One on One William “Beau” Clark, MD, D-ABMDI, Coroner

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September / October 2014 %5

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One on One peag William “Beau” Clark, MD D-ABMDI, Coroner 12

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36 22 Affairs of the Heart Editor’s Desk...... 10 Enhanced CPR and AED Healthcare Briefs...... 41 education required for high Hospital Rounds...... 55 school students Book Corner...... 65 Advertiser Index...... 66 27 The Road to Recovery Correspondents Part 2 of a 2-part series on heroin Quality...... 48 Nursing...... 50 36 Eat, Drink and be Secretary’s Corner...... 52 Merry All is not lost with head or neck cancer diagnosis peag 22

peag 27 editor’s desk

If anything unfolds, it’s supposed to. — John frusciante

We shouldn’t underestimate the importance of epidemiology as it relates to health. We all have a history to our present state of health, which includes genetics, environmental issues, and behavioral decisions. But, I’m not talking about quantitative epidemiology. I’m referring more towards an intuitive epidemiology. Most of our diseases are linked to a lifetime of psychosomatic effects on the body from our own thoughts. As children we were subject to an educational system designed to deliver facts such as the existence of nine planets, the smallest of which was Pluto. But few of us as children learn to properly manage our own minds in a way that doesn’t make us subjects to them. Our ability to manage our thoughts will have a profound effect on our personal health decisions both consciously and unconsciously. We have developed a wonderful society of comfort and functionality. So why is stress one of the most harmful diseases in our culture? It’s not because our society needs more perfecting. It’s because most people haven’t learned daily human living skills. It’s understandable. Remember the 1962 musical The Music Man? In the production, Professor Harold Hill comes to a small town in Iowa to make money as a salesman. However, before he can sell anything, he knows he needs to create a problem. So he creates stress and unrest so that he and his product can save the day. This is the constant message we receive in our society. The world has learned that your stress is a benefit to its advancement. So be equipped. The message is simple. You are not happy until you buy (fill-in-blank), or elect (fill-in-blank), or achieve (fill-in-blank). It’s a false promise of future happiness. But, it doesn’t work. It doesn’t work because you are developing a pattern of discontentment. Discontentment then manifests into anger, worry, and stress. By the time you get where you were going, you will simply become discontented with something else. This is the pattern. I don’t think the marketing efforts of companies, media, and politicians intend to put us in a perpetual lifetime state of discontentment. I think they want us to be discontented just to the point of buying what they are selling. But, the impulses on us are perpetual. And, by evidence of modern stress, most have not yet learned to properly handle these messages. In The Music Man, the people of Iowa bought Hill’s band equipment and then returned to normal. In our world, the next sales pitches are right around the corner. If you are grateful today, you have a better probability of being grateful tomorrow. If you are content today, you have a better probability of being content tomorrow. This is a pattern. Patterns of the mind are real. This is intuitive epidemiology–things we just know. Every thought comes from an impulse. Humbly know yourself.

Smith Hartley Chief Editor [email protected] dialogue

cor·o·ner /'kôrənər,'kär-/ noun: Coroner; plural noun: Coroners -an official who investigates violent, sudden, or suspicious deaths. Origin -in England, an official responsible for safeguarding the private property of the Crown.

one on one with William “Beau” Clark, MD, D-ABMDI

Dr. William “Beau” Clark was elected to a four-year term as East Baton Rouge Parish Coroner in November, 2011 and continues to practice emergency medicine in the Greater Baton Rouge area. Dr. Clark has served as Medical Director for the Louisiana State Police SWAT Team, Louisiana House of Representatives, Louisiana Department of Health and Hospitals Bureau of Emergency Medical Services, and East Baton Rouge Sheriff’s Office SWAT Team. Dr. Clark has been certified as a Diplomate of the American Board of Medicolegal Death Investigators. Dr. Clark is a native of Baton Rouge. He received his Bachelor of Science degree from Louisiana Tech University. He graduated from Louisiana State University School of Medicine in New Orleans and completed his residency in Emergency Medicine in Baton Rouge. He is board certified by the American Board of Emergency Medicine. e dialogue

Chief Editor Smith W. Hartley Why did you decide to pursue this position?

Dr. William ‘Beau’ Clark I am board certified in emergency medicine. That’s my specialty. In 2003 I decided I wanted to give back to the community so I became a sheriff’s deputy. I was working with the East Baton Rouge Sher- iff’s Office SWAT team. I really had this pas- sion for law enforcement, but I became a law enforcement officer kind of backwards. I am a doctor, but if I am going to hang out with you to be a police officer and do that kind of work I want to be trained, I don’t want to be sitting there not knowing what we are doing. As a SWAT team you travel as a group so you are never alone like you would be on patrol. I never did anything like narcotics or traf- fic, but I landed in this role as a law enforcement officer and we would go out and do missions and get bad guys and I realized I really liked it. Plus I felt it was a great public service because I was the doctor for the team, and they would use me as a law enforcement officer most of the time, but if someone got hurt, then I became the doctor for the team. Right before I decided to run for Coroner a few of my police officer friends came to me to be a doctor. A lot of people think of it in Editor Tell us a little bit about what the Coro- and said, “You should take a look at this—you reverse but everything we do related to our ner’s office does. are the only guy we know that’s this doctor jurisdiction really has to do with the judicial guy and this police officer guy and it’s kind branch of government. However what is nec- Dr. Clark The Coroner’s office has three juris- of a great mix to be a coroner. I have learned essary is having an understanding of medi- dictions. Certainly one is death and that is one some since then and really that’s what a coro- cine to do it. I think that’s why it feels like we are probably most notable for because of ner is: a law enforcement officer that happens such a great combination for me personally. what is seen on TV or what people’s general understanding of coroners is. It’s very important. It has to do with determining why people die. There are about 3000 cases a year that fit that criteria. Some of the nuances, however, are that the Coroner is the one in charge of identifying the deceased person. A lot of times you will see in the media, “Sher- iff’s Office identifies…” or “Police Department identifies such and such.” Well that’s really not their jurisdiction…the Coroner’s the one that’s supposed to do that. The second jurisdiction we have is very interesting; it’s the biggest workload we have, and that’s to do with mental health. We play two roles: one is the Order of Protective

14 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE term we use. When that happens they fill out Dr. Clark Yes, we don’t play any role in treat- what’s called a Physician’s Emergency Certifi- ment at all. cate or a PEC. That piece of paper basically says that this person is going to be invol- Editor So with the committals is there a untarily held for 15 days. But they can only standard? be held for 15 days if the Coroner comes in and says, “Yes it’s okay.” That piece of paper Dr. Clark No there’s not. An Order of Protec- that I then fill out is called a Coroner’s Emer- tive Custody is the first part and we do about gency Certificate or CEC. That really has to 1000 of those. That’s when somebody comes do with your Fourth Amendment Constitu- into the office off the street and says, “I think tional rights which say I cannot search or my neighbor’s got a problem.” Those don’t seize you or your property without probable all change into the other kind of committal. cause. My probable cause being that I think Some do, some don’t. That is just the mech- you are a danger to yourself. It takes two doc- anism to get the person from home to the tors to do it…one is the doctor at the facility hospital and not needing their permission. and the Coroner is always the second doctor. But there’s a lot of times when patients just We keep you to give you intensive psychiat- show up at the hospital and those folks can ric care until you are no longer a danger and also get committed. So on the CEC side, the then we can release you. latter part of that process, we do about 6000 We do about 1000 OPCs a of those a year. Now understand this, East year and 6000 CECs, so Baton Rouge Parish is the largest parish in almost double what the state, just shy of half a million people. We we are doing in the also have plenty of tertiary healthcare facili- death jurisdiction. ties in our community so patients are con- A lot of people stantly moving into the system rather than don’t know that. moving out of the system. So we commit a I personally go lot of people who are from other parishes as Custody or the OPC. This do them myself— well. It’s just part of where they end up from is a sworn affidavit that I go see people to our surrounding environment. any citizen who is a wit- do the committal ness to behavior can come paperwork—and sure Editor Where do you commit them to? into the office and say, “I think enough they’ll say, “But my neighbor has got a problem. I I’m not dead yet.” And I’ll Dr. Clark If the beds are available locally we think they are a danger to themselves. have to say, “No you’re not, but use the local beds. There are several free- I’ve heard them say they want to commit sui- this is a whole other thing the Coroner does.” standing facilities in town such as Apollo, cide.” Once they swear that affidavit it gives And then the last jurisdiction that most Baton Rouge Behavioral Health, Seaside, me the authority to go pick them up and bring people really don’t have any clue about is Oceans, etc. Then, some of the hospitals have them to a facility for evaluation by a physi- we are charged with the collection of sexual inpatient, acute, psychiatric care. Our Lady of can. That’s a safety net that we have in our assault forensic evidence. We don’t treat the the Lake obviously has a geriatric unit, they community and the state of Louisiana. Certain patient, we simply collect the evidence. Much have an acute unit, and then they have all of communities in other states don’t have that like collecting fingerprints at a crime scene. what exists at Tau, including an adolescent opportunity, which makes it challenging when We collect that evidence and testify in court unit. Baton Rouge General Mid City also has it comes to getting help for people. if necessary. a geriatric unit. The second piece of the mental health side That’s what I think is interesting—most has to do with once they are at the hospi- people only associate the Coroner with death. Editor These aren’t lockdowns are they? tal, they are seen by the physician, and the physician agrees, yes, this person is a dan- Editor So with regards to mental health, the Dr. Clark Yes, those are all lockdown places. ger to themselves or to other people or they Coroner’s office is primarily involved in the We can either commit them to one of those might be “gravely disabled”, which is another committal process? facilities or sometimes, if there is not a bed

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 15 dialogue

available, we still do all the paperwork pro- Dr. Clark No this process may be unique just cess required by law and then they have to to Louisiana. Other states use different meth- get sent to places out of parish—Vermillion ods. When we talk about the Order of Protec- Prescription Parish, Brentwood up in Shreveport is a com- tive Custody, in Arkansas that’s done in front mon pediatric location. So that’s where the of a judge, there’s no coroner involvement. Recycling patients end up. Around the country everybody’s got a little Program different type system. Globally with the coro- Editor Is there enough capacity out there? ner system and the relationship between the In July 2012 the OPC, the PEC, and the CEC, I think we have a Coroner’s office Dr. Clark No there’s not. That’s the big dis- pretty good system, because we have a fairly started a prescrip- cussion when we talk about mental health. good safety net when it comes to that pro- tion recycling pro- I read your article that you did with Jan cess. Where our system is broken is once you gram for medi- Kasofsky (Healthcare Journal of Baton Rouge get them committed and you know they need cations found on May/June). What’s very interesting about psychiatric treatment where do you do it? the person of or all of that is in the 80s the federal govern- What we would prefer is to do intensive in relation to the ment decides to stop funding these long-term acute psychiatric treatment. And I am talk- deceased. The mental health facilities. Those bed numbers ing a little out of my lane, because I don’t do medications are go down for long-term care. So that patient that for a living, but I am around it enough clues to what may backs up into the acute care bed and is stuck to tell you, that acute psychiatric treat- have influenced the person’s there. Then when we can’t get a patient out ment typically is for people who just need death even in the case of natu- of the emergency room into the acute care to be adjusted. Maybe they are not taking ral causes. The Coroner’s office bed, they are stuck in the ER. And when the their medications, they are out of whack, takes those medications as part emergency room gets too full they are stuck or they have mixed them with illicit sub- of their investigation and inven- on the street and sometimes, in jail. So the stances. With that whole process, once you tories them. If they are expired, whole system gets backed up because there get them back streamlined they don’t need damaged, or narcotics they are just not enough beds down on this end to go to a long-term facility. They can go are destroyed. All of the other of the spectrum. back home and be a productive member of ones are recycled to St. Vincent society and have good outpatient follow-up. DePaul. They do their inventory, Editor How many people would you say have The problem is having that acute environ- identify the medications, and orders to be committed at any given time? ment to do that in. For example the MHERE redistribute them to the commu- (mental health emergency room extension) nity. The Coroner’s office donated Dr. Clark I am trying to think of the best way at Earl K. Long, that’s what they did. A lot of close to 46,000 prescriptions in to judge that. As far as the PEC and the CEC times people would get sent to the MHERE 2012 and 70,000 in 2013. A lot of goes, today you are probably looking at and the Coroner may not ever get involved coroners around the state have 30-40 people on a PEC right now, sitting in because they were okay in 48 hours and started to do the same thing. It’s either a hospital or an acute care facility, wait- I had 72 to get to them. That was a great a good way to give back to the ing for me or one of my deputies to come and place to fix them and get them to outpa- community and helps the families do a CEC on them. I have a time frame. When tient. Because that’s really where you want who are not sure what to do with you do that PEC, the first piece of paper, the everybody. Could you imagine if you suffer the deceased’s medicine. Note: Coroner has 72 hours to arrive. So typically from high blood pressure and every time It is not legal to possess medica- we round every two days, every 48 hours, so your blood pressure went up I’d admit you tions not prescribed to you, so it we don’t miss anybody. So for example Mon- to the hospital? What you would prefer is removes an additional burden on day is a rounding day, so my deputies will all for me to tweak your medicines a little and the family and avoids misuse. round today, so tomorrow’s list won’t be as have you come back and see me in a week. big, but by Wednesday it will have grown a It’s no different with mental health. little bit more. Editor But there are mental health patients Editor I guess there’s not really a national that do need chronic long term housing and standard? care and we don’t really have a system.

16 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE dialogue

Dr. Clark We have some beds for them, but of Health and Hospitals stopped doing paper once a person gets in that bed they can “own” death certificates and started doing electronic it for a while. There is not a rapid turnover death certificates. We were one of the pilot especially in long-term care. It kind of locks programs for that in July 2012. Essentially that bed down. So if another person needs the way that works is we do our investiga- it they are kind of waiting over here. Which tion, we have an internal process to determine isn’t good. the final cause and manner of death, but that death certificate eventually lands in my inbox Editor Do you have an opinion on what and we can input our little piece and we can should be done then? sign it. I think the fastest I have ever signed a death certificate is probably about six or Dr. Clark How to fix it? Yes, I do. It has to do seven hours after someone has died. That’s with acute stabilization and the referral to not usual, but essentially that tells you the outpatient. What we know is that you could length of time compared to when they used add a few more long-term beds and it prob- to do it in a written fashion. You were looking ably would help the situation, but what we at six to seven weeks to let it pass through all saw with the MHERE at Earl K. was the abil- the necessary hands and snail mail. ity to get people better in a short amount of From an investigative standpoint, in the time and then get them to their outpatient back certainly we use the latest technology clinic appointment. That was the better sce- in our autopsies, everything you would see nario rather than long acute stays or nowhere like in a show like CSI. The only thing we don’t to send them. It just backs up into the emer- do is virtual technology because that really is gency room now. more fictitious for television. But we utilize x-rays and CAT scan machines and things of Editor How have the operations of the Coro- that nature. We can retrieve records about the ner changed with technology? Has it had a big impact in the way you do investigations?

Dr. Clark It’s as simple as having a depository or database to put your information in. Often- times we’ll have different legal cases going on and they will say, “Hey can we get all the documents from that 1971 case?” It was really like when you pull out the big Harry Potter kind of book of huge paper files. We now have the equivalent of an electronic medical record, but it’s an electronic death investigation tool. Hopefully many years from now if somebody comes we’ll just have to hit the print button and we’ll have a legible, printed report on any case. decedent from the hospital and we are able because like I said earlier, if you just went to Every time we do a report we make it fit to evaluate that and use it to determine the an adjacent Coroner’s Office you would be what Louisiana law says. Louisiana law says cause and manner of death. quite surprised. They have an office and that’s these are the following items that must be about it, they don’t have a morgue and all included in an autopsy report, the name, etc. Editor Has technology then been the biggest these other things. so the report autogenerates that and saves change in the Coroner’s field? our admin folks a ton of time. Editor How does the East Baton Rouge Coro- One of the most recent tools that was insti- Dr. Clark For those of us who can use it, I think ner’s Office work with the surrounding par- tuted as far as death goes was the Department so. It challenges the smaller offices I believe, ishes? What are some of the collaborations?

