Lawnwood Regional Medical Center & Heart Institute

We’re the Only Level II Neonatal Intensive Care Unit in St. Lucie County…

January 25th, 2010

Two hundred forty babies who were born prematurely or required special neonatal care were given the best possible start into the world last year in Lawnwood’s Level II Neonatal Intensive Care Unit.

With board-certified neonatologists on staff, RNs and respiratory therapists who are certified in neonatal care resuscitation, new moms and dads can rest assured that their tiny new arrivals are in the best hands possible.

“We are the only Level II Neonatal Intensive Care Unit in St. Lucie County,” notes Beth McNees, RN, LRMC, Director of Women Children Services. Any baby over 1,000 grams or 2 lbs. 3 oz. can be cared for in our unit. In addition to St. Lucie County, the primary referral sources for our babies, come from Indian River and Okeechobee Counties.”

Lawnwood’s Level II NICU also holds Childrens’ Medical Services provider status and has pediatric subspecialty support from physicians who cover the following specialty areas:

• Pediatric cardiology

• Pediatric pulmonology

• Pediatric neurology

• Pediatric endocrinology

• Pediatric orthopedics

In addition to utilizing all the latest state-of-the-art monitoring equipment, which graphically displays vital signs and oxygen saturation, our babies benefit from a softer touch as well. Music therapy has been found to be beneficial to premature babies as they orient themselves to life outside the womb.

Once babies go home from the hospital, they always hold a special place in the hearts of their temporary caregivers, the NICU nurses, physicians, and staff.

In the spring, we celebrate the graduates from our NICU unit with a party provided by our dedicated NICU staff. This time is enjoyed by the NICU graduates, as well as their parents, siblings and friends.

“We are dedicated to bringing together all the technology and medical expertise to care for these infants who are placed in our care during the most fragile days and weeks of their new lives. In the same way, we are here to promote bonding of the infants with their parents and siblings. We provide education and training so they’ll feel comfortable taking their child home when the time is right.”

For a tour of the area or to gain more information about the Level II NICU services, contact Kerrie Hurley, 772-461-4000, extension 4895.

Tags: Lawnwood Medical Center, Level II Neonatal Intensive Care Unit, neonatal care resuscitation, neonatologists, NICU, pediatric cardiology, pediatric endocrinology, pediatric neurology, pediatric orthopedics, pediatric pulmonology, St. Lucie County
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Lawnwood Regional Treats Patients Injured In Haiti

January 18th, 2010

This weekend Lawnwood Regional Medical Center and Heart Institute opened its doors to Haiti’s injured. The hospital offered to treat up to 8 trauma patients and 20 total patients per flight. Through a partnership with St. Lucie County Fire District, patients received immediate transport from the St. Lucie International Airport to Lawnwood Regional Hospital.

Lawnwood Staff Exceptionally Prepared for Trauma Care

Hospital spokeswoman Jana Eschbach noted that Lawnwood is uniquely equipped to treat serious trauma patients because it is a Provisional Level II Trauma Center. The hospital has 18 specialty doctors and over 200 physicians ready to respond. Dr. Danny Jazarevic brings first-hand experience of emergency trauma operations. He served as the former head trauma surgeon of medical mass casualties in Iraq.

The Provisional Level II Trauma Center designation means that Lawnwood provides comprehensive trauma care and offers patients 24-hour access to specialists, equipment, and personnel as needed. In addition to the medical treatment available in a traditional emergency room, a trauma center is staffed with trauma specialists who reach trauma patients’ bedsides within minutes of the patients’ arrival.

Injured Patients Slow to Be Evacuated

So far the majority of evacuees have been missionaries who were stationed in Haiti at the time of the earthquake and relief workers who got injured during rescue efforts. Both of Lawnwood’s evacuated patients arrived via Missionary Flights International, a non-profit agency that delivers relief supplies throughout the Carribean. Since the earthquake, the organization has clown continuous relief flights.

Fifty passengers arrived on the flight that bore Lawnwood’s patients. Of those fifty, only two needed medical care. Alan Good, a doctor who had been doing relief work in Haiti, was in stable condition, while another unidentified woman remains in poor condition.

