Innovative thinking and the future of health care!

In a world where it sometimes feels better to “stay the course,” it’s both exciting and refreshing to watch a new process unfold.

Led by Winjie Miao, President of Texas Health Harris Methodist Hospital Azle, and supported by a strong cast from the Center for Learning at Texas Health Resources, a small group of intrepid explorers are about to embark on a virtual journey to the future.

This dozen or so employees, representing a wide spectrum of experiences and skills are charged with “future thinking” their way to a new vision of health care delivery by Texas Health. To what model will health care morph, five, ten, twenty years from now? What should it look like? These employees hope to create a vision that will help us get to that reality.

Make no mistake. The future of health care will look much different that it does today, regardless of what is accomplished in the US Congress. As the demographics evolve, we will need to look ahead and be ready for an aging population. Bricks and mortar alone will not get the job done. New structures in health care delivery will need to be created to meet the growing needs of our communities. New ways to enhance disease prevention and disease management will be mandated – failure to do so will result in health care drowning in a sea of acute care needs with no lifeboat in sight.

Starting at the end of this month, this group will begin working on what the next generation of health care delivery will look like. Congratulations to all the members of the team for their willingness to think outside the box. Congratulations to Texas Health for its willingness to support and nurture such innovation.

Now, we would like to hear from you. What do you think the next generation of health care delivery looks like? Leave us a comment!

- Dr. Joe Prosser, chief quality officer
Texas Health Fort Worth
Texas Health Azle

What more can we do to ease our patient's anxiety??

As health care workers, we see many patients that become anxious in the hospital. Whether it be related to a new diagnosis, a disease process, or prior to any procedure, patients may not be able to cope. Essential oils can be very effective in promoting relaxation in patients with anxiety. These highly concentrated oils have chemical properties that can help sooth and relax the body. In the ICU's, we have used single oils or a blend of oils including Sandalwood, Mandarin, Frankincense, Bergamot, and True Lavender. Oils higher in esters, such as Frankincense and True Lavender are known to have calming properties. Studies on True Lavendar have shown to produce sedating effects similar to diazepam, whereas Sandalwood had shown to have an action similar to chlorpromazine.

Patients are given two to three different oils to choose from. Not everyone may enjoy a floral smell like True Lavender. We try to involve the patient in picking out the most suitable oil for them. Essential oils for anxiety have been administered through direct/indirect inhalation and the M® technique. The use of touch by using the M® technique adds an extra calming effect to the oil during application. Again, (as mentioned in previous posts) this can be taught to family to aid in care of their loved ones. What is more calming then light touch by a family member?

Our patients who used aromatherapy in the ICU responded with a decrease in anxiety on a numeric rating scale, expressed a feeling of relaxation, and overall enjoyed the experience. Medications like Ativan and Xanax are commonly used for anxiety, but may have unwanted side effects. Essential oils are a safer way to reduce patient anxiety and also reduce the amount of medication needed to calm a patient. Also, the use of essential oils can be a complimentary option to consider adding to your routine treatment/procedure.

- Erin Munoz, RN, Med-Surg ICU nurse

Red Wine: To Drink or Not to Drink

February is National Heart Health Month…Can red wine help your heart?

The Thought

Many years of research has touted the pros and cons of consuming alcohol, especially regarding heart health. New research has given insight into what the link between red wine and a healthy heart might be, but the real question is, “To drink or not to drink.”

The Research

Antioxidants, such as flavonoids, are generally thought to be one of the main components in red wine that promote heart health. Resveratrol has gotten the most fame for its suspected role, but studies have yet to confirm a heart-protective effect. Resveratrol is thought to help decrease inflammation and prevent blood platelets from sticking together, thus reducing blood clot formation. This, in theory, would decrease the risk for stroke. Resveratrol, among many other antioxidants, is also found in whole plant foods and juices, like cranberries and red grape juice. The jury is still out, however, regarding whether these foods or juices may be equally as helpful in protecting the heart as red wine or other alcohol.

Studies have also shown that alcohol consumption, in moderate amounts, may help slightly raise HDL (“good”) cholesterol, prevent artery damage from high LDL (“bad”) cholesterol and reduce blood clot formation. Studies have not concluded, however, that red wine is the only form of alcohol that can provide such benefits.

The Recommendation

The bottom line with alcohol consumption is moderation. Just because red wine is potentially helpful to heart health, more is not better! In fact, too much alcohol can cause triglyceride levels and weight to increase. Increased risk for high blood pressure, heart failure, stroke and breast cancer are just a few other problems related to excessive alcohol consumption. Moderate alcohol consumption is no more than one drink per day for women and two drinks per day for men. Remember, one drink is not equal to whatever will fit in your glass! One drink is: 12 ounces beer, 4 ounces wine, 1.5 ounces 80-proof spirits or 1 ounce 100-proof spirits.

It is also important to note that the American Heart Association does not recommend that you start drinking alcohol for heart-protective reasons if you do not generally consume alcohol. Remember, nothing is a cure-all or substitute for healthy lifestyle choices such as eating a balanced diet, exercising regularly, not smoking and maintaining a healthy weight! Certain health conditions and medications may contraindicate alcohol consumption. Check with your doctor about whether it is safe for you to drink alcohol.

If you have a question for the dietitian, visit www.texashealth.org/askamy

References

American Heart Association. Alcohol, wine and cardiovascular disease. Available at:
http://www.americanheart.org/presenter.jhtml?identifier=4422. Accessed December 9, 2009.
Ferreira M & Weems M. Alcohol Consumption by Aging Adults in the United States:
Health Benefits and Detriments. Jour Amer Diet Assoc. October 2008; 108: 1668-1676.
Mayo Clinic Staff. Red wine and reseveratrol: Good for your heart? Available at:
http://www.mayoclinic.com/health/red-wine/HB00089/NSECTIONGROUP=2. Accessed,
December 9, 2009.
Peregrin T. Wine- A Drink to Your Health?. Jour Amer Diet Assoc. July 2005; 105: 1053-1054.

