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From Dialing to Delivery: Patient Meal Preparation at YRMC
When you’re in the hospital, you have more important things to think about than how your meals are planned, prepared and delivered to your room. It’s one of the things that seamlessly happens behind the scenes to contribute to what you hope will be a comfortable stay. However, you’d be impressed to learn how many staff members and steps it takes so that you get that meat loaf, baked potato with sour cream, green beans and carrot cake within 45 minutes of picking up the phone to place your order. At Dignity Health, Yavapai Regional Medical Center (YRMC), meals are served room-service style. This means that you can call in any order, breakfast, lunch or dinner, between the hours of 7 AM and 7 PM. Your choices are only limited by the diet your doctor has ordered for you. The menu is extensive – similar to what you’d see in a restaurant. It begins with a build your own breakfast option, including a choice of eggs, omelets, breakfast burritos, breads and potatoes, meats, cottage cheese, cereals, fruit, dairy and vegetarian options. A soup of the day is always available, along with daily chicken noodle soup. There’s a variety of salads and build your own sandwich choices, grill items and a pizza bar. Hot meals are also available all day. Popular dishes include roast turkey or roast beef with gravy, salmon, meat loaf with baked potato and turkey tacos. Patients are free to mix and match menu items at any given meal, as long as they’re within their doctor’s orders. Jeanne Briggs, Registered Dietician and Director of YRMC Nutrition Services, says that the patient menu at YRMC is continually being reviewed and updated. “First and foremost, our patient menu is based on nutritional requirements,” says Briggs. “We follow the USDA/HHS Dietary Guidelines for Americans. Fruits and vegetables are central to our menu. We pride ourselves in having those featured. We cook healthier meals than many people do at home. For example, our meals are lower in sodium than many people are used to.” “We have a team approach to what goes on the menu,” Briggs continues. “We have input from professional dieticians, but we also listen to the clinical staff, since they’re on the floors with the patients and hear feedback more frequently than we do. We are continually revamping the menu to reflect our patients’ needs and wants. It’s all about being a good listener.” Plant forward, vegetarian, vegan and gluten free choices are also available. Briggs gives special recognition to Cafeteria Team Lead, Daniel Seale who regularly does recipe analysis for food content and potential allergy-causing ingredients for the cafe and patient menus. He is also responsible for the research and development of new recipes. In addition, Production Manager Shelley Stophlet (YRMC West) and Kim Hamilton (YRMC East) make sure that all departmental operations run smoothly. Briggs describes the process from order to delivery. When a patient calls their order in, the computer system will immediately show the operator what diet the patient is on and whether there are any requested items the patient is not allowed to eat. If necessary, the operator will contact the patient and makes suggestions for alternative choices. Once the order is finalized, three tickets are created. The first ticket goes to cold prep, which includes items that don’t need to be cooked, such as milk, juice or other beverage, a napkin, silverware and similar items. The second ticket goes to the cook who prepares the hot portion of the meal – typically the main dish. The third ticket goes to the checker who makes sure the order is accurate and looks appealing. “No burnt toast!” jokes Briggs. Finally, delivery staff brings the tray to the patient’s room. At the patient’s bedside, they open the lid and make sure the patient is satisfied. According to Briggs, the greatest challenge is scheduling. For example, “a patient may have a typical time they expect to eat lunch,” says Briggs. “Our continual goal is to prepare, cook and deliver a fresh meal within a 45-minute time frame. So, during high-volume times like lunchtime, we’ll sometimes call patients we haven’t heard from to schedule their delivery ahead of time. This allows the patient to receive their meal when they would like it and it helps us reach that 45-minute goal.” Briggs is gratified when patients and staff ask for YRMC recipes. “It happens quite often, and we always provide them,” she says. “Our carrot cake recipe is one of the most requested. It’s a homemade recipe we’ve used the entire 37 years I’ve been at YRMC. The recipe was brought in by one of the cooks before I started working here. People rave about it.” After 37 years, Briggs’ greatest reward is the fact that she gets to take care of people. She simply states, “It’s what I was born to do.” “Our staff loves working here,” she continues. “And we’re proud of the quality meals we make. We give our very best every day to support your wellness.”
