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TMCs Report to Our Community

TMC HealthCare Board of TrusteesLouise L. Francesconi, Chairwoman

Matthew Atlas, M.D.

Henry K. Boice

Michael W. Bracht, M.D.

Mary E. Cochran, M.D.

David J. Cohen

Susan L. Ernsky

Manuel M. Ferris

Lou Lancero, M.D.

Eduardo A. Leon

Michael R. Probstfeld, M.D.

Richard M. Moreno

Judith F. Rich

David F. Peachin

Joel D. Valdez

Jon R. Young

TMC Medical Executive CommitteeMatthew Atlas, M.D., Chief of Staff

Michael Probstfeld, M.D., Chief of Staff Elect

Department ChairsJ. Manuel Arreguin, M.D.

Brian Cammarata, M.D.

Christopher Florence, M.D.

Thomas Harmon, M.D.

Steven Ketchel, M.D.

Eva McCullars, M.D.

Moira L. Richards, M.D.

Steven Siwik, M.D.

George Wilcox, M.D.

Section ChiefsRobert Aaronson, M.D.

Michael Badruddoja, M.D.

Susan Bazzell, M.D.

Richard Callihan, M.D.

Amram Dahukey, D.P.M.

Charles Daniel, M.D.

Joel R. Goode, M.D.

Michael Hamant, M.D.

Barton Hodes, M.D.

David Killion, M.D.

Michael Lavor, M.D.

Douglas Lowell, M.D.

Marco Marsella, M.D.

Brandon Massey, M.D.

Ann OConnor, M.D.

Doug Peterson, M.D.

Ronald Quintia, M.D.

Gulshan Sethi, M.D.

Mohammed Sikder, M.D.

Keith Soderberg, M.D.

Paul Yurkanin, M.D.

TMC Foundation Board of TrusteesDavid J. Cohen, Chairman

Ann M. Aros

Henry K. Boice

Joni S. Condit

Palmer C. Evans, M.D., Life Trustee

Dorothy Finley, Life Trustee

Louise L. Francesconi

Anne M. Fulton-Cavett

Christine Kocsis

Christopher Maloney, M.D.

Sidney N. Mendelsohn, Jr.

Kevin Morrow

David F. Peachin

Rory R.J. Riley

Alan K. Rogers, M.D.

Keri Lazarus Silvyn

Alan Stein

Karen Thurman

Arlene Webster, R.N.

Jim Zarling

TMC Community Affairs recipientsAs corporate citizens in the Southern Arizona community, Tucson Medical Center provides support to other nonprofit organizations serving the region. Last year, TMC provided $239,535 to these important community partners. Below is a list of some of the organizations receiving financial support from TMC.

American Cancer Society

American Diabetes Association

American Heart Association

American Lung Association

American Red Cross

Ara Parseghian Medical Research Foundation

Arizona Chapter American Parkinson Disease

Arizona Blind & Deaf Childrens Foundation

Arthritis Foundation

Big Brothers Big Sisters of Tucson

Boys & Girls Club

Caregiver Consortium

Casa de los Nios

Childrens Action Alliance

CODAC Behavioral Health Services

Community Food Bank

Diaper Bank of Southern Arizona

Educational Enrichment Foundation

El Rio Community Health Center Foundation

Epilepsy Foundation of Arizona

Hispanic Scholarship Program for Southern Arizona

Juvenile Diabetes Research Foundation

Susan G. Komen, Southern Arizona

Leukemia and Lymphoma Society

Lupus Foundation

March of Dimes

National Alliance of Mental Illness

National Multiple Sclerosis Society

New Beginnings for Women & Children

Pima Community College

Pima Council on Aging

Ronald McDonald House

Southern Arizona AIDS Foundation

Southern Arizona Center Against Sexual Assault

Southern Arizona Red Cross

St. Lukes Home

Tucson Interfaith HIV/AIDS Network

Tucson Childrens Museum

Tucson Clean and Beautiful

Tucson Jewish Community Center

Tucson Nurses Week Foundation

University of Arizona

University of Arizona Hispanic Scholarship Endowment

Volunteer Center of Southern Arizona

Womens Foundation of Southern Arizona

YWCA

Our Mission: Tucson Medical Center delivers caring, personalized, quality health care to patients and their families in an environment that is supportive and compassionate. Report to our Community CreditsPublisher: Judy Rich, President and Chief Executive OfficerExecutive Editor: Julia Strange, Vice President, Community BenefitEditor: Cheryl KohoutGraphic Design: Nancy SerenskyContributing Writers: Jane Erikson, Tara Kirkpatrick, Marni Dittmar, Bruce Chandler, Michael Letson, LDon SawyerPhotography: Eric Suhm, Bruce Chandler, Erik Hinote, Dr. Donnie Sanson, Dr. Luis EsparzaCreative Strategy Team: Cheryl Kohout, Michael Letson,Christel Pettengill, Hope Thomas, Hilton & Myers Advertising, Raim & Associates LLC, Strategic Issues Management Group With special thanks to the TMC Community Benefit Task Force, TMC Financial Services, TMC Foundation, the TMC HealthCare Board of Trustees and the thousands of helping hands who make a positive difference every day. TMC HealthCare, 5301 E. Grant Road, Tucson, Arizona(520) 327-5461 www.tmcaz.com

1Judy F. RichPresident andChief Executive Of cer

In the pages of this community report, you will see that some of our best work takes place outside the walls of the hospital at Grant

and Craycroft. You will see your community

hospital at work in schools, at civic events, in

support groups. We are an economic driver,

obtaining goods and services from hundreds of

Tucson and Arizona businesses large and small.

We are exploring ways to make incremental

wellness changes and healthy choices close to

home as we begin to reform the health of our

community one step at a time.

Tucson Medical Center is a tax-exempt hospi-

tal. Th at means that instead of paying taxes, we

provide services and care to benefi t the com-

munity. In this report, we will endeavor to ar-

ticulate the tangible and intangible value we

provide to people of Southern Arizona. In the

end, our accountability is to you, our friends,

neighbors and families. And, in the spirit of our

values: we listen, we learn, we grow. If you see

opportunities for improvement, if you see plac-

es we can make a diff erence in the community,

we want to hear from you. Please contact Julia

Strange, vice president, Community Benefi t,

(520) 324-2017, or any member of our leader-

ship team.

Because of our solid fi nancial performance, we

are able to invest in bricks and mortar, we are

able to invest in the latest technology, we are

able to step into an elite group of hospitals na-

tionally in terms of our use of electronic medi-

cal records. And, importantly, we are able to in-

vest in programs and services that improve the

health and well-being of you, our community.

We listen, we learn, we growreport to our community

We have heart

We respect diversity and individuality

We honor body, mind and spirit

We tell the truth

We are responsible in how we use our resources

We have the courage to uphold our values

We work hard for our patients and each other

We are committed to professionalism and excellence

We listen, we learn, we grow

We are welcoming and friendly

We practice kindness in all our relationships

We reach out as teachers and as leaders

community

dedication integrity

compassionWe are responsible in how we use our resources

compassionWe are responsible in how we use our resourcesWe are committed to professionalism and excellence

compassionWe are committed to professionalism and excellence

We listen, we learn, we growcompassionWe listen, we learn, we grow

integrityWe practice kindness in all our relationshipsintegrityWe practice kindness in all our relationshipsWe reach out as teachers and as leaders

integrityWe reach out as teachers and as leaders

In 2009 we articulated the values that had been previously evident but unstated. I hope you will see reflections of the

heart and soul of thousands of caregivers who have defined our community hospital for 65 years.compassion

2 3

Tucson Medical Center has the widest reach of any hospital in Southern Arizona. From head to toe, and birth to the end of life, TMC provides comprehensive and compassionate care, in recognized centers of excellence, to our friends, families and neighbors. The most wonderful part of serving on the TMC HealthCare Board of Trustees for the regions largest nonprofit hospital is knowing that we touched the lives of more than 113,000 individuals last year. To echo one of the organi-zations value statements, we do it with heart. TMC is an organization based on a foundation of caring, and a focus on quality, that is a con-stant inspiration to me. But, a hospital like TMC cant focus on caring alone. It is caring plus state-of-the-art equip-ment and technology employed by the regions most experienced nurses and physicians that de-fine a patients experience. CEO Judy Rich and her leadership team have articulated values and forged partnerships to create a truly remarkable hospital for our community. Physicians, staff, community leaders, patients and their families have come together to start changing health care from the ground up. The electronic medical record we call ours OneChart is one major step we are taking to

transform the hospital and health care we pro-vide. Based on the Epic Enterprise platform, OneChart, a $28 million investment, places TMC in an elite class of hospitals nationally. I am very proud of our commitment and focus on deploying a world-class electronic medical record it was a bold decision, and a challeng-ing process. Our OneChart system will be suc-cessful not just because of the care and attention being paid to the technological details. Perhaps more importantly, it will succeed because of the active and passionate participation and advoca-cy of our physician partners, working alongside our hospital employees to make it happen

I believe the value of being a stand-alone com-munity hospital is that we are not, in fact, stand-ing alone. We have seen time and time again that the community stands behind TMC. Our doctors stand with us, and our staff is on the front line every day taking care of people from throughout our region. We give back through our commitment to aim high; through campus redevelopment, technology and innovation; and through our commitment to invest in our com-munity. Through our physician partners, our staff and my Board colleagues, TMC is seam-lessly integrated into the community.