Eschbach expects to treat Haitians at Lawnwood, once the US government has implemented an evacuation plan. “Obviously, there are political issues, health issues and infection issues that would have to be worked out with the governments of both Haiti and the United States,” Eschbach told TCPalms.com. The staff at Lawnwood is planning now, so they will be prepared once evacuees start to arrive. Eshback said that the facility will likely treat orphaned children in the coming days.

Photo courtesy of Scripps Treasure Coast Newspapers

Tags: Haiti, Haiti News, Haiti Relief, Lawnwood Medical Center, Lawnwood Regional Medical Center and Heart Institute
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Patient Medication Safety Ensured Through eMAR & Bar Coding

January 18th, 2010

According to an Institute of Medicine report, more than 7,000 hospital deaths each year are related to medications. Since this report came out in 1999, there has been a heightened focus on improving medication safety and reducing the number of medication errors. This is especially true at HCA hospitals, who have been a leader in this initiative.

Whenever a medication is given to you in the hospital, it is documented on an MAR (Medication Administration Record) that is stored in your medical record. This had previously been a manual paper process.

Our facility has implemented an electronic version of the MAR called eMAR. This technology is part of our core pharmacy information system where all aspects about your medication orders are recorded. The critical components of this safety technology are bar coded armbands, bar coded medications, and safety checks within the eMAR & Bar Coding software. To see a video on eMAR & Bar Coding click here: eMAR & Bar Coding

HCA’s results with eMAR have been instrumental in encouraging the FDA to develop a standardized bar code system for use throughout the pharmaceutical industry and at all hospitals to reduce the risk of medication errors that can seriously harm patients.

How it works

* Each patient receives an armband with a bar code. The bar code corresponds to the patient’s current medical record, including drug history, allergies and lab results. Bar code identifiers also appear on shrink-wrapped doses of medication.

* Before a medication is administered, bar codes on the patient armband and the medication are scanned, allowing the nurse or therapist to verify the right patient is receiving the right drug in the right dose at the right time.

* The software checks each medication against the patient’s drug history and lab results. If conflicts or potential drug interactions are identified, warnings alert the nurse to double check, verify and/or call the doctor before administering the medication

The “five rights” of patient medication administration:

1. The right patient

2. receives the right medication

3. in the right dose

4. via the right route

5. at the right time.

Benefits of eMAR technology

* Reduces medication errors through use of bar code identifiers on the patient armband and medication.

* Makes patient care information readily available to nursing staff during medication administration like critical values and comprehensive allergy and drug interaction information.

* Provides physicians with a comprehensive list of patient medication use.

Tags: bar coding technology, eMAR, Lawnwood Medical Center, Medication Administration Record (MAR), Patient Medication Safety
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Rehab Services Speed Recovery with Therapy

January 11th, 2010

Rehab – it’s a short five-letter word that refers to the Physical Medicine & Rehabilitation Department at Lawnwood Regional Medical Center and Heart Institute. One definition of rehabilitation is “a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible.”

“Sometimes, there has to be a ‘new normal,’” notes J. Carlo Bercy, M.S., Director, Physical Medicine & Rehabilitation. “Our therapists are trained to conduct an evaluation of the patient to determine what the patient is presently capable of doing compared to what the patient was able to do prior to the event which generated the need for therapy services.” This involves a team of licensed and/or certified therapists, covering five disciplines:

Physical Therapy

Occupational Therapy

Speech Therapy

Music Therapy

Recreational Therapy

The Physical Therapist focuses on strengthening, balance, transfers, mobility, gait and distance, while the Occupational Therapist focuses on the activities of daily living, such as bathing, grooming, feeding, dressing, toileting and functional tasks. Upon completion of their assessments, a Plan of Care is developed. Both short-term and long-term goals are established for the patient to measure progress, with the goal of returning the patient to his/her prior level of function.

Speech-Language Pathologists not only work with patients experiencing speech and cognition problems but also test and treat swallowing difficulties in patients, especially those at risk of aspiration pneumonia

Our Music Therapist utilizes vocal and instrumental music to assist the patient in achieving non-musical goals. Family members often participate in choosing songs the patient will find meaningful and encouraging. Music therapy services, offered in Acute Care and Inpatient Rehab (Pavilion), address social, communication, emotional, physical, cognitive, sensory and spiritual needs.