18 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE better have our ducks in a row, because your civil liberties are protected, as they should be, Number of as Americans. Coroner’s But that leading from the front scenario, Death Cases: I think that’s important. The other thing I like to say as far as being the Coroner goes, I 2824 in 2012 am still a doctor. I take care of people. That’s 2837 in 2013 what I do. Certainly some of my patients have died, but they still have a story to tell. So I am charged with figuring that out. Sometimes you see some pretty amazing cases, people who live to be 102 or 103 years old. And you think, “That’s just amazing; they’ve seen the dawn of television, a guy landing on the moon...” Other cases are very heart wrench- ing, people that are taken from us too soon. Or people, who died from something that’s not curable, like cancer.

Editor In the investigative process are there just some things that are problematic? What are some of your challenges?

Dr. Clark The biggest challenge when it comes to death investigation is suicide. It’s a challenge because pretty much every other type of death that occurs, if you ask me what hap- Dr. Clark Just like the District Attorneys Asso- Editor Tell me your general philosophies in pened, I can tell you why. When somebody ciation and Sheriffs Association, there is a the management of the Coroner’s office. says, “Why did my loved one kill themselves?” Louisiana State Coroners Association. It was I don’t have an answer for that. Nobody does. put together some time in the 80s. For a while Dr. Clark I am a lead from the front kind of And that’s the most challenging and hard part it had been a little bit dormant and about a guy. I think that’s the way I like to phrase it. about suicides. Of course I can give you the year and a half ago we revitalized it and now So you’ll often see me at death scenes. I think cause such as gunshot wound or overdose, we are starting to collaborate statewide. I am there’s a tremendous amount of informa- but that’s not the question they are asking one of the vice presidents of the organization. tion at the scene when you are investigating me. The question they are asking me is why As a matter of fact just last week we had our someone’s death. You learn in death investi- they did it and nobody has an answer. That legislative meeting where we look at Louisi- gation school, which I have gone to, just like becomes frustrating, because as a doctor who ana laws that pertain to coroners and which my guys, that you are going to get some stuff likes to help people I don’t have an opportu- ones need to be changed and fixed. We got out of autopsy, you are going to see stuff with nity to answer that question. together about 15 coroners from around the toxicology and histology, but what did you state and we went through a litany of differ- see where the person was? And you can piece Editor Do they expect you to know the ent things. Some of it is just bringing Loui- it all together. So you’ll see me out there. answer? siana law up to date from 40 years ago, but That’s also why I do these committals. I some of them are pretty significant, based personally do 2000 of the 6000 myself. So Dr. Clark They don’t expect us to know, but on the way we practice medicine now ver- I am out there in the environment making I wish I had an answer. I am not trying to sus then. Now you are seeing this revitaliza- sure we are protective of someone’s consti- downplay other types of death like acci- tion and this regrouping of coroners coming tutional rights. That’s a pretty serious thing dents and homicides, but it really is tough. together saying, “What do we need to do for in America. If I am going to take your Fourth I work very closely with the Baton Rouge our constituencies?” and so forth. Amendment right away from you we had Crisis Intervention Center. We created the

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 19 dialogue

Dr. Clark I believe that everybody has their role. The Coroner has his role and the Sheriff has his role, and we work very well together. However we are independent so sometimes I may rule on a death that impacts them. For example there was a mental health patient not too long ago that pulled a knife on two police officers and they had to defend themselves and they did. That is a homicide in the world the Coroner works with. I am not there to judge whether they were derelict in their duty as officers, that’s for the court system and the District Attorney’s office, but certainly at the end of it we have a big discussion about it. What did the Coroner do? What did law enforcement do? What did the DA do, etc.

Editor What do you see happening in the field of the Coroner’s office in the future?

Dr. Clark I think probably from a statewide Traumatic Loss Outreach program. They law enforcement aware, or any of the other perspective, you have larger jurisdictions had had something called BOSS, which was partners that the Coroner’s Office works with, and smaller jurisdictions. For example, we a response to the survivors of suicide, this I think it is my duty to say, “Hey guys this is work 24 infant death investigations a year, little niche, and they would show up and what we are seeing and we are seeing a big and other jurisdictions may work one every ‘‘help those folks. I thought of expanding the trend here, we need to start working with two years. Fortunately or unfortunately we program because oftentimes we might go to this.” Just like synthetic marijuana or syn- are very practiced at it; we’ve become good a scene where there’s been an infant death thetic cannabinoids, heroin, unsafe sleeping at what we do because we do it over and over and you are left with a mom and dad scratch- deaths where infants are in cribs with a lot of again and that’s only natural. So I see things ing their head. They need the same kind of pillows and they suffocate, deaths like that I like regional autopsy programs, like we have response and help, hand on their shoulder think are 100% preventable…if you follow the here, start to come into effect. You might see kind of scenario that a suicide survivor would rules, they don’t happen. We are involved in that in other pockets around the state where need. So that’s why we developed that pro- awareness campaigns in that capacity. you have these centers where everything kind gram and our investigators can activate the of occurs. It’s not to say there’s not going to program if they are at a scene and they see Editor Are you seeing an increase in the be a coroner in every parish; you would have the TLO is needed, we can get them over heroin deaths? to change the constitution of Louisiana to do there and they can help with the family. that. But it’s to say that that maybe the experts Dr. Clark We are. In 2013 we had a large num- live in this little epicenter and people send Editor Have you noticed any trends in your ber of heroin deaths; I believe 36 at the end things to us for us to review or manage or work? of the year. To date (July) we are at 15 con- assist them in managing it. I think that’s kind firmed with one pending. If you double that of where you see things going. Dr. Clark I have kind of made that part of my number then that would only be 32, but death I guess that’s kind of more of a death- mission. I can tell you that natural disease is unpredictable. In fact it wasn’t until the sec- related thing or maybe even a sexual assault is still the biggest thing that kills people in ond half of 2013 when we saw our increase. related thing because sexual assault victims our community. I wish it was less or I wish In August, September, and October last year will typically go to the parish that has all the it was natural disease at age 95, but it’s still we had almost ten heroin deaths per month hospitals. For example West Baton Rouge the biggest thing. However, I look for trends and we hadn’t seen that all year. doesn’t have a hospital so all their mental in other categories because I think those are health patients come here. And if someone the ones we can impact. For example when I Editor Have you noticed any policy changes doesn’t die at home, they typically die in a see an increase in heroin deaths. I am learn- or law enforcement changes that have come hospital in EBR Parish. So I think you see a ing about them after the fact, but whatever up recently as a result of your work or that reliance on regionalization. And that’s good I can do to make the public aware, to make affect your work? for everybody. n

20 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE

Education Affairs of the

Enhanced CPR and Heart AED education required for high

school students I By Kristen Cockrell In an effort to save lives, Governor Bobby Jindal recently implemented a law requiring that high school students learn Cardio Pulmonary Resuscitation (CPR) skills prior to graduation. The law, effective August 1, 2014, Kay Eddleman will require that high schools incorporate hands-on CPR training and basic automated external defibrillator (AED) instruction into a course which students are already required to take in order to graduate, such as health education or physical education.

Tom Willmott

ach school district will determine that students learn basic AED instruction, whether CPR certification is nec- which was not previously necessary. essary for students. Teachers must According to the American Heart Associ- E use an instructional program from ation, individuals trained in CPR, including either the American Heart Association or the youth and adults who received CPR training American Red Cross to train students, but do in school, are responsible for saving many not have to be CPR certified unless certifica- lives from sudden cardiac arrest, the lead- tion is required for students. ing cause of death in Louisiana. Only 10.4 Louisiana previously had a law in place percent of the thousands of people who suf- that required high schools to incorporate fer from sudden cardiac arrest every year basic CPR instruction into their curriculum. actually survive. “If you suffer sudden car- This law required that students learn general diac arrest and you don’t receive CPR or defi- information about CPR in a health educa- brillation within three to five minutes of col- tion course, which was required to graduate. lapse, your chance of survival drops, and that House Bill 542 expands on this law, requir- reality has to change—starting today,” said ing a more hands-on approach. This new Kay Eddleman, chair of the American Heart law will give all students the opportunity Association Louisiana Advocacy Commit- to practice CPR on a manikin, so that they tee. Receiving CPR immediately can poten- feel more comfortable performing CPR if an tially double or triple the survival rate of emergency situation arises. It also requires these victims. e Education

stops circulating and, in turn, does not flow to the brain, which makes the victim unable to breathe. Heart attacks are the most common cause, but trauma, overdose or drown- ing can also lead to sudden cardiac arrest. Giving victims CPR immediately will help blood flow back to the brain. Once the victim has received CPR, an AED should be used, if available, to read the victim’s heart rate and provide shocks if needed; the trained individual is able to follow the instructions on the AED until an EMT arrives. If no AED is available, giving a victim CPR until an EMT arrives can help save his or her life. Providing students with the opportunity and resources to use their psychomotor skills for CPR education will support their cognitive learning, which can help them effectively perform CPR. Teaching them how to effectively use an AED is extremely beneficial in saving lives as well. The Amer- you can’t put ican Heart Association is a price on the excited to increase CPR enormous value and AED education, training, and aware- Louisiana, the 17th state to pass this bill, bill author. “By pro- this law brings ness and decrease the will be making a large investment in CPR viding students with to absolutely number of lives lost to education, but the impact it will make is hands-on CPR instruc- everyone in sudden cardiac arrest in more than money can buy. “Louisiana is tion before graduation, louisiana Louisiana. “The legisla- now poised to create a generation of lifesav- we are adding thousands tive efforts of the American ers,” said Representative Tom Willmott, the of young adults with lifesaving Heart Association are a key fac- skills to our communities, year after tor in saving lives”, says Donna Klein, year. They will have the skills to save lives New Orleans Board Chair. “Bills such as this whenever [and] wherever someone suffers CPR bill are aimed at increasing the lifesav- cardiac arrest. You can’t put a price on the ing ability of our community. It takes efforts enormous value this law brings to absolutely by everyone to help to reduce the number of everyone in Louisiana.” Schools in the state lives lost each year to the number one killer have the opportunity to team up with local in our state and country.” hospitals, firefighters, and EMTs to support For more information about House Bill CPR training at little to no cost. The Amer- 542, sudden cardiac arrest, CPR, AED or ican Heart Association also offers CPR in CPR in School Training Kits, please visit the School Training Kits, which, though costly, American Heart Association website at www. can be used to teach hundreds of students. heart.org. n Each training kit includes ten inflatable man- Donna Klein ikins, ten training DVDs and many other CPR training supplies. According to the American Heart Asso- ciation, anyone can be a victim of sudden cardiac arrest at any time. It occurs when the heart stops beating; this means blood

24 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE

the road to recovery

When it comes to drugs and other compulsive behaviors, admitting that you have a problem is the first step to recovery. However, while this first step may be the most important, for heroin addicts especially, the most difficult steps lie ahead. e

Part 2 of a 2-part series on Heroin By Claudia S. Copeland, PhD heroin

Once a heroin addict realizes that he has a problem and decides to seek help, he must figure out how to kick the drug—get it out of his system and allow his body to readjust to a drug-free state.

Heroin relieves stress, and admitting on regular painkillers during an extended addiction and deciding to quit is stressful, hospital stay, this will be like a case of the creating even more powerful cravings for the flu. (Patients often don’t know they are going drug. At the same time, the addict must go through withdrawal; they simply think they Othrough a physical state of sickness (with- caught a bug.) Most addicts, however, have drawal) that generally lasts from a few days built up to very high doses, often regularly to a week. Like any drug taken regularly, taking heroin doses that would be lethal to heroin causes the body to compensate for non-addicted people. For these addicts, with- its actions in order to maintain homeostasis drawal can be very serious. It is not deadly, (and protect the body from dangerous effects but is extremely unpleasant. like fatal respiratory depression). With regu- Heroin withdrawal has two main physical lar administration of the drug, the body uses stages. In the early phase, about 12 hours after these compensation mechanisms to main- the last dose of heroin, addicts will experience tain a state of balance; in other words, the agitation, anxiety, muscle aches, increased user will no longer get “high” from a regular tearing, insomnia, runny nose, sweating, and dose of heroin, just “normal”. One addict, who yawning. This phase is followed by the late was respected as a conscientious employee in symptoms of withdrawal, including abdomi- his house painting job, took non-increasing nal cramping, diarrhea, dilated pupils, goose “maintenance” doses throughout the day. He bumps, nausea, and vomiting. While there is called it “his medicine” and claimed that he no way to make withdrawal easy, there are did not get high from the heroin at all, but he ways to make it less painful. One of the best needed it to continue to function. is leaving the place of addiction—going on When an addict decides to quit, her body vacation to withdraw. (The more remote, the will be thrown out of balance, into a state better—a tropical island or mountain cabin that is in general the opposite of the normal would do nicely.) If this option is available, it effects of the drug. (For example, one of the will not only make it much more difficult to effects of taking heroin is constriction of the break down and get some of the drug, but can pupils, giving a characteristic “pinned” look actually make the symptoms of withdrawal to the eyes. During withdrawal, the opposite milder. This is because the body uses cues is seen: her pupils will become dilated.) In the as warning signs that it is about to be poi- case of mild dependence, such as a person soned—not only the familiar tools of heroin

28 SEPT / OCT 2014 I Healthcare Journal of baton rouge use, but also the familiar environment and herbs that affect the nervous system, herbs people who tend to be around when the drug for the gut and digestive discomfort, those is used. This is all part of the body’s survival that can help relax the body, and whatever mechanism, and is based on conditioning. else is appropriate for the individual. After (Just as you might start salivating and feel- the crisis of detox, herbs can be used in the ing hungry when you walk into your favorite journey of restoring health.” restaurant, a heroin addict’s body will start Maypop also offers an acupuncture taking physiological actions to prepare treatment to help with detoxing. Known as for an influx of heroin when it “expects” a NADA, the procedure involves insertion of dose.) If an addict is able to go on vacation sterilized needles just under the skin at five to “detox”, the withdrawal symptoms can be designated points in each outer ear. Sief- substantially milder because heroin-asso- ert, a trained practitioner of the procedure, ciated environmental cues are absent. One emphasizes that “In the spirit of NADA, we word of warning, though: this method may offer a calm, quiet, and safe space for people actually lead to two phases of withdrawal. to receive the treatment with no questions Addicts who have detoxed completely on asked.” She continues, “People may use the vacation have been known to experience NADA protocol to aid their own healing pro- new withdrawal symptoms as soon as they cess or regimen. Those I’ve spoken to in the enter their old environment. These will be also been used in China and other countries. shop have volunteered the feedback that it much milder than the initial withdrawal, but In New Orleans, Maypop Community Herb has helped with stress, anxiety, insomnia, they can take a recovering addict by surprise, Shop offers both herbal remedies and acu- PTSD, and many other mental and physi- and the intense cravings he feels can lead puncture for detox. Maypop sells a variety cal imbalances. People react in different to relapse, even if he has completed a full of herbal products (they offer culinary herbs ways. Some fall asleep, some sit quietly, and withdrawal. (This is also a potentially deadly and spices, teas, oils, and creams in addition all appear more calm and peaceful when time—if the addict has gone through with- to medicinal herbs) but as an herbalist-owned they leave. Even sitting in the room without drawal, his body cannot counteract the drug shop, an important part of their mission is receiving needles has a calming and focus- as well as when he was addicted. Not under- health consultation and classes in self-care. ing effect.” For heroin addiction specifically, standing this, many addicts die of overdose According to Amy Seifert, one of three herb- she thinks that “in crisis state people react from the same daily dose that barely affected alists who run the shop collectively, “Herbal more dramatically to many situations and them before detoxing.) medicine can be used in addiction recovery. interventions. I’ve seen people in detox fall If leaving town is not an option, medica- There is unfortunately no magic herbal pill into the heaviest sleep, but on another day tion is available to help with withdrawal. that reduces cravings and makes recovery feel very little effect.” In spite of this variation, Buprenorphine and clonidine are two mod- a cake walk, though I wish there was. Herbs people do in general find that it helps. “People ern pharmaceuticals prescribed for this pur- can be a helpful tool in easing symptoms, have said they’ve found it helpful for relieving pose. There are also traditional medicines. increasing comfort and restoring the body agitation, muscle aches, and other symptoms (Remember, while heroin is a relatively to a healthier state. I look to the “nervine” and, used daily, in helping to stay committed newly invented drug, opium has been used by humans for thousands of years.) With- drawal symptoms are similar for all opiates, so it should not be surprising that traditional herbal remedies exist that can help with heroin withdrawal. As of 2006, ten traditional Chinese medicines for the treatment of opiate addiction had been approved by the Chinese State Food and Drug Administration, and at least six are in clinical trials. Acupuncture has