The Boards confidence in the leadership of the hospital is validated by the fact that we continue

to be profitable in tough economic times. Being profitable allows us to invest in the future; to realize a new vision for the campus; to support centers of excellence in neurosciences, cardiac care, maternity and pediatrics, and on and on. The community doesnt need to see an adver-tisement to know that the very best care is at TMC.

The volunteer community Board is made up of people of different professions, backgrounds, life experiences and perspectives. This allows for a rich vision of the kind of care Southern Arizona needs. We all benefit because there are lots of hearts and minds that understand what happens at a community hospital and lots of hearts and minds that understand what hap-pens in our community.

My vision? I see a hospital modernized through the electronic medical record and focused tech-nology investments. I see an organization high-ly partnered with the physician community in clinical areas of excellence. And I see world-class delivery of quality care that will positively im-pact generations to come.

confidence & community

Louise FrancesconiChairwoman,TMC Board of Trustees

I believe the value of

being a stand-alone

community hospital

is that we are not, in

fact, standing alone.

2 3

Drive around Tucson and its hard to miss signs of the economic climate we have been living in the last few years. And, as a community hospital, we have been impacted in many ways, but most dramatically in the changing face of charity care. As people have lost their jobs and become un-insured or underinsured, more and more are finding they need the safety net they never thought they would need: charity care services for necessary hospital and medical services. TMC is one of the largest hospital providers to patients on AHCCCS, Arizonas Medicaid program. In fact, from a gross charge stand-point, our mix of AHCCCS payers increased from 25.5 percent in 2008 to 27.1 percent in 2009. In real terms, that shift of 1.6 percent-age points away from health maintenance pro-grams and commercial plans resulted in about $1.5 million less reimbursement for TMC, as AHCCCS payments are significantly less than other payers. In addition, as people struggle financially, more are finding themselves unin-sured or in health plans with large deductibles. From 2008 to 2009, TMC saw a 25 percent increase in bad debt and charity care.

As a nonprofit community hospital, we recog-nize and celebrate our role as a safety net for the people of our community. TMCs mission calls for us to develop and support programs that improve the overall health and well-be-ing of our community. Our doors are open and we will continue to operate in a manner that provides health and medical services to a population that would not otherwise have ac-cess to care. With that said, we must maintain a level of fiscal responsibility that will allow us to continue to operate as a nonprofit com-munity hospital. Being nonprofit does not mean we can be unprofitable. In fact, we are compelled to achieve a positive operating margin so we can reinvest in the services our community needs. We need to support ourselves to further our mission. As chairman of the Finance Committee and member of the TMC Board of Trustees, I must work to balance our stewardship of resources and our mission to meet community need. I am pleased to inform you that TMC is in a solid financial position, which allows reinvest-ment in facilities, capital and programming.

And the successes of the last several years have allowed us to invest in the following projects:

$120 million in campus redevelopment$28 million in electronic medical record$25 million in other facilities improvements Fiscal discipline and careful stewardship of resources have allowed us to grow, thrive and expand while continuing to serve patients re-gardless of their ability to pay. Its important to note that your neighbors are investing their time as volunteer board and committee mem-bers to ensure the mission is upheld. A patient in need may not think about mission they just want to know our nurses and doctors are here to provide expert care for them. Behind all of this is a group of volunteers whose job is to advocate for the community and challenge management to operate effi-ciently and effectively. I care that members of our community can get the medical help they need, when they need it and we hold the safety net for the uninsured and underinsured in nonprofit hospitals like TMC.

Jon YoungChairman,TMC Finance Committee

the changing face of charity care

Fiscal discipline and

careful stewardship of

resources have allowed

us to grow, thrive and

expand...

4 5

highest quality state-of-the-art care with a personal touch

I have been a surgeon on staff at Tuc-son Medical Center for more than 10 years and have observed quantum changes in the physical plant, technol-ogy and personnel. As Tucsons only nonprofi t community hospital, TMC provides comprehensive care to our en-tire community without regard to abil-ity to pay. Th is is done in a caring and high-quality environment.

Providing this level of care is not with-out challenges. From the TMC Health-Care Board of Trustees, to CEO and President Judy Rich and upper-level administration, one senses a palpable commitment to quality and excellence. Partnering with physicians in order to deliver the best possible care in a fi scally responsible and viable manner is the or-der of the day at TMC. Excellent medi-cal care doesnt happen by accident. At TMC we are working hard every day to meet the challenges of 21st century medicine.

Take for example the OneChart elec-tronic medical record currently being implemented at TMC. Th is state-of-

the-art system promises to help us achieve our goal of the right treatment for the right patient every time. TMC is the community leader, the fi rst in Tucson to implement a totally func-tional EMR system.

Another accomplishment we are proud of at TMC is the Professional Practice Committee, or PPC, which has been operational for over a year now. Th is robust committee of dedicated hard-working professionals has changed the face of peer review from a punitive, fault-fi nding body to one whose goal is physician education and continual pro-cess improvement.

Americas healthcare delivery system is presently undergoing a revolutionary transformation. Th e future relationship that will develop among physicians, hospitals, insurers and government pro-grams is unknown. However, Tucson Medical Center remains committed to providing quality and compassionate health care to all residents of Southern Arizona.

Less than 1 percent of the

countrys 5,000-plus hospi-

tals currently have the com-

prehensive electronic medical

record that Tucson Medical

Center will have June 1.

TMCs $20 million project

known as OneChart: One Pa-

tient One Record uses Epic

EMR technology. The system will

streamline care processes and,

ultimately, redefi ne how hospital

care is delivered at TMC.

Fewer than 50 hospitals are at

Stage 6, out of 5,170 nation-

wide. Only 17 hospitals have

reached Stage 7.

The EMR adoption model, de-

veloped by Healthcare Informa-

tion and Management Systems

Society, scores hospitals on the

progress in completing eight

stages of adopting an EMR.

Stage 0 is where a hospital

might have some clinical auto-

mation in place, but is lacking

lab, pharmacy and radiology

systems

Stage 7 represents a health-

care system that has achieved

a paperless EMR environment,

and clinical information is read-

ily shared through continuity-

of-care electronic transactions.

Most Stage 7 organizations,

including Kaiser Permanente in

California, are multi-facility sys-

tems.

TMC is targeting Stage 6 a

complete EMR, including physi-

cian documentation, computer-

ized physician order entry, full

clinical protocols, and picture

archiving and communications

systems.

OneChart: TMC at the forefront with its EMR implementation

state-of-the-artstate-of-the-arthighest quality state-of-the-art care

state-of-the-arthighest quality state-of-the-art care state-of-the-arthighest quality state-of-the-art care state-of-the-arthighest quality state-of-the-art care with a personal touchstate-of-the-art with a personal touchhighest quality state-of-the-art care with a personal touchhighest quality state-of-the-art care state-of-the-arthighest quality state-of-the-art care with a personal touchhighest quality state-of-the-art care

state-of-the-artstate-of-the-artstate-of-the-arthighest quality state-of-the-art care

state-of-the-arthighest quality state-of-the-art care state-of-the-arthighest quality state-of-the-art care

state-of-the-arthighest quality state-of-the-art care with a personal touchstate-of-the-art with a personal touchstate-of-the-art with a personal touchstate-of-the-art with a personal touchhighest quality state-of-the-art care with a personal touchhighest quality state-of-the-art care

state-of-the-arthighest quality state-of-the-art care with a personal touchhighest quality state-of-the-art care state-of-the-arthighest quality state-of-the-art care with a personal touchhighest quality state-of-the-art care

state-of-the-arthighest quality state-of-the-art care with a personal touchhighest quality state-of-the-art care

Excellent medical

care doesnt happen

by accident

Michael R. Probstfeld, M.D.Chief of Staff elect

4 5

Tucson Medical Center broke ground Nov. 12 on a $120 million fi ve-year plan to ex-pand its ability to serve the community.

