Mid-Shore Health: The YMCA’s Winning War against Diabetes

There are a few things that the local health community knows about type 2 diabetes. The first is that it is an epidemic, with close to 28 million Americans already diagnosed facing a lifetime of a disproportionately higher risk of heart attacks, strokes, kidney disease, and a variety of other conditions that often lead to chronic disabilities and death.

The second is that close to 100 million Americans are assumed to be prediabetic. That’s right, about 100 million folks are walking around who could very quickly transition to a condition is experts say is the 7th leading cause of death.

The third is that those whose blood tests indicate a prediabetic condition can dramatically reduce the odds of developing full-blown diabetes by shedding 7% of their weight and committing to some form of exercise for at least 150 minutes a week.

That third fact is what the YMCA of the Chesapeake is now focused on.

Working with adults who are prediabetic, the Y has created year-long classes and support groups throughout the Mid-Shore to slowly and methodically educate their members that their pre-diabetic condition can be controlled or even eliminated with simple, common sense eating and light exercise.

Under the direction of Bridget Wheatley, the YMCA’s Diabetes Prevention Program Director, these outreach efforts are now starting to show some stunning results in the first two years of operations. The three formal classes are running at capacity, and more and more participants are forming informal support groups to maintain personal goals.

The Spy caught up with Bridget and several members of the Y’s support group in Denton a week ago to talk about their experience and the extraordinary sense of well-being that has come with modest changes in lifestyle.

This video is approximately five minutes in length. For more information about the YMCA of the Chesapeake and its Diabetes prevention programs please go here

 

Taking the Mystery Out of Easton’s Quality Health Foundation with Dr. Molly Burgoyne

There is one “big box” building at the Waterside Village that is not easy to identify. Among stores like Target, Dick’s Sporting Goods, Harris Teeter and BJ’s warehouse store, the large home of the nonprofit Quality Health Strategies remains a bit of a mystery for most who that drive by it on Marlboro Street.

Dr. Molly Burgoyne, chair of the Quality Health Foundation, the philanthropic arm of this extremely successful and locally founded health care services provider, wants to fill in that gap of local knowledge.

While QHS and its subsidiaries has grown to over 500 employees (130 of whom work in Talbot County) since it was founded decades ago by a small group of local doctors, it has always been modest in showcasing its innovative work in developing best practices for health organizations and sophisticated  integrity systems to safeguard against fraud in medical billing.

More importantly, particularly to Dr. Burgoyne, the “profit” of these enterprises goes right back into the community every year in the way of charitable grants. In fact, since 2006 QHF has awarded grants totaling more than $4.5 million to 66 organizations in Maryland and the District of Columbia.

The Spy spent some time with Dr. Burgoyne, who is best known locally as a highly regarded rheumatologist in the region, to talk her work with the Quality Health Foundation and its remarkable impact in reaching the neediest in our community with medical coverage and care.

This video is approximately five minutes in length. For more information about the Quality Health Foundation please go here.

Recovery: Maryland Approves Pharmacies Dispensing Naloxone

The Maryland Department of Health and Mental Hygiene recently announced that Dr. Howard Haft, the agency’s Deputy Secretary for Public Health, issued a new statewide standing order that allows pharmacies to dispense naloxone, the non-addictive lifesaving drug that can reverse an opioid overdose, to all Maryland citizens. The order follows legislation passed by the Maryland General Assembly and signed into law by Governor Larry Hogan that included a Hogan administration proposal to enable all citizens to access naloxone. Previously, naloxone was available only to those trained and certified under the Maryland Overdose Response Program.

“As the opioid epidemic has evolved, we have worked steadily to expand access to naloxone,” said Dr. Haft. “Pharmacies play an important role in providing access to naloxone and counseling on how to recognize and respond to an opioid overdose. This order is yet another tool to fight this crisis and to provide immediate assistance to overdose victims.”

The Heroin and Opioid Prevention Effort (HOPE) and Treatment Act, a bipartisan omnibus bill passed during the 2017 legislative session that contains provisions to improve patient education and increase treatment services, included the Hogan administration’s proposed Overdose Prevention Act. This updated standing order resulting from the new law further eliminates barriers to naloxone access for anyone who may be at risk of opioid overdose or in a position to assist someone experiencing an opioid overdose.

“By allowing even more people access to naloxone, we’re helping to save lives,” said Clay Stamp, executive director of the Opioid Operational Command Center. “We must remember though, that ultimately, those suffering from the disease of addiction or substance use disorder must be linked to additional treatment to aid in their recovery.”

Single doses of naloxone, also known by the brand name Narcan, have been demonstrated as effective in reversing a heroin overdose. However, more potent drugs such as fentanyl tend to require multiple doses to reverse an overdose. Emergency services—calling 911 or taking someone to a hospital’s emergency department—should always be sought in an overdose situation.

The Department of Health and Mental Hygiene’s 2016 Drug-and Alcohol-Related Intoxication Deaths in Maryland Report, released earlier this month, revealed that 2,089 individuals died from overdoses last year, a 66 percent increase from 2015’s data. For more information on opioid overdose recognition and response, click here.

In March, Governor Hogan declared a State of Emergency in response to the heroin and opioid crisis ravaging communities in Maryland and across the country. This declaration activated the governor’s emergency management authority and enables increased and more rapid coordination between the state and local jurisdictions. The Opioid Operational Command Center, established by Governor Hogan in January through an Executive Order, facilitates collaboration between state and local public health, human services, education, and public safety entities to combat the heroin and opioid crisis and its effects on Maryland communities.

