HeartBeat

HeartBeat
PROVIDENCE
QUALITY HEALTH CARE IN THE INLAND NORTHWEST | WINTER/SPRING 2016
CRITICAL CARE
IN THE AIR
How medical
transport flight teams
are saving lives
SURGERY
SPECIALISTS
Outpatient centers
streamline operations
without the need for
hospitalization
BIGGER
PICTURE
Bethany McCauley and
her Providence colleagues
want to improve how we
experience health care
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Providence Urgent Care
Now in three convenient Spokane locations:
• North: Highway 2 at Hawthorne Road
• Downtown: Just off I-90 at 5th and Division
• Valley: One mile east of Sullivan, on Indiana
Open daily 8 a.m. to 8 p.m.
providence.org/SpokaneUrgentCare
MyChart ®
Your Online Health Record
Get connected to
your health
MyChart offers 24/7 access to
your health care information.
Schedule appointments, email your care team,
view test results and more.
Sign up today. It’s free.
Go to Providence.org/mychart and click on your
region. From there, you can request an activation
code to get started or learn more about how
MyChart can benefit you.
Have an appointment coming up? Your care team
can help you get started with MyChart.
Providence.org/mychart

HeartBeat
PROVIDENCE
EXECUTIVE EDITOR MANAGING EDITOR
Sharon Fairchild
Allison Milionis
MEDICAL EDITOR
Jeff Collins, M.D.
ART DIRECTOR
Cameron Anhalt
CONTENT DIRECTOR
Matt Morgan
PHOTOGRAPHER
Gary Matoso
Copyright 2016 © Providence Health Care. Online at
phc.org. Published three times a year by MANIFEST LLC.
Send comments to heartbeat@providence.org or
Marketing & Communication, 101 W. Eighth Ave.,
Spokane, WA 99204.
Elaine Couture, Regional Chief Executive
BOARD OF DIRECTORS
Marian Durkin, Chair
Patricia Butterfield, Ph.D.
Ramon Canto, M.D.
Jeff Clode, M.D.
Dan Dionne, M.D.
Rich Hadley
Gary Livingston, Ph.D.
Keith Marton, M.D.
Providence Health Care Eastern Washington (PHC) is the
parent organization of a number of Catholic health care
ministries sponsored by the Sisters of Providence and
the Dominican Sisters in Spokane and Stevens counties.
These ministries include:
HOSPITALS
Providence Sacred Heart Medical Center
Sacred Heart Children’s Hospital
Providence Holy Family Hospital
Providence Mount Carmel Hospital (Colville)
Providence St. Joseph’s Hospital (Chewelah)
OTHER HEALTH SERVICES
PAML (Pathology Associates Medical Laboratories)
Providence Adult Day Health
Providence DominiCare (Chewelah)
Providence Emilie Court Assisted Living
Providence Medical Group
Providence Medical Park, Spokane Valley
Providence St. Joseph Care Center & Transitional Care Unit
Providence VNA Home Health
St. Luke’s Rehabilitation Institute
PHC is part of the Providence Health & Services health
care system, which spans five states from Alaska to California
and east to Montana. For more details, visit phc.org.
MISSION STATEMENT
As people of Providence, we reveal God’s love for
all, especially the poor and vulnerable, through our
compassionate service.
CORE VALUES
Respect | Compassion | Justice | Excellence | Stewardship
CONNECT WITH US
facebook.com/ProvidenceSpokane
facebook.com/ProvidenceSacredHeart
youtube.com/ProvidenceSpokane
twitter.com/Providence_PHC
Rob McCann, Ph.D.
Thayne McCulloh, Ph.D.
Jeff Philipps
Paul Pimentel
Mary Selecky
Curt Shoemaker
Larry Soehren
Ron Wells
PHOTO BY DIANE MAEHL
FROM THE HEART
Better Health
for Everyone
In 2003, two scholars defined
the term “population health,”
which at its essence is a way
to evaluate health care systems’
ability to benefit the overall
health of an entire community—
one individual at a time.
“The ultimate goal is to have
the population be healthy as a
group,” says Jeff Collins, M.D.,
chief physician executive at Providence,
in our cover story, “Mission:
Population Health” (page 14).
Dr. Collins explains how
Providence is applying population
health to improve our community.
Rhonda Medows, M.D., executive
vice president of Providence’s Population
Health Division, also shares
her thoughts about the initiative.
In this issue you’ll find other
examples of Providence benefiting
members of the community—near
and far. Turn to page 22 to read
THE PROVIDENCE VISION
about a tiny patient from Lewiston,
Idaho, who took a lifesaving
ride to Sacred Heart Children’s
Hospital aboard a plane equipped
to maintain the critical care environment
of a neonatal intensive
care unit during flight.
And on page 18, find out how
a former Gonzaga University
professor with a penchant for
fly-fishing received surgery at
Providence Surgery and Procedure
Center, the new, high-tech
outpatient surgical facility in
Spokane Valley, and was back on
his feet within days. On page 26,
read about our assessment of the
community’s top priority needs
for 2016–18.
More important than defining
the term in words, we
believe population health is an
action—one we’re committed to
every day. By providing care and
resources to every individual,
regardless of age or economic status,
our goal is to elevate the collective
health of our community.
Many blessings to you and
your family!
Elaine Couture
Regional Chief Executive
Providence Health Care
“CREATING HEALTHIER COMMUNITIES, TOGETHER”
WE CONTINUE TO PIONEER CARE DELIVERY,
WORKING WITH PARTNERS TO IMPROVE OUR
COMMUNITIES’ HEALTH AND WELL-BEING.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 3

CONTENTS
VOLUME 54, NO. 1
ON THE COVER: Bethany McCauley and
others at Providence are focused on improving
patient satisfaction and the quality of health
care while lowering cost. Read the story on
page 14. Photo by Gary Matoso.
30
28
12
18
22
14
10
9
Features
14 MISSION:
POPULATION
HEALTH
We’re improving the way
individuals experience
health care by focusing
on larger groups.
18
22
WALK IN,
HAVE SURGERY,
WALK OUT
See how ambulatory
surgery centers
streamline services and
reduce costs without
hospitalization.
CARE IN THE AIR
Medical teams provide
critical support for
patients throughout
the region.
5 HEALTHY LIVING
Emergency kit must-haves; making
housework a workout; how
to meditate on the go; and more.
8 INSIDER
New area clinics open; innovative
treatment for varicose
veins; and other news.
10 CHILDREN’S HEALTH
Get to know the new chief
executive of Sacred Heart
Children’s Hospital and his
vision for advancing care.
12 CARDIAC REPORT
An unrelated medical issue led
to the discovery and treatment
of a pregnant woman’s congenital
heart defect.
26 COMMUNITY
Providence is dedicated to
addressing the greatest health
needs of our communities.
28 FOUNDATION
One couple’s nonprofit group
is helping create a more homelike
environment for cancer
treatment.
29 M.D. SPOTLIGHT
A clinical ethicist sheds
light on her role in resolving
tough questions and difficult
situations in health care.
30 CALENDAR
Save the dates for these
winter/spring 2016 classes,
events and activities.
31 HEALTH TIP
Are you at risk for arthritis?
Here’s what you can do.
32 ROLE MODEL
A Providence chaplain makes
sure that spiritual services are
available to every person who
needs them.
OPPOSITE PAGE: THINKSTOCK
4 HEART BEAT WINTER/SPRING 2016

HEALTHY LIVING
3 Reasons to
Grab a Grapefruit
Grapefruit is easily added to breakfast, can brighten
up salads and makes for a tangy juice, too. Here are a
few compelling reasons to reach for the sour citrus:
1. VITAMIN C. Packed with vitamin C, grapefruit
can be a powerful ally in boosting immune
function, helping you fight colds and stay
healthy this winter.
2. LYCOPENE. Pink and red grapefruits owe their
beautiful bright colors to lycopene, which might
help you fight cancer, according to research.
3. FIBER. Grapefruit can promote a healthy
digestive tract. Plus, pectin, a form of soluble fiber
in grapefruit, has been shown to reduce LDL
(“bad”) cholesterol.
SHARE YOUR
HEALTHFUL
EATING TIPS
Have good ideas for including
healthier foods in your
family’s meals? Share them
with us on our Facebook
page. Go to facebook.com/
ProvidenceSpokane or email
heartbeat@providence.org.
QUICK TIP
Despite grapefruit’s cholesterol-lowering benefits,
you should avoid it if you are taking a statin medication
for high cholesterol. That’s because grapefruit can
increase the levels of the prescription drug in your
body, leading to a risk of muscle toxicity.
FREE Recipe Book Available
Providence Health Care’s 2015 Heart Healthy Guide features
culinary hits like Greek Lentil Stew and more. To request
your copy, just email heartbeat@providence.org.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 5