Recreational Therapy, offered to patients participating in Inpatient Rehab (Pavilion), uses every day activities to improve memory, cognition, balance and rehabilitation in support of the other therapeutic disciplines. Recreational therapists work with the patient to restore his/her ability to participate in activities of choice, such as golf, knitting, bowling, or shopping.

Rehab services are provided in three settings:

Acute Care

Inpatient Rehabilitation

Outpatient Rehabilitation

Acute Care is therapy provided in the hospital setting. Therapy sessions occur daily. In order for a patient to be accepted at the Pavilion for Inpatient Rehab, several admission criteria must be met. One of the criteria is the patient’s ability to participate in up to three hours of therapy daily.

When moving from Acute Care to Inpatient Rehab, the patient’s focus shifts primarily to therapy services to assist the patient in returning home and living independently.

Outpatient Therapy allows the patient to resume normal activities such as living at home, going to work or school, and attending therapy sessions in the Outpatient clinic. Lawnwood’s Outpatient clinic also provides sports medicine to local athletes.

Everyone on the Physical Medicine & Rehabilitation team at Lawnwood is eager to assist you or a loved one in returning to the highest possible level of function.

A referral from the patient’s physician is required for therapy. Learn more about the services offered by the Physical Medicine and Rehabilitation Department by calling the department office at 772.468.4446. Tours of the facility are available by appointment.

Tags: acute care rehab, inpatient rehabilitation, Lawnwood Medical Center, music therapy, occupational therapy, outpatient rehabilitation, Physical Medicine & Rehabilitation Department, physical therapy, recreation therapy, speech-language pathology
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Questions you’ve always wanted to ask about your hospital bill

January 4th, 2010

Why a $2 aspirin?

Have you ever wondered why hospitals charge so much for an aspirin? The short answer is you are not just paying for the pill, but the facility and technology, as well as the education and experience of the persons giving it to you.

For example, The Heart Institute’s dedicated operating suites are backed by a state-of-the-art

Cardiovascular Intensive Care Unit (CVICU), staffed by specially trained personnel who provide the highest quality care for the patient and comfort to the patient’s family and friends.

The Trauma Neurosurgical Unit, staffed by trauma-certified nurses and surgeons, cares for patients around the clock. “We have worked hard this past year, adding millions of dollars in equipment and physician coverage so that we are primed to become the Treasure Coast’s only Provisional Level II Trauma Center, all for the benefit of the patients we serve,” said CEO Rodney Smith.

The next reason for higher bills is lower reimbursement rates to facilities and physicians. Even the best insurance companies will only reimburse at 40%, while state-run programs are much lower.

Does the hospital benefit from lengthening your hospital stay, thus increasing your bill?

Delivering high quality, appropriate care to our patients is our top priority. While a longer hospitalization results in a higher bill, that is not our focus. Most insurance companies are up-to date with the less invasive surgical treatments and shortened recovery times. For example, while we have the best outcomes for cardiac patients on the Treasure Coast, we also use the least invasive procedures first, to speed your recovery in our hospital and discharge you back to your home environment as quickly as possible.

These include diagnostic services in our Cardiac Catheterization Lab, where interventional procedures such as angioplasty or coronary stent placement are performed. When these approaches will not resolve the problem, the hospital offers open heart surgery services, including coronary artery bypass grafting and valvular repair and replacement. Another minimally invasive procedure, endoscopic vein harvesting, allows the surgeon to obtain veins for bypass through a one-inch incision in the patient’s leg, versus an incision of several inches. This technique results in less pain and scarring and quicker recovery times..

Is it safe to pay my bill online?

Yes. All payment and account information obtained in other areas of our website is encrypted or encoded, securing the information so it can only be read by the intended recipients. You can pay online at www.lawnwoodmed.com.

Our financial services office number is (772) 468-4494; office hours are from 8:00 am to 6:00 p.m., Monday through Friday. We hope you use this service to resolve any billing inquiries that you may have.

