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5 Ways to Prevent Diabetes
November is National Diabetes Month, and with cases of the disease at an all-time high in the U.S., individuals must do everything they can to stay healthy. Learn more about diabetes prevention and also how to stop prediabetes in its tracks with these five helpful tips. Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it. And those with prediabetes are at risk for developing type 2 diabetes in 10 years or less, according to the Mayo Clinic. The American Medical Association notes that 4 million U.S. adults have prediabetes. Check out the American Diabetes Association’s prediabetes risk test. The good news: There are ways to manage — and even reverse — prediabetes. Renown’s Certified Diabetes Educator Stephen Compston, RD, LD, CDE, shares five steps for managing blood sugar and also avoiding an eventual diagnosis. How to Prevent Diabetes Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says. Exercise. Blood sugar is the body’s basic energy source. When you exercise, you are lowering your blood sugar. “People with prediabetes usually want to stay off of medication, so they must add something to their normal regimen that lowers blood sugar,” Compston says. “In this case, exercise is medicine.” Lose weight. A small decrease in your weight can drastically decrease your risk of developing diabetes in the future. The Diabetes Prevention Program study showed that a 7 percent decrease in body weight (14 pounds for a 200 pound person) can reduce a person’s risk of developing the disease by 58 percent. Get more rest. Studies link sleep issues to an increased risk of insulin resistance. It can also make it harder to lose weight. Thus, people that don’t get adequate sleep are at an increased risk for developing type 2 diabetes. See your doctor regularly. Schedule an appointment with your primary care provider at least once a year so you can track your health together. “A regular check-up and lab work can help identify what your blood sugars are doing so you and your doctor can develop a good plan for delaying the onset of diabetes,” Compston says.
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Elevated Levels of Arsenic and Other Metals Found In Nevada Private Wells
Study shows that many household wells need better drinking water treatment and monitoring Outside of Nevada’s bustling cities, private wells are the primary source of drinking water, serving 182,000 people. Yet some of the tested private wells in Nevada are contaminated with levels of heavy metals that exceed federal, state or health-based guidelines, a new study published in Science of The Total Environment shows. Consuming water contaminated by metals such as arsenic can cause adverse health effects. Scientists from DRI and the University of Hawaii Cancer Center recruited households with private wells through the Healthy Nevada Project. Households were sent free water testing kits, and participants were notified of their water quality results and recommended actions they could take. More than 170 households participated in the research, with the majority from Northern Nevada around Reno, Carson City and Fallon. “The goals of the Healthy Nevada project are to understand how genetics, environment, social factors, and healthcare interact. We directly engaged our participants to better understand environmental contaminants that may cause adverse health outcomes,” said co-author Joseph Grzymski, PhD, research professor at DRI, principal investigator of the Healthy Nevada Project®, and chief scientific officer for Renown Health. Nearly one-quarter (22%) of the private wells sampled had arsenic that exceeded safe levels determined by the Environmental Protection Agency (EPA) — with levels 80 times higher than the limit in some cases. Elevated levels of uranium, lead, cadmium, and iron were also found. “We know from previous research that Nevada’s arid climate and geologic landscape produce these heavy metals in our groundwater,” says Monica Arienzo, PhD, an associate research professor at DRI who led the study. “It was important for us to reach out to community members with private wells to see how this is impacting the safety of their drinking water.” Fewer than half (41%) of the wells sampled used water treatment systems, and some treated water samples still contained arsenic levels over EPA guidelines. Although average levels of heavy metal contaminants were lower in treated water, many homes were unable to reduce contaminants to levels considered safe. The state leaves private well owners responsible for monitoring their own water quality, and well water testing helps ensure water is safe to drink. This study shows that more frequent testing is needed to ensure Nevada’s rural communities have safe drinking water. This is particularly important as the effects of climate change and population growth alter the chemistry of groundwater, potentially increasing metal concentrations. “The results emphasize the importance of regular water quality monitoring and treatment systems,” said co-author Daniel Saftner, MS, assistant research scientist at DRI. Although the research focused on wells in Nevada, other arid communities in Western states are facing similar risks of water contamination. More information: The full study, Naturally Occurring Metals in Unregulated Domestic Wells in Nevada, USA, is available from Science of The Total Environment: doi.org/10.1016/j.scitotenv.2022.158277. This project was funded by an NIH award (#1R01ES030948-01). The Healthy Nevada Project was funded by grants from Renown Health and the Renown Health Foundation. Study authors included Monica M. Arienzo (DRI), Daniel Saftner (DRI), Steven N. Bacon (DRI), Erika Robtoy (DRI), Iva Neveux (DRI), Karen Schlauch (DRI), Michele Carbone (University of Hawaii Cancer Center) and Joseph Grzymski (DRI/Renown Health). About DRI The Desert Research Institute (DRI) is a recognized world leader in basic and applied environmental research. Committed to scientific excellence and integrity, DRI faculty, students who work alongside them, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Since 1959, DRI’s research has advanced scientific knowledge on topics ranging from humans’ impact on the environment to the environment’s impact on humans. DRI’s impactful science and inspiring solutions support Nevada’s diverse economy, provide science-based educational opportunities, and inform policymakers, business leaders, and community members. With campuses in Las Vegas and Reno, DRI serves as the non-profit research arm of the Nevada System of Higher Education. For more information, please visit dri.edu. About Renown Health Renown Health is Nevada’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 6,500 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. About the University of Hawaiʻi Cancer Center The University of Hawaiʻi Cancer Center through its various activities, including scientific research and clinical trials, adds more than $57 million to the Oʻahu economy. It is one of only 71 research institutions designated by the National Cancer Institute. An organized research unit within the University of Hawaiʻi at Mānoa, the UH Cancer Center is dedicated to eliminating cancer through research, education, patient care and community outreach with an emphasis on the unique ethnic, cultural, and environmental characteristics of Hawaiʻi and the Pacific. Learn more at https://www.uhcancercenter.org. Like us on Facebook at facebook.com/UHCancerCenter. Follow us on Twitter @UHCancerCenter.
