A Publication of SPRING 2019 CLARA MAASS MEDICAL CENTER healthytogether
THE ABCs OF ARTHRITIS
A MAJOR GIFT TRANSFORMS LABOR SUITES
A CHILD’S MEDICAL MYSTERY, SOLVED
WHERE TO GET THE BEST CANCER CARE
CMMC_Cover_Spring19_final.indd 1 4/4/19 8:59 AM A MESSAGE FROM LEADERSHIP HEALTH NEWS CLARA MAASS MEDICAL SAFETY: CENTER EARNS ACCOLADES CMMC’s steadfast commitment to improving the health and well- It Takes a Team being of the communities it serves is exemplified by the national awards and recognition we have received. Here are some recent examples: hen it comes to safety, our philosophy is simple. RWJBarnabas Health is committed to zero incidents of • OVERALL EXCELLENCE Awarded a Four-Star rating from the Centers for Medicare and Medicaid Services (CMS). preventable harm for our patients, families, visitors and W Released in 2019, the CMS rating provides details to the public each other. This quest, which we call Safety Together, is designed to help on more than 60 different quality measures in seven categories. create the best possible outcomes for our patients and an exceptional • SAFETY Earned 11 Grade “A” scores in Hospital Safety and work environment for our team. Quality from The Leapfrog Group. We’re applying the same tools used by High Reliability • LGBTQ Earned designation in LGBTQ (Lesbian, Gay, Bisexual, Organizations (HROs) in the manufacturing and nuclear industries. Transgender and Questioning) Healthcare Equality from the These companies have greatly reduced accidents by using standardized Human Rights Campaign Foundation in 2018. error-prevention processes. Similar safety systems are being embraced • SPECIALTY EXCELLENCE Earned Specialty Excellence by our staff in both clinical and non-clinical roles as they go about Awards from Healthgrades in Labor and Delivery, and Obstetrics their day-to-day tasks. and Gynecology, 2018, and in Bariatric Surgery, 2018, 2019. At Clara Maass Medical Center, we foster a culture of safety • DISEASE-SPECIFIC CERTIFICATION Earned the by implementing a program we call “Rounding to Influence.” Our Gold Seal of Approval from the Joint Commission with Disease- leadership team visits all areas of the hospital to ensure staff awareness Specific Care Certification in Acute Coronary Syndrome, and to provide additional education and support, especially to our Congestive Heart Failure, Elective Joint Hip Replacement, Elective Joint Knee Replacement and Advanced Certification in front-line staff. Every day, our management team starts the day by Palliative Care. sharing information about potential or existing safety issues that may affect patients, visitors or employees and identifying solutions • CONNECTIVITY Named by the American Hospital Association Health Forum to the 18th Annual Health Care Most for those issues. We’ve also required training on HRO for all of our Wired Hospitals list for 2016, 2017 and 2018. employees. All of our HRO initiatives are designed with the overall • WORKPLACE PARTNERSHIP Earned Platinum goal of keeping everyone who comes through our doors safe and recognition in 2018 from Health Resources and Services completely free from harm. Administration (HRSA) Workplace Partnership for Life Hospital Becoming an HRO means everyone who works for RWJBarnabas Campaign for increased organ donation efforts Health knows that they can make a difference for our patients, for their • QUALITY PATIENT CARE Designated Primary Stroke teammates at work and for our communities as a whole. We’re excited Center by the New Jersey Department of Health, and designated to empower our family of employees to do everything possible to Bariatric Surgery Center of Excellence by the American Society support our mission of excellence as we care for you and your family. for Metabolic and Bariatric Surgery. Yours in good health,
BARRY H. OSTROWSKY MARY ELLEN CLYNE, PhD 1 Clara Maass Drive, Belleville, NJ 07109 PRESIDENT AND CHIEF EXECUTIVE OFFICER PRESIDENT AND CHIEF EXECUTIVE OFFICER 973.450.2000 | www.rwjbh.org/claramaass RWJBARNABAS HEALTH CLARA MAASS MEDICAL CENTER READ OUR INTERACTIVE DIGEST ONLINE! www.rwjbh.org/claramaassmag
CONNECT WITH US ON @ClaraMaassMedicalCenter @Clara_Maass RWJBarnabas Health Clara Maass Medical Center
Clara Maass Medical Center complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. For more information, see link on our home page at www.rwjbh.org/claramaass. Clara Maass Medical Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. Llame al 973.450.2000. Clara Maass Medical Center konfòm ak lwa sou dwa sivil federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 973.450.2000.
Healthy Together | 2 | Spring 2019
CMMC_Memo_Spring19_final.indd 2 4/4/19 9:04 AM healthytogether contents SPRING 2019 5
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2. WELCOME LETTER. 12 12. WHERE TO GET THE 18. TEAMWORK FOR A community update BEST CANCER CARE. WEIGHT LOSS from our CEOs. For patients, what does SUCCESS. Dedicated it mean to have access professionals support 4. FOR YOU AND YOUR to a “comprehensive” patients before, during BABY. Parent cancer center? and after bariatric education programs at surgery. Clara Maass Medical 14. THE GOAL: Center. ZERO ERRORS. 20. QUIZ: DO YOU KNOW Our health system is HOW TO MANAGE 5. A JOYFUL CHILDBIRTH. A on a mission to achieve HYPERTENSION? Use major gift helps transform the highest safety these tools to help Labor, Delivery and standards. bring down high blood Recovery Room Suites. 9. MAKING A REAL IMPACT. 16. A BABY’S BEST FRIEND. pressure; plus, a tasty 6. THE CASE OF THE RWJBarnabas Health is How a therapy dog low-sodium recipe. MYSTERY RASH. Thanks committed to promoting helped one little girl 22. BREAST CANCER to expert help, a little community health. recover her strength. boy’s rare condition was SCREENING: WHAT resolved. 10. BETTER CARE FOR 17. BEHAVIORAL HEALTH EVERY WOMAN Where to OLDERGet ADULTS. the CRISIS: WE CAN HELP. SHOULD KNOW. 8. ASK THE DOCTOR: ALL Healthcare providers are Psychiatric emergency Don’t let common ABOUT ARTHRITIS.BEST Your CANCERtaking a fresh look atCARE care is available when myths prevent early questions, answered. how to treat the elderly. it’s needed most. detection. FOR PATIENTS, WHAT DOES IT MEAN TO HAVE ACCESS TO A “COMPREHENSIVE” CANCER CENTER THAT IS DESIGNATED BY THE NATIONAL CANCER INSTITUTE?
RWJBarnabas Health, in Fall 2018 partnership with Rutgers Cancer Clara Maass Medical Center RWJBH.ORG/CLARAMAASS PB | Healthy Together | Institute of New Jersey—the state’s | | 3 To learn more about programs and services at only NCI-designated Comprehensive Cancer Center—provides close-to- the Rutgers Cancer Institute of New Jersey, home access to the latest treatment visit www.cinj.org. and clinical trials. To learn more, visit www.rwjbh.org/beatcancer.
CMMC_TOC_Spring19_final.inddHealthy Together 3 | 12 | Spring 2019 4/4/19 9:05 AM FOR YOU AND YOUR BABY: Parent Education Programs CLARA MAASS MEDICAL CENTER IS HERE TO HELP YOU AND YOUR NEWBORN GET OFF TO A GREAT START.