HEALTHY LIVING
Are You
Ready for an
Emergency?
In the event of a power outage or
an emergency like a natural disaster,
it helps to have some basic supplies
handy. Here are a few staples to
include in your emergency kit:
Bottled water
Nonperishable, easy-to-make
food items
Manual can opener
Plastic utensils, paper plates
and cups
Diapers, wipes, formula and
baby food, if you have infants
Pet food, if you have pets
Flashlight
Battery-powered or
hand-crank radio
Extra batteries
First-aid kit
A whistle to signal for help
Wipes, garbage bags and
plastic ties for sanitation
Wrench or pliers to shut off utilities
Solar charger for cellphones
Sources: redcross.org, ready.gov
TURN YOUR
HOUSEWORK
INTO A WORKOUT
It’s important to get at least 30 minutes of moderate-intensity
exercise most days of the week. And here’s some good news:
Your spring-cleaning can pull double duty. Set a timer for
30 minutes, turn on some tunes and torch those calories.
Activity
Calories Burned
(per 30 minutes*)
Vacuuming 90
Mopping 90
Cleaning
windows
125
Burn Bonus
Before you enter each room, do
a short set of squats or lunges.
Work your shoulders and upper
arms by getting on your hands
and knees to scrub those
extra-dirty spots.
Before each window, run a flight
of stairs or do a set of crunches.
Washing
your car
140
Work your glutes by squatting
instead of bending over when
you dip your sponge into
the soapy water.
* Calorie counts are estimates. The number of calories you burn will depend on your weight,
metabolism and other factors.
Source: fitday.com
NEED HELP FINDING THE RIGHT EXERCISE?
Ask your provider or call 509-232-8138 to make an
appointment with a health coach.
THINKSTOCK (4)
6 HEART BEAT WINTER/SPRING 2016

AVOID THESE AT A RESTAURANT
If you’re trying to eat healthfully, a restaurant can
be a minefield. But when you know the common
pitfalls, you’ll know how to steer clear.
Bottomless breadbasket. How does one pass
up warm bread (and butter)? Don’t let it on
the table. When the server brings the
bread, politely say no.
Giant portions. A single restaurant
dinner can easily account for an entire
day’s worth of calories if you aren’t
careful. Share a meal or request a
to-go container when you order so
you can save half from the start.
Salad dressings. Salads are healthy,
right? Unfortunately, restaurant salad
dressings are often laden with fat and
sodium. Your best bet is to ask for
olive oil and vinegar and dress the
greens yourself.
54% OF AMERICANS OLDER
THAN 18 ARE DRINKING
COFFEE EVERY DAY.
PEOPLE WHO DRINK MODERATE
AMOUNTS OF COFFEE (ABOUT
1–3 CUPS) HAVE LOWER RISKS
OF CARDIOVASCULAR DISEASE,
CERTAIN CANCERS, PARKINSON’S
DISEASE AND TYPE 2 DIABETES.
Source: National Coffee Association
Meditate Anytime,
Anywhere
Meditation is a great way to lower stress and
improve your health. If you’re struggling
to make time, don’t fret. Even five to 10
minutes a day will provide a benefit. Check
out these tips for meditating on the go.
Don’t worry about the location. As long
as you can find a few uninterrupted
minutes, you can meditate. Your desk,
your parked car or the park across the
street will all work fine.
Use earplugs. They can help drown out
excess noise so you can focus.
Download an app. Peruse your app
store for programs that provide guided
meditation.
Take a walk. Use this as an opportunity to
meditate—move slowly and deliberately,
and savor your senses, taking in all the
sights, sounds, smells, tastes and feelings.
FIND YOUR OWN
OMMM …
To discover more about
meditation, go to phc.org
and click “Health Resources.”
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 7

INSIDER
New Clinics Near You
Providence Medical Group has you covered with two
new clinics in Spokane. New patients are welcome at
both locations.
Providence Family Medicine & Maternity Care
2020 E. 29th Ave., Lower Level, Spokane
509-626-9400
Providence Northpointe Family Medicine,
Internal Medicine & Pediatrics
9911 N. Nevada, Spokane
509-626-9420
ACCOLADES
HealthGrades has named
Providence hospitals among the
top 5 percent in the nation for
neurosciences, neurosurgery
(two years in a row), stroke
(three years in a row) and
overall pulmonary services.
Providence Sacred Heart:
America’s 100 Best Hospitals
for Stroke Care (2014–16)
Providence Sacred Heart:
America’s 100 Best Hospitals
for Critical Care (2014–16)
Providence Sacred Heart:
Distinguished Hospital
Award for Clinical Excellence
(2014–16)
3 Occupational Medicine
Clinics to Serve You
Providence opened its third occupational medicine clinic
in February 2016, at Providence Medical Park in Spokane
Valley. Working in coordination with Providence Urgent and
Emergency Care, primary care physicians and specialists,
and St. Luke’s Rehabilitation Institute, the program provides
employers and patients with:
Injury treatment and management
Industrial rehabilitation, massage therapy and
occupational therapy
Employer services (substance testing, Department of
Transportation physicals, hearing conservation,
pulmonary function and respirator fit testing, preemployment
physicals, fitness-for-duty exams)
Providence Holy Family:
5 stars for treatment of stroke
and sepsis (2013–16) and
respiratory failure (2009–16)
Providence Mount Carmel:
5 stars for treatment of
pneumonia and chronic
obstructive pulmonary disease
(COPD) (2016)
Visit one of the three clinics:
16528 E. Desmet Court, Spokane Valley
421 S. Division St., Downtown Spokane
551 E. Hawthorne Road, North Spokane
THINKSTOCK (2)
8 HEART BEAT WINTER/SPRING 2016

Unique Gifts to
Benefit the Foundation
In 2015, generous individuals and organizations
hosted more than 50 third-party fundraisers to
support Providence ministries in Spokane and
Stevens counties. These included traditional
fundraisers, like toy drives, bake sales and sports
tournaments, as well as more unusual avenues.
“We had a 4-H student sell her steer at the
Walla Walla Fair and donate the proceeds to
the foundation,” says Joyce M. Cameron, chief
development officer of Providence Health Care
Foundation. “We appreciate all of our foundation
friends, no matter what the event or how much
money is raised.”
“We had a 4-H
student sell her steer
at the Walla Walla
Fair and donate
the proceeds to
the foundation.”
READ MORE
Turn to page 28 to see how one couple
touched by cancer contributed.
Providence Vein
Center Now Offers
New Procedure to
Treat Varicose Veins
VenaSeal closure system improves
blood flow by sealing troublesome
veins. The system delivers a small
amount of specially formulated medical
adhesive to the diseased vein, rerouting
blood to nearby healthy veins. This
innovative treatment helps reduce discomfort
and recovery time. For more
information, call Providence Vein
Center at 509-626-9484.
Gina’s Update: A
Breath of Fresh Air
In the Fall 2015 issue,
we featured Gina Moriarty,
a bright 32-yearold
with cystic fibrosis
waiting for a lung transplant.
We’re pleased
to announce that she
got her wish. Moriarty
received a double lung
transplant on Sept. 18
and has returned home
to recover. Able to breathe on her own again,
she’s slowly rebuilding her strength and stamina.
Recovery can take up to a year, but Moriarty is
committed to the process. She and her husband,
John, consider this a new chapter in their lives.
“I cherish each day,” she says.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 9