Healthcare Journal of baton rouge I SEPT / OCT 2014 29 heroin

to their process. At times I’ve organized sev- facility with an emphasis on addiction treat- eral NADA practitioners to give the treatment ment”. As such, the treatment offered there daily to someone who is detoxing. It’s been is intended to help addicts not only quit done at the person’s home or in the corner the drug, but build a strong foundation for of the shop while we are open. It can be a a healthy lifestyle, including practical skills very empowering tool for people in addic- such as vocational and life-skills training. In tion recovery—for several reasons: In a crisis addition to medically assisted detox, their time having a daily goal can be helpful, and short-term residential program focuses on meeting that goal (going to receive the treat- drug rehab basics, including harm reduc- ment) is an accomplishment that feels good, tion skills and life skills. To address the high and of course for the benefits of the treat- rate of relapse among addicts after they have ment itself. In the same way that NADA can gone through withdrawal, Odyssey House help people in their detox process, I think it also offers a long-term housing support has a place in anyone’s healing process, be it program that employs a 4-6 month relapse with addiction recovery, healing past trauma, prevention model “with an intensive outpa- emotional health, or healing physical ail- tient component that combines therapeu- ments with methods that require long-term tic interventions with housing and employ- dedication.” In Baton Rouge, NADA ear acu- ment skill building.” Odyssey House strives puncture is offered at St. Anthony’s Catholic to be inclusive as well; it is one of the few Church in the Mid City North neighborhood. programs that accepts pregnant women and Of course, some addicts are simply postpartum women and their babies, and unable to detox in an outpatient setting. offers a residential program as well as ser- For them, a residential program can pro- vices not directly related to addiction, such vide the structure, discipline, and intensive as a reintegration program for ex-offenders, support needed to get through the initial HIV case management services, and a pri- stages of recovery. Several such residen- mary care community medical clinic. Ms. tial programs exist in southern Louisiana, Bosworth explains that “OHL empowers including O’Brien House in Baton Rouge individuals to become active participants and Bridge House, Grace House, and Odys- in their treatment and recovery to reclaim sey House in New Orleans. Amy Bosworth, functional, productive lives. OHL’s philoso- LCSW, the Senior Program Manager for phy is to treat the whole person, not just the Adult Residential Services at Odyssey House, addiction.” She emphasizes that treating the describes it as “a behavioral healthcare whole person also means treating clients as the individuals they are. “Some interventions (e.g. 12 step and Motivational Interviewing) work well for the majority of people, but even within that treatment track, a treatment plan does have to be personalized for each individual. A strengths perspective, which offers service providers a work practice which task of getting clean. “A safe environment, focuses on strengths, abilities, and potential one where the client is away from drugs and rather than problems, deficits, and patholo- alcohol and people who are actively using, gies, is essential ... each client has experienced is also an essential part of ongoing success- different circumstances that ultimately led ful recovery. Part of OHL’s philosophy is to to their substance abuse. While there may operate as a family. The community space of be common themes for the majority of cli- OHL is intended to be an open environment ents, each personal story is unique and the where clients are encouraged to share their same circumstances may affect individuals thoughts and feelings with their counselors in different ways.” Of course, at the core of and fellow clients without feeling judged. Our a residential program is a supportive envi- clients will have to deal with stress while in ronment in which addicts can focus on the treatment and in recovery, but stress is a part

30 SEPT / OCT 2014 I Healthcare Journal of baton rouge do, and the neglected relationship between music therapy, and expressive arts therapy. them needs to be rebuilt. “Even if the par- For school-aged children, the focus is on ents are good providers for the children,” says education—understanding addiction—and Danielle Kleiman-Pizzolatto, a former direc- therapy to help them understand their feel- tor of the program, “they often have bond- ings and express them. ing and attachment disorders. Very little eye While the challenges for addicted moth- contact, a lack of nurturing—when you’re ers are steep, the challenges for pregnant high, you’re so detached that you can’t rec- addicts are practically insurmountable. This ognize someone else’s affect.” A big part of is because, while the sickness of heroin with- the program, therefore, is “learning bond- drawal will not kill an adult addict, it can be ing and attachment; learning how to parent.” fatal for a fetus. Therefore, a pregnant woman Fathers are also included. While they can’t addicted to heroin cannot simply quit; if she live at Family House, they come in for fam- does, it could kill her baby. On the other hand, ily work, and there are also parenting groups Louisiana law states that if any baby is born for other family members. Whoever comes drug-exposed, the Department of Children to visit the clients must first attend a family & Family Services must be notified and the education and parenting session, including baby can be taken away. Add to this catch-22 understanding addiction and how to nur- that most obstetricians will not take heroin- ture children. Kleiman-Pizzolatto notes that addicted mothers, making it very hard for “women tend to be motivated by different these women to get any prenatal care at all. things than men. Their biggest motivation Among the few obstetricians who will take is their children, but their biggest triggers heroin-addicted mothers, the most common are also their children.” Any parent knows advice is for the mother to stay on heroin the stress of a baby who won’t stop cry- until the baby is born, as this is seen as the ing or a toddler throwing a tantrum. only option available. There is an alterna- This kind of behavior can be a very tive, though—replacement of the heroin strong trigger, as heroin is such an with methadone or Suboxone/Subutex efficient—and instant—reliever of (buprenorphine and naloxone), long-acting stress. The women often require opiates that will prevent withdrawal but are a lot of therapy; the past trauma much less addictive than heroin. The baby experienced by many is “atrocious, will still be born opiate-addicted, and will such as sexual trauma from young need to be slowly withdrawn (about 5 weeks ages—4, 5 years old” and abuse that in the hospital), but it is much better for baby went on for most of their childhoods. and mother than either prenatal heroin with- The mothers in Family House tend to be drawal (potentially lethal for the fetus) or the women in great pain who used heroin to mother’s staying on heroin. Kleinman-Piz- get some relief, rather than having tried the zolatto and others have only recently been drug to get “high” in the sense of having fun. able to “start the conversation” with DHH Like their mothers, many of the children authorities, and build rapport with local OBs of daily life. It is important that we teach our have experienced serious trauma. Kids have to get them to take these patients. They have clients coping skills so that they can navigate seen “serious beatings in front of them, pros- also made some headway with DCFS. Mean- stress and other daily life obstacles without titution, food deprivation”. In addition, these while, though, the conundrums and difficul- drugs and alcohol.” children, explains Kleiman-Pizzolatto, “are ties faced by pregnant heroin addicts remain. Teaching coping skills is also a corner- wired and programmed to become addicts Kleiman-Pizzolatto laments, “It is really hard stone of Family House, the first program because of their lack of nurturing”. It’s well- for these women to get off heroin.” in the state to accept pregnant women and known that children of addicts are at risk of Then, when addicts finally reach their women with children. Family House, which addiction themselves, so this is a big focus goal of getting clean, it’s not over. After going only accepts women and their children, is in the program—they want to be proactive through all the suffering of the withdrawal/ intensively focused on the unique issues in preventing the children from following in detox stage, they must face the hardest faced by addicted mothers and their kids. The their mothers’ footsteps later in life. For the stage of all—staying clean for the rest of their children need help as much as the mothers youngest children, this involves play therapy, lives. One of the oldest and most effective

Healthcare Journal of baton rouge I SEPT / OCT 2014 31 heroin

organizations for this stage of recovery is not a medical group at all; rather, it is a non- hierarchical group of addicts helping each other. Narcotics Anonymous, or NA, officially defines itself as a “fellowship” of men and women who have struggled with addiction. It is a global (129 countries), community-based organization that provides help from peers and offers an ongoing support network for addicts who wish to pursue and maintain a drug-free lifestyle. Member- ship is free, and there is no affiliation with any organizations outside of NA. It does not employ professional counselors or provide residential facilities or clinics. According to the Narcotics Anonymous World Services, “NA has only one mission: to provide an environment in which addicts can help one another stop using drugs and find a new way to live.” Furthermore, as one member from the New Orleans NA chapter explained, NA is not about heroin or any specific drug. On the contrary, the first of the 12 steps that form the basis of their recovery program puts the focus of recovery on the problem of addiction and not any specific drug. In the words of former addict CT (all NA members from the New Orleans and Baton Rouge chapters to all members: change your “playgrounds”, chemicals. I was the one spoke on condition of anonymity, and will “playmates” and “play-things”. Yes, I have putting them into my be identified by initials only), “We have one found this has become a whole life chang- body. They didn’t jump in problem: addiction. The compulsive use of ing process; one day at a time.” there on their own. I was just drugs is a symptom of our disease (alcohol The story of member DJ illustrates the switching one drug for another to and heroin are just other drugs).” delusion of thinking that addiction is about continue staying high. I had been around According to the local members inter- a particular drug: “Even though I didn’t like 12-step programs and seen close friends viewed, in the New Orleans Area, there are to drink, I found drugs were easily available get better. I saw the ‘lights’ come on in their several members with 30-plus years clean in many all-night bars in the French Quar- brains and smiles appear on their faces. Once and numerous members with over 20 years ter. And I could stay high until dawn. How- I knew this is what I wanted, I could see that clean. Regarding NA and heroin specifi- ever, I didn’t think I had a problem. I was whatever drug I was using was getting in the cally, one member emphasizes that “it is a on time at work every day. I didn’t shoot way of my efforts to have a good life. I began program of complete abstinence from all up with a needle. So I wasn’t an addict. The to consider that, maybe, I had a problem with drugs.” Another elaborates, “It is my opin- only addiction I could admit to, was tobacco. addiction. I got clean for one day and went ion that there are some differences in with- And I wasn’t even that heavy of a smoker. to my first NA meeting. I have never lost the drawal symptoms from each different type However, to ‘prove’ that I was not an addict, desire to stay clean since that day. With the of drug or combination of drugs. As for types I quit smoking tobacco. It was easy. I sim- support from a number of sponsors (one of treatments, that’s basically a question bet- ply switched to pot. To prove that I was not at a time), many long term friendships, lots ter answered by a doctor of medicine. How- a “pot-head”, I quit smoking pot. It was easy. I of hard work, I’ve stayed clean for over 25 ever... after detoxification, recovery from the simply started using cocaine. But I was sure I years. During this time I got a fantastic job disease of addiction is similar for all drugs.” was not addicted. So I quit using cocaine and with great benefits. Which would have been Recovery, in fact, goes far beyond giving substituted crystal-meth. And on-and-on. impossible without my recovery in NA. And up a drug: “It is my experience that recov- Then I heard the message of NA – We are I was then able to get additional help with a ery from addiction is an ongoing process of powerless over our addiction. When I heard mental illness. Despite being clean for many change. I followed the suggestions we give this, I realized I was not powerless over the years, there was still a sense of (sometimes)

32 SEPT / OCT 2014 I Healthcare Journal of baton rouge able to hold down a job, pay my bills, take emphasis on members working with each care of my kids and use drugs all at the same other and for each other: “I feel that one of the time. Needless to say, all of those other func- reasons this program works, is it is so flex- tions suffered as a result of my drug use, but ible. The steps are guidelines so they are open I didn’t see it that way at the time. My mar- to individual interpretation. For me, this has riage dissolved in the early 90s and by the allowed me to figure out what works for me late 90s things were rapidly falling apart. I and use that, rather than attempting to fit my still had not accepted that drugs or addic- personality into a ‘mold’ made by someone tion were my problems, but by that time I else. While I was using, my main goal was to had what are referred to as “moments of avoid how I felt when I wasn’t loaded. I think clarity,” instances when I knew at some level only other addicts really understand this. And the drugs were the problem.” His drug abuse I could relate to their problems and saw how eventually led to a conviction that required they had worked out solutions. If they could residential treatment as part of the sentence, do it; so could I. The other strong attraction and through this, he was introduced to NA. to NA for me is the idea of a ‘fellowship’. The After getting clean, relapsing, and then get- way we work together without having a par- ting clean again, he decided to continue his ticular ‘leader’ may seem strange to others. education, which “my drug use robbed from For me, I have found this means my opinion me so many years earlier. I started at the local and suggestions are just as important and overwhelming dread. I was diagnosed community college, transferred to California valid as anyone else’s. And having to work with chronic major depression. And State University, Sacramento and graduated out our common goals with each other has with long term professional support, I magnum cum laude in 2007 with a BA in been a keystone in my continued recovery.” finally dealt with the underlying prob- government-journalism. After writing news MK also credits the sense of fellowship and lems that probably led to my seeking part-time and freelance for a few months, I support in NA: “Twelve-Step programs are drugs in the first place.” DJ fully credits decided that the best thing to do would be not therapy per se, but we are therapeutic NA with saving his life. “Without NA, to earn an MA in communications studies communities. Our ‘Basic Text’ (the book’s title nothing would have been possible. I am and then use it to teach at the community is ‘Narcotics Anonymous,’ but we refer to it as finally happy with life and look forward to college level. While working on my MA, my the Basic Text), states, ‘The therapeutic value each new day. I firmly believe that, without major professors convinced me to apply for of one addict helping another is without par- NA, I would have been found dead in a gutter a Ph.D. program. I was accepted with fund- allel.’ While our ‘program’ of recovery entails somewhere in that same French Quarter that ing at LSU for the fall of 2011. I can say with much more than our community and our I had loved so much.” complete certainty that without NA, none of meetings, this aspect that we are all in this Denial is a common theme in the stories that would have been possible.” together and we are there to help and sup- of addiction. Baton Rouge member MK has Why is NA, an organization not made port one another works, for me, like nothing been clean for 10 years, after doing drugs up of professional treatment providers or else could have.” since he was a young teenager in the 1970s. built on the basis of science or medicine, NA is fundamentally about addicts help- “For most of my active addiction, I was what so powerfully effective? Member CT credits ing each other. But, what about family and many refer to as a “functional addict.” I was NA’s respect for members’ individuality and friends? For those close to someone strug- gling with addiction, the urge to help the one they love can be overpowering, but attempts to help are often futile and extremely frustrating. The responses of two members to this were striking: “I think addicts are very sensi- tive to their problems and may be very insen- sitive to the problems of others,” said one, “so I think family and friends should not get overly involved with the addicts’ problems and attempting to fix them for the addict. Co- dependency is a disease in itself.” Another member concurs that the role of loved ones should be minimal: “My family helped me get to NA meetings and basically got out of the

Healthcare Journal of baton rouge I SEPT / OCT 2014 33 heroin

way. They were able to does not address the funda- harm reduction phase. Heroin maintenance, give me plenty of room mental problem of addic- methadone maintenance, needle exchange. to work out my problems tion. After years of scholarly Legal injection rooms, a nurse there in case using the NA program and research on the history of anything goes wrong, subsidized housing a sponsor.” addiction, he has concluded that for addicts, psychologists...” Wait, heroin Perhaps the best thing a loved humans behave much as the rats in maintenance? Legal injection rooms?! Yes, one can do is pass on the encourage- the Rat Park experiment—we also need a rich that’s right. Vancouver provides social sup- ment of those who have recovered using NA, life, full of the natural things that are fulfilling port to addicts, and leaves it up to the addicts and direct them to the nearest chapter. In the to our species, like friendship, culture, and a whether they want to quit, go on methadone words of MK, “I have been doing this long sense of belonging to something greater than maintenance, or continue with maintenance enough to be convinced that anyone can do ourselves. If this is missing, people turn to doses of pharmaceutical heroin (currently, as it, but for the addict still out there, still using, drugs like heroin to fill the void. Essentially, part of a clinical trial recently upheld by the still suffering, if he/she doesn’t know about Dr. Alexander explained, the “experiment has Supreme Court of British Columbia), given us, we can’t help. To find Narcotics Anony- been replicated hundreds of times through under medical supervision with new needles. mous in the Baton Rouge area (officially, we history. When a civilization is crushed, addic- The truth is, addicts everywhere make this are the “Bayou Recovery Area of Narcotics tion follows.” In dealing with a heroin addic- choice for themselves anyway; they just have Anonymous) we can be reached via our hot- tion epidemic, “We’ve got to deal with the to get their heroin on the street if they choose line number at (225) 381-9609 and via our underlying social problems. If we can’t afford not to quit, which involves the risk of HIV, website at : www.larna.org/brareana.” The to look at them we can’t afford to solve our overdose, and violence, and supports and New Orleans chapter can be reached at www. problem with addiction.” In his home city of strengthens criminal networks. As the New noana.org. Vancouver, Canada, this view has helped to Orleans NA members pointed out, outsid- NA is powerful, but it does not work for all change an addiction crisis into a managed ers, even family and close friends, are limited addicts. One alternative is methadone main- social problem. “Prior to about 1950, Vancou- in their power to get an addict to quit; she tenance, in which the longer acting and less ver was in a heavy punitive phase. We had must choose to commit to that path herself. addictive opiate methadone is substituted for laws that were draconian, medieval—judicial Encouraging addicts to quit, but giving them heroin at specialized walk-in clinics. Some whipping as a penalty for heroin use, deporta- the drug in a safe environment if they choose methadone clinics in Southern Louisiana are: tion for Chinese, which destroyed the family, not to, addresses many of the sources of harm DRD New Orleans in New Orleans proper, life sentences, mandatory minimums. We had from heroin use. In fact, heroin clinics were New Orleans Narcotic Treatment Center all that stuff. We worked this approach to the used quite successfully in New Orleans and in Marrero, Choices of Louisiana, Inc. in La point where we realized by 1950 that it just Shreveport in the early 20th Century, until the Place, and Hope for Life Recovery Center in wasn’t working. [These measures] were not clinics were shuttered by court order in the Baton Rouge. solving the problems they were intended to 1920s. It seems shockingly radical, but so far, However, according to Dr. Bruce Alexan- solve. In fact, the problem appeared to be out this approach of focusing on social support der, who conducted the Rat Park morphine of control. So we went into a human phase. for addicts, and harm reduction until they’re addiction experiments described in Part We put tons of money into treatment. We built ready to quit, has worked better than any 1 of this series (https://www.healthcare- an entire prison outside the city as a site of other, according to Dr. Alexander. It’s no magic journalno.com/journal-categories-and- treatment for incarcerated users, and opened bullet, but “between treatment, harm reduc- departments/1533-dealing-with-the-devil) it up to non-incarcerated users. That didn’t tion, and enforcement, we have achieved a and who spoke with me for this article, this work out too well, either. We’re currently in a kind of stability.” n