Having a baby is one of life’s most exciting and cherished experiences, made more wonderful when parents feel good about their pregnancy and delivery, and have a team to lend support in raising and nurturing their newborn. The Maternity Center at Clara Maass Medical Center has a dedicated, experienced and professional staff to assist you and your family with getting a loving, caring start for your new addition.
TOUR OF THE MATERNITY INFANT CARE CLASS PREPARING FOR CHILDBIRTH CENTER AT CMMC Fourth Wednesday of each month, 7–9 p.m. Evening Option: First and second First Sunday of each month In two hours, learn what you need to Wednesday of each month, 7–9 p.m. or 9 a.m. and 10 a.m. know about parenting in an interactive Weekend Option: Third Saturday and Prepare for the birth of your child by “university” for parents-to-be. Learn the Sunday of each month, 10 a.m. to 12 p.m. touring the Maternity Center at Clara basics on how to navigate parenthood For parents who plan to deliver at the Maass Medical Center and learning about including topics such as newborn and Maternity Center at Clara Maass Medical our parent education series. Following postpartum care. Parents are welcome to Center, this workshop will help them to the tour, meet a member of our team attend at any time. prepare for the birth of their child by to discuss our admission process and discussing birth options available and explore the various childbirth options BREASTFEEDING WORKSHOP practicing birthing skills. Expectant mothers available at Clara Maass Medical Center. Second Monday of each month, 7–9 p.m. may attend at any stage of their pregnancy. For new mothers considering LACTATION SUPPORT FOR breastfeeding, our workshop offers the BREASTFEEDING MOTHERS assurance and knowledge needed to Our “Warm Line” is here for you! After the establish successful breastfeeding. Our birth of your baby, if you have questions or certified lactation consultant will share concerns about breastfeeding, call our Warm with new parents the advantages for both Line at 973.450.2868, 24 hours a day, and mother and baby of lactation, preparation, leave a message. Our Lactation Consultants nutrition and breast care. Dads-to-be and will return your call as soon as possible. partners are also welcome.
Registration is required for all classes, events and support groups. Call 888.724.7123. (Note: If a session does not reach a minimum number of participants, you will be notified and placed on the schedule for the next class.)
Healthy Together | 4 | Spring 2019
CMMC_Maternity_Spring19_final.indd 4 4/4/19 9:06 AM Donations make a difference: Brian Sterling, a trustee at both Clara Maass Medical Center and the Clara Maass Medical Center Foundation, and his wife, Linda, have made a transformative gift.
make use of a birthing ball (on which she can gently rock during labor to ease pain) or a birthing chair (which allows for a squatting position during labor).
GIVING THAT FEELS GOOD The Sterlings say that supporting the institutional priorities of CMMC is a key consideration for them. “We think Clara Maass is a jewel—a small community hospital that is really delivering top- quality medical care and healthcare to the community,” says Brian. “We have enormous respect for the judgment of President and Chief Executive Officer Mary Ellen Clyne and her team.” Brian, who grew up in West Orange, first became involved with CMMC after a cardiac scare in 2012 that sent him to the Emergency Department. “They took such good care of me,” he says. “And as we’ve gotten to know more about Clara Maass, their concept of wellness, in addition to healthcare, really reverberates with us. Wellness is about nutrition, it’s about A JOYFUL food security, having a clean place to live, getting educated—it all ties up, and that is what Clara Maass is promoting. It’s very important to us to help further their mission.” CHILDBIRTH Giving to CMMC is a source of personal A LEADING DONATION ENABLES ALL NEW MOTHERS AT CLARA MAASS satisfaction, the Sterlings say. “I’m a breast MEDICAL CENTER TO HAVE A FIRST-CLASS EXPERIENCE. cancer survivor,” says Linda. “You never worry about your health until something goes wrong, and then you realize how xtensive research has supported what experience,” says Linda. “Whether it’s your important it is. We have the benefit of many women know intuitively: The first child or your fifth, you want to have an having outstanding healthcare, but so many Eenvironment in which birth takes environment that moms as well as doctors people don’t, and you can see the financial place makes a big difference to the well- and nurses can feel positive about.” and other stresses it puts on their family. being of new mothers. The Labor, Delivery and Recovery “When we talk with Mary Ellen Clyne At Clara Maass Medical Center (LDR) unit at CMMC will now house six about all the different things Clara Maass (CMMC), every woman who gives birth richly decorated, contemporary suites with does to help families, it makes us feel will now have a state-of-the-art and holistic amenities such as refrigerators and coffee extraordinarily good to know that we’re environment, thanks to a transformative gift machines. All rooms are private, with having an impact on people’s lives at what by Brian Sterling, a member of the Board private bathrooms. Patients say that having may be one of the most important times in of Trustees of Clara Maass Medical Center privacy, as well as enough room for visiting their lives. We’re happy to be able to do it.” and of the Clara Maass Medical Center family members, is a priority as they bond Foundation, and his wife, Linda. with the newborn. “We have two children, and we want In addition to providing the latest To learn more about opportunities to make sure that women of all different technology and care, the LDR team at to give to Clara Maass Medical cultures and economic standpoints have CMMC takes a holistic approach to Center, visit www.claragiving.org. a positive and healthy labor and delivery childbirth. If she wants to, a woman can
Healthy Together | PB | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 5
CMMC_Foundation_SPR19_final.indd 5 4/4/19 9:07 AM To learn more about pediatric care at Clara Maass Medical Center, visit Lorena and her son www.rwjbh.org/claramaasspediatrics. Gabriel read together at home.
Healthy Together | 6 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 7
CMMC_EDPatientStory_SPR19_final.indd 6 4/4/19 9:08 AM THE CASE OF THE MYSTERY RASH WHEN A LITTLE BOY CAME TO THE EMERGENCY DEPARTMENT COVERED IN WELTS, THE EXPERTISE OF THE PEDIATRICS TEAM CAME TO THE RESCUE.