CHILDREN’S HEALTH
Developing Excellence
Sacred Heart Children’s Hospital fulfills virtually any medical
need of children in Spokane and the surrounding region.
As the sole source of specialized
pediatric care
for eastern Washington,
northern Idaho and western
Montana, Sacred Heart Children’s
Hospital is networking with community
physicians across the region to
provide quality care as close to home
as possible.
“We are currently building on the
success of our top-flight pediatric
specialists to offer world-class medicine
here,” says Children’s Hospital
chief executive Keith Georgeson,
M.D. “We are working to increase
the number of local subspecialists
to help provide coordinated care
for patients with complex medical
issues or chronic illnesses.”
The benefit of having Providence
hospitals across the region is that
children who are referred to Spokane
for advanced care can be sent back
to a facility closer to their home for
additional follow-up services.
MAKING CONNECTIONS
“Another initiative for the Children’s
Hospital is expansion of telemedicine
capabilities to provide virtual visits
with our specialists,” Dr. Georgeson
says. “For families whose children
PROVIDENCE
UNDERSTANDS KIDS
To learn more about Sacred Heart
Children’s Hospital and the growing
network of care in and around
Spokane, go to shmcchildren.org.
THINKSTOCK
10 HEART BEAT WINTER/SPRING 2016

By Danita Petek
face chronic diseases, this can mean
far less travel time to get the expert
care they need.”
Sacred Heart Children’s Hospital
is currently promoting an initiative
to establish best practices for the
care of children with appendicitis.
Providence physicians are being
trained on important components
of care, such as antibiotic choices,
testing during hospital stays, and
the use of ultrasound rather than
CT imaging for diagnosis, reducing
radiation exposure.
Dr. Georgeson is excited to offer
these types of care improvement.
“As the largest children’s hospital
in the Providence system, we can
help to change the quality of care
offered by our colleagues everywhere,”
he says.
12 YEARS OF
EXPERTISE
Sacred Heart Children’s Hospital
opened its doors for the children
of our region in 2003.
The caring team at Children’s
Hospital understands it can be
overwhelming when your child
needs medical care. You are not
alone in this journey. Doctors,
nurses and specialists are available
to not only diagnose and treat your
child, but also to guide and educate
your entire family.
The Children’s Hospital is ready
to treat nearly all pediatric patients
with physicians in all the major specialties,
including a large neonatal
practice for the smallest and most
fragile infants.
35,000+
Pediatric visits made
each year to Sacred Heart
Children’s Hospital
22,000+
Children treated each year
at Sacred Heart Children’s
Hospital’s dedicated pediatric
emergency department
61
Beds available for children
needing care in the neonatal
intensive care unit
Meet the New Chief Executive
KEITH GEORGESON, M.D.,
SACRED HEART CHILDREN’S
HOSPITAL, SPOKANE
Keith Georgeson, M.D., new chief executive
of Sacred Heart Children’s Hospital,
brings a wealth of expertise in children’s
services. He received his medical degree
from Loma Linda University and completed
a fellowship in pediatric surgery
at Children’s Hospital of Michigan. He
spent most of his academic career at
the University of Alabama School of
Medicine and was chief of surgery at
Children’s Hospital of Alabama for more
than 20 years. Dr. Georgeson has served
as chief of children’s services at Sacred Heart Children’s Hospital for
the past three years.
Dr. Georgeson has a national reputation as a leader in children’s
health care, serving as a director of the American Board of Surgery
(2000–06) and chairman of the Pediatric Surgery Board of the American
Board of Surgery (2003–06). He is past president of the American
Pediatric Surgical Association and a founding member and past
president of the International Pediatric Endosurgery Group. In 2011,
he received the William E. Ladd Medal from the American Academy
of Pediatrics for his work in pediatric surgery.
“We are blessed to have a leader with the experience, reputation
and stature as Dr. Georgeson to lead Sacred Heart Children’s
Hospital into the future,” says Elaine Couture, regional chief executive
of Providence Health Care. “Please join me in congratulating
and welcoming Dr. Georgeson to his new role.”
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 11

CARDIAC REPORT
The Brix family:
Jessica, Harley and
2-year-old Aniken
Getting Closure
A hole in Jessica Brix’s heart led to a stroke during
her pregnancy. Here is her story.
For more than 24 hours,
Jessica Brix didn’t know
what was wrong.
The 42-year-old Spokane Valley
woman was five months pregnant
with her third child in April
2014. On a routine Friday, she was
going to a baby goods store when
she began to experience physical
problems that worsened into the
next day. The symptoms—first,
difficulty picking up her keys and
later, trouble forming words and an
inability to cut her food—were odd
and increasingly troubling.
Yet she never guessed she had
suffered a stroke.
It wasn’t until the next day,
when she couldn’t put one foot
in front of the other, that her
husband, Harley, drove her to the
emergency department at Providence
Sacred Heart Medical Center
& Children’s Hospital.
After listening to the description
of her symptoms, the team there
immediately sent her in for a brain
scan. That’s when they discovered
a blood clot had dislodged from
somewhere in her venous system
and traveled through her heart to
her brain. “They picked it up right
away,” Brix says.
“Between the body’s own
defenses and the blood thinners
administered by the medical staff,
GARY MATOSO
12 HEART BEAT WINTER/SPRING 2016

By Mike Francis
PROVIDERS REALIZED
THAT BRIX HAD A
COUPLE OF HIDDEN
ISSUES SINCE BIRTH
THAT CONTRIBUTED
TO HER STROKE.
Jessica’s clot dissipated,” says
Philip Huber, M.D., an interventional
cardiologist at Sacred Heart
Medical Center.
UNDETECTED DEFECT
Brix was an otherwise healthy
woman who had no trouble with
the births of her daughter and son,
now 24 and 20. She’d had no history
of miscarriages, didn’t have diabetes
and had never been flagged as
having an elevated risk for disease.
During her care at Sacred Heart
and Providence’s Family Medicine
Spokane Residency Clinic, providers
realized that Brix had a couple
of hidden issues since birth that
contributed to her stroke.
It turned out that she had a relatively
common defect called a patent
foramen ovale, or PFO, a hole in the
heart that normally closes after birth,
but it did not in her case. “About 10
to 15 percent of the population has
the defect,” Dr. Huber says. “But
most never know it. In Jessica’s case,
it provided a pathway for a blood clot
to travel to the brain.”
Brix also had a blood condition
known as a Factor V Leiden
mutation, which increases the risks
of clotting.
Although neither condition is
necessarily dangerous, for Brix it
made the rest of her latest pregnancy
a high-stakes, suspenseful
affair. She underwent weekly ultrasounds
and twice-daily shots of
medication for the next five months
in an effort to reduce the risk of
blood clots. The medication was
carefully calibrated so as not to
affect the unborn child.
“We were scared for the baby
and for me,” Brix says.
In August 2015, much to everyone’s
relief, Brix gave birth to a
healthy baby boy. Two months
later, Dr. Huber, who had joined the
Providence team treating Brix when
she was about 30 weeks pregnant,
closed the PFO—the hole in Brix’s
heart—in a minimally invasive procedure.
The surgery went well, freeing
Brix from having to take blood
thinners for the rest of her life.
After a few more months of Brix
taking anticoagulants to prevent
blood clots, Dr. Huber says Brix
should be able to take nothing more
than a baby aspirin each day.
GRATEFUL FOR
HER HEALTH
Her medical ordeal over, Brix feels
powerfully grateful.
The Providence providers—
Dr. Huber, obstetrician Rilla
Westermeyer, M.D., oncologist
Mei Dong, M.D., the emergency
PUT YOUR HEART IN OUR HANDS
The heart defect patent foramen ovale is relatively common—
and treatable. If you’re concerned about your condition, call
509-474-3278 to schedule an appointment, or ask your
primary care provider for a referral.
department team, and all the
nurses and staffers—“were amazing,”
Brix says. “They were all so
good to me.”
Harley says his wife’s recovery
has been “miraculous.” The couple
were eager to tell the story of the
care they received at Providence.
“It was a rough road, but we’re
almost out of the clearing, which is
exciting,” he says.
Says Dr. Huber, “We’re always
glad we can help in a positive way.”
Diagnosing
and Treating a
Heart Defect
The patent foramen ovale (PFO) is
an opening between the heart’s
two upper chambers that allows
unborn children to breathe in the
womb. In most cases it closes after
birth, but for as much as 25 percent
of the population, it never does.
This heart defect may go undetected
for many years, but it can
be diagnosed when the opening
in the heart permits a blood clot to
pass through. In the case of Jessica
Brix, the medical team discovered
her PFO when they treated her for
a stroke.
For people who have no symptoms,
it’s not necessary to treat the PFO.
For others, medical providers may
prescribe blood thinners to reduce
the risk of stroke. And for some,
like Brix, a cardiologist may close
the opening with minimally
invasive surgery.
Source: clevelandclinic.org
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 13

