HealthCheck LRGHealthcare

Transcription

1 care. compassion. community. HealthCheck LRGHealthcare P.6 Behind the double doors. What goes on in the ER? P.4 Men s Guide to Better Health P.16 Doing Our Part SPRING 2017 LRGH.ORG

2 IWELL HELLO THERE! t s been a busy few months at LRGHealthcare since our last issue. We ve been working on finances, focusing on quality improvement, and preparing to go live with our new Electronic Health Record coming pril 1st. It s a new day for LRGHealthcare. Sunday, May 7 th 8 a.m. Walk 9 a.m. Franklin Regional Hospital 15 iken ve, Franklin 2-Mile Walk followed by brunch Walk with us! Together, let s raise awareness and funds and show support for those who are struggling with or recovering from, substance addiction or mental illness. $100+ in pledges/donations includes walk, brunch, and event shirt $20 per person includes walk and brunch (Children 10 and under Free) Prizes awarded for largest and most spirited team and most money raised! Own a business? Sponsorships are available! We hope the winter was kind to you and you enjoyed good health. If you have ever paid a visit to one of our Emergency Rooms (ER), you might be interested in our feature story, Behind the Double Doors on page 6. We ll take you on a virtual field trip inside a day in the life of the ER. You ll be amazed at just how much is going on there at any given time. We ll help you try to avoid trips to the ER by sharing ways in which you can be healthier. For starters, we ve got more new providers to share with you. Meet them on page 3. Having a hard time choosing a doctor or getting overwhelmed at your appointments? Check out tips for choosing and talking to your doctor on page 12. Liane Clairmont, Marketing ssociate & Editor Follow us on Facebook, Twitter and YouTube. Especially for the guys, we ve got a quick rundown on page 4 from some of our top specialists on what men should be focused on for their health. Plus we re outing the taboo topic of Erectile Dysfunction on page 18. If we re not embarrassed to talk about it; neither should you. Can t get the man in your life to see the doctor? We ll help you show him why it is easy and important on page 19 (sorry guys!). Join us in leaving the winter behind and looking ahead to a new day. What does your new day look like? Perhaps we can help get you there. P12. How to talk to your doctor How to Talk to Your Doctor CHOOSE DOCTOR YOU CN TLK TO: Decide what you re looking for in a doctor. Identify several possible doctors. Talk to their office staff to learn more about them. Make a choice. Good communication with your healthcare provider is key when it comes to getting good health care. GETTING REDY FOR N PPOINTMENT: Be prepared: make a list of concerns and bring it with you. Consider bringing a friend or family member along for your appointment. They might remember something that you have forgotten. Update your doctor on what s happened since your last visit even if you think it might not be important. GIVING INFORMTION: Share any symptoms. Provide information about your medications. Be open with your doctor about your habits and voice any/all concerns. To provide the best care, your doctor should understand you and a person and know what your life is like. GETTING INFORMTION: PRCTICL MTTERS: to benefit mental health services and substance addiction programs FOR MORE INFO OR TO REGISTER philanthropy@lrgh.org Before having a medical test, ask your doctor what it s for, what it will show, what it will cost, etc. Discuss your diagnosis and what to expect. Having a full understanding will help you make better decisions about your treatment. Understand your medications to ensure you re taking them properly to achieve the most effective outcome. TLKING TO SPECILISTS: sk questions if you are unclear. Write down as much information as possible. Tell your Primary Care Provider if you see a specialist, need surgery, or have gone to the Emergency Room or Urgent Care. 12 SPRING 2017 LRGH.ORG Do not hesitate to bring up concerns, even if they do not seem directly related to a medical condition. If the doctor is unable to solve your non-medical problems, they may be able to refer you to other resources that can help. DISCUSSING SENSITIVE SUBJECTS: Do not hesitate to discuss sensitive subjects with your doctor. Use brochures or booklets to introduce topics you may feel awkward discussing. MKING DECISIONS WITH YOUR DOCTOR: sk about different treatments and prevention. Talk about exercise. Sometimes exercise can be just what the doctor ordered! LRGH.ORG SPRING

3 4 MEN S GUIDE to Better Health 8 HELTHY LIVING Education Series 10 & w/patti Strohla, CNO 13 TSTE TEST THURSDY 16 DOING OUR PRT Substance buse and Mental Health in our Community 17 ERECTILE DYSFUNCTION What to know 19 TOP 10 Don t Turn Your Back to Good Health. Tune in to Open Mic with Pat Kelly every other Tuesday 9a-10a to hear about the goings on at LRGHealthcare and tips to lead you to better health. Contents LRGHELTHCRE HELTHCHECK SPRING 2017 pp.6 pp.4 pp.16 care. compassion. community. HealthCheck LRGHealthcare P.6 Behind the double doors. What goes on in the ER? P.4 Men s Guide to Better Health P.16 Doing Our Part SPRING 2017 LRGH.ORG Behind The Double Doors, day in the life of one of the busiest Emergency Rooms in NH LRGHealthcare GOLF CLSSIC SVE THE DTE UG 14, 2017 LCONI COUNTRY CLUB doctor THE IS IN NEW PROVIDERS LRGHealthcare continues to expand its network of providers and services to better serve you. Please join us in welcoming the following new providers! Laconia Clinic Internal Medicine Stacy Parker, PRN Weight Institute of NH & Primary Care Jennifer Pearson, PRN Convenience Care Gabrielle Gray, PRN Juanita Fernandes, PRN Hospitalists Nirali Dani, MD Lisa Cooper, PRN Thank You! for your support of the dvanced Orthopaedic Specialists Richard hrens, P-C 2017 LRGHealthcare Red Dress Gala: n Evening in Tuscany Presented by MB Tractor & Equipment Record-breaking $92,625 raised! The Red Dress Gala is held each year during merican Heart Month to raise funds to purchase state-of-the-art cardiac equipment at LRGHealthcare, and to spread awareness about heart disease and prevention. LRGHealthcare is grateful to the Red Dress Gala committee, corporate sponsors, auction donors, guests, and the many businesses and individuals who helped to make the night such a success! 2 SPRING 2017 LRGH.ORG For information about sponsorship opportunities, or to reserve your foursome, please call today! LRGH.ORG SPRING