34 SEPT / OCT 2014 I Healthcare Journal of baton rouge cancer treatment

we’ve been doing it (tlm) for 15 years but it continues to be something people are not aware of cancer treatment

I By Margo Pierce

n old procedure that’s getting new attention for its balance of pre- serving these functions with a less A destructive treatment is transoral laser microsurgery (TLM). First used in the 1980s, TLM makes it possible to remove small and medium-sized tumors via the mouth; no external incisions are needed. Dr. Andrew J. McWhorter, a physician in the field of otolar- yngology (treatment of cancers of the larynx and pharynx), says the delicate structures of the neck heal faster with this procedure. It’s easy to take for granted the most basic The only laryngologist in the state, McWhorter performs TLM at Our Lady of and automatic functions of everyday life – the the Lake Voice Center and would like to see ability to talk, eat a meal, and breathe with broader understanding about head and neck cancers and treatment options. Patients don’t ease. Simple maladies such as a sore throat or necessarily have to lose quality of life to be healthy. nasal congestion might make the value of those “People here say we live to eat and … things more apparent. However, the diagnosis people gather around times of eating here in Louisiana,” McWhorter says. “With the of a head or neck cancer underscores how the airway, breathing is at the top. But (there is) also the personalization of voice. It’s how we quality of everyday life can be affected, even interact with our outside world that defines permanently altered, by serious disease. e us, how other people perceive us.” While many head and neck cancers are treatable when identified early, McWhorter believes it takes “a holistic approach” to maintain a quality of life that preserves things such as consistent breathing, tone of voice and swallowing. “We approach these problems in a multi- disciplinary manner with the radiation doctors, the chemotherapy doctors, with the ‘‘ cancer treatment

surgeons,” he says. “(Patients) get the group’s same day, avoiding a week-long hospital stay Symptoms and collective recommendation on a case-by- or daily doses of radiation for six weeks. Fol- Treatment Options case basis. We want them to be educated low-up physical therapy consisting of vocal about what those are and what the conse- exercises and learning different swallowing While the dominant causes quences of those treatments are.” techniques make it more likely that patients of head and neck cancers Using laryngeal cancer as an exam- will preserve and maintain related quality- are the use of tobacco ple, McWhorter describes the larynx (also of-life functions. (smoking, chewing and known as the voice box) as “the crossroads” Wolfgang Steiner of Gottingen, Germany, snuff) and drinking alcohol, of the throat. The cartilaginous structure has is credited with adopting and improving the they have also been linked three valves that make sure food and air go procedure, which was first used as early as to environmental factors in the appropriate direction. It’s also respon- 1951 in France to remove tonsil cancer. The such as second-hand smoke. sible for regulating speaking and breathing. development of new surgical techniques and A number of factors affect When swallowing, the larynx comes up, specialized instruments expanded its use in prognosis and treatment tucks underneath the tongue and the tongue the United States for the removal of tumors options for head and neck pushes the food past it. One of the valves in the throat during the 1980s. McWhorter cancers. closes to protect the airway. TLM means says the use of TLM didn’t really “catch on” there is no need to risk the damage caused at first, but after additional advances were Symptoms include persistent: by cutting open the throat, creating a tempo- made in France during the 1990s, the surgery • Mouth sore that doesn’t heal rary airway (tracheostomy), moving muscles, is now more common. In fact in McWhorter’s • Sore throat and cutting into the larynx to extract a tumor. office, TLM is the norm, while open-throat • Trouble swallowing “Using the mouth as the portal of entry, surgery is a rarity. • Changes in voice we’re able to use laser technology, and Not all tumors can be removed with TLM, • Lump in the neck we’re moving toward robotic technology, to according to McWhorter, but those early- (Persistent is defined as lasting more remove these tumors in a minimally inva- stage and smaller sized tumors eligible for than two weeks.) sive fashion that preserves function,” he says. the surgery mean excessive treatment and Prognosis depends on: “That leaves radiation and chemotherapy to the related costs are avoided. He hopes that • Stage of the disease be used for other treatment for other people the increased use of this surgery will help • Location and size of the for other head and neck cancers that may debunk one of the most persistent myths tumor develop.” And, he notes, “The healing time is about laryngeal cancer. • Grade of the tumor much quicker. The functional recovery after- “It doesn’t mean (the) voice box has to • Patient’s age, gender, and ward is much better. And the swelling results come out. That’s what people immediately general health, including are much better as well, because we’re not think, that they’re going to have to speak whether the patient is deconstructing the apparatus.” with an electrolarynx,” he says. “We’ve been anemic. The transoral surgery is done on an out- doing it (TLM) for 15 years but it continues patient basis, and patients can eat dinner the to be something people are not aware of.” n Treatment options depend on: • Stage of the disease • Location and size of the tumor • Maintaining the patient’s ability to talk, eat, and breathe as normally as possible • Whether the cancer has recurred. ‘‘ Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 39 healthcare briefsNews I People I Information

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 41 and engage special populations – including youth State (ages 11-17) and college students (ages 18-24) that are disproportionately impacted by tobacco and University Health secondhand smoke. System Joins LaHIE Grey Appointed Vice Chair The Louisiana Health Care Quality Forum has of Strategic Activities announced that University Health System, which includes hospitals in Shreveport and Univer- Emily B. Grey, a partner at Breazeale, Sachse & Wil- sity Health Conway in Monroe, has enrolled as a son, has been appointed to the position of Vice participant in the Louisiana Health Information Chair of Strategic Activities in the American Health Exchange (LaHIE). Lawyers Association’s Hospitals and Health Sys- Emily B. Grey “In addition to meeting meaningful use require- tems Practice Group. At the AHLA Annual Meeting ments, participating in LaHIE will allow University Grey was also recognized for her leadership of the Health to provide improved continuity of care for Public Health System Affinity Group as Chair (2013- Protocol, or Lung-MAP, clinical trial. Sponsored by our patients,” said Marcus Hobgood, University 2014) and Vice Chair (2012-2013). the National Cancer Institute, Lung-MAP is a col- Health Chief Information Officer. As BSW’s Healthcare Section Leader, Grey is laboration between six major cancer programs and Dr. Pat Bass III, MD, MS, MPH is an Associate Pro- responsible for business development and stra- five pharmaceutical companies. For the first time, fessor of Medicine and Pediatrics at LSU Shreveport tegic planning initiatives of the Healthcare Indus- the trial offers patients with advanced lung cancer School of Medicine practicing at University Health, try Team. Grey is very active both professionally a personalized medicine approach to investiga- and a long-time advocate of electronic medical and civically, and has served in leadership roles tional treatments based upon the genetic makeup records. As a physician, Bass is excited that LaHIE throughout the Baton Rouge community. of their cancers. Lung-MAP uses genomic profil- offers the opportunity for patient medical infor- ing to match patients to medications targeting the mation to be available with any other provider in DHH Issues RFI for Disease genetic changes fueling the growth of their tumors. the Health Information Exchange, which will “help Management Services Participants will be tested just once using a “mas- them make their [health care] decisions,” he said. ter protocol” before being assigned to one of five The Louisiana Department of Health and Hospitals different clinical trial arms. T FL Announces Community (DHH) is seeking information regarding vendors LSU Health Sciences Center New Orleans, in part- Advocacy Grant Recipients that are capable of providing full Disease Manage- nership with Mary Bird Perkins Cancer Center, will ment services to a targeted high need, high cost enroll patients at four clinical sites in Louisiana – The Louisiana Campaign for Tobacco-Free Living population to assist Louisiana in improving out- the Interim LSU Hospital in New Orleans, as well (TFL), a program of the Louisiana Cancer Research comes and reducing costs for Medicaid recipients as Mary Bird Perkins Cancer Center locations in Center and administered by the Louisiana Public with chronic diseases. Houma, St. Tammany, and Baton Rouge. The over- Health Institute (LPHI), recently awarded approxi- The Department is interested in obtaining infor- all goal of the Lung-MAP trial is to enroll a total of mately $81,000 in Community Advocacy Grants mation regarding disease management options 10,000 patients among all sites (C AGs) to five Baton Rouge area community orga- to improve the management and quality of care nizations. In total, more than 30 Louisiana-based for the Medicaid fee-for-service (FFS) population OIG: Louisiana Must Pay community organizations received approximately that can be operationalized and savings achieved Back CHIP Funds $507,139 in one-year grant funding that began on within twelve months. July 1, 2014. F or more information view the RFI document at Under the Children›s Health Insurance Program The selected organizations include: www.dhh.louisiana.gov/assets/docs/Making_Med- R eauthorization Act of 2009, Congress appropri- Face to Face Enrichment Center - $18,000 icaid_Better/DiseaseManagementRFI.pdf. ated $3.225 billion for qualifying States to receive Baton Rouge AIDS Society - $18,000 performance bonus payments (bonus payments) LSU A&M College - $15,000 LU S HSC Chosen for Lung for Federal fiscal years (FYs) 2009 through 2013 to River Parishes Community College - $15,000 Cancer Clinical Trial offset the costs of increased enrollment of chil- Our Lady of the Lake College - $15,000 dren in Medicaid. TFL grantees will use their funding to support LSU Health Sciences Center New Orleans’ Stan- The Office of the Inspector General (OIG) dis- tobacco prevention and control programs that ley S. Scott Cancer Center is one of the six initial covered that the bonus payments that Louisiana facilitate youth empowerment, promote advocacy, sites to enroll patients in the Lung Cancer Master received for the audit period were not allowable

42 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE go online for eNews updates HealthcareJournalBR.com

in accordance with Federal requirements. While Blue Value Partnerships demonstrate that they continue through September 7. most of the data used in Louisiana›s bonus pay- have followed effective cost-saving strategies, The ads feature smoking-related health condi- ment calculations was in accordance with Federal Blue Cross will reward them by paying a percent- tions that people don’t commonly associate with requirements, OIG said the Department of Health age of the savings they achieved. The first five pro- cigarette use—including gum disease, pre-term and Hospitals overstated its FYs 2009 through viders officially began in new Quality Blue Value birth, and complications associated with HIV—and 2011 current enrollment in its bonus requests to Partnerships on July 1, and in late 2015, they will continue to emphasize more common conditions, CMS because it included individuals who did not have their first opportunity to receive a payment like cancer. They encourage smokers to call 1-800- qualify because of their basis-of-eligibility code. through the program. QUIT NOW, a toll-free number available to all Loui- As a result, CMS overpaid Louisiana $7.1 million siana residents 13 and older to access free quitting in bonus payments. LPO A Names 2015 support across the country, or visit www.cdc.gov/ The Feds have asked that DHH refund $7.1 mil- Floragraph Honoree tips to view the personal stories from the campaign lion to the Federal Government and ensure that and for free help quitting. future requests for CHIPRA bonus payments T he Louisiana Organ Procurement Agency (LOPA) include only qualifying children to comply with has announced its 2015 floragraph honoree—Jor- T een Rehab Center CEO Named a F ederal requirements. dan Aucoin. Jordan Aucoin’s image will be lovingly Behavioral Healthcare Champion decorated and placed on the Donate Life Float to BA CBSL Launches Quality be part of the Rose Bowl Parade on January 1, Behavioral Healthcare magazine has named Blue Value Partnerships 2015. Jordan’s family will be in Pasadena to be Johnny Patout, CEO of New Beginnings Adoles- part of this incredible event dedicated to honor- cent Recovery Center, a 2014 Behavioral Health- Building on the success of existing Quality Blue ing the gift of life and sight – given and received care Champion. Patout is one of only five individ- programs, most notably Quality Blue Primary Care, Nicholas Jordan “Crazy” Aucoin was a senior, uals nationwide to be honored for his dedication, Blue Cross and Blue Shield of Louisiana is rolling attended Pine Prairie High School, and played courage, inspiration, and excellence as a leader of out a new program to continue the transformation football for three years at strong safety and a behavioral health organization. to value-based care. defensive end. Well liked by his peers, Jordan was Quality Blue Value Partnerships launched this elected Basketball Homecoming Senior Prince. BSW Receives AHLA summer, with five large provider systems currently The oldest of five siblings, he was also a protec- Honors and More enrolled: Baton Rouge Clinic, Baton Rouge Gen- tive older brother. eral Physicians Group, Gulf States Quality Network, On November 18, 2010 Jordan was on his way The law firm of Breazeale, Sachse & Wilson, LLP Ochsner Health System, and West Calcasieu Virtual to pick up his two sisters from after school activi- (BSW) has been recognized by the American Medical Home. ties. He was in a motor vehicle accident and suf- Health Lawyers Association, Modern Healthcare, Quality Blue Value Partnerships best serves fered severe head trauma. Jordan had chosen to and Chambers USA. large provider groups that have an array of doc- become an organ donor when he turned 18. His American Health Lawyers Association recognized tors within the same healthcare system. To partic- family is very proud of this decision and it brings BSW as having one of the top healthcare teams in ipate in Quality Blue Value Partnerships, doctors them peace on the tough days. the country and in Louisiana with 100% involve- must already be enrolled in Quality Blue Primary ment. The American Health Lawyers Association Care, the population health management program C ampaign Returns to Help bases its ranking by the number of AHLA members Blue Cross introduced last year. Louisianans Quit Smoking each law firm has enrolled in the association; this Quality Blue Primary Care focuses on effectively includes attorneys, paralegals and non-paralegals. coordinating patients’ care with Blue Cross clini- Continuing with the success of last year’s land- A ll 11 members of BSW’s health law practice group cal staff who work directly with family medicine, mark national tobacco education campaign, the as members of AHLA. internal medicine, and general practice physicians. U.S. Centers for Disease Control and Prevention Modern Healthcare lists BSW as one of the “Larg- By adding Quality Blue Value Partnerships, large (CDC) is airing a second series of ads in 2014 fea- est Healthcare Law Firms” in the country, ranked provider systems can expand beyond primary care turing real people who are living with the effects 63 on a list of 69. The survey ranking method- and examine their patients’ treatment experiences of smoking-related diseases. The newest ads in ology is based on a blended score: Sum of 50% throughout the entire system, including with spe- the “Tips from Former Smokers” campaign tell weight from data collected in the survey (number cialists, hospitals, and outpatient centers that they the story of how real people’s lives were changed of healthcare lawyers) and 50% weight of Ameri- manage. These types of systems are also called forever due to their smoking. In Louisiana, 6,500 can Health Lawyers Association membership from Accountable Care Organizations. residents die every year from smoking-related dis- each firm. If the healthcare systems enrolled in Quality eases. The new ads began airing July 7 and will The lawfirm also received high rankings for five