STORY BY STEPHANIE CONNER
PHOTOS BY GARY MATOSO
MISSION:
POPULATION
HEALTH
PROVIDENCE IS DEDICATED TO
IMPROVING CARE FOR INDIVIDUALS
BY FOCUSING ON GROUPS.
Think back to your
last visit to a hospital emergency
department. What happened after
your visit? Did you go home confused
about your medications?
Were you confident you could take
care of yourself at home? Did your
provider’s office contact you to make
sure you were recovering well?
If you receive this kind of followup
care after you’ve been to the
hospital, you’ll be more likely
to recover well and less likely to
have to go back into the hospital,
explains Bethany McCauley,
BSN, R.N., care navigator for
Providence Medical Group. And
you’ll probably be happier with
your overall health care experience,
too.
That’s why Providence Medical
Group’s 11 R.N. care navigators
review hospital discharge
records daily.
“We reach out within two business
days to make sure they’re
doing well,” McCauley says. “We
talk to them about their medications,
and we work to identify any
gaps in their care.”
Those gaps might include a
need for a home health nurse or
medical equipment they were
supposed to receive.
“We also want to make sure
they’re eating well and that they’re
not at risk for readmission,” she
adds. “We schedule a follow-up
appointment with their doctor
and make sure they have a ride to
that appointment. We’re looking
at the whole picture.”
This whole picture is part of a
big picture—a concentration on
population health, an initiative
14 HEART BEAT WINTER/SPRING 2016

Bethany McCauley, BSN,
R.N., and Providence
Medical Group’s other R.N.
care navigators review
discharge records daily to
make sure patients have
no gaps in their health care
after they leave the hospital.
within Providence Health &
Services that’s focused on changing
the way people experience
health care, ultimately improving
health outcomes and patient satisfaction,
increasing the quality of
care they receive and even lowering
the cost of care.
WHAT IS POPULATION
HEALTH?
Population health is as vast as it
sounds. Jeff Collins, M.D., chief
physician executive at Providence,
offers some context.
“In the old world of health care,
doctors took care of patients and
hospitals took care of patients.
Everyone was focused on individual
patients and individual
episodes of care,” he says. “The
concept of population health is that
doctors still take care of [individual]
patients, but systems should
take care of groups of people.”
Behind population health are
the payers: insurance companies,
Medicaid and Medicare.
“The payers have said they want
better outcomes,” Dr. Collins
explains. “And they’re providing
the money to make it happen.”
Defining various populations, or
groups of people, is key for tracking
and measuring outcomes: Are we
making a difference?
Populations can be defined by
payer type, condition, age or other
factors. For example, one population
might be Medicaid patients
who have diabetes.
“You first define the condition
and relevant quality metrics, then
you analyze the data for gaps and
best performers,” Dr. Collins says.
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“Then you define systems of care
within a predetermined budget.”
That helps Providence identify
best practices and implement
changes to processes and systems
to improve patient care.
But while the payers have been a
driver of population health, Rhonda
Medows, M.D., executive vice president
of Providence’s Population
Health Division, sees an opportunity
to do more.
“We participate in every line of
business and every care setting,”
she says. “There’s so much amazing
potential.”
She wants her team to focus on
improving the patient experience and
improving care—regardless of payer
and regardless of the care setting.
Bethany McCauley, BSN,
R.N., sees health care
improve when R.N. care
navigators collaborate with
providers—and patients.
“It just makes sense,” she says.
“Why would you improve an aspect
of care for just a small portion of
your patients? Why treat one portion
of the population one way and
then go back to the old way for
another group?”
BETTER CARE,
BETTER HEALTH
So how does population health help
improve the quality of the health
care you receive from Providence?
Consider this example: If a
person has diabetes, it’s essential
that he or she manage that
condition to prevent complications.
That means making smart
choices with diet and exercise,
seeing a provider regularly, maybe
“GETTING AN R.N. CARE NAVIGATOR
INVOLVED WILL REDUCE THE LIKELIHOOD
OF AN UNNECESSARY EMERGENCY ROOM
AND URGENT CARE VISIT.”
taking medications, and monitoring
blood sugar levels.
“With population health and our
focus on the data, we can determine
which groups of patients
with diabetes don’t have good
control over their blood sugars,”
Dr. Collins says. “We can see which
physician groups are doing better,
then learn about their strategies
and share them with other practices
to help improve our delivery
of care to this population.”
Enter McCauley’s team of R.N.
care navigators again.
“A provider might pull a care navigator
in to meet with the patient,”
she explains. “We’ll work with the
provider to set up a care plan. Then
we’ll meet with the patient and ask
them what their goals are.”
Provided the patient is on board,
the care navigator will check in
periodically to make sure the
patient is meeting his or her health
goals, educate the patient and
answer any questions.
For patients with diabetes who
take advantage of a navigator,
McCauley says, there is evidence that
it’s making a difference: lower A1Cs
(a measure of blood sugar levels).
In addition, when patients are
educated about their chronic illness
and can manage it—and when
they have a relationship with their
provider—they don’t need to access
the emergency department as often.
“We know that getting an R.N.
care navigator involved will reduce
the likelihood of an unnecessary
emergency room and urgent care
visit,” McCauley notes.
Diabetes isn’t the only chronic
health condition that can be
improved with this kind of
approach. There are metrics in
place to track patients with heart
failure, depression, high blood
pressure and chronic obstructive
pulmonary disease, as well.
Providence is also looking at the
system’s efforts with certain preventive
care measures—making
sure children are on track with
16 HEART BEAT WINTER/SPRING 2016

their immunizations, for example,
and ensuring adults older than 50
are getting their colonoscopies and
that women are getting screening
mammograms.
Ultimately, when payers understand
the value of preventive care
and managing chronic diseases—
and financially compensate providers
who do this well—people
receive better care and tend to be
healthier overall, compared with a
health system that rewards providers
who simply treat the highest
number of sick patients.
IMPROVED
SATISFACTION
When people think about what
makes them satisfied with their
health care, a big piece is whether
they can get in to see, or access,
a provider.
That’s one population health
metric. “By leveraging some of the
data, we’ve been able to demonstrate
clear improvement in our
access,” Dr. Collins says.
The care navigators, who provide
a helpful link between the patient
and providers, are a key factor in
improving access.
Plus, some providers offer
same-day appointments, and
Providence’s Health eXpress app
allows contact with a nurse practitioner
for routine primary care
issues via Skype.
“It improves access and satisfaction
for patients,” says Scott
O’Brien, chief strategy officer at
One bold goal tied
to population health
is reducing the cost
of health care
An Often-Overlooked Population
Although payers (insurance companies, Medicaid and Medicare) get a lot
of attention related to population health, Providence Health & Services
is thinking more broadly—seeing how improving health care for one set
of people might benefit everyone.
One population that Providence won’t forget is the underserved.
“Providence is a faith-based organization with a core value of taking
care of the poor,” says Jeff Collins, M.D., chief physician executive at
Providence. “Serving the community isn’t necessarily part of population
health from the perspective of an individual payer, but there is overlap.”
Often, individuals with high-cost health conditions can’t afford health
care. Providence maintains its commitment to helping those who are poor
and vulnerable.
“Above and beyond what we’re paid to do,” Dr. Collins says, “we are
committed to taking care of our community, regardless of what
population they’re in.”
Providence. “And patients receive
high-quality care just as if they
were coming into the office.”
Another key to improving satisfaction
lies in better integrated and
coordinated care, Dr. Collins and
Dr. Medows say.
Your health information should
precede you, Dr. Medows notes. You
should feel as though your provider
knows you and is collaborating with
other providers on your behalf.
And in the future, Providence
can use population health data and
models to help anticipate the needs
of certain populations.
“The more we can predict, the
more we can prevent or delay serious
consequences,” Dr. Medows says.
PURSUING LOWER
HEALTH CARE COSTS
One bold goal tied to population
health is reducing the cost of health
care. By better managing people’s
chronic conditions, preventing
disease through excellent primary
care and identifying serious illnesses
early through screenings, the
Population Health Division believes
it’s possible to reduce the financial
burden of health care on society.
And that can benefit all of us,
they say.
“In an effort to manage cost, a lot
of companies are moving to higherdeductible
health plans,” O’Brien
notes. “So if we better manage your
health, we can limit your out-ofpocket
expenses for health care.”
But the key is reducing cost
while improving satisfaction and
the quality of care.
“Success isn’t exclusively solving
for one,” he says. “We’re trying to
balance all three.”
SHIFT IN APPROACH
For more than two years,
Providence has been focused on
population health. Then it elevated
its commitment by bringing Dr.
Medows in and launching a division
last summer. In the months
since, members of this team have
been working on developing tactics
and strategies to achieve the
ambitious goals outlined under the
auspice of population health.
If you haven’t already felt a difference,
it’s coming.
“The ultimate goal is to have the
population be healthy as a group,”
Dr. Collins says. “Every group is
made up of individuals, and every
individual counts.”
Even more than that, Dr. Medows
says, “everyone wins.”
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 17