4 The Men s Guide to Better Health Listen guys with all you ve got going on; your health can sometimes take a back seat. But, you ve got people who count on you, love you and would like to have you around for a long time. That s why we ve created this quick guide to show you the many simple ways you can lower your risks. LRGHealthcare has many specialists right here in Central NH and we asked for their advice. What should men be most concerned about in your specialty and how can they lower their risks? DIBETES High glucoses (sugars) over time cause premature aging to selective tissues in the body and keeping the glucose as low as possible for as long as possible, prevents this damage from happening. In men, erectile dysfunction/impotence is caused by many things, and diabetes is one of them. Controlling your glucose can prevent erectile dysfunction and many other diabetes complications from occurring. VSCULR DISESE Men (and women) should be aware of the main risks for developing vascular disease. The most significant risk factor is smoking, but there are other very important risk factors like diabetes, elevated cholesterol, hypertension and inactivity. Developing arterial disease is a significant marker for a lower life expectancy. ddressing these risk factors with smoking cessation, appropriate diet and medications, and a daily walking program can have a very positive effect on one s well being as well as life expectancy. 4 SPRING 2017 LRGH.ORG Dr. Barrett L. Chapin, Laconia Clinic Endocrinology Dr. Glen Fusonie, Vascular Surgery and Wound Healing Center Practicing our values of Care, Compassion, & Community... Offering exceptional care from screening and evaluation to treatment and follow up with timely access to the most sophisticated medical imaging technology in a compassionate and professional setting. UROLOGY Men of all ages should be concerned about their urological health. Young men (18-30) should be performing monthly testicular self-examinations to screen themselves for testicular cancer. If something feels abnormal or if there is any question, mention it to your physician. Men between the ages of 55 and 70 can benefit the most from prostate cancer screening every one to two years. frican merican men and men with a first degree relative (father and/or brother) with prostate cancer should be screened earlier. Finally, erectile dysfunction may affect men of all ages and there are many treatments available. The bottom line is get checked regularly and don t be afraid to ask questions. ORTHOPEDICS (spine focus) Lower back pain is common for both men and women. If not careful, it can be relatively easy to cause injury. To lower your risk, it is very important to follow proper lifting techniques such as bending with your knees rather than your back and reducing heavy lifting. In addition, it s important to maintain good posture and be sure to get your exercise. It doesn t have to be strenuous; simply move more and try not to sit for long periods of time. PRIMRY CRE Colorectal cancer is the second leading cause of cancer death in the United States. The good news is that the incidence and mortality rates have been declining in the United States. Screening for colorectal cancer is thought to be a major reason for the decline. Because colorectal cancer is so common and yet now treatable and curable, it is recommended that everyone over age 50 have some form of colorectal cancer screening. The gold standard is a colonoscopy but there are other less invasive screening methods. lso of note, family history is only a factor in 20% of colon cancer. Everyone should be screened. I encourage both men and women age 50 and over to have a discussion with their medical provider about colon cancer screening. Dr. Stephen D. Marshall, Laconia Clinic Urology Dr. Glenn Lieberman, dvanced Orthopaedic Specialists Dr. Peter Doane, Newfound Family Practice & LRGHealthcare Chief Medical Officer LRGH.ORG SPRING

5 BEHIND THE DOUBLE DOORS day in the life of one of the busiest Emergency Rooms in NH You re congested, you have a sore throat, and you re coughing up stuff. You tell yourself you re not getting sick; there s no time! But, after days of this, you ve had it. It s now 9pm and your doctor s office is closed; so is Convenience Care. To the Emergency Room (ER) you go, fingers crossed that it s not busy. When you arrive, you re relieved to see just one or two other people waiting. Oh good, it s not busy, you say to yourself. Or is it? You might be right. It might be a quiet time and you ll be in and out of there in no time. What you don t know is what s already happening behind those double doors. Did you know that upwards of six ambulances can arrive at the ER within as little as 15 minutes? In fact, things change all the time in the production that is a day in an LRGHealthcare ER. It s surprising the number of activities going on at any given time and the number of players involved to make it all happen. Steven Spielberg himself couldn t direct this! So, if you ve ever sat in that waiting room wondering, What are they doing back there? The short answer is LOT. For starters, the staff