so I caregiver for her mother and father, husband, aunt, and a family friend. knew how to help them,” she said. The experience was rewarding – During the more than two decades Robbins has been with the TMC and as she describes it, a godsend after her husband passed away. She Auxiliary, she’s served on the Auxiliary Executive Committee in was there for about seven years, did another seven-year stint at the most positions and was president in 2003. She also spent many years Northeast entrance, and also spent time volunteering at Hospice. helping organize the annual LoveLight ceremony, a tree-lighting event Who knew, though, that the spot that would make her most happy would that marks the approach of the holiday season each year at TMC and be the Concierge desk of TMC’s new Orthopaedic and Surgical Tower, benefits TMC Hospice. where she co-chairs the desk and volunteers two mornings a week. Robbins has established a number of life-long friendships over the “The people are fantastic, every day is different, and I am constantly years through the Auxiliary and says every time she puts on her teal learning new things,” she said. Does she have to deal with people who smock, she thinks to herself, “Today is going to be a good day because are upset? Absolutely. But the years she spent handling teacher and I’m going to help somebody.” With a firm belief that “longevity is more important than your hours,” Robbins has no plans to quit serving. She insists that what she takes home from each shift trumps what she gives. “I love the feeling of giving back,” she said. “I truly enjoy helping others and knowing that I have done something good for somebody.” “I LOVE EVERYTHING ABOUT THIS HOSPITAL,” SHE SAID. “I LOVE HOW PEOPLE ARE TREATED. I LOVE WHAT TMC DOES FOR THE COMMUNITY, AND I COMPLETELY AGREE WITH ITS VALUES.” TMC Volunteer Services: By The Numbers Robbins is one of 500 active volunteers who graciously give their • Shared cost between TMC and the Auxiliary for a much-needed time to TMC on a regular basis. An incredible force that, she said, is a renovation to the main Gift Shop. testament to the good work TMC does for the community day in and • Employee purchases represent 85 percent of the shop’s total sales. day out. While helping others by giving their time is one of the main Cardiac Rehab: $7,500 roles of the TMC Auxiliary, another responsibility is fundraising for • • TMC’s community programs. • For the Friends of Cardiac Rehab scholarship program that allows cardiac patients to receive the rehabilitation they otherwise would • Total Volunteer Hours: 79,000 not be able to afford. • Full-time Equivalent Positions: 41.1 • Hospice: $5,000< • Average number of volunteers working each day: 78 • Supports families’ needs including hotel rooms, rental cars, food and • Total Contributions: $184,900 general assistance. • Joel. M. Childers, M.D. Women’s Center Capital Campaign Pledge • TMC Foundation Events: $4,000 Payment: $50,000 • Annual Gala tables and Rock ‘N Rodeo. • First installment of a five-year building pledge. • Auxiliary Programs: $45,900 • Breast Screening: $50,000 • Associated costs for Auxiliary-run programs. • Hospital-based program that provides life-saving mammograms to underserved women. • Gift Shop Improvements: $22,000 HEALING Connecting art, healing, public health Jo Ann & Tom Loomis FROM It’s been shown to reduce stress and anxiety. Lower blood pressure. Reduce the need for pain medication. Increase a patient’s trust and THE ART confidence. And be a positive distraction for patients and visitors in what can be an intimidating setting. Art is powerful. And in a hospital setting, so are its therapeutic effects. The TMC Foundation believes in the healing power of art and strives to create spaces that will comfort and enhance the surroundings for TMC patients and their families. With a vision of accomplishing this with paintings, graphics and sculpture, the TMC Healing Art program was launched. Artwork has been acquired through donations and bequests of both individual and multiple works from Tucson area art collectors. “WE WHOLEHEARTEDLY Len and Doris Coris have donated three portfolios of original graphics and have committed to give the rest of their art collection to the TRUST THEIR JUDGMENT, program. “There is substantial evidence that the presence of art and AS THIS GROUP PROVIDES color in a hospital has a positive effect on patients, visitors and staff. IMMENSE VALUE TO THIS PROGRAM,” SAID MICHAEL DURAN. For this reason, we are very pleased to have pledged our personal art A group of dedicated community volunteers select art appropriate collection to the TMC Healing Art Program and hope that this will for a hospital setting and determine its best placement. Jerry Freund inspire other collectors to consider a similar donation,” they said. is a Western art collector who works at the Medicine Man Gallery “Our work with the TMC Foundation, the Art Committee and the new in Tucson, which specializes in Native American Art. Lauren Raab consulting curator has provided a solid foundation for the Healing Art is a former gallery owner and former curator of art at the University Program, the effects of which will be felt for generations to come.” of Arizona Museum of Art. Kay Ransdell worked for the prestigious Massachusetts College of Art and most recently consulted for various The program will take many years to fully develop, but patients, professional art colleges. Sandy Maxfield is a former board member visitors and staff are already seeing – and feeling - the benefits for the Tucson Museum of Art and is a current board member for the provided by the presence