Are there really that many patients who do not have insurance or do not pay their bills?

Yes! This is the data from 2008-2009 at Lawnwood of the self-paying, or uninsured patients. Below is the cost of business.

Lawnwood ’s Statistics
Total Patients Treated	74,960
Annual Hospital Admissions	15,449
Annual Emergency Visits	43,990
OB Deliveries	1,185
Total Medicaid Patients Treated	17,548
Medicaid Market Share	48.07%
Total Uninsured Patients Treated⁽¹⁾	14,113
Uninsured Care Market Share	44.75%
⁽¹⁾Excludes Medicaid patients treated

Uninsured Trauma Patients 22.00% (since May 1, 2009)

Total Salaries & Benefits	$ 85,260,000
Cost of Charity & Uncompensated Care	$ 19,575,000
Taxes Paid:
Federal Income Tax	$ 4,415,037
State Income Tax	$ 719,824
Indigent Care Tax	$ 2,918,152
Property Tax	$ 1,171,648
Sales Tax	$ 878,004
Unemployment Tax	$ 64,020
Other Local Tax	$ 5,344
Total taxes	$ 10,172,000
Capital Investment	$ 5,650,000
Total Local Vendor Support	$ 10,275,000
Minority & Women Owned Business Support	$ 133,541
Physician Specialty Coverage in the ED	$ 2,987,000
Total Economic impact	$133,919,000

Watch this video. Discover Powerful Medicine

Tags: CEO Rodney Smith, Hospital Bill, Lawnwood Medical Center & Heart Institute, Lawnwood Statistics, Provisional Level II Trauma Center, The Heart Institute
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Understanding Medicare

December 28th, 2009

If you are approaching your 65th birthday or may be eligible for Medicare due to certain disabilities, you may be wondering how health insurance under Medicare works. Here is a primer on Medicare that will give you basic information and, hopefully, answer some of your questions

What Is Medicare?

Medicare is health insurance for the following:

People age 65 or older

People under age 65 with certain disabilities

People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)

The Different Parts of Medicare

The different parts of Medicare help cover specific services. Medicare has the following parts:

Medicare Part A (Hospital Insurance)

Helps cover inpatient care in hospitals

Helps cover skilled nursing facility, hospice, and home health care

Medicare Part B (Medical Insurance)

Helps cover doctors’ services, outpatient care, and home health care

Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse

Medicare Part C (Advantage Plans) (like an HMO or PPO)

A health coverage option run by private insurance companies approved by and under contract with Medicare. Includes Part A, Part B, and usually other coverage like prescription drugs

Medicare Part D (Prescription Drug Coverage)

A prescription drug option run by private insurance companies approved by and under contract

with Medicare and helps cover the cost of prescription drugs.

Your Medicare Coverage Choices

With Medicare, you can choose how you get your health and prescription drug coverage. Below are brief descriptions of your coverage choices. Section 2 has more details about these choices and information to help you decide.

Original Medicare

Run by the Federal government.

Provides your Part A and/or Part B coverage.

You can go to any doctor or hospital that accepts Medicare.

You can join a Medicare Prescription Drug Plan to add drug coverage.

You can buy a Medigap (Medicare Supplement Insurance) policy (sold by private insurance companies) to help fill the gaps in Part A and Part B.

Medicare Advantage Plans (like an HMO or PPO)

Run by private insurance companies approved by and under contract with Medicare.

Provides your Part A and Part B coverage but can charge different amounts for certain services. May offer extra coverage and prescription drug coverage, sometimes for an extra cost. Costs vary by plan.

If you want drug coverage, you must get it through your plan (in most cases). You can’t use a Medigap policy with a Medicare Advantage Plan.

.Information provided as a service of Lawnwood’s Case Management Department. If you have additional questions or would like more information (please insert here what phone number or link you would like to include).
Excerpts from the CMS publication: Medicare and You 2010

Tags: Lawnwood Medical Center, Medicare, Medicare Coverage Choices
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Lawnwood Recognized by Life Alliance for Outstanding Organ Donation Record

December 21st, 2009

The U.S. Secretary of Health and Human Services and Life Alliance recently honored Lawnwood Regional Medical Center and Heart Institute. Lawnwood was recognized for the integral role it has played in the Gift of Life Donation Initiative, assisting hospitals throughout the nation with organ donations. We are the only hospital in South Florida and the Treasure Coast to receive such an honor.