WALK IN,
HAVE SURGERY,
WALK
OUT
THE PROVIDENCE SURGERY AND
PROCEDURE CENTER PROVIDES EASY
ACCESS TO QUALITY MEDICAL SERVICES,
NO HOSPITALIZATION NEEDED.
18 HEART BEAT WINTER/SPRING 2016

STORY BY SHELLEY FLANNERY
PHOTOS BY GARY MATOSO
Most people with labral tears
of the hip have contact sports
like football or hockey to thank for their
troubles. Not Frank Slak.
“Mine wasn’t from anything as cool
as that,” Slak says. “It was more of a
Lemony Snicket situation—a series of
unfortunate events.”
The former Gonzaga University professor
says the pain started in spring 2015
and worsened quickly. So quickly, in fact,
that he had to miss the last two weeks of
the semester.
“I used to stand and move around
the room a lot during my lectures,” the
68-year-old says. “I would start to turn
or pivot and the pain was just excruciating.
The pain got progressively worse, to the
point where I could barely walk.”
Slak’s physical therapist friend set him up
with orthopedic surgeon Bryan S. Mitchell,
M.D., who provided a diagnosis.
“I got an MRI that revealed not only a
labral tear, but also two growths on top of
my femur that had been wearing through the
labrum, causing bone-on-bone action,” he
says. “They’re not caused by anything specific.
Some people are just lucky enough to
have those growths, and I’m one of them.”
The treatment options were cortisone
injections, which last about 30 days per dose,
or surgery. Slak opted to have one cortisone
Frank Slak’s hip
was so painful that
he could hardly
walk. After outpatient
surgery followed by
rehabilitation, he’s
back to doing the
activities he loves.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 19

At ambulatory surgery centers,
says orthopedic surgeon
Bryan S. Mitchell, M.D., people
are less likely to have their
procedures postponed.
injection to hold him over until he
could have surgery to repair the tear.
Slak scheduled his procedure
with Dr. Mitchell at the Providence
Surgery and Procedure Center at
Providence Medical Park, which
is about 10 miles from his home in
Spokane. According to Slak, well
worth the trip.
CENTERED ON
SURGERY
The Providence Surgery and
Procedure Center is an outpatient
surgical facility, also called
an ambulatory surgery center, or
ASC. ASCs have been around for
more than 40 years; before their
inception, virtually all surgeries
were performed in hospitals. But
dedicated surgery centers do only
one thing—surgery—and can focus
all their efforts on doing it efficiently
and effectively, without the
patient needing to be hospitalized.
“With regard to the patient
experience, everything is incredibly
streamlined in the center,”
says William T. Page, M.D., an
orthopedic surgeon who operates
at Providence Surgery and
Procedure Center. “From what
time you check in to what time
you leave, everything is decreased
dramatically when compared with
the hospital setting.”
A lot of thought and research went
into the layout and design of the
Providence ASC, which welcomed
its first patient in February 2015. The
“I THINK MY SURGERY WAS SCHEDULED FOR
8:30 A.M. WE CHECKED IN AT 8, AND I WAS
HOME BY NOON.” —FRANK SLAK
design team paid particular attention
to a patient’s care journey.
“Not only is it a beautiful building,
but it’s also very efficient,” says
Kim Lett, the center’s director.
“Patients are greeted upon arrival
in registration then directed to the
surgery center on the second floor,
where they’re met by the surgery
center staff and prepared for their
surgical procedure. Once prepared
for surgery, they’re taken into an
operating room adjacent to their
room, eliminating unnecessary
movement throughout the center.”
The building’s small footprint
helps with time management as well.
“At the center, everything is
designed to decrease steps,” Dr. Page
says. “That means patients can be
in and out in literally half the time
spent at a hospital.”
Naturally, an ambulatory surgery
center hosting fewer patients at a
time also means more individualized
care than a hospital might be
able to provide, and fewer delays.
“In a hospital setting, there’s
always the potential that someone
20 HEART BEAT WINTER/SPRING 2016

else’s emergency surgery could put
off your procedure,” Dr. Mitchell
says. “Plus, with fewer patients at
the center, there’s the ease of parking
and check-in.”
For all these reasons, many times
surgical procedures at ASCs are less
expensive than hospitals. And yet,
ASCs like Providence Surgery and
Procedure Center offer access to
advanced equipment and surgical
staff expertise.
“The center follows the same
patient care guidelines and quality
metrics you would find in a hospital
setting,” Lett says. The center
received Joint Commission accreditation
in June.
RIGHT PATIENT,
RIGHT REASON
The types of surgeries available at
Providence Surgery and Procedure
Center grow with each passing
month of operation.
“We currently offer procedures in
gastroenterology and orthopedics,
including hand, shoulder, foot and
ankle surgery, as well as sports medicine
surgeries like ACL repairs and
hip scopes,” Lett says. “We’re looking
to expand our services to also
include general surgery, ENT [ear,
nose and throat] and potentially
neurological surgery.”
But not every person is a candidate
for surgery at the center.
People with complex cases or certain
chronic conditions and those
at high risk for surgical complications
will need to visit a hospital
for treatment.
“We consider the age of the patient,
his or her health history, including
chronic issues like severe sleep apnea
or kidney disease, and their disease
state,” says Karyl Pickard, clinical
manager of Providence Surgery and
Procedure Center.
“Some patients just won’t be candidates
for procedures here,” Lett
adds. “It has to be the right patient
for the right reason at the right time.
It’s all about the patient’s safety.”
RAVE REVIEWS
Slak was pleased to learn he was a
candidate for surgery at the center,
not because of the efficiencies, the
cost benefits or the ease of access.
He chose to have surgery 10 miles
from home because of the staff.
“The center is a sociological
phenomenon,” Slak says. “The
staff is incredible. Honest to
goodness, from the ground-floor
receptionist to the scheduler to
the nursing staff, anesthesiologist
and operating staff, you can tell
everyone really loves their job and
wants to be there. Those people
really care.”
Of course, Slak appreciated the
center’s ability to get him in and
out in a timely manner, too.
“I think my surgery was scheduled
for 8:30 a.m.,” he says. “We checked
in at 8, and I was home by noon.”
Slak’s surgery was a success, and
because he followed his postoperative
instructions and committed
to physical therapy, he was back on
his feet in no time.
“I went in for a follow-up with
Dr. Mitchell 10 days afterward, and
he couldn’t believe how well I was
doing,” Slak says. “I said, ‘I feel
great. I think I could walk without
the crutches,’ and he said, ‘Show
me.’ So I did.”
Slak’s procedure was July 30,
and he went back to work teaching
in time for the fall semester. More
important, he went back to his
hobby of fly-fishing.
“It’s the love of my life, next to
my wife and kids,” he says. “I usually
fish from a boat, and when
my hip was acting up, sitting in
a restricted place was out of the
question. I really couldn’t do much
fishing the whole spring. But since
I got the surgery, I’ve been right
back at it.”
AMBULATORY SURGERY
CENTERS BY THE NUMBERS
Ambulatory surgery centers, or ASCs,
are efficient, cost-effective alternatives
to hospitals for certain patients and
certain procedures. Here’s a look at
the numbers.
1970
Year the nation’s first ambulatory
surgery center opened in Phoenix
23 million
Number of surgeries performed at
ambulatory surgery centers in the
U.S. each year
31.8 minutes
Procedures performed in ambulatory
surgery centers are a half-hour
shorter, on average, than procedures
in hospital outpatient units
92%
Nationwide, ambulatory surgery
centers claim a high patient
satisfaction rate
$2.4 billion
Medicare would save this amount
each year if just half of eligible
surgery patients chose ambulatory
surgery centers rather than hospital
outpatient facilities
Source: Ambulatory Surgery Center Association
FIND OUT WHETHER
YOU’RE A CANDIDATE
If you need surgery and
want to check your eligibility
for the Providence Surgery
and Procedure Center, call
509-944-8920.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 21