of art and splashes of color in the hospital Amerind Museum. environment. “Our ultimate goal is to populate the miles of walls, the numerous courtyards and the many public areas at TMC with “The diverse expertise provided by this group adds to the integrity and appropriate paintings, photographs, graphics and sculptures,” said longevity of this program,” said Duran. “We are so privileged to have Michael Duran, vice president and chief development officer, TMC not only have their prowess, but also their time. We wholeheartedly Foundation. “Initial funding helped start and publicize the program trust their judgment, as this group provides immense value to this as well as pay for the transportation and framing of donated artworks. program,” said Duran. A highly qualified consultant also serves as program coordinator These gifts will provide comfort to patients and their visitors for decades and promoter. The TMC Foundation provided $25,000 in matching to come – with the hope is that others will be inspired to donate or funds, but we are always seeking charitable contributions to allow our bequeath part of their fine art collections to TMC’s Healing Art Program. volunteers to continue providing depth to this program.” For more information about getting involved with TMC’s Healing Art program please call Michael Duran at (520) 324-2501. In May 2013, when Tucson Orthopaedic Institute relocated to the TMC Photographer Donates Works Orthopaedic and Surgical Tower, Loomis decided to contribute even To Say ‘Thanks’ For Great Care more pictures to the fourth floor, the inpatient orthopaedic unit. “It really adds to the ambience that makes the fourth floor feel less like a Research suggests artistic nature scenes, specifically, in a hospital hospital and more like a healing environment,” said Dr. Housman. “It’s setting play a key role in creating a healing environment that can a nice reflection of a good patient experience. The nurses and other improve patient outcomes. doctors enjoy it as well.” Award-winning photographer Tom Loomis didn’t exactly have that “TMC is an exceptional hospital, and the people who work here are fantastic. in mind when he donated a handful of nature photographs to Tucson Dr. Housman has done nothing but excellent work for us,” said Loomis. Orthopaedic Institute. Instead, it was his way to thank Dr. Larry Loomis ran the Flagstaff Lumber Co. for 25 years, and then owned Housman – an orthopaedic surgeon he had gotten to know well over Tom’s Hardware for the next 10 years where he became known as the course of 15 years. Loomis and his wife, Jo Anne, both had their “Mr. Hardware.” He was 48 years old when he bought his first camera left and right hip joints replaced by him. “We were so pleased with Dr. and enrolled in a photography class at Northern Arizona University. Housman’s work that Tom just brought a print in to say ‘thank you.’ He was awarded Arizona Professional Photography’s Apple Award Then it was another one, and another one, and another one,” laughed in 2010. His work can also be found in offices and exam rooms at Jo Anne. medical clinics, dentists and ophthalmologists around Arizona. “It “I put the photographs up in the exam areas, and I got tons of means a lot to me that I’ve done some work that people will see for compliments about them,” said Dr. Housman. “Patients and their a long time. When we are no longer here, there will be others who families describe them as ‘remarkable,’ and would often comment that appreciate my work, and that’s why I do it. I want people to be able to they look like paintings.” enjoy some places that they may never get to experience.” PAYING Tucson couple enriches the lives of TMC IT FORWARD employees in loved one’s memory For years now, friends and family of Tommilee Phillips and her Tommilee Phillips & Dick Keiler husband Dick Keiler have known that a gift to a local food bank trumps a food basket at Christmastime. Or on birthdays. Or anniversaries. “We realized long ago that we got more genuine pleasure out of a donation in our name than anything else we could think of,” said Keiler. And over time, the idea has multiplied. “Now we have more than a dozen family members and friends who are doing the same thing. And they Frances Bond are being rewarded with the same gratification,” he added. It has been in that spirit that the couple has spent a good part of their retirement working with individuals and organizations in need. They spend their time raising money or establishing programs, adopting families or helping schools. So when Phillips’ beloved sister Frances Bond died in August 2013, the couple naturally began to think of ways to cherish her memory by giving back. Then an idea struck them. “My “WHY NOT START A sister – we always called her ‘Tootie’ – was such a special human being,” said Phillips. “She had a great sense of humor, and spent her FUND entire life taking care of others as a wife and mother to four children, as THAT FOSTERS a nurse and as a friend. So we thought, ‘why not start a fund that fosters care giving?” CARE GIVING?” It wasn’t long before a meeting with Michael Duran, vice president and “Tommilee and Dick are an example of two people who not only chief development officer, TMC Foundation, led to the formation of a believe in providing for others, but make it happen,” said Duran. “By memorial scholarship fund to support the work of TMC-U. TMC-U is a establishing this fund, they will assist TMC employees who dream of health-professional education program that offers TMC employees access earning their nursing degree, and improving their lives while making a to academic programs to