is constantly ramping up usually adding a nurse every hour and then tapering off at the end of the day, starting with as little as six people at 3am to as many as 16 at 3pm. This helps the ER be staffed according to how busy it is at that time of day. But, there is no black and white when it comes to slow or busy times in the ER environment. The lights are on; we re always here to take care of you and we always will. ~ Dr. Fred Jones, Chief of Emergency Medicine It s true the ER is open 24/7, but for purposes of our virtual field trip, we ll start our day at 7am. 7am: The first shift crew begins to arrive including three RNs, one tech (usually an LN or EMT), one physician, one greeter, and one registration employee. Things seem quiet right now, but things can change in an instant. The Clinical Lead RN, who s in charge of paying attention to patient need levels and what he/she is assigning to the nurses, is already putting out small fires such as making staffing adjustments because she s down two people. In between these administrative duties though, she s off to care for one of her patients. Meanwhile, the physician is checking in with another nurse on an antibiotic for his patient, while the Health Unit Coordinator (HUC) answers calls from potential patients asking whether or not they should come in for their particular ailments. 9am: More patients have arrived at the ER with varying issues. Unlike a restaurant where it s first come first served; in the ER the sickest are treated first. The Clinical Lead RN is on the phone with House Resource for an update on how many beds are available in the hospital, or anywhere for that matter in the event no beds are available within LRGHealthcare s two hospitals. Beds are a huge concern. They help the ER admit patients to where they need to be for further care and open up beds within the ER for new patients. Essentially, if no beds are available upstairs, it causes a real issue downstairs. Several beds are already in use and the triage nurse has one patient for his/her initial exam before entering the ER. 11am: It s getting busier. The HUC is answering calls, assisting with requests from providers and nurses alike, and coordinating discharges of patients. Meanwhile, a registration employee visits a patient to complete the registration process. One nurse is in the process of getting a patient s bowel movement tested while another heads down the hall to remove a patient s IV. Housekeeping has arrived to clean up an exam room. 11:30am 1:30pm: CODE PURPLE! code purple is called when the ER is full perhaps even overcrowded. When I first arrived, this code purple had 16 patients in rooms, three being treated in the hallway, twelve waiting in the waiting room, and the potential of three ambulances on the way. More beds in other areas had to be opened up to accommodate the continuous flow of patients. Still eight patients are in the waiting room. Phew I m tired just thinking about it! No time to eat, staff are grabbing handfuls of candy from a bag of Sour Patch Kids as they go in and out of the nurse s station. There is constant communication at the nurse s station amongst the entire team about patient statuses, who s being discharged where and how, did this patient get their medicine, who s picking up that patient at discharge, etc. nd, the phone calls are endless. Other departments of the hospital jump in to help. phlebotomist arrives to take a patient s blood in the hallway while a radiology tech walks in with her portable equipment to get an x-ray of a patient s ribs. Meanwhile, another radiology tech is taking patients straight from the waiting room to Medical Imaging to get their x-rays/scans done before they are even admitted. n ER tech checks on the nurses to see if anyone needs assistance, while another jumps in to empty a full soiled linens bag. Some of our ER Techs are LNs and most are EMTs. We love having the variety and mix of skill set they bring to the table. It s a great compliment to our patients needs. ~ Kendra Peaslee, Director of Emergency Services 2pm: Things continued to be so busy, not a single staff member had been off the floor to use the bathroom or get a bite to eat. Patti Strohla, Chief Nursing Officer (see page 10 for her &) ordered food for the staff from the cafeteria just so they could run to the break room for five minutes for a sandwich. 5pm: fourth provider has been brought in, which is not normal, but happens in extreme cases. It s been an especially difficult day to move patients through quickly because everyone was a tough discharge meaning there were too many challenges in the way of getting patients back home/into the community. This is why having an embedded care coordinator and ER care manager is invaluable. ~ Kendra Peaslee, Director of Emergency Services The embedded care manager and ER care manager are able to take those cases off the workload of the RNs. See the ER s key initiatives at the end of this article for more. Being a smaller healthcare organization, made (Continued on page 14) 6 SPRING 2017 LRGH.ORG LRGH.ORG SPRING