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Snakes! 3 Safety Tips for Outdoor Adventures
Seeing a snake while exploring northern Nevada’s trails is somewhat rare and the chance of a snakebite is even less common. However, it’s important to make sure you’re ready for snakes and know what to do in case of a snakebite. Hiking the rugged, stunning and varied landscapes of northern Nevada is a huge draw for many who live here. But it’s important to stay alert and be prepared while you’re out exploring the natural habitats of wildlife, especially if you encounter a snake or get a snakebite. As you prep for your next outdoor adventure, remember these three tips to stay safe in Nevada’s wilderness. 1. Leave snakes alone In general, if you don’t mess with snakes, they won’t mess with you. Seeing a snake is fairly uncommon because of their body camouflage and secretive nature, which are their first defenses in evading predators. According to the Nevada Department of Wildlife (NDOW), most snakebites happen when a person tries to capture or kill the snake. Nevada is home to 52 species of snakes and reptiles, according to NDOW. Only six can be dangerous to people and pets: Western Rattlesnake (this is the most common type of venomous snake in northern Nevada, especially around Yerington and Fallon) Sidewinder Mohave Rattlesnake Speckled Rattlesnake Western Diamondback Gila Monster (these live in southern Nevada’s Mojave Desert) Venomous snakes, like the rattlesnakes, have a wide head and thick body. Non-venomous snakes are usually more slender and have a narrow head. If you see a snake on the trail and you aren’t sure if it’s venomous or not, it’s best to be safe and leave it alone by moving away slowly. 2. Wear the right gear and take care where you walk NDOW and the U.S. Department of Agriculture suggest doing the following to decrease your chances of a snakebite: Wear over-the-ankle boots, thick socks and loose-fitting long pants. Stick to trails and stay out of the bushes or tall grass. Don’t step where you can’t see. If going over a fallen tree or large rock, step on it. Don’t jump over it. A snake might be lying on the other side. Always check stumps or logs for snakes if you’re going to sit on it. If you see one or hear a rattle, move away from the area slowly. Don’t run or make any sudden movements. Don’t handle or move a recently-killed snake as it can still inject venom. And for your dog, the best way to prevent a snake bite is to keep it on a leash. 3. Know what to do (and not do) if you get a snakebite Renown Health primary care physician Aaron A. Bertalmio, MD, reminds us the odds of getting a snakebite are very low. Roughly 7,000 to 8,000 people get bitten annually and only 5 percent die according to the U.S. Food and Drug Administration. But in the event of a snakebite, here’s what to do: Get medical help as soon as possible Stay calm to help keep your heart-rate low Remove constrictive clothing or jewelry Clean the wound with soap and water if available Cover the snakebite with dry, sterile cloth or adhesive bandage if available Keep the bite snakebite area level and below your heart if possible WHAT NOT TO DO IF YOU GET A SNAKEBITE: Apply a tourniquet (a tool used to stop arm or leg blood flow) Ice the bitten area Suck out the venom You’re now prepped and ready on what you need to know about Nevada’s slithery friends so you can stay safe and enjoy the outdoors!
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Bladder Control Treatment for Women – What’s Right for You?
