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THE PulseTHE PULSE is a publication of Community Relations

Questions regarding THE PULSE should be directed to:Editor - Michele Cohen, 336-7545 Corporate Communications Specialist

Editorial BoardSharon Gardner - Vice President, Human ResourcesMachele Headington - Director of Community RelationsTeri Norris - Director of RecruitingAlex Wade - Director of Compensation and BenefitsLaura Witek - Retention Specialist

Transit ions

Leslie Dalton, Director of Pediatrics/Women’s, has changed hats to become Director of Clinical Education. This is the first time that Leslie will not be working on a patient unit. As director of Clinical Education, Leslie is responsible to collaborate with leadership in making sure that all education objectives are met and that they are in line with YRMC’s strategic organizational goals. Clinical Education works with all types of clinical staff to evaluate the needs of the community and make sure YRMC has the resources to have better patient outcomes.

“It’s a challenging opportunity to help develop educational program that help others see the importance of aligning with the strategic goals,” Leslie said. She plans to focus on moving the clinical educators closer to the bedside so they can evaluate and assist with the education needs of YRMC’s clinical staff.

As a founding member of the Interdisciplinary Practice Council (IPC), Leslie has been working on policies and procedures that affect the patient care units hospital-wide for more than 10 years. For the past four years, she has been the facilitator for the IPC.

Leslie Dalton leads Clinical Education team

Judie McGinnis becomes Cardiopulmonary Services directorJudie McGinnis has been promoted to Cardiopulmonary Services director. She was previously Clinical Resources Coordinator for respiratory therapy and was interim director since February. Cardiopulmonary Services includes Respiratory Therapy, the Sleep Lab, EKG, EEG, echocardiogram, and Phase 1 and 2 of Cardiac Rehabilitation.

“Our department has been very supportive. It’s been an almost seamless transition,” said Judie, who has been a respiratory therapist at YRMC for 24 years. “YRMC is a really good place to work.”

Judie became interested in respiratory therapy after she learned about the field at a career camp. “I have allergies and respiratory therapy sounded interesting and a good thing to get into with a lot of career opportunities.”

On the coverRobin Harrison: Our Super Star

Robin Harrison, a physical therapist with Children’s Rehabilitative Services, is our newest Super Star. Robin, who spends most of her time working with children in Yuma schools, has demonstrated her dedication and commitment to the community in by helping children in need. She launched the Loan Closet Center for adaptive equipment for children. The center holds fundraisers and accepts donated equipment. It loans medical and mobility equipment to children who need it. When a child no longer needs the equipment, the Loan Closet refurbishes it and loans it out again.

“This was a nice surprise,” Robin said when she was presented with her Super Star award. Robin has been a part of the YRMC team for nearly 10 years. She is the third person to be honored with this award from Children’s Health Services.

Congratulations, Robin, for setting an example at YRMC!

Departments throughout YRMC are collaborating to improve patient services as part of our Six Sigma effort to achieve world-class quality.

The Emergency Department continues to looks for the key drivers that affects how long patients stay in the unit, and is examining how staffing varies with the time of day. The 2 p.m. Discharge project continues to study factors that could make a difference in the time of day patients leave, with the hopes of performing rapid cycle testing.

In this wave of Six Sigma, four additional groups have been formed: Smoking (chaired by Mark Hutsell); Wayfinding (chaired by Machele Headington); Employee Contact information (chaired by Dan Thelen); and OR throughput (chaired by Phyllis Abbott).

Currently, there are three sources of information about phone numbers for employees – Outlook, the Intranet; and Employee Self Serve. The information, however, does not match from these sources must of the time. The goal is to increase the accuracy and completeness of the information to 90 percent.

JOURNEY TO

Excellence

EXCELLENCE

YRMC is in the beginning stages of training a team to place peripherally inserted central catheters (PICC lines) at the patient bedside. A portable ultrasound allows nurses to place PICCs in the upper arm of patients whose veins aren’t visible or palpable, significantly improving the odds of a successful insertion. PICCs are gaining popularity due to the ease of insertion using ultrasound; they are cost-effective and have fewer serious complications.

We have initiated a training and preceptor program for nurses using portable ultrasound. A highly skilled PICC nurse consultant is creating a “train the trainer” program as we assume the demand for PICCs will continue.

Placement of PICC lines is currently being done in Interventional Radiology. By moving them to the patient bedside, it will free up the room for more complex procedures and patients will be able to have a PICC line placed sooner.

Vascular access is vital to the administration of IV medications and solutions. Without IV access, patients are unable to receive prescribed treatments and may experience delays in therapy, slower recovery, and extended length of stay. PICC lines have become the central line of choice for patients receiving IV therapies longer than 5 days.

Our main goal is to meet all of a patient’s long-term medication delivery and phlebotomy needs with one device and one insertion attempt to reduce the risk of complications associated with multiple venipunctures.