Th e project will be completed in phases and is to be fi nanced with a blend of fundraising, savings and borrowing, said Michael J. Duran, TMC Foundation vice president and chief de-velopment offi cer.

An ambitious campus redevelopment plan has been approved by the TMC HealthCare Board of Trustees, with a phased timeline for several major projects. Th e redevelopment will in-clude:

Expanded Pediatric and Maternity units New operating rooms New entrances New parking garages New four-story bed tower New medical o ces for physicians

Additionally, TMC is investing in sidewalks, trails and other amenities on its campus as part of its 2008 rezoning. Included is application for four of its historic structures the Water Tower, Erickson House, Arizona Building and Patio Building to be listed on the National Register of Historic Places, Duran said.

Neighbors continue to have input on the fu-ture look of TMC through the Architectural Review Board, which includes representatives from area neighborhoods and TMC. Th e ARB reviews and approves design aspects of the ren-ovation and expansion as part of the permitting process.

Solid fi nancial performance has allowed TMC to invest in its facilities and equipment for the future, while honoring its history, Duran said, adding that as the projects proceed, patient care services will continue without interruption.

The rst phase of TMCs $120 million

renovation involves expansion of the

current Pediatric unit by adding 16,000

square feet of new space and renova-

tion of more than 15,000 square feet of

existing space. The $12.5 million proj-

ect will:

Add new private pediatrics beds Remodel existing rooms to private Provide more space for families, in community rooms and at patient

bedside

Enhance play areas for children Create a central entrance for pediatric services at TMC

Ease coordination of pediatric services Expand pediatrics outpatient services and capacity

The resulting new general pediatric fl oor

designed by Hobbs+Black Architects with

the help of staff, physicians and patients

features private rooms throughout.

Children throughout the region will be

well-served by the extra capacity for pe-

diatric beds and the much-needed en-

hancements that create a childrens medi-

cal center within the hospital, said Michael

J. Duran, TMC Foundation vice president

and chief development offi cer.

This is a community effort, Duran said,

adding that the TMC Foundation is seeking

funds for the pediatric expansion and has

raised more than half of the needed funds

through the Block by Block, Miracles Hap-

pen capital campaign.

TMC breaks ground on $120M campus development

Capital campaign funds Pediatric renovations

6 7

community GARDENBack in the fall of 2009, a small seed of an idea was planted. Th e Green Team had just been created to help Tucson Medical Cen-ter look at better ways to use resources, and to encourage eff orts to reduce, reuse and recycle all kinds of materials. A chance remark about a garden during an early meeting was greeted with great enthusiasm from the team, and the Garden Club was formed. Th e group started with a great space an unused childrens playground and playset in TMCs LifeGain Park. A new home was found for the equipment, at the New Life United Pentecostal Church, and the rest of the play-ground space was cleared. Brad Wedding, supervisor of facility trades and TMCs longtime landscaping chief, took an innovative approach to creating new planting

beds. For three of the beds, he used the plastic rails that had framed the playground equip-ment. For another, he collected the concrete ashtrays that are no longer needed on the to-bacco-free campus and turned them upside down in two rows. Filled with soil, they make a fi ne raised bed. Winter planting produced caulifl ower, broc-coli, Swiss chard, onions, lettuce and carrots. A little herb bed has rosemary, thyme, chives, basil, dill and oregano. Th e Garden Club crew has put in several fruit trees, including apricot, apple, peach, plum, grapefruit, orange and lemon, and a beautiful grape vine. Warmer weather will see plantings of tomatoes, chili peppers, tomatillos, okra, eggplant and deco-rative gourds. Th e TMC Community Garden, like the community, is healthy and growing!

community GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENcommunity GARDENtmcs

6 7

Teresa Crocco had been hoping for the past few years to get back to a fi tness level that would make her feel and look her best. But with lung disease and foot pain, she faced a dif-fi cult challenge.

Th en she met Bill Cook. He was a Se-nior Services Health Coach volunteer trained to off er one-on-one support to help older adults reach personal health goals.

Crocco recalls their fi rst encounter at TMC Senior Services. We met in the Health Resource Center, and Bill

asked what I hoped to attain from the program. Together they came up with a plan for appropriate exercises. Stretching was important, as her muscles had stiff -ened. Th ey also discussed relaxation, breathing and meditation to help her reduce stress. Over the next two years, they met to review weekly goals. If Crocco did not meet her goal, Cook would ask, What activity can you do next week? He helped motivate her to stay on course, in a non-judgmental fash-

ion. She began taking daily walks and slowly increased the distance. With Cooks help, she soon was able to walk to the bank, the store and even the mall. If it werent for the Health Coach program, I would not be exercising every day, she said. Th e program helped me get back to where I was years ago, and has changed my life. I am no longer depressed, and I even wake up before the alarm clock goes off , ready to start my day!

non-judgmental health coaching keeps seniors on track

The program helped me get back to where I was years ago,

and has changed my lifeTeresa Crocco

8 9

OutreachcommunityAlex the AmbulanceSafe Kids Tucson, a public safety coalition spear-

headed by TMC, gets a boost whenever Alex the

Ambulance rolls by. Southwest Ambulance, one

of many community partners that make up Safe

Kids, has decorated Alex with vital water-safety

messages designed to save childrens lives.

Everyone Runs!TMC partners with Everyone Runs! to pro-

mote healthier lifestyles and to raise funds

in an all-inclusive atmosphere. Runners,

walkers and onlookers are welcome to

participate in events that range from short

jaunts for kids, to longer treks for hard-

core runners.

Helping HandsAn enthusiastic TMC crew helped the

Community Food Bank process food do-

nations as part of a 100 Helping Hands

project. During their first three-hour shift

at the Food Bank, the handy helpers filled

2,282 family food boxes, representing

63,564 pounds of food.

TMC Senior ServicesOlder members of the community can find a

Healthy Living Connection at TMC Senior Ser-

vices. In addition to support for patients during

and after hospitalization, Senior Services offers a

full program of educational and wellness oppor-

tunities in the community and in their dedicated

facility at the El Dorado Health Campus.

Business OfficeThe community-minded financial experts in the TMC

Business Office continue their tradition of supporting

worthy causes. The money is raised a few dollars at

a time, with employee donations to events such as

drawings for gift baskets to fund their projects.

Gifts included blankets and non-slip socks in a special

holiday delivery to the seniors at St. Lukes Assisted

Living.

Employees created a special presentation to accom-

pany their contribution to the Marks Fund, which pro-

vides emergency assistance for TMC employees in

crisis.

Food and gifts from the Business Office keep the

shelves stocked at Youth on their Own, a dropout-pre-

vention program that aids homeless young people.

Primavera Foundation clients are transitioning from

homelessness and poverty, with help from donated

items delivered by the Business Office.

The four-legged clients at Hope Animal Shelter, a no-

kill adoption haven for cats and dogs, get gifts of food,

treats and toys from the Business Offices special pet

collection.

ROCKS!Bu

siness Office tmcs

Be Safe SaturdayFamilies from throughout the

community flock to TMCs an-

nual Be Safe Saturday, with

more than 100 interactive in-

formation booths, safety les-

sons, exercise sessions, car

seat inspections, and TMCs

safety mascot, Tomas the Tur-

tle. The event showcases the

Childrens Miracle Network,

TMCs Desert Kids Safety Pro-

gram, and dozens of commu-

nity organizations that share

an interest in family safety.

NICU at SchoolNICU nurses have shared their time and their

school supply donations with students at

Fort Lowell Elementary School. Its a chance

for the nurses to connect with children who

are a bit larger than the tiny babies in the

Newborn Intensive Care Unit.