Is it COVID-19, the flu, a cold, allergies or asthma?
Cold and flu season is here and COVID-19 continues to spread. With every cough or sniffle, you may wonder if it’s asthma or allergies, the flu, the common cold or even COVID-19. How can you tell the difference? They manifest similar symptoms, making it easy to mistake one for another. The surest way to an accurate diagnosis is to see your doctor and get tested. Short of that, familiarizing ourselves with various symptoms associated with each condition can help lessen anxiety and reduce the crush on healthcare resources during the coronavirus pandemic. This list may help. While it is not exhaustive or a substitute for medical advice, it can help identify basic differences between, say, seasonal allergies and the much more serious COVID-19. COVID-19 Symptoms According to the World Health Organization (WHO) COVID-19 can affect people differently. People with mild to moderate symptoms can often recover at home. On average it takes 5–6 days for symptoms to show following infection, however it can take up to 14 days. Common symptoms include: Fever Dry cough Tiredness Aches and pains Sore throat Diarrhea Headache Loss of taste or smell Skin rash or discoloration of fingers or toes Difficulty breathing or shortness of breath. Chest pain or pressure Loss of speech or movement Flu (Influenza) Symptoms COVID-19 and Influenza are caused by different viruses. Yet these viruses spread in similar ways and cause many of the same signs and symptoms. However, there are a few differences. With the flu, symptoms can start suddenly and cause mild to severe illness, sometimes resulting in death. Common symptoms of the flu include: Fever (often very high, 101 or above) Headache Extreme tiredness Chills Constant cough Sore throat Runny or stuffy nose Body aches in bones and/or muscles Diarrhea and vomiting (more common in children) Cold Symptoms The common cold is usually mild compared to the flu and COVID-19. But even a mild cold can trigger unpleasant symptoms, so if you catch a cold, it’s good to take it seriously. Common symptoms of a cold include: Mild cough Sneezing Runny or stuffy nose Sore throat A short fever Aches and pains Asthma Symptoms Asthma is a chronic disease that inflames the airways. The best way to manage it is to take asthma medication, avoid triggers and treat asthma symptoms as soon as they occur. Common symptoms of asthma include: Coughing Wheezing (a whistling, squeaky sound when you breathe) Shortness of breath Rapid breathing Chest tightness Allergy Symptoms The American College of Allergy, Asthma, and Immunology points out that allergies generally occur when the immune system overreacts to something often harmless for others. For seasonal allergy sufferers, that means their bodies don’t react well to allergens like pollen, grass, and/or ragweed. Allergies are not contagious, unlike colds, the flu and COVID. Symptoms that often accompany allergies include: Runny nose, stuffy nose, and/or sneezing Wheezing or shortness of breath Dry Cough Mucus Rashes Fatigue Headache This chart is a handy reference tool when trying to distinguish between symptoms.
