Vital Signs Spring 2016

SPRING EDITION I 2016

SAVING THE SMALLEST IN OUR COMMUNITY

RESIDENTS:HERE TO STAYGenerations

Past and Future

Served By Kaweah Delta

KAWEAH DELTA HEALTH CARE DISTRICT22

ED: Fast-Paced, Team-Oriented Kaweah Delta’s emergency department (ED) nurse manager provides insight on changes made to better serve our community in the ED.

Our Family, Our HospitalMeet a local family who has had four generations born in Visalia and how Kaweah Delta has grown to serve them.

Saving the Smallest in Our CommunityA unique assessment got one newborn immediate attention for a congenital heart defect.

Here to StayMeet two Graduate Medical Education (GME) residents who choose to continue to practice medicine in Visalia.

Past & PresentMeet Dr. William Winn and what brought him to Visalia. Also, meet Felicia Vaughn and her care for the smallest in our community.

Vital Signs magazine is produced by Kaweah Delta’s Marketing Department.

SPRING EDITION I 2016

INSIDE THIS ISSUE

April is National Donate Life Month, a time to thank the registered organ, eye, and tissue donors in our community. In 2015, 30,973 lives were saved or healed by an organ transplant in the U.S. – an all-time record.

Kaweah Delta Medical Center will join the thousands of supporters that will be sharing their stories, sporting the Donate Life blue and green colors, and spreading the message of donation in the Valley during April. On April 21, our hospital is holding a donation registration drive in partnership with Donor Network West, the organ procurement organization that serves Northern California and Nevada. Donor Network West works in

close partnership with 175 hospitals to save and heal lives.

Kaweah Delta Medical Center has been a tremendous supporter of organ and tissue donation. Last year, it won a bronze medal award for holding engaging donation activities as part of the Health Resources and Services Administration Hospital Campaign.

One organ donor can save the lives of up to eight people and a tissue donor can heal more than 50 others. Anyone can register as a donor at DonorNetworkWest.org or at the DMV. For more information on donation or the registration drive, contact Marcella Corona at [email protected].

90,000

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ED VISITS IN 2015

3VITAL SIGNS I SPRING EDITION 3

While Kaweah Delta must plan for the future by developing a new acute care hospital, training the next generation of physicians and nurses, and providing the latest medical technologies, our most important work revolves around ensuring safety and clinical quality for patients. This is what we do every day, for each of our patients - whether in the Emergency Department providing life-saving care, in the Cath Lab treating critical cardiac conditions or in our Neonatal Intensive Care Unit (NICU) caring for premature infants.

During the past year we have been nationally recognized for achieving success in our clinical quality and patient safety efforts including:

•Earning for the second time an “A” rating for patient safety from the Leapfrog organization based on a wide range of patient safety measures. We know that we have performed at the level to achieve this distinction again.

•Recognition by U.S. News & World Report as being among the top 14% of hospitals in the nation who perform coronary artery bypass graft surgery.

• Achieving the Spine Surgery Excellence Award from HealthGrades for our superior outcomes in spinal surgery. Our orthopedic and neurosurgeons do an outstanding job in the area of spine surgery.

•Earning the General Surgery Excellence Award from HealthGrades for our outcomes in

LINDSAY MANN Chief Executive Officer

KAWEAH DELTABOARD OF DIRECTORS

ZONE 1Herbert Hawkins

ZONE 2Lynn Havard Mirviss

RN, Ed.DSecretary/Treasurer

ZONE 3John E. Hipskind

M.D., FACEP

ZONE 4Carl Anderson

President

ZONE 5Teresa Ramos

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where just five minutes taking one of 16 health risk assessments could

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FROM THE CEO

KAWEAHDELTA.org

general surgery and for two years in a row, the HealthGrades five-star distinction for colorectal surgeries.

•Receiving, for 10 years in a row, the five-star distinction for excellence in total knee replacement from HealthGrades.

•Being designated by Blue Cross as a Center of Excellence in cardiac surgery based on meeting nationally established standards across a wide range of cardiac surgery procedures.