Although going to the bathroom is not a typical conversation among women and their doctors, it’s an important one. It is a topic you may want to discuss with a urogynecologist, a physician who diagnoses, manages and treats pelvic health conditions in women. Kerac Falk, MD, a urogynecologist and assistant professor at the University of Nevada, Reno and Renown Health discusses overactive bladder in women and how to treat it. According to the National Institutes of Health, about 1 in 4 women struggle with pelvic health conditions, with over 40 percent of women over age 60 experiencing problems. While these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. In fact, many women don’t think of urine leakage as a medical problem, and only 1 in 3 women with incontinence seek care. So, while these conditions may be common, they shouldn’t just be accepted as a normal part of getting older. There are excellent treatment options that can significantly improve the quality of life. Overactive Bladder Symptoms in Women: As your body changes and ages, so does your pelvic health. Whether you just had a baby, are experiencing urgency issues or find you cannot go about your daily routine, sneeze or laugh without leaking urine – you’re not alone. An overactive bladder, also known as OAB, is more than feeling an urgent need to go to the bathroom. It can also include the following: Incontinence or lack of control over urination Waking up in the middle of the night to empty your bladder Going to the bathroom often, even every 30 to 60 minutes Symptoms of OAB can lead to a decreased quality of life, feeling as if you cannot go about your normal daily routine, or even become hazardous, increasing the risk of trips, falls, and bone fractures. Various Treatments are Available: Behavioral management (eliminating coffee, soda and alcohol which irritate your bladder) Pelvic floor physical therapy to optimize nerve and muscular function and coordination to prevent leakage Medications including tablets and local estrogen replacement Pelvic nerve stimulation and reprogramming treatments Botox to relax the bladder muscle Solutions for an Overactive Bladder: Simply put, OAB is a nerve and muscle problem, so the bladder needs to calm down. Although there is no underlying reason for OAB, some underlying conditions may exist, such as: High blood pressure Recent trauma Neurological conditions (such as stroke and multiple sclerosis) Lifestyle and non-invasive measures can usually reduce symptoms by as much as 50%, significantly improving quality of life. However, if these measures do not help your OAB, further bladder testing may be needed. Dr. Falk notes that “every patient has a unique situation and set of symptoms. My job as a urogynecologist and pelvic floor subspecialist is to work as a team with each individual to figure out what’s going on and design the best treatment approach that fits your needs and goals, whether that is conservative or with more advanced procedures. The outcome we are working towards is improved quality of life.” If you are bothered by your bladder, the best thing you can do is bring this up with your primary care doctor or gynecologist to begin to discuss solutions
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Healthy Nevada Project Returning Clinical Results to Participants
The Healthy Nevada Project – a first-of-its-kind population health study combining genetic, clinical, social and environmental data – has reached another landmark milestone. The study is notifying study participants at risk for familial hypercholesterolemia, BRCA and Lynch syndrome. “I took part in the Healthy Nevada Project to find out my ancestry. I didn’t even realize the test could give me so much information,” says 29-year-old Jordan Stiteler, who was recently diagnosed with familial hypercholesterolemia (also known as FH) through the Healthy Nevada Project. “After my dad passed away suddenly at age 45, I learned I had high cholesterol but I didn’t know it was genetic and I didn’t get an FH diagnosis until last week,” Jordan explains. “I immediately changed my diet, started walking more and doing more cardio. I also set up an appointment with my primary care physician for the first time in a while. I’ve talked with my family and even strangers about testing since my diagnosis. I hope my story will inspire others to test and can save someone’s family from going through the same loss I did.” Healthy Nevada Project Notifying Patients of Familial Hypercholesterolemia Risks Jordan is among the first Healthy Nevada Project participants to receive clinical results from the genetic study led by Renown Institute for Health Innovation (Renown IHI) – a collaboration between Renown and the Desert Research Institute Foundation. This groundbreaking population health study is now reaching out to study participants like Jordan, who asked to be notified of health risks. If study volunteers choose, the project will also provide guidance on treatment and additional testing for family members who may also be at risk. The project is starting with the return of FH risks which is a genetic tie to high cholesterol. Just a few months ago, a paper in the Journal of the American College of Cardiology recommended genetic testing become the standard of care for patients with a definite or probable FH diagnosis. Jordan says she plans to have her young son tested as well. “This is the future of health; not just reacting to sick people, but a coordinated effort between innovative technologies, data-driven researchers, and responsive practitioners to deliver personalized interventions to identify, prevent and treat disease,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown IHI. “As care providers, we often don’t see patients until they’re already sick and that’s a difficult problem. By embracing personal genomics, we can accelerate the ability of researchers to access data and apply those learnings back to our health system sooner.” In the Months Ahead: Notification of BRCA1/2 & Lynch Syndrome Risks The Healthy Nevada Project will start notifying study volunteers at risk for other CDC Tier 1 conditions including hereditary breast and ovarian cancer syndrome (BRCA 1/2 genes) and Lynch syndrome in the months ahead. These conditions are the key focus for the Healthy Nevada Project. The reason: Because early detection and treatment will save lives, and these conditions are some of the most common. “This research allows us to look into cancer, cardiac, respiratory illness and beyond to identify underlying causes, assess real risks and eventually initiate appropriate preventive actions much earlier. Human subject research is often intangible to participants – we are treated as subjects. The