Top 10 With Mike

Top 10 With Mike

UnityPoint Health - Fort Dodge's CEO and President, Mike Dewerff, getting close to everyone's work.

Every quarter we honor employees celebrating a milestone work anniversary – and every time I'm intrigued at how many of our team members have been here several decades. Staff who have served this organization for 30, 40 and even over 45 years, I find this amazing and a bit awe inspiring.

When I ask what has kept them here, the majority of these individuals will first respond, "Its the people I work with," and then they will state, " And I love what I do!" And that is what started me to think,  "What are the things our team does on a day-to-day basis that make the job satisfying?"  Which lead me to want to do  "Top 10 Things to do at UnityPoint Health – Fort Dodge."

I asked my team to submit their ideas and over the next year in which once a month I will work along side a department or shadow them in order to better understand their work and get a great appreciation for the work they do. Below is a summary of what I have experienced so far. 

Episode 10: Find inspiration at the Cancer Center

On Wednesday, December 13, I spent the day shadowing the Cancer Center team. I started with Don Koepsel and Tim Thompson in Radiation Oncology. Tim showed me how to 'warm up' the linear accelerator and do the daily quality checks. Talk about physics and science.electrons, neutrons, protons, gamma rays.felt a little like an old Star Trek episode, "Beam me up Scotty!" The technology and science has made amazing improvements since my mom received radiation treatments over 20 years ago. Our radiation techs are able to direct the radiation beam on the patient to within millimeters of the same spot with every daily treatment. This helps provide for much improved treatment of the tumor, and greatly reduces the patient's exposure to radiation. Tim told me his favorite part of his job is the relationships he develops with his patients. Radiation patients often come for daily treatments for 2-3 weeks, and share some of their most intimate thoughts and concerns; but they are also some of the most positive and uplifting people he's ever met. I'd have to agree with that as during my shadowing with Patient Registration, every Cancer Center patient that came through was upbeat and positive.

During my time in Radiation Oncology, I met one of the most beautiful, bravest young ladies I've ever met, who agreed to let me follow her and share her experience. Linda Jones is a 74-year old grandmother who is battling cancer. I learned so much about her in the short time I spent with her that day. For example, she works hard at everything she does, whether it's at Casey's, or Burger King, or Hy-Vee, or the print shop that she worked at for 30 years in Los Angeles before moving to Iowa. She's got a family that loves and supports her in this journey. She's also a self-proclaimed 'spitfire,' she made it clear to me from the moment I met her that, "She's going to beat this cancer!" I have no doubt she will. 

I also spent some time with all of our physician partners in the Cancer Center. Dr. John Hardie, a radiation oncologist and Dr. Sarah Tofilon, a medical oncologist with McFarland Clinic, and Dr. Josh Lukenbill, a medical oncologist with Medical Oncology and Hematology Associates. I observed a patient visit with each of the docs, and they all have an amazing 'bed side' manner about them. They genuinely care about the patient's holistic well-being in their healthcare journey. When I asked each of them separately about what they enjoy most about what they do, they all gave the same answer, "The intense relationships they develop with their patients." Are you starting to notice a theme here?

Next, I spent time in the Image Enhancement Center, where Jane Klingson, a local beautician who partners with us to help our cancer patients feel better and more confident about their image. Back to my favorite, Linda Jones was going to get her new wig. She asked Jane to shave all her hair off since it was disappearing anyway. This is quite an emotional time for a woman but, Linda bravely watched in the mirror as Jane carefully removed her little remaining hair; and in typical Linda style, she was good natured about the whole event. She looked wonderful in her new wig!

During my time in the Cancer Center, I also got to observe many of the team members play their important role on this amazing team. Nurses, Julie Barkema, Tara Lager and Sue Doolittle skillfully performed their responsibilities, and just as importantly, showed sincere care for how things were going for their patients. Charity Andrews and Toni Nixon helped relieve a little patient anxiety by listening to patients tell jokes in the Infusion Center. Julie Degner is the first person patients see when they enter the Cancer Center. I admire her positive, can-do, attitude. She is a light in the lives of everyone that comes through those doors. Emily McCollum is our Patient Navigator in the Cancer Center. She works with our patients on resolving any barriers they have to achieving their goals. Whether the barriers to access are financial, social, transportation, whatever the case may be, Emily is sure to know how to resolve it. Patty Grossnickle is our Nurse Coordinator. She makes sure we are performing at the highest quality possible. She keeps the team 'on task' with regard to Commission on Cancer and Accreditation requirements so our patients, our teammates, and our community are assured we are providing the highest cancer care in the country!

The thing that struck me the most about the Cancer Center was that every team member individually talked with me about how much they love forming relationships with the patients. And, while they acknowledge not everyone wins the battle against cancer, they take great joy and pride when they get to celebrate with their patients when they Beat Cancer, and 'Ring that bell!' The Cancer Center is another great example of a team that lives our FOCUS values and assures that patients know how much they matter to this world!

In summary, I want to thank the entire Cancer Center team..Don, Tim, Sue, Julie B, Tara, Julie D, Emily, Dr. Tofilon, Dr. Hardie, and Dr. Lukenbill. I especially want to thank Patty Grossnickle, not just for hosting me on this great day, but for her 42 years of dedication to Trinity and the Fort Dodge healthcare community.

While this is my last 'Mike's Top Ten' in 2017, I plan to continue to shadow more departments in 2018. Let me know if you have any ideas!

Episode 9: Keep Pace in the E.D. 