•Relative to infection prevention, the Center for Medicare and Medicaid Services’ (CMS) “Hospital Compare” report identifies Kaweah Delta as performing “better” than national standards in five critical measures of infection management.

We work hard to provide the proper context for delivering excellent care, including the development of essential facilities, the acquisition of state-of-the-art technologies and ensuring we are staffed by outstanding professionals. However, our top priority is to provide each patient with the safety and clinical outcomes they expect at Kaweah Delta.

As an organization, we are on an upward trajectory of continual improvement for our community. We know this by the external measures outlined above and many more that could be referenced. However, our progress is most evident in the daily efforts of our physicians, nurses, and many others who, in their care of each patient, work to meet nationally-recognized standards in the areas of safety and clinical quality.


As a teaching hospital, Kaweah Delta provides high tech equipment and facilities to our medical and support staff to offer award winning care to the community. In addition, by addressing parking concerns, to air lifting patients from our helipad, we are providing safe, secure, and convenient ways for our community to access quality health care.”

TO PROVIDE SAFE, HIGH-QUALITY, CUSTOMER-ORIENTED, AND FINANCIALLY STRONG HEALTH CARE

SERVICES THAT MEET THE NEEDS OF THOSE WE SERVE.

With every procedure and surgery performed, we are always making improvements to ensure the highest levels of patient safety. Kaweah Delta aims to uphold a safe patient environment with great outcomes for you and your family.”

Annually, Kaweah Delta’s external audits show our financial strength by having strong operating margins, adequate cash reserves, and a solid balance sheet. Additionally, Kaweah Delta continues to put responsible funding plans in place for current and upcoming projects.”

To ensure high-quality care, we collect and report hundreds of medical results, and use this information to measure ourselves and set goals for even better care. Whenever we see room for improvement, we act. To ensure the highest quality care for our patients, Kaweah Delta sets goals to meet or exceed state and national standards. We then collect data and measure how well we meet these standards. We improve on how we care for our patients until we meet our goals.”

Kaweah Delta has entered into the most dynamic growth phases in its history. We are planning a new acute care hospital to better serve you and your family for future generations. Your ongoing community support will help us become successful in our goals.”

“

K A W E A H D E L T A H E A L T H C A R E D I S T R I C T

“ “ “ “

JOHN E. HIPSKINDMD, FACEPZONE 3

LYNN HAVARD MIRVISSSecretary/TreasurerZONE 2

CARL ANDERSON PresidentZONE 4

TERESA RAMOS ZONE 5

HERBERT HAWKINS ZONE 1

5VITAL SIGNS I SPRING EDITION

1991 Kaweah Delta emergency department handles more than 30,000 patients per year2000 Kaweah Delta emergency department handles more than 50,000 patients per year2003 Kaweah Delta emergency department handles more than 60,000 patients per year2015 Kaweah Delta emergency department handles more than 90,000 patients per year

1921

1984

1993

2015

2013

2003

2009

1936

1952

19611963

1965

1969

Kaweah Hospital, Inc. was formed and opened at 415 W. School St.Population of Visalia: 5,753

The 43,000 sq. ft. western expansion project is completed, featuring an 18-bed intensive care unit, transitional care unit, rehabilitation department, and endoscopy lab.

East expansion completed, including an enlarged emergency department, a family birth center, and pediatrics department. The three-story expansion also enlarged the main lobby and radiology department.

Population of Visalia: 127,763The City of Visalia’s General Plan Update says Visalia can expect to grow to 165,000 by 2020, and an anticipated 210,000 residents by 2030.

