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Treatingthe MONITOR | November 2011 (3)tumorsCancer patients can get faster, more-accurate treatments in Varian TrueBeamIt’s like a Swiss army knifefor cancer treatment.In October, RenownInstitute for Cancer beganusing its newly installedVarian TrueBeam, astate-of-the-art radiationtechnology from VarianMedical Systems, used totreat cancer without surgeryin just minutes a day.on the beam only when thetumor is absolutely still. Thisfunction will be live startingearly 2012.“It’s a great plus, because thatmeans no extra proceduresfor the patient, no chance oflittle markers (that have beenplaced) inside their bodiesmigrating away from thetumor,” Cox said.Cancer patients now haveaccess to the region’s fastest,most accurate means offinding, identifying andtreating tumors down to thesize of a grain of rice, saidSusan Cox, the RenownInstitute for Cancer’sDirector of Cancer Services.In conjunction with theTomoTherapy Hi-ArtTreatment System, theaddition of Varian TrueBeammeans Renown now offersthe two leading radiationtherapy treatments availabletoday. With customizedtreatments for each patient,we can treat tumors of allsizes and types throughoutthe entire body.“There’s no tumor too big or too small that we cannot treat,”Cox said.For patients, the TrueBeam’s most-notable improvementover older devices is how fast they can complete theirtreatments.The X-ray-based TrueBeam attacks tumors in sessions under15 minutes a day.This way, the tumor does not have a chance to recoverbetween passes, Cox said.For physicians and technicians, though, the benefits arefar greater.One dramatic advance is TrueBeam’s respiratory gatingfunction — monitoring a patient’s breathing and turningJulie Pfaff, Radiation Therapist and Chris Koenigs, Medical Physicist demonstratingthe Varian TrueBeam.Patient safety, in fact, isanother benefit to havingthe new technology inthe treatment room, saidradiation therapist Julie Pfaff.“It has more than 3,800fail-safe checks that itperforms prior to eachtreatment beam,” Pfaff said.“It really gives you qualityof the beam; it ensures thatthe beam is accurate and isdelivering, including, what itsays it’s delivering, the shapeand the size,” Cox added.“The machine has a lot ofbenefits that we haven’t startedusing yet,” Pfaff said. “We haven’tstarted the stereotactic surgeriesor respiratory monitoring.”Stereotactic surgery guides surgeons or radiologists totargets within the body using a three-dimensional referencegrid. TrueBeam allows this form of surgery to be used for awider range of tumors throughout the body.“Now, we have different types of imaging that we can usefor image guidance to localize the tumor,” Cox said. “Itdoesn’t matter if it’s a soft tissue, if it’s a bone, or whathave you.”TrueBeam’s speed and accuracy, as well as its ability to findand treat extremely small tumors, also yield a less-traumaticexperience for patients.“I think this machine is making it a lot easier for patients todeal with their treatment and their recovery, and get back toa normal day and life.” Pfaff said.

(4) November 2011 | the MONITORgiving ColorNew crayon-collection drive benefits kids throughout Renown RegionalFor kids, a trip to the hospital is either frightening orboring, and anything that can take their minds off theirsurroundings is a plus.At Renown Regional Medical Center, two of the maincoping tools for children are a packet of crayons and acomic book.“It’s a good distraction both for our patients and ouryounger visitors,” said Erin Madewell, RN, Supervisorof Clinical Nursing for the Children’s ER at RenownRegional.It is a much-needed distraction as well, given how manychildren pass through Renown Regional’s doors each year.It also is an expensive distraction. Renown’s staff hand outat least 10 small packs of six crayons each day, seven daysa week, during the year — for a minimum total of 22,000crayons.To fill the need, Madewell, who began work at RenownRegional in late July, decided to stage a crayon-collectiondrive among Renown Regional’s employees.She started it in August, right around the time that storesin this area were holding their back-to-school sales.By the time the drive ended in October, various areasaround the Children’s ER were storing 25,000 crayons.“This is more response than I’ve had doing similarfunctions in other places,” Madewell said. “I’m superhappy about that.”Happy, but not surprised at the response she got from herco-workers throughout the hospital.“That’s why I chose to join Renown and why I camehere,” she said. “Everybody’s willing to give extra for ourpatients. I think that’s amazing.”Erin Madewell, RN, Supervisor/Clinical Nursing sits with a display of crayons inone of the Children’s ER offices.The fact that Madewell was able to create such a successfuldrive so soon after starting work is equally amazing.“It is a tribute to how well we are able to bring new staffon board and get them involved in the Renown culture,have them take part in Renown’s mission and commitmentto the community,” said Jeff Stout, MSN, RN, NEA-BC,Renown Regional’s Chief Nursing Officer.The crayon drive’s results also speak well about the entirestaff’s attitude towards their patients, Stout said.“It shows true leadership and a commitment to ourcommunity’s children,” he said.people at WorkMembers of the Administrative team at Renown Regionaltook a quick break for a photo. From left MaricarmenCresci, Administrative Secretary; Verna Webber,Administrative Secretary; and Sue Hanna, PerformanceSpecialist.