November, I spent my shadowing experience with the Emergency Department (E.D.) team. I started the day about 3:00 pm with charge nurse Julie Vermeer. She explained to me how the work flow goes in the E.D. I quickly realized what can seem like chaos to someone who isn't used to the fast-paced action of an E.D., is actually quite well orchestrated.with each musician playing his/her instrument, but coming together to make beautiful music! She told me the key to a great experience in the E.D. is communication. Communication between 'the floors' and the E.D; between the nurses and providers; between the E.D. staff and registration, ancillary departments, social workers, triage, and ambulance

I also spent some time with the triage teams of Jenny Telschaw and Matt Nahnsen (day) and Samantha  Baardson and Kyle Wenger (evening). The triage team is usually where a lot of pressure falls when the E.D. is busy. Sometimes the non-emergent patients/families have to wait in the waiting room when our E.D. is full and there are traumas that take precedence, and it can feel like a long time when those patients aren't feeling well. When I talked with Jenny about what she enjoys most about her transition from a homecare nurse to an emergency nurse, she said she loves the fact that she has an immediate impact on the patient's health. I can tell she has a passion for making a positive difference in people's lives, and that she's very proud of her Emergency Department teammates!

Next, I spent time with Dr. Sokol. Dr. Sokol is our latest addition to our E.D. provider team, and is our new E.D. Medical Director. After spending a few hours with her, I could tell she loves her job as an Emergency Medicine physician. Even on a relatively slow (more about the 'S' word later) night, she was multi-tasking faster than I could keep up! I also got to observe Grant Wilson, P.A., who came in during his day off to help out.another example of 'Owning the Moment' for his teammates. The most significant patient-care issue we had this night was a patient that came in with stroke symptoms. A stroke-alert was called, and the team went into action. Two of the most significant observations I had was how important an Advanced Directive is; and how important our UnityPoint Transfer Center is. After discussions with a Neuro surgeon at Methodist, a Des Moines Neurologist, and our own Intensivist, it was determined we needed to transfer the patient to Methodist. The transfer center sped up the process and did a great job of facilitating communication with the specialist physicians.

At 7:00, the evening shift started, and it seemed like we had pretty routine visits. I know we have many challenges with behavioral health and disruptive patients on a regular basis; but, somehow we didn't have any of those types of visits this night. One of my learnings with the night shift was that E.D. people are highly superstitious, which is why I think I was invited back! Even though it was a relatively slow night, I knew enough to not use certain adjectives to describe our night.words such as 'slow', 'quiet', 'calm' are sure to jinx the relatively calm evening routine. It was interesting to learn the team is even superstitious about when certain teammates work, and what phase the moon is in!

The thing that struck me the most about the Emergency Department team was that they have a passion for helping people in their worst moments, have great work ethic, and an unique sense of humor. Did you know we see about 23,000 patients through our Emergency Department every year? Or that we have over 570 number of years of combined emergency care experience in our E.D.! I also want to give a special thanks to Jim Vinsand who has worked with us for 44 years. We will be celebrating with him his retirement on Dec. 14. I should mention long time team members John Copper, EMT, who started in 1976 (42 years) and Lorrie Rykhus, ED Tech, started in 1978 (40 years), now that's dedication!

In summary, I want to thank the entire E.D. team for allowing me to spend time with them. I learned there's so much more to an Emergency Department than just what happens on TV shows like E.R. or Scrubs (or my personal favorite.M.A.S.H.). I want to individually thank Julie Vermeer, Shelby Wiley, Jenny Telschaw, Jenny Roe, Samantha Molskness, Dan Touney, Jillian Angstrom, Samantha Baardson, Dawn Miller, Kaylee Navarro, Annie Schoonover, Dr. Rachel Sokol, Grant Wilson, P.A., Dylan Feldmann, Oscar Mendoza, Carin Weitzheimer, and Mary Kruse.

Next, I'm looking forward to shadowing the Cancer Center in December.

Here is a link for information about Advanced Directives:

Episode 8: Take Compassionate Care Into the Home.

This month I had the opportunity to shadow the UnityPoint at Home hospice and homecare teams. I started the morning with the IDT(Interdisciplinary Team), which is a team of homecare nurses, social worker, and therapists who brainstorm about their more complicated patients. One thing that quickly became evident is great teamwork and communication. They knew all the patients by their first name, not an ID number or diagnosis;and they knew where their areas of non-medical risk were. 

I then moved into a home visit with Mallory Nelson, homecare nurse. 
Everyone from the morning's team knew this particular patient as he's very popular, and I quickly figured out why. Despite his chronic conditions he was upbeat, and positive. A pleasure to talk to about his family, his life, and his care. He obviously had a very good relationship with Mallory, and he seemed very engaged in their discussion about his conditions, his care-plan and medications, and upcoming doctors appointments. Despite his engagement, I understand his compliance with his care-plan is not the do we solve that? It's definitely a team effort filled with resilience and persistence. The homecare team demonstrates this everyday when they (at times) seem to care more about the patient's health than the patients do themselves! When I asked Mallory what keeps her going, she said it's the people and that it's something different every day. I can tell she has a passion for making a positive difference in people's lives.

Next, I spent some time with the team at the Paula J Baber Hospice House. My first stop was with Hospice volunteer, Patricia Cramer. Patricia has been a volunteer for three years, and does it because she wants a sense of giving back to the community and to the people that are dealing with tough times. The hospice nurses I shadowed were Becky Crampton and Natalia Harrington. Both Natalia and Becky told me individually that the people they work with are like family stating, "We support each other through tough times, and celebrate each other's successes."...his compliance with his care-plan is not the do we solve that? It's definitely a team effort filled with resilience and persistence. Dr. Gottula, Hospice Medical Director, provided great insight into hospice care. Mary Larson shared with me one of the special projects her volunteer team does with hospice patients and their family is the hand molds.

Rachel Hurtt provided me with a glimpse of a hospice home visit. I also got to spend some time with our new Hospice Medical Director, Dr. Gottula. Dr. Gottula has great insight into the end-of-life process and the feelings of the patients and family members have during the different stages of death and grief. I encourage anyone who has family members that go through Hospice, or the end of life decision making, to consider the PJB Hospice House - it's a very special place, very peaceful and respectful.