Before It’s Too Late is the state’s effort to bring awareness to this epidemic—and to mobilize resources for effective prevention, treatment, and recovery. Marylanders grappling with a substance use disorder can find help at BeforeItsTooLateMD.org and 1-800-422-0009, the state crisis hotline. 

Opioid Crisis Rural Maryland’s Worst Problem

DENTON — If there is one hopeful thing about Maryland’s opioid crisis, it’s that no one is denying the obvious.

“Very honestly nothing is working,” said Frederick County Sheriff Chuck Jenkins. “It’s unlike anything we’ve ever seen.”

For rural areas where communities are small and the stigma is large, opioids can be particularly insidious. The guy who jumped out of the moving ambulance after getting revived by naloxone might be an old high school classmate. The woman selling drugs at the hospital to fellow addicts could be the little sister of a good friend.

The epidemic is also a serious drag on government and medical resources in places where budgets are already stretched. Then there’s the psychic toll, especially on police, ambulance and hospital workers who slug it out on the front lines, often with the same addicts, day after day.

But while the opioid crisis appears to be kicking Maryland’s rural populations while they’re down, the silver lining might be in the size and inherent closeness of those communities, which are beginning to coordinate efforts to combat opioids in ways that simply aren’t possible in the state’s more populated counties.

Localizing the problem

“In our small area, opioids affect pretty much every family one way or another,” said Tommy Conneely, who runs the Lost Sheep Recovery Mission in Caroline County and said he has been seven years sober from alcohol.

Caroline, like other rural counties, is beginning to harmonize their anti-opioid efforts across a wide range of public, private and faith-based groups. The county’s drug and alcohol abuse council includes a diverse collection of law enforcement, education, substance abuse and mental health officials.

And people like Conneely, who, as an ex-cop now involved in faith-based recovery efforts, brings a wholly unique perspective.

The Caroline drug council is in the midst of a series of events hosted at volunteer fire departments, where the FBI documentary “Chasing the Dragon” is being shown, followed by a discussion initiated by former addicts and their parents.

“We found that we had a lot of family members (attend) who had loved ones in active addiction who needed support,” said Holly Ireland, executive director of Mid-Shore Behavioral Health, a referral and planning agency that receives some state funding and operates in Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties.

“What we haven’t quite figured out is how to tackle engaging the community that is addicted,” Ireland added.

In Harford County, which has one of the highest opioid-related per capita death rates in Maryland, the approach is also multifaceted. They’ve got drug education happening in elementary schools, a prescription return program, rehab for opioid-addicted mothers, a special opiate court and a host of other initiatives.

“We broke down barriers between the sheriff, the board of education, the health department and worked together to go into schools,” said County Executive Barry Glassman, R-Harford. “Our program was recognized by the National Association of Counties for the way it was opened up to the whole county to be part of it.”


And yet Harford’s opioid-related death rates have gone up in almost every category since 2014.

“We’re not gonna give up, but it’s gonna be one of those long-term struggles,” Glassman said. “It’s a generational thing that might take 20 years before we get a grip on it.”

Last August, Barry Ronan, president and CEO of Western Maryland Health System, joined an opioid task force that brought together a similarly wide cross-section of people in Allegany County.

It happened after Ronan was forced to ask that a police officer be stationed in Western Maryland’s emergency room from 3 p.m. to 7 a.m. every day to deal with the surge of sometimes violent addicts arriving for treatment.

“Our staff was being spit upon, assaulted, equipment was being broken,” he said.

In the past two years, Western Maryland Health has spent nearly $1.5 million in additional costs from opioid-related patient treatment.

“(The opioid crisis) eats up a lot of resources,” said Allegany County Sheriff Craig Robertson. “It takes away the ability for us to do normal law enforcement functions like checks on high-crime areas and speeding enforcement.”

The Allegany task force that includes Ronan and Robertson now meets monthly to coordinate efforts and share ideas.

“Trying to address this from a community perspective has paid off,” said Ronan, at least in terms of unifying the county’s approach. Ronan mentioned things like putting mental health professionals in ambulances as one of the efforts the group is now trying.

“Over the last few months, we’ve seen a slight decline in the OD numbers, which is encouraging,” Ronan said.

Emergency state

In 2016, there were 918 heroin-related deaths in Maryland through September according to the state’s health department, up 23 percent from the total in 2015 and up nearly 60 percent from 2014’s total.

Scarier still is the sudden rise in the use of fentanyl and carfentanil, synthetic opioids that can be more than 1,000 times stronger than morphine and are often mixed with heroin, to fatal effect. Fentanyl-related deaths increased nearly 120 percent between 2015 and the first nine months of 2016, to 738 statewide.

On March 1, Gov. Larry Hogan declared a state of emergency around the state’s opioid epidemic, committing $50 million over five years to the problem. It was the latest escalation in a series of his administration’s efforts to slow the state’s opioid death toll, which continued to rise in 2016, according to the latest reporting.

What Hogan’s emergency edict calls for is an action plan to be made and then implemented across a slew of state and local agencies throughout Maryland.

The effort is being led by Clay Stamp, the governor’s senior adviser for emergency management and the former director of emergency services for Talbot County, a rural area on the Eastern Shore.

“Education and prevention will move the needle,” said Stamp. “What it does is remove the demand from supply and demand.”

