Three Rivers Community Hospital Health Newsletter S pring 

INTHISISSUE
ED Express Success . . . . . . . . . . . . . . . . . . . . 2
Dedicated Doctors . . . . . . . . . . . . . . . . . . . . . 4
Bust a Move to Boost Your Heart . . . . . . . . 6
A Closer Watch . . . . . . . . . . . . . . . . . . . . . . . . 8
Heart-healthy Fruit Crisp Recipe . . . . . . . . 9
Dishing Out the Dose . . . . . . . . . . . . . . . . . . . 10
Stay Safe in the Sun . . . . . . . . . . . . . . . . . . . . 11
Community Health Education . . . . . . . . . . . 12

EDEXPRESSstory on page 2
EDExpress﹕FasterCare Express Success ED Express boosts satisfaction

W hen asked, community members

said length of stay (LOS) times in
the TRCH ED were long. With ED Express
(EDX), average LOS has been significantly
reduced, even with more patients
receiving care.
2009 ED
Patients per week: 650
Average LOS: 2 hours 52 minutes
First Week, January 2010
ED patients: 539
ED LOS: 2 hours 45 minutes
EDX patients: 136
EDX LOS: 1 hour 45 minutes
First Week, March 2010
ED patients: 527
ED LOS: 2 hours 45 minutes
EDX patients: 193
EDX LOS: 1 hour 40 minutes
N
ine p.m.—the end of a long Saturday.
After a six-hour round trip to the
varsity away game, diverted by an “The staff is very pleased,
ankle injury on the basketball court, the last
patients love it, and the
thing one Grants Pass family wanted to do
was wait in the Emergency Department (ED). volunteers are busily adjusting
Thanks to ED Express, they didn’t have to. to the changes. It is the best
ED Express is a new service at Three Rivers
Community Hospital (TRCH) that quickly thing that has happened since
ushers less emergent patients through the I’ve been a volunteer.”
ED to a six-bed unit of private rooms. There
— Jim Huffman
a physician’s assistant or nurse practitioner
Chair of the Patient Services Auxiliary
devotes personalized attention to each case,
from a broken ankle to a bout of flu and more.
“After a 15-hour day of traveling and
playing ball, this family was very happy to our patients,” says Win Howard, CEO of
be seen immediately through ED Express,” TRCH. “We have listened to the community,
says Dale Albright, DO, medical director of
and we have responded.” In the case of the
emergency and trauma services at TRCH. student athlete’s family, Dr. Albright says, to
“They were in and out in about an hour.”
not have to wait in the ED had a huge positive
Indeed a major reason behind ED Express impact and indicates that ED Express is
was the community’s call for shorter wait times. meeting its goal.
“ED wait time was the number one issue for

2 | To find out more about the TRCH ED Express, go to www.trch.org, keywords: ED Express
with fast, efficient care.

Behind the Scenes

One of the keys to the program’s success is a dedicated team
of volunteers. ED Express is located on the second floor,
separate from the Emergency Department to ensure privacy
and a peaceful, family-centered environment. To flow patients
efficiently, members of the Patient Services Auxiliary escort or
transport them by wheelchair from the first floor to the ED
Express check-in desk and private rooms.
“The volunteers often stay late when they don’t have
to, beyond their scheduled shift, to assist patients in ED
Express,” Dr. Albright says. “They’ve made a great impact on
patient satisfaction and our work flow in the department.”
The feeling is mutual, says Jim Huffman, chair of the
Patient Services Auxiliary. “This new process provides a calm
atmosphere, without the noise or confusion of the previous
Emergency Department,” Jim says. “The staff is very pleased,
patients love it, and the volunteers are busily adjusting to the
changes. It is the best thing that has happened since I’ve been
a volunteer.”
ED Express is available from 10:30 a.m. to 11 p.m.,
seven days a week. For more information about TRCH
emergency services, visit www.trch.org.

| 3
Dedicated Doctors You’ve got a friend at TRCH.

W
hen you’re admitted to Three Rivers Community
Hospital (TRCH), you’ll be greeted by a friendly
face—your hospitalist. “We are a group of six
board certified doctors, trained to deal with multiple medical
problems at the same time, even in the critical care situation, to
help our community,” says Amer Al-Khoudari, MD, hospitalist
medical director. Throughout your hospital stay, a hospitalist
oversees every detail of your health and keeps your primary care
doctor updated so that your treatment won’t miss a beat when
you return home.

Round-the-clock Care
Hospitalists offer many advantages, especially when you need
a doctor’s attention at a moment’s notice. “We specialize in
dealing with a wide range of problems in emergency situations,”
says Rahul Mehta, MD, who recently joined the hospitalist
group at TRCH. Hospitalists cover the hospital floor 24 hours
a day, so when a patient has complications or needs critical care,
they are available immediately.