Finally, I wrapped-up with a hospice home visit with Rachel Hurtt. First, we had to reschedule because the patient had to get her hair done because she knew the CEO was coming along - I was so flattered! This also reminded me that hospice patients can be out and about in the community, living life to the fullest. Part of the hospice nurse's role is to sit and listen to the patient talk about their daily activities, who's visiting them, what plans they have, etc. Often the only visitor these folks have for the day, is the hospice visit. I could tell right away that Rachel had built a relationship, and this patient trusted her very much.

The thing that struck me the most during my time with hospice was that everyone, including Dr. Gottula and the hospice house and home visit nurses, mentioned they feel like they get to know their patients more in the short time they are taking care of them, than some people who have known them for years. I guess I knew this from the death of my own loved-ones, but to hear our care-givers talk about it made me realize that spending time with someone in the last few weeks of their life is one of the most intimate things one can do.

Some fun facts about our homecare/hospice team; the total combined years of service for the 82 employees in both homecare and hospice is 619 years, with 19 employees having 15 years or more of experience! The Fort Dodge UnityPoint at Home agency is consistently is a top performer in the system in the "Rate this Agency" patient satisfaction score - their most recent score is 89.2%. Medicare (CMS) has also rated Fort Dodge UnityPoint at Home a 5-Star Agency the last two quarters. This is very impressive considering there are only two 5-Star Agencies in the state at any given time. (The other one was our Storm Lake location in 2nd quarter.) Congratulations to the whole UnityPoint at Home team, that is quite the accomplishment!

In summary, I want to thank the entire homecare and hospice team for allowing me to spend the day with them, and for teaching me about why homecare and hospice care is a special and unique service we provide to the patients and families in our community. I especially want to thank my host for the day, Angie Tracy; and all the people I spent time with including, Jen Kirchhoff, Mallory Nelson, Kendra Cook, Cindy Stanberg, Jaime Hayes, Roxanne Amhoff, Patricia Cramer, Mary Larson, Becky Crampton, Natalia Harrington, Dr. Gottula, Rachel Hurtt. They are clearly committed to Living our Values and making this a great place to work, a great place for physicians to practice, and a great place for patients to receive care! I plan on shadowing our HME (Home Medical Equipment) department in early 2018.

To learn more about the CMS homecare and hospice ratings programs, go to these websites:

Next, I'm looking forward to shadowing the Emergency Department in November.

Medicare (CMS) has also rated Fort Dodge UnityPoint at Home a 5-Star Agency the last two quarters.

Episode 7: Cath Lab and Lab

...uncover sickness and disease.

On Tuesday, September 7, I had the opportunity to shadow the Lab.I started the morning at 6:30 am drawing patients on 2N with Heidi Jensen. Talk about a thankless job. waking someone up who's not feeling well to stick them in the arm! But, Heidi did a great job of helping the patients understand that the tests the Lab run on their blood will help the doctors determine their care plans.

I then moved into Microbiology, I learned that this is where all the germs are discovered! Becky Rose, Theresa Compart, and Heather Anderson shared with me how they read culture plates and test for different bacteria and viruses every day, including influenza, RSV, strep A, etc. They also shared with me our new Bio-Fire molecular testing analyzer. The four Bio-Fire Filmarray panels include GI, Respiratory, Meningitis and Blood culture Identification;these panels together test for 24 viruses, 38 bacteria, six yeast and four parasites. Fascinating! One (ofmany) interesting things I found out in Microbiology is they assist our providers in making more definitive diagnoses in a timelier manner. When I asked Heather and Theresa what they like best about the work they do, they said, "it's something different every day. We never know what each day holds."

Next, I spent some time with Lois Fevold in Hematology, where they perform cell counts and help providers determine what's going on with patients. She said two things that struck me. First, that they are scientists. Through their education and training, they help determine, down to the cellular level, what's causing a patient to be sick. But secondly, what she said next really caused me to pause for a moment.they often times are the first to know if a patient has cancer. I hadn't thought of that before, but she's right. I'm sure that's a very emotional moment for our lab team.

Chemistry was next with Judy Vratny. This is the part of the lab that helps determine the levels of important contents of the patient's blood. Levels of protein, troponins, lipids, glucose, etc. are important for the providers to know so they can diagnose diabetes, heart, kidney, liver and many other diseases. Keeping our analyzers well maintained and calibrated are a big responsibility of the Lab. Knowing the instruments are turning out accurate results for every patient sample is a high priority.

Patty Larson walked me though the blood bank next. She taught me how to determine a blood type and to test for antibiotics in a newborn's blood. Did you know we issue over 1,000 blood products per year? That said, while we always have sufficient supply of blood on hand for normal operations, I think the hurricane events of this fall cause me to realize we can always use more. For this reason, I encourage you to give blood whenever possible - it's truly a life-giving act!

I wrapped up my time in the Lab with Assistant Manager, Steve Macleod. He shared with me the important role Pathology plays in detecting cancer and genetic disorders in tissue samples. There were gall bladders, appendices, placentas, and various biopsies ready to be shipped and tested. We assist our pathologists with frozen sections during surgeries here on sight, so the surgeon will know ASAP if the specimen is cancerous and if he/she needs to obtain additional sample, avoiding a second operation.

I didn't realize there is so much going on in our lab! Our combined hospital and clinic labs perform over 500,000 individual tests per year. We should be very proud of the level of lab services we provide for our patients and providers. The technology and equipment we use is some of the best in the industry. But, none of that would matter if we didn't have the well-trained and compassionate Lab team. I think Becky Rose put it best when she's asked, "What do you do?" she says, "I help save lives." I believe all the lab team has that culture of, "we help save lives," as should everyone in the organization! The Lab's commitment is demonstrated in the 516 years of service among its 34 employees, and their great patient experience scores of 93.6 (improved from 91.1 last year!).

In summary, I want to thank the entire lab team for educating me about everything they do. Specifically, Heidi Jensen, Heather Anderson, Becky Rose, Theresa Compart, Lois Fevold, Judy Vratny, Patty Larson, and Steve Mcleod. They are clearly committed to living our values and making this a great place to work, a great place for physicians to practice, and a great place for patients to receive care! arteries.