6 We invite you to take a look at our community education program offerings and encourage you to sign up for programs that help you meet your own health and wellness goals. Included in this listing are many free programs as well as some programs that have a cost. Please call the number listed for more information on a specific program. LIVING WELL Living Well: Chronic Disease Self-Management Program Wednesdays, 4/5-5/10 9:30-11:30 am FRH, FREE Matter of Balance: Fall Prevention Program Mondays, 4/3-5/22 9:30-11:30 am Taylor Community, Woodside Bldg., FREE Powerful Tools for Caregiver Tuesdays, 3/21-4/25 1:30-3:00 pm Bessie Rowell Community Center, Franklin, FREE Co-sponsored by Franklin VN Osteoporosis: Keeping Your Bones Healthy Wednesday, 5/3 11:30 am-12:30 pm Hillside Medical Park, Rehab Lot C, Gilford, FREE Farmers FRH Beginning late June Tuesdays, 3-6:00 pm dvance Directives 1st Tuesday of the month, 11:00 am-12:00 pm, FRH 1st Wednesday of the month 9:00-10:00 am, LRGH Better Breathers Support Group Heart Health: Cardiac Rehabilitation Lung Health: Pulmonary Rehabilitation SPRING 2017 LRGH.ORG Massage Therapy CHILDBIRTH ND PRENT EDUCTION Childbirth Classes , ext Breast Feeding Support Every Wednesday LRGH, FREE , ext Car Seat Safety Checks or , ext DIBETES Diabetes: Self Care Workshop Wednesdays, 5/17-6/21 9:30-11:30 am Franklin Savings Bank, Community Learning Center, Tilton, FREE Diabetes: Self-Management Education ext Prevent Type 2 Diabetes Call for info on next session Foot Clinic ext WTER EXERCISE Pool classes held at Hillside Medical Park- Rehab Lot C in Gilford. Call for times/dates. FITNESS Getting Ready For the Green Strategies to prepare for golfing and prevent injury. Wednesday, 4/19, 6-7:00 pm Interlakes Medical Center, Meredith, FREE Wellness Centers Exercise Program Laconia, and Moultonboro, Walking and Trail Guide Greater Franklin rea, FREE Call Fitness Consultations CNCER CRE Yoga for Breast/Gynecological Cancer Patients and Survivors 3rd Wednesday of the month, 5:00-6:30 pm Yoga From the Heart Breast Cancer & Beyond Support Program 1st Monday of the month 4:30-6:00 pm, LRGH Breast Prosthesis Fittings Wig Bank SMOKING CESSTION re You Ready To Stop Smoking? One on one quit smoking education/coaching, FREE Stop Smoking with Hypnosis 4/29 9:00 am-12:00 pm, LRGH 6/24 9:00 am-12:00 pm, FRH $85, The NH Tobacco Helpline quit-now ( ) or WOMEN S HELTH Mammography Bridge Program Let No Woman Be Overlooked: Breast & Cervical Cancer Screening Program NUTRITION & WEIGHT MNGEMENT Weekly Weight-In Mondays, 3:30-4:45 pm, LRGH Register: Bariatric Surgery Info Sessions 2nd Tuesday of the month, LRGH Managing Your Weight with Hypnosis 5/27, 9:00 am-12:00 pm, FRH $85, Bariatric Support Group 3rd Thursday of the month, 6:00-7:00 pm, LRGH, FREE Individual Nutrition Counseling Non-Surgical Weight Loss Options- Info Sessions Occur weekly. Days and times vary. LRGH, FREE Taste Test Thursdays Try a different super food every month; samples, recipes and fact sheets provided. FREE 1st Thursday of the month, 12:00-1:30 pm, LRGH 2nd Thursday of every month 12:00-1:30 pm, FRH Easy Cooking Classes Designed to teach you how to create a simple and well balanced meal. $15 for three classes. Huot Technical Center, Please remember to register! Programs may be cancelled due to weather or low registration. LRGH.ORG SPRING

7 s You r PTTI STROHL, CNO HOW LONG HVE YOU BEEN NURSE ND DMINISTRTOR ND WHT BROUGHT YOU TO LRGHELTHCRE? I ve been a nurse for almost 30 years and have been in hospital administration for probably 20 of those. I started my nursing career at Central Maine Healthcare in Lewiston, ME and moved through the nursing ranks there. fter 23 years, I left Central Maine to venture into healthcare consulting which landed me at Mt. scutney in Vermont where Kevin Donovan (LRGHealthcare s current President & CEO) was the CEO. There are two reasons I came to LRGHealthcare; the first was an opportunity to continue working with Kevin and the second was an opportunity to return to my nursing roots. Kevin is an incredibly dynamic forward thinking leader and combining that with the chance to have a more active role with nursing was a gift. S CHIEF NURSING OFFICER, WHT RE YOU RESPONSIBLE FOR? I m responsible for all nursing practice. While I spend a majority of my workday focused in the hospital setting both at LRGH and FRH, ultimately all nursing practice whether inpatient or outpatient, including the ambulatory practices has a dotted line up through the CNO. WHT IS TYPICL DY LIKE FOR YOU? Fortunately or unfortunately, I stepped into my new role right in the middle of several large organizational initiatives. My agenda is really being driven by three big projects: DNV GL (CoPs and ISO 9001) accreditation, the Cerner (Electronic Health Record) implementation, 10 SPRING 2017 LRGH.ORG In November 16, LRGHealthcare welcomed Patricia (Patti) Strohla, RN as Chief Nursing Officer (CNO). Patti is an accomplished nurse leader with clincal and leadership experience in emergency medicine, critical care, quality improvement, and implementation of electronic medical records. With that track record, needless to say; she knows a few things, but as CNO of this organization, she s got big shoes to fill! While she s not into having the public spotlight on her; she loves people and public service, so we thought you, the public might like to get to know her. and our Prism financial initiatives. I started right after our second DNV visit, so I had to jump right into crafting our responses to their feedback as well as preparing for our Cerner go live and then coming in on the heels of some of the Prism initiatives, I ve been focused on nurse recruitment and retention in hopes of bringing some staffing stabilization. While these have taken a lot of my focus, I am listening and learning about LRGHealthcare as far as what have we done; what can we do; what are our strengths; where can we do better; and where are our opportunities as well as starting to share some of my philosophy, past experiences and knowledge. WHT RE SOME OF THE CHLLENGES THT COME WITH THIS ROLE? I think it s the staffing challenges (many open nursing positions, desire to make sure we are competitive with wages while remaining fiscally responsible) and our size. Nursing makes up about 80% of the workforce. We have approximately 260 nurses across both hospitals and throughout our clinics and mbulatroy Surgical Centers and I want to ensure that they all feel they have some attention. So it s a balance of trying to learn the