Chris Murphy and Pam Sheldon look on as
Northwest MedStar’s fixed-wing plane—
equipped to maintain a NICU environment
during flight—approaches the hangar.
CARE
in theAIR
THE NORTHWEST MEDSTAR TRANSPORT
TEAM DELIVERS CRITICAL SUPPORT FOR
PATIENTS THROUGHOUT THE REGION.
22 HEART BEAT WINTER/SPRING 2016

STORY BY WILL MORTON
PHOTOS BY GARY MATOSO
AMELIA, a name known for
flight. “She flew before her sisters,”
says Amelia’s mom, Jane Harrington,
45, of Lewiston, Idaho. Then again,
Amelia wasn’t quite 2 days old at the
time of her courageous trip, and her
health condition was critical.
On Jan. 12, 2015, Jane and her family
arrived at St. Joseph Regional Medical
Center in Lewiston for a scheduled
delivery. Amelia was full term, but she
was breech. Her doctor successfully
turned her head down, and after inducing
labor, the delivery went quickly.
Amelia’s Apgar score—a measurement
of appearance, pulse, responsiveness,
muscle activity and breathing—
appeared normal, but she was not acting
like a healthy baby.
“She didn’t want to breast-feed.
She couldn’t latch,” Jane says.
Amelia was also hypotonic, or
“floppy,” as one doctor described it,
and jaundiced. Her blood pressure and
glucose levels were low. Soon, Amelia’s
neonatal care team had a diagnosis: sepsis,
a potentially life-threatening inflammatory
response caused by infection.
“At that point, she was never back
in my room,” Jane recalls.
DECISION TIME
Doctors moved Amelia to the neonatal
intensive care unit (NICU) at St.
Joseph and started her on antibiotics.
They called Sacred Heart Medical
Center in Spokane—one of two hospitals
in Washington with a Level IV
NICU capable of caring for the sickest
babies—to consult. The decision: Get
Amelia to Sacred Heart, fast.
With early diagnosis and treatment,
full-term infants like Amelia are not
expected to experience long-term
health problems associated with sepsis;
however, infection is a major cause of
With baby Amelia’s
life in the balance,
Jane and Shane
Harrington relied on
Northwest MedStar to
fly the young patient
100 miles to Sacred
Heart Medical Center.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 23

fatality during the first month of
life, contributing to 13 to 15 percent
of all neonatal deaths.
Jane’s husband, Shane, who had
gone home the night before with
their 14- and 16-year-old daughters,
made it back in time to see them off
as mother and baby were transported
to a nearby airport and the waiting
Northwest MedStar fixed-wing plane
that would fly them to Spokane.
As the pair took off, Shane
hopped in his car and hit the road. It
would take Jane and Amelia 30 minutes
in the air and two 20-minute
ambulance rides—one in Lewiston,
one in Spokane—to get to Sacred
Heart. Shane, over two hours.
“The drive,” he says, “was a blur.”
ON BOARD
The Pilatus is a turboprop aircraft
that hits a cruising speed of 300 mph
at a maximum altitude of 28,000
feet. These planes as well as the helicopters
in the Northwest MedStar
fleet are equipped to maintain the
critical care environment of a NICU
during flight.
On board, flight perinatal nurse
Pam Sheldon and flight respiratory
therapist Chris Murphy sat buckled
in their seats, back to back, with
Amelia next to them and Jane a
few feet away to the rear, watching
everything. Patients are transported
in isolates—self-contained
neonatal care units that are guided
by hoist and cable into the plane
and then secured.
“I try to keep in constant communication
with the parent,” says
Sheldon, a 30-year flight nurse. Not
only are patients and their families
experiencing a medical emergency,
but also they are flying in a turboprop
plane, and sometimes flying
for the first time.
The decision to use the fixedwing
plane over one of the helicopters
depends upon availability and
weather. (Helicopter pilots operate
in visual flight mode, which means
“if you can’t see it, don’t do it,”
Sheldon says.)
Jane and Amelia’s flight to Spokane
was smooth. Sheldon administered
glucose to Amelia during
the trip and made sure Jane knew
what every movement meant, even
just a thumbs-up for assurance.
REALITY SETS IN
For Jane, the trip was “very surreal.”
She hadn’t had time to process
it all. Getting through the
journey had been at the forefront of
her thoughts: There was the ambulance
ride to the Lewiston airport.
The flight. The landing at Spokane’s
Felts Field. Another ambulance
ride to Sacred Heart. Each leg
Chris Murphy and Pam
Sheldon are trained and
ready to deliver critical care
to patients during flight.
Northwest MedStar’s
coverage area is vast—
primarily eastern and
central Washington,
northern Idaho, Montana
and eastern Oregon. The
nonprofit organization
also provides patient
transport to Seattle and
other facilities throughout
the U.S. and parts of
Canada. Most recently,
Northwest MedStar began
serving Providence St.
Patrick Hospital and
Community Medical
Center in Montana.
24 HEART BEAT WINTER/SPRING 2016

entailed transferring Amelia in the
312-pound isolate.
Time slowed down again when
she entered the NICU. She realized
that she’d only had a little time in
the birthing room for skin-to-skin
contact with her baby and that
Amelia was in a struggle for her life.
“It was like reality slapping me in
the face,” Jane says.
NICU PREPARED
Neonatologists at Sacred Heart
had the whole picture—from the
moment Amelia was born to when
she entered their care, including
updates from the nurses in the
fixed-wing. “We’re in constant
communication with them prior to
their arrival,” says Meagan Clemmens,
Sacred Heart NICU assistant
nurse manager.
But the care providers are also
very aware of the parents. “We
know they’re overwhelmed with
information and take it slowly with
our explanations from the moment
we move the patient from the isolate
to our monitors,” she says.
Amelia was in the NICU for
two weeks before she responded
well enough to continued antibiotic
treatment to be moved to a
step-down unit for the rest of her
Sharing a Name—and a Mountain View
Pam Sheldon’s role in baby Amelia’s story ended when the Sacred Heart
neonatal intensive care unit staff took over for her Northwest MedStar critical
care transport team. But Sheldon notes her job as flight perinatal nurse
allows her reflective moments to cherish transports that end well. Sitting
buckled in the Pilatus turboprop, flying back to base, sometimes she just
enjoys the snow-covered mountains at sunset. Perhaps it’s the same view
that another Amelia admired also. Like baby Amelia, Amelia Earhart passed
through Felts Field as a passenger—in a Ford Trimotor plane in 1933.
recovery. In the many hours he sat
vigil on the third floor of Sacred
Heart, Shane heard helicopters
landing and taking off from the
roof. His fears turned to gratitude
when he realized Amelia would
make it.
“She had all the care and love
and compassion in the world
around her from the minute she
got there,” he says.
LOOK AT HER NOW
Doctors still don’t know exactly
what caused Amelia’s infection.
The usual bacterial suspects have
been ruled out, but organisms
with increased antibiotic resistance
have emerged that further
complicate management of the
infection. Early-onset sepsis usually
results from an organism acquired in
the birth canal and develops within
six hours of life.
Amelia was discharged Feb. 9. Her
entire ordeal lasted four weeks. Today,
at 13 months old, she loves to armycrawl
and play pat-a-cake. “Looking at
her now, you wouldn’t have known,”
Jane says. “She’s very happy.”
CHOOSE MEDSTAR
You have a choice for air medical
transport. Talk to your provider
and ask for the Northwest
MedStar transport team.
GET TO KNOW NORTHWEST MEDSTAR’S AIRCRAFT
HELICOPTER
Name: Airbus Helicopter H135
Ideal for: Landing at accident
scene or hospital; moving
patients over shorter distances
(less than 150 miles)
Cruising speed: 158 mph
On board: 3 crew, 1–2 patients
FIXED-WING PLANE
Name: Pilatus PC-12/47E
Ideal for: Smooth loading and
unloading of patients; longer
transports (5 hours of fuel);
inclement weather
Cruising speed: 270–300 mph
On board: 3 crew, 1–2 patients
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 25