Healthy Nevada Project is creating actionable information for our participants while engaging in leading-edge research on health determinants,” said Joseph Grzymski, Ph.D., associate research professor at DRI, principal investigator of the Healthy Nevada Project and chief scientific officer for Renown Health. Landmark Population Health Study Continues to Expand Since launching two years ago, the Healthy Nevada Project has quickly evolved and expanded. The pilot project enrolled 10,000 participants in just 48 hours in September 2016. In March 2018, phase two of project expanded to an additional 40,000 participants with genetic testing partner, Helix. Helix’s genomic sequencing provides participants and researchers greater depth and quality of DNA data. With this, they can gain further insights to improve health. During a recent media roundtable announcing the return of clinical results, the Healthy Nevada Project also announced plans to complete testing of 40,000 people by the end of 2018. This will bring the project’s total enrollment to 50,000 people – approximately 10 percent of northern Nevada’s population. The Healthy Nevada Project hopes to reach more than 250,000 people in its next phase. The ultimate goal is to offer genetic testing to every Nevadan interested in learning more about their genetics and health. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up
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COPD Explained: Protecting Your Lungs and Managing Symptoms
COPD (chronic obstructive pulmonary disease) is a progressive lung condition often mistaken for typical aging signs, like shortness of breath and coughing. While smoking and pollution can contribute to its development, lifestyle changes and medications can help manage its progression. Diagnosis typically involves lung function tests, chest X-rays, or CT scans, with treatments available through a pulmonologist or primary care provider. Renown’s Pulmonary Rehabilitation Program offers insights into living with COPD. What is COPD? According to the COPD Foundation, it is an umbrella term used to describe progressive lung diseases including: Emphysema: Damage to the small air sacs in the lungs (alveoli). Chronic Bronchitis: Irritation and swelling of bronchial tubes, causing shortness of breath and coughing for long periods of time. Asthma (non-reversible): When asthma medications cannot reduce swelling in the airways. COPD Risk Factors Smoking is the most significant COPD risk factor, and the American Lung Association (ALA) says it accounts for nearly 90 percent of cases. If you are a smoker, it is essential to seek help and quit. Other COPD risk factors include: Air pollution Genetics Second-hand smoke Chemical, fumes or dust in the workplace How Can You Protect Yourself? Stop smoking Renown Health provides support offering 4-week Smoking Cessation Virtual Classes, free of charge! Sign up today. Use natural cleaning products Many household chemicals, especially those containing bleach, can irritate the lungs – a condition called, chemical pneumonitis. Stay away from all types of smoke This includes smoke from fireplaces. Likewise, plan to stay indoors when it is smoky outside, or air quality is poor. Get active Of course, it’s never too late to start an exercise program. When exercising your heart pumps, circulating your blood and sending oxygen to every part of your body. Notably it strengthens your lungs, making it easier to breath. Talk to your doctor to see if you are healthy enough to begin exercising. Eat a healthy diet Surprisingly what you eat can affect your breathing. The American Lung Association encourages those with COPD to watch their sodium intake, eat smaller, more frequent meals (instead of three large ones), limit high fat foods and drink plenty of water. Avoid scented products Perfumes, aerosol sprays and plug-in air fresheners can trigger flare-ups. Get a flu shot Did you know chronic lung conditions, as well as, heart disease, cancer and diabetes, can be made even worse by the flu? Now is the time to get your flu shot for the season if you haven’t already. Renown’s Pulmonary Rehab staff is certified through the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR). Recently, Renown Regional Medical Center successfully completed a disease specific COPD certification survey by The Joint Commission. For two accreditation cycles in a row, the COPD Program has had zero findings during the rigorous survey.
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Department Spotlight: Patient Access
Health systems across the country recently celebrated Patient Access Week from April 2-8. Join us in recognizing our Patient Access team at Renown! Fighting the Good Fight starts the moment a patient steps onto the grounds of our health system. When patients visit Renown on their healthcare journey, they look to the experts to not only help them navigate through the complexities of the process but also ensure their experience with us starts off on the right foot. Renown Health’s Patient Access Representatives (also referred to as “PARs”) are the faces of this entire process. As the key links between patients, providers and insurers, they strive to create a welcoming and respectful environment for everyone. PARs are committed to providing all of Renown’s patients access to the quality care when needed. After all, it’s in their name! A Friendly Face PARs are the front faces of almost all clinical areas at Renown. As the starting point for much of the patient experience, the day-in-the-life of PARs can vary. Checking patients in and out, getting demographic information, verifying insurance, answering phone calls, fostering communication between patients and their care teams, scheduling patients for follow-ups, explaining financial responsibilities and our financial aid programs, creating an overall positive experience and environment, the list goes on – but they all remain united under one goal: setting patients off on the right foot as they access care through our health system. “Each day, PARs are met with new patients who are seeking solutions to different concerns,” said Macy Betts, PAR for Renown Women’s Health. “We are the front doors to this department. We are not just checking patients in and out; we are the first step to the patients receiving the care they deserve.” “We take pride in our work,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia, PARs for Renown Pediatrics. “Usually, we are the first point of contact within Renown, so we don’t take our role lightly. For example, when we see a newborn, we must ensure the registration has been verified, which consists of patient demographics, patient preferences and insurance verification. We