Stamp also said that public health will be the focus of the state’s plan, and likened the scale and approach of forthcoming efforts to those that were used for anti-smoking and HIV education in the past.

Some argue the state’s entire approach is misguided and destined to fail.

“The governor created a task force for heroin and it didn’t have a person in recovery on the task force,” said Mike Gimbel, the director of substance abuse for Baltimore County from 1980 to 2003. “They don’t understand heroin. They really think it’s like teen smoking. This isn’t drug prevention 101.”

According to Gimbel, there’s unlikely to be any headway made against the problem without a primary focus on long-term treatment and rehabilitation, not on naloxone, an anti-overdose drug, and vivitrol, which blocks opioid receptors in the brain for up to a month.

“We’re not going to medicate our way out of it. You don’t solve a drug problem with more drugs,” Gimbel said. “The model should be treatment on demand.”

Funding for Hogan’s state of emergency effort is authorized under the recently passed HOPE Act, which calls for a series of initiatives that revolve around reforming drug courts, naloxone distribution and hospital discharge procedures. The bill also calls for the establishment of “crisis treatment centers,” but requires only one to be up and running before June 2018 and mandates no others.

“It’s important that on the back side, there’s treatment,” said Stamp. “We have to beef up our ability to help people fighting addictions.”

A matter of faith

The inclusion of faith-based organizations on local drug councils is indicative of the all-hands approach in rural areas. What religious groups can bring to the opioid fight is significant in terms of manpower and a direct connection to the community.

“We’re a microcosm of what’s going on in the street,” said Pastor David Ziler of the Union Rescue Mission in Cumberland, a homeless shelter with 62 beds that serves about 200 meals a day. “If it’s happening, we’re going to see it before anyone else is seeing it.”

Ziler believes churches and religious organizations can provide what the government can’t.

“We’re throwing money at the problem, but we haven’t thrown people at the problem,” Ziler said. “(Religious organizations) are the biggest volunteer group in the world and we can offer more man hours than anyone.”

by J.F. Meils

The Heart of It by Amelia Blades Steward

Seven years ago, in the summer of 2010, English Tong was driving home from college in Arizona to Maryland’s Eastern Shore. She always tried to stay with friends and family whenever she could while road tripping. She wanted to split the drive into at least two days so she asked her parents if they knew anyone between Colorado and Maryland. English’s father had a suggestion, but not one she could have imagined.

Pictured left to right are the Tong children: Hunter Tong, Chloe Tong, and English Tong

Seventeen years earlier, English, her sister Chloe, and her parents, Rodney and Elizabeth Tong of Royal Oak, lost their brother and son, Hunter Tong, age two and one half, to an unexpected death. Hunter’s parents chose to donate Hunter’s organs. English’s father was suggesting that English stop in Topeka, Kansas on her way home and meet the family whose son received Hunter’s heart.

In honor of the 24th anniversary of her brother’s death, English wanted to tell the story of her meeting the young man who got her brother’s heart– Casey Artzer. She writes in her blog entry of March 9, 2017 for Sniglet Writings, “This is not a story of how my brother died, but of the life he brought after his death. I can only imagine how difficult it would have been for my parents to not only decide to donate his heart, but continue contact with the recipient’s family still to this day.”

Once English’s blog was published, Casey and his mother, read it and discussed it. Casey said he was ready to meet the whole family and reached out to them to set up a meeting this June at the Tong’s home.

Pictured is a painting of Hunter’s shoes done by artists Wendy Van Nest.

Elizabeth Tong states, “For me, meeting Casey has to be emotionally assimilated, it has even affected me physically. We received letters from each of Casey’s parents on the first anniversary of Hunter’s death, but I was unable to respond to them for seven years. After that, we have kept in touch at Christmas time through Christmas cards and notes, but we haven’t really talked.”

The Tong’s story begins on the night of Rodney Tong’s 40th birthday party in 1993. Hunter played long and hard with all the children in attendance at the birthday party. After Hunter woke up at 7 a.m. the next morning a little fussy, Rodney recalls rocking him back to sleep. At mid-morning, Elizabeth decided to wake him up and he was limp in her arms. Once at Memorial Hospital in Easton, the decision was made to fly him to Children’s Hospital in Washington, DC where Hunter was placed in intensive care. At this point, Rodney and Elizabeth both knew Hunter’s condition was serious, but they didn’t know what was wrong.

Rodney recalls, “On Sunday his brain scan was normal, but doctors were treating him for seizures and trying to figure the cause of the problem. Monday, the doctors discovered that Hunter’s brain was swelling and things had turned for the worse. At that point, the doctors told us that the damage to Hunter’s brain would most likely be fatal.”

Pictured is a painting by Nancy Tankersley of Elizabeth Tong with Hunter.

Elizabeth desperately clung to the words “most likely,” but not for long as the doctor in attendance that afternoon only shook his head and looked away when she tried to convince him that it was only “most likely,” in other words not fatal yet, leaving her the slightest glimmer of hope. Elizabeth remembers, “I can only assume, that was their way of gently giving us the real news, that Hunter was dying and there was nothing that could be done.”

At that point, shock took over, the kind of shock that consumes a person facing the worst kind of news. Elizabeth likens it to a time release capsule, allowing reality in only so often and only in amounts one can take. This shock allowed Elizabeth and Rodney to put one foot in front of the other and later to broach the subject of organ donation. As soon as it was raised, the wheels of donation were immediately set into motion.