A secondary goal is to decrease lengths of stay by providing the patients with proper vascular access devices to facilitate discharge.

Patients who might need a PICC are identified at admission or at the beginning of medication treatment. Nurses are working in collaboration with physicians to determine the best vascular access device for the patient and inserting and managing the care.

Lean Six Sigma update

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Improving patient carePICC lines to be placed at patient bedside

The staff of 2 West had identified a needed improvement: ensuring that chemotherapy supplies were readily available on our unit. There have been occasions when there were delays in starting chemotherapy because we didn’t have the right supplies. They convened a group including Marla Moore (2 West director), Bob Goodwille (representing Pharmacy), Laurie Priebe (2 West Clinical Resource Coordinator), Brenda Henkel (2 West MSR), Arnold Tutson (Materials Management), and Johnny McGee (Materials Management). Arnold and Johnny have been successful in working with departments to set par levels, barcoding, and maintaining supplies at agreed upon par levels. Pharmacy has traditionally ordered chemotherapy supplies, and Brenda had to do special orders for chemotherapy supplies. It was agreed that: par levels would be identified on specific chemotherapy supplies; they would be scanned by Stores when scanning all other supply items; the supply need would be communicated to Pharmacy; Pharmacy would increase its ordering on a routine basis to meet the par level needs on 2 West; and when par level needs are identified, Pharmacy would send the chemotherapy supplies to 2 West.

By implementing this process, it eliminated the need for last minute scrambles to have supplies, and it will eliminate any possibility of having to delay chemotherapy on a patient due to lack of supplies.

Mulit-departmental collaboration uses Six Sigma to find solutions

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Project LinusSandy Smith, with the local chapter of Project Linus, presented 45 quilted blan-kets to Ana Hoffman of Pediatrics. The blankets come in various sizes and pat-terns from infant to teen. The patients can take the blanket home with them.

Project Linus plans to make as many blan-kets as possible for the unit.

More than 90 children and their families celebrated their achievements since being a patient in the NICU at the 2nd NICU graduation party. The party included a jumper for kids, basketball hoops, clowns, face and body painting, rock decorating, informational booths and an eating area with free food.

Group and individual graduation photos were taken of the babies and toddlers.

Maggot debridement therapy (MDT), also called larval therapy and biotherapy, is an option now available to patients at YRMC to help promote wound healing. Sterile medical-grade maggots are used to breakdown dead tissue and bacteria in the wound and to stimulate wound healing. A single treatment may vary from 24 hours to 72 hours resulting in complete or significant removal of dead tissue from the wound. Maggots separate the dead tissue from the living tissue and do not eat living tissue.

Maggot therapy provides an alternative for patients who cannot have surgery to debride a wound, for wounds too painful to be debrided at the bedside, and for patients with infected wounds resistant to multiple antibiotics. This treatment originated in ancient times, and was used in the United States in the early 1900’s until the advent of antibiotics in 1931. It has made a comeback in the last 15 years due to the increasing bacterial resistance to antibiotics.

Any non-healing, necrotic skin and soft tissue wound, regardless of underlying diseases or the location on the body, can be treated with maggot therapy. A “corral” is created outside the wound to keep the maggots within it. About 10 maggots, each less than one-eighth inch long, are used for every square centimeter of wound area. They are applied with a cotton swab. A mesh cover is placed on top and secured with waterproof tape to keep the maggots in the “corral” and dry gauze finishes the wound dressing.

“I watched everything. It wasn’t scary,” said Dorothy Leonard, the first patient having maggot therapy at YRMC. She said she was pleased with the results and it didn’t require her taking time off from work.

Editor’s Note: Behind the Scenes is a new occasional feature to help YRMC staff understand how everyone is part of the team to provide world-class patient care.

Healthcare providers depend on BioMedical Engineering to keep a variety of therapeutic and diagnostic equipment in tip-top shape. The six-technician staff works on both big and small equipment, from X-ray machines to patient monitors, medical telemetry, EKG machines, and in surgery. They make repairs and perform preventive maintenance. If the manufacturer requires the item be returned for repairs, BioMedical Engineering coordinates the process. They work with departments so they can plan for future equipment purchases when they learn that parts will no longer be available, help standardize equipment used by more than one patient care area and negotiate bulk discounts with vendors.

“We’re also a resource for departments looking for accessories and new devices,” said Steve Matowik, BioMedical Engineering supervisor. “And we can research to make sure you’re getting the best price.”

Matowik, a BioMedical Engineering employee for 22 years, says the biggest change during that time is the increased sophistication of equipment and increased reliability. For example, patient monitors used to have seven circuitboards; now they have three.

Because of the sophistication of today’s equipment, the minimum requirement for a BioMedical Engineering technician is an associate’s degree in electronic technology and bachelor’s degrees in clinical engineering and biomedical technology are being more common.