need to be consistent and thorough because what we do affects every point of contact a patient may have within Renown.” “As my team’s senior PAR, my day begins with gathering the outpatient therapy work queue numbers and assigning the team to work them,” added Logan Johnson, Senior PAR in Pre-Registration at Renown. “Our goal is to contact and schedule patients for physical, occupational and/or speech therapy as soon as possible so that they have the maximum benefit and can get back to a normal life as quickly as possible. Our encounters can make or break the entire experience.” PARs never underestimate the power of good communication and compassion. Even during the busiest of times, our PARs work diligently to ensure all patients and their care teams fully understand the administrative side of whichever part of their journey they are about to embark on, lending a helping hand and a smile. “Whether you’re communicating with patients, leaders or coworkers, communication is key,” said Jonathan Figueroa, PAR for the Renown Institute for Heart & Vascular Health (IHVH). “We try and make sure that we do everything possible to make their visit go as smoothly as possible.” “Communication makes the world go round,” added Keith Madrona, Sherry Riley, Erika Rios and Andie Kilpatrick, PARs at Renown Urgent Care – Ryland. “Having a friendly attitude and demeanor is very important. “The PARs in Labor & Delivery do so much more than just registering patients – from escorting expectant parents to their rooms, welcoming newborn babies, processing pre-estimates and more – and the patience and excellent communication I receive from other teams is what keeps me going,” added Nanci Barash-Vietti, PAR for Renown Labor & Delivery (L&D). “This is critical to the success and effectiveness of the PARs in our department.” Shift changes for PARs mimic other teams at Renown, leveraging technology and both written and spoken communication to ensure the next shift begins successfully. "When I come in, the night shift will give me a report on what is going on and what the schedule looks like during the day; then I log in to my computer and get everything that I will need for that day up on the screen,” said Allie Boracchia, PAR for Renown L&D. “Usually around this time we have a 7-8 a.m. induction scheduled for the first patient, so I will grab the pre-made packet that the night shift put together, the unit clerk will call the nurse to get a room number, and I take the patient to the room and have them sign all the forms. After the patient has the baby, then we admit them and finish registration. This is continuous all day long.” Our PARs all agree that regardless of the setting, whether it be emergent or routine, every patient is looking for that advocate from the moment they enter through our doors. “Being friendly, patient and understanding is a must,” said Sheryl Lundgren, PAR for the William N. Pennington Institute for Cancer. “It is so nice being able to brighten the days of patients who are living with a cancer diagnosis.” “In the urgent care setting, a lot of the patients we see are not feeling their best, so it is important that we show them we care and are here to help make check in go smoothly,” added Sam Deithrich, PAR at the Renown Urgent Care – Los Altos. “Patients are relieved that they are speaking to a real person that will help set up appointments,” added Rick Jordan and Celeste Landry, PARs in Lab Services at Renown South Meadows. PARs embrace lifelong learning at Renown, especially as their roles differ day-to-day. They are always ready to jump in and assist on tasks that might be new for them, growing their skills on the job and never hesitating to say, “How can I help?” “As a PAR, you are always learning new things, even when it seems like you know just about everything,” said Liz Cardenas-Ramos, PAR for Renown Endocrinology. “It’s been such a positive experience.” “Giving yourself grace to learn and grow in Patient Access is the key,” said Maggie Savoie, PAR for Renown Primary Care – Fernley. “I find myself learning every day at Renown, and if you’re learning, you’re growing. Being able to take a breath and say, ‘this is a learning opportunity for me, and tomorrow I will be better a better PAR because I’ve gained this knowledge’ is an amazing way to stay positive in the position.” “In L&D, we are all multi-tasking, and every day I am learning something new about my department and patients, as well as how to excel in my position,” added Nanci Barash-Vietti. Renown PARs are the front lines to health care access, and they wear that badge with pride. Jeanette Flores, PAR in the Emergency Department at Renown South Meadows, sums up the role of Patient Access well: “Talk about first impressions!” “I am proud of our team and the excellent care we give our patients,” said Dawn Linker, PAR for the Renown IHVH. “We want them to have a good experience.” Impactful Accomplishments The role of our Patient Access team members goes beyond the desk. A patient’s healthcare journey begins, and sometimes even ends, with the helping hands of our PARs, leaving a lasting positive impression of Renown. "Our interactions with the patients make a difference before they see the provider, so we always demonstrate a welcoming and helpful atmosphere for the patients to feel like their needs are being met,” said Mary Dettling, PAR for Renown Endocrinology. “I love seeing the difference we make in peoples’ lives,” added Shannon Leone, PAR for the Stacie Mathewson Behavioral Health & Addiction Institute. “We can get patients at their toughest and worst times. Watching them overcome their fears, traumas and addictions has been very rewarding.” Our PARs don’t just make goals for themselves – time and time again, they surpass them, all in the name of patient experience and excellence. “We have not only met our monthly point-of-sale scores, but we also have exceeded our stretch goal for the last eight months and our scores have been in the 50th percentile or higher,” said Jeanette Flores. “Along with being the top point-of-sale collectors, we have also been known to be some of the sweetest and most helpful staff at South Meadows,” said Katie Morrill, PAR in the Emergency Department at Renown South Meadows. As their teams grow, so does their impact on our patients. PARs are dedicated to providing the best customer service possible, and with their expanding teams, that service goes even further, even throughout the pandemic. “A year ago, we only had one PAR; now, we have a full and amazing team,” said Alex Bucholz, PAR for Renown Advanced Wound Care. “We have come so far in a short amount of time.” "During the pandemic, we have maintained a core group of individuals who come