oung Gabriel had always been a bright, curious ball of fire. Morrison, MD, a pediatric allergy, immunology and infectious So when, at age 3, he began to mope around the house and disease specialist at CMMC who also serves as the Director of Y didn’t want to play as he normally did, his mom, Lorena, Pediatrics. knew something was wrong. About 12 hours after Gabriel was admitted to the Pediatric “The symptoms were vague—fatigue and fever—but not especially Unit, Dr. Morrison came to Lorena with the answer: Gabriel had alarming,” she says, “until one night, he suddenly broke out with a a rare condition called erythema multiforme. Caused by a virus, rash and welts all over his tiny body.” it can lead to welts and blisters on the skin, mouth and eyes. “It’s The welts were “everywhere”—on his torso, legs, arms, neck, a skin rash, and it’s a scary one,” says Dr. Morrison. “It evolves ears, face and lips. His skin itched horribly. “It was awful,” Lorena over several days and you get what look like bull’s-eyes all over the says. “His skin was swollen from head to toe.” None of the over-the- body. Sometimes it comes after a cold, sometimes it comes after counter medications she tried helped. medication. It’s uncommon, but it does happen.” The medical team was able to assure Lorena that Gabriel’s A RARE CONDITION welts, though worrying, would eventually go away on their own Lorena had never been to Clara Maass Medical Center (CMMC), but and that he would probably have no long-term side effects. her instincts told her to head to the Emergency Department (ED) She stayed with him in the Pediatric Unit for three days as the there. “Gabriel’s pediatrician had always spoken highly of it, and it’s medical team worked to get the itching under control. just a few minutes from our home,” she says. That decision connected Gabriel to a deep team of pediatric WHAT PARENTS NEED specialists, both in the ED and in the Pediatric Unit. He needed that During this time, Lorena developed a new appreciation for her expertise, because the cause of his condition was far from obvious. local hospital. Gabriel arrived at midnight, and emergency physicians worked “The doctors and nurses did exactly what I would want them to quickly to examine him and run tests. do,” she says, recalling their swift, exacting actions. “Their confidence “We see tens of thousands of patients every year in our said to me, ‘Although there’s something wrong, we’re going to figure Emergency Department, and we are experts at uncovering the cause it out, tell you what it is and get treatment underway.’” of health conditions, even rare ones,” says John Fontanetta, MD, “This is what we do every day, but we understand that an Chairman of Emergency Medicine. “For children, we also have a ED visit is certainly not what a parent does every day,” says Dr. total of 60 pediatric specialists, with several on-site 24 hours a day, Fontanetta. “We know that reassurance is what a parent needs, as to provide additional expertise for patients like Gabriel.” much as their child needs care.” “The team took steps immediately to alleviate the severe “When it comes to medical care in some hospitals, there can be a itching,” Lorena says, with gratitude. “From the time my son separation between the caregiver and the patient,” Lorena says. “But arrived at Clara Maass, everyone worked hard to make him more at Clara Maass, beginning with the staff in the ED, they managed to comfortable break down any barrier and become part of my family. Everyone I while seeking met made us feel this way.” the cause of his Gabriel, now 7 years old, is in first grade and back to his bright, discomfort.” active self. He has had no more symptoms. Over the next But the experience made a big impact on the family. In several hours, appreciation, Lorena now serves on the Advisory Board of staff researched CMMC’s Center of Excellence for Latino Health (www.rwjbh.org/ possible causes claralatinohealth), and when she and a relative recently needed of his condition. hospital care, CMMC was their choice. They called in “It’s now a family thing between us and Clara Maass,” she says. JOHN FONTANETTA, MD SUSAN HAGEN MORRISON, MD Susan Hagen “The people there are amazing.”
Healthy Together | 6 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 7
CMMC_EDPatientStory_SPR19_final.indd 7 4/4/19 9:08 AM Q&A ASK THE DOCTOR
ALL ABOUT ARTHRITIS OUR ORTHOPEDICS EXPERT SHARES INSIGHTS ABOUT PREVENTION AND TREATMENT.
he term “arthritis” is a catch- balance between being sedentary and being all phrase for more than 100 active to the point where it’s excessive T conditions that affect joints and and you’re causing damage. The old adage their surrounding tissues, causing pain “train, don’t strain” is a good one to keep that can range from mild to severe. About in mind. 54 million U.S. adults have arthritis, Inflammatory arthritis is best treated FRANK FEMINO, MD according to the Centers for Disease by a rheumatologist, who can prevent joint Control and Prevention. Frank Femino, damage through proper medication. MD, Director of Orthopedics at Clara what to do, as opposed to you telling it Maass Medical Center (CMMC), answers a How is arthritis treated? what to do, it’s time to think about joint few key questions about this common—and I like to start with very conservative, replacement. Joint replacement is the sometimes debilitating—condition. holistic treatments. These include proper ultimate cure for arthritis of the hip and footwear; weight loss, if needed; and an knee, but it’s a personal decision. The What causes arthritis? exercise program or physical therapy to patient has to feel not only physically There are many types of arthritis. Broadly increase joint flexibility and strength. ready, but emotionally ready. speaking, it can be divided into either This can always be supplemented with “wear and tear” or “inflammatory.” oral medication, as necessary. Herbal What is the surgery and Wear-and-tear arthritis, or supplements, such as turmeric, are often recovery like? osteoarthritis, is caused by the joints helpful. Glucosamine and chondroitin I think of joint replacement as a temporary wearing out due to overuse or injury. sulfate are also widely available over inconvenience for the patient. At CMMC, Inflammatory arthritis is a disease that the counter. Check with your physician we use minimally invasive techniques for causes inflammation and pain in the joints. to be sure herbal and over-the-counter surgery and the latest in pain management Two common examples are rheumatoid medications are safe for you. to speed recovery and get the patient back arthritis and psoriatic arthritis. Injections of either cortisone or gel to normal activity. Many patients stay in (hyaluronic acid) can give sustained relief the hospital only one or two days, and What can people do to prevent from arthritic pain. some even leave the same day. They then arthritis? receive physical therapy at home for a week Maintaining good health is the best When should a person consider or so, and then as an outpatient. preventive measure. This includes proper joint replacement to relieve Some patients may require a short stay nutrition; weight loss, if necessary, through arthritis? on our Transitional Care Unit, and then sensible dieting; and an exercise program It’s based on pain. If, after conservative they go home. Either way, they’re back to that avoids overuse or injury. There’s a care, your knee or hip is telling you an active lifestyle quickly and comfortably.
To learn more about orthopedics at Clara Maass Medical Center, visit www.rwjbh.org/ortho.
Healthy Together | 8 | Spring 2019
CMMC_OrthoArthritis Q&A_Spr19_final.indd 8 4/4/19 9:09 AM purchase socks for its patients, which has strengthened the vendor’s capacity to grow and expand. • HIRE LOCAL: RWJBH has pledged to hire 350 Newark residents by 2020 as part of the Newark 2020 partnership of local institutions and employers. Jersey City Medical Center’s Career Ladders program, which will soon be adopted system-wide, helps develop a path to promotion for entry-level employees. • INVEST LOCAL: To spur innovation and future investment, RWJBH has invested in Audible.com’s Newark Venture Partners Labs IT innovation center to stimulate the establishment of new businesses. Through partnerships, the RWJBH system helps improve community health, reduce disparities and enhance equity, including: • SAFE AND HEALTHY HOUSING: MAKING A Robert Wood Johnson University Hospital New Brunswick participated in the New Brunswick Healthy Housing Collaborative, designed to work with families to create REAL IMPACT high-health environments in homes RWJBARNABAS HEALTH IS COMMITTED TO PROMOTING COMMUNITY throughout the region. RWJBH is currently in discussions with national, state and HEALTH, BOTH INSIDE AND OUTSIDE A MEDICAL CENTER’S WALLS. local partners to expand its commitment to creating affordable housing in other child is taken to the emergency FINDING WHAT WORKS communities throughout the state. department for asthma, is “Traditionally, the way in which • FOOD SECURITY: A Wellness on A treated and sent home—to an institutions like ours have delivered Wheels mobile greenhouse travels to apartment where leaky pipes cause mold healthcare has been to wait for people communities throughout the entire that triggers her asthma. to come to us,” says Michellene Davis, RWJBH region. Additionally, youth in A man is given a prescription for high Esq., Executive Vice President and Chief Newark created a documentary, “Food for blood pressure but can’t afford to get it Corporate Affairs Officer for RWJBH, who Thought,” to explore the impact of food filled. heads the SICI effort. “Now we’re acting on insecurity on a community’s health. A woman is counseled about healthy the fact that health disparities begin and Davis believes the SICI effort will eating to help control diabetes but doesn’t continue outside our doors. We’re looking inspire and energize not just RWJBH have access to fresh fruits and vegetables. at the whole patient and the context in employees, but community members as Because social conditions play a critical which he or she lives.” well. “People will want to come to an entity role in wellness, The range of approaches is broad. that has high-quality, culturally competent RWJBarnabas “Every RWJBarnabas Health hospital clinical care, and at the same time invests Health (RWJBH) conducts its own community health needs in creating good in the world,” she says. has ramped up assessment, because each community is “This is about being the change you wish its commitment unique,” Davis explains. Recent examples of to see in the world. Everyone is welcome to to communities’ SICI-related efforts include: join us on this journey.” whole health • BUY LOCAL: RWJBH has made a through its deep commitment to buy from local Social Impact and minority- and women-owned To learn more about RWJBarnabas and Community businesses. For example, Newark Beth Health’s social impact initiatives, Investment (SICI) Israel Medical Center has a contract visit www.rwjbh.org/socialimpact. MICHELLENE DAVIS, ESQ. Practice. with Newark vendor Rock Ya Socks to
Healthy Together | PB | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 9
System_SICI_Spring19_final.indd 9 4/5/19 1:21 PM BETTER CARE FOR OLDER ADULTS HEALTHCARE PROVIDERS ARE TAKING A FRESH LOOK AT HOW TO TREAT THE ELDERLY.