On Tuesday, September 5, I completed my shadowing experience with the Cath Lab. I started the morning with Matt Tracy preparing for the day. It had been a busy Labor Day weekend, as the on-call teams were called in three times over the long weekend. Matt shared some of the cases from the weekend with me, and gave me some basic anatomy and circulatory lessons, prior to my observing the day's procedures. He also shared with me his love of toys, like his Toyota MR2 (that his son refuses to let him sell), and his philosophy that 'life's too short to not have some fun' - I couldn't agree more with Matt!

The first procedure I observed was a cardioversion with Dr. Berry, Jay Honomichl, and Dan Tracy. I listened while Dan interviewed the patient about her health and medications during her prep for the procedure. Although it's a relatively easy, non-invasive procedure, the patient seemed a little anxious. as any of us would if we were having heart-health issues. Dan did a nice job of helping the patient relax and feel a little more at ease during the time he was interviewing her. Jay and Dr. Berry also did a nice job of answering the patient's questions and assuring her that she'll feel much better after the procedure. Sure enough, she went home later that day, "feeling like a new woman!"

By the end of the cardioversion, it was time to observe the first of two heart caths with Dr. Cookman, Tatum Baade, Matt, Jeana Benson, and Bob Olson. The technology in the cath lab is quite impressive, and the procedure itself is amazing to observe for a non-clinician like me. I can't imagine what it was like in the 40's when diagnostic cardiac catheterization was being first introduced - I wouldn't want to be the first patient to have a wire stuck into my arteries! That said, the procedure and the technology pale in comparison to the skill and techniques of our physicians and staff. I watched as Tatum and Matt helped Dr. Cookman skillfully maneuver the wire through the patient's arteries to the heart, and identify the problem areas. Then, Dr. Cookman, using his years of experience, combined with the state-of-the-art technology determined the best course of action for the patient. In this case, it was determined the patient didn't need a stent.

The second heart cath did result in a stent being inserted into a main artery. Again, the impressive work by our care team and the technology resulted in re-opening of the closed artery and allowed the blood to flow to the remaining portion of the artery. The final, and best, outcome was relief of the symptoms the patient had been experiencing. Since the patient is awake during the procedure, they can get a little anxious but Jeana and Bob did a great job keeping the patients calm and resting at all times.

My biggest revelation from my experience in the cath lab was the pride in the program, not only from those that have been here since the beginning like Dr. Cookman and Matt Tracy, but among the team that has been working hard to maintain the great reputation the program has built over the years. They all love helping patients at their greatest time of need and are truly making a difference and improving the patient's quality of life.

In summary, I want to thank all the cath lab team members I worked beside that day; Brenda Swank, Dan Tracy, Beth Spencer, Tatum Baade, Matt Tracy, Jeana Benson, Bob Olson, Robb Winters and Roxann Gerrard. You all should be very proud of the legacy you built and continue to build upon! Thank you for living the values, and working for the Best Outcome for Every Patient Every Time!

Next, I'm looking forward to learning from the Home Care and Hospice teams in October.

Episode 6: Nutrition and EVS.

...serve-up nutrition with a smile.

On Friday, August 25, I experienced another shadowing experience with the Nutrition Services team. I started out the morning with Bev Vote, Nutritional Hostess. She and I delivered breakfast trays to patients in the CCU and 2N. One thing I noticed is that a patient's meal is very personal to them. At times, food (and the people that deliver the food) can be considered the one thing that feels 'normal' in their healthcare experience, perhaps the one thing they can truly evaluate if it's, "As good as mom makes!" What I also found was that Bev knew the patient's likes/dislikes.especially when they had been with us before, or for a few days in a row.

I will admit that my body was not used to all the walking around our hostesses do. Bev told me that one day a student shadowed her with a pedometer, and it showed they had walked 20,000 steps by noon! For a sense of perspective.10,000 steps in a whole day is considered very active! Wow!

After delivering breakfast, I did dishes with Tara Ottinger. well, actually she did the dishes. I mostly watched and helped put a few things away. Tara joined Trinity after working at Subway. When I asked her what she liked best about working at Trinity, she said the variety of the work. Some days she's washing dishes, some days she's preparing meals, and some days her workload changes by the hour.

Some of you may have come through the cafeteria when I was working with Keith Sturtz. He and I (mostly Keith) worked the grill as colleagues and families came through for breakfast. Keith taught me some of the secret technics of flipping eggs or rolling a wrap - they make it look easier than it really is! I apologize to anyone who had to wait a little longer than normal for their omelet or breakfast sandwich. This was a nice opportunity to get to know people as they waited for their breakfast, I could tell Keith truly enjoyed this part of his job.

Next, I observed Jenny Bohn collect meal orders for the afternoon and following day. This is a tough job, as patients rarely have an appetite, and usually didn't seem too interested in trying to decide what they want to eat later that day, or the next day. However, Jenny did a great job of helping them think about what they can eat, and what they might enjoy. This would be a good time to mention that Trinity will be getting Room Service for our patients! Room service is an innovative concept in patient meal service. Traditionally, patients have had to plan their meals 24 hours in advance. With room service a patient can order a meal when she or he feels like eating and within a specified period of time (usually 45 minutes or less), the meal will arrive. Room service will give the patient more flexibility in both selection and time of meal service while striving to achieve the highest level of patient care possible. The planned start date is October 23.

Before heading to Java City, I spent a little time with Dena Johnson delivering special requests, or changing meals and menus as patients change their minds, or physicians write different orders. Again.there was a lot of walking throughout the hospital, meeting the needs of patients, and working together with the direct caregivers.

I then went to work with Jeanie Cook, one of our baristas in Java City. She and Cindy Polk have a high pressure job as resident baristas. I know that when people want their coffee strong, they need it now! This is a learned skill that takes some time to master. Everyone has their own custom coffee, and Jeanie and Cindy usually get to know everyone's little coffee nuances.