Yavapai County’s First COVID-19 Patient: A Story of Friendship and Miracles
There are times when people touch our lives in unexpected and powerful ways. Amid extraordinary circumstances, strangers can share a common experience that unites them, instantly and enduringly. This is the story of such a bond, and of a remarkable recovery from a devastating illness. Richard Barrington had been ill for a week. He was fatigued and had a fever and persistent cough. On March 24, 2020 breathing became increasingly difficult. He called 911 and was transported to Dignity Health -Yavapai Regional Medical Center (YRMC) West in Prescott, Arizona. Little did Barrington know that for the next six weeks he would be fighting for his life as the first COVID-19 patient to be admitted to a hospital in Yavapai County. Barrington is 77 years old and a heart attack survivor. By any measure, this puts him in a high-risk category for COVID-19. “The doctor told my daughter that my chances of survival were less than ten percent,” says Barrington. “I’m a born-again Christian, so I’m prepared to die,” he pauses. “But considering the outcome, God must have something more for me to do.” Barrington doesn’t remember much about his hospital stay. He was put on a ventilator right away and remained on it for most of his stay, mainly in the ICU. He was unresponsive twice. Barrington’s daughter spoke with the staff several times a day, advocating for her father and developing a close bond with those who were keeping him alive and helping him heal. “My daughter tells me that at one point, the staff asked what they could do to keep me comfortable and comforted,” recalls Barrington. “She suggested putting my phone on Spotify and playing my favorite Christian music playlist. It turns out that the music comforted the staff too.” The staff’s affection for Barrington grew the longer he was there. His doctor nicknamed him his “miracle patient” because of Barrington’s strength in fighting the virus. “The care was extraordinary,” says Barrington. “They were really rooting for me. One of the first days that I can remember is the day they took me off the ventilator. The nurses were joyful. ‘You survived, you lived, thank God!’ they said.” Barrington continues to stay in touch with the staff at the Critical Care Unit. Nurse Manager Julie Briggs hears from him regularly. “Each time we communicate, he is always so grateful for the care he received,” says Briggs. “What a kind and wonderful man. It has been a pleasure to get to know him.” Barrington feels the same about the friends he made at YRMC. As far as his long-term recovery, Barrington is understandably taking it slow. After discharge, he stayed at a rehabilitation center for three weeks, followed by another three weeks at a nursing home, then a month in California where his daughter facilitated his care. He is now home and doing well. “I’m 75 to 85 percent better now, but my energy level isn’t what it used to be. I still have memory issues too. Quoting scripture is harder,” he admits. Barrington has been advised that it will take 6 months to a year to recover. In the meantime, he is reading aloud every day, on the advice of his doctor. Exercise, crossword puzzles and other interactive activities occupy much of his day. Barrington encourages everyone to get a vaccine when it becomes available. “If we can lower the death rate and hospital rates, then let’s get it done,” he says. The support and love between the staff and Barrington will live on in his heart forever. “I just don’t have enough praise to give those caregivers,” he says. “When I was discharged, the staff lined the halls to cheer me on. It was amazing that they would care that much to come out and help me celebrate my miraculous victory. I was feeling the love.”
Is Interventional Radiology Right for You?
Medical innovation moves forward at a rapid pace, with continuing technological advances and an ever-increasing understanding of health and the human body. Interventional Radiology may be one of the best examples of this phenomena. Thanks to this highly specialized medical field, procedures that once required surgery, a hospital stay, and extensive recovery time are now being performed on an outpatient basis using minimally invasive techniques. In fact, most of the procedures are performed without an incision. Interventional Radiology (IR) combines the use of advanced imaging such ultrasound, X-rays, CT scans and MRI to guide the treatment of a variety of conditions. Interventional Radiologists are board-certified physicians who are trained in both radiology and minimally invasive therapies. They treat conditions in virtually every organ system, including: Blood vessels Nervous system Reproductive system Gastrointestinal tract Liver Urinary tract Cardiovascular disease Cancer Dialysis access Back pain Leg pain and swelling Dr. Matthew Dicker is a Diagnostic and Interventional Radiologist with Yavapai Regional Medical Center. He emphasizes that a team approach delivers the best care for his patients. “Taking care of each patient starts with our office staff and administrative staff at the hospital. A great group of nurses and technologists help before, during and after each procedure,” Dicker says. “And of course, collaboration with the hospitalists and vascular surgeons as well as primary care providers creates the best possible 360-degree care for the patients in our community.” Dicker explains that Interventional Radiologists are consultants to virtually all of the specialties and subspecialties at YRMC, in addition to performing procedures specific to each. “Having the expertise to perform these procedures and having the facilities and support staff to perform them is a great benefit to the Quad Cities,” says Dicker. “The hassle of driving to Phoenix or elsewhere is no longer necessary.” As with the practice of medicine in general, Interventional Radiology continues to keep pace with ever-developing research and technology. “New and different ways to treat disease are happening almost daily,” Dicker notes. “We strive to perform the newest treatments safer than before. For instance, opening blockages in the leg arteries is being performed with access through the ankle as opposed to the groin where it had been typically performed, which significantly decrease the risk of bleeding while having the same excellent results.” “We are excited to introduce intravascular lithotripsy to break up plaque in the arteries that causes blockages,” he continues. “It uses the same technology that has been used for years to break up kidney stones.” Interventional Radiology allows for a quicker recovery time, less pain, reduced cost and a lower risk of complications. If you are a candidate for surgery, talk to your healthcare provider to see if an Interventional Radiology procedure makes sense for you as an alternative. “It is rewarding when a procedure is successful, a patient is happy with the results, and they are surprised that it was done without an incision with very little if any pain,” says Dicker. Click here to learn more about YRMC Imaging Services.
