PhysicianQuarterly Published by Kettering Health Network • Q3 2018

Inside

Heather Pulaski, MD, on Partnerships to Improve HPV Vaccination Rates • Network Addresses Opioid Epidemic

Kettering | Grandview | Sycamore | Southview | Greene | Fort Hamilton | Soin | Kettering Behavioral WE NEED EXPERTS! Table of Contents Are you willing to volunteer your expertise in any of the following areas?

AuthorContribute Physician Speak at community Author Physician  Serve as media Quarterlycontent articlesideas events Quarterly articles spokesperson PhysicianQuarterly NETWORK SOIN/GREENE Published by Kettering Health Network • Q3 2018 Email [email protected] or call (937) 762-1053 4 New initiatives address community opioid epidemic 29 Soin Medical Center adding five-story tower to campus 6 Innovative pain relief strategies for surgical patients 30 Radiation services now available By Scott Adkisson, DO, and David Brouhard, MD 32 Mobile imaging unit provides a creative solution 7 The value of as community leaders 32 Greene Memorial Foundation to host 23rd Circle of Victory By Mike McCullough Jr., MD 33 Greene Memorial Hospital hosts open house and safety fair We are called to serve vulnerable populations, 8 Gem City Market: oasis in the Dayton food desert 33 Save the date for Springfield Health Center open house and opioid-addicted patients might be the most 9 34 4,000 vulnerable population in our region right now. Middletown to start caring for patients in August Soin/Greene welcomes new providers Inside Heather Pulaski, MD, on Partnerships to Improve HPV Vaccination Rates • Network Addresses Opioid Epidemic

10 Kettering | Grandview | Sycamore | Southview | Greene | Fort Hamilton | Soin | Kettering Behavioral PreHab: improved outcomes for joint replacement patients Number of opioid-related Tiffany Thompson, MSN, RN, OCN, 11 Clean hands are caring hands overdose cases treated in on addressing the opioid crisis (pg. 4) By Jeffrey Weinstein, MD FORT HAMILTON On Our Cover ’’ Montgomery County in 2017 Gynecologic oncologist 12 Breast cancer prevention: risk reduction 35 Ground broken for Hamilton Health Center on Main Heather Pulaski, MD, is (pg. 4) Community involvement is so important—from the By John Haluschak, MD 36 Dedicated phone line to emergency department physicians partnering with the American 36 personal level to the organizational level. 13 Increasing HPV vaccination rates Fort Hamilton makes facility renovations Cancer Society for initiatives By Heather Pulaski, MD 37 Fort Hamilton welcomes new providers to properly educate patients Roy Chew, PhD, president of Kettering Health Network, 14 Shout Outs 37 Save the date for Ticket to Hollywood on the value of vaccination $9.8 billion on the value of joining Gem City Market (pg. 6) 16 New programs help prevent diabetes (read more on pg. 13) Cost to national healthcare ’’ 18 Information systems update This will make for better communication, more timely KETTERING PHYSICIAN NETWORK system of hospital-acquired By Charles Watson, DO referrals, and, ultimately, higher quality care. 38 Brain & Spine service line rebrands infections (pg. 11) 38 KPN primary care holds MyChart enrollment contest Leah Avera, MD, on the collaborative nature KETTERING/SYCAMORE 39 KPN welcomes new providers of the new Middletown facility (pg. 7) 19 Save the date for 18th annual Ribbon of Hope ’’ We are all aligned around taking good care of patients and 19 Kettering facility renovations improve patient experience 30,000+ 20 Celebrating providers for a job well done Number of Americans to be diagnosed with are collaborating to position all parties for strong success. 22 Kettering/Sycamore welcomes new providers HPV-related cancer each year (pg. 13) Rebecca Ramirez, MD, on expanding hospitalist care team at Grandview (pg.’’ 24) GRANDVIEW/SOUTHVIEW We have an incredible team, and their commitment 23 Elements of high-functioning primary care practices to patients and each other is the reason By Paul Martin, DO this hospital continues to grow and touch lives. 24 Hospitalist care team grows at Grandview 25 Grandview expands to meet needs in West Dayton Rick Dodds, president of Soin Medical Center and Greene Memorial 26 New skills center at Southview to open this summer Hospital, on construction and expansion at Soin (pg.’’ 30) 27 Eagle Seekers supports teaching kitchen Physician Quarterly is published by Kettering Health Network to 28 Grandview/Southview welcomes new providers support communications between physicians, residents, fellows, alumni, and hospital administration. 58% Managing Editor: Addison Hudgins Reduction rate of conversion to Type 2 diabetes Design & Layout: Christie Mildon for patients who participate in intense lifestyle Additional Writing: Leigh Wilkins intervention programs for prediabetes (pg. 16) Cover Photography: Lee Ann Yahle Additional Photography: AGI Studios, Lee Ann Yahle

2 Network Network 3 Addressing the Opioid Epidemic with GROW New initiatives offer a fast track to addiction treatment

ettering Health Network is teaming up with to the hospital to meet with the patient and get Meaningful solutions the Montgomery County Drug-Free Coalition him or her into a medication-assisted treatment Thompson worked closely with Kto connect opioid-addicted patients with program. If the patient has been discharged from infectious disease specialist treatment programs quickly, with the added benefit the hospital before a GROW team can arrive, Jeffrey Weinstein, MD, of providing long-term follow-up. The initiative the team will make a home visit within 24 hours, GROW’s executive sponsor, comes at a critical time in the fight against opioid as long as the patient gives consent. The peer and hospitalist Ashlee Ames, addiction. Last year, more than 4,000 overdose supporter will stay in contact with the patient long MD, to launch GROW at cases were treated in Montgomery County. This term, offering support and accountability. GROW the network. This spring, number does not include the thousands of patients teams have been successful in working with law she offered 16 training and who needed care for health issues related to their enforcement agencies throughout Montgomery Jeffrey education workshops for Weinstein, MD intravenous drug use. County, but this is the first time teams are being physicians, nurses, social dispatched to the hospital setting. One of the keys to helping people overcome opioid workers, behavioral health addiction is responding quickly when they ask for The idea of bringing GROW to Kettering Health specialists, and other providers. help. In the past, opioid-addicted patients who Network came from Tiffany Thompson, MSN, Speakers included the county’s presented in a network emergency department RN, OCN, clinical nurse manager for the medical GROW coordinator, a or another care setting received information and surgical intensive care units at Grandview recovering opioid addict, and a about treatment options. This spring, the network Medical Center, who simply saw a need. “We are community outreach manager launched Get Recovery Options Working called to serve vulnerable populations, and opioid- from Cornerstone Project, a (GROW) to complement the current strategy. addicted patients might be the most vulnerable drug rehabilitation center in Ashlee population in our region right now,” Thompson Dayton. Participants learned Fast-tracked treatment Ames, MD ANOTHER PATH TO DRUG REHABILITATION says. “GROW is a way to be the hands and feet about the nature of drug Now, if a drug-addicted patient expresses interest of Jesus, fulfill our mission to improve lives in the addiction, how to have a constructive conversation GROW will help many opioid-addicted patients, but what about communities we serve, and strengthen partnerships with patients about medication-assisted treatment, in treatment, a network physician or employee those who resist the offer of immediate treatment? Or those can call GROW. GROW staff will dispatch a with amazing organizations that share our and resources that are available in our community social worker and a peer supporter, who is also a commitment to addressing the opioid crisis.” for addicts and their families. who leave the emergency department before a GROW team recovering addict. The two-person team will come arrives? Kettering Health Network emergency department staff “Nurses have told me that before we introduced GROW, they were reluctant to talk about drug can offer these patients a referral card, which allows them to rehab with patients because they didn’t feel like show up at Cornerstone Project’s Xenia Avenue intake facility at they had anything to offer,” Thompson says. Fort Hamilton Hospital efforts any time and be fast-tracked into medication-assisted treatment “GROW will help us embrace these patients with Another initiative, based at Fort Hamilton Hospital, also focuses on getting compassion and respect by providing meaningful either there or at a partner facility. people into addiction treatment quickly. Fort’s Opiate Recovery Task Force, solutions as they try to overcome their addiction.” or FORT, began in 2015 and is led by Jennifer Mason, an emergency medical The referral cards are part of the Montgomery County Drug-Free services coordinator based at the hospital. When a patient in the Fort Hamilton Coalition’s Front Door Program. Police officers from nine county emergency department seems serious about getting into treatment, a group jurisdictions have been distributing these cards for some time, that includes Mason, an addiction social worker, and a member of local law enforcement goes to the patient’s home within a few days of the emergency To learn more about GROW, contact but the network’s participation marks the first time a medical visit to encourage participation in drug rehab treatment. The Ohio Attorney [email protected] facility has been part of the effort. More than 10,000 cards are General’s Office recently made a $100,000 grant to help fund the Hamilton available at emergency departments throughout the network. Police Department’s involvement in this program. The hospital’s emergency department also has created a recovery resource booklet about addiction, naloxone, opioid withdrawal, and local recovery resources. It is available to anyone who visits the Fort Hamilton Hospital emergency department.