culture amidst the big projects going on and building relationships with my teams. WHT DO YOU LIKE BEST BOUT THE JOB? I love patients and nursing and I like to share knowledge and problem solve. That s why I ve been in this career for as long as I have. Before nursing I worked in law enforcement and I loved that too. While that may seem somewhat of a dichotomy, it s all public service. Nursing is at the core of healthcare and we are partners in something unique and great we help people through the good, the bad, and the ugly parts of life. There are so many facets of being a nurse and of the career itself, if you care about people, patients and your team, you are part of something special. Nurses have a better place at the table in healthcare than they ve ever had in my career. They re being seen more as partners with physicians and that is a big step forward. HOW DO YOU FIND WORK/LIFE BLNCE? I believe work/life balance is really important, but you re kind of talking to the pot calling the kettle black. I m just not very good at it. I have to work as most do, but more importantly, I like to work. That being said, I do encourage everybody to have a work/life balance. We have to take care of each other our work never ends; we will always have patients so work/life balance has to be hard coded into the plan. In my spare time, I spend time with my daughter who is a teacher in VT and mother who lives in CT. We have mini golf tournaments, love to read, be outdoors especially on the water and of course, support UConn Women s Basketball (whether they win or lose even though they have won 102 straight!). WHT IS IT THT MKES YOU MOST PROUD OF THE LRGHELTHCRE NURSES/CLINICL TEMS YOU OVERSEE? There is such a level of commitment here. It s incredible. The people who live in this community and all its surrounding towns believe in both Lakes and Franklin and the organization at large. The nursing leaders also live locally and they too are committed to LRGHealthcare and to their nurses. They re constantly striving to share what they know, make sure their staff is taken care of, and do the best job for their patients. Lastly as I mentioned above, the physicians talk a lot about their partnership with the nursing units. It is not that way everywhere I have been and it s half the battle. To have a strong organizational core you need three things patients, doctors and nurses (and of course a strong financial backbone) and we are in a good place. WHT DO YOU FIND MOST REWRDING BOUT BEING NURSE? Being able to use my skills to care for and provide comfort to those in need. I also love the dynamic, constantly evolving field of medicine and the opportunity to share knowledge and educate both patients and other clinical staff. Knowing that you re playing a role in helping somebody no matter what the situation is birth of a child, death of a loved one, learning to adapt after an illness or traumatic injury, or learning to accept a diagnosis, you can really have an impact in the lives of many. CONSIDERING BECOMING NURSE? WHT S THE BEST DVICE YOU COULD GIVE TO SOMEONE WHO S Be open to new experiences and be patient with career development. There s a lot to learn and a lot of people say, I want to go right to ICU, or I want to go right to the Emergency Room. If you specialize too early, you lose a lot of opportunity to master the basics. Not that you don t learn to become an expert in a specialty area, but if you start as a generalist and really master your nursing skills, then those skills can come with you. Foundational knowledge is really important. BOUT NURSES? WHT DO YOU WISH LL PTIENTS COULD KNOW/UNDERSTND No matter what, the nurses really care about them. While perhaps it shouldn t, sometimes the busyness of the day, a challenging interaction, or even something in our personal lives can creep into our work life and affect us in a way that makes us seem uncaring but EVERYONE who s involved, no matter what their role; licensed nursing assistant (LN), housekeeper, nurse, food services ambassador, or physician etc. is there because they really and truly do care about the patient. lot of things. Seeing that new technology is WHT EXCITES YOU MOST BOUT THE FUTURE OF LRGHELTHCRE? coming into LRGHealthcare is huge. For example, you hear respiratory people say they went to chart something, but the doctor had the chart, so they couldn t. Then they attempted again, but the patient was in physical therapy and the chart was in there with them so once again, they couldn t document the care they gave which means no one else knows what they did. Having an electronic health record (coming soon) means that anytime, anywhere, anyplace; the chart is accessible to all members of the healthcare team and that helps to make for better patient outcomes. lso exciting for LRGHealthcare is having a new CEO. s previously stated, I have the advantage of having worked with Kevin and he s a phenomenal leader. Being a part of an already talented team of Sr. dministrators while Kevin leads us into the future is exciting. I can t go without mentioning politics, so seeing what happens to healthcare under a new president will be interesting. nd lastly, I m excited to be able to share some of what I ve accomplished and seen in my roughly 30 years in healthcare with my great group of nursing colleagues and all the amazing staff here at LRGHealthcare! I am honored to be part of LRGHealthcare and its future. LRGH.ORG SPRING