Helipad construction complete and operational. 483 total landings (366 outbound transports and 117 inbound transports from 06/03/13 – 01/20/16)

Measure M passed to fund Acequia Wing. Population of Visalia: 107,550

Funded by Measure M, construction of Acequia Wing is complete adding a cardiac intensive care unit and telemetry beds, four cath labs and three cardiac surgery suites, chest pain center in the emergency department, non-invasive cardiology services, maternal and child health services, and shelled space for future expansion. Population of Visalia: 124,442

Visalia Municipal Hospital was established, and opened on October 15.Population of Visalia: 7,263

Opening of 36-bed maternity wing with two labor rooms.Population of Visalia: 11,709

March 28, voters approved the establishment of a hospital district.Population of Visalia: 15,791August 1, the former Visalia Municipal Hospital (60 beds) became Kaweah Delta District Hospital.

December 14, bond passed by voters to build a 150-bed hospital. The hospital qualified for a bond designated for acute patient beds and long-term patients. Entire hospital replaced with 224-bed hospital.Population of Visalia: 27,268

Hospital Growth to Meet Community Growth

ED VISITS

AND BEYOND

HERBERT HAWKINS ZONE 1


In the early 1900s, the Ainley family migrated from Iowa to Elderwood, California in search of investment opportunities. With partners, Charles and Agnes Ainley purchased land and invested in irrigation to plant orange trees. Unfortunately, the family ran out of water and chose to convert the land to raise cattle. Charles and Agnes’ family grew with five sons and one daughter. Their third eldest son, Ralph, went on to graduate from UC Berkeley with a bachelor’s degree in agriculture and returned home to settle in the old homestead. Ralph married Jessie Herrington in 1920 and they raised their four sons and one daughter in Elderwood. The youngest of the five was Frank, who was the first to be born in Visalia at Kaweah Hospital, Inc. located at 415 W. School St.

“Because my uncle, who I am named after, was a doctor and medical director in Southern California, all my siblings were delivered by him, but I was first to start the tradition in Visalia,” said Frank Ainley, 83.

After graduating high school in 1951, Frank served in the National Coast Guard, and in 1953, he married his wife Barbara Brewer, who was the first Woodlake Lions Club Rodeo Queen. Frank and Barbara’s three

sons and daughter were born in the 36-bed maternity wing at the Visalia Municipal Hospital, which was added to the hospital in 1951.

“I returned home from the Coast Guard a day after the births of Tim and Annette, but I was there at the Visalia [Municipal] hospital when Frank Jr. and Craig were born. In those days, men were not allowed in the delivery room,” said Frank. “I did not witness their births, but I have fond memories of my children thereafter. My boys and I gathered and branded cattle, and my daughter Annette stayed close to me on the ranch, and remains close to me today.”

Annette, a speech pathologist, married Tom Buckley in 1979 and moved to Visalia to raise their three daughters, Tiara, Vanessa, and Brittany; all born at Kaweah Delta District Hospital. “To say the least, the event was painful, but overall, each experience was very satisfying,” said Annette. “With Brittany, I remember being one of the first to use an ABC (Alternative Birth Care) unit, which allowed for the entire birthing process to take place in the same room. In both my prior experiences, labor took place in one room, and delivery in another. My most memorable experience was in

1983 when Vanessa was born and we had an earthquake. I remember the floor was rocking, and it felt weird being up on the second floor.”

Vanessa Buckley married Evan De Jong and they currently reside in Visalia raising their two children, Greyson and Harper. Both children were born at Kaweah Delta Medical Center and stayed in a private room within the newly built Mother/Baby unit in the Acequia Wing.

“I heard from close friends who went to hospitals in Fresno about how they shared rooms with other mothers. It was nice to have privacy with my family,” said Vanessa. She recalls nursing staff caring for her son Greyson, allowing her to obtain some quality rest. With Harper, it was a planned event to be induced into labor. “I remember arriving at a scheduled time and date. They had a room waiting for me, I received my epidural, watched TV as I waited, and then came Harper. I had a very joyful stay, the experience was a dream and the medical staff was even better than I would have ever imaged.”

In 2014, the Ainley family welcomed four great grandchildren. Although being a mother of four, Barbara Ainley, now a great grandmother,

GenerationsPast and Future


As Our Family Has Grown, So Has Our Hospital


was overjoyed to have witnessed childbirth for the first time in the labor and delivery unit, and spent quality time with Ted Jr. in the Mother/Baby unit. Sadly, weeks after witnessing the miracle of childbirth, Barbara lost her battle with cancer shortly after arriving to the emergency department at Kaweah Delta.