4 Network Network 5 Innovative Pain Relief Strategies Providing Leadership in the Midst Reduce Opioid Use for Surgical Patients of Ohio’s Opioid Crisis

n the midst of the current opioid crisis, surgical Perioperative Surgical Home Initiative hysicians established the Montgomery County Learning more about opioid addiction has patients still need pain relief. Anesthesiologists at Medical Society in 1849 mainly in response broadened my perspective and motivated me to be Surgical patients can play an active role in IKettering Health Network, in collaboration with Pto a devastating cholera epidemic that was part of the solution. Earlier this year, for example, minimizing post-surgical pain—starting in the surgeons in multiple specialties, are establishing killing 15 to 20 Dayton area residents per day. If I attended a meeting at Sycamore Medical Center weeks before their . That’s the thinking evidence-based, multimodal strategies to provide we adjust the population to summer of 2018, this sponsored by the South Dayton Metro Regional behind the new Perioperative Surgical Home effective, non-opioid pain relief. would be the equivalent of about 15,000 souls Chamber of Commerce. The speaker, Lori Erion, Initiative, another collaboration between lost daily! Today, within the context of our opioid founded Families of Addicts in Dayton, which has Orthopedics is a great place to initiate these and surgery. crisis, Dayton area physicians are once again called received national recognition as a positive source Nancy strategies, because there is so much standardization We are developing educational materials that upon to provide leadership at a critical moment in of education, empowerment, and acceptance. She Pook, MD within the specialty. Metrics help us look at costs cover topics such as weight loss, smoking cessation, our region’s history. shared from personal experience how terrifying and outcomes, meaningfully measure progress, and nutrition, pain medication options, and expectations it is for a parent when a child becomes addicted find areas for improvement. One area of focus is As we know, about 30% of opioid addictions begin for recovery. The goal is to educate patients prior to heroin, and how it affects every area of life— joint replacement surgery, where narcotics, once in the clinical setting. In April, data was released WHAT CAN YOU DO to surgery so that they can be actively involved emotional, relational, financial, etc. She cited one the mainstay of pain control, are often not the showing a 10% drop in opioid prescriptions TO HELP ADDRESS in improving their surgical outcomes. We want statistic that a parent’s work productivity can sink primary agents used. Instead, oral medications nationwide for the first time in 20 years; Ohio THE OPIOID CRISIS? to get them through surgery safely with the least to 40% of capacity in the midst of a child’s opioid such as Tylenol, Celebrex, and Gabapentin are data reflects a similar decrease. Progress is even pain possible, which will allow them to start addiction. As Lori eloquently describes an example given in the immediate pre-operative period. In better at Kettering Health Network. In the last • Download Pause rehabilitating quickly and regaining functionality. of her agony, “Your addicted child will constantly the operating room, we often use a combination five years, we have reduced opiate prescriptions materials at Patient education may be particularly effective for blow up your cell phone all day long so that you are of regional anesthetic techniques, including spinal by 20% and decreased repeat emergency visits ketteringhealth.org/ patients undergoing an elective procedure (such as emotionally and physically exhausted. Anything you anesthetics paired with indwelling nerve catheters for minor pain complaints by more than 50%. A pause. An outpatient joint replacement), but can be beneficial for others do at your job suddenly takes low priority.” and peripheral nerve blocks (adductor canal, program called Pause, led by Kettering Health and inpatient version as well. fascia iliaca, and popliteal). These strategies are Network physician Nancy Pook, MD, builds on The opioid crisis can take a toll on physicians, too. are available. well established at Sycamore Medical Center, and General and colorectal surgeons are working these significant accomplishments by providing It is disheartening to see so many people succumb becoming increasingly used at Kettering and Soin through protocols for certain patient groups now, physicians, pharmacists, and others with resources to addiction, and it can be tempting to judge them. • Visit the Ohio State medical centers as well. and will be following close to reduce opioid use even further. Pause expanded We must remember that addiction is a significant Medical Association behind. Eventually, we expect that this initiative to the outpatient setting in May, offering an Epic disease with an end result—heroin overdose is website at Pain is often the most significant in the first will be rolled out to all service lines throughout smartset with links to medications, , end-stage addiction, even when it is accidental. OSMA.org to access 24 hours after surgery. If we can set a patient's the network. and referrals, as well as nutritional and dietary online learning expectations leading up to surgery and utilize prescriptions to manage painful conditions. It The good news is that many people within Kettering as many multimodal, non-narcotic techniques Health Network, our community, and the state materials, and is available to all network providers who treat take the Smart Rx as possible, this will minimize their narcotic patients in the outpatient setting. of Ohio are mobilizing to win the war on opioid requirement in the post-operative period. Patients addiction. Let’s surf the energy of change and make course, available for by will be able to more quickly transition to non- Dr. Pook’s leadership is a great example of how things better for our patients, their families, and continuing medical anesthesiologists Scott Adkisson, DO, and narcotic analgesics in the recovery phase. David Brouhard, MD. physicians can help address the opioid crisis in our society as a whole. In the process, we just might find education credit. community. Physicians must take a leadership role. more meaning in our interactions with addicts and Dr. Brouhard (pictured above) is leading the Instead of prescribing opioids as we always have, help them overcome this devastating disease. • Visit FOAFamilies.org Perioperative Surgical Home Initiative. we can prescribe alternatives for some patients and to learn more about help them understand the reasons why. We also Families of Addicts. can communicate with legislators to help protect by our ability to prescribe opioids appropriately, Mike McCullough Jr., MD, / especially in the , cancer, and post-op gynecology. settings. And we can stay informed about recent discoveries into the science of opioid addiction In addition to caring for his patients, Dr. McCullough and recovery. is president of Montgomery County Medical Society.

6 Network Network 7 Gem City Market: Future Oasis Kettering Health Network Middletown in the Dayton Food Desert to Start Caring for Patients in August Emergency center is the first to open

est Dayton is one of the worst food deserts president of Kettering Health Network. “The ettering Health Network Middletown is set mission to provide high-quality care within the in the United States, with thousands of market is a unique opportunity to get involved for an open house on August 5 and ribbon community,” says Kettering Physician Network Wresidents lacking access to affordable and in the Dayton community and support the effort Kcutting on August 7. family physician Leah Avera, MD, who nutritious food. A new enterprise called Gem City to provide West Dayton residents with access to has been named medical director of Kettering Market hopes to change that—and you can help. fresh, healthy foods.” Designed to serve the healthcare needs of the Health Network Middletown. community and located conveniently on State Gem City Market is the first major project of To buy a share and become a member, Route 122 in Middletown, the center will provide “I am excited by the collaborative nature the new the not-for-profit Greater Dayton Union Co-op physicians and employees can: comprehensive care that is centered around the facility will provide for our patients, physicians, Initiative, which was founded in 2015 with the 1. Visit gemcitymarket.com whole patient—mind, body, and spirit. and staff,” Dr. Avera says. “There will be access to twin missions of addressing Dayton’s food crisis testing and laboratory services all within the same and incubating cooperative businesses to bring 2. Click “Become a Member” The site will feature Kettering Physician Network building. My staff and I will also have a closer sustainable jobs to Dayton. The community- and 3. Click “Purchase a Membership” team-based care practices. relationship with the specialists there, which will worker-owned grocery store will be located in providers will be accepting patients; a variety make for better communication, more timely 4. Under “Payment Options” select “Employer the Salem Avenue corridor, just across the bridge Leah of specialist practices will be offered, including referrals, and, ultimately, higher quality care.” Discount” from downtown Dayton and less than a mile from Avera, MD , , and orthopedic surgery. Grandview Medical Center. 5. Select “Kettering Health Network” as the employer and enter your employee ID with a Located within the full-service, 24/7 emergency The organization is currently in the capital “k” at the beginning department, Kettering Health Network fundraising stage, and has begun selling Middletown will also offer a full range of outpatient memberships to local residents who want to get imaging and testing services, including MRI, CT, Save the Date involved. Members will receive discounts at the X-ray, cardiac testing, and outpatient labs. market and have opportunities to participate in Kettering Health Network physicians Groundbreaking for the 65,000-square-foot center Open House leadership roles. A membership costs $100, and and employees can join Gem City Market took place in May 2017. “This new facility fits August 5 Kettering Health Network will cover half the cost for $50—half price! A membership costs in perfectly with the Kettering Health Network for network physicians and employees. $100, and Kettering Health Network will Ribbon Cutting cover half the cost. August 7 The market hopes to break ground by the end of this year and open in late 2019. Kettering Health Network “Community involvement is so Middletown important—from the personal level to the organizational level,” says Roy Chew, PhD, Roy Chew, PhD