the MONITOR | November 2011 (5)rising Above averageEmergency angioplasty at Renown Regional exceeds speed-of-care targetsSpeed, accuracy and still morespeed — those are the keys tohelping heart-attack patients survivewhen they come to the emergencydepartment.Specifically, they are the keys toimproving a patient’s door-to-balloontime, the time it takes to get a heartpatient’s blocked arteries treated viaangioplasty once they reach the ERadmitting desk.The American College of Cardiologyhas established 90 minutes as themaximum safe target time for theprocess. The faster this process takes,the less heart muscle ends up dying.At Renown Regional Medical Center,a lot of heart muscle has been savedthis year.“From Jan. 1 to Sept. 30, we’re at 62 minutes mediantime,” said Karen Meskimen, Cardiovascular BusinessDevelopment Administrator for the Renown Institute forHeart & Vascular Health.That is the figure that will be reported to the federalCenters for Medicare & Medicaid Services, which tracks thepercentage of each hospital’s emergency angioplasty casesthat achieve or beat the 90-minute target.For the nation’s other major center for tracking thisinformation, the ACC’s National Cardiovascular DataRegistry, the report is equally impressive.“We are at the best we have ever been: we are at 100 percent(reaching the operating room) in less than 90 minutes,”Meskimen said.That figure is for the ER’s door-to-balloon performance forall of 2010, with a total qualifying patient count of 90.The Emergency Angioplasty team in the ER’s south trauma room: From left Jonathan Laine, MD; Andrea Shulze,RN; Jesse Northrop, RN; Alicia Mujica, RN; Shelly McAbee, RN; Kelsey Brown, RN; Maggie Griswold, RN; KelsayHernandez, RN; Marilyn Braninburg, RN; Michelle Teachenor; Tom Thayer, RN and Jorge Galicia.The overall goal is to get Renown Regional’s average below60 minutes, Meskimen said.“We’ve had some really short times because the processmoved really smoothly,” she said.In one case, a team was able to complete the process in 27minutes.The reason for the two figures is that both organizationshave slightly different criteria for defining ST elevatedmyocardial infarction, or STEMI, patients — those whoseheartbeats give off an abnormal electrocardiogram readingduring one of the heart’s recovery periods.Aside from dropping the average door-to-balloon time,a big goal is to convince people who think they might behaving a heart attack to call for an ambulance and get to theER as soon as possible — rather than waiting to see if thepain goes away, Meskimen said.people at WorkAs part of their Pride Day celebration, employees from Credentialing, MSO andMedical Group offices at Ryland and Vista contributed to a coat drive for Libby BoothElementary School, one of the Partners in Education with Renown Health. Shownfrom left, Kelly Dawson, Patient Access Representative, Occupational Health; CourtneyTilley, Patient Access Representative, 975 Ryland; and Nastassa Montgomery, MedicalAssistant with the Los Altos Medical Group.

(6) November 2011 | the MONITORsmart health ConnectionsEnhancing the wellness and health of adults age 50+In service to the community,Renown offers free events,lectures and discounted labscreenings through its SmartHealth Connection program.“We reach out to the publicto educate them about all thethings we do, prior to themever needing us,” said LoriMitchell, Renown’s Managerof Wellness Resources, whoco-founded Smart HealthConnection 18 years ago.These days, Mitchell’sWellness Resources programworks with Smart HealthConnection, whose EventSpecialist is Judy Wilkinson.“Judy plans events, and we helpcarry them out,” Mitchell said.It’s a membership program, but membership is free. Thosewho sign up receive a monthly newsletter and are notifiedabout luncheon lectures, classes, health screenings andspecial events.“Being a member keeps them in the loop and aware ofservices that Renown offers,” Wilkinson said.And although the program is designed for those ages 50 andabove, “everyone is welcome at any event,” Wilkinson said.Smart Health Connection familiarizes people withRenown, so they know where to go when they need care.From left, Jan Olson, Business Support Partner; Judy Wilkinson, Event Specialist: Smart Health Connection and Lori Mitchell,Manager of Renown Wellness Resource Center, helped run a recent Low-Cost Screening event at Renown South Meadows.Low-cost lab screenings are available every Wednesdaymorning at one of four locations also part of Smart HealthConnection. Patients pay for lab work out-of-pocket andinsurance is not billed. Costs range from $15 to $65 andinclude everything from a complete blood count to athyroid profile.“It saves them hundreds of dollars,” Wilkinson said.“It’s important that other Renown employees know aboutthis, because someone might call the hospital and ask,‘Where can I go for lab work? I’m unemployed, or I have a$5,000 deductible,’” Wilkinson said. “The employee can tellthem we have these services.“People may not have the need for a particular servicewhen they come to a lecture,” Wilkinson said, “but I’ll geta phone call months down the road where someone willsay, ‘You had a doctor talking about that subject: How do Ireach him?’ It has lasting effects.”“It brings them to us and they’ll remember: ‘Renown didthis for me when I really needed it.’”Visit www.renown.org/shc for the list of locations andscreenings available.people at WorkA team of employees from Admitting at Renown Rehabilitation Hospitalwon the pumpkin carving contest at that facility. Shown with theirwinning entry, from left, are Jayme Salcedo, Care Coordinator Assistant;Melissa Gallegos, Patient Access Representative; and Julie Wenzel, RN.