“It all happened very quickly, but I am glad she was able to meet her great grandchildren,” said Frank, lifelong spouse to Barbara. “I feel blessed to have had the compassionate care we received by Dr. [Lori] Winston and our nurse Catherine [Carlton]. Prior to my wife’s passing, Dr. Winston continuously informed me of her status, and gave me hugs when I needed it. We were able to have our entire family in the room when she passed, and I am very thankful for that.” Dr. Lori D. Winston is an emergency medicine physician and Catherine Carlton is registered nurse at Kaweah Delta Medical Center.

Over the years, the Ainley family has welcomed four generations in Visalia. Kaweah Delta has and will continue to evolve to serve the Ainely’s growing family and many more families in our community.


FOUR GENERATIONS OF THE AINLEY FAMILY HAPPILY SERVED BY KAWEAH DELTA

As Our Family Has Grown, So Has Our Hospital

Pictured (Top to bottom): Frank Ainley, Annette Buckley, Vanessa De Jong, and Greyson De Jong.




EVERY PARENT’S FEAR

Approximately one percent of newborns have a congenital heart defect, with one out of four requiring surgery, according to the Centers for Disease Control and Prevention. This statistic for newborns became an unfortunate reality for the parents of Logan Flores: Cameron Flores and Bonnie Huerta of Visalia.

Born at a healthy 7 pounds 11 ounces on Sunday, September 13, Logan didn’t have any complications at birth and passed all screenings and physical examinations. “He nursed well all night and we gave him a bath to get him ready to be released home Monday morning,” said Bonnie. “His grandmother had already brought the car seat to the room, he just had a few more tests to complete.”

Mary Hurick, registered nurse in Obstetrics Postpartum at Kaweah Delta, took Logan to get his hearing test with his father, Cameron, and the first test was good. “Then they did the oxygen level test and saw that the oxygen levels had not increased like they are supposed to,” said Cameron. “So, they took him to the NICU for a more in-depth test. It was the scariest thing ever – they needed to consult with the pediatrician and call in Dr. Coll.”

HELIPADLogan is one of 370 outbound helicopter transports since the Medical Center partially funded the construction of the helipad in 2013 to benefit from having access to air travel from Kaweah Delta.

in Our Community

Savingthe Smallest

Pictured above (Left to Right):Dr. George H. Latta, Mary Hurick, RN, Dr. Ana Carolina Coll, Cameron Flores, Bonnie Huerta, and baby Logan.


Dr. Ana Carolina Coll, the only pediatric cardiologist between Bakersfield and Fresno, confirmed Logan’s condition from an echo test. “Kaweah Delta is the only local hospital that has pediatric echocardiography and pediatric cardiology services on site, which make it possible for immediate diagnosis and management,” said Dr. Coll. Logan was diagnosed with total anomalous pulmonary venous return (TAPVR), a rare congenital malformation in which all four pulmonary veins do not connect normally to the left atrium of the heart.

Each year, more than 35,000 babies in the United States are born with congenital heart defects. According to the National Heart, Lung, and Blood Institute, congenital heart defects are the most common type of birth defect. A simple test, not routinely used nationwide, can indicate a heart defect that prevents blood from passing through the lungs properly. At Kaweah Delta Medical Center, all newborns are screened within 24 hours of birth

using a pulse oximetry, a non-invasive measure of oxygen in a baby’s blood involving a sensor placed on the foot. This process is also known as the congenital heart defect test.

“At this time, Kaweah Delta is the only hospital in the county to perform the AAP (American Academy of Pediatric) congenital heart disease newborn screen, which measures the [oxygen] saturation of the newborn in the upper and lower extremities to rule out major congenital heart disease,” said Dr. Coll. “Congenital heart defects can cause lifelong health issues, among them cognitive and neurodevelopmental delays.”