Finally, I wrapped up my morning with Dietician, Fanqing Feng. Fanqing works with clinicians to determine which patients need to be visited with, in order to do a nutritional assessment and then help educate patients on why their physician orders a specific meal for them. Fanqing, and the nutritional team, play an important role in making sure our patients are getting the nutrition they need, which will help them recover faster, and ultimately avoid being readmitted to the hospital.

My experience with the Nutrition Services team was very enlightening. I was very impressed with the teamwork, but within their department and across departments as they make sure every patient is nourished, every day. They take their role very seriously in the journey of our patient's health and recovery. They are also some of the hardest, and most dedicated, workers I've met. Did you know the Nutritional Services department has over 256 combined years of service to the patients of UnityPoint Health? Amazing!

In summary, I want to thank Ellen Lantz, supervisor, for hosting me, and special thanks to the teammates I spent time with: Bev, Keith, Jenny, Dena, Tara, Jeanie, and Fanqing. The entire team was generous with their time and knowledge. They are truly living the FOCUS values, but especially Owning the Moment and having a positive impact on the lives of our patients every day!

...make things clean and infection free.

My afternoon after working with Nutritional Services in the morning, was spent shadowing our Environmental Services (EVS) team.

I first was partnered with Nancy Rossow to clean a room on the Pediatric unit. We cleaned every inch of that room that a patient could have possibly touched! While this particular room wasn't an urgent need, Nancy's pager went off at least twice for other urgent cleanings on 2N to prepare for a new patient. There is definitely a balance between quickly disinfecting a room, and effectively preventing infections. When I asked Nancy what she values most about her work, she said she, "Really enjoys playing a role in the care of the patient, preventing infections, and therefore preventing readmissions."

I will have to admit after cleaning along-side of Nancy and experiencing how thorough of a job our EVS team does, the cleaning we do at home seems rather inadequate.

The end of my day was spent shadowing Brian Mundt. We started with the trash-pickup route, but we didn't get far before Brian was being paged by teammates requesting various items - everything from beds to red boxes. At one point, Brian was three or four deep into extra requests and had to keep notes for his next 'to do' item. I personally lost track of where we were on the original pickup route. The one thing I noticed about Brian, and I'm sure almost everyone who knows Brian notices, is he's always courteous and respectful, and a very hard worker. In fact, Brian told me one of his favorite things about his work, was the physicality of the work. I'm guessing most do not know about Brian is that he and his fiancé just had their first child two months ago. Brian is a very proud father of a little son; and everything he does, is for him.

My experience with the EVS team was very enlightening concerning the vital role they play in helping our direct-care team take care of patients. The EVS team is not always recognized in the vital role they perform in our patient care areas. If they were not as conscientious as they are in their work, our patients could potentially be staying in a contaminated environment. They truly understand the infection-prevention process and we all should be proud of how clean our organization is. Their hard work shows with their 92% percentile ranking on Press Ganey survey results. Talk about Championing Excellence!

In the end, I was very impressed with the cross-departmental teamwork between the EVS Department and the rest of the organization, as well as how hard-working every member of the EVS team is. They are a very dedicated and loyal team as well, as evidenced by the sum of 316 employee years of service to UnityPoint.

Next, I'm looking forward to working alongside the teams from the Lab and Cath Lab this month!

Episode 5: Extend compassion.

During July, I experienced my fifth shadowing experience with the Berryhill Center for Mental Health. I started my day with Kim Chase and the ACT program. (There is information about the ACT program at end of this blog.)

We visited 7 different clients with diagnosis' ranging from schizophrenia to bipolar disorder. Honestly, I expected to see people in which you could tell they were struggling with mental illness. But, as it turns out, they look like you and me. Everyone has a 'back story' of how they ended up where they are. But, as Kim put it, "I wish we could get these individuals into our program earlier in their story, so they don't end-up having an event that forces them into our program."

When I asked Kim why she enjoys her work, her response was, "I can't imagine doing anything else. The ACT program is what I've always been meant to do." In observing her interaction with her clients, I'd have to agree - she is truly living the value of Owning the Moment with each and every patient she takes care of.

During my time with Kim, I gained more insight into why we provide this service. In addition to the fact that it's the 'right thing to do' for these patients, it's significantly less expensive than some of the likely alternatives for this population. Daily visits with these patients allows us to make sure they are taking their meds correctly, that they aren't in a mental health crisis, and are generally taking care of themselves. I'm 100% convinced the patients that are in this program would end up in our Emergency Department or ICU, if we didn't help them keep their meds straight every day (Information at end of cost savings).

Next, I shadowed Ronni Arnold with the Integrated Health Home (IHH)/Community Support Program (CSP). We visited with a client that was struggling with depression and medical issues. Fortunately for this client, they have a strong family support system. She was "17 years sober," she said with pride in her eyes!

One of the things that I observed during this time was how Ronni made future plans with the client, which (I believe) helped the client look forward to something positive in the future. Ronni shared that she really enjoys the variety in her day, and the empowerment she feels to be able to think 'outside the box' with each client, and do what's best for them.

I also tagged along with Chelsey Heim as we observed a visit with a client that is working at LifeWorks. The purpose of this session was to work with the counselors at LifeWorks to help our client determine the kind of work he likes to perform and where he thought he'd like to work. After talking about the various tasks and employers he'd experienced over the prior few months, he decided he'd like to continue working at LifeWorks - and he was very happy about that.

I wrapped up the day with Jennifer Pullen and Roxanne Fevold and the Parent Child Interaction Therapy (PCIT) Group. This was a very interesting lesson in parenting skills for children with ADHD or Autism, but could really be a parenting lesson for all of us. I watched a couple therapy sessions and the real-time coaching that's provided by Roxanne is a very unique, but proven effective, way to teach parents how to interact with their child. I even got to play the role of the parent in a practice session, and it's much more difficult than it seems to be reflective, supportive, and non-directive in our parent-child communication - especially when the child is being a challenge!