8 Network Network 9 ’’ PreHab Leads to Improved Outcomes Clean Hands are Caring Hands for Joint Replacement Patients

ore and more joint replacement candidates are Kettering Medical Center Joint Center Council. ospital-acquired infections (HAIs) are a major network hospitals is about 71%. Unfortunately, participating in pre-operative Orthopedic surgeons cited research that PreHab but often preventable threat to patient safety. doctors tend to be less compliant than other Mservices, a strategy developed at Kettering results in shorter hospital stays, lowers utilization HAccording to the Centers for Disease Control providers in these observations. As vigilant as we Health Network that helps patients prepare mentally of post-surgery services, lowers costs, is associated and Prevention, each year 1.7 million HAIs occur are, we can do better! One research study showed and physically for surgery. The service, called with fewer comorbidities, and facilitates sending in U.S. hospitals and 99,000 patients die from that hospitals that achieve 90% compliance with “PreHab,” is getting high marks from patients and more patients directly home. such infections. HAIs are a significant cause of hand washing have an average drop in HAIs of their surgeons and is resulting in better outcomes. morbidity and mortality, and result in longer 70%. Another study looked at a hospital with very Trend to same-day surgery hospital stays, increased exposure to antibiotics, good hand washing compliance to see if further Richard PreHab is available at all outpatient therapy The group was inspired, and Billy Cannarozzi, and an annual cost to our national healthcare improvement made an impact. A hospital that Forster, MD locations within Kettering Health Network. It is a physical therapist and team lead at Kettering system of $9.8 billion. started at 83% and got to 96% compliance over a appropriate for patients with arthritic conditions Woodman, began working two-year period saw a 15% drop in its HAI rate. who have failed conservative treatment, such as closely with orthopedic surgeon Richard Forster, High-tech strategies, such as the use of an physical therapy, injections, and bracing, and have MD, to develop the program. PreHab began as a ultraviolet light-emitting robot to disinfect Based on conversations I’ve had with physicians elected to proceed with joint replacement surgery. pilot program at the Kettering Sports Medicine patient rooms, can help prevent infection. But the and other providers, lack of knowledge about hand When a physician refers a patient for PreHab, the Woodman location, and has since been rolled out most effective strategy—good hand hygiene—is hygiene is not the problem. The truth is, we simply physical therapist does an extensive chart review to all of the network’s outpatient therapy facilities. decidedly low-tech and can have a far greater get busy and either forget or disregard good hand to understand the patient’s deficits and needs, impact. hygiene practices. If that’s true for you, consider contacting the physician if questions arise. PreHab Orthopedic surgeons Donald Ames, MD, Aram turning over a new leaf. Your patients’ well-being typically involves one or two visits with a physical Donigian, MD, Elizabeth Dulaney-Cripe, MD, Based on the infection control team’s observations depends on it! therapist, who provides: Matthew Hess, MD, Steven Kleinhenz, MD, of hand hygiene practices on inpatient units, • An assessment of baseline function and Kenneth Pohl, MD, championed the PreHab compliance among healthcare providers at our • Exercise protocols to address deficits, build program with Dr. Forster, and have been very by strength prior to surgery, and aid in recovery pleased with the results. Since its implementation, Jeffrey Weinstein, MD • Information about what to expect during , Infectious Disease the PreHab visit done prior to surgery has resulted Specialist and Chief Quality Officer, Kettering recovery in 90% of those patients being discharged to and Sycamore medical centers • Guidance about , including home-based care. the importance of rest, ice, and proper To refer a joint replacement medication use “The trend is for joint replacement to shift to being candidate for PreHab, use • Training and practice performing the a same-day surgery for some patients, so it’s more Epic to place an order for activities of daily living during recovery, critical than ever that they learn in advance what to expect and how to prepare,” says Cannarozzi. WHAT IS HAND HYGIENE COMPLIANCE? physical therapy, adding including doing transfers, navigating stairs, “Many PreHab patients do not even need home specifics about the patient’s and using appropriate assistive devices • For most patient interactions, use alcohol-based sanitizer before care, and some literature indicates they may require needs in the notes field A customized approach less post-surgery therapy compared to patients entering the room and again upon exiting. (e.g., “PT evaluation and PreHab complements the Joint Class and who don’t have PreHab.” • For interactions with patients in C. diff isolation, use an alcohol- treatment, considering total education patients receive during their pre- joint replacement”). admission testing visit, in which orthopedic Physical therapists are seeing a higher volume of based hand rub before entering the room and wash with soap and nurses and physical and occupational therapists PreHab patients each month as more surgeons water when you leave. provide more general information about surgery, see the benefit of this individualized evaluation the hospital stay, and recovery. Each PreHab visit and treatment session. Feedback from patients has • Wear gloves if you might come into contact with blood or other is customized to the patient’s specific needs to been very positive, Cannarozzi says—patients say body fluids. maximize their recovery. they feel more prepared for surgery, have realistic expectations, and are more confident that they can • Follow additional, posted guidelines for patients in isolation. The idea of offering PreHab began where many manage their care once they return home. great ideas do—during a monthly meeting of the

10 Network Network 11 Breast Cancer Prevention: The Importance of Increasing Risk Reduction Therapy and Counseling HPV Vaccination Rates

reast cancer occurs in one in nine women, Here is the take-home message: if your patient has very year, more than 30,000 Americans will against genital warts and the HPV types found in of women who live to age 85. Like prostate a family history of hormone-positive breast cancer be diagnosed with an HPV-related cancer. more than 75% of HPV-associated cancers. INITIATIVES TO Bcancer, breast cancer is an age-related cancer, (excluding the minority with BRCA), with at least EThe HPV vaccine is a cancer prevention IMPROVE THE with a higher incidence as one gets older. two members in the family, they run a likely 20- vaccine, but, due to general vaccine concerns, The HPV vaccine has an early impact in 50% chance of getting breast cancer after age 47. hang-ups regarding the sexual nature of the virus decreasing HPV prevalence and preventing genital COMMUNITIES But if a patient has an estrogen-positive cancer, When menopausal, they should consider taking transmission, and health care access, current rates warts, a mid-life outcome of decreasing dysplasia WE SERVE which is particularly less aggressive (low Ki67 Aromasin at 25 mg daily for up to five years. The of completing the vaccination series in American and the associated procedures, which can threaten score, lower grade), we often find that it runs in the drug does effectively prevent hormone type breast youth is only around 40%. fertility, and the late outcome of prevention of Dr. Pulaski is currently family and, very often, occurs between the ages of cancer in most cases. If perimenopausal, they can HPV-associated cancers. working with American 47 and 65. Nearly 35-40% of breast cancer will be Nationwide, many initiatives are calling for an take Tamoxifen instead, but this is not effective Your role as a provider Cancer Society on this family history-related type, or what has been increase in HPV vaccination rates. In countries birth control. Like most medications, Tamoxifen initiatives to increase called a non-BRCA familial breast cancer. This where coverage is over 50%, HPV prevalence Many clinicians underestimate how parents or carries risk, but much less before age 55. HPV vaccination rates in familial type of breast cancer is often preventable. has gone down almost 70%. The HPV vaccine patients value the HPV vaccine, and think they Dayton and in Kettering If a patient has these same risks but is unwilling has a good safety profile with over 10 years of have preconceived concerns regarding the vaccine. We now know some of these breast cancers may to choose breast cancer prevention medication, active clinical use, in addition to the controlled Regardless, the best predictor of successful Health Network. be related to the genes like Chek2, ATM, PALB2, exercise in the form of brisk non-aerobic activity trials monitored in its development. There is no completion of the HPV vaccine is consistent Currently, in Kettering and others. Regardless, they are allowed to occur and calorie reduction is nearly half as effective. increased risk for death, neurological conditions, recommendation from a healthcare provider. In Physician Network because of estrogen being made in a woman’s Again, note this is absolutely not true for BRCA infertility, autoimmune disorders, or venous essence, your role and voice as a physician makes primary care practices, body. Prior to menopause, a woman’s cycle may patients (especially BRCAI, where breast cancers thromboembolism (VTE). the biggest difference in helping parents to make be somewhat protective, but without the cycle, are often hormone-negative), and prophylactic the choice to protect their children with the data shows that the rate of Patient education the smaller amount of estrogen produced by the mastectomy should be considered instead. HPV vaccine. HPV vaccination is lower adrenal gland (produced by the aromatase enzyme Oophorectomy is recommended, and must be It’s important to educate patients, and their than that of tDap and being present) is the culprit. performed after child-bearing is completed, in the parents when the patient is a minor, about the The most effective way to give a recommendation meningococcal vaccine, case of BRCAII and really should be considered for the vaccine is to bundle the HPV vaccine with the other vaccines that A large clinical trial of breast cancer prevention necessity for the HPV vaccine. As physicians, for BRCAI patients. A genetic counselor should the tDap and meningococcal vaccines that are gave over 6,000 women with significant family we can properly inform regarding the myths of should be offered to the see patients if a family gene is found, as they also recommended for this age range. The HPV history of breast cancer either a placebo or the vaccine, who should receive it, and why. The same age group—a trend are well-informed of the facts and what may be vaccine should be stressed as a cancer-preventing Aromasin (an aromatase inhibitor), and resulted current CDC recommendation is to vaccinate girls that is consistent with commonly overlooked. Breast cancer prevention vaccine, and clinicians can provide written material in prevented invasive breast cancer in nearly two and boys ages 11-12. Many parents and patients national data. medications like Tamoxifen and Aromasin are regarding the vaccine’s efficacy and safety for those thirds of women. This trial excluded the BRCA- have a misconception that vaccination is only covered or approved by insurance if lifetime risk of who are still uncertain about proceeding. positive women where this strategy is often not necessary for girls. However, many types of cancer Dr. Pulaski’s initiatives getting breast cancer is more than 20%. helpful (BRCAI) or may be less ideal (BRCAII). are related to HPV, including cervical, vaginal, with the American Cancer vulvar, anal, penile, and throat cancers. Society, in combination What was more surprising is that only one third by with other programs, will Heather Pulaski, MD, took the product for five years, because they lost If the series of shots are completed under the age gynecologic oncologist by with Kettering Cancer Care aim to give providers more interest after they realized they might not be of 15, then only two shots are needed. Catch-up John Haluschak, MD, oncologist with on shots can be done until the age of 26, and the information and support taking the real thing. This drop-off rate was the Kettering Cancer Care vaccine can be initiated as early as age nine. There is for patient education same in the placebo group and the drug group. in order to continue to It should be noted that osteoporosis was slightly no evidence of waning protection with the vaccine. For more information or further discussion, Dr. Pulaski encourages physicians to reach out improve our community. worse with the drug Aromasin, mainly in the first Dr. Haluschak has an interest in prevention, cancer HPV vaccinations are not live virus vaccines; they to her at [email protected] couple years. In addition, one out of 25 women genetics, and genitourinary cancers. In a future issue, contain a capsid protein from the virus and are had significant symptoms and had to stop the he will also address pros and cons of prostate cancer non-infectious and non-oncogenic. This procures You can also find downloadable factsheets drug (due to bone pain or menopausal symptoms). screening, including PSA screening and the current U.S. higher levels of antibodies than seen with a natural and more resources for speaking to patients Using risk reduction, one out of 25 women prevention task force recommendations. He encourages infection. The new nine-valent vaccine protects about the vaccine at cdc.gov/hpv/hcp probably can’t take the product. Fortunately, the other physicians to reach out to him for discussion on other 24 out of 25 patients likely can. these topics at [email protected]