“If not for this test, Logan would have been sent home and it would have caused increased problems later for his breathing,” said Bonnie.

Soon after, Dr. Coll made arrangements to have him air lifted from Kaweah Delta’s helipad to another medical institution for open heart surgery.

“At that moment, our lives changed drastically,” said Bonnie. “During his entire stay we did not leave him.” Dr. Coll remained in contact with Logan’s family throughout his stay. Dr. Coll carefully explained each step to Logan’s parents and she continuously communicated with his surgical team. “I have the good fortune of being a Stanford graduate which facilitates access to the doctors taking care of my patients. They know me there, and know how important my patients are to me,” said Dr. Coll.

“His surgery went really well,” said Cameron. “However, he required additional medical attention that kept him longer.” Dr. Coll advocated to have Logan transferred back to Kaweah Delta’s neonatal intensive care unit (NICU) for post-operative care. Having two siblings, Cecily and Lilliana, Logan’s family appreciated being close to

“home. “I really needed to be near them as well, so having him back in Visalia was good,” said Bonnie.

NEONATOLOGY

First 5 Tulare County provides funding for the Pediatric Hospitalists program at Kaweah Delta, which includes a team of neonatologists and specialists. Logan’s team included neonatologist Dr. George H. Latta, who specializes in medical care for ill or premature newborn infants. “Doctors Coll and Latta worked well as a team and the NICU has some stellar nurses who became attached to Logan,” said Bonnie.

After Logan was discharged, two nurses made regular home visits at the Flores’ home once a week to help with physical therapy in areas that needed more development due to hospitalization for the first two months of his life. Additionally, Cameron and Bonnie were trained on aftercare from Kaweah Delta. Because of Logan’s surgery, he needed to use a feeding tube and have a pediatric gastroenterologist, Dr. Roberto Gugig, closely monitor his eating habits. While Logan continues to show progress, all efforts from his medical team continue to ensure Logan is active with a healthy development.

“Logan is an interesting case where we have a newborn who is not sick at first and would have developed serious issues and later become ill,” said Dr. Coll. “We are fortunate to have the resources to aid the most precious members of our community.”

“This simple oxygen test performed at Kaweah Delta really did save Logan’s life and it should be a standard of care everywhere,” said Cameron. “We are so grateful to have such quality care, technology, and specialists like Dr. Coll and Dr. Latta in our own community.”

This simple oxygen test performed at Kaweah Delta really did save Logan’s life.” – Cameron Flores


Prior to entering the medical field, graduate medical education (GME) Chief Resident, Dr. Sean Oldroyd, was in the restaurant industry managing restaurants professionally and providing quality customer service to each of his patrons. He enjoyed being able to serve others, but felt his position was lacking an intellectual challenge and human component he desired. “What I was missing was the aspect of service you get with medicine, a position of trust that is unique and prominent in health care,” explains Dr. Oldroyd.

After leaving the restaurant industry, he went back to school to complete his pre-med training and worked as an emergency department technician, spending time around nurses, physician assistants, doctors, and continuously asked questions. “My experience in the hospital was enough to convince me I would be very happy working in medicine for the rest of my life,” said Dr. Oldroyd.

Kaweah Delta’s GME is a formal hospital-based training and education program, intended for recent graduates from a medical school to commence their residency phase in pursuit of board certification in their chosen specialty. Following medical school, Dr. Oldroyd started his residency training in July 2013 at Kaweah Delta in the first class of the GME emergency medicine program. “It is emblematic of the character and mission of the hospital to have a GME program,” said Dr. Oldroyd. “The challenge of GME is it adds complexity, but it is what the hospital believes in and that’s impressive to me. As for plans to expand the hospital and GME, I think it speaks to the values of the hospital and their commitment to improve health care in this area. We are indebted to all the leadership who had the vision to plan to transform the hospital.”