prepare them to enter the nursing field and other commitment to care for others. I admire and applaud how this couple aspects of health care. As part of the program, TMC pays for most of the prefers charitable donations rather than exchanging gifts and hope cost of tuition and books for eligible employees who commit to work for it’s a concept more Tucsonans will adopt. On behalf of the TMC-U the organization after successfully completing all requirements. students who will benefit from this generosity, thank you.” “Over the 13 years we’ve been in Tucson, we have come to really like Phillips and Keiler hope one day to meet someone whose life was and admire TMC,” Keiler said. “So when we discovered that they had affected by the fund. Someone who was able to create a better life a professional education program offering employees of the hospital through hard work and dedication and a boost from financial aid. And access to academic programs to prepare them for a nursing career, we they would like to think that others will consider honoring loved ones realized we had found a natural fit. Helping someone in Food Service in this way. Meantime, they will continue to reap the joy of giving or Transportation, for example, fulfill his or her dream of becoming a while looking back on lives well lived. nurse would be the perfect way to remember Tootie since nursing was such a passion for her.” Phillips agrees. “This is such a perfect way to honor my sister. We are so impressed with what this program does. It gives both of us great comfort to know that she will be remembered in this enduring way. I believe she is up in heaven now smiling. And very, very proud.” The TMC Foundation Partnership With Blue Cross And Blue Shield The TMC Foundation is fortunate to have a strong partnership with Blue Cross and Blue Shield of Arizona. Through the efforts of Maribel Barrios, the TMC Foundation has received generous support for Women’s Health and Wellness. BCBSAZ sponsored the annual Gala and various women’s programs, and they and co-sponsored Vivir la Vida. The free bilingual women’s health event features physician presentations, a healthy lunch, cooking demonstration and health screenings for bone density, pulmonary function, blood pressure, diabetes and cholesterol. More than 230 women received this valuable health information. BCBSAZ has dedicated efforts in the Hispanic community for many years and this is one example of its commitment to the Latina community. The TMC Foundation is very lucky to work with businesses like BCBSAZ and look forward to a partnership that continues to flourish for years to come. Thank you, BCBSAZ! DEMENTIA TMC and Handmaker fill a void in CARE dementia care for compromised elderly in Tucson For more than 40 years, Tucson Medical Center and Handmaker Jewish Services for the Aging have had a strong relationship rooted in HANDMAKER cooperation and respect with the ability to pinpoint and address critical needs in the community. One of these issues involved the growing RAISED AN ADDITIONAL problem of the geriatric-psychiatric, or gero-psych, community in $1.5 the Tucson area. There are limited services available that offer an appropriate level of care for this very specific patient population. MILLION WITH THE HELP OF A combination of professionals, volunteers and donors created a unique THE TUCSON COMMUNITY and compassionate approach to caring for these people, who oftentimes suffer from dementia. “Having TMC and Handmaker team up for this concept makes great sense,” said Don Shropshire, TMC president emeritus. “This will meet a need that exists and is not currently being adequately met.” Learn more about the Paul & Lydia Kalmanovitz Elder Care Center by visiting the link below www.handmakerfoundation.org/ The Paul & Lydia Kalmanovitz Elder Care Center is being constructed The first floor of the center will be run by Handmaker and will consist on the Handmaker campus, with an anticipated completion date of of a 20-bed unit focused on intensive dementia and Alzheimer’s care. late 2014. It’s a free-standing 36-bed dementia, Alzheimer’s and gero- The unique residential setting will provide long-term care to this very psych facility that will be the first of its kind for Southern Arizona. specific patient population. TMC will operate the second floor, a 16- The state-of-the-art facility is funded completely with philanthropic bed unit dedicated to gero-psych care. It will provide acute psychiatric money. TMC received a $3 million grant from the Paul and Lydia care to patients who require a short-term stay. Martin describes the Kalmanovitz Foundation of San Francisco to build a facility that type of patient who may receive acute care in the new facility: “A would provide exceptional and unique dementia care to elders in need. urinary tract infection, for example, to a compromised 85-year-old Handmaker raised an additional $1.5 million with the help of the could make a perfectly lucid, calm person seem like someone who Tucson community. is violent and delusional.” He used a Bell scale to illustrate the cycle of life and how oftentimes treatment of the elderly is not dissimilar “This facility will be for the advanced elderly, possibly suffering from to pediatric patients as organ systems are more fragile at either end some sort of dementia, including Alzheimer’s, and most likely already of the Bell curve. “Everyone understands how quickly simple things in an assisted-living or skilled-nursing facility,” explained Art Martin, can affect an infant. At the other end of that curve, the advanced and Handmaker CEO. The influx of this patient population is expected to