n elderly man who’d been A NEW APPROACH Two areas stood out as ripe for admitted to the hospital was The American Hospital Association, in expansion. One was the James and Sharon A disoriented. “He thinks he’s partnership with the Catholic Health Maida Geriatrics Institute at Monmouth talking to his father, who died years ago,” Association of the United States, the Medical Center Southern Campus, where the man’s daughter told his doctor. “Does Institute for Healthcare Improvement Dr. Israel is the Director, which specializes this mean he has Alzheimer’s?” and the John A. Hartford Foundation, has in all aspects of inpatient and outpatient He did not. What he did have was created the “4M Model” to guide hospitals geriatric care. The other is Better Health, delirium, brought on by the many changes and health systems in providing age- a senior membership program offered by in his routine caused by his admission friendly care. The four elements are: the Institute, with a full range of health, to the hospital. It’s a common problem What Matters: taking the time to wellness and social events. Both the for elderly patients, according to Jessica sit down for a discussion with an older Institute and the Better Health program Israel, MD, Corporate Chair, Geriatrics patient to understand his or her concerns, will be replicated at Saint Barnabas and Palliative Care, for RWJBarnabas goals and preferences for treatment. Medical Center in Livingston and Robert Health (RWJBH). Medications: taking additional care Wood Johnson University Hospital “Family members get alarmed, but in with drugs. “Giving a new prescription Hamilton this year, with other RWJBH many cases, that confusion is treatable— to someone who is 90 years old is not the hospitals to follow. though we may have to be a bit of a same as giving it to someone who is 19,” The RWJBH system is moving detective to find out what the problem says Dr. Israel. “As we age, medications ahead on multiple other fronts. Eight is,” she explains. “It could be anything don’t work the same way in the body, and hospitals have or are working toward from untreated pain, to an electrolyte there’s a greater risk of interactions.” Nurses Improving Care for Healthsystem disturbance, to a urinary tract infection, Mentation: identifying and managing Elders (NICHE) certification, and all to a sleep/wake cycle disturbance.” depression, dementia and delirium. hospitals will ultimately have Geriatric Sensitivity to changes in routine is Mobility: making sure a patient is Emergency Department Accreditation just one of many reasons older patients helped to move safely every day so he or (GEDA). As part of the RWJBH need thoughtful care, Dr. Israel says. As she doesn’t lose the muscle tone needed partnership with Rutgers University, the U.S. population ages—by the year for everyday tasks. the geriatrics team also is working to 2030, 1 of every 5 residents will be older enhance existing geriatrics fellowship than 65, according to the U.S. Census BEST PRACTICES training programs for physicians. Bureau—RWJBH facilities are at the When Dr. Israel took on her role And all RWJBH employees will take a forefront of a national drive to develop as Corporate Chair, Geriatrics and computerized learning module, currently age-friendly care. Palliative Care, almost two years ago, in development, that will help them “Throughout she knew that the RWJBH system understand what it means to be older. the system, we’re already had some exemplary age-friendly The possibilities are endless, because taking a very programs. To extend their reach and to geriatrics itself is so wide-ranging. close look at what share ideas across hospitals, she created “Sometimes the best person to reach out it means to be a geriatrics collaborative. “Every hospital to is not a doctor, but a physical therapist, age-friendly, not in our system has a multidisciplinary nutritionist or social worker,” says Dr. just in hospital team focused in geriatric care that may Israel. “The thing I love most about care, but in all include doctors, nurses, social workers, geriatrics is that it’s not some group of areas in which we physical therapists, administrators, doctors telling you what to do. It’s a team treat patients,” pharmacists and health educators,” says of people looking at your life and helping JESSICA ISRAEL, MD says Dr. Israel. Dr. Israel. you live it to your best.”
Healthy Together | 10 | Spring 2019
System_AgeFriendly_Spring19_final.indd 10 4/5/19 1:22 PM HOW TO GET BETTER CARE Jessica Israel, MD, Corporate Chair, Geriatrics and Palliative Care for RWJBarnabas Health, offers these tips for older adults. • Have an advocate. “Sometimes four ears are better than two when it comes to a doctor visit or hospital stay,” says Dr. Israel. • Ask questions. If you don’t understand something or it isn’t the way you thought it was going to be, ask. • Keep an accurate list of medications and physician contact numbers with you. This will help doctors treat you more quickly if an emergency arises. • Explore advance directives. “Patients of all ages should assign a healthcare proxy,” advises Dr. Israel. “But then also be sure to tell that person what your wishes are in the event that complicated medical decisions must be made.”
To learn more about age-friendly programs and services at RWJBarnabas Health, visit www.rwjbh.org/seniorhealth.
Healthy Together | 10 | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 11
System_AgeFriendly_Spring19_final.indd 11 4/5/19 1:22 PM Where to Get the BEST CANCER CARE FOR PATIENTS, WHAT DOES IT MEAN TO HAVE ACCESS TO A COMPREHENSIVE CANCER CENTER THAT IS DESIGNATED BY THE NATIONAL CANCER INSTITUTE?