12 Network Network 13 Shout Outs

Paul Hoover, vice president of including teaching marketing at Walla Walla Mike Rabuka has joined Kettering Health Strategic Development, and University’s School of Business. Josefer will lead Network in the role of director of the Senior John Weimer, vice president of the network’s strategy to position us for future Division. In this role, Mike will serve as Emergency and Trauma market growth. administrator of Sycamore Glen Health Center Services, have been named and have strategic oversight of Sycamore Glen Dayton Business Journal 40 Vicki Davies has assumed the Retirement Community. Mike will help shape under 40 winners for 2018. The responsibilities of Chief post-acute strategy, operations, and services for Open House Compliance Officer, in addition Paul award recognizes rising leaders assisted living and long-term care residents. to her role as vice president of August 5 Hoover in Dayton under the age of 40, Mike is joining the network from the Adventist Have a Shout Out and nominations were judged Internal Audit Services. Her Care Centers in Florida, where he served as the Ribbon Cutting to share? Email on professional oversight of both departments regional director of Operations with oversight over August 7 enhances and protects the physicianquarterly@ accomplishments, community six skilled nursing facilities. Mike is a Licensed Kettering Health Network Middletown ketteringhealth.org leadership, and awards and Vicki organization and its mission. Nursing Home Administrator. milestones. Nearly 200 Davies Since joining the network in individuals around the Miami 2015, Vicki has successfully Joseph ( Joe) Stratton, BSN, RN is filling 40th Anniversary Safety Fair and Concert Valley were nominated, with created an internal audit function, identified cost a new role at Southview Medical Center winners spanning a wide variety reductions, and strengthened internal control as administrative director for Perioperative August 12 of industries. This is the 21st measures. She has earned the Certified Public Services, Endoscopy, and service line director for Southview Medical Center John Accountant certification. Orthopedics at both Southview and Grandview. Weimer year Dayton Business Journal has honored the region’s His duties in this new role will include orthopedic Brad Olson, MBA, has joined Eagle Seekers Golf Outing brightest young professionals. growth and cost reduction as well as collaboration the network as the vice with other network orthopedic service line leaders. August 13 Tim Dutton, vice president of president of Managed Care. Joe’s most recent position was Clinical Operations Human Resources, has been Brad will oversee payer director for Perioperative Services at Southview. Dayton Country Club promoted to senior vice relationships and managed care Joe started his healthcare career at Southview in president of Kettering Health contracting teams. This is a new 2002 in Materials Management, then moved on Employee Golf Outing Network. Tim will remain in leadership position that is made to the Surgery Department as a Nursing Assistant his current role with expanded Brad possible by combining and Anesthesia Tech. September 24 Compliance and Audit, and is responsibilities. Tim has proven Olson NCR Country Club integral to revenue cycle Kurt Lewis has accepted the position of Tim himself invaluable to the strategy and the increasing demands of healthcare Grandview Medical Center System’s director of Dutton network through his leadership and continued commitment to reform. Brad brings a strong background in finance Operational Design. Kurt started in health care at Ticket to Hollywood the mission and community. and comprehensive experience in all components Greene Memorial Hospital where he worked as a of public and private health insurance and staff accountant for five years. He then worked at September 29 Josefer Montes, PhD, MBA, payment innovation—from both the payer and Grandview as the Business Manager in Nursing, Fort Hamilton Hospital has been named vice president provider perspectives. Brad is from Denver, and for the past nine years he has served as of Marketing and Colorado, where he was interim vice president and Finance Manager for Grandview Medical Center Communications for Kettering director of Network Operations and Contracting System. Ribbon of Hope Health Network. Josefer was at Humana. October 2 most recently dean of Sinclair Community College Undergraduate Affairs at Josefer Kettering College. Josefer has Montes over 25 years of marketing and Network Medical Staff Dinner management experience, October 3 Marriott at the University of Dayton

14 Network Network 15 Two New Programs Can Help Change the Outcome for People with Prediabetes

s many as 84 million people in the United intensity physical activity (brisk walking) to at For One Patient, a Wonderful Life Change States have prediabetes, and their risk of least 150 minutes a week. The program, which is Adeveloping Type 2 diabetes is four to 12 times recognized by the CDC, is based on more than a Patricia Tyo-Lanahan has finally found a successful strategy for losing higher than it is for people with normal glucose decade of research. In a U.S. Diabetes Prevention tolerance. Based on current trends, one third of Program study, for example, patients in the weight and adopting a healthier lifestyle. Earlier this year she began these individuals are likely to develop Type 2 intensive lifestyle intervention arm of the trial had meeting with a dietitian at Kettering Health Network and attending diabetes in the next five years, according to the a 58% reduction in the rate of conversion to Type the Diabetes Prevention Program (DPP). So far, she has lost 15 pounds Centers for Disease Control and Prevention. 2 diabetes over three years, and a 34% reduction and experienced marked improvements in her overall well-being. over 10 years. Risk reduction was even more The stakes are high for these patients, and pronounced among individuals age 60 and older motivating them to take action sooner rather (71% over a three-year period). Tyo-Lanahan’s primary care physician began talking to her about than later is essential. Kettering Health Network losing weight two years ago. “I tried eating less, but I just didn’t know recently launched two new programs designed to Who should particiate? enough about nutrition to make progress,” says Tyo-Lanahan, 61. help people with prediabetes make the lifestyle Duck Diabetes and the DPP are available without “Plus I was in a lot of pain from a chronic back injury, so exercising changes needed to avoid diabetes and experience a physician referral, and recommended for anyone was almost impossible.” better overall health. with a fasting blood glucose in the 100-125 mg/dl Duck Diabetes range, a hemoglobin A1C between 5.7 and 6.4, or a body mass index > 25. At her doctor’s recommendation, Tyo-Lanahan began doing physical The first is Duck Diabetes, a free one-hour therapy and meeting with Jessica DiTommaso, a registered dietitian presentation for those who are just starting to “Patients who have prediabetes can significantly with the Kettering Health Network Diabetes & Nutrition Center. think about lowering their diabetes risk. The reduce their risk of developing Type 2 diabetes by class takes place several times a month, and offers losing just 5-7% of their body weight,” says Lea DiTommaso invited her to sign up for the DPP, which DiTommaso practical tips about eating out, grocery shopping, Ann Dick, network director for the Kettering was co-teaching. “The idea of focusing on diabetes prevention with a increasing physical activity, and weight loss. Health Network Diabetes & Nutrition Center. group of people really appealed to me,” Tyo-Lanahan says. “I had had “Program participants benefit from the group Intensive prevention program an aunt who died of the disease, and I saw what she went through. I interaction, accountability, and support, as well as The second is an intensive behavioral lifestyle very focused, practical information about diet and knew I was at risk too, and I just couldn’t do that to my family.” intervention modeled on the national Diabetes exercise.” Prevention Program (DPP). The yearlong program, Tyo-Lanahan says that education has made all the difference—she For information about program dates and locations taught by Kettering Health Network lifestyle is soaking up information about the importance of eating nutrient- or to register, patients can: coaches, including diabetes educators and fitness dense food, counting fat grams, and planning her meals ahead of experts, helps participants make lifestyle changes • Visit ketteringhealth.org/diabetes to decrease their risk of developing diabetes. The time to avoid unhealthy choices. Perhaps the biggest impact on her class consists of one-hour group sessions that meet • Contact the Diabetes & Nutrition Center health is the improvement in her back pain—she now describes it as a weekly for the first four months, twice a month for at (937) 401-7588 “dull 6 or 7” as opposed to a “fiery 8” on the pain scale. “I have to lose five months, and once a month for three months. more weight, but the class is helping me focus on one obtainable goal The cost is $360, and affordable monthly payment If you are interested in receiving free at a time,” she says. “This has been a wonderful life change for me.” plans are available (not all insurances cover informational materials about these this program). programs for your patients, call (937) 401-7566, or email The two major goals of the DPP are for [email protected] participants to achieve and maintain a 7% loss of their initial body weight and increase moderate-

16 Network Network 17 Information Systems Update Kettering Medical Center Foundation New software and changes help with timely communication and collaborative care to Host 18th Annual Ribbon of Hope