Did you know we have 1 of only 5, PCIT programs in the State of Iowa right here in Fort Dodge?

My experience with the Berryhill team was VERY enlightening. The current state of mental health care in Iowa is a mess to say the least. It's time we take mental health care as seriously as we take medical health care. While our local resources may be limited, I believe the depth of commitment and talent we provide every day is truly making a difference to help our mental health patients in the Fort Dodge region.

In the end, I was very impressed with the teamwork across the different care-givers and programs at Berryhill. Many of these patients are in a more than one Berryhill program, so the therapist, counselors, Advanced Practitioners, and Psychiatrists all work together along with Family Medicine, Public Health, Lifeworks, and other agencies in the area to provide the Best Outcome for Every Patient Every Time.

In summary, it was an amazing experience and a privilege to spend time with the Berryhill teams. I want to thank all of those I had the opportunity to shadow.specifically Kim Chase, Brianne Lundberg, Sherri Dolecheck, Melissa Klass, Carlie Dickerson, Joan Kitten, Ronni Arnold, Chelsey Heim, Roxanne Fevold, Jennifer Pullen, and Rachel Amhof.

Next, I'm looking forward to working alongside the teams from Nutrition Services and Environmental Services!

Here are those links for more information I spoke about:
What is ACT?

Cost savings with the ACT Program:


Episode 4: Making great first impressions

On Thursday, June 29 I experienced another great shadowing experience with the teams from Registration, Information Desk/Volunteer Services, and Valet. Work starts at 5:00am in Registration so those that have an early-morning surgery can get checked in.  I shadowed Sandra Laubenthal, who has worked in registration for over 18 years.  The morning started with mostly patients for cataract surgery, or other same-day surgeries.  Later in the morning, cancer and infusion patients started arriving.  With every registration, I noticed Sandra making a connection with the patient and his/her family.  When I asked Sandra, 'What she likes best about working in UnityPoint Health Registration?', she said she loves the people she works with and the variety of patients that she helps.

One of the things that struck me most about my experience with Sandra was how sensitive she is to the patient's emotional needs.  Sometimes, the patient is in a hospital for the first time in their life, and aren't really sure what's about to they're anxious, a little scared, and nervous...even if it's just a minor surgery from our perspective. Sometimes the patient has been here several times, and are perhaps upset that they have to have 'yet another surgery'. Whatever the case may be, Sandra used her emotional intelligence to show empathy, compassion, and optimism with the patients. On a side note, Sandra did say that often times, the Cancer Center patients are the most positive, optimistic patients that she meets.I can't wait to shadow the Cancer Center later this year!

Next, I shadowed Cheyenne Miller at the Information Desk, and a couple volunteers, Bruce Kentfield and Linda Lasher. This team of colleagues works closely together to make sure we are providing the BEST first impression possible. Often, these folks are the first people our patients and visitors see when they enter our organization. I frequently hear from visitors, patients, vendors, and colleagues from different organizations, how friendly our team is...they say, "I ALWAYS get a 'hello' or 'good morning' when I walk in the door". On this day, I got to witness our teammates truly living that Value of Owning the Moment!

One of the things that I observed during this time was how much the volunteers truly enjoy their role and the opportunity to have a positive impact on patients/visitors lives...perhaps because they are donating something more valuable than money...their time!

I wrapped up the day with the valet teams at the main entrance, and entrances B and C. The first thing I noticed is how these folks are rarely standing still. I don't think Mitch Sells ever sat down!  Did you know we park approximately 250-300 cars per day! Obviously more in the winter or storm days...which only makes it that much more impressive that this team is the busiest when they are having to face the difficulties Mother Nature throws at us. 

My experience with the valet team was VERY enlightening...that job is way more than just 'parking cars'.  As if trying to keep 30-40 cars at a time, in three different locations, aligned with their owners isn't challenging enough...they also need to keep those organizational skills while helping disabled patients in and out of their cars and the building, provide accurate guidance to patients while keeping the traffic flowing, and do all this during (sometimes) inclimate weather! I even witnessed a valet having to mediate a fender-bender between two customers!

In the end, I was very impressed with the emotional intelligence of all the team members that have that first interaction with our patients. This team truly understands the quote "You never get a second chance to make a great first impression"! Also, the teamwork among these three groups was vital to helping to make that great first impression. Whether it was rounding up wheelchairs, calling for rides, or taking people to their appointments, everyone was willing to pitch in to help our patients.

In summary, it was a great experience and an honor to spend time with our 'First Impression' teams from Registration, Information Desk/Volunteer Services, and Valet.  I want to thank all of those I had the opportunity to shadow...specifically  Sandra Laubenthal, Shelly Treloar, Cheyenne Miller, Bruce Kentfield, Linda Lasher, Lisa Peterson, Carol Rice, Mitch Sells, Sam Salinas, Bonita Mclarnan, and Steve Estlund.

Next, I'm looking forward to shadowing and learning from the team at the Berryhill Center!

Episode 3: Keeping up with Acute Care

On the morning of Friday, May 26, I completed my third Top 10 Bucket List experience by spending the day with our great Acute Care team. I arrived on 2 North at 3:30 a.m. so I could get a sense of both night and day shifts. I started with Kayla Habhab, Charge Nurse for 2 North, and was soon observing my first admission coming through the Emergency Department. Though the patient was in and out of consciousness, the nurses were very compassionate, thorough and organized ensuring the patient a smooth admission.

The remainder of the night shift was relatively routine, allowing me the opportunity to listen and watch Kayla complete her Charge Nurse responsibilities. She checked patient statuses with nurses and completed the coming day shift assignments. The staffing levels on this evening and the following day's shifts where good. Making Kayla's, and the dayshift Charge Nurse Heidi Lennon, jobs a little easier.