in every day and help keep this office and all its parts moving smoothly,” added Shannon Leone. “We have maintained a full patient load the last three years and never had to close our office for any reason. We have even had the opportunity to start our Medicated Assisted Treatment and Transcranial Magnetic Stimulation programs.” "We successfully operated and maintained our pediatric COVID clinic, which is the only one within our five clinics,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia. “We feel proud knowing our tiny humans are protected with the COVID vaccine.” Like many other teams at Renown, our PARs are masters at teamwork. Despite any obstacles that may happen along the way, they are always there for each other to ensure every patient gets the care and attention they deserve. “We call ourselves the ‘A-Team’ here in Pulmonary,” said Shannon Birnberg, PAR for Renown Pulmonary & Sleep Medicine. “We have persevered through changes, additions and departures. We are most proud of bringing different personalities to the team and being super strong and effective.” “I have noticed the team always steps up whenever needed,” added Brittany Hughes, PAR for the Renown IHVH. “Everyone has a great attitude and is very positive!” “While our team is fairly new, we are growing together, learning our strengths and weaknesses and always pushing for stronger unity,” added Angel Freer, PAR in the Emergency Department at Renown Regional. When our PARs find ways to simplify a process or make a workflow run more efficiently, they don’t waste any time in making that happen. They take any opportunity to enhance patient experience. “Our team came up with a solution on how to get patients registered faster,” said Jess Castillo-Marquez, PAR in Lab Services at Renown Regional. “We came up with modalities which assign each PAR their own procedure in which they will be registering for during their scheduled shift. It has been a great success, helping our productivity and keeping our patients satisfied with our service.” “We are proud of our successful implementation of our new therapy workflow,” added Logan Johnson. “Patients are now waiting much less to be contacted about their care.” Our PARs know that teamwork makes the dream work, and their commitment to the patients they serve – and the goals they continue to blow out of the water – continue to inspire them daily. “You are only as strong as your team,” said Aundie Yonker, PAR in the Emergency Department at Renown Regional.
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Department Spotlight: Renown Transfer and Operations Center
Stepping into the Renown Transfer and Operations Center (RTOC) means stepping into a transformative hub of excellence where lives are saved and healthcare is reimagined. As a cornerstone of Renown Health's commitment to exceptional patient care, the RTOC serves as a dynamic nerve center that seamlessly coordinates medical resources, ambulance rides, hospital bed space, remote home systems, hospital transfers and emergency preparedness. In this best-in-class facility, the boundaries of what is possible in healthcare are constantly pushed, and new horizons of patient care are discovered. Staffed with a dedicated team of skilled professionals, the RTOC harnesses the power of advanced technology and compassionate expertise to ensure that patients receive the highest level of care and support, no matter where they are. Through a synchronized network of communication, coordination, and compassionate care, the RTOC team ensures that patients receive the critical support they need when it matters most, working tirelessly to redefine what it means to deliver world-class healthcare. A National Standard Charged with the goal of overseeing the placement and transportation for every patient, the RTOC officially launched in 2021 as northern Nevada’s first and only transfer center of its kind and a nationally celebrated facility. As Renown’s highly coordinated care logistics system, this team uses the cutting-edge technology at their fingertips to customize healthcare to the needs of every patient, manage patient flow and drive healthcare innovation. “Compared to where we’ve started to where we are now, it’s a 180-degree difference,” said Kelli McDonnell, Manager of RTOC. “When we first started building our facility right before the pandemic happened, we took what was six conference rooms and classrooms and turned it into a command center that organizations across the country admire and come to Reno to see what we do. Mel Morris, the Director of RTOC, was recruited exclusively to build our facility with her history of building successful hospital command centers. Many people didn’t realize what a transfer center was or that Renown was the only center in the region – and we only continue to grow.” This best-in-class facility, and the masterful team behind it, handles: Coordinating all incoming patients transferred from neighboring hospitals and 27 counties across northern Nevada, Lake Tahoe, northeast California and neighboring states. Matching patients to the most appropriate bed placement using diagnostic, triage and Epic electronic medical record clinical information in conjunction with medical staff expertise to outline a plan of care that determines the best bed assignment given the patient’s needs. Coordinating video-enabled Telehealth monitoring capabilities for Renown’s four Intensive Care Units (ICUs), as well as Renown patient Telehealth and virtual visits. Monitoring Remote Home systems with Masimo during the COVID-19 pandemic, where some patients received hospital-level care in the comfort of their own homes while Renown clinicians monitored and evaluated their data and plan of care. Serving emergency and disaster management for area hospitals, first-responders and the community with local, regional and statewide emergency and disaster management for sudden-onset emergencies. The RTOC is home to many different critical roles for our health system, including Transfer Center Nurses, Ride Line Coordinators, RTOC Coordinators and more, many duties of which each team member cross-trains on to be able to fill in whenever needed. While their roles may differ, their commitment to their patients remains the same – and they all work together to achieve the same outcome: delivering the right care, at the right time and place. “As an RTOC Coordinator, we do a variety of different things,” said Anna Schaffer, RTOC Coordinator. “We do triage coordination to help our nurses and hospitalists get patients in the emergency department admitted, and we also do bed control to find patients appropriate bed placement. Communication is important, so we always make sure to stay closely