compromised elderly are the same way. Something simple that you and grow. By the year 2050, an estimated 16 million older adults will suffer I would shrug off can send them over the edge to where suddenly they from dementia, costing our health care system more than $172 billion are not the same person.” annually. More importantly though, the families of these patients are immensely impacted. Handmaker provides some comfort and certainty about the road that lies ahead for these patients in the Tucson community, their families and caregivers. Another trigger could be a mix of medications that cause more Shropshire added that having this new elder care center could problems than they solve. Assisted-living homes may not be help reduce hospital readmission rates. He knows that helping the equipped to appropriately deal with these patients when they compromised elderly requires immense sensitivity - and that it’s more experience a change in their mental activity and have a behavioral than just the patients who deserve our care. “We also must help the outburst. The acute-care part of the new facility will stabilize these family. They are dealing with the emotions of seeing their loved one patients, and get them back to where they are currently living. deteriorate. At TMC, we know the importance of caring for the entire “These patients’ families take great comfort from knowing that our family, and it’s something that we will continue to do at this new goal is to get their loved one stabilized so that they can return to the facility.” environment where they are happiest,” said Martin. The long-term care portion of the facility will have a different focus. It will give comprehensive and dignified elder care to patients in a safe setting that becomes familiar to them. It’s better for these patients, Martin said, than being sent to multiple care homes, and even hospital emergency rooms. “It’s very sad, as the worst thing you can do to an elderly dementia patient is ship them from location to location. That’s what is currently happening in Tucson because there are few options for these patients. This new facility will provide a welcoming place for these patients which, in turn, will give their families peace of mind knowing that their loved one is getting proper care rather than falling through the cracks of the system,” he said. ERICKSON “We’ll do it later” LEGACY Hope and Alan Green knew they had to update their wills, but they never carved out the time to actually sit down and do it. “We had an SOCIETY old, bad habit of saying ‘this is the year we’ll do it,’” said Hope. A SPOTLIGHT ON habit that was about 20 years overdue in a 31-year marriage. HOPE AND The retired mail carriers moved to Tucson from Miami in 2008. ALAN GREEN Blessed with good health, their need for a hospital was not immediately important to them. They saw an ad in the newspaper about a class being offered at TMC Senior Services about elder law and financial preparedness. They attended and soaked up good information. Perhaps most importantly, they left inspired to actually take care of business. The pair attended another class that was offered through the TMC Foundation Planned Giving Council. “The lecture was full of laughter and the presentation was directed right at us - all the reasons that we needed to take care of this monumental business NOW. We didn’t realize Hope & Alan Green how important it was because of changing our residency to a new state,” said Alan. “What do you do when you move across the country and lose your support network?” asked Hope. “Who helps you through this maze of trusts, wills, and financial and medical powers of attorney?” The TMC Foundation staff assisted the Greens by guiding them us, and how incredible that it keeps spreading and enhancing the lives through difficult conversations. “We were able to get all of our of Tucsonans and beyond,” they said. questions answered and were able to set up our estate to the best of our To learn more about the TMC Foundation’s Planned Giving Council, ability. Now we can truly relax and enjoy our future, and each other,” please contact Julie Wolfe-Beadle at (520) 324-3411. said Hope. “As part of the process, we visited TMC and learned all about its rich history and vital role in the Southern Arizona community. We appreciate the spirit of this wonderful and dedicated group of people who have an awesome track record of helping our community in so many different ways while having great foresight for the future. Out of all the different hospitals in the Tucson area, TMC showed us which one we want to be ‘our hospital of choice.’ Our bequest follows our hearts – to give back so that TMC can continue giving to the community,” they said. “NOW WE CAN TRULY The Greens said the process helped enhance their mental health by providing them with the peace of mind that this work is finally done. RELAX They’ve discussed the process with close friends – which has prompted AND them to tackle this important planning sooner rather than later. ENJOY OUR “We appreciate working with the TMC Foundation and are excited to have the opportunity to pay our good fortune forward. What a gift FUTURE, TMC gave AND EACH OTHER,” SAID HOPE “A REAL Former TMC patient wins big after RAFFLE devastating diagnosis FOR REAL For Tucson resident Renee Sowards, 2013 was bittersweet. In January, she was diagnosed with a tumor in her spine. Just three months later, PEOPLE!” her life took a 180-degree turn. Today, she’s healthy – and driving around in a brand new Audi coupe– all because of the care she received at TMC and a decision to buy tickets for TMC’s first-ever Mega Raffle.

