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Overcoming poverty is not a task of charity, it is an act of justice. Like slavery and apartheid, poverty is not natural. It is man-made and can overcome by the actions of human beings. Sometimes it falls on a generation to be great. You can be that great generation. Let your greatness bloom. – Nelson Mandela, February 2005, Make Poverty History Campaign in London Lifting away the curtain that symbolized the front door, I entered a dark, cinderblock room and instantly became overwhelmed by an unpleasant odor. Working with oncology patients as a Child Life Specialist and an Occupational Therapist for over ten years, I recognized that smell. I had arrived in Guatemala – more than 3,000 miles from Reno – and it was my first day of a week-long trip where I would be serving alongside physicians in low-income communities providing free medical care for residents. My name is Brittany Jemmoua, I am an occupational therapist at Renown, and I recently volunteered with Kalan Kuxtal, a non-profit Guatemalan organization. I served alongside physicians by providing free primary care mobile clinics and home visits. The care we provided focused on prevention, intervention, education and lifestyle/medication management as we partnered with local entities, such as fire stations, community centers and schools to transform hundreds of lives. Speaking in both English and Spanish, I collected patient intake information, performed exams, tested for diabetes, and collaborated on a diabetes research project focused on daily risk assessment. Beyond these tasks, I immersed myself in the culture and learned more from the Guatemalan people than I could have ever imagined. Similar to Renown, Kalan Kuxtal Operates with Community at its Core Kalan Kuxtal, a Mayan expression meaning “life guardian,” is different from other volunteer medical trip organizations, and I took home valuable insights and lessons from their way of life that I now consider daily in my practice at Renown. I expanded my knowledge about diabetes, hypertension, pharmacology, infectious diseases, pregnancy complication, vector-borne illness and tuberculosis. We conducted home visits for socially neglected populations rather than expecting everyone to come to our clinics. I found that being welcomed into people’s homes gives you a different lens in which to view how their medical diagnoses interact with living conditions, occupations, and quality of life. This is when I met Mercedes and her mom. Her mom, Ms. Valencia, had jaundice skin and a substantial Basal Cell Carcinoma aggressively protruding from her face that impacted eating, hearing, seeing, sleep and social interactions. This opportunity to serve within their home led to an important palliative care conversation that would have been missed had we stayed in the clinic. We combed the rural neighborhoods assessing people’s risk for diabetes, taking glucose tests and educating families about their next steps. Many individuals had uncontrolled diabetes and misunderstandings regarding basic health management strategies. At the end of the day, many people demonstrated feelings of empowerment by actively offering solutions regarding how they will manage their day-to-day glucose with diet and exercise. Small actions can lead to big changes, and in the long-term, these health actions can help them avoid medication costs and focus on affording basic life necessities, such as water and electricity. Kalan Kuxtal organized a cultural day that included going to local businesses and community leaders to learn more about how they support the people of Guatemala. For example, Valhalla Macadamia Farm’s main goal is to help communities gain access to income, employment, and improved wellbeing by donating macadamia trees to families to grow and then sell macadamia products. A Weeklong Trip with Lifelong Impacts Each patient made a lasting impact on me, both personally and professionally. One specific family I saw in the clinic had a unique situation in that their two-year-old daughter, Margareth Elizabeth Cifuentes Bautista, was laboriously diagnosed with irregular corneal syndrome associated with glaucoma of congenital origin. Due to Guatemala’s limited prenatal screens and interventions, Elizabeth is nearly blind. While highly spirited and happy, she trips, bumps and feels her way through life. One barrier to her healthcare access is that her hard-working parents remain well below the poverty line, making less than $900/month. I am working to connect them with generous US Ophthalmologists and pediatric eye specialists to explore how we might save her sight and help her family. Their biggest dream is that she could recover her eyesight. “I know that this is not a life-threatening situation, but it is still something that never stops hurting me,” Jorge Cifuentes, Elizabeth’s father, said. “Unfortunately, our situation here is very hard. This country [Guatemala], although beautiful, it is very difficult to get ahead. We are people living in underprivileged conditions which complicates our situation even more. However, we are still trying to thrive by being kind and hardworking people. Thank you for helping us.” I have had the privilege of an opportunity for education, access to healthcare, employment and am aware that inequity and injustice prevail. This experience reinforced my understanding that medicine is a physically and mentally demanding profession that requires a commitment to service, continuous learning and adaptation both on local and global scales. I encourage everyone to please join me in serving the underserved by volunteering. Brittany is an experienced Occupational Therapist at Renown and volunteers with Kalan Kuxtal and other entities, such as The Robert Unsworth Foundation and Rock Steady Boxing to elevate communities. She loves being an Occupational Therapist; however, her life experiences confirm that her true calling is to become a physician. She is currently applying to medical school. Brittany is eager to earn the responsibility to improve lives and communities as their engaged physician. Brittany is tentatively scheduled to return to Guatemala at the end of this year to continue partnering with the people for a better future. You are welcome to join!