8 How to Talk to Your Doctor CHOOSE DOCTOR YOU CN TLK TO: Decide what you re looking for in a doctor. Identify several possible doctors. Talk to their office staff to learn more about them. Make a choice. Good communication with your healthcare provider is key when it comes to getting good health care. GETTING INFORMTION: Before having a medical test, ask your doctor what it s for, what it will show, what it will cost, etc. Discuss your diagnosis and what to expect. Having a full understanding will help you make better decisions about your treatment. Understand your medications to ensure you re taking them properly to achieve the most effective outcome. TLKING TO SPECILISTS: sk questions if you are unclear. Write down as much information as possible. Tell your Primary Care Provider if you see a specialist, need surgery, or have gone to the Emergency Room or Urgent Care. GETTING REDY FOR N PPOINTMENT: Be prepared: make a list of concerns and bring it with you. Consider bringing a friend or family member along for your appointment. They might remember something that you have forgotten. Update your doctor on what s happened since your last visit even if you think it might not be important. GIVING INFORMTION: Share any symptoms. Provide information about your medications. Be open with your doctor about your habits and voice any/all concerns. To provide the best care, your doctor should understand you as a person and know what your life is like. 12 SPRING 2017 LRGH.ORG PRCTICL MTTERS: Do not hesitate to bring up concerns, even if they do not seem directly related to a medical condition. If the doctor is unable to solve your non-medical problems, they may be able to refer you to other resources that can help. DISCUSSING SENSITIVE SUBJECTS: Do not hesitate to discuss sensitive subjects with your doctor. Use brochures or booklets to introduce topics you may feel awkward discussing. MKING DECISIONS WITH YOUR DOCTOR: sk about different treatments and prevention. Talk about exercise. Sometimes exercise can be just what the doctor ordered! LRGH-THE FIRST THURSDY OF EVERY MONTH 12-1:30 PM FRH-THE SECOND THURSDY OF EVERY MONTH 12-1:30 PM Try a different super food every month; samples, recipes and fact sheets provided-free Citrus Cured Salmon Serve this salmon on toasted baguette, bagel slice or cracker topped with finely chopped red onion, dill, chives, grated lemon zest, and/or crème fraiche (sour cream) for a delicious canapé. INGREDIENTS: 1 cup coarse salt 1/2 cup sugar 1 tablespoon freshly grated orange zest 1 teaspoon freshly grated lemon zest 1 teaspoon freshly grated lime zest 1 (3-pound) skin-on salmon fillet, pin bones removed and very thin pieces of flesh trimmed INSTRUCTIONS: 1. In a small bowl, stir salt and sugar to combine. In another small bowl, combine orange, lemon and lime zest; set aside. 2. Place a sheet of parchment paper-lined aluminum foil, large enough to extend beyond the length of the salmon, on work surface. Spread one-third the salt mixture in center of parchment-lined foil; place salmon skin-side down on salt bed. Sprinkle zest mixture evenly over salmon and top with remaining salt mixture; salmon should be completely covered. 3. Fold foil up to contain salt; place a second sheet of parchment paper-lined aluminum foil over salmon and firmly crimp sheets together to form a tight package in which salt mixture is in contact with all surfaces of salmon. Transfer salmon packet to a baking sheet. Set a pan or large dish on top of salmon; top with cans or bricks to weight down. Transfer to refrigerator; refrigerate for 24 hours. 4. Unwrap salmon and remove it from salt mixture. Rinse salmon and pat dry using paper towels. Set salmon on a rack or paper towel-lined tray and refrigerate 8 to 24 hours more. Chocolate Chia Pudding Yields 4 ½ cup portions INGREDIENTS: 6 tablespoon Chia Seeds 1.5 cups milk (non-dairy if desired) 1 tablespoon Pure Maple syrup 3 tablespoon Cocoa Powder ½ teaspoon ground cinnamon Pinch Cayenne Pepper Pinch Sea Salt INSTRUCTIONS: Blend the Chia Seeds with milk. Cover and refrigerate overnight for at least 8 hours. dd the Cocoa powder, maple syrup, cinnamon, cayenne and salt, blend until about half the seeds are broken up or about 1 minute. Divide the pudding, top with cream, toasted hazelnuts and cocoa nibs. Chia pudding will keep covered in refrigerator for up to 5 days. Nutrition Information: Calories: 176 Pro: 8 Fat: 9g Sodium: 83mg Fiber: 11g CHO: 21g LRGH.ORG SPRING PRIL FTS & MY SEEDS

9 (continued from page 7) up of two rural community hospitals, Lakes Region General Hospital (LRGH) and Franklin Regional Hospital (FRH) don t have full teams of specialists inside the hospital at all times. So, the ER staff needs to be experts at everything and they are. We get to play in everybody s sandbox for a short period of time. We re not just a community hospital. It s astounding what we can do. - Dr. Fred Jones, Chief of Emergency Medicine Yet, when specialist care is needed, LRGHealthcare has it from their excellent local neurologists, to the partnership with Mass General and its Telestroke program. There are also the talented orthopaedic providers/surgeons of dvanced Orthopaedic Specialists and the Laconia Clinic; ENT providers of ENT ssociates of NH who perform excellent repairs right in the ER; and the skilled vascular surgeons of the Vascular Surgery and Wound Healing Center, to name a few. 7pm: Nurses are placing follow up calls to patients who chose to leave before being seen during the busy hours. If there was a cause for concern, the nurses and/or HUC will check in with the patients to make sure they re doing okay. 14 SPRING 2017 LRGH.ORG 9pm: Security is keeping a presence in the ER as they try to do on a regular basis. They keep a watch on the parking lot and are available when needed for cases involving a violent or combative patient, drug and alcohol misuse, etc. nd, back up is always available from the Franklin and Laconia Police Departments. patient has arrived showing potential signs of stroke. nurse wheels the patient immediately to get a scan in nuclear imaging. Meanwhile, another nurse is making balloon characters using blue latex gloves to cheer up a hurt three year old. The worlds of the LRGH and FRH ERs are always turning, but this is where our field trip ends. nd, to think, this is just a snippet of the things I saw. Imagine what I didn t see! What we have here in our community is truly special and I, for one am thankful to have the stellar team we have right here at LRGHealthcare. You re being taken care of by your friends and neighbors and that s how we want our patients to feel. ~Dr. Fred Jones, Chief of Emergency Medicine Ways the ER Gets You In and Out uicker 9 NURSING PROTOCOLS: To speed things up, depending on the patient s needs, x-rays, blood work, etc. are started straight from waiting room. This can sometimes mean a time savings of 45 minutes to two hours! 