In cases of serious injury, the right care at a trauma center can mean the difference between life and death. Hospitals with trauma centers are poised not only to provide superlative care to trauma patients, but also to play an active role in the community.

Benefits of a Trauma Center
Hospitals with trauma centers must adhere to strict international standards regarding the timeliness of care, the kinds of doctors and specialists on staff and the presence of specific equipment and facilities. Trauma patients need this high level of care because they have incredibly complex needs, which require specialized attention. These centers must meet guidelines set by international organizations, the American College of Surgeons and the state of Florida.

Trauma care programs such as the one at Lawnwood have extensive critical facilities, a vascular surgeon on staff, specially trained trauma nurses, and trauma team availability 24 hours per day. Undoubtedly the greatest benefit of local trauma centers is patient survival rates. In addition to the high-quality care that patients receive, they also receive care much more quickly. Says Lawnwood CEO Rodney Smith, “[Trauma centers] make it more likely that critically ill patients will have access to care in that ‘golden hour,’ the first 60 minutes after a trauma.”

A trauma patient arrives at Lawnwood Regional Medical Center and Heart Institute via helicopter.

Meanwhile the presence of a trauma center bolsters the Dr. Danny Jazarevic, chief trauma surgeon at Lawnwood Regional Medical Center and Heart Institute, notes that a trauma center improves care for an entire hospital. “It really has a halo effect, because it impacts every aspect of care, from radiology to the ICU,” he says, “so the entire hospital delivers better care in every area.”

Trauma Center Success Stories
Lawnwood Regional Medical Center and Heart Institute opened the doors to its Treasure Coast Provisional Level II trauma center last year ago. Since then, the trauma center has served over 500 patients. On November 12, 2009, the 500th patient, 79-year-old Frantisci Spacil was admitted to the Lawnwood trauma center after falling from a ladder. He received state-of-the-art care for his potentially paralyzing injuries.

His wife, Mary Ann Spacil, said “This was fast—and the surgeons stay with you from one department to the next—very quickly to figure out what was wrong.” Had Frantisci arrived at a facility without a trauma center, he would have needed to be transferred, a delay that could have prevented his recovery.

The Treasure Coast Provisional Level II trauma team has also reached out to the community. They regularly participate in Drunk Driving education programs with local high schools. Through mock crashes, the trauma team and first responders like EMT’s and firefighters partner to give students a sobering reminder of the consequences of drunk driving.

Treasure Coast Trauma Center nurses hand out safety supplies at the 2009 Back to School Safety Fair.

Meanwhile, Treasure Coast trauma center nurses teamed up with Pt. St. Lucie Police for the “Back to School Safety Fair,” where trauma nurses distributed safety lights and other equipment to children at local elementary schools.

This year marks Lawnwood’s Treasure Coast Provisional Level II Trauma Center’s first anniversary. Its impact on the community can be measured in saved lives—through both outstanding care and community presence.

In 2009 over 49,000 people died from colorectal cancer. Yet unlike most other forms of cancer, the disease is largely preventable. People can significantly lower their risk of colorectal cancer through healthy habits and regular screening. March has been designated as “Colon Cancer Month” to raise public awareness of the disease, its causes and how to prevent it.

Who’s at Risk for Colorectal Cancer

The following factors increase a person’s risk for developing colorectal cancer:

•  Being older than 50
• Using tobacco products (either smoking or “dipping”)
• Obesity
• Sedentary lifestyle
• Personal or family history of colorectal cancer OR benign colorectal polyps
• Personal or family history of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
• Family history of inherited colorectal cancer

Reducing the Risk

Patients can take several steps to reduce their risk for colorectal cancer. Maintaining a healthy lifestyle significantly improves colon health and decreases risk for developing the disease. Doctors recommend that patients take the following steps to prevent colorectal cancer:

• Get plenty of physical activity and regular exercise
• Maintain a healthy weight
• Eat a high-fiber diet, rich in vegetables, fruits, nuts, whole grains, and beans. Calcium-rich foods like low-fat milk are also important.
• Limit consumption of red meats and processed meat
• Quit smoking and using other tobacco products
• Limit alcohol consumption

In addition to maintaining personal health, patients should follow recommendations for regular pre-cancer and cancer screenings. Most patients should start regular screenings at age 50, but those with elevated risk due to family history or other medical conditions should ask their health care provider about starting sooner.

• Every five years, a virtual colonoscopy, a double-contrast barium enema, or a flexible sigmoidoscopy
• A fecal occult blood test (FOBT) or fecal immunochemical test (FIT)every year
• Stool DNA tests as recommended by the patient’s health care professional
• Every ten years, or after any abnormal test results, a traditional colonoscopy

This month, take the time to learn your risk for colorectal cancer and to get the proper screening.

Our kidneys regulate waste removal from our blood and serve a role in the endocrine system. When the kidneys are damaged, dialysis is necessary to regularly cleanse the blood. This damage may occur as a result of renal (kidney) cancer, internal injury or kidney disease. Depending on the cause of the kidney failure, patients may need dialysis temporarily or permanently.

The Purpose of Dialysis

Each day, the body filters approximately 1,500 liters of blood. The kidney does that filtering and routes the materials through the urinary tract to the bladder, where it is expelled in our urine. The kidneys ordinarily filter the blood in two ways:

· Diffusion: The kidneys remove toxins and other waste, such as excess minerals

· Ultrafiltration: The kidneys eliminate extra water from the blood.

Without this filtration, toxins build up in the blood, leading to coma and eventually death. Therefore dialysis is necessary any time the kidneys fail to function properly.