Match MD New passwords he 18th annual Ribbon of Hope event will unprecedented response, the network aired an be held on Tuesday, October 2, at Sinclair updated version of the special in October 2013 As Match MD continues its network rollout, As Kettering Health Network information TCommunity College. to generate awareness of breast cancer and to Kettering Physician Network practices are now systems improves its security against data breach inform viewers of her progress. Lori’s true-to-life searchable on the Kettering Health Network “hacking” attacks, new password requirements were Health and wellness and boutique vendors will be depiction of her struggle to beat the disease is now version of Match MD. This will be followed by introduced in June. Physician passwords need to be available beginning at 10 a.m. Registration will used as a cancer education tool and continues to affiliate practices and then strategic post-acute ten characters and a mix of letters, numbers, and begin at 11 a.m. with the luncheon starting at inspire women around the world. partners, including skilled nursing facilities (SNF) characters. Password strength will automatically be 11:45 a.m. and home health care. In the near future, clinical documented with minimum strength requirements. The Ribbon of Hope luncheon originated in 2001 on-call schedules will be required to be posted in Physicians will also have to change their passwords This year’s feature speaker will be Lori Allen, who as a fundraiser for the Women’s Wellness Fund. Match MD. Further communications on the exact every 180 days. Again, further information on this currently stars in the TLC network’s 10-season Over the years, the luncheon has grown from 75 date will be forthcoming. change will be forthcoming. reality show “Say Yes to the Dress: Atlanta” and attendees to over 650. The Fund, established in four-season “Say Yes to the Dress: Bridesmaids,” 1995, provides breast imaging services and other EMS Connect which are filmed on site at her Atlanta-based women’s cancer care to uninsured or underserved EMS Connect phase one is now live and bridal salon, Bridals by Lori. women in the Dayton area at no cost to them. providing emergency medical service (EMS) In 2012, Lori shared her personal battle with run sheet information to emergency department by breast cancer in the TLC special, “Say Yes For more information or to register, (ED) providers electronically. As a result, EMS Charles Watson, DO, Chief Medical to the Cure: Lori’s Fight,” which won the kmcfoundation.org/ribbon information is much more readily available to Information Officer for Kettering Health Network visit 2013 Realscreen Award for Best Health and ED providers in a relevant timeframe. Further Wellbeing Programming. Due to the program’s functionality in the future will provide KHN Epic data, including , current meds, and As always, if you have questions or problem list data, to the EMS crews in the field. suggestions please do not hesitate to contact me at [email protected] or (937) 914-7361. Kettering Medical Center Renovations to Improve Patient Experiences

ith the continual goal of creating the best Patient rooms in Labor and Delivery are being possible experience for patients, Kettering updated as well. These changes are being made WMedical Center is moving forward on with the overall goal to help make patients’ time in multiple construction projects. the hospital more comfortable at a time when they may be feeling a lot of discomfort. The building of a new hybrid operating room will allow for additional and safer procedures. Hybrid Additional updates will include South Dayton operating rooms are equipped with advanced moving into the Boonshoft building and medical imaging devices that enable minimally centralizing under the name Kettering Physician invasive . Surgery waiting areas are Network Urology. getting a complete remodel, along with the Atrium Grill; this project will be completed in two phases and is expected to be done by the end of the year.

18 Network Kettering | Sycamore 19 Celebrating Providers Who Go Above and Beyond

Nomination forms are available in physician ettering and Sycamore medical centers lounges, the Kettering medical staff services continue to honor physicians and providers office, and the medical staff services intranet Kthrough the monthly recognition program. page. Clinical staff and physicians also can Recently recognized honorees include submit a nomination by email; nurses can Michael Welker, MD, orthopedics (February), submit their nominees via Network Star cards. Ashlee Ames, MD, hospitalist (March), Meghan Musser, DO, medical imaging (April), Robert Moore, MD, hospitalist (May), Drew Springer, PA-C (April), and Hetal Desai, PA-C (May).

May’s Physician of the month, Robert Moore, MD (right), was honored by Thomas Proctor, MD (left).

February’s Physician of the Month, Michael Welker, MD (left), was honored by Thomas Proctor, MD (right).

April’s Allied Health Professional of the Month, Drew Springer, PA-C (center), was honored by Thomas Proctor, MD (left), and Deanette Sisson, MSN, RN (right).

March’s Physician of the Month, Ashlee Ames, MD (right), was honored by Thomas Proctor, MD (left).

May’s Allied Health Professional of the Month, April’s Physician of the Month, Meghan Musser, DO (left), Hetal Desai, PA-C (right), was honored by was honored by Thomas Proctor, MD (right). Deanette Sisson, MSN, RN (left).

20 Kettering | Sycamore Kettering | Sycamore 21 Welcome Providers Elements of a High-functioning Kettering | Sycamore New Physicians and Advanced Practice Providers February-April 2018 Primary Care Practice

ANESTHESIOLOGY OTOLARYNGOLOGY SURGERY here has been an increased focus on the importance of primary health Readiness for Change: Staff should be involved Bachar Hachwa, MD Lyndsey Ritze, PA-C Mark Hoeprich, MD Ashleigh Stroble, Maria Buchanan, PA-C care across the United States and other industrialized nations. This focus in planning for practice changes, implementing Cassidy Boyer, APRN-CRNA Dayton Gastroenterology, KPN Brain & Spine APRN-CNP South Dayton Surgeons Treinforces the importance of quality primary health care via a range of changes, and they should know why changes are Inc. Southwest Ohio ENT Hakeem Ellis, APRN-CRNA (937) 643-9299 (937) 534-0330 approaches, such as regional clinincal integration with a focus on information Specialists, Inc. taking place. Supplemental education and training Shawn Vedamani, MD (937) 320-5050 Michael Snider, PA-C and technology including e-health, ensuring a skilled workforce, improving should be provided to the staff when changes OB-GYN (937) 496-2600 Bradley Wisler, MD Andrea Hoffman, PA-C Wright State Physicians infrastructure, and a laser focus on financing and clinical system performance. are being made to promote an environment of Kettering Anesthesia Jonathan Kushner, MD Sheela Barhan, MD learning and improvement. Associates PALLIATIVE CARE The Research, Engagement, and Practice Tactic Teams of the ongoing five- Digestive Specialists, Inc. Marilyn Kindig, DO (937) 424-2469 (937) 293-8228 George Talbot, MD Holly Long, APRN-CNS year Family Medicine for America’s Health Project provided the following Management Incentives: Incentives are an important (937) 293-2169 Innovative Care Solutions, Physicians Women’s Leandra Gray, APRN-CNP elements that support the provision of quality sustainable care for patients. part of encouraging staff to implement and LLC Wright State Physicians DIAGNOSTIC Health Care Partners These elements are the proven building blocks of a high-functioning primary maintain change by recognizing and promoting HOSPITALIST (937) 203-4848 MEDICINE (937) 245-7777 (937) 458-6757 care practice. They are interrelated, where poor practice function in one areas of improvement, new skills, techniques, and Jason Broomhall, MD element will significantly affect the function of another element. Karishma Samtani, MD Michael Galloway, MD Kamran Jafree, MD ways of working. Natalia Gaulke, DO KHN IP Med Geoffrey David Towers, MD Amy Kinter, APRN-CNP Patient-centric, Community-focused Care: Jessica Wobb, MD Garick Hill, MD The practice must provide continuous, Process Improvement: Data must be collected (937) 395-6665 John Matsuura, MD Kettering Network Jerome Yaklic, MD Cincinnati Children’s coordinated, and comprehensive medical care to individuals and their families. Wright State Physicians and analyzed on areas such as workload of staff Radiologists, Inc. Shakeel Ahmed, MD Hospital Medical Center Laura Peterson, MD Wright State Physicians This must be accomplished through a continuous patient/health care/physician members; the management of part-time staff; (937) 208-2850 (513) 636-1199 (937) 297-6306 Amber Richardson, DO Dept. of Surgery relationship based on trust, clinical expertise, the use of evidence-based data on patient waiting times; data about billing South Dayton Acute Care Josette D’Amato, DO practices, and patient input. processes and financial management, etc. The Consultants (937) 208-2552 EMERGENCY Wright State Physicians data should be regularly reviewed and systems MEDICINE (937) 433-8990 Women’s Health Care Leadership: Physician leaders need to actively maintain the vision and mission Kartick Patel, DPM should be in place for staff to identify, discuss, and James Wornyo, MD Partners Community Foot and UROLOGY of their practice. These leaders support and coordinate staff with the use of Bradley Boothe, improve the way the practice works. (937) 208-6810 Ankle Care sound management tools to achieve a shared practice goal. Specialists, Inc. APRN-CNP Tamara Thorn, APRN-CNP (937) 426-9500 South Dayton Urological Software and Information Technology: The ease of use Organizational Management: Organizational management includes defined (937) 436-4658 Kettering Behavioral ORTHOPEDICS Associates of software systems to collect and process quality Professional Group roles, responsibilites, and accountability for medical staff; flexibility in the way Nicole Boucuvalas, information about the clinical care of patients, (937) 294-1489 staff can work; conflict resolution strategies; cash flow management; processes FAMILY MEDICINE (937) 534-4600 APRN-CNP their needs, and their health outcomes, as well as KPN Orthopedics & Sports for budgeting; and regular staff meetings to communicate and review activities. Iman Bastawros, MD information about the financial and billing aspects KPN Primary Care – Brittany Fridley, PA-C Medicine – Springboro KHN IP Med Clinical Governance: Clinical governance includes the use of clinical information of the practice is crucial to being able to value a Far Hills (937) 433-5309 (937) 395-6665 practice’s performance. (937) 298-7351 and management systems such as patient registries and recall systems; Kristen Horgan, PA-C Hassan Al-Shammaa, MD processes for tracking referrals; medication interaction alerts; evidence-based Michelle Bizzarro, Orthopedic Associates reminders for patients; and appropriate clinical protocols. APRN-CNP Chowdry Bashir, MD of SW Ohio Joshua Bumgardner, PA-C Morgan McCroson, PA-C (937) 428-0400 Team-based Communication: Team-based communication is characterized by KPN Primary Care – Folashade Oyekunle, collaboration, both formally and informally, in day-to-day work. All staff must by Cornerstone APRN-CNP understand and value the roles of everyone else in the practice and how these Paul Martin, DO, Chief Medical Officer for (937) 562-2291 Tara Perdue, PA-C Grandview and Southview medical centers South Dayton Acute Care roles complement each other. Consultants Patient Communication: Patients should be provided bidirectional access to (937) 433-8990 information about their health and the opportunity to discuss it. Patients need to be routinely asked what information they would like and how it could best be provided to them.