BENEFITS OF GME RESIDENTS

“What a teaching hospital means is if you end up in the hospital, most likely you will not only see one, but rather a team of doctors,” explains Dr. Oldroyd. “You have multiple people reviewing your case. Whenever there are learners, inevitably people will ask questions and that pushes innovation and improvement. The environment becomes one of exploration and investigation into what is the best practice for any given condition. Our hope is that it will improve the care for anyone who comes to Kaweah Delta.”

What drew Dr. Oldroyd to Visalia was the patient population and his understanding that it has historically been underserved. “Our community needs access to great health care. Also, it provides an opportunity to get good training, and to give back to the community that’s providing that training. There are good days

As for plans to expand the hospital and GME, I think it speaks to the values of the hospital and their commitment to improve health care in this area.

“

First Graduating Class of GME Residents

DR. SEAN OLDROYDEMERGENCY MEDICINE

HERE TO STAY


and bad days, but every day feels like a privilege, in how we are allowed into peoples’ lives, especially knowing how difficult of a time it can be for them.”

Kaweah Delta’s emergency department (ED) will soon be upgraded to accommodate greater patient demand. ED patients range from someone experiencing chest pain, concerned they are having a heart attack, to patients transported by ambulance from a serious car accident. “Every day is different. We can always count on our ED being very busy, above that it is very difficult to predict the patient you will get, whether an illness or injury. Regardless, our responsibility is to improve their health and even save lives,” shared Dr. Oldroyd. “In the future, I want to stay in medical education. I envision myself continuing to work with medical students and residents in the ED.”

WHAT I LOVE ABOUT VISALIA

Dr. Sean H. Oldroyd grew up in Boulder, Colorado located at the base of the foothills of the Rocky Mountains. Similar in geography to Boulder, Visalia also provides the opportunity to create childhood memories of hiking, camping, and skiing.

“I appreciate that I can take my children camping, like I enjoyed as a kid. I love that we have access to the mountains and the beach is nearby, it’s great. The summers are a little hot for me, but I can’t complain, Visalia is great,” said Dr. Oldroyd with an appreciative smile.

Emergency MedicineGME Graduation Date: June 16, 2016

CLASS OF 2016 EMERGENCY MEDICINE RESIDENTS

Trung Le, MD

Daniel Fong, MD

James Chong-Han Tse, DO

Sean Oldroyd, DO

Ty Philipson, MD

Matt Poliakoff, DO


Family Medicine GME Graduation Date: June 16, 2016

CLASS OF 2016FAMILY MEDICINE RESIDENTS

Fahad Hashmat, MD

Kamel Kamel , MD

Ehab Swehli, MD

Asma Tariq, MD

Aisha Umbreen, MD

Marwan Zoghbi, MD

First Graduating Class of GME Residents

DR. FAHAD HASHMAT FAMILY MEDICINE

HERE TO STAY


From a young age, Dr. Fahad Hashmat held an inquisitive mind about how things worked. His mother was a nurse in Pakistan, and he remembers spending time in the pediatric unit participating in volunteer work. However, it was the illness of a 16-year-old family member with systemic lupus erythematosus (SLE) that influenced him to pursue medicine and find answers to complicated illnesses.

“I was confused and I questioned why at such a young age does she need to suffer so much,” said Dr. Hashmat.From there forward, it was his mission to be a family medicine doctor. While in Karachi, Pakistan, Dr. Hashmat completed his medical degree at Dow Medical College, a highly respected institution for its integrated teaching comprised of applied knowledge. He went on to conduct clinical research at the University of California, Los Angeles, and soon after applied to Kaweah Delta’s graduate medical education (GME) program to start in June of 2013.

“I didn’t know much about Visalia before interviewing for the program,” explains Dr. Hashmat, “and I learned first-hand it was a very sophisticated program and there would be many opportunities. I also learned quickly how precious and inviting the community is in Visalia.” Dr. Hashmat recounts the positive experiences he has had from strangers to his next door neighbors. “I fell in love with the place, the people, and the faculty. People were so friendly.”

