St. Anthony's Spotlight Magazine April 2013 - St. Anthony's Medical ...

IN THIS ISSUE4 New names, same great care6 Better medicineapril 2013I heart St. Anthony’sPage 2One of St. Anthony’s cardiac teams: from left, Steve Parker, Radiology tech;David Morton, M.D., cardiologist; Lisa Slavik, R.N., B.S.N.; and Terri Marsh, R.N.

For top-notch cardiac care, I heart St. Anthony’sTerri Marsh, R.N., CardiacCatheterization, was sound asleepin her warm bed in the Fenton areawhen her beeper went off during thewee hours of a cold January morning.“Code stemi,” was the message,referring to a severe type of heartattack. Marsh was one of themembers of St. Anthony’s heart careteam on call that morning.“I know when I get that pageI have to get to the hospital in30 minutes,” Marsh noted. Shearrived in 15, and met with fellowteam member Lisa Slavik, R.N.,B.S.N., and their anxious patientand his family in the EmergencyDepartment.William “Bill” Griffin, 66, wasashen-faced. He hadn’t been in ahospital as a patient for 40 years.His wife, Ellen, sat beside him, stillwearing her print pajama pants.Griffin had awakened about 2 a.m.at his home in Arnold, suffering dullchest pains. Initially he had brushedoff the discomfort, thinking he hadheartburn. But when he sat down athis computer and broke into a coldsweat, he knew it was much moreserious than that. He stood up, andnearly passed out. On his handsand knees he crawled back to thebedroom to wake his wife, who dialed911.“Your heart goes out to the familiesfirst,” noted Marsh, 44. “Every familyis scared: you can see the panicand fear on their faces.”Working fast, they consoled thefamily, telling them they understoodGriffin was having a heart attackand that they would move him tothe Cardiac Catheterization Lab asquickly as possible. Slavik preppedthe patient with electrodes and IVdrips while Marsh gathered thenecessary background information.“We try to spend less than fiveminutes in the ED, because they saytime is muscle,” Marsh said.”Themore time that’s lost, the more heartmuscle they’re losing.”“Your heart goesout to the familiesfirst. Every family isscared: you can seethe panic and fear ontheir faces.”Terri Marsh, R.N.,Cardiac CatherizationThey rushed Griffin into the cathlab, where they met fellow teammembers David Morton, M.D., andSteve Parker, Radiology tech RT (R).Over a period of several hours, theteam managed to stabilize Griffin’sheart, and Dr. Morton put a stentin one of his arteries. It wasn’t easy:Griffin’s heart stopped twice andhe was defibrillated, or shocked, 20to 30 times to resurrect a flaggingheartbeat and correct abnormalcardiac rhythms. Soon after, Griffinunderwent cardiac bypass surgery. Hereturned home a few days later, andis a little tired but otherwise is doingwell, his wife said.“Everything fell into place, fromthe arrival of the paramedics tothe cardiac team waiting for us,”Ellen Griffin recalled. “He shouldn’thave been here, according to whatthey told me. After talking toDr. Morton, I could tell it was anexperience for him, too. No merewords can ever express the depth ofgratitude we both have forDr. Morton, Terri, Lisa and Steve.There are many other nurses from theCVICU that we very much want tothank also for the excellent care theygave Bill during his stay atSt. Anthony’s.”Bill Griffin’s story is one of manypatient successes to come out ofSt. Anthony’s Heart Specialty Center,which is working to become one of2 spotlight | april 2013

Facing page: Steve Parker, Dr. Morton,Terri Marsh, Lisa Slavik - one ofSt. Anthony’s cardiac teams.the country’s top-performing heartcare programs. It was created in2011 through a unique partnershipbetween the medical center andThe Heart Specialty Associates, apractice that now includes 13 of thearea’s top cardiologists. The HeartSpecialty Center provides a seamlesscontinuum of care for cardiacpatients: inpatient and outpatient,medical and surgical, preventionthrough rehabilitation.“Our team members in the HeartSpecialty Center are extremelydedicated and absolutely top-notch,as Mr. Griffin’s care has shown,” saidDr. Morton, who also serves as chiefmedical officer of St. Anthony’s. “Itrequires that whole team, going fromEMS to the Emergency Departmentto the cath lab, to make it work. Allof those pieces have to be workingtogether and in sync.”At any one time, three membersof the 19-staff-member Heart CareTeam are available on call, said EllenSmith, director of CardiovascularInterventional Medicine.