22 Kettering | Sycamore Grandview | Southview 23 Grandview Grows Hospitalist Care Team Grandview Expansions to Meet Needs in West Dayton Community

s Grandview Medical Center prepares for Inc. “The doctors and specialists joining us are not randview Medical Center is moving forward increased volumes, the physician team is strangers, but are just extended family coming over on multiple expansions to prepare for Agrowing with the addition of new hospitalists. to Grandview.” Gincreasing patient volumes following the closure of Good Samaritan Hospital. With the changes in the West Dayton community, “This is very much a team Grandview leaders have identified a need to grow approach,” says Rebecca Cath and EP lab additions the hospitalist care team. These new Grandview Ramirez, MD, Kettering One significant project includes the expansion Kettering Physician Network Hospitalists Health Network Chief of the cardiac Cath lab, as well as the addition will partner with the existing care team from Hospitalist Officer. “We are of an electrophysiology (EP) lab—a service that Internal Medicine Care, Inc., who have practiced all aligned around taking will now be offered at Grandview for the hospitalist medicine at Grandview for many years. good care of patients and are first time. The new group of hospitalists Rebecca collaborating to position all began clinical practice at Ramirez, MD parties for strong success.” A new 7,500-square-foot wing targeted to open Grandview in June. in September will house the new EP lab and Cath labs. EP labs at Kettering Medical Center “The nice thing about this have been at capacity for some time, and further To kick off construction of the emergency department transition is that it keeps the expansion in the network has been needed. expansion, hospital and local leaders took turns community together,” says Leaders have identified a plan for growth at knocking down a wall in Grandview administration Troy Tyner, DO, president Grandview specifically, as open heart surgical with a sledgehammer. Troy of Internal Medicine Care, back-up is needed for the addition of an EP Tyner, DO Kettering Health Network, cites recent statistics lab. The current changes in the West Dayton indicating that West Dayton residents suffer a community are providing impetus for moving higher number of heart attacks and strokes. For (From L to R): Sheryl Spires, NP-C; Ben Thomas, DO; Ingrid Brown DO; forward on these projects right away. Opeyemi Alli, MD; Ruth Muriithi, MD; Joseph Crawford, DO; Sunila Paul, this reason, expanding emergency services for this MD; Troy Tyner, DO; Michael Boggs, MD; Carla Myers, DO; Greggory Volk, DO; Cardiovascular Management Unit community is all the more critical. “The expansion Radhika Akella, MD; Abdul-Mannan Masood, MD. of Grandview’s emergency department will prepare Another recent change to Grandview includes us to save more lives,” Chew says. the Cardiovascular Management Unit (CVMU) that opened on June 4. This is a step-down The first phase of the ED expansion has included telemetry unit with a capacity of 23 beds, taking a three-bay triage area, a consultation room, and care of those with a cardiac history, such as an expanded registration area. Next phases include congestive heart failure or those who have had a a second computed tomography (CT) scanner, cardiac catheterization. advanced patient care and critical care bays, expanded imaging services inside two new trauma “We have many highly experienced cardiac rooms, and the new Cath and EP labs. nurses, and are excited that this unit is open and serving patients,” says Connie Donaldson, MS, Most of these services will be offered by fall, with RN-BC, and director of Patient Experience, the entire project expected to be complete in Medical-Surgical Nursing, Orthopedics, and November. Support Services for Grandview and Southview medical centers. “We don’t want to see West Dayton become a healthcare desert, so our commitment is to make Emergency department expansion sure the entire community has access to quality Construction also continues for the emergency health care,” says Chew. “We really feel expanding department expansion that will double services at this critical time is simply the right current capacity. Roy Chew, PhD, president of thing to do.”

24 Grandview | Southview Grandview | Southview 25 The Big Reveal: New Procedural Eagle Seekers Supports Skills Center to Open Soon Teaching Kitchen Teaching kitchen will hold cooking and educational classes for residents, medical staff, and community

fter more than a year of planning, fundraising, The center will hire a coordinator to facilitate he Eagle Seekers charity golf tournament which is licensed by Tulane University’s School and construction, the Wetherell Innovation & scheduling, help maintain the facility, and interact marks its 30th year with a festive fundraiser of Medicine. The culinary medicine program, AProcedural Skills Center is set to open with medical device manufacturers and other Ton August 13 at Dayton Country Club. a partnership with the University of Dayton in August on the campus of Southview organizations to offer training modules. In recent Highlights will include golf, dinner, auctions, dietetics program, includes a monthly lecture, Medical Center. years, residents have traveled to other locations and entertainment! Golf is optional, and all monthly journal articles, and four “teaching for these training opportunities, which are often are invited. kitchens,” which currently take place at UD. The primary purpose of the center is to provide hosted by industry. The curriculum covers evidence-based nutrition training opportunities for residents and fellows All proceeds will benefit construction of a Brent education, as well as societal factors that influence in specialties such as general, orthopedic, hand, “Our goal is to offer the best state-of-the-art teaching kitchen. The teaching kitchen will be Bamberger, DO nutrition in our country and guidance on how to otolaryngology, and obstetric-gynecologic surgery. surgical training center available to medical service a place to hold cooking and educational classes. help patients make good food choices. The $650,000 center, which was named in honor providers of the Dayton region,” Dr. Bamberger Grandview Medical Center’s culinary medicine of Russ Wetherell, former Grandview Medical says. “We will keep expanding and improving the program will hold classes for resident physicians Over the past three years, Eagle Seekers proceeds Center president, is located on the second floor center so residents and others can keep up with the there, as part of its two-year curriculum, have helped support the Grandview Foundation’s of the Yankee Medical Building. The center latest innovations and technologies.” renovation of the Rieck Center for Osteopathic replaces the skills lab located in the old morgue at and construction of the Grandview Medical Center. Wetherell Innovation & Procedural Skills Center at Southview Medical Center—over $3 million Skills center features include: WETHERELL INNOVATION & in capital improvements to support medical education. Invitations—including information • 900 square feet of teaching space, and an PROCEDURAL SKILLS CENTER about sponsorships, golf foursomes, and tickets additional 900 square feet for an office, supply to the dinner and auction—will be mailed to room, and restrooms Janitor Office BEBE AA HEROHERO Fight Hunger and physicians’ homes. • Refrigerated storage for anatomy specimens Locker RR (W) Room Chronic Disease! • Four hands-on student training stations and Supplies a central teaching table outfitted with surgical RR (W) Information is available at lighting and instruments. One station has a grandviewfoundation.org and from the high-resolution camera, whose images can be Secured Entry WETHERELL GRANDVIEW FOUNDATION foundation staff at (937) 723-3358, or by visiting broadcast to remote locations for review and Cooler th the foundation’s new office on the lower level of critique, and to document improvement. INNOVATION & 30 ANNUAL the 425 Building. • Simulators to practice injections, surgical PROCEDURAL knots, intubation, scopes, and other You're SKILLS CENTER procedures invited • Upgraded scopes, imaging technology, drills, Procedural Skills Lab 2,714 SF and other state-of-the-art equipment Teaching table, SECOND FLOOR PLAN 898 SF © 2017 Kenneth J. Seidl, Registered Architect light & camera “Some people have innate surgical skills, but most [email protected] 937.299.5333 surgeons need a great deal of structured learning 0 5' 10' 20' Monday, EAGLE SEEKERS GOLF TOURNAMENT experiences and purposeful practice before they Please note that this drawing scales August 13 are ready to operate on patients,” says Brent 1 inch equals 10 feet Bamberger, DO, orthopedic surgery, who has been Procedural Skills Lab Expansion integrally involved with the center. “This center 668 SF will provide opportunities to practice essential Dayton surgical skills, work with new techniques and Country Club technologies, and receive meaningful feedback.”