Renee Sowards Shortly after her diagnosis, Sowards began researching which neurosurgeon she would literally trust her life with. She decided to go with Dr. Abhay Sanan from the Center for Neurosciences. She called his office to get the new patient process started, and hadn’t even made an appointment yet when she received a phone call that confirmed she had made the right choice. “My phone rang at 8 o’clock on a Sunday night. It was Dr. Sanan. He said ‘I need to see you right away.’ I told I DON’T CARE WHICH him I had jury duty the next day. He paused and said, ‘So I take it PRIZE I WON, I WAS JUST you’re still ambulatory?’ I knew right then that my situation was very serious,” she said. “Because of where the tumor was located, I stood a DELIGHTED great chance of losing my legs.” TO BE A WINNER! Two weeks later, Sowards was in the operating room. Her surgery Kathy Rice from the Mega Raffle told Sowards she was an Early Bird was a success. When she learned she would spend the next five days winner and won one of three great prizes – but… she’d have to come at TMC recovering, Sowards had a unique request for hospital staff. down to the car dealership the next day to learn which fabulous prize “I asked if Keigo, our 140-pound well-behaved Akita could stay with it was. “I pulled out my brochure and looked at the Early Bird prizes me in my room.” To her surprise, the answer was yes. “It was so and was so excited! I didn’t sleep at all that night. I just kept thinking, comfortable to be able to sit in my chair and just rub my toes on him ‘either I’m going to travel somewhere or I’m going to get a brand new as he lay at my feet. Having him there really helped me heal,” she car.’ Truthfully, I didn’t care which prize I won. I was just delighted to said. “My husband had a hard time leaving my side when I was going be a winner!” through this. Knowing that I was receiving the best care and had Keigo with me gave him the peace of mind he needed to go home at night.” When she arrived at the dealership, Sowards learned $14,000 cash plus the 2013 Audi A5 Premium Plus Coupe Quattro Tiptronic was hers! Sowards recovered and eventually headed back to work where a TMC It was quite the change for the self-described “soccer mom” who has Mega Raffle brochure arrived in the mail. “I flipped through the pages driven a minivan for the past 25 years to haul kids around town, or and thought, ‘what a great way for TMC to raise money.’” And then a pick-up truck to take the dog places. “I still can’t believe it. I keep she saw a testimonial from one of Dr. Sanan’s other patients. “When getting up just to look at it in my driveway. The TMC Mega Raffle is I saw that, I thought to myself – I had such excellent care at TMC a real raffle for real people. The hardest part about winning? I had to and Dr. Sanan was so wonderful, I’m going to buy three tickets as a break it to Keigo that no dogs are allowed in the new car!” way to pay it forward.” Sowards was 12 years old the last time she won anything – four tickets to the Beatles’ first U.S. tour. Needless to say, she never thought she’d actually win. “I really just thought I was making a contribution to the hospital that gave me such great care.” And then… she got the call. Mega Raffle Was A Big Risk “The TMC Mega Raffle was a big risk, but it resulted in great reward,” said Michael Duran, vice president and chief development officer, TMC Foundation. “It is, without a doubt, a new and exciting way to raise funds for patient care at TMC. We are grateful Southern Arizonans really embraced the TMC Mega Raffle in its inaugural year and hope that excitement continues to grow. It was remarkable to hear how many TMC patients, like Renee, bought tickets as a simple way to pay it forward and then ended up winning big prizes. I look forward to hearing more of these incredible stories in the years to come.”

https://www.youtube.com/watch?v=DHFYLrYI65o COMMITTED Old Pueblo Anesthesia TO TMC Tucson Medical Center is fortunate to have a deep history and strong partnership with Old Pueblo Anesthesia, the exclusive provider of anesthesia services at TMC since 2007. OPA physicians are committed to the safety and well-being of our patients while providing the highest quality perioperative care, including our pint-sized patients for whom there is a dedicated team of pediatric anesthesiologists. An OPA doctor is on site at TMC’s Labor and Delivery unit, every second of every single day, to care for the mothers of the nearly Dr. Allison Greening & Connor Abbott 6,000 babies born at TMC each year. These anesthesiologists are ready to provide routine and emergency obstetric support and comprehensive post-operative pain management services, in addition to anesthesia services for adults and children undergoing surgical and gastroenterology procedures, MRI and CT scans, and interventional radiology procedures. For more information on Operation Walk USA visit:

http://www.opwalkusa.com/ Dr. Kim Rafacz & Preston Marsh For more information on Healing the Children visit: http://healingthechildren.org/ But their commitment to the community extends far beyond that. TMC’s Breast Health Program, which has provided more than 6,000 “Giving back to the people of Southern Arizona remains one of free screening mammograms to women in need since 1998. our biggest priorities,” said anesthesiologist Dr. Hill Johnson, OPA “We are heavily invested in TMC,” said Dr. Johnson. “We want the president. For the past decade, OPA has been the title sponsor of the hospital to succeed, and we think it’s important for us to express that. TMC Foundation Gala. The 2013 event entertained guests with an We are happy to contribute in this way and help with improving the “Old Hollywood” theme while supporting TMC for Women. “Caring overall health of the community.” for women is part of OPA’s long-standing history in the Tucson area, and it’s an area where our physicians especially love working. Many OPA physicians also take part in extraordinary philanthropic work of OPA’s founding physicians were obstetrical anesthesiologists who by providing care for those who are underserved both here at home influenced the group’s dedication to this service,” said Dr. Johnson. and abroad. OPA anesthesiologists were an instrumental part of a program that was brought to TMC under Operation Walk USA, By being the title sponsor, OPA helped provide ongoing support to the a private, nonprofit, volunteer medical services organization that future of women’s health in our community. “As the market leader for provides free surgical treatment for patients who do not have access women’s care, TMC is committed to providing a lifetime of care for to life-improving care for debilitating bone and joint conditions. women, about women. Whether a woman is having her first child or For the second year in a row, OPA physicians signed on to provide a life-saving surgery, she deserves a safe and welcoming environment free services to ten deserving patients who underwent total joint with state-of-the-art services and a caring touch,” said Michael Duran, replacement surgeries. vice president and chief development officer, TMC Foundation. Proceeds from the Gala assist in the purchase of life-saving equipment and allow TMC to continue providing educational outreach to the community and medical staff. OPA’s contribution also helps support programs and services like “OPA is proud to be part of the TMC community and the phenomenal “Providing care to those who are underserved is a responsibility team caring for Operation Walk patients,” said anesthesiologist Dr. that we take very seriously, and are very passionate about,” said Dr. Brian Cammarata, director of quality assurance at OPA and chief Johnson. “We are committed to TMC, and look forward to many years medical information officer at TMC. “As physicians, we are committed of supporting Southern Arizona’s community hospital.” to providing quality anesthetic care for every patient. In the short time TMC has been paired up with Operation Walk, this service has become an integral part of the TMC community and has positively impacted patients’ lives.” Another remarkable case OPA was proud to be a part of involved a 14-year-old girl from Honduras who came to the U.S. through an organization called Healing the Children. Little Silvia suffered from a debilitating case of scoliosis and thanks to a remarkable team of health care professionals, received the surgery she so desperately needed. OPA anesthesiologist Dr. Luis Esparza’s ability to communicate with Silvia “WE ARE in Spanish helped her feel a little more comfortable so far from home. HAPPY “I had the opportunity to be involved in providing care for her that she TO CONTRIBUTE IN THIS WAY could never have obtained at home. I think that we sometimes lose sight AND HELP WITH IMPROVING of the fact that what seems routine to us can have such a huge impact on others. Being involved in cases like hers helps to remind me of that. I THE OVERALL was happy to be part of the team that cared for her.” HEALTH OF THE COMMUNITY.” Old Pueblo Anesthesia by the numbers More About Old Pueblo Aneshesia Years in the Tucson community: 27 OPA has physicians who are certified by the American Board of Anesthesiology as specialists in pediatric anesthesia care. These Number of physicians: 41 physicians have advanced training and knowledge in caring for patients Number of patients served each year: 20,000 from premature infants through adolescence who are undergoing surgical procedures. In addition to these pediatric specialists, OPA also Number of women in labor and delivery cared for each year: 5,000 has physicians who specialize in cardiac and obstetric care. Number of charity cases performed in 2013: 331 SUPERB “She absolutely saved my life.” CARE AT TMC TMC patient credits superb care at TMC for Women for life-saving decision When Lee Toomey had a few Pap tests come back abnormal, she didn’t think much of it. Her OB/GYN, Dr. Gayle Dean, did an in-office procedure that remedied the problem until Toomey was instructed to return a year later. “At that visit, Dr. Dean told me she found some abnormal cells, but she didn’t think doing the procedure again would be

Dr. Gayle Dean OB/GYN effective. She said I needed a hysterectomy,” said Toomey. Toomey was scheduled, and underwent the procedure using the minimally invasive da Vinci robot in February 2013. It was a move that may have saved her life. During the hysterectomy, Dr. Dean found cancerous cells. Lee Toomey “When she told me she found cancer, I remember thinking to myself, ‘thank God she is my doctor, and thank God they found it when they did,’” Toomey recalled. Today, she credits Dr. Dean with saving her life. “She made the right decision in saying I should have a hysterectomy. My situation could have been a lot worse if the cancer wasn’t caught as early as it was. I have 100 percent confidence in her,” she said. Toomey’s follow-up care confirmed the cancerous cells are indeed all gone. “In talking with my friends who had hysterectomies 20 or 30 years ago, I learned that they were down for at least six weeks. I was so “ I REMEMBER THINKING TO MYSELF, impressed with how technology has improved, and couldn’t