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Therapy Institute
Executive Health Program

Is Obesity a National Security Threat?

According to the Pentagon, 75% of young Americans are unable to serve in the U.S. military due to being physically unfit, not having a high school diploma or having a criminal record. 27% of prospective applicants cannot join because they are overweight; making weight factors the single biggest factor in limiting potential recruits.

Child obesity rates have tripled in the last 30 years. 1 in 3 American children ages 10-17 are overweight or obese. The White House has taken notice and so have many retired admirals and generals who have formed Mission: Readiness. (www.missionreadiness.org)

To add to this impending crisis, our current troops are gaining weight at an alarming rate. The number of troops diagnosed with being overweight or obese has more than doubled since the start of the war in Iraq.

According to a Defense Department study, from 1998 to 2002, 1 to 2 out of every 100 servicemen was diagnosed as overweight or obese. By 2003, nearly 1 in every 20 servicemen was diagnosed as overweight or obese. Stress and readiness for deployment are the most frequent cited reasons for gaining weight.

Obesity issues that affect the general public, such as fast-food restaurants and popular sedentary activities such as video games, are also affecting military personnel.

"Overweight/obesity is a significant military medical concern because it is associated with decreased military operational effectiveness," according to the January edition of the Defense Department's Medical Surveillance Monthly Report.
If the chronic illnesses increase in health care dollars, decreased life expectancy and the other myriad of maladies that affect us with each increasing percentage of obesity don’t get our attention, decreased military effectiveness and increased national security risks should.

What are you going to do to fight this epidemic in our country?

- Tiffany Norris, MSN, RN, BC, PMHNP
Bariatric Nurse Coordinator

Sources: Washington Post, Mission: Readiness.

An experience through the med-surg residency program.

Being a part of the Med-Surg Residency was a really interesting experience for me. I got to see all of the med-surg floors at Texas Health Fort Worth and as I rotated through the floors I got to bring my experiences from the previous units with me.

Through the residency program, I was exposed to a lot of different opportunities that I might not necessarily have received if I had just hired on to one specific unit. I was able to see an actual kidney transplant from before the surgery, through the surgery and even the monitoring that occurs after the surgery on the unit. I was able to take care of patients receiving chemotherapy, patients with chest tubes, ones that had recently had strokes and patients before and after all different types of surgeries.

As much as I enjoyed working in all of the different units by the end of the year of rotating I was more than ready to have a home on a specific unit. Even though there were a lot of really great units none of them really felt like home for me and I was a having a difficult time trying to decide which unit to apply for.

Palliative Care was suggested to me as a unit that I should apply for. I was skeptical at first because I wasn’t too sure what palliative care was and the 7-70 schedule was something that was completely new to me. However, I thought that it was an interesting concept and thought that I would apply for the unit. Once the unit opened I realized that I had truly found my home. I love the Palliative Care Unit and know couldn’t imagine working anywhere else. We really strive for excellent patient care and with the overlap we have more opportunities then most units to concentrate not only on our patients physical needs, but also on our patients’ and their families emotional and spiritual needs, as well.

All the staff really work together to try to give our patients the best possible experience at a really difficult time in their life. Another great bonus is the fact that we work really closely with Dr. Mathe and the Nurse Practitioners and are able to easily communicate with them when we need something.

- Ashley Hodges, RN
Palliative Care Nurse

End-of-Life Care - a Learning Opportunity

“I must have missed that course in school.”

Whether we are referencing seminary, social work school, nursing school, or medical school, there are some career experiences that leave us feeling like we must have missed something. Staring into the faces of a family that is struggling with decisions about end-of-life care is one of those situations. As human beings who are nurtured by families and communities, we have developed some basic skills that help us respond when a neighbor or a stranger is grieving. We know we should be kind to them, express sympathy, and offer to help. Our extensive advances in medical technology, however, have left some patients and their families trapped in difficult “in between” territory. A human being who in days past would have died in the natural course of a disease process can now be kept alive by machines, medicine, and around-the-clock nursing interventions. That person can be kept alive far beyond his or her ability to appreciate or enjoy life.

You and I are often the people these patents’ family members look to for guidance amid these emotional and moral quagmires. Responding to their searching stares with inspiring clichés or just more technical information proves unhelpful. This is true because the ethical and religious mazes of these dilemmas are mixed in with longstanding family dynamics and the messy landscape of anticipatory grief with all its sadness, guilt, and anger.

“Was I sick the day we had this lecture?”

If that’s how you sometimes feel when you care for people in these predicaments, this year’s Faith Community Leadership Summit is one you cannot afford to skip. You will hear from clinicians who courageously lead patients and families through the humbling and holy encounter with dying. They will teach from both their personal experiences and state-of-the art research. If you feel like you missed out on a piece of training when confronted with these situations, this is make-up day. Don’t miss it.

Register today here! . For more information, please call 817-703-8432.

- Timothy Madison, PhD, BCC
Chaplain Manager
timothymadison@texashealth.org

Red, Red, Red!

What are you doing to beat heart disease? Check out this fun video about beating heart disease and "Going Red." Hope it inspires you!

http://www.youtube.com/watch?v=UjHz-ErKqlg

Please share this video with others!

Happy Heart Month and don't forget to wear red on Friday (National Wear Red Day).