connected with the charge nurses on those floors.” “We start with a basic ‘need to know’ and place patients accordingly,” added Karly Brown, RTOC Coordinator. “We get surgery numbers, ICU capacity and discharges and find beds for all patients as quickly as possible. We have the advantage of being able to see the entire hospital.” “I primarily schedule transportation for patients at the hospital who are either going home or going to a skilled nursing facility,” said Sarah Clark, Ride Line Coordinator. “I get requests from case managers to schedule rides, and I work with REMSA and other ambulance services to schedule them. It relies a lot on appropriate and efficient communication and critical thinking.” Patients in facilities across northern Nevada and northeastern California, especially the rural communities, look to the RTOC to help guide ambulances, bed coordinators and hospital staff in finding care for our rural patients. “As a transfer center nurse, I facilitate incoming patients from rural facilities in Nevada and surrounding areas in California,” added Meg Myles, Transfer Center Nurse Specialist. “There are days we may take up to 30 direct admissions from these areas.” “We are the point of contact for inter-facility transfers, whether we are sending patients out or bringing them into Renown,” said Lisa Lac, Transfer Center Nurse Specialist. “We take phone calls from those rural areas, identify what services are needed, connect them to the appropriate provider and coordinate any transfers.” “Simply put, we are the bed wizards,” said Addison Rittenhouse, RTOC Coordinator. The RTOC team continues to break barriers and push the boundaries of medical excellence through leveraging the technology at their fingertips and their unwavering dedication to the health of our community. Inspiring a new era of medical possibilities, these team members have achieved a multitude of accomplishments for both their department and their patients since the birth of the center. “We have significantly reduced the time it takes to get patient admit orders in, thanks in part to the new Triage Coordinator role, and we provide easier access for patients to transfer to us from other facilities,” said Beth Rios, RTOC Coordinator. “We have taken a bigger role in helping the smaller hospitals in our area in caring for patients and improve patient throughput.” “As a team, we’ve done a lot of work in creating an engaging and positive environment, and our internal morale committee has been a huge help with that,” said Kelli McDonnell. “We’ve been working tremendously over the last year and taking all the feedback that we received from the Employee Engagement Survey to make improvements. We had 100 percent survey participation within five days, which is incredible.” “I am so proud of our escalation and problem-solving skills,” said Becca Dietrich, RTOC Coordinator. “When an issue is raised to us, we will always find a timely solution on our end so our care teams can focus on the issue in front of them. We are the eyes in the sky, seeing movement everywhere.” Each day in the life of our RTOC team members is a testament to their commitment, resilience and timework, making a profound impact on countless lives.
Read More About Department Spotlight: Renown Transfer and Operations Center
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Sterling Silver Club Member Masterpiece
A Gallery-Worthy Member Artistry usually refers to a person’s ability to express their unique creativity in powerful and surprising ways. But there is also an art to living your life in ways that celebrate who you are, your limitless potential, the people you love and the community you care about. So imagine our delight to discover a Sterling Silver Club member and artist whose artistry of life reaches far beyond gallery walls. An Early Love of Art Born in Chicago, Illinois, Debbie arrived as the last of her parents’ three children and has two older siblings, Cynthia and Henry (a.k.a. Skip). As is usually the case, school played an important role in their shared childhood and Debbie remembers being drawn to art assignments in class from an early age. “When I was a young girl, I loved working on various art projects at school,” she recalls. “I always found myself learning something new and then teaching it to everyone I knew.” Later, Debbie would play violin in the school orchestra, join the swim team, and to continue to learn about art and its broader influence. “I remember taking a class and learning about color theory,” recounts Debbie. “I was so impressed with how colors relate to one another and also discovered how primary and secondary colors can be used together to make everything from products and advertising to what we wear more pleasing to the eye.” Expression-ism. “Art allows you to express yourself,” says Debbie. “And I’ve always been quite happy being expressive.” Though Debbie’s affinity for art was obvious, it wasn’t destined to be her career… at least initially. After earning degrees in marketing and public relations at North Central College in Naperville, Illinois and George Williams College of Aurora University in Williams Bay, Wisconsin, respectively, Debbie began what turned out to be a career in technology. In the Chicago area, she held positions as a systems analyst and computer programmer and a role in marketing and public relations for a computer software company. Then it was off to Los Angeles, California with her new husband, David, where she worked in sales and education for another software company. The couple returned to Elmhurst, Illinois to start their family but eventually moved to and settled in Minden, Nevada where David had an insurance business for 23 years and their children grew to become the adults their grandparents dreamed of. “My mom and dad would be most proud of our children,” beams Debbie. “They (her parents) always hoped for the best for them and would be over the moon that they are doing what they want to do, two of them in the field of medicine.” Debbie and David now live in Carson City, Nevada and their three children have established lives of their own. Jeffrey, the oldest, is a pastor and holds two master’s degrees. Rachael is an OB/GYN provider in Southern California and a graduate of University of Nevada, Reno School of Medicine (UNR Med). And their youngest, John-Henry, is finishing up his medical training and will soon be a trauma surgeon. Furry Family Members Debbie’s other “kids” are of the four-legged variety. “Mercedes and Bentley are really our luxury pugs,” she admits. “But are named after famous characters from books, not luxury cars.” She also says they are goofy, much-loved and simply melt the hearts of everyone they meet – “always!”