believe how good I felt when I got home. There was no pain – there wasn’t ‘THANK GOD SHE even any discomfort. I could have gone and played bridge the next IS MY DOCTOR, day, I felt that good,” she said. Toomey, a retired math teacher, was AND THANK GOD THEY FOUND IT walking her dogs within a week of her procedure and is back to annual WHEN THEY DID,” gynecological visits - happy to have the scare behind her. TOOMEY RECALLED. MAKING A Kohl’s Cares: Associates in Action who DIFFERENCE genuinely make a difference The Kohl’s Cares Associates in Action volunteer program is one of those concepts that sounds too good to be true; so when you realize that it’s not, you’re amazed at how generous one organization can be. The program was created to support and recognize Kohl’s associates’ gifts of volunteer service in communities nationwide. For the past 8 years, TMC has been fortunate to be Kohl’s hospital

Kelsey Musgrave partner in Tucson. Kohl’s associates are available to volunteer at TMC events that enrich the lives of children. TMC benefits from their gifts of time and talent – but that’s not all. For every five Kohl’s associates from one location who volunteer at least three consecutive hours each in a single day, Kohl’s provides a $500 grant in recognition of their volunteer service. “Giving back to the community is a big part of what we do,” explained Sarah Musgrave, Kohl’s Southeast Tucson store manager. “Everyone has a special Volunteer Services & Community Programs Director connection to TMC. Either their children were born there, or TMC Hope Thomas with Kohl’s volunteers was there for them during an emergency. When associates are asked to volunteer for TMC events, they always get really excited to have the opportunity to help out.” That connection became even more deep-rooted for Musgrave, whose Time Adds Up 1-year-old daughter, Kelsey, was recently diagnosed as having a minor In 2013, Kohl’s associates logged 88 volunteer hours during 22 TMC stroke when she was born. “We spend a lot of time with her at pediatric events. Their time equates to $11,000 worth of labor. outpatient therapy. I just can’t imagine what I would do if TMC wasn’t there. I have always been passionate about TMC, but this experience has really hit home about how important TMC is to families,” said Musgrave. “Anytime there is an event at TMC, we strive to make it a Kohl’s Cares $1,500 grant, not just a $500 grant.” Kohl’s Cares granted $49,729 to TMC for this program in 2013, bringing When associates volunteer their time, they’re encouraged to bring their the total amount of money they have granted to TMC to $451,000. children, friends and family. “We believe it’s good for our children to see their parents volunteering and for them to learn the importance of giving back at an early age,” said Musgrave. “We are so honored to have the support of such a generous company that is as passionate about caring for children as we are,” said Erika IN 2013, KOHL’S ASSOCIATES Grasse, TMC Children’s Miracle Network director. “Kohl’s associates are incredible to work with. They are reliable, enthusiastic and LOGGED 88 VOLUNTEER professional. They share our desire to improve the community through HOURS DURING 22 TMC EVENTS. outreach events. We couldn’t ask for a better partner in furthering our THEIR TIME EQUATES TO mission here at TMC and look forward to many more years of working alongside them to improve the lives of Southern Arizona children.” $11,000 WORTH OF LABOR. Kohl’s Cares Vest It Up! Kohl’s Cares Vest It Up! program: same success, but with a twist inflatable swimsuits or suits with a life jacket-like belt sewn in thinking they’re making the child safer in the water,” said Tracy Koslowski with For the second year in a row, TMC for Children and Kohl’s Cares the Drowning Prevention Coalition of Arizona. “These devices can give a teamed up to build on the success of the Kohl’s Cares Vest It Up! child and parents a false sense of security about the water. An arm floatie program. Vest It Up! provides hundreds of Tucson area kids ages 4 to 17 can slide off or pop and leave a weak swimmer stranded far from a wall with a Coast Guard-approved personal flotation device, or life vest, upon or shallow water. The life jacket belts can just as easily hold a child upside completion of eight free swim lessons. The program is offered year- down on the surface as right side up.” round at local YMCA pools. The combination of life-saving PFDs and swim lessons is believed to keep kids safer in and around water. In 2013, parents and caregivers were invited to exchange their child’s floaties for a voucher to participate in the program. The National Drowning Prevention Alliance warns against using unsafe flotation devices that are not Coast Guard-approved. Water wings or floaties, inflatable water rings and other pool toys can create risks for an unassisted young swimmer. They are not approved for safety and won’t protect your child against drowning. Only Coast Guard-approved life jackets are designed and tested for safety. “Many parents put their children in floaties, NOW Loop donation enhances TMC HEAR THIS Senior Services L’Don Sawyer, Michael J. Duran, J.D. with Dr. Robert Dean & Stephanie Navaarrete Thanks to a facility upgrade donated by a local physician group, attendees at TMC Senior Services classroom events may now be able to hear what’s happening more clearly than ever. An induction loop – also known as a hearing loop or room loop – has been installed at the Healthy Living Connections classroom at TMC Senior Services, 1400 N. Wilmot, on the El Dorado Health Campus. The