“We also have one team memberas a backup to call others in the eventthat there are two heart attacks atthe same time, which happens moreoften than you’d think,” Smith said.“In that case, we call everyone andask them to come in. I have neverhad a time that the staff won’t comein to save a life.”Caregivers cannot dwell on thegravity of the situation – and thepossible consequences involved—until their work is done, Marsh said.“You kind of go into an auto mode– you know you have to prioritizeand get things done, because there’sso much at stake,” Marsh said. “Youhave to remain calm: panic createschaos. It just works like an engine.We have the best nurses down here –it’s a hard job.”And for Marsh, the mission ispersonal. Nine years ago, her fatherdied of a massive heart attack onthe driveway outside his home. Hermom, Barbara Marsh, spent 16 yearsin Cardiac Cath and is now retired.“For me, my job has a wholedifferent meaning,” she said. “If I cansave somebody’s parent, save themfrom knowing that hardship, that’swhy I do this.”The next morning was probably thebest day of Marsh’s 25-year career atSt. Anthony’s. The heart team hadfinished its work, and Marsh wasworking in the electrophysiologylab when a call came in: Dr. Mortonwanted to see the three teammembers. He motioned them intothe waiting area where the Griffinfamily was sitting, and introducedthem to the family as the caregiverswho saved Griffin’s life.“That was the best thing I haveever seen a doctor do,” Ellen Griffinrecalled. “He gave his team thecredit.”The family, in turn, thanked theteam.“It was something I’ll never forget,that day, seeing the family’s faces andrealizing how appreciative they were,”Marsh said. “It touched my heart thatwhat we do matters.”It certainly does, Griffin recalleddays later.“How can you ever repay someonewho saves your life?” he asked.did you know?St. Anthony’s...• Is one of 30 heart care providersacross the country selectedrecently to take part in a studyof a device designed to preventblood clots in patients with atrialfibrillation.• Has a heart failure program, theonly such program in theSt. Louis area. Patients enrolled inthe program have been proven notonly to feel better and experiencefewer related symptoms, butalso to decrease drasticallytheir hospital readmissions. Theprogram also has improved heartfunction in some patients.• Has on its staff cardiologistDavid Dobmeyer, M.D., of HeartSpecialty Associates, one of thefew doctors in the area whoperform a procedure for repair ofthe Patent Foramen Ovale (a flapin the wall of the atrial septumthat can lead to strokes in young,otherwise healthy patients) witha 10-minute catheter procedurethat uses a device known as aseptal occluder.• Has a circulatory assist device,an Impella heart pump, that helpssupport the blood circulation ofcritically ill patients, allowingcardiologists to perform heartprocedures in a much safermanner.spotlight | april 20133

New names, same great careHEART PAVILION RENAMED JOHN K. PRUELLAGE HEART & VASCULAR CENTEROn Feb. 4, St. Anthony’s Heartand Surgical Pavilion was renamedin honor of John K. “Jack” Pruellage,a dedicated member of the medicalcenter’s board of directors from 1996through his death in May 2012.The state-of-the-art center ishome to St. Anthony’s HeartSpecialty Center and boasts fourcardiac catheterization labs, threeInterventional Radiology suites,two electrophysiology labs, oneendovascular operating room andthe Heart Evaluation and RapidTreatment (H.E.A.R.T.) Unit (seeaccompanying story), said EllenSmith, director of CardiovascularInterventional Medicine.“What I think sets us apart is ourstaff and physicians,” Smith noted.“Even those for whom St. Anthony’swas not their first choice, by thetime they are discharged they oftenpoint out that it was an awesomeexperience and they will tell others.We are a hidden gem, and we loveour patients and our work.”St. Anthony’s ElectrophysiologyLab was the first in the Midwestto have the Carto3 heart mappingsystem, which allows surgeons tobuild a three-dimensional model ofeach patient’s heart. CardiologistGreg Botteron, M.D., does themajority of the mapping for atrialfibrillation.