26 Grandview | Southview Grandview | Southview 27

Existing Classroom Welcome Providers Construction to Begin Soon Grandview | Southview New Physicians and Advanced Practice Providers February-April 2018 on New Tower at Soin

ANESTHESIOLOGY FAMILY MEDICINE INTERNAL MEDICINE oin Medical Center has experienced This is just the latest in a series of construction Christine Croom, Brittney Fridley, PA-C Karishma Samtani, MD Stephen Fried, MD Tamara Thorn, APRN-CNP tremendous growth since opening its doors projects at Soin, which have included expanding APRN-CRNA KHN IP Med Alliance Physicians, Inc. Kettering Behavioral Sin 2012. Now, the hospital is embarking on the emergency department and opening two new Barbara Landesman, MD Joshua Frueauf, (937) 395-6665 (937) 384-4838 Evokes, LLC Professional Group its biggest expansion effort yet—the construction patient care floors to almost triple the hospital’s APRN-CRNA (513) 947-8433 (937) 534-4600 of a five-story patient care tower, which will open bed count. “This tower was part of the campus’s Jacqueline Hope, Suzanne Bell, MD Casey Harnly, PA-C before the summer of 2020. original master plan, and we are beginning this APRN-CRNA David Cox, DO Shamsuddin Pracha, MD RADIOLOGY project sooner than originally anticipated. We are Haley Nemcik, Lois Henson, DO Dayton Lung and Sleep ORTHOPEDICS Rebecca Paessun, MD “The impetus for this expansion is the fact that starting construction far earlier than we expected APRN-CRNA Marilyn Jones, MD Medicine, Inc. Andrew Malarkey, DO TeamHealth Anesthesia Victor J. Cassano Health Dayton Physicians we have had double-digit growth each year as the KPN Primary Care – (937) 832-5292 to,” says Dodds. community continues to depend on us for high- (561) 623-2021 National Center (937) 771-2422 Raja Khan, MD (937) 558-0220 quality medical care,” says Rick Dodds, president Dodds credits employees and physicians for the (937) 531-0113 Jason Broomhall, MD CARDIOLOGY Ruth Muriithi, MD of Soin Medical Center and Greene Memorial hospital’s success. “They are our difference makers,” Donna Vogel, APRN-CNP KHN IP Med Kristen Horgan, PA-C Bryan Canty, MD Hospital. The tower will be located behind the he says. “Over the years, employees and physicians Angela Bartlett, Orthopedic Associates KPN Primary Care – (937) 395-6665 Natalia Gaulke, DO hospital’s current inpatient structure. It will have focused a lot of time and energy on making APRN-CNP of SW Ohio Vandalia Ann Rivera, MD add more operating rooms and post-anesthesia sure the community knows about us and chooses Lisa Grow, PA-C Kristie Farkash, APRN-CNP (937) 428-0400 Kettering Network (937) 619-0050 care space, a new cardiac catheterization lab, 30 us for their health care. We have an incredible Parthiv Shah, MD KPN and Radiologists, Inc. KPN Heart & Vascular Pamela Sutherly, PA-C Diabetes Julie Weller, APRN-CNP additional inpatient rooms, and shelled space team, and their commitment to patients and each Orthopedic Associates (937) 297-6306 (513) 867-3331 (937) 335-3010 (937) 401-7575 to accommodate future growth. Construction is other is the reason this hospital continues to grow (937) 280-4988 Tammy Dann, DO scheduled to begin this fall, and disruptions to and touch lives.” Ceferino Cata, MD Shane Sampson, MD Pain Evaluation & NEPRHOLOGY everyday life on campus will be minimal. John Duchak, MD Providence Medical Management Center Syed Najeed, MD Group Natallia Maroz, MD of Ohio Renal Physicians, Inc. KPN Heart & Vascular AY DRIVE (937) 436-0300 L GATEW (937) 439-4949 ROYA (937) 223-3053 (937) 222-3118 GENERAL SURGERY EMERGENCY Nicholas Houlis, DO Future location MEDICINE Victor J. Cassano Health

James Wornyo, MD Center of new patient To Royal Gateway Emergency Medicine and Grange Hall Rd. (937) 558-0200 Specialists care tower (937) 436-4658 Soin Medical Center Frank Kearse, DO Envision Physician Main Entrance EMERGENCY Services DROP-OFF Ollie Davis Pavilion Soin Medical aj Center R &

(215) 442-5058 u d In

P PARKING

PENTAGON BOULEVARD

Ollie Davis Entrance VISITOR PARKING VISITOR PARKING Rows 1-7 Rows 1-8

To N. Fairfield Rd., Interstate 675, and Commons Boulevard

NORTH

28 Grandview | Southview COMMONS BOULEVARD Soin | Greene 29 The Kettering Cancer Care expansion at Soin provides more accessible care, offering a range of options to provide Radiation Oncology Services the specific treatment needed for Now Available at Soin Medical Center each patient.

ettering Cancer Care at Soin celebrated the opening of its radiation oncology services, Kcompleting the multi-phase expansion in early May. Ronald Hale, MD, medical director of Radiation Network and community leaders attended a ribbon Oncology, and other network and community leaders celebrated the opening of radiation cutting on May 3, where leaders spoke to what this oncology services at Soin on May 3. expansion will mean for community members.

“As many of you can relate with your own personal situations, there’s never a great time for sickness or illness,” said Rick Dodds, president of Soin The center features a state-of-the-art Medical Center and Greene Memorial Hospital. linear accelerator, as well as a CT scan and simulation “When it happens though, we want to be here and lab, dosimetry lab, and four new exam rooms. we want to be ready.”

Along with the recently expanded infusion center, this new space brings state-of-the-art, whole- person cancer care to Greene County.

“Our physician leaders know what their patients need, and our staff know the hearts and minds of our patients,” said Elizabeth Koelker, executive director of Oncology for Kettering Health Network. “Their empathy and their compassion is an inspiration that’s incomparable to anything you will ever see.”

Community members toured the new space during an open house on May 9.

30 Soin | Greene Soin | Greene 31 Mobile Imaging Unit Provides Greene Open House and Safety Fair a Creative Solution for the Soin Cath Lab

he Cath lab at Soin Medical Center is running of care in the mobile unit as they would in the reene Memorial Hospital hosted an open at full capacity, with weekday procedures fixed Cath lab. The fixed Cath lab will continue house and safety fair on April 15. Over 280 Tstarting at 7 a.m. and wrapping up at 6:30 p.m. to provide diagnostic and interventional coronary Gpeople braved the rain to come to the hospital Plans are underway to add a second Cath lab in angiographic procedures. and learn more about safety. Highlights of the 2020. But with patient volume booming, the Cath event included: lab team just can’t wait. This summer, they’ll begin When the new Cath lab opens in 2020, the mobile unit will roll off into the sunset and be replaced • Emergency Vehicle Exploration offering non-coronary angiographic procedures in ■ a fully functional, mobile imaging lab that will be by a mobile computed tomography or magnetic Fire truck ■ located adjacent to the emergency department. resonance imaging unit. Soin Medical Center is Ambulance committed to continuing to provide high-quality The current Cath lab provides cardiac Cath, service for the growing number of patients who • Family Fun ■ pain management, and depend on it for their care. Teddy bear clinic procedures. Patient volume has been on the ■ Balloon animals

rise since late 2016, when the team added ■ percutaneous coronary interventions to its long Doc McStuffins list of services. Emergency PCIs save lives but • Health Screenings and Wellness Tips also create scheduling challenges, since they delay • Facility Tours planned cases. For example, an emergency cardiac Greene Memorial case can effectively bump 25 scheduled pain management procedures. “This year the Cath lab is on track to surpass patient volume numbers set Foundation to Host 23rd in 2017, which were up 32% from the previous year,” says Barb Robinson, BSN, RN, director of Nursing, Perioperative Services, Centers of Annual Circle of Victory Excellence, Invasive Cardiology, and Maternity Services at Soin Medical Center. “The growth in Springfield Health Center Open House patient volume at Soin is amazing, and we need to keep innovating to provide the best possible care ave the date for Sunday, October 7, for this year’s annual Circle of Victory NGFIE for our community. This mobile unit will allow RI LD fundraiser. The event will be held at Apple Country Farm Market. P us to increase capacity and improve the patient S SRegistration begins at 12:30 p.m. with the cancer awareness walk starting ettering Health Network is expanding services into the experience.” at 2 p.m. Springfield community with the opening of Springfield Health KCenter this summer. The mobile unit will provide a wide variety Proceeds from this event benefit cancer care services of lower acuity, non-coronary angiographic The health center will feature a wide range of medical specialties, providing in Greene County. Since its inception, procedures. These include establishing dialysis all ages access to quality care close to home. Currently, the facility offers H R Circle of Victory has helped hundreds of E E access and ports for chemotherapy, implanting orthopedic and primary care services, with imaging, physical therapy, heart A T men, women, and children across Greene L EN pacemakers, performing kyphoplasty and and vascular care, and women’s health services opening in August. TH C County, not only by helping underwrite cancer peripheral vascular interventions, and providing treatment, but also with medication, wigs, pain management therapies such as epidurals and Join us for an open house on July 31 and enjoy: prostheses, and other financial burdens born by pain pumps. Registration, pre-op and post-op care Tuesday, July 31 cancer patients. • Facility tours for patients undergoing a procedure in the mobile 5:30-7:30 p.m. unit will take place in the current universal care • Health fair 2100 Emmanuel Way, Springfield unit. Patients will be transported to the mobile circleofvictory.org Visit to register. • Physician meet-and-greet Register at ketteringhealth.org/springfield imaging lab via a climate-controlled, covered • Complimentary refreshments walkway. They will receive the exact same level

32 Soin | Greene Soin | Greene 33 Welcome Providers Ground Broken for New Health Center Soin | Greene New Physicians and Advanced Practice Providers February-April 2018 in Hamilton