Advanced Wound Care: A Deep Dive into Healing
Take a deep dive … drill down … unpack the situation, they’re all about looking below the surface to understand complexities. That’s the kind of work that goes on every day at Advanced Wound Care at Dignity Health, Yavapai Regional Medical Center (YRMC) in Prescott Valley. “With non-healing wounds of the lower-extremities it’s critical to understand the underlying issues,” says Cheryl Sofonia, MPH, Program Manager, Advanced Wound Care at Dignity Health, YRMC. “A chronic wound cannot be healed until you know its underlying cause.” Here’s the Plan After a patient is referred to Advanced Wound Care by their primary care provider or other physician, the “deep dive” can begin. This includes a history and physical, lab work, imaging (an MRI or x-ray), and a thorough assessment of the non-healing wound. “This information is the foundation of every patient care plan at Advanced Wound Care,” explains Sofonia. What are the most common, non-healing wounds of the lower extremities? Arterial ulcers – These non-healing wounds form on the outer side of the ankles, feet, heels, or toes. The cause of these chronic wounds may be blocked arteries, diabetes, age and hypertension, to name a few. Venous ulcers – Typically found below the knee and on the inner ankle, these non-healing wounds can be triggered by poor circulation in the leg’s veins. Other risk factors include varicose veins, obesity, and smoking. Diabetic foot ulcers – For people with diabetes, a minor blister can develop quickly into a non-healing wound that requires intense therapy. Pressure ulcers – Long-term weight and friction on a specific area – often the feet – can lead to a non-healing wound. Other chronic wounds are caused by burns, radiation, and non-healing surgical wounds. In general, a wound that doesn’t heal after four weeks is considered chronic. Such wounds affect approximately 3% of people age 65 and older as well as more than 8 million U.S. residents. A Patient-Focused Approach Advanced Wound Care takes a team approach to diagnosing and treating chronic wounds. The patient – who is at the center of the team – receives treatment from exceptional wound care specialists and visiting physician specialists as well as experienced healthcare professionals. The Advanced Wound Care team includes: Two certified wound care physician specialists 11 registered nurses, including certified wound and ostomy nurses An occupational therapist who specializes in treating secondary lymphedema, a buildup of fluid in the tissues caused by another disease or condition An interventional cardiologist A podiatrist An infectious disease specialist Additionally, the experts at the Vein Center at Dignity Health, YRMC, are located adjacent to Advanced Wound Care. The Vein Center conducts ablation therapies to treat patients with issues related to the arteries and veins. “The collaborative nature of Advanced Wound Care benefits patients in many ways,” Sofonia says. “One of the most important aspects of our structure is that our patient care is centralized so people don’t have to travel to different clinics for care.” Talk to your healthcare provider for a referral to Advanced Wound Care. For more information, visit Advanced Wound Care at YRMC.org or call 928-771-4788.