8 9

Last summer provided painful lessons over and over again about the dangers of leaving children unattended around water whether its a swimming pool, a bathtub or even a cooler with water just a few inches deep. In 2009, there were 23 water-related in-cidents involving Southern Arizona children. Six were fatal. Tucson Medical Centers staff becomes in-volved with many of these tragedies at the point where fi rst responders are desperately trying to save a life. At TMC, we have the best doctors and nurs-es specializing in caring for children, said Melissa Moreno, Emergency Department manager. From the minute a child is brought through our doors by paramedics, the doc-tors and nurses do everything we can to save the childs life. We put in tubes to help them breathe, continue CPR, start medication IVs to get the heart to beat, but often it just isnt enough. Th ese children may have been underwater for minutes, depleting their brains of oxygen and fi lling their lungs with water, and their chances of survival are slim, Moreno said.

Often, all we can do is hope for a miracle, and we prepare for the next step which is comforting the family as we tell them we couldnt save their childs life. Recognizing the critical need in the commu-nity, TMC and Safe Kids Tucson enhanced their drowning prevention messaging and partnered with others in the community to spread the word. Th e key message for the community coalition is for anyone with chil-dren to follow the ABCs of Water Safety: Adult supervision, Barriers and Classes. Even in cases where we are able to save the child, months of hospitalization and therapy are often ahead, said Moreno, noting that education, vigilance and preparation are key. If you have children, I urge you to be vigilant around water and to become certifi ed in CPR. Early CPR has often been the diff erence be-tween life and death in these children.

the ABCs of water safetythe ABCs of water safetythe ABCs of water safetythe ABCs of water safetythe ABCs of water safetythe key to drowning preventionplant

services holiday fund

The crew at TMC Plant Services is used to x-

ing things and thats their goal as they raise

money throughout the year to help meet special

needs that certain families face during the holi-

day season.

The concept started with eight workers who felt

inspired to make a difference in a direct way, and

it has grown every year to about 20 employees to-

day. The group expects to accomplish even bigger

things as they look to the future.

The workers donate a little cash each payday and

hold fund-raising golf tournaments to support their

dedicated Holiday Fund. It can add up to a couple

of thousand dollars, all of which goes to make the

holidays special for several local families. In 2009,

the program added an Air Force family in need, as

part of the Davis-Monthan AFB family assistance

program.

Our guys do all the shopping, based on the list of

what these families need, said Derrell Blair, man-

ager, Plant Services. One change weve made

through the years: weve decided not to do the gift

wrapping ourselves. Not our strong point.

For the next holiday season, the team has set a

goal of $3,000 to enable the program to expand.

Theyd like to connect with a nursing home, to pro-

vide gifts for seniors in need.

10 11

Pal Evans was probably a freshman in high school when he figured out what he wanted to do with his life.He grew up in Coaldale, Pa. coal-mining country where his father worked as a rock contractor. One day his dad gave him a tour of the mine where he worked.

He said to me, Well, do you think you want to do this for the rest of your life? and I said, Heck, no, Evans recalled.

Evans uncle was a general practitioner, and the stories he told were fascinating to young Evans. The mine tour settled it.

A doctor was born

And now, after more than 40 years as a doctor and hos-pital administrator well-loved and respected in both of those roles Dr. Palmer Evans has decided to retire. July 9 will be his last day at Tucson Medical Center, one week before his 69th birthday.

Everything Ive done, Ive really enjoyed and loved, Ev-ans said. The relationships Ive had and the people Ive come across along the way its been wonderful.In recent weeks, Evans has found time to reflect on his career.

Two factors drove his decision to become an obstetri-cian-gynecologist. His mother and his aunt were two of the most important people in his life, guardian angels through tough times. And his first clinical rotation at Temple University medical school was in OB/GYN.

I got to deliver babies and I got to help with surgeries and I thought, Boy, this is really cool. I really love doing this. Thats how I got down that path. I never regretted it at all.

I never thought it was a bother to get up in the middle of the night to deliver a baby. I always thought I was partici-pating in a miraculous event, each time.

In 1972, as Evans was finishing his residency at the Uni-versity of Pennsylvania, he took the advice of Dr. Edward Wallach, who would become a renowned fertility expert and chairman of OB/GYN at the Johns Hopkins Univer-sity School of Medicine.

He had worked in Tuba City (on the Navajo Reserva-tion) and he said, If you really want a wonderful experi-ence, go to a hospital there, where youre the only OB, Evans recalls.

Lessons learned

During his two years at the Fort Defiance Indian Hospi-tal, from 1972 to 1974, Evans learned two of the most important lessons of his life.

It was the only time in my career when I was ever really needed, he said. Here in Tucson theres always someone to fill in for you. But not there. I was it. And there I was seeing things like bubonic plague and typhoid fever and a huge amount of toxemias of pregnancy I really learned a lot.

Dr. Pal Evans a career of service

10 11

Lesson Two: The Navajo view of life and death I was taking care of a Navajo woman who had a very malignant tumor of her uterus. I was sending her back and forth to the In-dian Health Service Hospital in Phoenix. One day the Fort Defiance ER called me and said Dr. Evans, Catherines here and it doesnt look like shes doing very well. So I rushed down and I said OK, Catherine, were going to start an IV...

And she looked at me and said, Dr. Ev-ans, Ive gone to all the medicine men, and Ive gone through all the healing cer-emonies, and Ive gotten all the treatment youve sent me for, and now its my time to go. And Im ready.

For Evans, it was hard to face. But I learned then and there that theres a time to go, and this was her time. And that I wasnt going to cure everybody.

Evans came to Tucson at the suggestion of a friend he had made while in training at Philadelphia General Hospital: Dr. James Lohman, who served at the former Davis-Monthan Air Force Base Hospital before completing his residency in Philadelphia.

Evans wound up at the former Tucson Clinic, for decades one of Tucsons two leading multi-specialty group practices.

He took classes through the American Col-lege of Physician Executives and became a local officer of the American College of Ob-stetricians and Gynecologists. He became a member of the TMC Foundation Board of Trustees in 1992, and played a key role in TMCs creation of a statewide managed-

care system, and subsequent exploration of merging with what was then the Samari-tan Health System in Phoenix. The merger idea was dropped in October 1996.

It was also that year that Evans gave up the obstetrics part of his clinical practice. He gave up gynecology three years later.

Important Lessons Three and Four

In 1984, Sally Evans was working with her husband as an OB/GYN nurse practitio-ner when she became seriously ill. The di-agnosis was lupus, a chronic auto-immune disease that has required her to be hospi-talized numerous times, and eventually forced her retirement.

I was bound and determined that as a physician, I was going to find the answer, so Sally wouldnt have to tolerate this, Ev-ans recalled. And I think the most impor-tant lesson I have ever learned in this life was that I couldnt solve her problems, and that she didnt need me to do that.

She didnt need me to be her physician. She needed me to be there for her. It re-ally helped me in my dealings with my patients. I could listen to them and empa-thize with them, better than before Sally became ill. And I was able to tell my pa-tients husbands what their role was, what they needed to do.

In March 1999, it was Pal who was hospi-talized for a triple coronary bypass sur-gery.

Looking back on it, that was a very posi-tive experience for me, Evans said. Num-ber one, Im doing well, but it also helped

me keep my priorities straight. You have to take care of yourself and your family, and everything else comes after that.

Evans will retire as Senior Vice President and Chief Medical Officer of TMC. He also has led the hospitals quality improve-ment efforts, and has overseen TMCs par-ticipation in a national pilot study of a new health care model, called the Accountable Care Organization, or ACO. It brings to-gether hospitals and physician groups who agree on ways to reduce costs while im-proving the quality of patient care. TMC is heading one of three ACO pilot projects nationwide.

Critical to how an ACO will operate is what Evans calls one of the transforma-tional things thats really going to make a difference in health care electronic med-ical records. Instead of paper charts, all pa-tient data will be kept in a secure computer system that can be accessed by hospitals and doctors involved in a patients care.

The electronic medical record allows for the integration of information, Evans said. It allows us to align everything so we can really do the right thing for our patients. Medical errors will go down. Patient safety issues will be addressed. Its going to make a huge difference.

Will there be bugs to work out? Of course, Evans said.

You have to realize, Im an eternal opti-mist, he said. I dont think theres any function for pessimism except to make you feel bad. Health care has been in a state of transition for the last 20 years. I

think theres hope. And what I like about TMC is the attitude and the commitment that we want to do things better.