As a resident, Dr. Hashmat is part of the team of residents who operate the new Family Medicine Center in Visalia, which is in full operation seeing more than 50 patients per day. Working with patients can be a very emotional experience for Dr. Hashmat. “It is heartwarming to have such an impact on the lives of residents of Visalia and to be able to do it with an incredible health care institution like Kaweah Delta,” said Dr. Hashmat. “I have encountered patients near death, and have been able to not only improve their health, but improve their quality of life, which is important to me knowing they can spend quality time with their family and children.” Additionally, he has enjoyed being involved in the community and has participated in health fairs and conducted onsite high school physicals.

To date, Dr. Hashmat’s greatest highlight of Kaweah Delta’s GME program has been the hands-on experience when conducting procedures in the emergency department, urgent care, pediatrics, and in women’s health. “I can confidently go on to any work opportunity, be it a hospitalist or urgent care, and manage care effectively. Procedures now come natural to us. From speaking with my colleagues at other academic centers, most are surprised in the number of procedures we conduct and how hands-on the program allows us to be,” said Dr. Hashmat.

“

WHAT I LOVE ABOUT VISALIA

As an avid lover of nature and sightseeing, Dr. Hashmat and his family enjoy being close to the snowcapped Sierra Nevada mountains. “I believe it is a perfect fit for my family because I really enjoy being able to have my morning coffee, go to the Sequoia [National Park] to enjoy the snow, and be back home for lunch. Additionally, Visalia has affordable housing with a vibrant downtown and small town atmosphere. If we want the big city feeling, we have Los Angeles and San Francisco nearby.”

Dr. Hashmat lives in Visalia with his wife, who is a local pharmacist, and 18-month-old son, who was born here at Kaweah Delta Medical Center.

It is heartwarming to have such an impact on the lives of residents of Visalia.”


90,000


According to the National Hospital Ambulatory Medical Care Survey, emergency department (ED) visits are on the rise with more than 136 million visits annually. Here at home, the Kaweah Delta Medical Center ED has experienced steady growth, caring for 90,000 patients in 2015, in a space designed for half that many. The ED is continually working to implement new strategies, but the simple fact is our growth has outgrown our square footage.

A fully functional ED is critical to the health of our community and to each patient we care for. Our talented emergency teams manage patients with all types of medical and surgical illnesses and injuries. Within a few hours, teams may attend to a cardiac arrest or stroke patient, aid a 3-year-old trauma victim from a car accident, assess early complications of a pregnancy, evaluate a suicidal teenager, and treat a 90-year-old with

abdominal pain. With the addition of our neurosurgical physicians this year, we have increased the complexity of patients we are able to care for at the emergency department. This is excellent news for our community because patients who were previously transferred to other facilities can now be treated here; however, it has added another strain on treatment space availability. We are not the only ones affected. Ambulance crews are often found in our hall with their patients waiting for a bed to open, reducing the availability of those crews for other emergencies. As our volumes have increased, it has been increasingly difficult to deliver timely care in the ED, so we find ourselves constantly working on improving our processes to better serve our patients in our current space.

A few years ago, the FAST ER started with a goal of having patients seen by a provider and for treatment to begin

FAST-PACED, TEAM-ORIENTED

within 30 minutes of arrival. We had to find other ways to reduce long waits for care, so even though we know most patients would prefer a bed, we began to see some of our patients in chairs in Zone 1 of our ED. We have recently replaced our hall chairs with hall recliners to increase patient comfort, and allow us to give necessary medications quickly and safely. In Zone 1 of the ED, we developed red, green, and blue teams. Each team has two nurses, a technician, physician, and resident physician who work together to provide more unified, and efficient care. While these short-term solutions have helped, our long-term solution will be for Kaweah Delta to expand the ED. This will not only give patients a better place to receive their care, but will allow us to provide the kind of safe, high-quality care that is important to our patients, their families, and all of us.