The family had to wait from Monday through Wednesday for the drugs to get out of Hunter’s system in order for the doctors to pronounce him dead. This gave English and other family members and friends time to come to Washington to say good-bye. The doctors never were able to tell the Tongs the cause of Hunter’s death.

When asked whether she needed a medical explanation for what caused Hunter’s death, Elizabeth comments about her son, “I don’t need a name for what happened to Hunter. Hunter came and did what he was supposed to do and left us very gently.” She adds thoughtfully, “It’s been a good thing to transplant his organs – it’s something beneficial coming out of something so horrific. A piece of him went on.”

On March 10, 1993, Hunter Tong died. The next day, Casey Artzer from Kansas, got a new heart.

Lisa Colaianni, Donor Family Advocate with The Washington Regional Transplant Community, who met the Tongs after the donation and who has become a family friend, comments, “I can’t imagine trying to think of others while going through such a tragedy as the Tongs experienced. Twenty-one people die every day needing an organ transplant. They gave the ultimate gift of life to another boy and that provided them with hope in their despair. Today, we have a 25-year old who is alive because of Hunter’s donation.”

Pictured is Hunter doing what he loved to do most, snuggling with his sister Chloe

For sisters Chloe and English, the memories are scant of their brother Hunter. English can only remember bits and pieces of Hunter, so for her, Casey makes him real. Family videos of Hunter following English around and mimicking her actions prove the special bond they had. Chloe was only four months old when Hunter died. According to Elizabeth, however, Chloe and Hunter had a special connection as well. He proudly announced to everyone who called, “new baby,” referring to his new little sister. He constantly wanted to be next to her and touching her.
Chloe comments, “I had questions about Hunter as I grew up. I identified with qualities of him as I grew up, always trying to help my dad do things a boy would do because he had lost a son.”

Rodney recalls the rich relationship he had with his son, if only for a short time. He states, “I was able to spend quality time with him because I was doing carpentry work at the time. He loved to be with me on jobs. He had work boots to wear when he went with me. I have a memory of building a railing on our steps and Hunter figured out at age two what screws went into what holes. He would pick up tools and ask what they were.”

He adds, “He loved mechanical things – cars, back hoes, and mechanic shops. He loved being with me when I was doing things and adored being with my father, who was a builder by trade.

He made toys for Hunter out of scraps of wood and fixed things.”
Elizabeth recalls Hunter as being very attached to family and not wanting to leave his mom to go to preschool. She states, “He would always say about doing new things, ‘When mine gets older.’”

English writes in her blog about meeting Casey,

“The family asked me to meet them at his high school, where he would be performing in his school band, playing the saxophone. I remember being really picky about what I wore (a striped grey and green sweater, black skinny jeans) and trying really hard to focus on my driving over there. I walked into an empty entrance way to the school, more nervous than I had ever been in my life. Having no idea where I was supposed to go, I started to panic a bit, when a short, blonde, friendly face came racing up to me, wrapping her arms around me. His mother had been waiting for my arrival outside of the auditorium, and all of a sudden I was surrounded with so many enthusiastic greetings and smiles and hugs from his older sister and father.

Pictured is a painting by Tankersley of Rodney Tong with Hunter.

The first time I ever saw, in person, the man carrying my brother’s heart, was on that stage with a saxophone. If I remember correctly, he performed last, with a large group of other seniors.

After the show, we moved out into the lobby, waiting for him, and his younger sister, to join us. So many people approached and introduced themselves to me, commenting on how amazing this was and that I needed a camera crew following me. All I could think about was how I was going to react to shaking his hand, looking him in the eye, and hearing his voice. The poor guy was probably more overwhelmed than I, so I tried not to scare him by bursting into tears or wrapping my arms around him too tightly. He was just so sweet, soft, and obviously nervous, for good reason.

Once finished, the family took me to dinner. There were quite a few people with us, so it was a large group. I remember eating some kind of chicken wrap and stumbling over questions I had for him about his life and interests. One thing I definitely remember is never wanting the night to end, as it had given me a high I had never felt before, nor since.”

While the family members’ reactions have each been different, each family member is approaching the June 13 meeting of Casey with great anticipation. The week Casey and his family are here, the Tongs are planning a musical gathering with friends because of Casey’s own musical interests. English recalls her memory of Casey, stating, “Casey is a quiet and reserved person.

He is into alternative things like our family – a more liberal person, I think, and one who thinks outside of the box.”

Elizabeth adds, “I have thought about a bit of our son coming home. I haven’t wrapped my head around that yet. All of us want it to be as gentle and natural as possible for Casey. We want him to get to know us and for our meeting to be as organic as possible.”

For Chloe, who perhaps knew Hunter the least, but who had a special bond with her brother, comments, “I have always wanted to meet Casey. I was angry I hadn’t met him sooner. It’s so cool that it is such a major organ that was transplanted from my brother.”

Rodney tries to grasp the upcoming meeting, stating “Our son is dead but he’s not – his major organ is still beating. I want to hear his heartbeat when I meet Casey. I want to put my ear next to his heart.”

Lisa states, “It is highly unusual to have a meeting between a donor family and a recipient 24 years later. Most meetings like this happen within the first five years of the transplant.” She adds, “What I love about this story is the sibling side of it, which is not told that often. The fact that English met the recipient and then wrote the blog, which went everywhere, and ultimately reached the family, is very unique.” She adds, “The Tongs understood from the very beginning the importance of telling their story so that others may register to become donors.”