Tips for Living with COPD
While it may be alarming to receive a diagnosis of Chronic Obstructive Pulmonary Disease (COPD), it’s important to educate yourself about the disease and what treatment choices are available to you. Making these decisions as soon as possible is key to improving one’s quality of life. What is COPD? COPD is a general term for a group of lung conditions, including chronic bronchitis and emphysema, where airflow from the lungs becomes increasingly blocked over time. Symptoms include shortness of breath, wheezing or a chronic cough. The American Lung Association estimates that 16.4 million people in the U.S. are living with COPD. 85 to 90% of those cases are caused by smoking. However, nonsmokers can get COPD as well. Long-term exposure to secondhand smoke, air pollution and fumes from certain chemicals can also play a role. Rocky Higgins, Respiratory Therapist at Dignity Health, Yavapai Regional Medical Center (YRMC) advises her patients to follow a handful of basic steps when diagnosed with any lung condition, including COPD. Listen to your Healthcare Provider First, Higgins recommends that you get on board right away with your physician and respiratory care team. COPD treatment may include medication, oxygen therapy or a pulmonary rehabilitation program. “We are all here to help you be successful and healthy,” she says. “Ask questions so that you understand your care plan, and don’t hesitate to ask your pharmacist if any questions arise about your medication.” Quit Smoking If you currently smoke or vape, quit. For someone with COPD, quitting smoking will make a huge difference. But Higgins recognizes that for many of us, it’s easier said than done. “Any habit change is difficult. You need to WANT to change the behavior and recognize that it will have its challenges,” she notes. “Try to be able to laugh at yourself rather than dog yourself when things roll in the wrong direction. Remember you are human. We sometimes learn through mistakes, but often it’s the best way to learn.” This excellent advice is especially relevant for those who attend YRMC’s smoking cessation classes. Higgins has been a program facilitator since 1986. Each session includes seven 90-minute classes and offers discounted or free Nicotine Replacement Therapy (NRT) to qualified clients. “There’s no pre-sign up. Clients can just show up to the introductory class and learn about the program. They can sign up at that time,” says Higgins. You can find out when the next session begins by contacting YRMC at (928) 771-5102. “Help is also available to all Arizona residents by calling the Arizona Smokers Hotline (ASHLine) at 1-800-556-6222,” Higgins adds. “ASHLine offers phone conversations with trained tobacco/nicotine coaches and NRT to clients who qualify.” Get Some Exercise “Quitting smoking and exercising go hand in hand,” states Higgins. “Replace those cigarettes with light hand weights, exercise bands or squeezy balls.” She explains that the idea is to replace a negative reaction (the urge to smoke) with a positive result (exercise). Incorporating some type of exercise will also help your body through the withdrawal symptoms and take your mind off of those negative feelings. “It is a known fact that exercise creates endorphins, those feel-good chemicals created in our brains,” says Higgins. For those who have COPD, regular exercise can also strengthen the lungs and improve circulation, which may increase the flow of oxygen throughout the body and reduce symptoms. Find Support Emotional support can be an integral part of staying on top of COPD. It’s important to know how to recognize and handle any feelings of anxiety, stress or depression that may arise. Talk to your healthcare team about counselors or support groups that may be available to you. Many people who attend the YRMC smoking cessation classes are appreciative of the support they receive from those who are taking the class. They note that it helps to share their experiences with someone who is going through a similar time in their lives. A healthy and happy life is possible with COPD. Experts recommend that you keep the dialog going with your care providers, stay active and seek out the support you need.