9 DIRECT BEDDING decreases what s called door-to-doc time. If there s an open room, the patient goes straight to it rather than waiting in the waiting room to be triaged first. 9 DEPRTMENTL RESOURCES: Other hospital departments help save time as well. For example, a radiology transport person helps get patients to/from radiology in a more timely manner. 9 STREMLINED MENTL HELTH CRE: We partner with Genesis Behavioral Health to provide more timely care to patients with behavioral and mental health needs. 9 CRE MNGEMENT: The embedded care coordinator helps get patients set up with a primary care provider, will coordinate transportation, assist with management of their medications, etc all in an effort to help increase their ability to stay well and prevent future ER visits. ER Bragging Rights 9 Three quarters of the physicians are Board Certified and residency trained in Emergency Medicine; many trained at Dartmouth (those who aren t have many years of experience.) 9 One third of the physicians come from Ivy League schools. 9 Nurses maintain many certifications in order to work in ED. 9 The entire team has the skills and experience for the same level cases as the bigger, level one or two trauma centers. 9 Great nurse/doctor relationship for a true team environment. Pride inour Team ICU dvancing our knowledge to advance your care Part of the national ICU Liberation Collaborative using an integrated, team-based approach to the care of critically ill and injured patients for better outcomes and reduced health care costs. Proudly Serving Lakes Region General Hospital and Franklin Regional Hospital lrgh.org LRGH.ORG SPRING

10 Doing Our Part One of the most important issues affecting our local communities and New Hampshire at large is the opioid crisis. Couple that with, the limited mental health resources in our state and we ve got some real challenges on our hands. But, along with community partners, LRGHealthcare is committed to facing these issues head on. ERECTILE it s okay, you can say it; there s nothing to be ashamed of. If you suffer from ED you are not alone; in fact, you re with over 30 million merican men who are affected by it. ED is defined as the persistent inability to achieve or maintain an erection and men who suffer from it should know what causes it and what treatment options are available. In October 15, through a partnership with Horizons Counseling Center, LRGHealthcare opened the LRGHealthcare Recovery Clinic, a medication-assisted treatment program at Franklin Regional Hospital. This program aims to help people achieve long-term recovery from addiction through the use of counseling services and medication treatment like Suboxone at the same time. The Recovery Clinic has since provided treatment to 301 patients and counting and with the need so great, a second location was opened in December 16 at Hillside Medical Park in Gilford. LRGHealthcare and Genesis Behavioral Health are partners in meeting the specialty care needs of mental health patients in the communities they serve. NH is challenged by limited availability of resources for people with mental illness. With a Genesis Behavioral Health office on site at LRGH s Medical Office Building, integrated primary and behavioral healthcare is provided to these patients due to the working partnership between LRGHealthcare providers and Genesis Behavioral Health staff. Genesis Behavioral Health and LRGHealthcare continue to explore opportunities that improve access to care and provide a bridge for people entering into treatment. Stay tuned for more as this relationship develops and resources are expanded when Genesis Behavioral Health introduces Lakes Region Counseling Services later this spring. With the opening of its new location in Franklin, LRGHealthcare has lent its support to Hope for NH Recovery through a financial contribution. Hope for NH Recovery provides direct service to support long term recovery from substance misuse through peer support, family support, assistance with accessing services and training and employment counseling. ccepting New Patients sk about our monthly meet and greets! (603) LaconiaClinic.com 16 SPRING 2017 LRGH.ORG We are where you are Laconia Clinic Pediatrics Department of TWO types: psychogenic and organic. Psychogenic causes include: Depression Stress nxiety Treating and/or addressing the above causes will usually lessen psychogenic ED. Organic ED occurs when there is an underlying medical condition that may be causing ED. Some medical conditions linked to ED include: Vascular disease Diabetes Hyperlipidemia Heart disease Low testosterone Obesity ED may also indicate an underlying cardiovascular disease because symptoms for ED and atherosclerosis (a disease of the arteries) are very similar. This is why any man who experiences ED should undergo a thorough medical examination. While treatment of the medical condition may not always cure ED, treating the condition may prevent it from getting worse. There are certain groups of medication that can cause ED as well such as: Blood pressure medications