New treatment option provided by Wound Care

Behind the Scenes:A look inside BioMedical Engineering

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Books for young patientsAlfred Barajas-Ruiz, representing Kohl’s, presented 610 books to Jennifer Stanton, of Pediatrics, and Woody Martin, YRMC Foundation president. The books in-cluded copies of “From Head to Toe” and “The Secret Birthday Message,” both by Eric Carle, and Charlie Brown favorites by Charles Schulz. Kohl’s also sold these books at a special price of $5, with the proceeds going to the Foundation.

2006 World Breastfeeding Week – 25 years of protecting breastfeedingResearch is clear that breastfeeding is optimal nutrition and the perfect, life-sustaining food for babies. Breastfeeding provides nutritional and health advantages that last far beyond infancy and offers health benefits to mothers as well.

The theme of World Breastfeeding Week (August 1 to 7) is highlighting the importance of protecting breastfeeding in communities. It celebrates the 25-year history of the International Code of Marketing of Breastmilk Substitutes, which provides guidelines for the appropriate marketing of infant formula and bottle feeding products and challenges communities to provide a supportive environment.

Hospitals, clinics, workplaces, childcare centers and community businesses and organizations can all protect breastfeeding by establishing a breastfeeding-friendly environment and atmosphere. This can be done by providing places for women to breastfeed or express their milk, encouraging mothers to breastfeed and making appropriate referrals for assistance when needed.

Lactation consultants can help breastfeeding families throughout the entire period that mother and baby are breastfeeding. For more information or help with breastfeeding, call either Jackie Haney, RN, IBCLC at 336-1228 (YRMC) or for WIC clients, Dolores Messer, BA, IBCLC at 317-4500.

YRMC consultant BVA, Inc., recently was honored with the Microsoft Winning Customer Award for outstanding competitive efforts in the United States. This award was for their work to transition YRMC’s multiple network operating systems into a pure Microsoft platform. This included the move from Groupwise to Outlook 2003.

The amount of effort performed by Information Systems, New Horizons Training and BVA was critical to the success of YRMC’s new email application.

The transition to Outlook, by-the-numbers: l 8 months of planning and communicating upcoming changes l 408 users trained t 46 classes taught over 9 days l 288 hours, 3 staff members and 4 days to migrate the data t 1,261 users accounts t 207,733 messages migrated t 145,289 contacts migrated t 59 Conference Room/resource accounts t 24,324 appointments migrated l 224 hours and 14 staff to install Outlook 2003 on over 400 workstations t 72 hours of round-the-clock on-site Outlook support after first day of implementation

Work at YRMC earns honors

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Clinical credentials Five more YRMC nurses have earned the credential of Certified Medical-Surgical Registered Nurse. They are Nora Gambling, Amberly Hodgin, and Victoria Lohmann, (all of Yuma Regional Home Care,) and Carolyn Dowell and Melvina Mendez (of MedWest). The CMSRN recognizes those who have achieved the highest standards of medical-surgical nursing practice. It is awarded to those who have successfully completed the board certification test in medical-surgical nursing.

More congratulations Not to be forgotten in this year’s crop of YRMC grads are Edward Friedrich and Celia Renteria (both of Clinical Education). They were part of the group that obtained a Master of Science in Nursing from the University of Phoenix. Also Jean Wahl (Care Coordination) and Aurora Valenzuela (Womens/Pediatrics) each received a Bachelor of Science in Nursing from University of Phoenix.

Our YRMC athletesThree YRMC employees competed on a five-person team at the Camp Pendleton World Famous Mud Run on June 10, a 10K event with obstacles at Camp Pendelton Marine Base in Oceanside California. YRMC employees were

Elizabeth Hammonds (Volunteer Services), Sam Tawzer (Health Records) and Marty Schotten (Diagnostic Imaging). They finished the obstacle course in 1:51:15. Way to go Trailblazers!

Shay Andres (Community Relations) competed and finished the San Diego Rock and Roll Marathon on June 4. This is a 26.2-mile Boston Marathon qualifying event. The course starts near downtown San Diego and goes around Mission Bay finishing at the Marine Base. Shay, you rock!

Professional kudosTravis Gregory (Human Resources) has received his certification as a Human Resources professional from the Society of Human Resources Management. Travis is also the Yuma chapter president.

Helping Yuma industry growSharon Gardner (Human Resources) has joined the Board of the Greater Yuma Economic Development Corp. The mission of the non-profit public/private partnership is to expand economic activity within Yuma County by attracting commerce and industry to the region, and to assist in developing the region’s existing industry to its fullest potential.