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Department Spotlight: Physiatry
Pain is a top reason that Americans seek access to healthcare. In fact, according to the U.S. Pain Foundation, chronic pain affects nearly 50 million people across the country. More than likely, you know someone who has been impacted by chronic or acute pain. Fortunately, there is a talented team of healthcare professionals committed to rehabilitating and enhancing the life of any patient living with pain. At Renown Health, these team members represent the Physiatry department, who are charged with a goal of maximizing physical function, managing pain and nurturing independence. Headquartered at Renown South Meadows Medical Center, patients suffering with a disability, chronic pain and physical impairments can rest assured that they have the most caring and compassionate physiatry experts on their side throughout the entire physical rehabilitation process. What is Physiatry? Physiatry (also known as physical medicine and rehabilitation, or PM&R), is a medical specialty that helps diagnose and treat conditions related to the musculoskeletal and nervous systems. Unlike other medical fields that often use surgery or medication, physiatry emphasizes non-invasive techniques, therapies and interventional procedures to help with pain and improve physical function. Renown’s physiatry team has a holistic approach to care, combining medical expertise with personalized rehabilitation strategies to support long-term health and independence. Physiatry is hyper-focused on diagnosing, managing and treating conditions that affect physical function and quality of life. The Physiatry Philosophy Our Physiatry team’s treatment philosophy centers around a multidisciplinary approach that combines medical care with rehabilitation and healthy lifestyle changes. They offer a variety of programs and services, including: Home Exercise Programs: Customized exercises designed to strengthen muscles, improve flexibility and support recovery. Physical Therapy: Hands-on care from skilled therapists who guide patients through techniques to restore function and reduce pain. Well-Being and Lifestyle Support: Emphasizing overall health and encouraging lifestyle changes that support physical and mental well-being. At Renown, the Physiatry department is full of friendly faces, including: PM&R and pain medicine physicians (also known as physiatrists) Medical assistants Physician scheduling coordinators Patient access representatives Practice site leaders Physiatrists set each patient up for success with education, treatment planning and management. They take advantage of cutting-edge technologies and interventions for pain, such as: Epidural Steroid Injections (ESIs) Facet Joint Injections Radiofrequency Ablation (RFA) Trigger Point Injections Joint Injections (Knee, Shoulder, Hip) Physiatrists are also masters of multidisciplinary care, coordinating with members of a patient’s healthcare team (including physical therapists) to ensure they have the best treatment plan possible. Playing a crucial supportive role, physiatry medical assistants (MAs) assist our physiatrists in caring for patients on both a clinical and administrative level. From helping during procedures to providing education and guidance, these medical professionals are key in ensuring each patient’s visit – and as a result, their rehabilitation journey – is successful. “My normal day in Physiatry is very smooth,” said Rosita Gans, Medical Assistant. “I make sure my schedule is at 100% to prioritize patient needs. It helps that everyone is so respectful and friendly.” Our patient access representatives (PARs) and physician scheduling coordinators are the front faces of physiatry. They serve as a patient’s first line of communication when checking in, making an appointment, handling insurance verifications and several aspects of follow-up – all with a smile on their faces. “My job as a PAR involves checking patients in and out, verifying their insurance and demographic information, scheduling and following up on appointments, referrals to Special Procedures and more,” said Andrea Ruiz, Patient Access Representative. “I am in contact with patients on a daily basis.” “It’s all about making sure every patient is taken care of in a timely manner,” added Kasey Sinfellow, Physician Scheduling Coordinator. At the core of keeping things running, you’ll find Antonio Quintana, Practice Site Leader. Thanks to his expert leadership skills and can-do attitude, his department has been able to reach new heights. A large part of this team’s success lies in their approach to the practice of physiatry. For them, there is no such thing as a “cookie cutter” treatment plan. Dr. Casey Keating, a pain management physician working with the Physiatry team states, “We understand that there is no ‘one size fits all’ when it comes recovery. We come up with a plan of action customized to meet your needs.”