organization offers a wide range of lectures and activities for older adults throughout the year. The generous support for the upgrade comes from Tucson Ear, Nose and Throat, a local practice founded in 1987 by a core group of leading otolaryngologists. The group includes seven physicians and five audiologists plus more than 30 staff members. At the dedication of the classroom system, Michael Duran, TMC Foundation vice president and chief development officer, officially thanked Tucson ENT for its generosity – adding that this really does reflect philanthropy throughout the community. He noted that the doctors saw a need among the patients they see and pooled their resources to make it better for the community. Dr. Robert Dean treated THE SUPPORT FOR THE UPGRADE the audience to an informative presentation on hearing loss. Members COMES FROM TUCSON EAR, of the ALOHA (Adult Loss of Hearing Association) Board of Directors NOSE AND THROAT, A LOCAL and volunteers were available to talk about support groups and other services for people with hearing loss. PRACTICE FOUNDED The loop system employs a wire around the room and an amplifier to IN 1987. send an electromagnetic signal throughout the area. Hearing devices THE GROUP INCLUDES SEVEN equipped with a telecoil will pick up the signal and convert it to PHYSICIANS AND FIVE audible sound. Telecoils are tiny bundles of wire that are part of the AUDIOLOGISTS mechanism inside many newer hearing aids and cochlear implants. In addition, attendees may use special headphones provided at events to hear the amplified signal. TMC FOUNDATION EVENTS

TMC FOUNDATION GALA https://www.youtube.com/watch?v=TLj9u4P6ta8

ROCK ‘N RODEO

CHILDREN’S MIRACLE NETWORK RADIOTHON

ERICKSON LEGACY SOCIETY EVENT

HOOK ‘N SLICE GOLF TOURNAMENT TMC Foundation Gala sponsorships help purchase new equipment, promote health and safety education, and expand pediatric programs for children and families As the market leader for women’s care, TMC is committed to served at TMC. providing a lifetime of care For Women, About Women. Whether a woman is having her first child or a life-saving surgery, she deserves Erickson Legacy Society Event a welcoming and safe environment with state-of-the-art services and a This event honors the tradition of legacy giving at the annual Erickson caring touch. Proceeds from the TMC Gala will support the future of Legacy Society event. Named in honor of TMC’s first legacy donor, Women’s health in our community. Join us for A Night in Rio at the Mrs. Anna Erickson, the Erickson Legacy Society recognizes and thanks beautiful Westin La Paloma Resort & Spa. those who make a bequest or lifetime gift to the TMC Foundation. Rock’N Rodeo Hook’N Slice Golf Tournament The TMC Foundation hosts Rock ‘N Rodeo, an event to support This annual golf tournament supports TMC’s Children’s Miracle TMC Hospice. The special evening includes live entertainment and a Network. Golfers enjoy stunning views of the city and the surrounding gourmet meal, as well as silent and live auctions. You can win special mountain ranges while playing 18 holes. prizes at the blackjack tables or kick up your boots and line dance! Children’s Miracle Network Radiothon 94.9 MIXfm and The Morning Mix with Bobby Rich, Greg Curtis and Mrs. Grant help make miracles happen for children in Southern Arizona. The trio broadcasts live for more than 24 hours while volunteers dedicate themselves to answering the phones and taking pledges. Every dollar raised stays here in our community and generous ANNUAL REPORT CREDITS TMC HEALTHCARE TMC FOUNDATION TMC MEDICAL Publisher Judy Rich, RN, President and BOARD OF TRUSTEES BOARD OF TRUSTEES EXECUTIVE COMMITTEE Chief Executive Officer Louise L. Francesconi, Chairwoman Christine Aronoff, Chairwoman J. Manuel Arreguin, M.D., Chief of Staff Michael Parseghian, M.D. Digital Editor Alicia Moura, J. Manuel Arreguin M.D. Jodi A. Bain Douglas Lowell, M.D., Chief of Staff Elect Ronald Quintia, M.D., DDS Communications Director Henry K. Boice Henry K. Boice Abraham Bressler, D.O. Richard Rosenthal, M.D. Design Cirrus Visual Michael W. Bracht M.D. Kim Bourn Lance Clyde, M.D. Abhay Sanan, M.D. Photography Eric Suhm David Cohen Jeffrey J. Cesare Amram Dahukey, DPM Gulshan Sethi, M.D. Cover Art BrainDance Productions Susan L. Ernsky David J. Cohen Ives de Chazal, M.D. Steven Siwik, M.D. Videos BrainDance Productions Jay A. Katz M.D. Palmer C. Evans, M.D., Life Trustee Gayle Dean, M.D. and Duck Soup Productions Shawn Stafford, M.D. Eduardo A. Leon Louise L. Francesconi Fadi Deeb, M.D. Elias D. Stratigouleas, M.D. REPORT TO OUR Douglas Lowell M.D. Anne Fulton-Cavett Rainier Diaz, M.D. David Teeple, M.D. COMMUNITY CREDITS Judy F. Rich, R.N. Lewis Jones Lionel Faitelson, M.D. Paul Walshaw, M.D. Executive Editor Julia Strange, Vice President, Community Benefit Beckie Torrey Fran Katz Thomas Harmon, M.D. George Wilcox, M.D. Editor Cheryl Kohout, Digital Media Gay Tosch Patricia Lohse Barton Hodes, M.D. J. Paul Yurkanin, M.D. Communications Analyst Jon R. Young Sidney “Pete” Mendelsohn Steven Ketchel, M.D. Contributing Writers Cheryl Kohout, David F. Peachin David Killion, M.D. Kimberly Romo, Julia Strange Judy Rich, R.N. Julie Klein, M.D. ONCENTER CREDITS Keri Silvyn Clifford Martin, M.D. Steven Siwik, M.D. Brandon Massey, M.D. Executive Editor: Michael Duran J.D., Vice President and Chief Development Officer David Smallhouse Abhilash Nair, M.D. Editor: Kimberly Romo, Arlene Webster, R.N. William Odette, M.D. Communications Specialist Jim Zarling John P. Pacanowski, M.D. Contributing Writers: Michael Letson, Kimberly Romo