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 43 practice areas and had twelve attorneys listed in Hunter oversees a corps of volunteers from the Blue Angel. Landry serves on the board of the Down Chambers USA: America’s Leading Lawyers for surrounding Shreveport-Bossier-Benton area that Syndrome Awareness Group of Baton Rouge, par- Business for Louisiana. The BSW Practice Areas provides meals and groceries, afterschool and ticipating in planning several annual events raising listed in the 2014 edition of Chambers USA include: weekend programs, and mentoring and tutoring funds for the organization. Her charity will receive a • Healthcare to hundreds of at-risk children and their families. $5,000 dollar grant from the Foundation. • Construction • Jennifer Maggio of Baton Rouge. A former sin- • Gaming & Licensing gle mother herself, Maggio founded The Life of a Golf Tournament to Aid LOPA • Labor & Employment Single Mom Ministries to work with churches and • Litigation: General Commercial. communities around the world in establishing sin- This year’s Justin Harrison’s GolfForeLife tourna- gle parent support groups. Her nonprofit business ment supporting the Louisiana Organ Procure- Blue Cross Names Angel model has been duplicated around the country ment Association will be held Monday October Award Winners as well as abroad and she has written four books 13, 2014 at Le Triomphe Golf & Country Club, 100 encouraging single parents. Club Boulevard in Broussard. T en more names have been added to the list of • Isaac McFarland of Keithville. A high school Harrison became passionate about organ and outstanding volunteers for children in Louisiana junior, McFarland founded Game Changers, an tissue donation after his grandfather died wait- with the selection of this year’s winners of the organization devoted to educating schoolchildren ing on a heart transplant. Less than one year Angel Award presented by the Blue Cross and on hunger in local communities and the world. The later, at age 15 ½, Justin became a hero to seven Blue Shield of Louisiana Foundation. The award group has provided hundreds of “tackle boxes” people, and their families, as he gave them life is given annually to those who donate their time of food to children in underserved communities. through organ donation and sight through cor- and talents to better the lives of Louisiana children, He also tutors students at a neighborhood recre- nea donation. whether through enrichment projects in the areas ation center and assists with community vegeta- LOPA is currently seeking sponsors for this year’s of arts and education or programs addressing the ble gardening. Golfe For Life Tournament. Your contribution will direst needs of an underserved population. • Hank and Debbie Perret of Lafayette. Following benefit the continuous grief support program for Each winner will receive a $20,000 grant for the the death of their son Miles from cancer in 1996, the families that say yes to donation and LOPA’s charity of his, her or their (a husband-and-wife the Perrets began devoting their volunteer time to community education program. team is among this year’s honorees) choice. efforts supporting cancer patients and their fami- F or more information go to www.lopa.org or con- Receiving the Angel Award this year are: lies. Since then, Miles Perret Cancer Services has tact Libbie Harrison, 337-349-574 or lharrison@ • Ashley Belding of New Orleans. A pediatric helped thousands of families in a 10-parish area, lopa.org, or Suzanna Morton, 256.724.2255 or social worker, Belding has volunteered for more offering wellness, nutrition and exercise classes, [email protected]. than 20 years at Camp Pelican, a weeklong resi- wigs and prostheses, support groups, and fam- dent camp for children who are on ventilator assis- ily events. tance or suffer from other pulmonary disorders • Jackie Silverman of River Ridge. After working Local such as asthma, cystic fibrosis or tracheotomy. For with homeless families in the aftermath of Hurri- more than half of that time, she has organized and cane Katrina in New Orleans, Silverman founded St. Gabriel Health Center managed Pelicanpalooza, revamping it and turn- the New Orleans Women’s Shelter in 2007. The earns PCMH Recognition ing it into the camp’s principle fundraiser. organization has provided a stable and safe home- • Laura Domingue of Baton Rouge. Domingue style environment for more than 350 children and The National Committee for Quality Assurance founded Trafficking Hope, which since 2007 has their mothers. (NCQA) announced that St. Gabriel Health Cen- raised awareness in Baton Rouge and throughout • Nancy Zito of Baton Rouge. Zito quit her job ter, Inc. has received NCQA Patient-Centered Medi- the state of the modern day slavery that is human teaching at a private school to become founder, cal Home (PCMH) Recognition for using evidence- trafficking. She has been instrumental in the devel- principal and executive director of the Gardere based, patient-centered processes that focus on opment of Louisiana Hope House, a 32-acre cam- Christian Community School, serving an area highly coordinated care and long-term, participa- pus that provides life skills, vocational training, notorious for poverty, drugs and violent crime. In tive relationships. faith-based counseling and medical care to victims four years, the school’s reputation for academic T o earn recognition, which is valid for three years, of human trafficking. excellence has grown, even though almost all the St. Gabriel Health Center demonstrated the abil- • Brian Hunter of Shreveport. Hunter is the driv- students come from families at or below the fed- ity to meet the program’s key elements, embody- ing force behind Common Ground, a community eral poverty level. ing characteristics of the medical home. NCQA center serving one of the poorest neighborhoods Also being recognized is Blue Cross vice president standards aligned with the joint principles of the in Shreveport. As volunteer executive director, of IT integrated services Laura Landry as the 2014 Patient-Centered Medical Home established with

44 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE go online for eNews updates HealthcareJournalBR.com

the American College of Physicians, the American Academy of Family Physicians, the American Acad- emy of Pediatrics, and the American Osteopathic Association.

Brother-Sister Duo Arrested for Medicaid Fraud Desi Valentine, MD R. Mark Sayes, MD Alexandra Brown, MD

The Louisiana Attorney General’s Medicaid Fraud Control Unit (MFCU) with assistance from the Bales to Headline O’Brien Sayes earned his medical degree from Tulane East Baton Rouge Parish Sheriff’s Office, arrested House Events University School of Medicine in New Orleans. He 49-year-old Barbara Jean Smith, of 9245 Cedar completed his internship at Quillen-Dishner Col- Court Drive in Baton Rouge, on two counts of Susan Ford Bales, daughter of the late President lege of Medicine at East Tennessee State Univer- Conspiracy to Commit Medicaid Fraud. Her arrest Gerald Ford and Mrs. Betty Ford will be in Baton sity in Johnson City and completed his residency comes after the July 2 arrest of her older brother, R ouge September 24th and 25th to help raise training at the University of Mississippi Medical 50-year-old Cleveland Smith, also of 9245 Cedar funds for the O’Brien House and raise awareness Center in Jackson. Court Drive in Baton Rouge, on two counts of Med- of the impact of substance abuse and addiction icaid Fraud. Both were booked into the East Baton on families. Annette (Mrs. John) Camp will serve Brown Joins HORNE’s R ouge Parish prison. as Honorary Chair of the 2014 breakfast. Healthcare Delivery Institute Cleveland Smith was employed as a personal Bales will share her family’s story of her mother’s care attendant, providing in-home care services very public struggle and recovery from alcoholism HORNE LLP has hired Alexandra Brown, MD, as the to his sister, Barbara, from Nov. 2013 through Jan. and addiction to pain killers at the 12th Annual associate director of its Healthcare Delivery Insti- 2014. Through an investigation, it was learned that O’Brien House breakfast at the Capital Hilton on tute. Brown joins Director Thomas Prewitt, MD, on numerous occasions Cleveland falsely billed the Thursday, September 25th at 8am. on the leadership team of the institute where she Louisiana Medicaid Program for personal care ser- T he breakfast is a reservation only event, and will focus on the development and instruction of vices performed on his sister during the dates and persons may reserve a seat by emailing Breakfast- the Advanced Training Program. times she was not actually home. Agents allege [email protected] or calling Gail Gai- The ATP trains students, who fill roles in their that Barbara signed-off on service logs submitted ennié at 225.344.6345. While the breakfast meal healthcare organizations ranging from clinicians by Cleveland to the Louisiana Medicaid program is provided at no cost, a request for donations is toO CF s, in both the theory and methodology of for payment. Witnesses confirmed that Barbara included in the morning’s program. continuous quality improvement in the health- was providing private sitting services to others out- On Wednesday evening, September 24th, Bales care environment. The program is a sister-program side of her home, and that the private sitting shifts will share hosting duties with John Turner and Jerry to Dr. Brent James’ internationally recognized overlapped with times that Cleveland reportedly Fischer at their home for an Inaugural Gala Dinner Advanced Training Program at Intermountain rendered Medicaid personal care services to her. benefitting O’Brien House. The evening will start Healthcare. with a private reception with the hosts followed by The Advanced Training Program has opened reg- Valentine Joins Baton Rouge a limited seating dinner, where Chef John Folse will istration for its Fall 2014 and Winter 2015 terms. General Physicians present a six course dinner of Louisiana cuisine. This Details about the program, including exact dates first time event is by invitation only, and more infor- and tuition fees are available at connect.horne-llp. Desi Valentine, MD, has joined Baton Rouge Gen- mation can be obtained by contacting either Bar- com/hdiatp. eral Physicians. Dr. Valentine is board certified in bara Anne Eaton or Gail Gaiennié at 225.344.6345. family medicine. She earned her medical degree R ibbon Cut on Ochsner Denham from Louisiana State University School of Medi- Sayes Joins Baton Rouge Springs Health Center cine in New Orleans and completed her residency General Physicians training at Baton Rouge General Medical Center’s Ochsner Medical Center-Baton Rouge recently held Family Medicine Residency Program. She is a mem- R. Mark Sayes, MD, has joined Baton Rouge General a ribbon cutting for the new Denham Springs South ber of the American Academy of Family Physicians Physicians. Dr. Sayes specializes in family medicine Health Center to premiere its new facility, which will and the Louisiana Academy of Family Physicians. and has more than 20 years of experience. He is house primary care physicians, urgent care ser- Dr. Valentine’s office is located at 3401 North Bou- board certified in family medicine and is a mem- vices, and multiple rotating specialists. This 13,000 levard, Suite 200 in Baton Rouge. ber of the American Academy of Family Physicians. square foot health center features 27 exam rooms

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 45 Present at the ribbon cutting for Ochsner Denham Springs Health Center were (L-R): Rubin Patel, MD (Urgent Care Lead Physician), Bradley Ward (Manager of Clinic Operations), Cheree Wheeler-Duke. MD (Primary Care Physician), Scott Mabry (Chief Operating Officer), Debbie Williams (Director of Clinic Operations), William Baird, MD (Associate Medical Director of Primary Care), Daniela Cardozo, MD (Primary Care Physician), Laura McNash (Manager of Clinic Operations), Robert Hart, MD (Regional Medical Director), Eric McMillen (Chief Executive Officer)

with laboratory and imaging services on site. that Golden had purportedly provided to Medi- PBC R Hires First Chief Business The clinic opened in August with two primary care beneficiaries. Development Officer care physicians in house – Dr. Cheree Wheeler- On July 29, 2014, Ebere pled guilty before Chief Duke and Dr. Daniela Cardozo. It will also offer U.S. District Judge Brian A. Jackson to conspir- David Winwood, PhD has been named Penning- urgent care with extended hours from 8 a.m. to acy to commit healthcare fraud, in violation of ton Biomedical Research Center’s first Chief Busi- 8 p.m. Monday through Friday. Specialists in car- Title 18, United States Code, Section 1349. Ebere ness Development Officer (CBDO), underscoring diology and nephrology will rotate through the faces up to ten (10) years in federal prison and a the importance of moving research discoveries Denham Springs South Health Center on a regular fine of $250,000, or twice the gross gain or gross focusing on health, prevention, and treatment of basis with more specialists to be added in other loss derived from her offense. Ebere will also be chronic diseases into the global marketplace. areas as the clinic grows. Located at 139 Veterans required to forfeit the proceeds of her crime. In Dr. Winwood brings more than 20 years of expe- Blvd., this is the second Ochsner clinic in Denham her plea agreement with the United States, Ebere rience in technology transfer and commercializa- Springs. admitted that, through her company, she submit- tion to Pennington Biomedical. As CBDO, he will Patients of the new Ochsner Denham Springs ted numerous fraudulent claims to Medicare for lead externally facing outreach in pursuit of new South Health Center also will have access to enteral nutrition related products that she had business initiatives, strategic partnerships, and MyOchsner, a secure online tool that allows purportedly provided to Medicare beneficiaries, sponsored research, and the development of com- patients to communicate with physicians, sched- even though the beneficiaries did not have feed- mercialized technologies. ule appointments, view lab results, and more. ing tubes and therefore did not need enteral nutrition and did not qualify for it. Ebere admitted that, NeuroMedical Center H ealthcare Company from September 2003 through November 2011, Announces Name Change Operators Convicted through Golden Medical, she submitted approximately $800,000 in enteral nutrition related claims T he NeuroMedical Center Surgical Hospital has United States Attorney Walt Green announced alone. Judge Jackson scheduled Ebere’s sentenc- changed its name to The Spine Hospital of Loui- that Imeh U. Ebere, age 55, of Baton Rouge, Loui- ing for November 20, 2014. siana, at the NeuroMedical Center. With all nine siana, and Sheila R. Hives, age 51, of Baker, Louisi- Hives pled guilty before Chief Judge Jackson operating neurosurgeons in Baton Rouge, five ana, have each been convicted of healthcare fraud to receiving healthcare kickbacks, in violation of pain management physicians, and three ortho- offenses in connection with their roles at Golden Title 18, United States Code, Section 1320a-7b(b) pedic spine surgeons operating at their hospital, Medical Equipment & Supply, Inc., a Baton Rouge- (1)(A). Hives faces a maximum possible sentence the center thought it was most fitting to change based company that provided durable medical of five (5) years in prison and a fine of $250,000. the name, to what they do best – spine surgery. equipment in the Baton Rouge area since 2003. Hives will also be required to forfeit the proceeds The Spine Center features: In 2012, a federal grand jury indicted Ebere and of her crime. In her plea agreement, Hives admit- • 9 Neurosurgeons Hives, charging them with a variety of offenses ted that she received illegal kickbacks from Ebere • 3 Orthopedic Spine surgeons arising out of a fraudulent scheme through which to induce Hives to refer Medicare beneficiaries to • 5 Pain Management Physicians Ebere and Golden submitted false reimburse- Golden Medical. Judge Jackson scheduled Hives’ • 10 Neurologists ment claims to Medicare for enteral nutrition sentencing for November 7, 2014. • 5 Pain Management Physicians

46 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE go online for eNews updates HealthcareJournalBR.com

• 4 Physical Medicine & Rehabilitation helps the body track protein intake, it also shows • 4 NeuroPsychologists that protein intake profoundly influences metabo- • 2 NeuroRadiologist lism and that scientists may be able to use protein Hospital Services include: specific signals like FGF21 to influence our metab- • Neurosurgery, Pituitary Tumor Removal olism in a unique way. Surgery Pennington Biomedical’s Thomas Laeger, Tara • Pain Management Henagan, Diana Albarado, Leanne Redman, David Winwood, PhD • Neurology George Bray, Robert Noland, Heike Münzberg, and • NeuroRadiology Thomas Gettys contributed to this work, as well as • Sleep Center researchers at the Virginia Polytechnic Institute • Lab Services. and State University and the University of Wash- ington. The study was funded by the National Insti- New Moreau Physical tute of Diabetes and Digestive and Kidney Diseases Therapy Clinic Opens (NIDDK), at the National Institutes of Health (NIH).