Born March 20, 2006David Hernandez III (left in photo)

4 pounds 10 ounces18 1/4 inches

andJacob Carlos Hernandez

5 pounds 5 ounces18 1/2 inches long

Proud parents areTerri Hernandez (Administration)

andDavid Hernandez (Information Systems)

2 bundles of joy

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Reaching the STARS!The following staff have recently been caught in the act of doing something great. As a result, they are being recognized by the Star Recognition Program:Teresa Anglin Labor PoolBarbara Biro Employee HealthAlfredo Castillo LaboratoryJulie Catabay MedWestDonna Chapman LaboratoryLaura Federico ICUStephanie Garrett LaboratoryEdith Guislan ICUAmanda Guzman Labor PoolBob Hathaway Volunteer ServicesYolanda Holbrook Patient AccessLynette House MedWestSharon Lara MedWestLisa McGarry L.D.R.P.Norma Molina L.D.R.P.Winnie Moore Labor PoolMari Noel Diagnostic ImagingLori Nolte Care CoordinationBetty Norby Volunteer ServicesDaniel Padilla Diagnostic ImagingCelia Renteria L.D.R.P.Cindy Seely LaboratoryDawn Smith MedWestEdith Stanfield L.D.R.P.Fito Vasquez Plant OperationsDelores Watkins LaboratoryBelinda Young ICUBlanca Zamora Labor Pool

Healthcare Career CampStudents attending the Healthcare Career Camp got a behind-the-scences peek at SPD and learned how it fit into the processes needed to maintain Operating Rooms.

The camp helps students learn about the various departments and occupations that make up a hospital.

CorrectionB.J. Bellamy’s first name was incorrect in the June issue. Her full name is Beverly Bellamy. Her retirement photo appeared in the issue.

We apologize for the error.

Come to the Western Dance

featuring Craig Morgan

Saturday, Oct. 7Yuma County Fairgrounds

Tickets $50 each through Sept. 7; then $60. Active military $45 with ID.

(ticket includes tri-tip dinner)Buy online at www.yumaregional.org or

from the Foundation, x7045See the Intranet for payroll deduction form.

Proceeds benefit the YRMC School Health Care Program, serving uninsured children in six school districts throughout Yuma County.

Educational opportunitiesEssential Training Update: register on HealthStreamFriday, Sept. 15, 9-11 a.m.; CPR 11:15 a.m.-4 p.m., Corporate Center.

Employee CPR: All are 8:30 a.m.-1 p.m. at Corporate Center. Register on HealthStream; call x1373 for questions.Tuesday, Aug. 15 Tuesday, Aug. 29Tuesday, Sept. 12 Tuesday, Sept. 26

CPR Courses: All are 3-8 p.m. at Corporate Center. Cost $35 for course; $10 for textbook. Reservations required. Call 336-1373.Healthcare Provider Course:Monday, Aug. 14 Monday, Aug. 28Tuesday, Sept. 5 Monday, Sept. 11Heartsaver Course:Monday, Aug. 7 Monday, Sept. 25

CPR Challenge Course: One-hour course in CR1&2 for those with a current Healthcare Provider card (before it expires) and must have completed pre-test on HealthStream with at least 84 percent score. Free for employees; $25 for non-employees; book $10. Call 336-1373 to schedule your specific time.Tuesday, Aug. 22, 1-4 p.m.Friday, Sept. 15, 8 a.m.-noon

Heartsaver/First Aid: 9 a.m.-5 p.m. at Corporate Center. Cost $45 for CPR and first aid; $25 CPR only; $35 First Aid only; optional textbook, $10. Call 336-2336.Saturday, Sept. 16

2-day ACLS: 8 a.m.-5 p.m. at Corporate Center. Cost $100; textbook $40; handbook $15. Call 336-2336.Sept. 22-23

1-day ACLS: 8 a.m.-5 p.m. at Corporate Center. Cost $75; textbook $40; reference book $15. Call 336-2336.Saturday, Aug. 19

ACLS Challenge Course: Contact Clinical Education, 336-2336, to schedule an appointment for the 1-hours ACLS written exam. Participants may bring and use the reference book. Score 84% or better to be scheduled for a skills check-off on Friday, Sept. 22.

Leadership Training Calendar: register on HealthStreamCrucial Conversations, 1 p.m. – 5 p.m. Tuesdays for 5 weeks, starting Aug. 5, new Computer Lab 1, Corporate Center, presented by Teri Norris. Develop better communication skills and enhanced capacity for creating true dialog and understanding during challenging interactions. Must commit to attend all sessions, complete assigned reading and practice concepts between classes. Materials charge of $125 per person will be assessed to the participant’s department. Class size limited.

Part 2 — Leadership and Self-Deception, Wednesday, Sept. 13, 3-5 p.m., Corporate Center, presented by Troy Love. Follow-up class to the initial Leadership and Self-Deception half-day course. You must have attended the initial course and read the book, “Leadership and Self Deception” (copies available for check-out in the Medical Library).

2400 S. Avenue AYuma, AZ 85364-7127