After he retires, Evans expects to continue his role with the TMC Foundation, and with the hospitals Senior Services pro-gram. He is medical director of cardiac rehab, and would like to continue that, as well as his role with the Arizona Health-care Leadership Academy, and teaching with The University of Arizona Eller Col-lege of Management.

This actually is not the first time Evans has retired. He did so four years ago, but was asked to come back to TMC in 2007. But it sounds like this time is for real.

Sally and I want to enjoy our time to-gether. We love to load the dogs into the RV and take off, he said. And I want to spend a lot of time with my grandkids. They all live around here and its always fun to spend time with them. Ive missed that, so Im looking forward to it again.

12 13

Staff , physicians, families, friends and neighbors celebrated Tucson Medical Centers 65th anni-versary by lighting up the landmark Water Tower for the holiday season.

Hundreds of people enjoyed the cool early Decem-ber evening for an old-fashioned birthday celebra-tion complete with live music, corn dogs, lemon-ade, eggplants and cucumbers.

Th ats right eggplants and cucumbers. In recogni-tion of the initial planting of the TMC Community Garden, the 17th Street Farmers Market set up an area to sell fresh winter fruits and vegetables. Th e stand was nearly bare as dark settled in.

Mr. & Mrs. Claus, the Grinch, Frosty the Snowman and Santas helpers were on hand for photo ops and play; one lucky girl won a new bicycle for her win-ning coloring contest entry.

President Emeritus Donald Shropshire joined Presi-dent Judy Rich at dusk to fl ip the switch to a roaring crowd as 65 lit up in red and green on the historic Water Tower, the fi rst structure built on the campus in 1926.

Th e lights on the Water Tower were visible north to Sunrise Drive and beyond, and remained lit un-til the end of the year. When TMC fi rst opened its doors in 1944, it was far outside of town with no streetlights, let alone a blazing Water Tower or a green Grinch.

Over the years, TMC has grown as the city has grown, and will continue to be run by and for the people of Southern Arizona.

lighting it UP!

12 13

Jessica Grubb, a patient relations representa-

tive in the TMC Emergency Department, want-

ed to do something anything to support her

colleague, Becky Willis, RN, who was ghting

leukemia.

Grubb decided to rally friends and colleagues

from throughout the hospital to Light the Night in

honor of Willis by participating in the Leukemia &

Lymphoma Societys evening walk and fund-rais-

ing event held in late September. It is the nations

night to pay tribute and bring hope to thousands of

people battling blood cancers.

The planning team, headed by Grubb and her

colleagues in the Emergency Department and

Childrens Emergency Center, held bake sales,

donated money, raised money and walked for the

cause. Collectively they donated 327 hours to help

a friend and co-worker in need.

When all was said and done, TMC Emergency Ser-

vices was awarded the Gold Corporate Award for

the fund-raising success of $6,125; Becky Willis

received a Shining Star award for raising more than

$1,000; and Jessica Grubb received two awards

for her efforts. But, those awards were secondary

to supporting a friend.

The Leukemia & Lymphoma Society funds life-sav-

ing research that has contributed to major advanc-

es in the treatment of blood cancers and treatments

for other types of cancer, such as chemotherapy

and stem cell transplants. These treatments have

helped patients live better, longer lives.

leukemialight the NIGHT

Recognizing that heart disease is the No.

1 killer of Americans, Tucson Medical

Center is dedicated to improving heart

health. In 2009, TMC celebrated Heart

Week in October.

The week included a physician symposium,

free on-site screenings at TMCs fi rst Heart

Check and educational events for staff.

The Heart Check was a great success with

316 people showing up on a Saturday morn-

ing to receive the free screenings, which in-

cluded a carotid Doppler test, blood glucose

test, an EKG, education and more.

More than 60 TMC staff members volun-

teered, including physicians, physician as-

sistants and nurse practitioners. Look for

Heart Week, again, in October.

Lighting the Nightfor a Friend

tmc the HEART of the community

Becky Willis & Jessica Grubb

14 15

As Southern Arizonas largest hospital, Tucson Medical Center is both a top employer and a major economic driver in the region. Of TMCs $400 mil-lion in annual expenditures, more than 70 percent stays within the community and directly impacts the local and state economies. The largest piece of the hospitals annual expenditures is $200 mil-lion in salaries and benefits paid to more than 3,500 full- and part-time employees. And, of the $90 million in annual supply costs, more than 38 percent, or $35 million, is spent with Tucson and

Arizona vendors and suppliers.

Of the remaining $110 million in non-wage expenditures, 45 percent, or $50 million, benefit-ted the state and local economies. (Expenditures in this category include physician and other pro-fessional contracted services, new equipment and refurbishing, leas-ing, repair and maintenance, and community health expenses.) The result is more than $285 million directly impacting state and local economies. And, as a nonprofit community-owned hospital, TMC is able to

reinvest both in the hospital and in the community. Nonprofit status ensures that there are no stockholders with whom to share any earnings. And as a commu-nity-owned hospital, TMC does not send jobs or dollars back to a parent companys headquarters. Being community-based and nonprofit leaves millions of dol-lars here in Southern Arizona each year, said Steve Bush, TMC senior vice president and chief fi-nancial officer. And in 2009 the TMC Health-Care Board of Trustees approved

$120 million in refurbishment projects over the next five years, or an average of $24 million an-nually. Much of this money is spent with local contractors and professional firms. These construction dollars come at an opportune time, Bush said. Im sure the folks working on our pediatric build-out are not only proud to be building some-thing important for the commu-nity, but also happy to have the work. And were glad we have the financial wherewithal to give them the work.

bulk of $400M in TMC spending stays in regionBeing community-based and nonprofit leaves millions of dollars here in Southern Arizona each year

When parents send their child to school,

safety issues may not be foremost in

their minds. October 2009 was differ-

ent for the families of two students at

Townsend Middle School.

On separate occasions, just days apart,

two students were stuck by vehicles while

crossing Grant Road to meet friends. Both

accidents were just minutes from Townsend

and seconds from Tucson Medical Center.

Townsend principal Barbara Kohl and TMC

Security director Bill Fleming stayed with the

students as they received treatment from

paramedics. Both students recovered and

returned to school, but the impact of their

accidents was life-changing for all involved.

A community team dedicated to improving

student pedestrian safety around Townsend

Middle School went into action. Brain-

storming sessions involved partners from

the school, Tucson Unified School District,

Pima County Bike & Pedestrian Safety, Tuc-

son Police Department, the Governors Of-

fice of Highway Safety, City of Tucson and

TMCs Community Outreach team.

A walk about around the school property

identified areas of concern, and quick fixes

were made. Action plans are in the works,

including traffic sign and signal upgrades,

sidewalk improvements and classroom pe-

destrian-safety instruction.

TMCs commitment to improving the health

and safety of the community extends in very

real ways to the streets and sidewalks sur-

rounding the hospital campus.

townsend traffic SAFETY

14 15

Jennifer and Trent Humphries know

how fortunate they are to have three

healthy children especially since last

August, when their youngest had to be

hospitalized with a common stomach

virus.

The stomach flu made its rounds

through the Humphries household, and

21-month-old Rebekah was the last to

become ill.

I took her to the doctor after a couple

of days, because she just wasnt getting

better, Jennifer said. The doctor told us

what to do at home, but it still wasnt get-

ting better, and by about the fifth day, she

woke up too weak to lift her head up.

The familys pediatrician arranged for

Rebekah to be seen immediately in the

Childrens Emergency Center at TMC.

From there the toddler was admitted and

treated with IV fluids and other medica-

tion. She was able to go home two days

later.

Rebekahs hospital bill amounted to

about $4,200 charges the familys high-

deductible insurance plan would not pay.

Jennifer and Trent, who have their own

computer-repair business, arranged to

make monthly payments. They hoped to

pay off the bill by the end of the year.

But after they made two payments, the

rest of their bill was paid by the Commu-

nity Care program, which is funded in part

by donations to the TMC Foundation.