At the end of her blog, English writes, “Oh, and one last little detail, the one I tend to leave out and only recently revealed to my parents. The last song he and his band played that night on the stage where I first saw him? My Heart Will Go On by Celine Dion.”

To read English Tong’s blog, visit http://snigletwritings.blogspot.com/2017/03/the-tornado-going-on-outside.html?spref=fb. For information about making the decision to be an organ donor, visit Washington Regional Transplant Community’s website at www.beadonor.org.

Mid-Shore Health Futures: How Our Regional Hospitals Measure Up

Susan Coe was in search of cottage cheese.

The chief experience officer and senior vice president at University of Maryland’s Shore Regional Health was looking in on a new patient at UM Medical Center at Easton. The patient, she learned, wanted her cottage cheese not in a small compartment on a tray but on a plate.

“She had her heart set on the platter,” Coe said.

The nurse immediately called food services to make the change but Coe said she decided to go get the plate of cottage cheese herself.

“It’s about respecting the patient,” she said.

That attention to patient satisfaction is part of a major change in hospitals, including at Shore Regional Health. Before 2007, hospitals largely measured their success by looking at “hard” data that evaluate patient safety and outcomes for specific procedures or events, such as heart attacks or infections. But in the past decade, the federal government began requiring that hospitals also measure how satisfied patients are with their care. Each hospital patient is given a 27-question survey that asks a range of questions, from how well the doctors and nurses communicated, to how noisy and clean the hospital was, to whether the patient would recommend the hospital to a friend.

And Shore Regional Health didn’t like what it was seeing, at least in one area.

Robert Carroll, regional director performance measurement & improvement, said that for the last eight quarters patient satisfaction ratings had been declining at the Easton and Dorchester facilities (considered one entity in ratings) and at its Chestertown hospital. The latest published data, from April 2015 to the end of March 2016, show that the Shore Regional Health hospitals score below average in patient satisfaction nationally and statewide. This is the despite the fact that the hospitals scored average or above average in most of its quality and safety ratings both statewide and nationally.

By contrast, the latest data show that Anne Arundel Medical Center in Annapolis and Peninsula Regional Medical Center in Salisbury rate better than average statewide and nationally in patient satisfaction. Peninsula also scored better than average in quality and patient safety ratings statewide and nationally. And Anne Arundel rated better than average nationally in quality and a safety, while it rated average statewide. In Maryland, consumers can go online to get information on safety, quality and satisfaction ratings at the Maryland Health Care Commission website (http://healthcarequality.mhcc.maryland.gov).

In December, Shore Regional Health launched a program called HEART to change patients’ perception of their care. And that, Coe said, required that caregivers consciously reconnect with what brought them into health care in the first place. “It’s about empathy, communication and connection,” Coe said. “It’s listening, watching, understanding.”

In the first phase of the program, 25 peer counsellors were trained. From January through March, those counsellors then led three-hour sessions among Shore Regional Health’s more than 2,000 employees. The focus, Coe said, was on helping caregivers see the hospital experience through the patient’s eyes.

“Every patient is reluctant to enter the hospital,” said Trena Williamson, regional director of communications and marketing at Shore Regional Health. “But for the medical staff, this is their normal.”

A new mother with a sick baby might see things differently than a veteran nurse with other, sicker patients, Williamson said. The HEART program helps staff “recalibrate” so as to see the situation from the patient’s perspective, she said.

Coe said patient satisfaction surveys are helpful but it is the comments that are most useful.

“The scores give us a number but the comments give us gifts of insight and direction,” she said. “We really look at comments– and we follow up.”

Keeping a patient-centered focus is “baked into the culture” at Anne Arundel Medical Center, where about 10 percent of hospital patients and 1 in 5 office visitors are from the Eastern Shore, said Maulik Joshi, executive vice president of integrated care delivery and chief operating officer.

Joshi said new hires are made based on their willingness not only to deliver the best medical care but also to make sure patients feel a personal connection.

“We own ‘I care’ behavior,” he said. “I—I sit down and talk with a patient at the beside; C—I connect with patients by smiling and saying hello; A—I answer quickly when someone has a question; R—I always tell everyone my role; and E—I always escort people.”

At Peninsula, the team approach and employees who live in the community and have worked many years at the hospital are key to both a high quality of care and patients’ happiness, said Sheri Matter, the hospital’s vice president of patient services.

Nurses and doctors together visit the patient to ensure everyone—including the patient—understands the plan of care, both in the hospital and when the patient goes home, she said.

And, she said, there is a “direct correlation” between patient satisfaction and “higher quality outcomes.”

“You have to listen,” she said.

Coe, at Shore Regional Health, would agree.

There, HEART has entered Phase 2: coaching and helping hospital staff put the program into practice. After that, “we’ll expand, go deeper,” she said.

In the meantime, Carroll said he is not worried about the ratings.

“We’re doing this because it’s a better way to do it,” he said. “The numbers will take care of themselves.”

The Regional Overview

If you have a heart attack, bicycle accident or need knee surgery, it’s useful to know how your hospital rates in quality of care, safety, and patient satisfaction.

Thanks to a growing trend in healthcare that looks at outcomes instead of just treatments, many government and private groups collect and disseminate data on hospitals’ performance. The information includes everything from specific comparisons about the likelihood of getting a hospital-acquired infection to how quiet the hospital corridors are at night. Hospitals are graded on these benchmarks and can be compared across a state or against a neighboring state.