Moreau Physical Therapy’s newest clinic is now Bone Marrow Donors Sought open at 3129 Perkins Road. Clinical Director, Rob- bie Lazarine, PT, DPT, will lead the Moreau team Mayor-President Kip Holden, Mary Bird Perkins – at the Perkins location. Lazarine is a graduate of Our Lady of the Lake Cancer Center, and Be the Andrea Brown, MD, FAAFP Louisiana State University Health Sciences Center Match have launched a 90-day bone marrow dona- and has been practicing for two years in the Baton tion drive, from August 12 – November 1. R ouge community. R egistration drives will be held throughout In addition to offering a wide range of therapy the city in an effort to sign-up as many potential L eBlanc’s special interest is in Manual Therapy. services, Moreau will be offering biomechanical donors as possible. Registering is easy and only She also supports the Amyotrophic Lateral Scle- and running assessments. requires filling out a medical questionnaire and a rosis (Als) and Down Syndrome foundations by quick cheek swab. participating in community walks and events. She R esearch Offers New Look at While there is a critical shortage of donors across hopes to bring awareness and involvement of the Hormones and Weight Loss the country, only 28 percent of registered donors illnesses to the community. belong to minority groups with only 7 percent Researchers at Pennington Biomedical Research being African- Americans. Brown Joins Baton Rouge Center have discovered a new pathway that con- Bone marrow drive events are scheduled General Physicians trols how our bodies respond to a diet that’s low throughout the “90-Day Donor Challenge” and in protein. This finding could improve treatments additional sites may be added. For an up-to-date Andrea Brown, MD, FAAFP, has joined Baton Rouge for obesity and diabetes. listing on bone marrow registration drives, call General Physicians. Dr. Brown is board certified Data collected by Chris Morrison, PhD and his (225) 215-1234 or visit www.mbpolol.org/donor- in family medicine and has more than 15 years team of researchers at Pennington Biomedi- challenge. Any organization, group or club inter- of experience. cal provides a new explanation for why protein ested in scheduling a registration drive should call She earned her medical degree from Louisiana intake profoundly influences metabolism and (225) 910-4872. State University School of Medicine in New Orleans body weight. They found that in both mice and and completed her residency training at Baton humans the amount of protein in the diet affects New Therapist Joins R ouge General Medical Center’s Family Medicine a hormone known as FGF21. If protein consump- Kleinpeter Physical Therapy Residency Program. She is a Fellow of the Ameri- tion is restricted, the body increases production can Academy of Family Physicians and a member of FGF21. Mice lacking the FGF21 hormone did S ophia LeBlanc, DPT has joined the practice of of the Louisiana Academy of Family Physicians. not change their food intake, metabolism or body Kleinpeter Physical Therapy located in Baton Her office is located at 23845 Church Street in weight when placed on a low protein diet, indicat- Rouge and Zachary. LeBlanc received her under- Plaquemine. n ing that without FGF21 the mice couldn’t detect graduate degree in Kinesiology at Louisiana State dietary protein content. University in Baton Rouge. She attended the Uni- M orrison’s work, published in the Journal of Clin- versity of South Alabama in Mobile, where she ical Investigation, not only suggests that FGF21 earned her Doctorate of Physical Therapy.

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 47 The Case for Big Data

Big Data: it’s a small phrase that packs a large punch in our current health care environment, but what does it really mean, and why does it matter?

ig Data refers to a massive volume ultimately combine to improve revenue cycle And of course, Big Data plays a critical role of information, both structured management through reduced claims sub- in population health management, which is and unstructured, that is too large mission errors and denied claims and fewer fast becoming a core component in national Bto be processed via traditional resources wasted on error correction and efforts to improve health care. Population techniques, yet has the potential to drive im- resubmitted claims. health management has a broad scope, re- provements in quality and costs. In health Yet the value doesn’t stop there. Big Data quiring health care organizations to define care, the transition to health information can also have a positive impact on resource their patient populations, identify gaps in technology (IT) has led to a virtual explosion utilization. A 2012 report by the Institute of care, stratify risks, engage patients in care in data availability, yet this data has largely Medicine, for example, estimates that $765 management, and measure patient outcomes. remained an untapped resource – one that billion is wasted each year through issues It is an integral component of national efforts could be converted into strategic business related to inefficient service delivery, exces- to achieve the Institute for Healthcare Im- information, hence the growing number of sive administrative costs, and other items. provement’s Triple Aim goals of better care, references to the “Big Data Revolution.” Effective processing of data, however, would better outcomes, and lower costs. But is Big Data something that can truly enable health care organizations to better Big Data analysis allows health care orga- “revolutionize” health care? It is, indeed, ac- track and manage patient volumes, services, nizations to target high-risk populations to cording to a 2011 McKinsey report stating and supply chains as well as their workforces. reduce costs and improve outcomes, which that if U.S. health care systems were to use In addition, fraud and abuse, one of the is why the Office of the National Coordinator Big Data creatively and effectively, the result largest factors in spiraling health care costs, for Health Information Technology (ONC) would be an estimated eight percent savings accounts for as much as 15 percent of an- has made population health and Big Data in health care expenditures. The report fur- nual health care expenditures, estimates the key elements of its 10-year plan. ther notes that effective use of Big Data could U.S. Department of Health and Human Ser- Karen DeSalvo, MD, National Coordinator, yield more than $300 billion in annual value. vices (HHS). Much of these costs are related in May at the eHealth Initiative’s National This tremendous value comes in several to improper coding, providing unnecessary Forum on Data and Analytics, said, “We’re forms. Effective use of Big Data can assist medical services and billing for services that beginning to have a way to aggregate infor- health care systems in determining pa- were not provided. By leveraging Big Data, mation to see populations…What that allows tient eligibility, validating coverage, assess- we can identify and reduce fraud and abuse us to do is to improve quality and safety, if ing payment risks, managing submissions, by revealing trends, patterns, and predictions we are using this information properly, and and tracking performance. These benefits in service utilization. improve the health of not just the patients

48 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE Cindy Munn Executive Director Louisiana Health Care Quality Forum

innovative partnerships. Such partnerships and set their own data standards. will require organizations to align their goals But while these organizational HIEs do with those previously thought to be competi- have great value, in today’s health care en- tors and to adopt a unified focus on data trans- vironment, their value can – and should - be parency – a step that many have been hesi- optimized through connectivity to a neutral, tant to take even though the health care sector centralized data architecture capable of cap- shares a focus on evidence-based practices. turing, storing, aggregating, reporting, shar- This is largely the result of varied ap- ing, and mining that data. Statewide HIEs are proaches to ‘evidence-based’ medicine, which increasingly expanding their capabilities to has led us to implement these practices dif- include these value-added services. ferently across the care continuum. This has Many state HIEs – including the Louisi- in turn caused us to analyze our data based ana Health Information Exchange (LaHIE) – on individual organizational needs rather have long surpassed the simple bi-directional than the needs of the health care system as sharing of data to meet the new challenge a whole, which has contributed to both an of Big Data. These advanced statewide HIEs industry-wide hesitancy in terms of transpar- have, like LaHIE, begun offering robust popu- ency and a lack of interoperability. lation risk management, analytics, and clini- In fact, ONC, in its February 2014 report, cal integration solutions that enable health in the hospital but the greater population.” “Igniting an Interoperable Healthcare Sys- care organizations to leverage their data to Essentially, to paraphrase DeSalvo, the tem,” stated that interoperability “is a prob- improve quality and outcomes while reduc- data about Big Data shows it can reduce lem of our own creation,” and issued a call to ing costs and maintaining competitiveness costs, improve decision-making, and provide action for greater data sharing among health in their markets. These HIE infrastructures more accurate information on quality perfor- systems. present a cost-effective, neutral platform that mance while improving care and outcomes “It is not at all like the lack of ineffective break down the internal data silos that were at both the individual and population levels. therapies for specific diseases where reso common in yesterday’s health care system. And there are a number of trends converg- searchers and clinicians are tirelessly explor- Thus, the underlying theme of the Big Data ing to push us toward its use. We have an ing the details of specific causes. The lack movement is this: If we are to truly achieve incredible supply of data, thanks to the digita- of industry-wide commitment to use open the goals of the Triple Aim, we must harness lization of health care; our technical ability to standards-based communication strategies and use our growing mass of health care data mine that data has expanded exponentially; has contributed to the lack of interoperabil- to our collective advantage. and federal-level requirements are focused ity,” the agency wrote. However, while other industries are har- on making data more transparent. Through data-sharing partnerships across nessing and leveraging their data to improve We also find ourselves now in a health care the health care industry, we have the oppor- efficiencies and decision-making, the health environment in which payment models are tunity to answer ONC’s call to action, reverse care sector – which has the most to gain from rapidly changing – the days of the fee-for- these trends and build a health care environ- its use – is lagging behind. There will be chal- service system are disappearing in favor of a ment in which clinical quality improvements, lenges, to be sure, but we can no longer deny system in which providers must consistently population health management and innova- the prominent role of Big Data in our health review clinical data for their patients to moni- tion are truly attainable. care environment. tor and direct treatment, outcomes, and costs Yet these partnerships must be enhanced Big Data - two tiny words that represent to receive reimbursement. by strategic investments in the storage, the culmination of more than a decade’s So in the midst of these trends and this analysis and management of Big Data. For progress in the digitalization of health care transition to a value-based health care sys- many health care provider organizations, this and signify the beginning of a revolutionized tem, the question becomes, how do we har- investment has already begun through the system of care – offers the opportunity to ness Big Data? How do we tap this largely development of internal health information not just transform health care, but to drive untapped resource and capitalize on it? exchanges (HIEs), which enable these orga- it forward at lightning speed. The health care sector must create nizations to share data with select partners And that’s why it matters. n

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 49 because they are picking up shifts at other Fatigue and Burnout institutions and there is no way to track this. A nurse may only be working 36 hours each week at one institution, but she is picking up 2 in Nursing: or more 12-hour shifts at another institution. It is not unusual then to discover that nurses Implications for Clinical may be working 60-72 hours each week. This practice has become an ever-increasing con- Nursing Practice cern, not only for Boards of Nursing, who are charged with protecting the safety of the public, but for nursing administrators generally who are also charged with protecting the In my 40 years in the nursing profession, I have heard discussion safety of patients and insuring excellence of Fatigue and Burnout in Nursing: nursing practice in their institutions. Implications for Clinical Nursing Practice of burnout and fatigue at one level or the other. In the early days Nurses who work these types of hours may of my career, with 8 hour shifts and standard 40 hour work experience fatigue as well as neurobehav- weeks, it wasn’t so great an issue as it appears to be in 2014. With ioral deficits that ultimately lead to burnout. the advent of the Baylor weekend staffing program in 1981 at It is not only the number of hours that are problematic, it is the longer shifts with fewer Baylor University Medical Center in Dallas, Texas, 12-hour shifts breaks, less recovery time between shifts and on weekends were born. This plan was intended as a 2-day an increasing patient load and acuity. While nurses do profess greater satisfaction with alternative where nurses working 24 hours on the day shift were the 12-hour shifts, the longer the shift con- paid for 36 hours and on the night shift, they were paid for 40 tinues beyond that timeframe, the greater is hours. This plan was particularly popular with nurses returning the fatigue and increasing dissatisfaction with the longer hours. As stated previously, it is im- to school, who could take classes during the week and then work possible to guarantee a 12-hour shift because weekends and get paid full time including benefits. The Baylor factors such as unpredictable patient needs, unanticipated shift changes, and unplanned plan was so successful that it was soon copied across the United overtime are not easily predictable.2 States and in Canada, England, and Egypt.1 What is nursing burnout, then? Nurses will describe it in different ways, but ultimately what we are talking about is chronic fatigue, owever, as they say, beware of irritability, insomnia, and poor performance. unintended consequences. What It may be related to excessive work hours, began as a unique 12-hour shift inadequate staffing, inability to control work Hopportunity has morphed into schedule and/or work environment, declin- universal 12-hour shifts across this country. ing quality of patient care, high patient/staff Nurses generally work 3 of these shifts each ratios, verbal abuse, and/or perceived lack week and get paid for 40 hours with full ben- of administrative support. Physical manifes- efits. While this may seem reasonable, the tations include headache, back pain, weight shifts aren’t really 12 hours, more like 14 with gain or loss, gastrointestinal problems, in- end-of-shift duties including catching up on creased susceptibility to colds and viruses, charting and shift report and there is no con- mood swings, loss of empathy, apathy, de- trol over how many hours nurses are working creased alertness, frequent use of sick days

50 SEPT / OCT 2014 I Healthcare Journal of baton rouge Karen C. Lyon, PhD APRN, ACNS, NEA Executive Director Louisiana State Board of Nursing

How, then, do we change the culture of hobbies and other self-care activities. Other nursing to reduce and prevent fatigue and coping activities include striving for work- burnout? First and foremost, the healthcare life balance, accessing Employee Assistance industry must recognize its role to influence Programs when necessary, and developing and control the work environment. Nurse self-assertive behaviors including boundary executives are not only instrumental to the setting, saying no to work, taking vacations, safety of the work environment, they are re- and self-limiting overtime. sponsible for the quality of care received by Fatigue and burnout are real issues that in- their patients from the professional nursing fluence patient care outcomes and job perfor- staff. The Institute of Medicine has recom- mance. Ultimately, they may even influence mended that nursing shifts not exceed 12.5 a nurse’s decision to remain in the profes- hours and the nursing work week should not sion. Because most of us enter this profes- exceed 60 hours in a 7-day period.3 The fol- sion to help individuals deal with their own lowing considerations are specific to nurse pain, suffering, and illness, we may very well executives: ignore the symptoms of fatigue and burnout 1. Assess the organizational culture re- in our own lives. Helping our colleagues rec- garding fatigue and fatigue awareness ognize and manage these distressing signals 2. Develop specific policies regarding will insure that all nurses continue to excel length of work time in direct patient care in their role as caretaker, care coordinator, 3. Ensure that employees recognize and and lifeline for patients managing the varied honor their ethical responsibility to provide and complicated sequelae of their multiple safe and high-quality nursing care for their medical conditions. n patients 4. Encourage a culture that allows safe expression of fatigue-related concerns 5. Encourage a culture that respects nurs- References: es’ scheduled days off and vacation time 1 Garner, L.F. and Bufton, K.A. (2001) History of nursing at Baylor University 6. Evaluate staffing issues and solicit input Medical Center. Proceedings of Baylor from affected staff in order to resolve these University Medical Center, 14 (4), October issues 2001. Retrieved from http://www.ncbi.nlm. nih.gov/pmc/articles/PMC1305904/. 7. Create limits on the number of voluntary overtime hours nurses can work to prevent 2 Walsh, R. (2013) Nurse Fatigue. adverse nurse and patient outcomes Emergency Nurses Association White Paper. August 2013. 8. Post federal regulations in break rooms, Retrieved from http://www.ena.org/ locker rooms and bathrooms practiceresearch/research/Documents/ 9. Provide information via intranet or NurseFatigueWhitePaper2013.pdf hard copy on the harmful effects of long 3 Institute of Medicine. (2003). work hours, multiple consecutive shifts and Keeping patients safe: Transforming and excessive tardiness. The consequences of shift work.2 the environment of nurses. Retrieved from http://www.nap.edu/catalog. such fatigue are physical, mental, and emo- Additionally, there are skills that individual php?record_id=10851 tional. Nurses may have decreased reaction nurses can develop to help them cope with fa- time, slowed information processing, com- tigue and burnout. They include maintaining promised problem solving, negative attitudes, a sense of humor, debriefing with colleagues poor judgment, diminished capacity for criti- after particularly stressful events and/or cal analysis, and even clinical depression.2 shifts, and engaging in exercise, meditation,

Healthcare Journal of baton Rouge I SEPT / OCT 2014 51 Growing Use of ADHD Drugs Demands Attention

As concerns rise about the record levels of prescription drug use for the treatment of Attention Deficit Hyperactivity Disorder, the Louisiana Department of Health and his spring, a national report pub- the surprising rate of growth for the use of lished by Express Scripts, the na- these prescriptions, the Department of Health Hospitals is committed tion’s largest prescription drug and Hospitals took steps to grow our pool to finding a sustainable T manager, revealed that the number of research on this issue. I was excited to of young American adults taking medications see the members of the Louisiana Senate solution. for Attention Deficit Hyperactivity Disorder Health and Welfare Committee pass a reso- (ADHD) nearly doubled from 2008 to 2012. lution asking DHH to study the most effec- This same report found even deeper concerns tive means to ensure proper use of ADHD for Louisiana, revealing that our state ranks medications in Louisiana. In an effort to find second highest for ADHD prescription rates these answers, we have created a workgroup in the country. As the report looked deeper comprised of representatives from all of our into Louisiana’s demographics, the numbers program offices, who each represent differ- grew even more drastic. Furthermore, Loui- ent viewpoints and expertise on the issue. siana boys ages 12-18 also see high rates of We took special care to select members and medication use with a total of 13.6 percent. physicians who have extensive knowledge Out of the entire nation, we have the high- of the issue, many coming from psychology est number of young women on ADHD treat- or sociology backgrounds. This workgroup ments with 7.8 percent of girls ages 12-18 and will thoroughly examine this issue and ul- 8 percent of Louisiana women ages 19-25. timately determine the most effective way This means that the percentage of our 19- to ensure proper use of these medications. 25 year old women on these medications is Furthermore, as this workgroup expands to nearly double the national average. include experts outside of DHH, their work As national and state concerns grew about will lead into an ADHD focused symposium