Between 7:00 and 7:30 am, I watched several bedside shift reports.  I've always understood these are important communication moments and key to smooth transitions of care from shift to shift; however an additional benefit I observed was the involvement of the patient during this time. The outgoing nurse 'Manages Up' the incoming nurse, setting the patient's mind at-ease in terms of the experience and skills of the incoming nurse.  Also, the patient has the opportunity to ask questions and participate in the shift report - which seemed to help the patient better understand their care.  Lastly, the white boards are updated at this time. Personally, I really appreciate the white boards, they are the first thing I always look at as I walk into the room, mainly to see what name the patient wants to be called.

Next - the morning's patient rounds. This is the time used for preparing and communicating to patients the plan for their day and restates their goals or needs. It was this time of morning that things really started picking up on the floor - Nutrition Services, Radiology, Lab, PT, etc., coming to do their part in patient care.  I shadowed Diane Walstrom, along with a student Amanda Hamer, while she rounded on her four patients. Diane did a great job of communicating with patients and families, explaining what was going to happen that day, and taking care of any needs the patient had at that moment. 

I also had the opportunity to shadow with Trinity Hospitalist, Dr. Boppana as she rounded on with patients. She did a very nice job of sitting at eye-level with the patient. I'm confident the simple act of sitting eye-level with the patient put the patient at ease and helped them connect with her, which ultimately helped them better understand her thoughts from a clinical perspective.

The morning eventually led to the 10:15 report out with our cross-continuum team. This reporting, led by the hospitalists, brings together nursing, pharmacy, homecare, palliative, and care coordinators.  Current health status, projected discharge plans, and possible referral needs are all discussed. This 'best practice' was rolled-out across the entire UnityPoint Health system about six months ago. Having observed a number of these report outs, I would have to agree that it is a highly-effective way to get all departments, including post-acute partners, to collaborate on the care of the patient. It has proven to be one of the most effective tools in achieving the best outcome for the patient and reducing readmissions.

I wrapped up my 'shift' by observing a discharge planning session with Care Coordinator, Sarah Knutson.  The discharge planning process actually starts at the time of admission. Sarah gave very good instruction to the patient, and perhaps more importantly, to the patient's family.  The discharge planning session with the patient and family is one of the most important parts of making sure the patient has a safe environment to go home to - wherever 'home' may be.

One of the things that struck me most about my Acute Care experience was the family atmosphere on the night shift and a feeling that they can always rely on their teammates to provide help. There's a sense among many night-shift teams since they are the only ones in the building, they need to deal with whatever is dealt to them.  Another interesting observation was the variety of conditions they experienced. In fact, Kelsey Dornath shared with me that one of the things she likes the most about working in Acute Care is that there's something different every night.   She likes the variety of a busy inpatient unit and the challenges that comes with it.

Another thing that struck me was how organized the day shift is. What seems like organized chaos when on occasion I stop up for 5-10 minutes, is actually a very organized process. Our cross-continuum teamwork is happening all the time across many different departments; Nutrition Services, Environmental Services, Radiology, Oncology, Physical Therapy, Lab, Physicians, and more!  Diane shared with me that she has the timing of her day down to the TV show her patients are watching.  If she doesn't have meds administered by the time Price is Right is on, or if breakfast isn't done by the end of the morning news, she knows it's going to be a long day!

In the end, I was very impressed with the passion our Acute Care team has to get our patients healthy and into a safe environment after discharge. Our job doesn't end when our patients leave our four walls - care coordination also includes working with our partners outside our organization. Lastly, I can't believe how achy my back and legs were at the end of the shift. I suppose it's the price I pay for sitting in meetings most of the day.  It made me even more impressed that our care-givers are delivering a great patient experience, while their muscles and joints are put to the test!

In summary, it was a great experience and an honor to spend time with our compassionate, intelligent, and hard-working teams on 2 North. I want to thank all of those I had the opportunity to shadow, specifically, Kayla Habhab, Kelsey Dornath, Kylie Echelberger, Alexis Betten, Diane Walstrom, Sarah Knutson, Dr. Boppana, Amanda Gramblin and Kristi Myers.

I'm looking forward to shadowing and learning from the Valet, Information Desk and Registration teams in June!

Episode 2: Scrub-up for Surgery

[April] Last week, I completed my second "Mike's Bucket List" experience by spending the day with our talented surgical teams. At 6:30 am, I met Anne Hogan-Steele, who was my tour guide for the day and did a great job of 'showing me the ropes.' Other than having an appendectomy when I was 19, I haven't spent much time in an operating room, so I wasn't sure what to expect from the day. After pulling on my first-ever pair of scrubs, I joined the Team Report in the surgery breakroom. Team Report was just my first of many discussions among team members which were all about preparation and organization.

I started the morning with a sinus procedure by Dr. Gonzalez. My first impression was that Dr. G and the OR staff were very methodical and purposeful with regard to preparing for the case, even though it was a relatively minor procedure for them. The other thing I noticed was the cool technology that was used; watching the computer monitor as the tiny scope work into the upper limits of the patient's sinuses was pretty amazing!

Second surgery was a procedure to remove some arthritis and fuse a finger with Dr. Purudappa. Since only local anesthesia was used for this procedure, the patient was awake and alert during the entire surgery. What I was most impressed with this surgery was how well Angie Totten, RN, helped calm the patient's anxiety as the procedure (the sounds of drilling and scrapping) moved along. We listened to Elvis and talked about Buddy Holly and the Surf Ballroom during much of the procedure!

My next surgery was with Dr. Willerth to remove plaque from the carotid artery. As many of you heard during the employee meetings last month, I don't have the strongest stomach when it comes to blood and this was the most likely situation for me to become nauseous. Surprisingly, I found myself more fascinated, than nauseous! A gaping hole in the patient's neck was the first thing I saw when I approached the operating table. But then I noticed how meticulous Dr. Willerth and the nurses were with regard to disconnecting and re-connecting all the 'highways' of the circulatory system. Now I understand when surgeons tell me their work is like trying to work on a car while it's running. This surgery was quickly followed by a couple fistula surgeries by Dr. Willerth. Again, the meticulous work that a vascular surgeon must perform is so impressive!