Rebekah was really, really, really sick, and

she received wonderful care, Jennifer

said. Of course, we wanted to pay the

bill. But these are tough financial times,

and we really appreciated the help. It was

a very scary experience, but it turned out

to be a wonderful experience, and TMC

was great.

a bad caseof the fluA sudden illness, a serious car accident or other medical crisis can happen to any-one, at any time. And for many people even

those with health insurance being faced with a hospital bill only adds to the crisis. TMCs Community Care policy provides fi-nancial assistance to families and individuals who are unable to pay their share of the cost of their hospital care. As a nonprofit commu-nity hospital, it is TMCs mission to deliver quality care to all patients, regardless of their ability to pay. Community Care helped 2,941 patients in 2009, reducing the amount they owed by a combined total of more than $6 million. Heres how the policy helped two families last year: A Healthy Couple for 26 Years

Kevin and Cheryl Konow will celebrate their 32nd anniversary May 13. For the first 26

years of their marriage, they enjoyed good health and the financial security that came from running their own cotton-harvesting business near Yuma.

Then in 2004, Kevin suddenly became criti-cally ill with a disease called Guillain-Barr syndrome, which left him temporarily para-lyzed from the neck down. The couple had no insurance to cover the $200,000 cost of Kevins month-long stay at TMC, most of it in intensive care. Their assets made them ineligible for AHCCCS, the states Medicaid program. The Konows wanted to pay their bill, and worked out a plan with TMC in which they agreed to pay $10,000 at the end of each har-vest season. They continued with their harvesting busi-ness until last year, when Kevin suffered a re-lapse of Guillain-Barr, which left him with

community CARE

continued on Page 20...

Community Care helped

2,941 patients in 2009,

reducing the amount they

owed by a combined total

of more than $6 million.

tmc

16 17

TMC nurse Marcie Paradise was work-ing her shift in the hospitals progres-sive critical care unit when her leg went numb.

I thought, oh my gosh...Im having a stroke, she recalled. Then, I said, No, no, thats impossible. It probably just fell asleep.

But then, her arm went numb. Looking for an aspirin to chew, she could only find an Excedrin in her purse. She tried to eat some yogurt, but kept missing her mouth.

Im having a stroke! Paradise cried out in the nurses lounge. I just burst into tears. It was so terrifying. This all happened within five minutes. Another nurse quickly helped her into a wheelchair and pushed her quickly to Neurology.

It was there that TMC Stroke Director David Teeple, M.D. and the new Neuro Red protocol saved Marcies life.

Neuro Red is a process we put in place to identify stroke patients quickly so we can provide effective therapy in an efficient manner, said Teeple, who championed

the project last year and has since person-ally trained emergency room staff, rapid response nurses and critical care nurses to recognize possible stroke symptoms of incoming patients.

Stroke is the third leading cause of death in the United States. TMCs acute stroke response team responds to strokes 24 hours a day, seven days a week. A neurol-ogist is also on call 24 hours a day.

Like a Code Blue, a Neuro Red demands immediate attention as doctors must evaluate the patient and determine

whether the stroke is the result of a blood clot (ischemic) or a burst blood vessel (hemorrhagic). There are over 700,000 strokes per year, 85 percent of which are ischemic. The only FDA-approved treat-ment for ischemic stroke is tPA, or tissue plasminogen activator, a powerful clot-busting drug. However, its only effective if given within 4.5 hours of the onset of symptoms. If the stroke is hemorrhagic, blood thinners must be avoided.

Neuro Red is successful at TMC because it brings together physicians from Neurology, Neuroradiology, Emergency

TMCs NEURO RED Process Calls Attention to StrokeStroke is the third leading cause

of death in the United States.

TMCs acute stroke response team

responds to strokes 24 hours a day,

seven days a week. A neurologist is

also on call 24 hours a day.

Marcie Paradise, TMC nurse

16 17

Truth be told, children dont really want to go to the hospital.Thats why Tucson Medical Center launched its Child Life program to meet the social, emotional and psychological needs of their youngest patients. With funding from the Childrens Miracle Network, the child life specialists have the necessary tools to help children feel as comfortable as possible in the hospital and even find some fun and happiness while they are there.

Child life specialists are trained professionals whose expertise is helping children and their families through difficult life events, said Child Life manager Jolene Eggert. Children process information much differently than adults, so it is our job to understand and ensure that we help them through these challenging events to ensure they do not have lasting negative effects. Whether its showing a movie while the child undergoes a fluoroscopy test or facilitating a medical play session, child life specialists provide age-appropriate distractions for children and help prepare them for medical procedures using anatomically correct dolls and other tools that can reach children at their individual developmental level. They also help parents adjust to the difficulty of having an ill child by providing resources and education about what to expect for the family.

Children who have access to child life specialists have a much easier time being in the hospital because, no matter how ill they are, the specialists can bring some joy into their hospital stay, said Dr. Mary Cochran, a Tucson pediatrician who serves on the TMC Board of Trustees. Individuals who are interested in becoming child life specialists receive their college education, training and certification to work with hospitalized/ill children. They work throughout the hospital, including the pediatric units, fluoroscopy area, surgery and emergency departments. TMC is committed to caring for children, but it would not be possible to have as many child life specialists as there are currently in several areas of the hospital without the support of Childrens Miracle Network, said Cochran.

child life specialists easeyoung patients hospital visits

and Neurosurgery, in addition to other disciplines including Nursing, Pharmacy, Radiology, Laboratory, and physical, occupational and speech therapy to provide collaborative care. They also meet monthly to review the effectiveness of the process and look for ways to improve it.

Paradises stroke was caused by a blockage in one of the brains blood-carrying arteries. She was given tPA and recovered over the next few days in the intensive care unit. Her symptoms ultimately resolved and, one year later, she has no residual problems.

You hear about people waiting in the ER for 12 hours, sometimes more, said Teeple. Most stroke victims are not fortunate enough to have a stroke in the hospital. My hope is to give any patient who comes into TMC with ischemic stroke the same chance that Marcie had.

NEURO RED is

a process we put

in place to identify

stroke patients

quickly so we can

provide effective

therapy in an

efficient manner

Dr. David Teeple, TMC Stroke Director

18 19

Sula is an agricultural community of about 3,000 people in western Honduras, one of the poorest countries in Central America. But Sula grows great coffee beans and pineapples, and has its own 26-bed hospital. And, thanks in part to a crew of compassion-ate doctors, nurses and others from Tucson Medical Center, the residents of Sula receive excellent health care. A TMC team of about 25 has traveled to Hospital Centro Socorro de lo Alto for a week to 10 days every January for the last four years. They deliver babies, replace farm workers worn-out hips and knees with state-of-the-art artificial joints, treat children with chronic ear infections, fit older residents with hearing aids the list goes on. Patients pay what they can. Some pay nothing. All are grateful. We all like to do this, and we get a lot out of it, said Dr. Donnie Sansom of Old Pueblo Anesthesia, a member of the TMC volunteer team. Every time you give to the people of Sula, you get a lot more, emotionally and spiritually, Sansom said.

The Honduran people are very kind and loving and they say thank you. They wait for 12 hours to see a doctor and they dont complain. Youre not buried in paperwork. It keeps you refreshed and focused on what medicine is all about. Since 2003, the hospital has been a part of Evange-listic International Ministries based in Arkansas, with no affiliation to TMC. A Honduran obstetrician-gy-necologist serves as director of the hospital, which has its own support staff. But it depends almost en-tirely on doctors and other health professionals from across the United States who volunteer their time and skills. The hospital also relies on donations of cash, medi-cations, equipment and supplies everything from Band-Aids and pencils to ventilators, laboratory equipment and surgical tables. This January we worked on a gentleman who had been waiting for an artificial hip since last year, San-som said. His artificial hip was donated, as was his doctors time. Now he can walk without pain.

tmc team tends to rural Hondurans

18 19

While walking through the TMC

hallways, you may detect laugh-

ter therapy in action.

Sounds of Ha, ha, ha and ho, ho,

ho are signs of simple stress-reliev-

ing techniques taught to hospital

staff by Dr. Gulshan Sethi, TMCs

medical director of cardiothoracic

surgery. As a richly accomplished

surgeon, Sethis recent interest in

integrative medicine has everyone

laughing for joy.

Laughter therapy consists of three

components, including a series of

breathing exercises and stretching

and a period of unconditional laugh-

ter exercises, followed by guided

relaxation. Sethi reminds us that

people who fail to smile or laugh in

stressful or uncomfortable situations

may be more prone to heart prob-

lems.

Laughter in the workplace is conta-

gious and does not require any spe-

cial equipment or space. It is one of

the most economical and easy-to-

practice anti-stress measures.