In Maryland, which has a unique arrangement with the federal government for hospital reimbursements, consumers can go to a state website to see how their hospitals compare on many of these milestones.

The Maryland Health Care Commission, an independent agency, has an online consumer guide that can help answer many of your questions:

Sources: Shore Regional Health; Peninsula Regional Medical Center; Anne Arundel Medical Center

For example, you can use the website to look at a combined quality and safety score for every hospital in the state. Most hospitals in the state rank average on combined quality and safety compared with other Maryland hospitals, including the University of Maryland Shore Medical Centers at Easton, Chestertown and Dorchester. The only ones listed as better than average statewide are Peninsula Regional Medical Center in Salisbury, the Johns Hopkins Bayview Medical Center in Baltimore, and the University of Maryland St. Joseph Medical Center in Towson. Anne Arundel Medical Center, rated average statewide, is among 21 Maryland hospitals rated better than average compared with hospitals nationwide.

Much of the data come from the federal government, through the Centers for Medicare & Medicaid Services. The federal site also has its own hospital comparison tools. You can also go directly to the centers’ site: Medicare.gov. The direct link to the hospital compare site is found here.

Using that site, you can find and compare hospitals across the nation and check them out against the ones in your own backyard.

With all the information that is collected, using the sites can be a little daunting. But there is a way to cut through the clutter to find what you’re looking for.

Start out with the overall ratings to see how the hospitals stack up

Zero in on areas that align with your procedure–for example, maternity care or orthopedic surgery.

Look at the patient satisfaction measures, which tell you things like how well the hospital staff communicates with patients about the discharge instructions, prescriptions, etc.

If you have to go to the emergency room, there’s also information on how quickly you’ll get attention from the medical staff. Easton, Chestertown and Peninsula hospitals were rated better than average in six measures for how quickly emergency room patients were handled compared with other hospitals in the state. Anne Arundel was below average in four of the six measures.

 

Spy Contributor Robert Tiernan was managing editor of Consumer Reports from 2006 to 2015. Spy Contributor Ridgely Ochs covered health care, personal health and medicine for more than 20 years at Newsday on Long Island. They both now live on the Eastern Shore of Maryland.

UM SRH Celebrates Nursing Excellence at Annual Awards Presentation

University of Maryland Shore Regional Health’s Nurse Excellence Awards was held on Monday, May 8 at the Todd Performing Arts Center at Chesapeake College. The occasion was the premier event in the celebration of Nurses’ Week 2017, May 7-12.

Individual winners of UM SRH’s 2017 Nurse Excellence Awards are shown with Ruth Ann Jones, senior vice president, Patient Care Services and CNO (third from left): From left: Hope Honigsberg, Dawn Ruby, Taffie Wilson, Vernon Usilton and April Ewing.

Leading the event presentations, Ruth Ann Jones, UM Shore Regional Health’s senior vice president of Patient Care Services and chief nursing officer, noted that this year marked the sixth anniversary of the Nurse Excellence Awards and that the 2017 honorees were selected from a total of 48 individual nominations and 10 unit/department nominations, the greatest number submitted since the awards were established. “This awards program was established by nurses and for nurses as a way to recognize those who go above and beyond to always deliver exceptional care,” said Jones. “All nominees deserve our appreciation, as do their families and other supporters who help make it possible for them to go the extra mile in the care they provide.”

Ken Kozel, president and CEO, spoke glowingly of the pivotal role that Shore Regional Health’s 600 nurses play in achieving the organization’s vision of being the Region’s Leader in Patient Centered Health Care. “Our nursing team’s strong partnerships with our physicians and other members of the health care team enable us to continue to “raise the bar” on safety, quality and patient experience,” Kozel said. “I know that I speak for the entire leadership team when I express my gratitude for our nurses’ active engagement in developing new care models, recommending and adopting new technologies, creating new protocols for patient care, supporting the professional development of all team members, and adapting to the almost daily changes and challenges in the health care landscape.”

John Dillon, chairman of the Board of UM Shore Regional Health, cited “the outstanding reputation of Shore Regional Health’s nursing team – for their expertise, their dedication to our patients and family members, and their continued advancement of clinical care in all units and departments” as a constant in an era of rapid change in the health care system. “When a community member shares a story about an experience at one of our hospitals or outpatient facilities, that story almost always includes the nurse or nurses, often mentioned by name, who provided expert and compassionate care,” Dillon said.

UM Chester River Home Care won the Unit/Department Award for Excellence in Clinical Outcomes. Shown after the award presentation are UM CRHC staff members with Ruth Ann Jones (center); left of Jones, Rene Baker and Trish Focht; right of Jones, Katie Davis and Melissa Myers.