The evening brought with it an emergency elbow surgery. What was a little different with this surgery by Dr. Purudappa was that it was on a pediatric patient. Despite the young patient's cries coming out from being under anesthesia , I'm confident Dr. Purudappa helped saved that child's long-term arm mobility and flexibility with this surgery.

Reflecting on my time with the surgery teams, I found them to be very well orchestrated and very prepared. I found them to be most similar to a baseball team; different individuals playing different roles but collectively trying to accomplish a singular goal. Everyone counts on each other to know what needs to be done - anesthesia, circulator, nurse, second assist, surgeon, sterile supply. all play a role in the success of the surgery. Their teamwork was phenomenal! I found their focus on patient safety and infection control to be very impressive. For example, before surgery the patient acknowledges where on their body they are having surgery. Then the team takes a 'timeout' to pause before each surgery to double check all the important facts.

When I asked some of the nurses about what they liked about surgery, they stated they enjoyed that it was something different every day. After my one day of shadowing, I'd have to agree with that statement! When I asked about their challenges, they talked about how they have a relatively short amount of time to have (conscious) face-to-face interactions to make an impression on the patient. From what I observed, all the teammates did a great job of connecting with the patients in the short amount of time they have.

Some of the things that stood out to me the most about our surgeons I was able to shadow was their patience, their meticulous skills and knowledge of the internal workings of the human body, that they are expert problem-solvers, but mostly that they genuinely enjoy performing surgery. I would ask our surgeons to work on any of my family members, any time.

In summary, I was very humbled and honored to shadow our highly skilled and truly passionate, surgery teammates this month. I want to thank all of those I had the opportunity to shadow, including, Brad
Rohr, Katie Thomas, Greg Porter, Ann Hogan-Steele, Megan Mason, Katie Coleman, Angie Totten, Jeni Fox, Megan Hicks, Carolyn Elsberry, Eric Hage,Sara Slotten, Dr. Gonzalez, Dr. Purudappa, and Dr. Willerth.

I'm looking forward to shadowing and learning from the Acute Care teams in May!

Episode 1: Run to an Emergency Situation

[March] Last week, I completed the first of many "Mike's Bucket List" experiences by spending the day with some of our emergency responder personnel.  I spent most of the morning with paramedics Terry Evans and Tony Ward and paramedic-in-training, Jon Shreck .

We received our first call just before 8:00am. Terry and Tony quickly shifted from mundane (but necessary) paperwork and checklists into adrenaline-induced, muscle memory action; obtained from years of training and experience — all kicking in at the sound of a radio tone, heard only by the paramedics. In all, we had three ambulance runs that morning.

Whether it was a Trauma Yellow accident or a medical emergency in the home, there were some important consistencies that were immediately apparent - paramedics do an amazing job of putting patients at ease. They do this by remaining calm and using AIDET, looking the anxious patient in the eye, focusing on the patient's immediate health needs during a period of relative chaos and reassuring the patient's loved ones that they have the situation under control. I followed up with all three patients when the situation became more stable as they were resting in their exam rooms. All expressed great appreciation for the great work of our paramedics and for the teamwork of our emergency team members! 

When Terry was telling me why he chose to be a paramedic, he said he enjoyed making an immediate impact on patients health in an emergency situation.  It's clear to me that Terry and his teammates are role modeling our FOCUS values of Champion Excellence and Own the Moment. This was confirmed at the Sweetheart Gala the following Saturday night (March 4) when Dr. Matt Maggio publicly shared his heart attack experience and how the quick response and specialized training of defibrillation by Tony Ward and the other emergency personnel saved his life! 

I started the afternoon with a Community Paramedicine visit.  A Community Paramedicine visit can be defined as emergency personnel making a non-emergent home visit to a patient that has been identified as 'high risk' to return to the emergency room or readmitted to the hospital.  They can be high  risk for a number of health, social, or economic issues. The goal of the program is to prevent and reduce the need for high-cost services by making sure some of the most vulnerable members of our community are keeping their doctor appointments, maintaining their meds, eating right, maintaining healthy relationships, etc. During the visit, Terry and ER social worker, Carin Weltzheimer, were welcomed into the house by the patient. Terry had an instant connection with the patient. He reassured the patient and her spouse that they were there to help her and there would be no cost to them - at which time she felt more at ease and was more open and honest about the status of her health. Carin and Terry helped her make a follow-up physician visit, coached her spouse on the importance of staying on her med schedule and educated them on other services available for assistance.  I'm very confident this visit saved this patient from ending up in the ER again in the near future. The Community Paramedicine Program is truly an innovative, unique program that is reaping benefits for community members of the Fort Dodge region! 

The day wrapped up with a quick trip in the air ambulance. LifeFlight nurses, Tammy Williams and Laurie Gehrke, along with pilot Josh Ralph walked me through a routine pre-flight briefing where they covered the flight plan, the weather forecast and discussed possible scenarios if weather or mechanical issues forced a change. We didn't have an actual emergency situation, but if we did they would have then walked through the clinical situation and discussed the plan. The flight itself was short but very educational in terms of the unique benefits and challenges of emergency air transportation. The time I spent with this team confirmed the important role an air ambulance plays in a rural region like northwest central Iowa, when seconds matter in many of the emergencies the region experiences.

I want to thank all the teammates I had the opportunity to shadow.Terry, Tony, Jon, John Copper, Teresa Morlan, Matt Nahnsen,  and Julie Lines; emergency department social worker, Carin; air ambulance nurses Laurie and Tammy, and pilot Josh.  I was truly impressed with their knowledge, professionalism and passion for helping people in their greatest moments of need! 

I'm looking forward to shadowing and learning from the Surgical teams in April!

Episode 3: Keeping up with Acute Care

Episode 3: Keeping up with Acute Care

Episode 3: Keeping up with Acute Car

Episode 9: Keep Pace in the E.D.