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“Safety is Number One,” isn’t just a saying – it's a fact of life, especially at Renown Health. The safety of all patients, visitors, staff and volunteers is always the top priority, and our Security Department takes that commitment seriously. This team is devoted in their efforts to provide a safe environment for all, building cooperative and proactive security processes leveraging crime prevention techniques and state-of-the-art technology. Renown Security sets the safety and well-being bar high, and they continually exceed that standard day in, day out at all of our hospitals and urgent care, primary care and lab locations.  Specially Trained, Continually Present  Our Security Department isn’t staffed with your run-of-the-mill Security Officers; these team members surpass security and safety expectations. Think city and state police-level standards. You read that right – many of Renown’s Security Officers come from Nevada Highway Patrol, the Washoe County and Carson City Sheriff’s Offices, the state probation and parole board and more.   This team fosters specialized training in a collaborative environment. Every member of the security team has extensive training in compassion, empathy and de-escalation techniques to provide the highest levels of safety and security. They implement this training in all their daily duties, whether they are saying a simple ‘hello’ to a patient passing by or preventing harm to a staff member.  Before their shift begins, the team meets to debrief meeting to discuss major incidents that occurred on the previous shift. These meetings ensure the next shift is aware of situations to be on special alert for and individuals to look out for. After, the team members head off to their assignments.  “The day could be as mellow as greeting someone at the welcome table, or it could be as chaotic as de-escalating someone in distress,” said Emmanuel Fernandez-Orozco, Supervisor of Security at Renown Regional. “Regardless of the day, every experience is rewarding in its own way. The only thing that is promised is that every day will be different.”  While every Security Officer has varying experiences, one aspect of their job always stays the same: they are always on alert for any potential safety issue. Even on the “slowest” days, it is important for this team to stay vigilant in order to mitigate any potential risks. There are several security programs that the team uses to keep everyone at Renown safe and secure: Renown's security operations center team (also known as dispatch) monitors all cameras in real time, with security officers patrolling parking areas 24/7.   Security escorts are always available for any employee, patient or guest at every Renown location. Security Officers can escort anyone to their designated site, check surroundings for danger and monitor the person until they safely leave for their next destination.     Rescue officers are available for any Renown location where an employee feels unsafe.  Security maintains a strong relationship with the Reno Police Department (RPD) and assists with reporting and providing information that aids RPD in pursuing and deterring criminal activity.  “In security, we are a counselor, teacher and rule enforcement officer, all rolled into one,” said Bob Stone, Supervisor of Security for Renown Health. Talk about master multitaskers!  Protection is only one part of the job. Through positive and meaningful interactions with guests, patients, community and staff, regardless of where they are posted, the Security Department continually helps Renown achieve its mission of making a difference for the people they serve.  Devoted Dispatch Speaking of multitasking, no one does this better than the Security Dispatch Center. Security Dispatchers are the “eagle eyes in the sky” at Renown, keeping a close watch on everything that happens within every Renown location, as well as REMSA (including Care Flight). From overlooking the many cameras around campus and administering codes over the PA system to manning the radio and phones to ensure Security Officers are dispatched quickly, our dispatch team helps ensure every safety or security issue at Renown is immediately addressed.  When a call comes in, dispatchers like Jessica Fernandez, Security Dispatcher for Renown Health, go through a quick discovery process (sometimes in seconds) to figure out the details of the situation or code and what level of security is needed to assess and de-escalate.   According to Jessica, the ability to prioritize is something she values in her work. “80 percent of our duties are on the phone and the radios, and we are skilled in prioritizing concerns based on the sheer volume of calls we get,” she said.  Jessica and her teammates are proud of the outcomes from their calls. Their attentiveness to every nook and cranny at Renown and their quick response times to make them not only a valued partner to the Security Department but also a necessity to our health system.  Your In-House De-Escalation Experts  Being in a hospital environment is undoubtedly stressful for any patient, and many factors can increase these emotions. The Security Department takes these feelings seriously and never hesitates to take appropriate action to ensure the safety of everyone at Renown. With the unfortunate rise of violence against healthcare workers, especially amid the pandemic, our first-rate security team has been crucial in countering violence with specialized de-escalation techniques.  The key to de-escalating, according to the Security Department, is to put yourself in the shoes of whoever you are working with. As stated by Bob Stone, the team approaches each situation by asking themselves: How would I want to be treated if I was in the same circumstance?  “Being empathetic to their situation and listening to what is going on in their lives is key to re-directing them accordingly,” said Bob. “Applying real-life experience to similar circumstances can make them feel like they are not alone. Educating people on hospital policies can also help them reduce their anxieties and solve the problems.”   Jhorddy Lopez, Security Officer at Renown Regional, approaches each situation with the mindset of knowing that each person’s reactions are different. “Different techniques need to be implemented every time,” said Jhorddy. “You have to use your best judgment call.”  Quick and effective judgment calls are a task that the Security Department has conquered. Rosie Garcia, Security Officer at Renown Regional, knows that using your best judgment means getting both sides of the story. “Whenever I need to step in and de-escalate a situation, I first speak with whoever is attending to the patient and gather information,” said Rosie. “Then, I always get the patient’s side as well. I want to understand how they’re feeling, so both the staff member and the patient can meet in the middle and come up with a collaborative solution.”  An example of the heroism and advanced de-escalation displayed by our Security Officers takes us back to last spring. In the middle of the night, a Care Flight helicopter transporting a patient and their family was about to touch down on the landing pad outside of Renown Regional. Right as the helicopter was about to land, an individual jumped over the safety barricade and onto the landing pad. Alexander Pico, a former Security Officer Lead at Renown Regional (who recently joined the Carson City Sheriff’s Department) immediately communicated with the individual to leave the area. The individual then went under the rear blade, which is the most dangerous part of the helicopter. Knowing that he had to risk his own life at this point to save another, Alexander ran around the back of the helicopter and tackled the individual, preventing catastrophic injury or even death. Steve Perkins now uses this example of a swift judgment call, which was captured on dispatch cameras, as training material for new staff.  Exceptional character, compassion and emotional intelligence are the attributes that every member of the Security Department holds. As noted by Steve Perkins, these attributes “allow for a quick assessment of each situation in order to de-escalate and move towards the best possible solution."  Securing the Job  The Security Department at Renown is actively hiring caring, dedicated team members who are ready to jump in and perform exceptional high-risk healthcare security services for our health system.  “We seek people with the right combination of ability and demeanor,” said Steve Perkins. "The training and skills development we provide result in a high caliber of success.”  Every team member in the Security Department is passionate about the same thing: helping others. And in a healthcare environment, this is important.  “Working a healthcare security job is far different than working any other security job,” said Jhorddy Lopez. “At a hospital, you get the chance to interact with people one-on-one. I get to experience the feeling of, ‘I can make a difference in this person’s life.’”  Any interaction can change the course of a person’s day, and the Security Department embraces this fact. “I really do love helping people so much, whether it be an elderly patient who needs help with their wheelchair or a situation where I need to step in and de-escalate,” said Rosie Garcia.   In order to succeed in this fast-paced department, being a collaborative team member is crucial. “A good coworker is a team player – someone that loves to work in a team atmosphere,” said Emmanuel Fernandez-Orozco.  Jhorddy Lopez reiterates this, adding that “communication and trust are also extremely important. Everyone has to have great communication skills and have each other’s backs.” For people like Bob Stone, having a special connection to Renown inspires him to serve. As someone who experienced two life-saving hospital stays here, he is proud to give back to the organization that gave so much to him. “It was only natural to return to a facility I was familiar with my entire life,” said Bob. “After serving as a paramedic and transporting patients into Renown from Plumas County, I knew I was not done giving back to the community. Renown was the place to do exactly that.”  All Genders Welcome  A common misconception about the security field is that it is strictly a “man’s job.” In Renown’s Security Department, that couldn’t be further from the truth.   As a female Security Officer, Rosie Garcia is a prime example of proving that idea wrong. As a master patroller and de-escalation expert, she ensures everything is running smoothly and that everyone feels safe at all times.  “When I first started here, I knew right away that nobody that works here is biased,” said Rosie. “Everyone is equal, and I am treated as an equal in this department. I know I can do the job as well as any man."  Both Rosie and her counterparts in the Security Department firmly believe that this line of work is for everyone, and they continually lift each other up and support one another.  “No matter your gender, as long as you have confidence and integrity, you will do well,” adds Rosie.  The Bottom Line If you are passionate about creating a secure environment to ensure patients get the care they deserve and employees receive the safety they merit, the Security Department is your team to join.  “I come into work with pride,” said Jhorddy Lopez. “Knowing that I can change someone’s life – that makes me proud to work here.”  “You’re in good hands with us,” closes Steve Perkins.