To learn more about programs and services at Comprehensive RWJBarnabas Health and the Rutgers Cancer Institute Cancer Center
of New Jersey, visit www.rwjbh.org/beat cancer. A Cancer Center Designated by the National Cancer Institute
Healthy Together | 12 | Spring 2019
System_CancerCare_Spr19_final.indd 12 4/5/19 1:24 PM THE CUTTING EDGE: BLOOD AND BONE MARROW TRANSPLANTS For some cancer patients, a blood and bone marrow utgers Cancer Institute of New Jersey, a partner of transplant (BMT) can be an effective treatment and RWJBarnabas Health, is the state’s only National Cancer even a potential cure. The Blood and Marrow Transplant RInstitute-Designated Comprehensive Cancer Center. Only Program at Rutgers Cancer Institute of New Jersey is the 50 cancer centers in the U.S. have earned that classification. It’s an only such program in New Jersey that’s integrated within impressive achievement—but what does it mean to cancer patients an NCI-Designated Comprehensive Cancer Center. and their families? “All blood and immune cells are made in the bone We asked Steven K. Libutti, MD, FACS, Senior marrow,” explains Roger Strair, MD, PhD, Chief of Vice President of Oncology Services, Blood Disorders at Rutgers Cancer Institute. “Blood RWJBarnabas Health, to explain. cells carry oxygen, fight infection and prevent bleeding. Dr. Libutti is also Director, Rutgers Immune cells also fight infection by attacking anything Cancer Institute of New Jersey in the body that’s perceived as not belonging, or and Vice Chancellor for Cancer foreign.” In a BMT procedure from a donor, a patient receives a transplant of healthy blood and immune Programs, Rutgers Biomedical Health cells and those cells in turn grow and make new cells, and Sciences. including immune cells that can attack cancer cells. If the person’s own cells are used, there is no immune If a person who has been attack of cancer, but the cells allow a rapid recovery diagnosed with cancer asks your from high-dose chemotherapy. advice, what do you tell him or her? At Rutgers Cancer Institute, BMT is used to treat a A diagnosis of cancer can feel overwhelming, and variety of blood and immune disorders, including acute people want to know where they should go for treatment in order and chronic leukemias, various types of lymphoma, to get the best possible outcome. Hodgkin’s disease, multiple myeloma and more. I always tell people that cancer doesn’t travel well. It’s more the rule than the exception that a patient requires multi-modality treatment, such as surgery, chemotherapy and radiation therapy. The patient is best served by staying as close to home as possible information. When a patient goes to an NCI-Designated while getting exceptional treatment. Comprehensive Cancer Center, he or she gets the benefit of their Patients should listen to the advice given by their physician, collective knowledge, clinical trials and research. and get more than one opinion. They also need to be able to cut through the noise and static of the marketplace. That means they Does a patient need to travel to New Brunswick, should understand the meaning of the word “comprehensive” where Rutgers Cancer Institute is located, in order when it refers to cancer treatment. to take advantage of its services? No. We have built a network across all 11 RWJBarnabas Health What does it mean to be a Comprehensive Cancer hospitals so that the outstanding treatment and care provided by Center? Rutgers Cancer Institute is available as close to home as possible Many cancer centers will use the word “comprehensive,” but for all New Jerseyans and those in our region. it doesn’t have the same meaning as a Comprehensive Cancer If, for example, a patient lives near Saint Barnabas Medical Center that’s designated by the National Cancer Institute (NCI), Center in Livingston, that patient will find that the cancer which is very specific and prestigious. program there is anchored by Rutgers Cancer Institute; that he or An NCI designation is a five-year grant that is acquired she has access to many of the same clinical trials as those taking through an arduous, competitive, years-long process. Only 70 place in New Brunswick; and that experts in surgery and radiation cancer centers in the country are chosen and of those, only 50 oncology and so on are partnered with Rutgers Cancer Institute. receive the designation Comprehensive Cancer Center, meaning Now, let’s say that a patient needs a specialized service— that they do for example, a bone marrow transplant, which we do in New laboratory Brunswick. Because we have a coordinated system, we can research and seamlessly transfer care of that patient to New Brunswick. Our clinical trials, as partnership with RWJBarnabas Health allows patients to enter well as provide the world of an NCI-Designated Comprehensive Cancer Center services directly through multiple doors. to patients. We’re also creating an extensive cancer navigation program to All of help patients throughout and after treatment. Our goal as a cancer these centers program is not only to have the best treatments, physicians and collaborate clinical trials. It is also to give the best care in helping patients STEVEN K. LIBUTTI, MD ROGER STRAIR, MD and share navigate what can be the most challenging period of their lives.
Healthy Together | 12 | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 13
System_CancerCare_Spr19_final.indd 13 4/5/19 1:24 PM THE GOAL: ZERO ERRORS THE RWJBARNABAS HEALTH SYSTEM IS ON A MISSION TO ACHIEVE THE HIGHEST SAFETY STANDARDS.
To learn more about RWJBarnabas Health, visit www.rwjbh.org.
Healthy Together | 14 | Spring 2019
System_HRO_SPR19_final.indd 14 4/5/19 1:34 PM f a nuclear power plant has a serious they can actively prevent accident, it’s big news. In large part, harm,” says Dr. Bonamo. The Ithat’s because organizations in this goal of zero defects is seen as and other high-risk industries, where everyone’s responsibility. errors can be catastrophic, have developed robust safety policies to prevent mistakes TOOLS FOR from being made. In industry parlance, SUCCESS they’re what’s known as High Reliability To aid in this quest, staff Organizations, or HROs. members have a number of The parallels to healthcare systems, tools and techniques to use. with their high-stakes, highly complex They include: operations, are clear. “At RWJBarnabas Stopping the line. “In Health, we’re on a journey to becoming the past, if a staff member an HRO,” says John Bonamo, MD, MS, had a feeling something For Seth Rosenbaum, MD, MMM, SVP, Chief Medical Officer at FACOG, FACPE, Executive Vice President wasn’t right, he or she might Robert Wood Johnson University Hospital Hamilton, his team, and all and Chief Medical and Quality Officer at have buried that instinct, RWJBH employees, HRO values are a daily priority. RWJBarnabas Health (RWJBH). “There’s no thinking ‘I’m probably end point, no HRO certification. Instead, wrong,’” says Dr. Bonamo. being an HRO is a way of doing business. “Now they’re empowered to say, ‘I’m not MANY VOICES Ultimately, it delivers the highest-quality comfortable with X, Y or Z.’” “Each of our employees has a new voice, a care and safest experience for our patients Recently, he recounts, a nurse was chance to practice at the top of their skills and for our employees.” preparing a young woman to go into and be heard,” says Dr. Bonamo. “We’ve The aim of the initiative, called “Safety surgery for gall bladder removal when the made significant progress in our safety Together,” is clear—and bold. “Our goal patient mentioned she had a “funny feeling” event rate, and we’re confident it’s going to is zero incidents of preventable harm to in her chest. The nurse called an EKG continue to go down.” patients and employees,” Dr. Bonamo says. (electrocardiogram) tech and refused to send Each RWJBH hospital has created “That’s it.” the patient to the OR until the test was patient-family advisory councils to get done. As it turned out, the woman was in more insight into how they can improve THE THREE-LEGGED STOOL the middle of having a heart attack, and the delivery of care. In any circumstance, Dr. “When people are interviewed in large-scale delay may well have saved her life. Bonamo says, patients should demand the focus groups about what they want from a Clarifying questions. If a staff member is highest quality in their healthcare. “You hospital, they tend to mention three things,” not sure about something that’s happening, wouldn’t take a flight on an airline that says Dr. Bonamo. “One is, ‘Help me’—that’s he or she can be comfortable asking for didn’t have the highest-quality standards about excellence in the quality of clinical clarification. In addition, every order gets and a great safety record,” he says. “It’s the care. The second is, ‘Be nice to me’—and repeated back. If the dosage ordered is 50 same thing in healthcare. You should be that’s about the patient experience, the milligrams, the pharmacist or nurse will seeking care in a facility that’s on a journey communication and kindness. clarify, “That’s five-oh, right?” If the verbal to becoming an HRO.” “Then there’s ‘Don’t hurt me.’ That’s order is for a urology test, there will be an about safety, the third leg of the stool. For alphabet check to be sure it wasn’t for a a long time, hospitals didn’t pay enough neurology test. attention to that. Cross-checks. “That means that if you THE ABCs OF “Now, the best hospitals realize that you see me making a mistake, you correct me or BECOMING AN HRO can have the most expert surgeon and the ask if I’m sure that’s right,” says Dr. Bonamo. At RWJBarnabas Health, all team greatest bedside manner, but those things “In the past, people were afraid they’d be members follow these principles aren’t enough if a patient falls out of bed or told to mind their own business. of safety: gets an infection from a catheter.” “But now we realize that if I have a 1 in peak up for safety. Over the past 1,000 chance of making a mistake and you S year, all employees have a 1 in 1,000 chance and we cross-check A ccurately communicate. at every RWJBH each other, there’s a million in one chance facility have of making a mistake. We’re realizing that F ocus on the task. received in-depth healthcare is a team sport.” E xercise and accept a training in safety, Safety huddles. Every unit in every questioning attitude. error prevention building has a stand-up safety huddle each and performance morning to go over the previous T houghtfully interact. excellence. “We’re 24 hours and forecast the next 24. An hour giving employees later, there’s a facility-based huddle, a larger Y ou and me together. JOHN BONAMO, MD a new skill set so gathering with the same purpose.