“We get patients from all over theMidwest because of Dr. Botteron’sexcellent outcomes and reputation,”Smith said. “What sets us apart morethan anything else is our physicians.David Dobmeyer, M.D., for instance,is doing highly complex procedures,such as Atrial Septal Defect (ASD)repair, Patent Foramen Ovale (PFO)repair, carotid stenting, and catheterbasedtreatment of peripheralvascular disease. In collaboration withDr. Botteron, Dr. Dobmeyer willbegin enrollment soon in a nationalstudy to examine the efficacy of acardiac device that will take the placeof blood thinners in patients withatrial fibrillation.”Heart disease is the leading causeof death in the United States, forboth men and women. St. Anthony’s13 cardiologists on staff haveboard certifications in cardiology,echocardiology, electrophysiology andperipheral vascular treatment.“In the community, we areconsidered one of the better heartservices,” said cardiologist David J.Morton, M.D., chief medical officerof St. Anthony’s.Dr. Dobmeyer agreed. “We doeverything here that the universityhospitals do, except pediatrics andtransplants,” he said. “We do allsorts of coronary interventions,and have a response time for heartattack patients that’s considerablyfaster than the national average. Wetake pride in being able to offer thepeople of South County and thesurrounding area state-of-the-art andcutting-edge cardiac therapies. Wewould not be able to do this withoutthe commitment and dedication ofSt. Anthony’s Medical Center andits exemplary staff of nurses andtechnologists.”Although the work is stressful,the payoff is worth it, said Kate Lee,R.N., Cardiac Catheterization.“After you get the artery open, allthe color goes back to their faces,and they’re feeling better, you derivea certain satisfaction – that could bemy father or grandfather,” Lee said.Patty Mitchell, a scheduler for thecath lab, joined St. Anthony’s in 1982in SPD Central Supplies. At thetime, the hospital had only five floorsand one cath lab.“It’s fast-paced and very busy,” saidMitchell, who has worked in the cathlab since 1989. “I have great coworkers:they are the best.”4 spotlight | april 2013

Facing page: The Heart and Surgical Pavilion atSt. Anthony’s Medical Center recently was renamedin honor of John K. “Jack” Pruellage, who served asa dedicated member of the medical center’s board ofdirectors from 1996 until his death in May 2012.Right: Tamara Taylor, ANP, and Connie Kray, R.N.,manager of the H.E.A.R.T. Unit, discuss a patient’scare.RAPID TREATMENT UNIT TOOPEN IN LATE SUMMERTo treat patients who aren’thaving an active heart attack, butneed further evaluation beforeheading home, the eight-bed HeartEvaluation And Rapid TreatmentUnit (H.E.A.R.T.), opened in May2012 in the Physicians Office Center.The H.E.A.R.T. unit’s patientsare referred from the urgent carecenters, Emergency Department andphysicians’ offices. Nurse practitioners,R.N.s and techs on staff 24 hours aday, seven days a week, treat cases ofchest pain, heart failure, and atrialPatty Mitchell works with a patient toschedule an appointment for a cardiac cath.fibrillation or irregular heartbeat.“It’s basically dedicated to theoutpatient treatment of heartproblems in an attempt to decreasereadmissions and allow us to bettertake care of heart failure specifically,but also other cardiac problems,” saidDavid Morton, M.D., chief medicalofficer. “It’s going to become thenucleus for a heart failure programfor the whole hospital, which isbeing developed now by cardiologistCharles Carey, M.D.”Baseline protocols are followed,such as IVs, electrocardiogramsand lab tests, to ensure the patient’scondition doesn’t require emergencyintervention.“A lot of times, those patients areout in three to four hours, whereas anormal hospital stay might involvea couple of days,” said Connie Kray,manager of the H.E.A.R.T. Unit.In August, an expanded, 10-bed unit – the Lewis Rice HeartEvaluation and Rapid TreatmentUnit - is scheduled to open, Kraysaid.The new unit is being funded bycontributions from friends, colleaguesand family of the late John K.Pruellage, a board member of St.Anthony’s who served as a championof the medical center and providedwise counsel and dedicated leadershipthat helped the medical center tothrive as an independent health careprovider.Kray first joined St. Anthony’sCoronary Intensive Care Unit in1978, when there were only abouttwo cardiologists on staff and thecath lab had yet to be built. Shecontinues to do some procedures.“Our census is definitely going up,”Kray said of the H.E.A.R.T. Unit.