ANESTHESIOLOGY EMERGENCY HOSPITALIST PAIN MANAGEMENT ettering Health Network leaders, Fort Cassidy Boyer, CRNA MEDICINE Hassan Al-Shammaa, MD Jerome Hric, MD Tammy Dann, DO Hamilton Hospital executives, and local Pain Evaluation and Hakeem Ellis, APRN-CRNA James Wornyo, MD Chowdry Bashir, MD Newborn Audiology Kofficials celebrated the start of a new health Emergency Medicine Screening P.C. Management Center Bachar Hachwa, MD Morgan McCroson, PA-C center in Hamilton with a groundbreaking Specialists, Inc. of Ohio Roy Haines, MD Folashade Oyekunle, (856) 782-2212 ceremony on April 16. Stephen (937) 395-8166 APRN-CNP (937) 439-4949 Henderschedt, MD Tara Perdue, PA-C NEUROLOGY Hamilton Health Center on Main will house FAMILY MEDICINE PALLIATIVE MEDICINE Patricia Knopf, MD Amber Richardson, DO Sonia Anand-Nichols, MD outpatient services including physician practices Janny Kehr, APRN-CNP Wendy Schmitz, MD Nirvana Kundu, MD South Dayton Acute Care Barbara Landesman, MD and imaging and lab services. Construction on Community Physicians of Consultants Anna Zivkovich, MD Renee McClain, APRN-CNP Francisco Vega- the 16,000-square-foot facility is expected to be Yellow Springs Bermudez, MD Innovative Care Solutions David Tibbits, MD (937) 433-8990 completed in spring of 2019. (937) 767-7291 Stephen Fried, MD (937) 203-4848 Shawn Vedamani, MD INFECTIOUS DISEASE Evokes, LLC Bradley Wisler, MD Anantha Rojanala, MD PODIATRY Kettering Anesthesia KHN IP Med Kunal Desai, MD (484) 351-8459 Kartick Patel, DPM Associates, Inc. Kaili Fan, MD (937) 395-6665 ORTHOPEDICS Community Foot James Galbraith, MD (937) 293-8228 Specialists Zachary Denka, MD Richard Groger, MD Sunishka Soin Family Wimalawansa, MD (937) 322-7607 CARDIOLOGY Satish Sarvepalli, MD Advanced Plastic and Practice Center South Dayton Acute Care Caitlin Chabut, PA-C RADIOLOGY KPN Heart & Vascular (937) 558-3900 Consultants (937) 203-8527 David Elkon, MD (937) 433-8990 CompHealth Locum DIAGNOSTIC GASTROENTEROLOGY Nicole Boucuvalas, Tenens RADIOLOGY Lyndsey Ritze, PA-C INTERNAL MEDICINE APRN-CNP Dayton (419) 996-5063 Douglas Eulberg, PA-C Frank Farkash, APRN-CNP KPN Orthopedics & Sports Dayton Interventional Gastroenterology, Inc. Medicine Brittney Fridley, PA-C Jason Broomhall, MD Radiology (937) 320-5050 Luke Menner, DO (937) 433-5309 Natalia Gaulke, DO (937) 424-2580 KHN IP Med Kettering Network Kayla Fryman, PA-C (937) 395-6665 Radiologists, Inc. Kristen Horgan, PA-C Orthopedic Associates (937) 297-6306 of SW Ohio UROLOGY (800) 824-9861 Ashley Leutze, PA-C Springfield Urology (937) 342-9260

34 Soin | Greene Fort Hamilton 35 Dedicated Phone Line to Fort Hamilton Welcome Providers Fort Hamilton New Physicians and Advanced Practice Providers Emergency Department Physicians February-April 2018

eferring physicians now have direct access to • Referring physician involvement ANESTHESIOLOGY EMERGENCY NEUROLOGY ORTHOPEDICS an emergency department physician at Fort in hospital care Kathleen Harvey, MEDICINE Bhupesh Khadka, MD Theresa Sevilis, DO Kristen Horgan, PA-C RHamilton Hospital through a dedicated phone APRN-CRNA Jamie Duck, PA-C Stanca Schilff, MD Chut Sombutmai, DO Orthopedic Associates • Expectations of visit discussed line. This line can be used to speak with an emer- Daniel Mosher, Sarah Joseph, MD The Kidney and Telespecialists, LLC of SW Ohio APRN-CRNA • Emergency department staff anticipate arrival Thomas Lauck, MD Hypertension Center (239) 208-2212 (937) 428-0400 gency department physician regarding patients that TeamHealth Anesthesia have been referred to the emergency department. Troy Reeves, APRN-CNP (513) 241-5630 • Improved continuity of care with follow-up (561) 623-2021 Addison Tarr, DO ONCOLOGY RADIATION calls given in 3-6 hours TeamHealth Emergency Elisha Lancaster, MD This new service offers a variety of benefits: Kurt Leuenberger, MD ONCOLOGY DIAGNOSTIC Medicine The Kidney and Hypertension Center Suzanne Partridge, MD Jessica Wobb, MD • Improved communication RADIOLOGY Fort Hamilton (856) 686-4322 David Waterhouse, MD To utilize this service, call (513) 867-2254. Daniel (859) 341-6281 Radiation Oncology • Expedited care Wannemacher, MD Cynthia Chua, MD Professional Radiology Inc. FAMILY MEDICINE Amr Moussa, MD Oncology (513) 867-2315 • Decreased redundant testing (513) 872-4500 Abigail Tennant, PA-C Karl Pembaur, MD Care Inc. KPN Primary Care – The Kidney and (513) 751-2273 Heritage Rossgate Hypertension Center (513) 738-3900 (513) 861-0800

Stanley Scheidler, DO Scheidler Medical Preferred (513) 737-0257 Fort Hamilton Facility Renovations Ticket to Hollywood

o continually improve and provide the best, most welcoming environment for patients, TFort Hamilton has recently made renovations to some major areas. ave the date for Saturday, September 29, and Anniversary Legacy Campaign projects at Fort join the Fort Hamilton Hospital Foundation Hamilton Hospital. The theme this year is Pearl All the flooring in the common areas has been Sand the Colleagues for this year’s Ticket to Harbor. updated. Carpet has been replaced with plank Hollywood event. flooring that has a rubber backing to cut down on noise. Outside brick has been repainted, and the This evening of entertainment will To RSVP, contact Sonja Kranbuhl at parking lot has been resealed and repaved, adding include a dinner and silent auction, [email protected] more handicap spaces. and all proceeds will benefit the 90th

The operating room remodel included new flooring, painting, and a new air handler that will Ticket better regulate the temperature in the operating 2 018 room. Every waiting room and lobby now also has HOLLYWOODHOLLYWOOD new furniture for visitors.

36 Fort Hamilton Fort Hamilton 37 Kettering Physician Network Welcome Providers Kettering Physician Network New Physicians and Advanced Practice Providers Brain & Spine Rebrands February-April 2018

ettering Physician Network has rebranded and This elite Brain & Spine practice has three BEHAVIORAL MEDICINE FAMILY MEDICINE Dena Mason-Zied, DO NEUROSURGERY enhanced the neurosurgery service line. The locations, and offers neurosurgery, neurology, and Tamara Thorn, APRN-CNP Michelle Bizzarro, James Mark Hoeprich, MD Kpractice and service line, formerly Kettering pain management, as well as a broad range of Kettering Behavioral APRN-CNP Slaughenhaupt, DO KPN Brain & Spine Medicine Center KPN Primary Care – Physician Network Neurosurgery, which grew out neurological services. Joshua Bumgardner, PA-C (937) 643-9299 Michelle Russell, DO Springboro Remick of Neurosurgery, Inc., is now Kettering Physician (937) 534-4600 KPN Primary Care – (937) 531-0124 RADIATION ONCOLOGY Network Brain & Spine. This rebrand aligns Cornerstone closely with Kettering Health Network’s Brain & CARDIOLOGY Jessica Wobb, MD (937) 562-2291 HOSPITALIST MEDICINE Fort Hamilton Radiation Spine service line. Angela Bartlett, APRN-CNP Oncology Iman Bastawros, MD Brittany Fridley, PA-C Caitlin Chabut, PA KPN Primary Care – Hemapriya Kumar, MD (513) 867-2315 Lisa Grow, PA-C Far Hills Archana Nair, MD KPN Heart & Vascular KPN (937) 298-7351 SURGERY (937) 395-6665 Maria Buchanan, PA-C Abigail Tennant, South Dayton Surgeons APRN-CNP Kettering Physician Network (937) 534-0330 KPN Primary Care – Heritage Rossgate Primary Care Holds MyChart Contest (513) 738-3900

n January, the Patient-Centered Medical Home KPN Primary Care has a MyChart activation goal (PCMH) team held its own version of March of over 51% activation for empaneled patients. IMadness and launched a three-month MyChart MyChart gives patients the ability to access their enrollment contest. Primary care practices were Kettering Health Network medical information at split into three divisions and then seeded into a any time, from anywhere, through a secure online bracket. On the first of each month, the practices connection. With a MyChart account, patients with the highest percentages of increase moved on can send inquiries to their provider about minor to the next round, and the practices with the lowest medical problems, schedule eVisits, review their percentages fell off the bracket and moved to the medical information, renew prescriptions, manage “benchwarmer list.” Practices “on the bench” were doctor’s appointments, view their test results, and then ranked by the total number of new MyChart pay bills online. sign-ups over the course of the contest.

Congratulations to the MyChart Activation Tournament Division Winners: KPN Primary Care – Heritage Ross KPN Primary Care – Upper Valley Troy

KPN Primary Care – Ollie Davis KPN Primary Care – Vandalia National In total, 7,764 patients signed up for MyChart in a three-month period!

38 Kettering Physician Network Kettering Physician Network 39 NONPROFIT ORGANIZATION US POSTAGE PAID Dayton, OH 3535 Southern Blvd PERMIT No. 45 Kettering OH, 45429 First Name Last Name, Degree Office Name Address 1 Address 2 City, State Zip Code