Children laugh out loud more than

300 times each day. Its time to join

in the fun! Take time daily to breathe,

stretch and laugh and enjoy the

long-term benefits of better health.

laugh your way to a healthier life

tmc team tends to rural HonduransChronic ear problems are common in children in Honduras, and doctors from Tucson Ear Nose and Throat have joined the TMC group, providing medi-cal and surgical care to save childrens health and hearing.

Our presence grows each year, Sansom said. Next year our plan is to teach CPR to the Honduran nurses who have never had CPR training. Im a CPR in-structor and my Spanish is limited, but one of the techs here is bilingual and shes going to go down and work with me on it. The nurses there are very hard-working and very bright, and willing to learn. Hospital Centro Socorro de lo Alto has its share of challenges, Sansom said. The power will go out. The water will go out. The equipment will break down. Thats how it is. You stretch yourself. Youre outside the box.

The power will go out. The water will go out. The equipment will break down. Thats how it is. You stretch yourself. Youre outside the box.

Dr. Gulshan Sethi, TMCs medical director of cardiothoracic surgery

20 21

In 2009, TMC Foundation celebrated a quarter-century

relationship with Childrens Miracle Network, bene ting

childrens services at Tucson Medical Center.

TMCs affi liation began the year after CMN was founded in

1983 with the commitment that funds raised through the

nonprofi t organization remain in the local community. The fi rst

CMN telethon in Tucson was held on KVOA-TV Ch. 4 in May

1986.

Since then, various telethons, radiothons and corporate fund-

raising events in Tucson have generated more than $10 mil-

lion and every penny raised here has stayed here to support

TMC for Children.

Planning is underway for Aug. 25-27, when TMC will again

take to the airways with Clear Channel Radio and 92.9 The

Mountains morning show for a radiothon to share TMCs story

about taking care of the children of Southern Arizona.

children at TMC benefi t from

no muscle strength from the waist down. He was hos-pitalized again at TMC, this time at a cost of about $8,000. By the end of last year, the Konows had paid $44,500 to the hospital. And after reviewing their situ-ation, TMC chose to write off the rest of their balance. Th e hospital also helped Kevin fi nd discount plans to help cover the cost of his medications.

Kevin gets around by wheelchair and is too weak to operate his harvesting equipment, so he now teaches others how to repair and maintain farm equipment. Cheryls full-time job, she said, is helping Kevin get around.

We just deal with this as best we can, Cheryl said. TMC was great with us. Its possible we could never have paid off that bill. Th ey were just a blessing. Th ey gave us a second chance at life. Jean Newton, manager of TMCs patient fi nancial services offi ce, said she and her staff gladly took the Konows under our wing. Th ey are wonderful, diligent, hard-working people who made every eff ort to pay their bill.

community CARE

...continued from Page 15

25 years of CMN support

Jean Newton

20 21

From left to right: Eric Anctil, Russ Cohen, Joel Goode,

and Luis Esparza take a break during their week-long

humanitarian mission to Haiti.

A boy is all smiles on his fathers lap after

getting his arm treated by Tucson physicians.

The three orthopedic surgeons and one

anesthesiologist traveled to Haiti to provide

medical assistance to earthquake victims.

With support from their practices, the community, and TMC, four physicians with strong TMC ties traveled to Haiti in January to help with earthquake relief efforts. Drs. Russell Cohen, Joel Goode and Eric Anctil of Tucson Orthopaedic Insti-tute were joined by Dr. Luis Esparza of Old Pueblo Anesthesia. TMC employees and community members stuffed two shuttle buses with goods to aid Haitis earthquake victims. The goods were delivered to Haiti by World Care, an international relief organization based in Tucson.

Help in Haiti

22 23

Cardiac CareThe cardiac care services at TMC combine leading medi-cal and surgical specialists with expert staff and state-of-the art equipment to treat patients in all stages of cardiac disease.

Our cardiac catheterization suites are equipped to provide diagnostic and treatment procedures performed by cardi-ologists, nurses and technologists.

Two operating rooms are dedicated to cardiothoracic and cardiovascular surgery. And our cardiac diagnostics pro-gram includes exercise stress testing, echocardiography, heart monitoring and other services. Childrens CareTMC is an associate member of the National Association of Childrens Hospitals and Related Institutions the only NACHRI member hospital in Southern Arizona. Being an associate member reflects TMCs commitment to chil-drens health care.

TMC for Children includes the regions first dedicated Childrens Emergency Center, the only pediatric hospice and the only pediatric gastrointestinal laboratory.

TMC for Children offers inpatient and ambulatory sur-gery programs with dedicated pediatric anesthesiologists and child-life specialists, and also includes the hospitals acclaimed Newborn Intensive Care Unit, Pediatric Inten-sive Care and Pediatric Therapies. Behavioral HealthPalo Verde Hospital provides behavioral health services based in a community hospital setting. We have 48 adult inpatient beds, intensive outpatient programs for adults

and seniors, and 24-hour crisis and evaluation services. Our diverse team of behavioral health professionals works in an atmosphere of collaboration, providing care to our community since 1960.

Emergency CareTMCs Emergency Department is the largest in Southern Arizona, caring for close to 100,000 patients each year. About a third of those patients are children, who receive specialized care in Tucsons first Childrens Emergency Center. TMC has dedicated a separate area with child-fo-cused equipment and staff to serve the families of South-ern Arizona. NeurosciencesTMC and the Center for Neurosciences provide non-stop neuroscience care, staffed 24 hours a day with neurosur-geons and neurologists. The TMC Neuroscience Center offers the regions most comprehensive diagnostic and treatment services for patients with neuromuscular and neurological disorders, including treatment for Parkin-sons disease, brain tumors, epilepsy, multiple sclerosis, cancer, strokes, seizures and other brain, nerve and sleep deprivation disorders.

The facilities include two neurosciences operating rooms, a neurointensive observation unit, a neuronursing unit, epilepsy monitoring units for both adults and children, a Sleep Diagnostics Lab, a Neurophysiology Lab, and a neuroradiology biplane, the gold-standard for state-of-the-art multi-dimensional brain scanning. Imaging and Diagnostic ServicesTMC provides a full range of imaging and diagnostic services including X-ray, mammography, CT scan, ul-trasound, MRI, EEG, EMG, diagnostic radiology and

nuclear medicine imaging. TMC offers imaging services in a family-friendly environment, with an emphasis on low-dose pediatric imaging and designated kid-friendly waiting areas. Since 2008 TMC provides all-digital im-aging services, eliminating the need for film and allow-ing doctors to look at results and images from their office computers.

Intensive Care UnitsTMC has adult, cardiac, pediatric and newborn Inten-sive Care Units, all with state-of-the-art equipment and specialized nursing staffs specially trained to care for the complex needs of critically ill patients. MaternityTMC continues to deliver the most babies in Southern Arizona, with the family-oriented, specialized obstetrical and newborn expertise to support expectant mothers and families throughout the pregnancy and birthing experi-ence. Experienced anesthesiologists, perinatologists and neonatologists are available at all hours.

tmc services

continued on Page 24...

22 23

giving moreTMC will report more than $33.4 million in community bene t and charity care for 2009. This is a $5 million increase over 2008 reporting. TMC utilizes the commu-nity bene t standards endorsed by the American Hospital Association.

What makes up this number?Uncompensated care includes both charity care and bad debt. Charity care is free or dis-counted health services provided to people who can demonstrate that they do not have the means to pay the full cost of care and who meet the organizations fi nancial-asistance policy criteria. Bad debt consists of services for which the hospital anticipated but did not receive payment. Charity care and bad debt are reported in terms of costs, not charges.

For more information about TMCs charity care policy, visit www.tmcaz.com.

Nonprofi t hospitals also report unpaid costs of public programs for low-income people the shortfall created when a facility receives payments that are less than the cost of caring for public-program benefi ciaries. Community benefi t programs and activities provide treatment or promote health and healing as a response to identifi ed commu-nity needs. These programs and activities help improve access to health care services, enhance the health of the community and advance medical knowledge.