The Quad Cities Welcome Dignity Health, Yavapai Regional Medical Group
The recent affiliation of Yavapai Regional Medical Center (YRMC) and Dignity Health also includes YRMC PhysicianCare. The 26 multispecialty medical clinics – located in Chino Valley, Prescott and Prescott Valley – are now known as Dignity Health, Yavapai Regional Medical Group (YRMG). “From our patients’ perspective, the new name is the major change,” says Robert Thompson, MD, MBA, Executive Medical Director, Yavapai Regional Medical Group. “They will see the clinics re-branded with the YRMG name, and the Dignity Health logo on our signage as well as on any communication they receive from their providers.” YRMG’s provider team will not change and the clinics will continue to accept the same health insurance as they have previously. Patients can reach their physician using the same telephone number. They also will go to the same location for their appointments. According to Dr. Thompson, the YRMC-Dignity Health affiliation will build on YRMC’s current excellent programs and services to expand healthcare in our growing community. “The affiliation with Dignity Health will expand services and increase innovation throughout the entire YRMC health network, including Yavapai Regional Medical Group,” Dr. Thompson says. “One of the first steps will be the growth of our clinics to include more specialty physicians and primary care providers.” Yavapai Regional Medical Group currently includes nearly 100 providers in community-based clinics specializing in: Cardiology, Prescott and Prescott Valley Endocrinology and Psychiatry, Prescott Gastroenterology, Prescott Infectious Disease and Pulmonology, Prescott Neurology, Neurosurgery and Physiatry, Prescott Occupational Medicine, Prescott Orthopedic Surgery, Prescott Valley Pain Management, Prescott Valley Palliative Medicine, Prescott Pediatrics, Prescott Primary Medicine, Family Medicine and Internal Medicine, Chino Valley, Prescott and Prescott Valley Vascular Surgery For YRMG clinic locations, visit DignityHealth.org/YRMG. Keep up-to-date on the YRMC-Dignity Health affiliation and other YRMC news, by subscribing to YRMC HealthConnect.
Yavapai Regional Medical Group Welcomes Director of Geriatric and Palliative Medicine
Sam W. Downing, MD, is the new Director of Geriatric and Palliative Medicine for Dignity Health Yavapai Regional Medical Group (formerly YRMC PhysicianCare). The Clinic, which serves the entire Quad Cities, is located at: Dignity Health Yavapai Regional Medical Group, Palliative Medicine 802 Ainsworth, Suite C Prescott, Arizona 86301 (928) 775-5567 Sam W. Downing, MD Even though Yavapai Regional Medical Group, Palliative Medicine is located in Prescott, many Palliative Medicine appointments occur throughout the community. From Dr. Downing’s perspective, this “we-meet-you-where-you-are” approach to medical care is one of the strengths of Palliative Medicine. “Our team sees patients in the Palliative Medicine Clinic, care centers and private homes,” said Dr. Downing. “That’s an advantage to some people who may be homebound or who are concerned about going out into the community during a pandemic.” The team Dr. Downing oversees includes physicians, physician assistants, a nurse practitioner, a registered nurse, and a social worker. All of these caregivers are experts at managing the complexities of living with a serious illness. Dr. Downing describes Palliative Medicine as complementary to an individual’s primary care. The Palliative Medicine team cares for people with advanced illness, life-limiting illness, complex conditions, or chronic disease. Palliative Medicine: An Added Layer of Support “Palliative Medicine is an added layer of support,” Dr. Downing explained. “We’re not designed to replace the treatment and care someone is currently receiving. Much of what we do is help patients understand their choices and options. We also support them as they define their priorities for their medical care.” Dr. Downing is an expert at all of the above. He’s board certified by the American Academy of Hospice and Palliative Care as well as the American Academy of Family Physicians. He has had a 30-year relationship with YRMC, joining the community after completing a Family Practice residency at Phoenix Baptist Hospital. He earned his medical degree from the University of Colorado Health Sciences Center in Denver. Sharing his expertise with the community is a priority for Dr. Downing. He serves on the Board of Directors of Northland Cares, an outpatient services organization for people living with HIV/AIDS. Dr. Downing also speaks frequently to audiences about age-related issues. Geriatric Assessment Clinic to Open in 2021 Dr. Downing’s experience is in demand as Yavapai Regional Medical Group is in the process of developing a Geriatric Assessment Clinic. Due to open in 2021, the self-referral program will feature comprehensive assessments for people concerned about cognitive impairment and memory disorders. “This is exciting news for the people of our community who may be worried about their own, or a loved one’s, cognitive decline,” said Dr. Downing. “The Geriatric Assessment Clinic will include a four-hour, multi-disciplinary evaluation followed by specific recommendations on how to prevent further cognitive decline. Down the road, a complementary support program will address the needs of patients and their families who are dealing with cognitive challenges.” For more information about Yavapai Regional Medical Group, Palliative Medicine, talk to your primary care provider, visit YRMC.org, or call 928-775-5567.