joint Replacement registryImproving patient decisions for procedures, devices and outcomesFor the first time ever in the United States, an officialregistry to track joint replacement devices and their successrates is being instituted, and Renown is playing a part.A new project of the American Academy of OrthopedicSurgeons, the privately-funded, not-for-profit AmericanJoint Replacement Registry (AJRR) will help patients andsurgeons make more informed decisions about total jointprocedures, devices and outcomes.The project is currently in its pilot phase and thanks to EricBoyden, MD, Renown Regional Medical Center is one of itsfirst participants, said Tracy Kaltenbacher, BSN, RN, ONC,Total Joint Coordinator at Renown.the MONITOR | November 2011 (7)“The only way we could participate is if we had anactive physician champion, and Dr. Boyden is ourphysician champion for this,” Kaltenbacher said. “He wasinstrumental in our being chosen from over 70 sites toparticipate in the pilot. There are only 18 sites participating,so it’s really very exciting.”Over the past year, Renown has been working closelywith AJRR to help make the project work. One “bug” thatsurfaced involved the electronic transmission of encryptedpatient information. Renown was one of 10 sites thatexperienced issues with data submission, so AJRR wasinstalling new software in November in order to solve theproblem. By the end of 2011, Renown should be able tobegin submitting appropriately-encrypted patient data.Once AJRR is up and running in early 2012, it will trackas many as 90 percent of all artificial joint implants in theU.S., the reliability of those implants, and the success ofphysicians performing surgeries. It will also be able tonotify joint replacement recipients quickly in case ofdevice recalls.From left, Alicia Glassco, RN, Manager of Orthopedics; Eric Boyden,MD, Director of Arthroplasty; Tracy Kaltenbacher, RN, Joint ReplacementCoordinator and Victoria Bryn, Patient Access Representative. Not picturedis Joan Lapham, RN, Business Development Administrator.AJRR data will also improve the quality of Renown’s ownTotal Joint Replacement program.“If we can track what implants are doing well and reducethe amount of revisions that we do, then it’s safer for thepatient and helpful for our program,” Kaltenbacher said.“We can also use that data to look at our own complicationrates, make quality adjustments, and benchmark ourinformation against other national institutions.“It’s just another aspect of better quality care, which is ourultimate goal.”people at WorkAt Renown Medical Group, Los Altos, Sparks, from left, Editha Manalastas,Patient Access Representative, and Rachael Hadley, Medical Assistant/PatientAccess Representative, took a quick break for a photo.

employees of the monthRenown Health Employees of the Month are rewarded and recognized for their embodiment of the fourFundamentals of our healthcare network. For more information about how to nominate a fellow employee visit thePeople section on Inside Renown.PEOPLENancy Bell, Administrative Secretary,Renown South Meadows Medical CenterNancy took the initiative to create a color-coded, detailed weeklyanalysis for Healthy Tracks. The report was broken down bydepartment leaders so they could assess progress for their areas. Nancycreated this form from a data file and created a tool that was usableand easy to read and understand. Nancy’s efforts were instrumentalin helping Renown South Meadows reach a Healthy Tracks completionrate of more than 70 percent.SERVICEMichael Atkinson, RN, ICU Roseview Tower, Renown RegionalMedical CenterMichael is an excellent nurse who is supportive of his peers and alwayswilling to help. Recently, a patient was transferred from another facility andneeded tests and a physician evaluation. The Urologist needed a urologycart urgently, plus the patient was in a lot of pain and needed a procedureimmediately. Michael heard about the situation and retrieved the cart,enabling the physician to do what needed to be done to assist the patient.QUALITYAshley Dimpel, RN, Medical and Telemetry,Renown South Meadows Medical CenterAshley in the photo second from the left, identified a process thatneeded to be improved for patients who were receiving Total ParenteralNutrition and Peripheral Venous Nutrition. These patients need to havetheir blood sugars checked every eight hours, and it was determined thatthe order for this process had not been built into EMR. The departmentis now working with pharmacy to ensure orders are entered.STEWARDSHIPVal Lizares, Critical Care Technician, Medical and Telemetry,Renown South Meadows Medical CenterVal was recognized for implementing a 5S project (a cycle strategy thathelps to keep our workplace safe and organized) for her department.She worked closely with the leadership team to pull all supplies out ofprivate patient rooms to reduce the risk of contamination. Now suppliesare kept outside patient rooms in cabinet drawers at the door. Nursingstaff takes only what they need into the patient room. Not only has thisreduced contamination, it is also saving money on supplies. Val is shownin the center holding her EOM letter.the MONITOR | Your No. 1 Source for Employee News and InformationSubmit story ideas by visiting Inside Renown>Newsletters> Submit a Story Ideaor contact editor Noelle Castrorena, Communications.