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Is a man in your life struggling with depression? Many men find it difficult to acknowledge when they need help. Recognize their unique warning signs of depression with insights from psychologist Dr. Herbert Coard. Over 6 million men are diagnosed annually, often displaying symptoms like anger and aggression instead of sadness. Learn how to support them and understand these often-misinterpreted indicators. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel-good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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Process improvement, program oversight and performance growth are the three “P’s” that mark the crucial aspects of ensuring everyone within our health system rows in the same direction. The duty of ensuring we transform together under the guidance of strong leadership and clear goals is no easy task – consistently finding performance gaps to close and focusing attention on our many strategic initiatives requires the care and collaboration of team members devoted to continually finding new ways to make Fighting the Good Fight better, brighter and broader. The forefront of innovation and organizational excellence can be found within Renown Health’s Transformation Management Office (TMO). As the heart of program management and strategic business analysis at Renown, the TMO steps up to the plate to ensure our organizational goals resonate through every layer of our health system, from teams on the frontlines to senior leadership. The mastery of these team members lies not only in their abilities to direct resources where they matter most but also in their roles as stewards of our health system’s future.  The Eagle Eyes of Improvement  When it comes to understanding and supporting Renown’s strategic direction, the TMO acts as our eagle eyes in the sky, overseeing the programs and processes that keep our health system running every day, which in turn helps improve the health and well-being of all our patients. The TMO manages three main functions that are vital to our health system’s bottom line:  Leadership Alignment: Aligning organizational goals with management’s plans and the work of the frontline team members, ensuring that everyone is working to achieve the same purpose and partnering with leaders for performance improvement along the way. Program Management: Emphasizing our resources on high-impact strategic initiatives while developing and overseeing 1-3 year roadmaps for all programs at Renown. Strategic Business Analysis: Assisting with closing performance gaps by identifying process improvement opportunities and new capability requirements.  “The TMO is here to ensure alignment between organizational goals (strategy) and the plans of our leaders (projects, improvement initiatives and roadmaps) so that our frontline teams are focused on the right things and receiving the maximum amount of support,” said Jamie Baldemor, Director of Transformation Management. “We are all here to fulfill our purpose for our community; we can do this faster and more effectively when we are rowing in the same direction all together.”  “In this role, no two days are the same,” added Alan Smith, Transformation Manager. “The team is enthusiastic about the work and vigilant about tackling new challenges. There are days when we engage with frontline teams, listening and observing to gain an understanding of a problem to solve. Other days are spent collaborating with department leaders, identifying new projects and working to shepherd ideas through complicated processes and remove barriers. It is easy for us to see the impact of our work where the change happens daily. As a relatively new department, we have been able to quickly understand the strengths of the team and get to work.”  Knowing that ensuring the longevity of our health system heavily involves successful leadership, the TMO’s approach to achieving our organization’s short-term and long-term goals involves closely collaborating with leadership to align growth strategies with support services.  “We engage with operational leadership teams at all levels across the organization,” said Robert Forrest, Manager of Enterprise Portfolio Planning. “Most days, we work alongside leadership teams to understand how they aim to grow their business and then work to identify impacted support services teams. This usually involves understanding how project needs match up with resource availability and how we can execute when resources are not available.”  The TMO is staunchly dedicated to improving patient outcomes. Our health system can always count on this team to find new ways to expand and enhance our clinical impact to meet the healthcare needs of Renown’s service areas – and they do it by being expert collaborators.  “On a daily basis I collaborate with administrative leaders, physician leaders and executives to intake, prioritize and scope projects and ideas,” said Rob Blamire, Enterprise Program Manager. “These projects enhance patient care in neurosciences, cardiology, oncology, children’s health and women’s health. My team is currently working on numerous projects that will expand clinical space and services to support our growing community.”  Amidst their culture of enthusiasm and dedication, each member of this team finds their work deeply satisfying, eagerly anticipating each day full of new challenges to solve. Fueled by a shared passion for Renown’s trajectory that drives their collective efforts, they look forward to the promising horizon of our health system’s future.   “Being a part of the TMO is fulfilling, and I enjoy coming in to work every day,” said Samy Arellano, Enterprise Program Manager. “The people on this team are passionate about where the organization is heading. I am excited for Renown’s future!”  Unique Backgrounds, Exceptional Results  Many teams at Renown draw attraction from a diverse array of professional experiences, and the TMO is no different. No two team members have the same background – a fact that the TMO uses to their advantage to pull from a wide range of expertise in order to optimize our organizational goals.  "I have experience in healthcare settings as an aide, analyst and manager,” said Rob Blamire. “My diverse professional background includes physical therapy, primary care, pediatrics, healthcare consulting and multispecialty settings. I ended up in the Transformation Management Office while seeking work with overlap among Renown divisions. A team member in the TMO is an exciting position to understand and support the strategic direction of Renown.”  For some of these team members, process and program improvement has always been a calling. Being at the forefront of furthering the strategic initiatives for the largest integrated not-for-profit health system in Nevada continues to be an opportunity they embrace daily.  "I am grateful to have started my career in process improvement, then called the Transformational Health Care department, where the team was responsible for the execution of 40+ improvement initiatives each year,” said Alan Smith. “After leadership roles in Emergency Services and Renown Medical Group, I returned to my true passion of process improvement to make an impact on a large scale to improve patient outcomes and experiences, as well as contribute to our future goals as a health system.”  “I began my time here in process improvement and was exposed to the wildly complex nature of our healthcare system,” added Robert Forrest. “I spent four years on the team running Kaizen and rapid process improvement workshop (RPIW) events, piloting and deploying our daily management system, and supporting organization-wide initiatives as needed. From there, I transferred to the Enterprise Project Management Office as a Strategic Business Analyst. In this role, I supported new projects and initiatives by collaborating with Operational Leadership teams and Project Team members to develop the scope of new requests.”  While their backgrounds may differ, one collective goal remains the same among the TMO: help Renown achieve new heights and further its goals, which in turn helps us expand on our mission to make a genuine difference in the health and well-being of our community. The best part? This team gets to do precisely that day in, day out.  "Prior to working at Renown, I worked at the Reno Housing Authority as the Director of IT,” said Samy Arellano. “I led IT initiatives and strategic goals for the agency. The goal was to provide better client experiences through technological innovation. I joined the TMO at Renown because I felt that this team was excited about helping Renown leadership reach organizational strategic goals, and I really loved that part of my role as the Director of IT. Now I get to do that every day!”  As the team weaves their enthusiasm for our health system into their daily work, the TMO’s commitment to realizing Renown’s vision will never waver. Through their dedicated efforts, this team exemplifies how strategic transformation can pave the way to a healthier future for all our patients.  The Renown Reason  The TMO is a stellar example of Renown’s determination in action – and to them, working for Renown is a no-brainer. With their devoted efforts and community-minded spirit, they embody our health system’s pursuit of excellence in healthcare delivery.  “I am proud to work at Renown Health and drive strategic programs focused on improving membership and patient access,” said Joseph Brooke, Enterprise Program Manager. “This is so important to the community we serve. Our TMO team, Renown leaders and so many colleagues that I work with day to day are committed to making a difference.”  "My passion for working to make a difference locally is why I chose to work at Renown,” added Samy Arellano. “I stay because I see the good this organization does in the community.”  Like every department at Renown, these team members feel a special attachment to Renown’s mission. They feel a sense of fulfillment not only within their career goals but also within their personal lives.  “I love Renown’s mission,” said Robert Forrest. “Coming in every day knowing that we are making a genuine difference in the health and well-being of the people and communities that we serve makes this job incredibly rewarding.”  “Renown aligns with my career aspiration to work in a large, clinically integrated healthcare system focused on improving population health,” added Rob Blamire.  As a driving force behind improvement and progress, the TMO continues to shape a future of transformative healthcare processes and programs. Here at Renown, we can proudly call them the pioneers of fostering lasting change for our health system for years to come.  “Renown has been the best hospital and health system I’ve been a part of. For as long as I’ve been here, there has been an obvious commitment to providing exceptional care to the community which includes many of my family members and friends. I am proud every day to be a part of making it even better,” closes Alan Smith.

Read More About Department Spotlight: Transformation Management