Healthy Together | 14 | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 15
System_HRO_SPR19_final.indd 15 4/5/19 1:34 PM Therapy dog Burton helped ease demanding A BABY’S therapy sessions for toddler Ava Finelli. time,” her mother, Laura, says. “These kids require a whole team, and we’re very well versed in treating children with respiratory issues as well as various BEST FRIEND neuromuscular disorders,” says Dr. Fantasia. HOW A THERAPY DOG HELPED The doctor acknowledges that the team also ONE LITTLE GIRL RECOVER had a secret weapon: Burton, a 2-year-old therapy dog. “She loooved Burton,” she says. HER STRENGTH. EYES ON BURTON espiratory Syncytial Virus, known During therapy sessions, Burton would as RSV, is an infection in the An RWJBarnabas Health facility position himself across from Ava so that R respiratory tract that can lead to she could work on stretching and moving serious problems. It’s always a matter of her arms to reach him. He ran back and concern when a baby gets it, but is even Ava contracted RSV in January 2018, at forth across the room so that she’d work on more so when the child has an underlying not quite 2 years old, she could not cough turning her head from side to side. Because medical condition. strongly enough to rid her airways of mucus. Ava focused so intently on Burton, her That was the case for little Ava Finelli, She had trouble swallowing, and became therapy sessions were eased. “Burton was her who was born with Spinal Muscular weaker, struggling to lift her head and move motivator,” Laura says. “He’s so friendly and Atrophy (SMA), a genetic disease affecting her arms and legs. energetic, he really helped her forget how part of the nervous Ava was sent to Children’s Specialized difficult the movements were.” system that leads Hospital for treatment. “She had an Ava was discharged after two months. to weakness in the intensive therapy program,” says Michele She continues to get outpatient therapy limbs. Children Fantasia, MD, the physiatrist and specialist and to take Spinraza, a promising new with SMA have in pediatric rehabilitation medicine who medication for SMA. “She did very well weak intercostal oversaw the plan. After several weeks of with us overall,” Dr. Fantasia reports, “and (between the respiratory, physical, occupational and pool was able to go back to her home, family and ribs) muscles, and therapy, Ava showed remarkable progress typical toddler activities.” underdeveloped and was able to lift her head and to better For more information about Children’s lungs and chest move her arms and legs. “It was incredible Specialized Hospital, call 888.244.5373 or MICHELE FANTASIA, MD muscles. When to see the progress Ava made in such a short visit www.childrens-specialized.org.
At Children’s Specialized Hospital, we provide world-class care for children and young adults who face special health challenges across the state of New Jersey and beyond. Our locations in Bayonne, Clifton, East Brunswick, Egg Harbor Township, Hamilton, Jersey City, Mountainside, New Brunswick, Newark, Toms River and Warren treat everything from chronic illnesses and complex physical disabilities like brain and spinal cord injuries, to developmental and behavioral issues like autism and mental health.
Healthy Together | 16 | Spring 2019
System_CSH_Spr19_final.indd 16 4/5/19 1:32 PM BEHAVIORAL HEALTH CRISIS:
WHERE WE CAN HELP WE SERVE Clara Maass PSYCHIATRIC EMERGENCY CARE IS AVAILABLE WHEN OUR COMMUNITY NEEDS IT MOST. Medical Center PESS hen a mental health issue causes an The PESS unit is based in the CMMC Emergency covers these individual to act in a way that places Department, where screeners respond to calls through municipalities: W himself or others in danger, it’s likely to a 24-hour hotline. • Belleville be a psychiatric emergency. These emergencies form • Bloomfield a broad category that can include situations such as REACHING OUT • Caldwell threatening suicide, threatening another person or The program, which marked its one-year anniversary experiencing acute post-traumatic stress. at CMMC last November, is extending its reach. “We • Cedar Grove In time of a psychiatric crisis, a professional want to help people avoid coming to the hospital,” • East Orange assessment and a connection to appropriate services says Tess Medina, MAS, BSN, RN, BC, Assistant Vice • Essex Fells may be needed. The Psychiatric Emergency Screening President, Behavioral Health Services at CMMC. “We • Fairfield Service (PESS) at Clara Maass Medical Center have a mobile outreach team, including staff located at • Glen Ridge (CMMC), the designated provider of immediate the West Orange Police substation three days a week.” • Livingston psychiatric care for the western portion of Essex The mobile response team travels to patients to • Maplewood County, is available to help. provide assessments at their home, school or any other Although the first instinct for many people facing location throughout the 20 municipalities where the • Millburn a psychiatric crisis is to go to the nearest Emergency PESS unit provides services. The team also provides • Montclair Department, other resources in the community are outreach to universities, correctional facilities, nursing • North Caldwell better suited to provide comprehensive help for homes and nearby hospitals. • Nutley behavioral health issues. “What’s amazing is how we’ve been able to increase • Orange “We may have a family member calling about our presence in the community—we’ve nearly tripled • Roseland a loved one, a mental health clinic calling about a the number of mobile screenings that we do,” says • South Orange patient, or the police may call PESS when they see Wanda Maragni, Licensed Clinical Social Worker and someone they know behaving erratically,” says Joe Director of PESS. “Our goal is to take care of people • Verona Cuffari, LPC, Assistant Vice President of Psychiatric in the communities we serve so they can be evaluated • West Caldwell Emergency Services at RWJBarnabas Health. quickly and receive the care that they need.” • West Orange
If you or someone you know is experiencing a psychiatric emergency, you can call the PESS crisis intervention hotline 24 hours a day, seven days a week at 973.844.HELP (4357). To learn more or to make an appointment at any of the RWJBarnabas Health Behavioral Health Network sites throughout NJ, call the Network Access Center at 800.300.0628.