ntidepressants ntihistamines If it appears a medication might be causing the ED, ask your doctor if that medication can be changed to another that may not have the same side effect. If correcting the underlying condition does not work or is not possible, there are a number of treatment options available ranging from oral medication to surgery. You and your doctor should determine which option best suits your needs. That s why it s so important to be open and honest with him/her. Your doctor can help you figure out the best course of action and may refer you to a urologist for further discussion. If you haven t already, it s important to establish a relationship with a primary care provider (PCP) who can help you manage your overall health. Find a Physician at lrgh.org LRGHealthcare also offers a urology practice at Laconia Clinic with four skilled providers. LaconiaClinic.com or *Many thanks to Dr. Stephen D. Marshall who provided the above facts about Erectile Dysfunction. Dr. Marshall is a physician with Laconia Clinic Urology and is trained in all aspects of adult urology. He has a special interest, however in men s health, specifically erectile dysfunction, male stress urinary incontinence, benign prostatic hypertrophy, and urethral stricture disease/urethral reconstruction. LRGH.ORG SPRING

11 DON T TURN YOUR BCK TO GOOD HELTH Top 10 Excuses Men Use to void Seeing a Doctor How to Counter them (Courtesy of NH1.com June 17, 2016) Your Life Your Comfort Your Movement dvanced Orthopaedic Specialists Your quality of life is more important than ever, and our providers keep you moving in your own backyard. We are where you are. Specialties Total Joint Care Back Spine Care & Neurosurgery Chiropractic Care Sports Medicine Hand & Wrist Foot & nkle Trauma & Fracture Department of Lakes Region General Hospital PROVIDERS Jeffrey Clingman, MD Gary Francke, MD John Grobman, MD lexander Hennig, MD Jeremy Hogan, MD advortho.org (603) Maple St., Suite 100 Gilford, NH Glenn Lieberman, MD nthony Salerni, MD Richard hrens Jr., P-C Kyle Przekaza, P-C Marcelle Zebuhr, P-C Matthew Jensen, DC 1 I don t have a doctor. Step one toward staying healthy is finding a doctor you can trust, but you ll never know who that is, unless you try. See page 12 for helpful tips about finding a doctor. 3 There s probably nothing wrong. You may be right, but you re not a doctor. You need one to be sure. Finding a health problem early can make a huge difference in the quality and length of your life. 5 I don t want to spend the money. If you think spending time with a doctor is expensive, try spending time in a hospital. 7 I don t want to hear what I might be told. Maybe you smoke and/or drink too much or have put on weight. Even so, your doctor is there to help you. I don t have insurance. 2 Everyone should have insurance under the ffordable Care ct. In NH, you can sign up online at CoveringNewHampshire.org. I don t have time. 4 There are about 8,766 hours in a year and you want to save two when those two hours could save your life? Doctors don t DO anything. 6 When you get a checkup, you often get tests. It may seem like you don t get anything, but you do. You get news and knowledge that bring better health if you act on it. I ve got probe-a-phobia. 8 You don t need a prostate cancer exam until you re 50. Even then, remember your chances of survival are much better if it s caught early. Here for you when you need us most... You have every right to be proud of your Emergency Department team. Your team treated us with respect and all had a warm smile and comforting bedside manner. They are definitely good at what they do and made us all realize we were in good hands! ~ TL 9 I d rather tough it out. If pro athletes can play hurt and sacrifice themselves for the team, you ought to be able to suck it up, right? Wrong! The Game of Life is about staying healthy for a long time a lifetime. My significant other has been nagging me 10 to get a checkup. Maybe you don t want to give in, but isn t it possible you could be wrong? Give in on this one and see the doctor. 18 SPRING 2017 LRGH.ORG LRGH.ORG SPRING

12 STTS ND FCTS $ 33,169,365 The value of the many community benefits LRGHealthcare provided to its communities last year. LRGHealthcare assisted 88 patients last year to receive free or reduced rate screening mammograms. Our Medication Connection Program helped 160 clients get access to free or reduced cost medications. 3,256 Number of calls LRGHealthcare emergency ambulance services responded to last year. 26 cities and towns in LRGHealthcare s service area. In partnership with local fire departments, LRGHealthcare assisted 288 seniors with replacing and/or installing smoke detectors/ batteries on National Senior Safety Day. 5,692 Number of at-risk patients our Care Coordinators assisted last year through our comprehensive Care Coordinator Program. Gums to gout. We ve got you covered. Research has proven that your medical health and your dental health are closely related. Together, Tufts Health Freedom Plan and Northeast Delta Dental can improve the health of its members. To learn more about this partnership, that is strengthening the link between medical and dental health, contact your Benefits Broker or visit thfp.com/bettertogether 328 Babies born in the LRGH Family Birthplace last year. 36,211 Visits to the LRGH and FRH Emergency Rooms in SPRING 2017 LRGH.ORG LRGH.ORG SPRING

13 SO not convenient. But, Convenience Care is. LRGHealthcare care. compassion. community. 80 Highland Street Laconia NH lrgh.org Occupational Health Services Convenience Care Hillside Medical Park, Lot C 14 Maple Street, Gilford Mon Fri 7am 7pm Laconia Clinic Convenience Care 724 Main St, Laconia Mon Fri 7am 7pm Sat Sun 8am 5pm *Hours may vary. lrgh.org/care LRGHealthcare care. compassion. community.