Types of Dialysis

There are two main types of dialysis. The appropriate treatment depends on the patient’s condition, medical history and other factors. Studies consistently show that choosing the right dialysis method makes a huge impact on patients’ health.

Hemodialysis

During hemodialysis the blood actually circulates outside the patient’s body. A catheter is inserted into the patient’s vein, siphoning the blood through a machine with a specialized filtration system. The blood then returns to the patient’s body through another catheter. Hemodialysis then, essentially works by giving patients an external, artificial kidney. The process usually takes three to four hours per week.

Prior to beginning hemodialysis, a patient must prepare properly. First, a blood vessel must be enlarged. This step is usually completed surgically. Once hemodialysis treatments begin, they can be completed at a hospital, dialysis center or in the patient’s own home. Home dialysis requires specific training and the absence of certain medical conditions.

Peritoneal Dialysis

The alternative to hemodialysis is peritoneal dialysis. Although the procedure takes longer, peritoneal dialysis gives the patient much more freedom because it can be completed at home, without multiple visits to a clinic. Patients who pursue peritoneal dialysis are generally very motivated to assume responsibility for their own care and maintain more active lifestyles. Patients who continue to travel, attend school or go to work often opt for this treatment method. It is also preferred by patients who get to tired from hemodialysis, such as children or the elderly.

During peritoneal dialysis, a sterile solution that contains glucose and minerals is run through the peritoneal cavity of the abdomen. A membrane in this cavity is semi-permeable, meaning that it lets only certain materials pass through it. The membrane acts as a filter for the blood and the sterile solution absorbs any waste materials. The solution is eventually removed from the body, along with the waste it absorbs.

Effectiveness of Dialysis

Dialysis is not as efficient as the kidneys. Patients generally must take medication and watch their food and liquid intake. Since dialysis does not completely remove waste from the blood, both men and women may experience reduced fertility during dialysis.

The only alternative to dialysis is a kidney transplant. Many patients wait for years before finding an appropriate donor. Therefore, patients should take care of their kidneys and do what they can to reduce their risk for kidney disease:

· Diabetes is thought to cause roughly half of all kidney disease. Eating a proper diet can protect people from developing Type II diabetes.

· Since hypertension (high blood pressure) is linked to approximately 25% of kidney failure cases, patients should monitor their blood pressure, exercise regularly and practice other heart-healthy habits.

· Exposure to chemicals like lead, solvents and fuels has been linked to kidney failure. Adults should try to limit their exposure, especially in industrial settings.

· Certain medications are processed in the kidneys. Overuse of these medications can contribute to kidney failure. Patients should consult their doctors regarding proper dosages for both prescription and over-the-counter medications.

Preventative care and healthy habits help safeguard the whole body, including the kidneys. Dialysis is an effective treatment option, but patients should take care to avoid kidney disease if possible.

For patients with heart disease, full recovery takes both persistence and diligence.  One key aspect of recovery is cardiac rehabilitation.  This treatment complements diet and exercise to give patients comprehensive support and guidance.  Patients who actively participate in cardiac rehabilitation enjoy advantages that go beyond merely improving heart health.

What is Cardiac Rehabilitation?

As part of American Heart Month, the week of Feb 14 to 20 is Cardiac Professionals Week and Cardiac Rehabilitation Week.  The cardiac professionals at Lawnwood Regional Medical Center and Heart Institute would like to take this important opportunity to share the purpose and benefits of cardiac rehabilitation. 

What is Cardiac Rehabilitation?

A comprehensive cardiac rehabilitation program includes counseling in a variety of areas) such as medication use, nutrition, and the disease management process), along with the development and implementation of an exercise program that accounts for a patient’s physical capabilities and limitations.  A cardiac professional also guides the patient through returning to work and overcoming other risk factors like obesity, smoking, or high cholesterol.

The goal of cardiac rehabilitation is to prevent the spread of heart disease and even reverse its effects.  Each patient’s rehabilitation therapy is unique, but usually includes the following components: 

• A tailored diet that lowers cholesterol and fat content, supports weight loss, and provides balanced nutrition.
• Support with smoking cessation if needed
• An exercise program that may include close monitoring via ECG

The treatment is ideal for patients who have angina, recent heart attacks, congestive heart failure, coronary artery bypass graft surgery, stable chronic heart failure, or balloon angioplasty (PTCA).  Doctors may also recommend cardiac rehabilitation for patients who have a pacemaker or heart transplant. 

Benefits of Cardiac Rehabilitation

Patients who participate in cardiac rehabilitation experience multiple benefits beyond a shorter recovery time.  They generally report a greater sense of well-being and express more optimism about future health.  Meanwhile, patients who actively participate in rehabilitation are more likely to return to work and enjoy greater function and quality of life. 

When patients comply with their rehabilitation programs and maintain their healthy lifestyles once monitored care has ended, they usually report long-term success with reducing their risk for heart-disease related conditions.  Patients’ success rates directly depend on how faithfully they follow their regimen.

Who Conducts Patients’ Rehabilitation?

It is important that qualified cardiac care professionals supervise every aspect of cardiac rehabilitation.  Generally cardiac nurses directly supervise care and check in with the patients’ doctors regularly.  At Lawnwood Regional Medical Center and Heart Institute, our cardiac team carefully develops treatment plans for each patient.  Our doctors and nurses work together to ensure that each patient receives the best cardiac rehabilitation services possible. 

This week, take the time to learn more about the cardiac care teams and treatments available in your area.  Their knowledge and expertise can significantly improve your heart health.

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.

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

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.

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.

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.

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

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