52 SEPT / OCT 2014 I Healthcare Journal of Baton rouge Kathy Kliebert Secretary, Louisiana DHH

that will provide a valuable opportunity to include a variety of stakeholders in the process of shaping important policy decisions. However, I know that this is no simple issue for our workgroup to tackle. Research across the board shows us that testing patients for ADHD can be difficult, especially in children. According to a 2002 study by P. Fonagy, only 33 percent of preschoolers with confirmed ADHD still received the same diagnosis three years later. The typical symptoms of the disorder, including elements of inatten- tion, hyperactivity, and impulsivity, are difficult to distinguish from the highly inconsis- be referred for testing because of disruptive risks of other psychiatric conditions, and the tent, typical behavior of young children. This behavior. Girls more commonly display the possibility of seizures for high-risk patients. factor plays a major role in the difficulty in di- “distracted” symptoms of the condition which These risks come at a high cost when re- agnosing the disorder in young children. We may be more easily overlooked and therefore search shows us that nearly 50 percent of also see overarching evidence that outside result in fewer referrals for testing. those youth that are receiving these stimu- factors such as age or classroom behaviors These drugs provide solutions for many lants may not meet criteria for ADHD. It is can also influence diagnosis. For example, ac- patients who need them, however, they still also known that risk of addiction increases cording to our Medicaid data, the percentage come with considerable risks. Normal side ef- dramatically for patients who do not require of five year old boys on ADHD medications fects of ADHD treatment drugs vary from ap- the medication. With such a high number of in Louisiana nearly doubles for those born petite suppression to mood swings or tempo- prescribed patients not meeting the criteria in the two months leading up to the kinder- rary growth rate suppression. The major risks for diagnosis, addiction is a huge concern. garten cut-off date, making these students of these medications are considerably higher, Furthermore, an abundance of prescriptions the youngest in their class. Furthermore, including addiction, adverse reactions in pa- contributes to widespread abuse of these boys across the nation are far more likely to tients with cardiovascular disease, increased drugs. Express Scripts also found that one in 10 teenagers has abused or misused ADHD medication in the past year. It is important that we take a deeper look at the substantial increase in the number of Lou- isiana residents receiving these medications and the consequences that go along with our high rate of diagnosis. We are committed to investigating this issue with the help of our experienced and knowledgeable workgroup, while gathering sustainable solutions to ensure that these medications are being used properly. I am looking forward to continuing to promote the health of our citizens in new ways with a new understanding of the impact of these drugs. n

Healthcare Journal of Baton Rouge I SEPT / OCT 2014 53 hospital Roundshospital news & Information

Kids in Asthma Camp explore an ambulance as part of a lesson in coping with emergency situations.

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 55 O ur Lady of the Lake Celebrates A Magnet® designation holds many benefits for an even more challenging process, requiring a Magnet® Designation hospitals, allowing organizations to attract and hospital to provide evidence that Magnet® stan- retain top nurses; improve patient care, safety, dards have been both met and exceeded during O ur Lady of the Lake Regional Medical Center has and satisfaction; foster a collaborative culture; the four-year period since the last designation. received the prestigious designation as a Magnet® advance nursing standards and practice; and hospital by American Nurses Credentialing Center reduce costs. Doctors, Patients Celebrate (ANCC) for the second consecutive time. Applicants undergo a rigorous evaluation that Heart Procedure Anniversary The Magnet Recognition Program® identifies includes extensive interviews and review of nurs- healthcare organizations that demonstrate excel- ing services. To earn designation, hospitals must “It’s a club.” That’s what a small group of patients lence in nursing and deliver the highest quality of meet stringent standards for quality, patient care, said about themselves as they gathered together patient care and outcomes. ANCC is the largest nursing excellence and innovation in professional to mark the first anniversary of a highly-spe- and most prominent nursing credentialing orga- nursing. cialized procedure at Our Lady of the Lake that nization and has awarded Magnet® status to only Our Lady of the Lake hosted an on-site re- allowed them to have open-heart surgery with- the top eight percent of hospitals in the U.S. accreditation visit in June and welcomed four out the open-heart surgery. The Magnet Recognition Program® is based on appraisers to its campus. The appraisers visited F rancis Bowling of Holden was one of 27 research that demonstrates how creating a posi- patient care units and interviewed various groups patients to have received a transcatheter aortic tive professional practice environment for nurses of personnel to learn more about the organiza- valve replacement, or TAVR, over the past year. leads to improved outcomes—for both staff and tion. Nurses at all levels of practice, physicians She joined 11 other TAVR patients who traveled patients. The designation highlights vision- and hospital administration leaders were involved from across the state, some from as far away Mis- ary leadership, nursing structure, professional in the evaluation process, and a total of 1,700 sissippi, to reunite with the doctors, nurses, and practice, quality improvement, nursing research, team members participated in the overall effort. medical staff who saved their lives. and how it affects improved care for patients. T o earn the designation, Our Lady of the Lake had The minimally-invasive procedure is used to to pass 89 sections of criteria from patient out- replace a narrow or diseased valve in the heart comes to nursing job satisfaction, to leadership without surgeons opening up the chest. Instead, and structure within the hospital. a balloon-expandable heart valve is inserted into Our Lady of the Lake previously achieved the body through a tube-based delivery system a four-year Magnet® designation in 2010. that enters through a small cut in the thigh or Earning a re-designation is considered rib cage.

ABOVE Lynn Troutman of Fernwood, Mississippi thanks Our Lady of the Lake Cardiologist Dr. Bill Helmke with a kiss on the cheek for saving her life.

RIGHT The first patients of a special heart valve replacement procedure unite in recognition of the one-year anniversary of the procedure at Our Lady of the Lake Regional Medical Center.

56 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE go online for eNews updates HealthcareJournalBR.com

Baton Rouge General Earns Installation of the new Elekta Versa HD radiation A for Patient Safety technology, offering greater speed and superior focus on tumor size, shape, and volume, which For the third year in a row, Baton Rouge General makes treatment more efficient and effective. is the only hospital in Baton Rouge to earn an “A” The Cancer Center began its renovation and for patient safety from the Leapfrog Group, an expansion project in June 2013 and is sched- independent, non-profit employer-sponsored uled to be completed in its entirety in early 2015. organization. Remaining major projects include main entrance L eapfrog Group’s Hospital Safety Score program and front lobby area, donor recognition wall, radi- reviews the outcomes and processes of more than ation oncology area, family and visitor hospitality 2,600 facilities across the country and generates a area, and meditation room. report card for each, with an A, B, C, D or F letter Courtney Neubauer, MS, RDN, LDN, CLT grade. The grade indicates the hospital’s overall O chsner-Baton Rouge outcomes in keeping patients safe from prevent- Adds Three Physicians able conditions, including infections, acquired of the standard blood and scratch tests. injuries such as bedsores, and falls, as well as pro- Neubauer earned her dietetics degree from Loui- Ochsner Medical Center-Baton Rouge announced cess outcomes such as proper staffing and medi- siana State University, earned her Master of Sci- the addition of three new physicians to its team cation reconciliation. ence degree in Nutrition from the University of – Dr. Jeryl Breaux in internal medicine, Dr. Smita L eapfrog’s scoring methodology is comprised Alabama and completed her dietetic internship at P echitty in rheumatology, and Dr. Zhe Zheng in of 28 evidence-based, national performance Southern University. She is a member of the Amer- cardiology. measures to determine hospitals’ safety scores, ican Academy of Nutrition and Dietetics, Louisiana Dr. Jeryl Breaux is board certified in internal including 15 process or structural measures and and Baton Rouge Dietetic Associations, and the medicine and comes to Ochsner from Livonia 11 outcome-based. Weight Management Education Practice Group. Community Health Center in Pointe Coupee where L earn more and see the full report at Hospital She was also the Recognized Young Dietitian of the he has practiced since 2005. Breaux also served as SafetyScore.org. Year in 2009 by the Louisiana Dietetic Association. a staff physician for the CARE Network, a community outreach program by the Mary Bird Perkins Woman’s Dietitian First to MBP – OLOL Cancer Center Cancer Center, since 2004. A native of Franklin, he Be LEAP Therapy Certified Completes Phase One received his medical degree from Louisiana State University. Breaux will be located at the Ochsner Woman’s Center for Wellness, operated by Wom- Mary Bird Perkins – Our Lady of the Lake Can- Health Center on Summa. an’s Hospital, is the first facility in Baton Rouge cer Center has opened the phase one areas of its Dr. Smita Pechitty is currently a hospitalist at to go beyond standard food allergy testing when $23 million renovation and expansion project that Ochsner Medical Center in Baton Rouge and will diagnosing and treating food reactions. Wom- began last summer. The following are the com- be moving to the clinic side to specialize in rheu- an’s dietitian Courtney Neubauer, MS, RDN, LDN, pleted phase one projects: matology. Pechitty earned her medical degree CLT, became the first dietitian in Baton Rouge to A 14,000-square-foot infusion suite with an from NTR University of Health Science in India and obtain certification as a LEAP Therapist. Neubauer onsite state-of-the-art clinical oncology phar- completed her internal medicine internship and joined Woman’s in May 2011. LEAP Therapy cre- macy for expedited drug preparation and deliv- residency at Memorial Medical Center and Tem- dentialing is only available to registered dietitian ery. The suite also includes 52 semi-private and ple University. She previously worked as a hos- professionals. four private infusion bays with televisions, head- pitalist at Abington Memorial Hospital in Abing- Certified LEAP Therapists receive advanced clini- sets, and Wi-Fi for mobile devices for enhanced ton, Pa., prior to joining Ochsner in 2011. Pechitty cal training in adverse food reactions, including patient comfort. will be based out of the Ochsner Health Center on food allergies, food sensitivities, and food intol- The 8,149-square-foot Thomas J. Moran Imaging Summa as well. erance. Using specialized, training certified LEAP Center, offering the latest in diagnostic technolo- Dr. Zhe Zheng comes by way of Providence, R.I., Therapists can identify food-sensitivity triggers gies, including CT, ultrasound, nuclear medicine, where he was a fellow in cardiovascular disease that can go unnoticed through standard blood PET/CT, and MRI. The diagnostic imaging center, at the Alpert Medical School of Brown University. and scratch tests for food allergies. Certified LEAP which plays a critical role in treatment planning Zhang is board certified in internal medicine, Therapist use the Mediator Release Test, a blood and palliative therapies, is named after Moran, a echocardiography and nuclear cardiology. He test, to check for food sensitivities within 93-per- grateful and generous patient who benefited from has authored numerous book chapters and arti- cent accuracy, far exceeding the accuracy levels imaging during his treatment. cles for peer-reviewed journals on several topics,

Healthcare Journal BATON ROUGE I SEPT / OCT 2014 57 Graduates of the forty-fourth class of the North Oaks School of Radiologic Technology are: (front row, from left) Tiffany Hebert, Jamie Canal, Britney Rogers, Megan May, Hilarie Smith, (second row, from left) Kimberly Taylor, Nicole Coslan, Clint Cambre, Rashima Jenkins, Tim Hollywood, Sam Crenshaw, Jacy Clemons, and Natalie Forst.

including cardiology. Zheng received his medi- and Hilarie B. Smith, McComb, Mississippi. Cancer Center Recognized for cal degree and a master’s degree in cardiovascu- The ceremony marked the conclusion of a Cancer-Fighting Messages lar disease from Shandong Medical University in 2-year program that included 2,000 clinical train- Jinan, China. He also earned a PhD in Biochem- ing hours, according to Program Director Marsha Mary Bird Perkins – Our Lady of the Lake Can- istry and Molecular Biology from the University J. Talbert. cer Center has been named the recipient of sev- of Toledo in Toledo, Ohio. Zheng will be rotat- Outstanding achievement awards were given to eral national and local advertising awards in ing between several Ochsner facilities through- three of the graduates during the ceremony. The recognition of its cancer-fighting messages. Acco- out the region. He will practice at the Sherwood Academic Achievement Award was presented to lades were presented from the following: CLIO clinic on Mondays, the Denham Springs South Canal for obtaining the highest overall scholastic Healthcare Award, Cancer Awareness Advertis- clinic on Tuesdays and Wednesdays, the Och- average with a GPA of 3.79, and the Performance ing Awards, Healthcare Advertising Awards and sner Health Center on O’Neal on Thursdays, and and Attitude Award for exceptional performance Baton Rouge Chapter of the American Advertis- at Ochsner Health Center-Tangipahoa in Ham- in the clinical setting was given to Hebert. Tay- ing Federation. mond on Fridays. lor presented the Dannye Young Taylor Always Recent awards include: Remembering Others Award, named in honor • “Live Courageously” Campaign North Oaks Honors New of his wife, to Clemons in recognition of her out- • “The Note” TV spot, Bronze Award - CLIO Radiology Techs standing patient care skills. Healthcare Award In addition, Cambre, Canal, Clemons, Coslan, • “Thank You” TV spot, Silver Award - Health- Graduates of the forty-fourth class of the North Crenshaw, Forst, Hebert, Hollywood, May, Rogers, care Advertising Award Oaks School of Radiologic Technology were Smith, and Taylor were recognized as members of • Print ad, Gold Award - Healthcare Advertis- reminded to “always remember your roots” dur- Lambda Nu, an honor society for the Radiologic ing Award ing a ceremony July 7 in the E. Brent Dufreche and Imaging Sciences. To become a member of the • Billboard, Bronze Award - Healthcare Adver- Conference Center, located on the North Oaks society a member must maintain a 3.0 cumulative tising Award Medical Center campus. grade point average out of a possible 4.0. • Advertising Campaign with TV, Silver - Health- The 13 graduates are: Clint Cambre, Port Vin- Applications for the 2015-17 class will be care Advertising Award cent; Jamie L. Canal and Timothy Hollywood, accepted through April 1, 2015. To request an The 2013 Taste event collateral H ammond; Jacy B. Clemons, Kentwood; Nicole application, call or write: Program Director, North • Silver Award - Cancer Awareness Advertising L ynn Coslan, Independence; Samuel E. Crenshaw, Oaks School of Radiologic Technology, P.O. Box Award Weatherford, Texas; Natalie E. Forst, New Orleans; 2668, Hammond, Louisiana, 70404, (985) 230- • Merit Award - Healthcare Advertising Awards Tiffany Leigh Hebert and Kimberly Taylor, Poncha- 7805. Applications are also available on-line for • Silver Addy - Baton Rouge Chapter of the toula; Rashima R. Jenkins, Bossier City; Megan printing at www.northoaks.org in the “Join Our American Advertising Federation Elise May, Covington; Britney Rogers, Franklinton; T eam” section. The 2013 Taste logo

58 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE

• Gold Award - Aster Award paid conference registration and expenses to • Meagan Blanchard, MD • Silver Award - Healthcare Advertising Award attend the conference and a $5,000 award to the • Savarra Mantzor, MD • Silver Addy, Baton Rouge Chapter of the Amer- hospital. • Laura Clayton Kleinpeter, MD ican Advertising Federation Woman’s received the Star Safety Award in 2013 The Pediatric Residency Program at Our Lady • “Sheila’s Journey” video production, for its Failure Mode Effects Analysis (FMEA) process of the Lake Children’s Hospital recently received • Silver Addy Award from the Baton Rouge to proactively identify risks prior to its move to its renewed accreditation by the Accreditation Coun- Chapter of the American Advertising Federation. current location in August 2012. cil for Graduate Medical Education (ACGME). The program, which has been in place at Our Lady of Woman’s Receives 2014 OLOL Children’s Hospital the Lake Children’s Hospital since 2010, received Safety Star Award Graduates Pediatric Residents commendation for “demonstrating substantial compliance with the ACGME’s Program and F or the second straight year, Woman’s Hospital Our Lady of the Lake Children’s Hospital Institutional Requirements for Graduate Medical was recognized by the Louisiana Hospital Associa- announced this year’s graduates of the Pediatric Education.” tion as one of three 2014 Safety Star Award recipi- R esidency Program. Eight graduates have com- Out of 971 applications, 12 new residents were ents. Woman’s received the award for implement- pleted the intensive three-year pediatric training selected for admission in 2014. They began their ing Mobilab technology in inpatient areas. This and will stay in Baton Rouge and practice primary rotations in July, bringing the total number of system allows the hospital to improve the accu- care, pediatric hospital medicine, and pediatric pediatric residents in the three-year program racy of patient identification, eliminate delays, emergency care or will continue specialty training to 33. The program is the second largest in the and decrease the need for specimen relabeling. in prestigious fellowships focusing on pulmonary state and the only one in Louisiana to offer a track The LHA Malpractice and General Liability Trust and critical care, hematology/oncology, neurol- focusing on primary care. F und present the Safety Star Award each year to ogy, neonatology and more. healthcare facilities that have “successfully imple- Our Lady of the Lake Children’s Hospital Four Hospitals Complete mented ideas or processes which have led to the congratulated: EMT Safety Training reduction of general or professional liability expo- • Melody Hawkins, MD sure in technology use, process improvement or • Michelle Jones, MD The EMT personnel from four Louisiana hospitals patient safety initiatives,” according to the LHA. • Emily Richard, MD were recognized after completing a safety training The hospital was recognized at the LHA Summer • Christina Holmes, MD program last month designed to improve decision- Conference in July. In addition, Woman’s received • Day Breen, MD making skills in emergency response scenarios. The training program, Safety: Emergency Responder Vehicle Education (S:ERVE), was offered as a benefit of the LHA Workers’ Compensation Trust Fund. The S:ERVE curriculum included online simula- tions and training on safe vehicle operation, as well as guidance on navigating different scenarios typical in emergency situations. T he four hospitals recognized were Hardtner M edical Center, LaSalle General Hospital, Natchi- toches Regional Medical Center and North Caddo Medical Center. Each hospital was provided a lun- cheon by the LHA Workers’ Compensation Trust F und in recognition of their EMT staff’s completion of the S:ERVE program.