Life Alliance and Lawnwood Work Together

Once a patient is progressing towards non-recovery, but still has vital organs intact, The University of Miami Hospital Life Alliance Team is alerted. Life Alliance Team members work with Lawnwood’s ICU Nurses and staff to determine a patient’s eligibility and willingness to participate in the donor program.

“I think it speaks to the generosity of the community that 100% of the patients able to donate, did. And each patient and their family helped saved multiple lives with that one decision,” said Trauma ICU Charge Nurse, Tracy Durden. “I think more people need to voice to their families they want to be a donor so the process is simplified.”

Good Can Come From Tragedy

Becoming a Level II provisional trauma center has added to the volume of critically injured patients who may become viable donors. “In a lot of motorcycle or car crashes, patients come in with severe non-recoverable head injuries. The injury is limited to the brain, so all the organs are perfectly normal, but the patient is brain dead. Sometimes we get young patients, who are the best-case scenario for organ donation, in a very tragic scenario,” Trauma ICU Director Lisa Sharot shared.

“The public needs to know that livers can be resected, divided, and sent to two children, not just adults. We can save lives young and old. One person’s organs can save 200 people… Yes, 200.”

“These families really get closure. They feel like something good has come out of this tragedy and adversity. They feel as their loved one’s life has not been wasted. They want to help,” Sharot continued.

The Heart Institute is also a place where families are consulted on organ donation, in case a best possible outcome is not the end result. To date, our hospital has been a lifeline to more than 50 patients.

Tags: Gift of Life Donation Initiative, Lawnwood Medical Center, Life Alliance, Lisa Sharot, Organ Donation, Tracy Durden, U.S. Secretary of Health & Human Services, University of Miami Hospital
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Stiff Heart Valves Opened Through Valvuloplasty Procedure at Lawnwood’s Heart and Vascular Institute

December 14th, 2009

There are many ways our body’s largest muscle, the heart, can become diseased. Arteries can become narrowed or blocked. Heart rhythm problems can develop. Infections and congenital heart problems (those you’re born with) can cause disease. Valves, which keep the blood flowing forward during its journey through the heart, can become damaged or diseased.

When this happens, they may not function properly. One of these conditions involving the heart valves is called valvular stenosis. In simple terms, one or more of the heart’s valves has become stiff, causing the heart muscle to work harder to pump the blood through the valve.

Reasons Heart Valves Become Stiff

• Infection (such as rheumatic fever or staphylococcus infections)

• Aging

If one or more valves become insufficient (leaky), blood leaks backwards, which means that less blood is pumped in the proper direction.

Symptoms of Valvular Heart Disease

dizziness
chest pain
breathing difficulties
palpitations
edema (swelling) of the feet, ankles, or abdomen
rapid weight gain due to fluid retention

Valvuloplasty – A Procedure that Can Help

Lawnwood’s Heart and Vascular Institute’s Cardiologist, Dr. Prasad Chalisani, is the only cardiologist in the region to offer a procedure called valvuloplasty. It is a procedure that can be performed in certain situations to open a heart valve that has become stiff as a result of disease or the aging process. Not all conditions in which a heart valve becomes stiff are treatable with valvuloplasty. There may be other reasons for your physician to recommend a valvuloplasty.

The valvuloplasty procedure involves advancing a very small, narrow, hollow tube, or catheter from a blood vessel in the groin through the aorta into the heart. Once the catheter is placed in the valve to be opened, a large balloon at the tip of the catheter is inflated until the leaflets (flaps) of the valve are opened. Once the valve has been opened, the balloon is deflated and the catheter is removed.

Other related procedures that may be used to assess and treat the heart at Lawnwood include resting and exercise electrocardiogram (ECG or EKG), Holter monitor, signal-averaged ECG, cardiac catheterization, chest x-ray, computed tomography (CT scan) of the chest, coronary artery bypass graft surgery, valve repair/replacement surgery, echocardiography, electrophysiological studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, and ultrafast CT scan.