The 2017 Shore Regional Health Nurse Excellence Award winners are:

Outstanding Achievement in Care Delivery: Commitment to Others–Taffie Wilson, Regional Resuscitation Education Coordinator, Professional Nursing Practice

Outstanding Achievement in Leadership–Vernon Usilton, Clinical Nurse, Emergency Department, UM Shore Medical Center at Easton

Outstanding Achievement in Mentorship/Advocacy–Dawn Ruby, Clinical Nurse, 2 East, UM Shore Medical Center at Easton

Outstanding Achievement in Professional Nursing–Hope Honigsberg, Clinical Nurse, Ambulatory Surgery Center, UM Shore Medical Pavilion at Queenstown

Outstanding Achievement – Promising Professional–April Ewing, Clinical Nurse, Emergency Department, UM Shore Medical Center at Dorchester

Unit/Department Excellence in Clinical Outcomes–UM Chester River Home Care

About UM Shore Regional Health: As part of the University of Maryland Medical System (UMMS), University of Maryland Shore Regional Health is the principal provider of comprehensive health care services for more than 170,000 residents of Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties on Maryland’s Eastern Shore. UM Shore Regional Health’s team of more than 2,500 employees, medical staff, board members and volunteers work with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

UM CMG – Women’s Health Gynecologist Celebrates 400th Robotic Surgery

University of Maryland Community Medical Group – Women’s Health gynecologist Dr. William Katz recently performed his 400th robotic surgery on the Eastern Shore.

The 400th procedure took place on May 3, 2017 at University of Maryland Shore Medical Center at Easton. Dr. Katz has been providing gynecologic and robotic surgery on the Eastern Shore for more than 16 years, and also has been in practice for a total of more than 25 years.

Dr. Katz uses robotic surgery to treat several common conditions of the female reproductive system including uterine fibroids, uterine prolapse, endometriosis and adenomyosis.  Robotic surgery offers many benefits to patients compared to open surgery: shorter hospitalization and faster recovery times, small incisions, and reduced pain and discomfort.

“Dr. Katz has been a great mentor in the Eastern Shore community for many years,” comments Michele Wilson, vice president of operations for UM CMG. “This is an incredible accomplishment that represents the experience and expertise he uses to best serve patients on the Eastern Shore.”

Dr. Katz is affiliated with multiple hospitals on the Eastern Shore, including University of Maryland Shore Medical Center at Chestertown and University of Maryland Shore Medical Center at Easton. He received his medical degree from University of North Carolina at Chapel Hill School of Medicine.

Dr. Katz sees patients at 490 Cadmus Lane in Easton, Suite 106. Patients may make an appointment with Dr. Katz by calling 410-822-1221.

About the University of Maryland Community Medical Group

The University of Maryland Community Medical Group (UM CMG) is a multi-hospital, multi-specialty, community-based physician-led group, and part of the University of Maryland Medical System. With more than 300 primary care physicians, specialists, and advanced practice clinicians in more than 65 locations across the state, UM CMG offers patients a vast network of highly experienced providers, delivering care right in their neighborhood. For more information, visit www.umcmg.org.

When Mental Health Services and Economic Development Meet with Ben Kohl

While it might be hard to put the two together, there appears to be a significant link between the expansion on the Mid-Shore of behavioral health services and its economic development impact.

A case in point can be seen lately in both Kent and Talbot Counties with the growth of “Eastern Shore Psychological Services (ESPS), a privately-owned, mental health service provider. In Chestertown, a new office recently opened its doors in downtown that not only will be serving the needs of an estimated 4,000 individuals in Kent County who may be in need of psychiatric help but also adds twelve, relatively well-paid, professional positions to the town’s economic life. And this is also true in Talbot County, where ESPS’s presence has grown to over fifty staff members to handle its ever increasingly portfolio of work.

In fact, when you realize that only a few years ago Eastern Shore Psychological Services was made up of three professionals working out of a small office on Route 50 has now grown to have over 130 full-time employees, you begin to understand that economic development can come in many forms. And in this case, it comes with the real benefit of helping the 20% of the Mid-Shore population who need temporary or long-term help with through community, school and family-based treatment and evaluation services.

All of this prompted the Spy to reach out to Dr. Benjamin Kohl, who heads up ESPS programs on the Mid-Shore and has overseen much of this growth since joining the practice eight years ago. In our interview, Ben talks about the circumstances that led to his organization’s growth, including a marked increase in individuals enrolled in health insurance policies, but also, and more importantly, the slow but steady end of the stigma attached to those seeking out help for depression, attention deficit disorders, or drug/alcohol addiction, among many other conditions.

This video is approximately five minutes in length. For more information about “Eastern Shore Psychological Services please go here.

Opioid and Heroin Overdoses Have Reached ‘Crisis Level’ In Maryland

When Carin Miller’s son was about 19 years old, he began to abuse heroin by snorting pills, eventually moving on to shooting up. This went on for six years before he got help.

Lucas Miller’s history of drug use started in high school with smoking marijuana. When he moved out of his parents’ house, one of his housemates had access to between 750 to 1,500 pills at any given time between five houses located in Frederick, Maryland.

“My son was addicted to heroin, he’s in recovery by the grace of God since Thanksgiving 2014, I think that’s where we are at,” Miller said.

Opioid overdoses now rank with cancer, strokes and heart attacks among the top killers in Maryland.

State and federal lawmakers have passed legislation aimed at addressing the crisis, although they and public health experts agree the battle will be long.

On April 10, the Maryland General Assembly passed several bills to address this ongoing statewide crisis. The Start Talking Maryland Act, HB1082, and the HOPE Act, HB1329, were both passed.

The HOPE Act would increase access to naloxone, an overdose-reversal drug and would require hospitals to establish a new protocol when discharging patients treated for substance abuse disorders. It also introduced Keep the Door Open, a provision that provides three years of funding to reimburse community health providers. The act also requires the Behavioral Health Administration to establish a crisis treatment center before June 2018.

The Start Talking Maryland Act would require schools to have defined education programs on opioid addiction.