COMMUNITY
HOW WE’RE IMPROVING OUR HEALTH
To learn more about Providence Health Care’s
community benefit program and community
health needs assessment, go to phc.org and
click “Community Support.”
Creating Healthier
Communities, Together
How Providence identifies—and meets—
our communities’ greatest needs.
As health care continues
to evolve, Providence is
responding with dedication
to its Mission and
a core strategy to create healthier
communities. One way we’re doing
this is by partnering with community
organizations to conduct
a formal community health needs
assessment. The goal is to learn
about the greatest needs of the
most marginalized groups of people
in our communities. This assessment
helps us create solutions to
fulfill unmet needs and guides our
community benefit investments,
not only for our own programs,
but also for many partners.
In 2015, we began with baseline
data gathered in a 2013 communitywide
needs assessment
conducted by Priority Spokane,
a civic leadership group made up
of the local government, businesses,
nonprofit organizations
and local funders. Working with
this group and with the Spokane
Regional Health District, Providence
solicited further input.
Dozens of participants from
throughout the community and
representing multiple organizations
provided feedback.
THINKSTOCK
26 HEART BEAT WINTER/SPRING 2016

OUR STARTING POINT: COMMUNITY HEALTH MEASURES IN 2015
Providence used results from 2015 surveys and data from the health district to establish current
community needs and top priority needs for 2016–18:
PRIORITIZED NEED SPOKANE COUNTY MEASURES FOR 2015
Mental health Nearly 11 percent of adults self-report poor mental health
28.5 percent of youth suffer from depression
48 children out of every 100,000 are victims of child abuse
Diabetes One quarter of youths and adults are overweight
10 percent of adults have diabetes
Only 55 percent of surveyed adults are regularly physically active
Dental Nearly 30 percent of people do not receive regular dental checkups
Immunizations Only 40 percent of preschoolers receive on-time immunizations
More than 6 percent of school-age children have vaccine exemptions
Stable housing In 2014, Spokane County had 1,149 people who were homeless,
including 146 families with children
MEASURING OUR PROGRESS
The research in 2015 also included a review of Providence’s last community health needs assessment.
Providence conducts a thorough assessment every three years, which directs our work until the next
assessment. In 2012, the assessment identified and prioritized the following health concerns:
Mental health and substance abuse
Access to care and care coordination
Obesity and diabetes
In response, Providence made a significant investment in time, resources and funding to programs
that were most likely to have an effect on these needs. Below is a sample of the work that was done
with community partners in 2013–15 to improve the overall health of our community.
PARTNER TYPE OF PROGRAM OUTCOMES OUR SUPPORT
Christ Clinic
Low-cost clinic;
behavioral health
5,813 patient visits;
1,290 unique patients
served
Funding given
Community Detox Service
of Spokane
Partners with Families and
Children/Child Advocacy
Center
Homeless Respite Program
at House of Charity
Spokane Prescription
Drug Access Network
Dental Emergencies
Needing Treatment
Sobering services
Child neglect/abuse,
specialty exams
Recuperative care for homeless
after acute hospital care
No-cost, reduced-cost
medications
Reduces emergency
department visits for
dental emergencies
577 total admissions
from emergency
department
772 children served;
547 caregivers served
195 homeless men and
women served
351 patients served;
259 prescription refills
provided
1,160 patients referred;
701 appointments
Program funded and
operated by Providence
Funding given
Funding given
Funding given
Funding given
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 27

FOUNDATION
HOST A FUNDRAISER OF YOUR OWN!
For more information and ideas about
making a difference in the community,
call 509-474-4917 or visit phc.org/giving.
To learn more about Cancer Can’t, visit
cancercant.info.
Comforts of Home
A cancer patient raises money to transform
hospital rooms into healing spaces.
Imagine spending three
weeks out of every month
away from home. Now imagine
it in a hospital room,
receiving aggressive chemotherapy,
away from your spouse
and children. That was Jonathan
Van Keulen’s reality for nine
agonizing months as he battled
osteosarcoma, a rare and serious
form of bone cancer.
During Van Keulen’s long stay at
Providence Sacred Heart Medical
Center, he yearned for the simple
comforts of home. Oncology rooms
are designed to help caregivers
administer treatment, but they can
be utilitarian. Van Keulen and his
wife, Becky, began to ask themselves
what it would take to create a more
homelike environment. A comfy
recliner. A fridge stocked with favorite
foods and a microwave to heat
them. Walls with beautiful art rather
than a cluttered bulletin board.
And so a nonprofit organization,
Cancer Can’t, was born.
Cancer Can’t hosted a golf
tournament and dinner last fall
and raised $123,000—enough
to totally refurbish 16 rooms in
Sacred Heart’s Oncology Unit.
“Jonathan and Becky’s efforts
have truly been spectacular,” says
Joyce M. Cameron, chief development
officer of Providence Health
Care Foundation. “We are so
grateful that they used their personal
experience with cancer to
pay it forward. These new rooms
will make such a difference to our
cancer patients.”
For the Van Keulens, the refurbished
oncology rooms are just
the beginning. Cancer Can’t and
its board of directors are exploring
many other ways to support area
oncology patients. “We can give far
more than cancer could ever take
away from us,” Van Keulen says.
“Cancer can’t, but we can!”
During Jonathan Van Keulen’s battle
with bone cancer, he and his family
started a nonprofit organization to help
add softer touches to treatment areas.
STARR IMAGES
28 HEART BEAT WINTER/SPRING 2016

M.D. SPOTLIGHT
Doing the
Right Thing
Difficult questions come up routinely
in health care. Andi Chatburn, D.O., M.A.,
explains how clinical ethicists can help
bring clarity.
ANDI CHATBURN, D.O., M.A., MEDICAL
DIRECTOR FOR ETHICS, PROVIDENCE
HEALTH CARE, EASTERN WASHINGTON,
AND PALLIATIVE CARE PHYSICIAN,
PROVIDENCE SACRED HEART MEDICAL
CENTER & CHILDREN’S HOSPITAL
AND HOLY FAMILY HOSPITAL, SPOKANE
Q: What do you do in your role as
medical director for ethics?
A: At its core, my job is to focus on how we ought to
care for one another. Part of that means making sure
that our hospital policies empower us to care for our
patients in a way that is consistent with our Mission
and values. Another part is to maintain an internal
culture of ethics through ongoing staff education. And
the rest of my job is to be available to patients and families
for ethics consultations.
Q: What is an ethics consultation?
A: Ethicists are often called in to help resolve tough
questions in difficult situations, such as how much
medical intervention, if any, is right for a patient near
the end of life. We meet with the patient and family and
ask questions like: What matters most to you? How do
you prefer to receive care? What would be a good outcome
for you? Our role is to ask, to listen, to hear the
patient’s story and to respect the patient’s values and
preferences. If the patient is unable to make decisions
for himself, we work to make sure that the people he
trusts are involved in his care.
Q: What drew you to your specialty?
A: As an undergraduate, I studied religion and philosophy
in addition to pre-med. One class, called Suffering
and Meaning, was pivotal for me. It explored all aspects
of suffering, from the Buddhist teachings of suffering
as a part of all life, to the biblical story of Job, to Rabbi
Harold Kushner’s book “When Bad Things Happen to
Good People.” That led me to pursue palliative medicine
and a master’s degree in clinical ethics. I feel that
the work of clinical ethics ties directly into my call to
medicine to relieve suffering of all kinds: physical, emotional,
spiritual, relational and metaphysical.
Q: What have you learned through
your work?
A: When I ask people questions like, “What matters
most to you?” I get answers such as, “Being married to
my spouse for 70 years” or “Being able to give to my
community.” In the midst of the most difficult medical
situations, these are the things people are thinking
about. It’s a constant reminder of what’s important,
and it helps me stay centered in my own life.
HOW TO REQUEST AN
ETHICS CONSULTATION
Patients and families in any of Providence’s
eastern Washington hospitals can request
an ethics consultation through their doctor
or nurse or by paging 509-880-2935.
OUR ROLE IS TO ASK,
TO LISTEN, TO HEAR THE
PATIENT’S STORY AND
TO RESPECT THE PATIENT’S
VALUES AND PREFERENCES.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 29