If you need a referral to a physician or would like more information about cardiac services offered at Lawnwood, call 1-800-382-3522.

Tags: Dr. Prasad Chalisani, Lawnwood Medical Center, Stiff Heart Valves, Valvular Stenosis, Valvuloplasty
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We’re getting the word out about Lawnwood’s ER wait times

December 8th, 2009

Take your pick! Find out our ER wait times on your iPhone, via text message, or on our website!

While the national average wait time to see a doctor in the Emergency Room is one hour, Lawnwood is continually striving to beat the national average. Since introducing its ER wait times program, it has done just that. Now you can find out what the current wait time at our hospital ER is before you arrive, which is going over extremely well with our patients. as we are getting the word out about ER wait times in a number of innovative ways.

Mike Peto, RN, comments, “Patients like that we get to them faster than other hospitals. If it were your mother, wouldn’t you want her seen by a doctor sooner rather than later? And when it comes to children, what appears to be a simple injury can often get worse quickly. It is a patient safety measure to get them into our ER as quickly as possible.”

Fast Track at Lawnwood’s ER

“Patients who just need stitches or have a cut are stitched up in our Fast Track region,” continues Pieto. “It allows them to come in, be seen by a doctor, get quick medical attention, and then leave, freeing up our ER beds for the more seriously injured.”

When a patient arrives at the ER, a system records how many minutes it takes from arrival until being seen by a physician. Wait times are updated every half hour. Here’s how you can gain access to this valuable information:

• Free iPhone web-app

iPhone users can get up-to-the-minute wait times for all of the HCA East Florida Emergency Rooms by simply bookmarking a web-link. To add to your home screen from the iPhone or iPod Touch, just go to: er.hcaeastflorida.com. For more detailed instructions go to http://www.hcaeastflorida.com from a computer and click on the iPhone ER Wait Times Link.

• Lawnwood’s website

If you aren’t an iPhone or iPod Touch user, just check out ER Wait Times on our website: http://www.lawnwoodmed.com/

• Texting

Simply text “ER” to 23000 to immediately access current ER wait times.

iTriage

Wait times are also now available on iTriage, an interactive technology that allows consumers to evaluate their symptoms, learn about the possible causes, and find appropriate locations for treatment. iTriage also includes access to information about disease and medical conditions and descriptions of medical procedures. HCA East Florida Division is one of the first hospital systems in the nation to implement this cutting edge resource. Access iTriage at: http://www.itriagehealth.com/

For more information on any of the information included about ER Wait Times or iTriage, call 1-800-382-3522.

Tags: ER Wait Times, Fast Track, iPhone, iTriage, Lawnwood Medical Center
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Treasure Coast Trauma Center Nurses are Doing Their Part to Keep our Children Safe

November 30th, 2009

Flashing safety strobes were handed out to children by Treasure Coast Trauma Center nurses on October 10^th to hopefully prevent them from traumatic injury on Halloween.

The free event held at Jensen Beach’s Indian Riverside Park featured displays of antique fire trucks, rescue vehicles and boats, information on infant car seat safety and fire safety, as well as fun for the kids – bounce houses, pony rides, food & local vendors.

In late August, Trauma Center nurses handed out 1,000 of the flashing lights to students in Port St. Lucie at bus stops, along with the help of Port St. Lucie Police, who drove the nurses to various bus stops. The goal is to make children easier to see as they walk or ride their bikes to school, or wait for a school bus. The children were urged to clip the lights to their backpacks or their clothing to make them as conspicuous as possible to approaching motorists.

In the past several years, a number of accidents involving students being hit by vehicles have been recorded, including two fatalities. Andrea Mulligan, Director of the Trauma Center’s Progressive Care Unit, was one of the nurses who participated in the safety program. She says, “Many of these children are walking to school when it is still dark, making it difficult for cars to see them. We want to do what we can to prevent accidents and keep children safe.”

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Tags: Child safety, Flashing strobe lights, Lawnwood Hospital, Port St. Lucie, Treasure Coast Trauma Center
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