Uncompensated Care (Charity Care and Bad Debt) .....$14,908,079Unpaid Costs .............................................................$ 9,997,656Outreach & Education .................................................$ 8,554,493Total ..........................................................................$33,460,228**unaudited gure

community benefi t as reported in community benefi t as reported in 2009

community benefi t as reported in community benefi t as reported in 2009

community benefi t as reported in 2009 benefi tcommunity benefi t as reported in benefi tcommunity benefi t as reported in community benefi t as reported in community benefi t as reported in 2009community benefi t as reported in benefi tcommunity benefi t as reported in community benefi t as reported in 2009community benefi t as reported in

giving back

unpaid costs

29.9%

bad debt

25.6%

27.3%

outreach & education

17.2%

charity care

24

Senior ServicesTMC Senior Services offers a variety of programs and support, including services during the hospital stay and after patients go home, plus year-round wellness programming and volunteer opportunities. This unique program is headquartered on the El Dorado Health Campus.

Therapy ServicesTMC Therapy Services is committed to providing the high-est quality of care with specialized staffing and innovative pro-gramming. Multidisciplinary teams of dedicated health care professionals make it possible for patients of all ages to access the appropriate intervention and treatment at each point in the therapy continuum.

We offer services for inpatient acute therapy, assistive technol-ogy, audiology, cardiac rehabilitation, hearing aids, pediatric therapy and stuttering therapy. Working in a team approach, experienced and specialized staff provides multiple levels of care. Our therapy staff includes physical therapists, occupa-tional therapists, speech-language pathologists, audiologists, exercise physiologists and registered nurses.

Respiratory CareTMC Respiratory Care helps patients achieve the optimum level of daily functioning through goal setting, assessment and monitoring. The team provides diagnostics and therapeutic services, disease management, health promotion, and patient and caregiver education.

Respiratory therapists assess and treat respiratory ailments, including chronic lung conditions such as asthma, bronchitis and emphysema, as well as more acute multi-systemic prob-lems stemming from other conditions such as heart disease, stroke or trauma. Specialty services include bronchoscopy, hyperbaric oxygen therapy, pulmonary function testing and sweat chloride testing.

Recognizing the staffs commitment to their patients, the Ari-zona Society of Respiratory Care honored TMC Respiratory Care last August as Arizonas Department of the Year. Other ServicesTMC offers many more programs serving Southern Arizonans from birth to the end of life. More information about pro-grams such as therapies, gastrointestinal, vascular and much more is available at www.tmcaz.com.

Saguaro PhysiciansSaguaro Physicians LLC offers the community a healthy vari-ety of medical services. Primary care providers and specialists deliver care in internal medicine, family practice and rheu-matology with quality and convenience as their cornerstones. Saguaro Physicians offices are in growing neighborhoods throughout the north, east and southeastern sections of town. In 2009, TMC HealthCares employed physician group went live with its electronic medical record. Once TMC goes live in June with its system, both the physician and the hospital will have access to a patients medical records. TMC FoundationTMC began with a single act of philanthropy when Mrs. Anna E. Erickson donated land to the community for the develop-ment of a much needed-hospital. A legacy of community sup-port continues today through the TMC Foundation. As Tucson Medical Centers charitable arm, the TMC Founda-tion is able to touch the lives of people throughout Southern Arizona. Gifts to the foundation go toward funding the latest in life-saving medical equipment, improving facilities, provid-ing educational programs for TMC patients and staff, and pro-moting community well-being and safety.

tmc services...continued from Page 22

TMC HealthCare Board of TrusteesLouise L. Francesconi, Chairwoman

Matthew Atlas, M.D.

Henry K. Boice

Michael W. Bracht, M.D.

Mary E. Cochran, M.D.

David J. Cohen

Susan L. Ernsky

Manuel M. Ferris

Lou Lancero, M.D.

Eduardo A. Leon

Michael R. Probstfeld, M.D.

Richard M. Moreno

Judith F. Rich

David F. Peachin

Joel D. Valdez

Jon R. Young

TMC Medical Executive CommitteeMatthew Atlas, M.D., Chief of Staff

Michael Probstfeld, M.D., Chief of Staff Elect

Department ChairsJ. Manuel Arreguin, M.D.

Brian Cammarata, M.D.

Christopher Florence, M.D.

Thomas Harmon, M.D.

Steven Ketchel, M.D.

Eva McCullars, M.D.

Moira L. Richards, M.D.

Steven Siwik, M.D.

George Wilcox, M.D.

Section ChiefsRobert Aaronson, M.D.

Michael Badruddoja, M.D.

Susan Bazzell, M.D.

Richard Callihan, M.D.

Amram Dahukey, D.P.M.

Charles Daniel, M.D.

Joel R. Goode, M.D.

Michael Hamant, M.D.

Barton Hodes, M.D.

David Killion, M.D.

Michael Lavor, M.D.

Douglas Lowell, M.D.

Marco Marsella, M.D.

Brandon Massey, M.D.

Ann OConnor, M.D.

Doug Peterson, M.D.

Ronald Quintia, M.D.

Gulshan Sethi, M.D.

Mohammed Sikder, M.D.

Keith Soderberg, M.D.

Paul Yurkanin, M.D.

TMC Foundation Board of TrusteesDavid J. Cohen, Chairman

Ann M. Aros

Henry K. Boice

Joni S. Condit

Palmer C. Evans, M.D., Life Trustee

Dorothy Finley, Life Trustee

Louise L. Francesconi

Anne M. Fulton-Cavett

Christine Kocsis

Christopher Maloney, M.D.

Sidney N. Mendelsohn, Jr.

Kevin Morrow

David F. Peachin

Rory R.J. Riley

Alan K. Rogers, M.D.

Keri Lazarus Silvyn

Alan Stein

Karen Thurman

Arlene Webster, R.N.

Jim Zarling

TMC Community Affairs recipientsAs corporate citizens in the Southern Arizona community, Tucson Medical Center provides support to other nonprofit organizations serving the region. Last year, TMC provided $239,535 to these important community partners. Below is a list of some of the organizations receiving financial support from TMC.

American Cancer Society

American Diabetes Association

American Heart Association

American Lung Association

American Red Cross

Ara Parseghian Medical Research Foundation

Arizona Chapter American Parkinson Disease

Arizona Blind & Deaf Childrens Foundation

Arthritis Foundation

Big Brothers Big Sisters of Tucson

Boys & Girls Club

Caregiver Consortium

Casa de los Nios

Childrens Action Alliance

CODAC Behavioral Health Services

Community Food Bank

Diaper Bank of Southern Arizona

Educational Enrichment Foundation

El Rio Community Health Center Foundation

Epilepsy Foundation of Arizona

Hispanic Scholarship Program for Southern Arizona

Juvenile Diabetes Research Foundation

Susan G. Komen, Southern Arizona

Leukemia and Lymphoma Society

Lupus Foundation

March of Dimes

National Alliance of Mental Illness

National Multiple Sclerosis Society

New Beginnings for Women & Children

Pima Community College

Pima Council on Aging

Ronald McDonald House

Southern Arizona AIDS Foundation

Southern Arizona Center Against Sexual Assault

Southern Arizona Red Cross

St. Lukes Home

Tucson Interfaith HIV/AIDS Network

Tucson Childrens Museum

Tucson Clean and Beautiful

Tucson Jewish Community Center

Tucson Nurses Week Foundation

University of Arizona

University of Arizona Hispanic Scholarship Endowment

Volunteer Center of Southern Arizona

Womens Foundation of Southern Arizona

YWCA

Our Mission: Tucson Medical Center delivers caring, personalized, quality health care to patients and their families in an environment that is supportive and compassionate. Report to our Community CreditsPublisher: Judy Rich, President and Chief Executive OfficerExecutive Editor: Julia Strange, Vice President, Community BenefitEditor: Cheryl KohoutGraphic Design: Nancy SerenskyContributing Writers: Jane Erikson, Tara Kirkpatrick, Marni Dittmar, Bruce Chandler, Michael Letson, LDon SawyerPhotography: Eric Suhm, Bruce Chandler, Erik Hinote, Dr. Donnie Sanson, Dr. Luis EsparzaCreative Strategy Team: Cheryl Kohout, Michael Letson,Christel Pettengill, Hope Thomas, Hilton & Myers Advertising, Raim & Associates LLC, Strategic Issues Management Group With special thanks to the TMC Community Benefit Task Force, TMC Financial Services, TMC Foundation, the TMC HealthCare Board of Trustees and the thousands of helping hands who make a positive difference every day. TMC HealthCare, 5301 E. Grant Road, Tucson, Arizona(520) 327-5461 www.tmcaz.com

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TMCs Report to Our Community