Healthy Together | PB | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 17
CMMC_PESS_Spr19_final.indd 17 4/4/19 9:09 AM TEAMWORK FOR
aving successful bariatric (weight loss) surgery is far from a solo Hjourney. WEIGHT Of course, having a really skilled surgeon is key—and Clara Maass Medical Center (CMMC) has three who specialize in the procedure. “Surgery is a tool, but it’s only part of the equation,” says Naveen LOSS Ballem, MD, Director of Bariatric Surgery at CMMC. “We also have a full team that supports the patient before, during and after the surgery.” The bariatrics team at CMMC is SUCCESS comprehensive. It includes a secretary, a A DEDICATED GROUP OF BARIATRICS PROFESSIONALS SUPPORTS nurse manager, a nurse navigator (who is the contact person for patients, helping to PATIENTS BEFORE, DURING AND WELL AFTER SURGERY. provide medical information and direct them to other resources) and a clinical reviewer. The team also includes bariatric
Healthy Together | 18 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 19
CMMC_Bariatrics_Spring19_final.indd 18 4/4/19 9:10 AM their minds to go ahead with it,” says and haven’t been active in a while. “But I Kristin Carlino, RD, Bariatric Dietitian. try to convey before we meet that they’re “After meeting with the surgeon, they not coming to see me for a brutalizing have a good understanding of what the workout,” Gonnelli says. “No one is forced operation will entail, but not necessarily a to do anything they don’t want to do. I good understanding of what their diet will show them some movements. For some, all be like.” they can do at first is lean against a wall Many patients are apprehensive about or desk, and focus on contracting their how their eating habits will need to change, abdominals, or do a wall-sit with knees and the dietitians can address some of slightly bent. I alter each exercise to suit those concerns. “We want patients to learn each patient.” to think differently about their food,” says Exercise, he says, is important for Carlino. “For instance, a patient might ask several reasons. “If they don’t exercise, me to recommend the healthiest fast food. they might lose too much muscle mass.” Instead, I urge them to prep their meals the In addition, strength training—and night before, so they don’t have to rely on building muscle—can help mask the fast food restaurants.” Dietitians talk about loose skin that sometimes remains after portion sizes, vitamin needs and general extreme weight loss. healthy eating habits. “We’re teaching Pre-surgery, patients also consult with a healthy eating for life,” she says. psychologist and may need clearance from In some bariatric surgery programs, a cardiologist or pulmonologist as well. Teamwork: from left, Steve Gonnelli, CPT, Exercise patients only get 15 minutes with Physiologist; Kristin a nutritionist, or only meet with a A LASTING BOND Carlino, MS, RD, Bariatric nutritionist as part of a group, says Post-surgery, in addition to visits with the Dietitian; Denise Freire, Silvana Blanco, RD, Bariatric Dietitian. dietitians and exercise physiologist for a Bariatric Secretary; Linette Castro, BSN, RNC-NIC, But at CMMC, the meetings are personalized exercise prescription, patients HNB-BC, Bariatric Nurse individual, and last for an hour. Some of have several ways to stay in touch. They Navigator; Alina De the nutritional advice patients receive visit their surgeon once a year for follow- Almeida, RD, Bariatric Dietitian; Silvana Blanco, has more to do with behavior than with ups—for life. They can also join a monthly RD, Bariatric Dietitian. what specific foods to eat. “We talk about bariatric support group at the hospital. Not pictured: Dawn Bibbo, things like eating slower, turning off the Recent meetings have included a Zumba MSN, RN, ONC, Bariatric TV while you eat, handling stress eating,” class, a farmers market, yoga, stress relief, Manager. explains Blanco. holiday eating and vitamin information. Some patients continue attending the GETTING ACTIVE group for years. “And they’re really The same kind of individualized support is welcoming to new people,” says Carlino. applied to fitness by Steve Gonnelli, CPT, The team at CMMC sees approximately the bariatric team’s exercise physiologist. 500 patients a year, ranging in age from dietitians and an exercise physiologist “I meet with patients once before and once the late teens into the 70s. Team members who meet with patients to help them after the surgery,” say they love seeing the changes in their permanently transform their bodies with he explains, patients’ lives—changes that often go way healthy lifestyle choices. “and I make beyond fitting into a smaller clothing size. recommendations “Yesterday we found out that one of FOOD FOR THOUGHT based on each the patients who lost 100 pounds got a Patients meet with a dietitian anywhere person’s strengths new job,” says Blanco. “She couldn’t work from two to six times over the course and weaknesses.” before because she was in too much pain of their treatment. “We start seeing Many patients from excess weight.” Like so many, that patients after they’ve met with a surgeon, have knee pain, patient reaped the rewards of hard work but before they have the surgery—and back pain, or and good health habits—with the help of a sometimes even before they’ve made up NAVEEN BALLEM, MD shoulder pain great team.
To learn more about bariatric surgery at Clara Maass Medical Center, attend one of the monthly “Surgical Options for Weight Loss” seminars led by one of CMMC’s bariatric surgeons. To register, visit www.rwjbh.org/weightloss.
Healthy Together | 18 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 19
CMMC_Bariatrics_Spring19_final.indd 19 4/4/19 9:10 AM QUIZ DO YOU KNOW HOW TO MANAGE HYPERTENSION? IF YOU HAVE HIGH BLOOD PRESSURE, THERE ARE SEVERAL TOOLS THAT CAN HELP BRING IT DOWN.
ypertension, also known as high 1. A low-sodium diet means I have to put Work closely with your doctor to determine blood pressure, means that your away the salt shaker. how much medicine you need to take, and Hblood is pushing too forcefully n T n F for how long. Be sure to take medication against the walls of your blood vessels. exactly as prescribed. Over time, this force can damage delicate 2. I only need to take my blood pressure 3. TRUE. Any foods that have potassium— tissues in the arteries and can ultimately medication until my numbers come down. including bananas, sweet potatoes and lead to heart attack, stroke or other n T n F leafy greens like spinach, broccoli, kale or cardiovascular problems. collards—can help flush sodium out of the “Because hypertension symptoms are body. A daily cup of blueberries has been subtle, many people don’t do enough to 3. Certain foods can help bring blood shown to lower patients’ blood pressure. manage the condition in its early stages,” says pressure down. Fish that are high in omega-3 fatty acids— Eli Chakhtoura, MD, Director of the Cardiac n T n F like salmon, mackerel, herring, sardines and Catheterization Laboratory at Clara Maass albacore tuna—have many cardiovascular Medical Center. 4. Exercise will raise my blood pressure. benefits and also lower blood pressure. “Fortunately, if you n T n F have hypertension, 4. FALSE. Regular physical activity—30 there are many 5. Relaxing can help lower blood pressure. minutes on most days of the week—has been things you can do n T n F shown to bring blood pressure down. It to keep it under makes the heart stronger, meaning it has to control.” Take work less to pump blood, which decreases this quick quiz to AND THE ANSWER IS … the force of blood in the arteries. Walking, see how well you 1. FALSE. It’s true that if you are adding cycling, swimming and dancing can be understand the a lot of salt to foods, you should cut back. effective ways of lowering blood pressure, as ELI CHAKHTOURA, MD condition. However, up to 70 percent of the sodium in can active house and yard work and sports. our diets comes from packaged, processed 5. TRUE. In a short-term stressful situation, foods, including canned soups and sauces, your body produces a surge of hormones that fast food and cured meats such as bacon. Your heart doesn’t beat just can cause your heart to beat faster and your To reduce sodium intake, eat fresh foods for you. Get it checked. To blood vessels to narrow. Long-term stress can whenever possible. For processed foods, lead to behaviors that contribute to higher schedule an appointment with read the Nutrition Facts on food labels to blood pressure, such as smoking, drinking a Clara Maass Medical Center determine how many milligrams (mg) of too much alcohol and eating unhealthy cardiac specialist, visit sodium are in each serving of the product. foods. A healthy lifestyle and a change in www.rwjbh.org/heart. 2. FALSE. It is possible that you will need to attitude can do wonders for improving your take the medicines for the rest of your life. cardiovascular health.