CALENDAR
Classes, Events
and Activities
Winter/Spring 2016
SEE MORE EVENTS
Check out the full
calendar of events at
phc.org/heartbeat. Hover
over “Health Resources,”
then choose “Calendar
of Events.”
INHS COMMUNITY
WELLNESS CLASSES
To register, go to wellness.inhs.
org (unless otherwise noted).
RESPECTING CHOICES
Join us for this free advanced-care
planning workshop, where we will
help you begin to reflect upon,
understand and start those important
conversations about your goals,
values and beliefs for your future
health care choices.
HEALTH COACHING
Meet one on one with a registered
dietitian, a certified diabetes educator,
a tobacco cessation educator or
an exercise physiologist to discuss
and execute your personal health
goals. For an appointment, call
509-232-8138.
INBODY
The InBody machine gives you a
complete picture of your body composition.
Take a one-time test for
$20, or buy three and get one free.
LIVING WELL WITH
DIABETES
This six-week program will help
you take control of your diabetes.
Family members or support people
are welcome to attend.
QUIT FOR GOOD
Let us help you kick the tobacco
habit for good. This free four-week
program is available to you
anywhere via a live, interactive
webinar.
BABY-SITTING BASICS
This fun class will help provide
the skills and training young
baby sitters need to be safe
and successful.
LUNCH-AND-LEARN
WEBINARS
Join us on your smartphone, tablet
or computer for fun, interactive
presentations on a variety of health
and wellness topics. Hosted on the
third Thursday of each month from
noon to 1 p.m.
1 in 3
American women say heart disease
is their greatest health threat
GO RED FOR WOMEN
GET READY FOR BLOOMSDAY
Free Bloomsday training clinics will
be at Spokane Falls Community
College gym on Saturdays starting
at 8:30 a.m., March 12 through April
23. Hear from training experts,
stretch and warm up with a personal
trainer, then walk or run weekly
routes at your own pace. To register,
visit phc.org or call 509-474-2397.
PROVIDENCE HEALTH &
FITNESS EXPERIENCE
Located at the Spokane Convention
Center on April 22 (4–9 p.m.),
April 23 (10 a.m.–6 p.m.) and April
24 (10 a.m.–3 p.m.). Visit spokane
womensshow.com for details.
Come together in the fight against heart disease, the No. 1
cause of death among women. Mark your calendars for a fun-filled
day that will include a lunch, a keynote speaker, heart-healthy presentations,
a silent auction and health screenings.
WEAR RED AND JOIN IN THE HEART-HEALTHY ACTIVITIES!
MARCH 9, 9 A.M.–2 P.M., SPOKANE CONVENTION CENTER,
BALLROOMS 100AB
OPPOSITE PAGE: THINKSTOCK
30 HEART BEAT WINTER/SPRING 2016

HEALTH TIP
Joint Solutions
If you’re worried about developing arthritis—or even
if you’re not—there are ways to lower your risk.
Arthritis is a general term
referring to more than a
hundred conditions, including
osteoarthritis, rheumatoid arthritis,
fibromyalgia and gout. Being female
and having a family history of
arthritis does increase your risk for
developing one of these conditions,
according to the Arthritis Foundation.
But it doesn’t necessarily
mean you’re bound to the same fate
of joint pain as your mother.
Osteoarthritis is the most common
joint condition and is what
many people refer to when they
say “arthritis.” The disease occurs
when the tissue and cartilage
between joints break down. The
symptoms of osteoarthritis are
joint stiffness, pain and swelling.
WHAT YOU CAN DO
Researchers are still trying to
pinpoint an exact cause of osteoarthritis,
but for now, moderation
seems to be the path to prevention.
Being overweight raises your risk
of developing osteoarthritis, as
does having a prior sports injury.
52 mil
Estimated number of U.S.
adults who have a form of
doctor-diagnosed arthritis.
Experts recommend engaging in
moderate-intensity exercise for
30 minutes per day.
If you begin to notice the symptoms
of osteoarthritis, see your
doctor sooner rather than later.
And start a joint-pain journal, jotting
down when you experience
pain and stiffness, what you were
doing just prior and what, if anything,
alleviated the pain. That
will help you and your doctor
determine how best to manage
your condition.
TREATMENT OPTIONS
Physical activity. Light exercise,
such as walking, yoga or tai chi,
can help reduce pain and preserve
range of motion. Strengthening the
muscles surrounding an arthritic
joint can help take pressure off the
joint, thereby reducing pain.
Medication. Medication is available
in the form of pills, syrups,
creams or injections. It may take
some time to find one that works
for you, which is why your joint
journal will be important.
Physical therapy. Working with
a therapist, you’ll strengthen jointsupporting
muscles, learn proper
form for everyday activities and
work on range-of-motion stretches.
Assistive devices. Lots of
products are available today that
make living with arthritis easier,
including canes, walkers, scooters,
splints, orthotics, jar openers and
steering-wheel grips.
Surgery. If other treatments
stop working, your doctor may
recommend joint repair or replacement
surgery. Artificial joints and
the surgical techniques to place
them are better than ever and can
even get you back to doing many
of the activities you love.
TAKE THE NEXT STEP
Want to know more about your
options? Call your primary care
provider and ask for a referral
to an orthopedist in your area.
READ ON YOUR TABLET OR PHONE: PHC.ORG/HEARTBEAT 31

Providence Sacred Heart
Medical Center & Children’s Hospital
101 W 8th Ave
Spokane, WA 99204
NON-PROFIT
ORG
US POSTAGE
PAID
HEART BEAT
ROLE MODEL
Clark Peterson, Chaplain
Soul Support
Clark Peterson works the evening shift as a
chaplain at Providence Sacred Heart Medical Center.
Late into the night, he sits with patients and families,
offering support and solace as they face medical
emergencies, traumas and, sometimes, goodbyes.
Peterson is part of a team of chaplains that covers
the hospital 24/7 to make sure that spiritual services
are available to every person who needs it. Although
people sometimes assume that the chaplain’s role is
to promote a particular religious belief, “that couldn’t
be further from the truth,” Peterson says. “Our role
in the hospital is to try to help each individual draw
strength from whatever is sacred or holy to them.
“The Sisters of Providence didn’t separate the healing
of the body and the healing of the soul,” Peterson
adds. “They knew it was a whole package, and by
caring compassionately for the whole person, they
demonstrated the love of God.”
Clark Peterson and his fellow
chaplains help people draw spiritual
strength while in the hospital.
WANT SOMEONE TO TALK TO?
Chaplains are available around the clock in
Providence hospitals to provide respectful,
confidential support, with sensitivity to each
individual’s culture and beliefs. For more
information, ask your provider.
GARY MATOSO
OUR MISSION IS TO REVEAL GOD’S LOVE FOR ALL, ESPECIALLY THE POOR AND VULNERABLE, THROUGH OUR
COMPASSIONATE SERVICE. OUR VALUES ARE RESPECT, COMPASSION, JUSTICE, EXCELLENCE AND STEWARDSHIP.