Woman’s Cancer Programs Receive Reaccreditations

The LSU Health Sciences Center Baton Rouge Obstetrics and Gynecology residency program at Woman’s Hospital recently received reaccredita- Woman’s held its commencement ceremony this summer. Pictured: Lin Dang, MD/MPH (Educational Chief); Kayla Fontenot, MD; Woman’s Program and Site Director F.A. Moore, III, MD; O’Neil “Jay” tion from the National Accreditation Program for Parenton, MD (Administrative Chief); and Stephanie Schwartzmann, MD. Breast Centers (NAPBC) and the American College

60 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE go online for eNews updates HealthcareJournalBR.com

OLOL Children’s Hospital Graduates Pediatric Residents

upcoming appointments and more. Registra- tion is easy – activation codes are available on the “After Visit Summary” form received at North Oaks Physician Group clinic appointments or when discharged from North Oaks Medical Center or North Oaks Rehabilitation Hospital. Patients who use doctors affiliated with North Oaks Physician Group also may request an access code in person at any clinic in the network by showing a photo ID. North Oaks myCHART is powered by Epic, an of Surgeons’ Commission on Cancer. Woman’s continuum of care services, patient outcomes and international health care technology firm and received a three-year/full accreditation by the data quality. The facility must also undergo an industry leader specializing in Electronic Health NAPBC through demonstrated compliance with on-site evaluation every three years to demon- R ecord (EHR) technology. North Oaks imple- 27 required standards. According to the NAPBC, strate compliance. mented EHR technology system-wide in March “accreditation challenges breast cancer centers 2013. The public launch of North Oaks myCHART to enhance the care they provide by addressing OLOL Ranked as a compliments Epic upgrades implemented August patient-centered needs and measuring the qual- Top Performer 13, 2014. ity of the care they deliver against national standards. NAPBC-accredited breast centers are dedi- For the fourth consecutive year, Our Lady of the OLOL Earns Bariatric cated to providing the best patient-centered care.” Lake has been named as a Best Hospital by U.S. Center Accreditation Accreditation by the NAPBC is granted only to News & World Report. Our Lady of the Lake is centers that are voluntarily committed to provid- ranked among the best hospitals in Louisiana Our Lady of the Lake Regional Medical Center has ing the best possible care to patients with diseases and as a top performer in Baton Rouge. received full accreditation as a comprehensive of the breast. To maintain accreditation, Woman’s The annual U.S. News Best Hospitals report rec- bariatric facility by the new Metabolic and Bar- must monitor compliance with NAPBC standards ognizes hospitals across the nation that excel in iatric Surgery Accreditation and Quality Improve- to ensure quality care and undergo a rigorous on- treating the most challenging patients. ment Program (MBSAQIP). site evaluation and review of its performance every U.S News & World Report is one of many rank- MBSAQIP accreditation signifies that Our Lady three years. Woman’s was initially accredited by ing groups that help healthcare organizations to of the Lake has demonstrated a commitment to the NAPBC in May, 2011. measure efforts for ensuring high quality. delivering the highest quality of care for bariat- In addition, Woman’s received a three-year/ ric surgery patients. To earn accreditation, the full accreditation with commendation by the North Oaks Health System hospital met the essential criteria that ensure its American College of Surgeons’ Commission on Offers Patients Online Access ability to support a safe bariatric surgical care Cancer. The hospital demonstrated compliance program and measure up to the institutional per- with all 34 Commission on Cancer required stan- North Oaks Health System’s patients can now formance requirements outlined by the accredi- dards and earned a Silver Commendation rating access their health records on any computer or tation standards. by meeting five of the eight commendation eli- smart phone by using myCHART—a secure, online The MBSAQIP is a joint program of the Ameri- gible standards. medical record patient portal. can College of Surgeons and the American Society T o maintain this accreditation, a facility must A personal activation code is required to set up for Metabolic and Bariatric Surgery. The program monitor compliance with required standards an account at mychart.northoaks.org. Patients, accredits inpatient and outpatient bariatric sur- encompassing all areas of the cancer program, age 18 and older, can use myCHART to view lab gery centers that have undergone an independent including program management, clinical services, results, medication lists, discharge summaries, and rigorous peer evaluation in accordance with

Healthcare Journal BATON ROUGE I SEPT / OCT 2014 61 nationally recognized bariatric surgical standards. North Oaks Primary Care Clinic Expands In addition to providing bariatric surgery services, Our Lady of the Lake also holds free monthly seminars on the first Tuesday of every month to North Oaks Primary Care Clinic of Independence has expanded staff and ser- learn more about weight loss surgery, and frequent support group meet- vices to offer health care for patients of all ages, from birth to senior adult- ings for patients who have had weight loss surgery. hood. New patients are welcome. The clinic is located at 230 Masonic Drive in the heart of the Town of Independence. Family Nurse Practitioner Rebecca Haase, APRN, FNP, has joined her husband, Dr. Anthony Haase III, an Internal Medicine Physician and Pediatri- cian, in practice at the Independence-based clinic. The Haase’s specialize in wellness check-ups, vaccinations, treatment for common illnesses and injuries, and management of complex health concerns for entire families (newborns to senior adults and everyone in between). A self-described “local boy” Dr. Haase made a promise to come back and serve his community after medical school. He earned a bachelor’s degree from Southeastern Louisiana University in Biological Sciences/Chemistry before earning his medical degree from Louisiana State University (LSU) School of Medicine in New Orleans. He completed his internship and residency through the LSU Medicine/Pediatrics Residency Program in New Orleans and joined North Oaks Physician Group in August 2011. With an extensive background in critical care nursing, Rebecca Haase earned a bachelor’s degree in Nursing from Wichita State University in Kan- sas and recently earned an Advanced Nursing Practice master’s degree from Southeastern Louisiana University in Hammond.

L ane Regional Offers Breakthrough Heart Procedure

Lane Regional Medical Center is the first hospital in the region to implant Boston Scientific’s new S-ICD® System, the world’s first and only commer- cially available subcutaneous implantable defibrillator for the treatment of patients at risk for sudden cardiac arrest. Sudden cardiac arrest is an abrupt loss of heart function. Most episodes are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia or ventricular fibrillation. Recent estimates show that

Dr. Charles Thompson

62 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE go online for eNews updates HealthcareJournalBR.com

Baton Rouge General employees celebrate soaring past the donation goal for the 2014 You, Me & BRG Employee Giving Program.

approximately 850,000 people in the United States chest, and the electrode beside the breastbone. $1.1 million has been donated by this program are at risk of sudden cardiac arrest but remain Fluoroscopy is required for implanting the leads to support 61 projects throughout both hospi- unprotected. attached to traditional transvenous defibrillator tal campuses – ranging from innovative robotic The S-ICD System is designed to provide the systems. technology for heart and GYN patients to facil- same protection from sudden cardiac arrest as T o date, more than 1,400 S-ICD System devices ity enhancements. transvenous defibrillators, however the S-ICD Sys- have been implanted in patients around the world. F or more information on projects funded tem sits entirely just below the skin without the F or an animated video of S-ICD implantation, visit: through this program, visit BRGeneral.org/ need for thin, insulated wires – known as elec- http://www.youtube.com/watch?v=VgHf0lRwMnw. T ogether. trodes or ‘leads’ – to be placed into the heart itself. This leaves the heart and blood vessels BR General Employee Giving OLOL -MBP Cancer Center untouched. Program Breaks Record to Participate in NCORP Dr. Charles Thompson, an interventional cardiologist at Cardiovascular Institute of the South in M ore than 1,000 Baton Rouge General employ- Louisiana and Gulf South residents will soon Zachary, recently performed the first procedure ees raised a record-breaking $277,000 in dona- have more options to seek advanced cancer at Lane. Dr. Thompson said, “The S-ICD System tions and pledges through the annual You, Me & treatment, thanks to a $5.6 million National Can- will open up opportunities for some patients to BRG Employee Giving Program, which supports cer Institute Community Oncology Research Pro- receive an ICD who previously could not because programs and services at the not-for-profit, com- gram (NCORP) award. Presented to LSU Health of vein access problems. It has two main community hospital. The program, which is facilitated Sciences Center-New Orleans by the National ponents: (1) the pulse generator, which powers through Baton Rouge General’s Foundation, is Cancer Institute (NCI), the NCORP grant will the system, monitors heart activity and delivers an opportunity for employees to join together continue through 2019 and focus on conducting a shock if needed, and (2) the electrode, which to make a financial contribution that directly multi-site cancer clinical trials and cancer care enables the device to sense the cardiac rhythm impacts all aspects of the hospital. delivery research studies in many Louisiana com- and deliver shocks when necessary. Overall it is One hundred percent of the funds raised munities. Working in partnership with LSU-New a very effective, patient-friendly device.” through the program directly support employ- Orleans will be grant collaborators Mary Bird Per- Implantation with the S-ICD System is straight- ees, patients, and their families through hospital- kins – Our Lady of the Lake Cancer Center and forward using anatomical landmarks, without wide focus projects, employee-driven projects, LS U Health Sciences Center-Shreveport, referred the need for fluoroscopy (an X-ray procedure and the employee assistance fund (EAF) which to collectively as the Gulf South Minority/Under- that makes it possible to see internal organs in helps staff members who have experienced served NCI Community Oncology Research Pro- motion). Both components are implanted just major life challenges, such as fires and floods. gram (GS-MU-NCORP). under the skin — the generator at the side of the Since the program began in 2010, more than NCORP replaces two previous NCI

Healthcare Journal BATON ROUGE I SEPT / OCT 2014 63 community-based clinical research programs: designated birth facility. Ochsner Medical Center maintained by continuing to practice the Ten the NCI Community Clinical Oncology Program – Baton Rouge is the only hospital in Louisiana Steps as demonstrated by quality processes. and the NCI Community Cancer Centers Pro- that has this designation. “This effort required three years of work, man- gram (NCCCP). The Cancer Center had been part Baby- Friendly USA, Inc. is the U.S. authority for datory training of all employees, training of phy- of NCCCP since 2007 until the program ended in the implementation of the Baby-Friendly Hospital sicians, and enhanced patient education and June 2014. The new NCORP effort builds on the Initiative (“BFHI”), a global program sponsored experiences,” said Ochsner – Baton Rouge Chief strengths of the previous programs and aims to by the World Health Organization (WHO) and the Nursing Officer Dawn Pevey-Mauk. “The facility better address the most pressing issues affecting United Nations Children’s Fund (UNICEF). The initia- underwent policy and procedure reviews, patient the conduct and delivery of care in communities tive encourages and recognizes hospitals and birth- interviews and an onsite inspection. We could not across the nation. This effort is unprecedented in ing centers that offer an optimal level of care for be more proud of our clinical team who are so Louisiana, and is one of only 12 of its kind in the breastfeeding mothers and their babies. Based on focused on bringing evidence-based practices to country to serve as a Minority-Based NCI Commu- the Ten Steps to Successful Breastfeeding, this pres- the bedside of the patient.” nity Oncology Research Program. tigious international award recognizes birth facili- F or more information on NCORP, visit www. ties that offer breastfeeding mothers the informa- Woman’s Hosts Junior mbpolol.org/ncorp. tion, confidence and skills needed to successfully Volunteers initiate and continue breastfeeding their babies. Ochsner—Baton Rouge T here are more than 20,000 designated Baby- High school students ages 15 to 18 spent their Designated Baby-Friendly F riendly hospitals and birth centers worldwide. summer gaining real-world experience at Wom- Currently there are 194 active Baby-Friendly hos- an’s Hospital. Baby-Friendly USA announced that Ochsner Medi- pitals and birth centers in the United States. The The Junior Volunteers worked in several areas, cal Center – Baton Rouge has received prestigious Baby-Friendly designation is given after a rig- including Oncology, Labor and Delivery, Imaging, international recognition as a Baby-Friendly orous onsite survey is completed. The award is Sterile Processing, and more. n

Pediatrician Dr. Gregory Gelpi spoke to Woman’s Junior Volunteers about careers in medicine.

64 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE Reviews by the bookworm

Lately, it seems as though everything sets your teeth on edge. The neighbors are way too noisy. Cus- tomer service… isn’t. Your in-laws are a bunch of ingrates. And your co-workers? Let’s not go there.

You’re over just about everything: overworked, overloaded, and overwhelmed. But when you read “The Mayo Clinic Guide to Stress- Free Living” by Amit Sood, MD, MSc, you might start to feel overall better. In today’s world, it’s nearly impossible not to feel strain. At least that’s how it seems, and it only gets worse as we “get hijacked by impulses, infatuation and fear,” the brain wants to “escape the present moment,” and the mind thinks everything’s a danger. Says Sood, we “struggle with what is,” which is the very definition of stress. Part of the reason for the struggle is that, when you’re awake, your brain operates in one of two ways: default or focused. You’ve undoubtedly experienced both. In focused mode, you’re so immersed in the task at hand that you forget about almost everything by Amit Sood, MD, MSc. surrounding you. In default mode, your brain wan- c.2014, DaCapo Lifelong Books ders like an idle shopper, moseying from problem to worry to idea, spinning and projecting future scenarios. The key is to teach yourself to stay on “focused” mode and out of the “black hole” of mean- dering default. Part of that can be done with “attention training,” which has a classroom then turns to the science of the brain, which many facets and which “speaks to the child” in you; and by “refining serves as a nice reminder but – since bookstore shelves are packed interpretations,” which appeals to the adult within. with brain books – might be unnecessary for some readers. Learn to pay “joyful attention,” which helps with calming and That’s okay, though, because what comes next is worth it: Sood keeps your mind occupied so it doesn’t wander. Learn CRAVE, pa- teaches us to “train” our minds to stress when appropriate, live tience, and CALF when relating to others. Free your prejudices in with acceptance, and appreciate others. This, too, might be rep- order to “open to the world.” Accept that nothing is perfect and that etitious for readers who’ve filled up on motivational-type books there are times when forgiveness isn’t required. Begin each day with like this one, though I took great delight in this particular handling thankfulness. Learn pride in work. And remember that compassion of the subject. for others should extend to compassion for yourself. I also liked that Sood didn’t pretend this is easy, but reduc- When an institution like the Mayo Clinic attaches its name to a ing stress and lessening worry sure sounds appealing and that’s book, you kind of expect it’d be totally serious stuff, right? enough for me. If it is for you, too, then “The Mayo Clinic Guide to Nope. Author Amit Sood has quite a bit of fun in this book, which Stress-Free Living” is a book you can really sink your teeth into. n certainly supports its title and its joyful cover. But first, “The Mayo Clinic Guide to Stress-Free Living” opens in

Healthcare Journal of BATON ROUGE I SEPT / OCT 2014 65 advertiser index

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66 SEPT / OCT 2014 I Healthcare Journal of BATON ROUGE

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