Healthy Together | 20 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 21
CMMC_Hypertension_SPR19_final.indd 20 4/4/19 10:06 AM LOW-SODIUM RECIPE: TURKEY QUINOA STUFFED PEPPER SERVES 7
The American Heart Association recommends no more than 2,300 milligrams of sodium a day for adults. For entrees, keep sodium below 700 milligrams, says Elizabeth Hanna, Clinical Nutrition Manager at Clara Maass Medical Center. This recipe has 329 milligrams of sodium per one-pepper serving.
INGREDIENTS: DIRECTIONS: • 8 ounces tri-color quinoa • Preheat oven to 400 degrees F. • 7 fresh whole peppers—variety • Prepare quinoa according to recipe. of green and red • Cut tops off peppers and rough-chop them; set aside for meat mixture. • 3 teaspoons canola oil • Remove seeds from peppers; wash and set aside in a baking dish sprayed • ¼ ounce minced garlic with vegetable oil spray. 1 • 2 /3 ounces chopped yellow • In a pot over medium heat, add oil, garlic, onions and chopped peppers. onions Sauté for 2–3 minutes. • 1 pound ground turkey • Add ground turkey, Worcestershire sauce and black pepper. Cook until meat • 2 ounces Worcestershire sauce is browned and internal temperature is at least 165 degrees F. • ½ teaspoon black ground • Add diced tomatoes and tomato paste. Stir to combine. Cook for 5 minutes or pepper until most of the liquid is absorbed. 1 • 1 can (13 /3 ounces) diced • Add quinoa to the meat mixture. Stir thoroughly. tomatoes, no salt added • Fill each pepper with mixture. • 1 6¾ ounce can tomato paste • Cover pan and bake for 30 minutes. 2 • 1 and /3 ounces part-skim • Uncover dish. Top each pepper with 1 tablespoon mozzarella cheese. Return mozzarella cheese, shredded to oven to melt cheese.
RECIPE © 2019 FROM SODEXO MINDFUL MEALS
Healthy Together | 20 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 21
CMMC_Hypertension_SPR19_final.indd 21 4/4/19 10:06 AM BREAST CANCER SCREENING: WHAT EVERY WOMAN SHOULD KNOW
RWJBarnabas Health and Clara Maass Medical Center, in partnership with Rutgers Cancer Institute of New Jersey—the state’s only NCI-Designated Comprehensive Cancer Center—provide close-to- home access to the latest treatment and clinical trials. Visit www.rwjbh.org/beatcancer.
Healthy Together | 22 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 23
CMMC_BreastCa_Spring19_final.indd 22 4/4/19 9:16 AM DON’T LET COMMON MYTHS STAND IN THE WAY OF EARLY DETECTION.
hen it comes to breast cancer, things you can do breast cancer over the course of her knowing the best ways to before your next lifetime. Of these cases, only 5 to 10 W detect and treat the disease screening: percent are associated with a hereditary at its earliest stages can be the key to a • If you’re predisposition. This means that 90 good outcome. We asked Maria J. Kowzun, premenopausal, percent or more of new breast cancer MD, Breast Surgical Oncologist with schedule the cases arise in women with no family Rutgers Cancer Institute of New Jersey, mammogram for history of the disease. who currently sees patients at Clara Maass the time of your Even if you can’t think of anyone in Medical Center, to address some of the most monthly cycle your family who was ever diagnosed with misunderstood aspects of breast cancer risk, MARIA J. KOWZUN, MD when your breasts breast cancer, it’s still important to have screening methods and treatment. are least tender. regular screening mammograms so that • Take an if you do develop the disease, it will be IF THERE’S NO LUMP over-the-counter non-steroidal anti- detected and treated early. IN MY BREAST, I CAN’T HAVE inflammatory drug (NSAID), such as BREAST CANCER. ibuprofen, 45-60 minutes before the A BREAST CANCER FACT: Breast cancer has to start somewhere, mammogram. (Check with your doctor DIAGNOSIS IS ALMOST and it starts with just a few microscopic cells first.) ALWAYS FOLLOWED BY that multiply. The point of regular screening • Try concentrating on your DISFIGURING SURGERY. mammograms is to catch cancer early, before breathing—deep breaths in and out—to FACT: For the vast majority of breast it gets too large and begins to spread to help you relax, as anxiety can add to your cancer cases, surgery is the first line of the lymph nodes and the rest of the body. concern about potential discomfort. treatment. However, our goal as breast Mammograms have caught cancers as small as The important thing to remember surgeons is to perform surgery in a way a pinhead or a grain of rice—smaller than can is that a mammogram should never hurt that is cosmetically acceptable to the be detected by a physical exam. so much that it stops you from keeping up patient. We’ve come a long way from Monthly breast self-exams—and with regular breast cancer screenings. If the radical mastectomies of the past regular physical exams by a doctor—are you’re concerned about pain, talk to your that left patients without the breast still important, since cancer can arise doctor. and the underlying muscle. For patients in between screenings even in women with small and early-stage cancer, who get regular mammograms. But BREAST CANCER IS lumpectomies are now available that mammograms are the gold standard for RARE IN OLDER WOMEN. remove the cancer itself with just a small detecting cancer at the earliest stage, FACT: According to the American Cancer margin of normal breast tissue around it. when surgery can be completely curative. Society, 44 percent of new breast cancer If we anticipate that surgery may cases in 2017 were diagnosed in women result in cosmetic deformity, we can MAMMOGRAMS between the ages of 60 and 79, so it’s rearrange breast tissue during surgery ALWAYS HURT. essential to be vigilant. It’s important for in order to recreate a natural-looking FACT: There’s sometimes minimal discomfort every woman to have a discussion with breast. For patients who require during a mammogram since, in order to get a her doctor about her own circumstances mastectomy—removal of the entire good image, it is necessary to gently compress and when it’s okay to stop having regular breast—we work with plastic surgeons the breasts between two glass plates. The mammograms. to offer breast reconstruction using degree of discomfort that a woman will feel implants or a patient’s own body tissue. depends on many factors, including her own THERE’S NO BREAST Ultimately, our goal is not just to sensitivity to pain, breast structure (especially CANCER IN MY FAMILY, SO treat the breast cancer, but to treat the if the breasts are cystic) and so on. MY RISK IS MINIMAL. whole person and to physically restore If you’ve experienced pain during FACT: There is a 1 in 8 chance that her so that she can feel happy when she mammograms in the past, there are a few an American woman will develop looks at herself in the mirror.
To learn about breast cancer screening and treatment at Clara Maass Medical Center, call 973.844.4161. To request a mammogram appointment, visit www.rwjbh.org/mammo.
READ OUR INTERACTIVE DIGEST ONLINE TO LEARN MORE ABOUT BREAST CANCER SCREENING. www.rwjbh.org/claramaassmag
Healthy Together | 22 | Spring 2019 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 23
CMMC_BreastCa_Spring19_final.indd 23 4/4/19 9:16 AM NONPROFIT U.S. POSTAGE PAID Lebanon Junction, KY PERMIT #799 1 Clara Maass Drive, Belleville, NJ 07109
Your heart doesn’t beat just for you.
Get it checked. It beats for your husband or wife, your children and grandchildren. It beats for your brothers and sisters, your friends and lovers. It beats for everyone who cares deeply about you. So please, get your heart checked. For them. For you. For more information and to make an appointment with one of New Jersey’s top cardiologists, visit rwjbh.org/heart.
22152453 CMMC Cardiac man dog Healthy Together 8.375x7.29_m1.indd 1 3/12/19 9:48 AM CMMC_BackCover_Spring19_final.indd 24 4/4/19 9:17 AM