Other opioid related bills passed by the General Assembly were HB1432, which places a restriction on the number of opioid painkillers a doctor can prescribe to a patient per visit, and SB539, a bill that sets new penalties for distributing fentanyl.

The opioid-related legislation have been sent to Maryland Gov. Larry Hogan’s desk for his signature. The governor has until May 30 to either sign or veto the 900 bills passed by the General Assembly; otherwise they automatically become law.

On March 1, Hogan signed an executive order, declaring a state of emergency in response to the heroin, opioids and fentanyl crisis “ravaging communities in Maryland and across the country.”

“We need to treat this crisis the exact same way we would treat any other state emergency,” Hogan said in a statement. “This is about taking an all-hands-on-deck approach so that together we can save the lives of thousands of Marylanders.”

The final numbers for 2016 are expected to show that approximately 2,000 people died from heroin and other opioid overdoses in the state over the last year, about double the number of deaths in 2015.

Additionally, drug overdose deaths rose by 19.2 percent from 2013 to 2014 in Maryland, according to a press release from Sen. Ben Cardin, D-Md.

“There’s no question, no question there has been a spike in opioid overdoses,” Cardin said in an interview with Capital News Service. “Let me indicate the numbers in Maryland are shocking as we are seeing the doubling and tripling over the last couple of years, but the Maryland numbers are typical to what we see all over the country.”

Both Cardin and Sen. Chris Van Hollen backed passage of the 21st Century Cures Act and the Comprehensive Addiction and Recovery Act of 2015 (CARA). Van Hollen was a cosponsor for the 21st Century Cures Act.

“The opioid addiction epidemic is having a devastating impact on communities in Maryland and across the country,” Van Hollen said in a statement for Capital News Service. “I fought to pass the 21st Century Cures Act, which helps states expand programs to treat those suffering from addiction, but we must do much more to prevent substance abuse and to get help to those who need it.”

The 21st Century Cures Act was signed by President Barack Obama in December. It will provide $1 billion over two years for state grants to support opioid abuse prevention and treatment activities. CARA, a bipartisan bill, was signed into law by Obama last July. CARA assists drug-dependent newborns and their parents.

The federal Department of Health and Human Services has just awarded Maryland a $10 million grant under the 21st Century Cures Act.

“These grants are a small but encouraging step toward addressing the opioid crisis,” Rep. John Sarbanes, D-Towson, said in a statement. He was among those who pressed for the funds in the law. “But to make real progress in our effort to combat the epidemic, it’s the responsibility of Congress to provide additional resources to programs, families and communities in Maryland and across America that are working day in and day out to end the crisis.”

Van Hollen said there is more to be done with the crisis, including “protecting the significant investments made by the Affordable Care Act, and ensuring institutions like the National Institute for Drug Abuse at NIH in Maryland and others across the country have the resources necessary to carry out their critical missions.”

On March 29, President Donald Trump signed an executive order creating a presidential commission designed to combat opioid addiction and the opioid crisis nationwide. New Jersey Gov. Chris Christie is leading the commission.

A main reason for the doubling of overdoses for Maryland has been a new street drug, fentanyl, a powerful synthetic opioid that dealers are increasingly blending into regular heroin and selling cheaply.

Fentanyl is coming to the United States from China, and that needs to be stopped, Cardin said. The senator added that there also is work to be done with Mexico to stop heroin from flowing from that country.

“We’ve seen an abuse of using these drugs for pain and an abuse of people selling these drugs on the street and getting people addicted,” Cardin said. “There are things we can do to dry up the supply and help people who have addiction and health issues.”

In response to the rise in drug-related deaths, Hogan announced on March 1 that he has budgeted an additional $10 million per year to combat overdoses over the next five years.

Miller said Hogan’s action would help, but more money is needed from the federal government.

Miller is no stranger to opioid abuse as well. She said her husband, Greg Miller, had been abusing opioids since the late 1990s after he was hit by a drunk driver and had an additional, separate accident at work.

It reached a point where her husband’s withdrawals were so terrible that he almost died after being denied narcotics prescriptions at Frederick Memorial Hospital six years ago, Miller said.

“I was trying to get my husband off the pills, never thinking that my own kids would go on them after they saw the hell that I was put through,” Miller said.

Three years ago, Miller co-founded Maryland Heroin Awareness Advocates (MHAA), a grassroots organization in Frederick. It was founded “out of necessity,” by a group of women from Frederick in order to save their children from the opioid and heroin epidemic, Miller said.

“We have all been affected in some way, a lot of my colleagues have lost their children to overdoses,” said Miller, who is the president of MHAA.

Miller noted that there is not enough education about these drugs in schools. While one of her colleagues is invited into middle and high schools in Carroll County to give presentations, MHAA is “just nipping the bud” at giving presentations in Frederick County, Miller said.

Frederick County is a 40,000-student district with 10 high schools.

“We really give the principals the autonomy to address any issue in their community,” said Mike Maroke, Frederick County Public Schools deputy superintendent. “They determine if this is something be address or not.”

If the Start Talking Maryland Act is signed by Hogan, it would require schools to have opioid education programs, possibly through presentations such as MHAA’s.

After one presentation at a school, Miller handed out index cards to the students, ranging from seventh to twelfth grades, and asked for their feedback. She recalled what happened next: “One little girl came up to me and handed me her card and it said ‘Thank you for coming out and telling us about drugs because I wouldn’t want to lose any friends because my dad died a couple of months ago from a heroin overdose.’”

 

by Jess Nocera