EMERGENCYDEPARTMENT Message from Karen Hansen,

emergency department nurse manager at Kaweah Delta

Emergency Department visits in 201590,000

WINNDr. WilliamPulmonologist

Where we have been, and Where we are going.Dr. William Winn was raised on the grounds of the former tuberculosis hospital in Springville, California, where his father was the medical director. It was in high school when he first felt his calling to become a doctor. “I recall working on the switchboards,” said Dr. Winn, “and visiting with a woman who had very severe valley fever. It was a simple conversation, but it had made a significant impact in my choice of career.” After graduating from high school in Porterville, he moved away to pursue his medical training.

In 1969, Visalia, with nearly 30,000 residents, had progressively invested in building a four story, 224-bed district hospital, replacing the previous 68 beds. The new hospital was completed, and it was at that time Dr. Winn looked to move back to the Valley. “I always wanted to be part of the growth and development of medicine in Tulare County,” said Dr. Winn. “The construction of this original inner core of the hospital was the greatest thing for miles around. It was the deciding factor for my coming to Visalia rather than Porterville. I could see that the town was building for the future and Visalia was a good fit. I had my pulmonary specialty training and I felt I could use and further develop as a specialist in Visalia.”

Dr. Winn believed during this time there were many medical challenges that were not just about needing more space, but bringing in more talent and the best technologies. Dr. Winn recalls when he first arrived, there was not a ventilator or respirator for patient care available and he advocated for bringing these new devices to Visalia. “Many individuals, including Dr. Norman E. Sharrer, were focused on making Visalia’s new hospital a regional referral center, which would have high-quality health care.”

Kaweah Delta is now home to multiple graduate medical education (GME) programs, called residency programs, to train specialists who will become board certified and often stay to practice medicine. “Kaweah Delta has grown and developed much further than I would have ever imaged,” said Dr. Winn. “Not only as a recognized medical center, but a teaching institution that will continually attract talent to our area.” Dr. Winn states that for the future of Kaweah Delta, we must look to the needs of the community, continue to bring state-of-the-art technologies, and recruit and retain the best and brightest doctors. “We have to watch our population growth and develop a prudent plan for the future, which must include adequate facilities.”

Kaweah Delta has grown and developed much further than I would have ever imagined.”

“

18 KAWEAH DELTA HEALTH CARE DISTRICT

Dr. William Winn

Where we have been, and Where we are going.

VaughnFeliciaRN

For the past 20 years, Felicia Vaughn has been in the health care industry, serving the smallest in our community in maternal child health. Over the years, Kaweah Delta has supported Felicia’s interest to grow professionally, being employed as a nurse assistant, a LVN, and a registered nurse. “I have grown with Kaweah Delta and it’s a message I share with others that education is never ending,” said Felicia.

Felicia is currently the nurse manager for the neonatal intensive-care unit (NICU) at Kaweah Delta Medical Center. Patients in the NICU range from premature babies at one and half pounds to full term babies who are sick and need oxygen. Felicia holds the importance of patient care as a top priority and is actively involved in making rounds, monitoring vital signs, providing treatment, and leading her team by example with hands-on care.

Felicia reflects on the opportunities to show how compassionate care can make a big difference for a family that has an ill newborn. “Over the years, I have had the pleasure to serve families in my community and I am part of their special stories. Mothers have stopped and shown me pictures from years ago of their child being discharged from the NICU, and

shared how much of a memorable day it remains for them,” said Felicia. “Moments like this make me proud to be on this team, with neonatologists, respiratory therapists, fellow nurses, and all other line staff.”

Felicia is currently working with the executive team at Kaweah Delta to develop a new NICU on the sixth floor of the Acequia Wing with a fiscally responsible plan and budget. The new location will expand its current 15 critical beds to 23 beds in addition to eight step-down rooms located in Labor and Delivery. With this growth will be the addition of 10 new nurse positions to join the NICU team.

I have grown with Kaweah Delta and it’s a message I share with others that education is never ending.”

“

Felicia Vaughn, RN



This is not Logan’s mom.It’s his pediatric cardiologist.

LOGAN’S STORY I PAGE 10

Documents

Vital Signs Spring 2016