“It’s truly amazing what we can donow. It’s been quite an adventure.I really have seen over the yearsthat, compared to other communityhospitals, we’re way ahead. We’ve hadpeople come from other cath labs inother hospitals to observe, and theysay, ‘Wow, you do that?’“We have some excellentcardiologists, and our staff is justwonderful,” Kray added. “The patientslove it here.”Soon, the H.E.A.R.T. Unit staffwill focus on follow-up care withpatients who have been identifiedby their physicians as high-risk forreadmission, Kray said. They will beasked to return within two or threedays of discharge for a free visit,during which they will see a nursepractitioner, have their medicationschecked, lungs listened to, dietaryeducation reviewed and weightmeasured. Rapid weight gain is asign of fluid retention and worseningheart failure.After the patient returns home, thestaff will call him or her once a weekfor a month. The patient is expectedto follow up with his or her physicianand/or heart failure clinic in seven to10 days after discharge.“Our main focus is heart failurepatients, to get them education andto help them stay well,” Kray said.“It’s a win-win situation. The patientgets education and a better quality oflife, and the hospital saves money. Itwill be nice to see that we’ve made adifference.”spotlight | april 20135

etter medicineO v er s eein g da y - to - da yclin ica l a ctiv ities:A conversation with David Morton, M.D., chief medical officer“Really, havingthe ability toprovide thehighest level ofcare to patients,that’s our bottomline. That’s whatwe’re here for.”Q: DR. MORTON, IN 2012YOU WERE APPOINTEDCHIEF MEDICAL OFFICER,AND ARE CHARGED WITHFACILITATING INTERACTIONSBETWEEN MEDICAL STAFF,ADMINISTRATION AND THEBOARD OF DIRECTORS TOASSURE EFFECTIVE ANDEFFICIENT DELIVERY OFMEDICAL CARE. IN ADDITIONTO YOUR DUTIES AS THEMEDICAL CENTER’S CHIEFMEDICAL OFFICER, YOUCONTINUE TO PRACTICEAS AN INTERVENTIONALCARDIOLOGIST. HOW DOESYOUR PRACTICE AFFECT YOURDUTIES AS CHIEF MEDICALOFFICER?A: As chief medical officer, I’mresponsible for overseeing theclinical activities in the hospitaland quality programs, as well asbeing directly responsible for thecardiac service line. As a practicingphysician, I think I have a betterinsight into the day-to-day clinicalactivities. My practice keeps meconnected with some of the qualityissues, and it allows me to be moreeffective in working to improve them.Q: IN 2011, THROUGH AUNIQUE HOSPITAL/PHYSICIANPARTNERSHIP, THE HEARTSPECIALTY CENTER WASESTABLISHED ATST. ANTHONY’S, WITH A GOALOF BECOMING ONE OF THETOP CARDIAC PROGRAMS INTHE COUNTRY. PLEASE TELL USHOW THE CARDIAC TEAM ISPROGRESSING TOWARD THISGOAL.A: That’s always going to be ourgoal, to get to the top and staythere. The Heart Specialty Centeris basically St. Anthony’s cardiacservice line, and it requires that wecontinue to keep up with the latestadvancements in cardiac surgeryand groundbreaking treatmentsfor heart failure, abnormal heartrhythms and heart attacks, all thosedifferent pieces. Really, having theability to provide the highest levelof care to patients, that’s our bottomline. That’s what we’re here for, andthat’s what motivates all of us.Q: ST. ANTHONY’S CARDIACPROGRAMS BOAST SEVERAL“ONLIES.” ONE OF THESE ISTHE OUTPATIENT HEART FAILUREPROGRAM, THE ONLY ONE OFITS KIND IN THE REGION. CANYOU TELL US MORE ABOUT THISPROGRAM?A: Patients with heart failureaccount for 43 percent of the fundsspent by Medicare, accordingto the Centers for Medicare andMedicaid Services. St. Anthony’sHeart Failure Program is meant tobe a comprehensive one to treatinpatients and outpatients with heart6 spotlight | april 2013

failure. It will serve as a communityresource to help nursing homestake care of patients, and provideongoing support to primary carepatients. Treating an acute heartflare-up in the hospital is easy;treating long-term heart failure is amuch more complicated endeavor.Q: WE’D LOVE TO KNOWMORE ABOUT YOUR FAMILYAND HOBBIES. ALSO, ISTHERE ANYTHING YOU’D LIKEOTHERS TO KNOW ABOUTYOU THAT ISN’T COMMONKNOWLEDGE? FOR INSTANCE,ONE OF OUR CO-WORKERSHAS HEARD YOU ENJOYSWIMMING WITH SHARKS?A: I like to play golf and sail inthe Caribbean. I’m a divemaster,as is my son, Luke. He and I divetogether, and yes, I’ve done someshark dives. Sharks won’t botheryou: they don’t really see you asfood. My favorite place to dive?Probably the Great Barrier Reef.ABOUT DR. MORTONA South County native—his momstill lives in the family home onTelegraph Road—Dr. DavidMorton is a Mehlville High Schoolgraduate. He earned his medicaldegree from the University ofMissouri-Columbia in 1982 andcompleted his residency at theBowman Gray School of Medicineof Wake Forest University and theNorth Carolina Baptist Hospitals,Inc. in 1984. He completedhis cardiology fellowship at theUniversity of Cincinnati School ofMedicine in 1986 and is boardcertified in internal medicineand cardiology,as well asinterventionalcardiology.Dr. Morton is theformer presidentof Metro HeartGroup, formerlythe area’s largestcardiologygroup. In 2011,Dr. Morton and10 colleagues, and their nurses,technicians and staff partneredwith St. Anthony’s to create HeartSpecialty Associates. The hospital/physician partnership includesgeneral cardiologists, noninvasiveand invasive cardiologists,interventional cardiologistsand electrophysiologists, andhas as its goal to develop themost comprehensive heart careprogram in the region and one ofthe best in the country. Dr. Mortonand his wife, Kathy, live in westSt. Louis County.spotlight | april 20137

St. Anthony’s Employee Wellness Heart Care FUNdtargets indiscriminate killerEvery day, 2,200 people in ournation die of cardiovasculardisease, the leading causeof death in the United States. AndSt. Anthony’s employees are atthe forefront of a campaign to callawareness to, and to raise funds totarget, this equal-opportunity killer:the Employee Wellness Heart CareFUNd.In spring 2012, St. Anthony’s staffraised more than $35,000 for theAmerican Heart Association’s HeartWalk campaign. That generosity ledto the idea that some of those fundscould be used to benefit the medicalcenter, our staff and the surroundingcommunity, while still making asubstantial donation to the AmericanHeart Association. Recently,St. Anthony’s Charitable Foundationand the Employee Wellness HeartFUNd Committee joined forces tolaunch the 2013 Employee WellnessHeart Care FUNd.The FUNd’s goals are to encourageSt. Anthony’s employees to have funtogether in heart-healthy ways; andto raise money for great causes:• 25 percent to the American HeartAssociation Heart Walk• 25 percent to St. Anthony’semployee wellness programs• 50 percent to fund communityhealthy initiatives, includingAutomatic External Defibrillators(AEDs), Phase 3 Cardiac Rehab andCPR Anytime kits for the SouthCounty community.The committee’s fundraising goalthis year is $30,000. Employeesraised $2,000 in February by makingdonations to wear red on “Wear RedDay,” Feb. 1.St. Anthony’s Heart Care Fund committee includes, front row: Denise Kimble, CourtneyBaxter, Patricia Reed, Rebecca Wilson; middle row: Kathleen Williams, MeganGluesenkamp, Cecilia Mancuso, Mary Lawrence, Nancy Houlihan, Mary Ann Winkeler;back row: Jamie Nobbe, Katie Rayfield, Liana Kopchak, Connie Kray, Alicia Cummiskey;Not pictured: Janice Aubuchon, Danielle Clapper, Michael Goldmeier, David Morton,Kristin Neusel and Kory Stout.“Heart disease takes thelives of far too many people inthis country, depriving theirfamilies and communities ofsomeone they love and carefor - a father, a mother, a wife,a friend, a neighbor, a spouse.With more than 2 millionheart attacks and strokes a year,and 800,000 deaths, just aboutall of us have been touched bysomeone who has had heartdisease, heart attack, or astroke.”Kathleen Sebelius, secretary,Department of Health andHuman Services“Your donations to this fundwill be put to work directly to thebenefit of those in our communitywho need it most, bringing themlifesaving technology, preventativecare, counseling and personalizedrehabilitation,” said Liana Kopchak,development coordinator for St.Anthony’s Charitable Foundation.“It is so exciting to see differentdepartments racing to see who canraise the most money for heart carepatients and our community. Plans forT-shirt sales, bake sales, a trivia night,kickball tournament and a NCAApool are underway, and our five-weekemployee walking bootcamp kickedoff on April 4.”For all the latest heart FUN, checkback often at iheartstanthonys.org.And be sure to join St. Anthony’steam on May 4 for the AmericanHeart Association’s Heart Walk atBusch Stadium.Spotlight is published quarterly by the Marketing department atSt. Anthony’s Medical Center.Editor: Robbi Courtaway, ext. 6894Graphic design/layout/photography: Christy Siebert, ext. 6835