Traffic Flow
Eighty percent of patients admitted to TRCH come through
the Emergency Department (ED). Hospitalists play a key role

4 | Hospitalists le to right: Ranganathan G. Madharan, MD; Tarandeep Arora, MD; Rahul Mehta, MD; Bader Abu Ghalyoun, MD; Ezerdeen Hamad, MD;
 in determining who needs to be admitted to
the hospital for further care. They admit six
to 15 patients per day and care for 25 to 35
patients at any given time. By working quickly
and skillfully to direct appropriate patients to
hospital beds, hospitalists open space in the ED
and reduce wait times.
Good for All
Even if you aren’t in need of hospital care, you
can benefit from the role hospitalists play in
local healthcare. “When primary care doctors
can delegate the care of their hospitalized
patients to the hospitalists, they are able to
see more patients in the office,” says Barbara
Curtis, RN, resource management and clinical
support services director for TRCH. “This
means that both new and established patients
can get appointments sooner.”
Equal Opportunity Care
For patients who don’t have a regular doctor,
hospitalists fill an important need by serving as
and Amer Al-Khoudari, MD
their primary care physician when hospitalized.
“We provide care for the uninsured patients
and for people who do not have a primary
care doctor,” says Tarandeep Arora, MD, who
recently joined the hospitalist group. This
includes creating personalized discharge care
Hospitalists cover the
hospital floor 24 hours a
day, so when a patient has
complications or needs
critical care, they are
available immediately.
plans for patients to follow after they leave the
hospital. For patients who aren’t likely to get
follow-up care in a doctor’s office, sometimes
due to a lack of insurance, these care plans can
To learn more about TRCH hospitalists, go to www.trch.org, keyword: hospitalist
decrease the chance of returning to the hospital
due to recurring health problems. “This is a
valuable service to the community,” adds
Dr. Arora. “Someone must be there to take care
of them.”
Happy Doctors, Happy Patients
The hospitalists love their jobs, and it shows.
The team has a strong rapport with one
another, extending contagious goodwill to their
patients. “We all live in this community, and
we love this community,” says Dr. Al-Khoudari.
“We all work like one family, and that has a
great impact on the patients’ care.”
Dr. Mehta adds, “The schedule supports
our family lifestyle. We work together and
recreate together. It’s also a very challenging
job. I love internal medicine, so the more
challenging, the better.”
Dr. Arora agrees: “It’s exciting. We have
many patients in intensive care. It keeps you
on the edge of your seat, but we love to use our
training to help them get better.”
| 5
TargetHeartRateinExercise Bust a Move to Boost Your Heart
Y ou’re halfway through your morning jog. Soaked

in sweat, panting for air, you press on, spurred
by the exhilaration of a successful run. Or is it?
“Overdoing it when exercising can actually cause more
harm than good,” says Kathy Gallego, cardiopulmonary
services manager at TRCH. “When you push too hard,
you can become sore and fatigued.”
So what’s a body to do? Take the talk test: if you can
still hold a conversation while exercising, your oxygen
needs are being met.
In scientific terms the goal for the average person
while exercising is to maintain your target heart
rate, which is between 55 percent and 85 percent
of your maximum heart rate. To calculate, follow
this simple formula: 220 minus your age, multiplied
by 0.55 to 0.85.
Target rates may be lower for heart patients or
higher for hardcore athletes. Talk to your doctor
to determine what’s right for you.
A
healthy heart is the key to good
living. Keeping your ticker in
shape can prevent chronic health
problems and increase energy. What does
the doctor order? Exercise!
“The entire body benefits from
moderate, daily physical exercise,” says
Doug Burwell, MD, a board certified
cardiologist with Southern Oregon
Cardiology, LLC, at Three Rivers
Community Hospital (TRCH). “Aim for
30 minutes per day to maintain weight and
60 minutes to lose weight.”
Fit for Every Foot
There’s no shortage of options for
exercising. “Walking is one of the most
effective forms of cardiovascular exercise,
plus it’s inexpensive and accessible year-
round,” says Dr. Burwell. Swimming,
biking, aerobics, and gym machines such
as ellipticals and stair-steppers are also
good choices.
“Aim for 30 minutes per
day to maintain weight and
60 minutes to lose weight.”
—Doug Burwell, MD
Benefits Galore
How does exercise help your heart? Let us
count the ways. According to Dr. Burwell,
regular physical activity can have multiple
benefits:
• Helps control weight
• Raises HDL (“good” cholesterol)
• Lowers LDL (“bad” cholesterol)
• Lowers triglycerides (a chemical cousin
of LDL)
• Lowers blood sugar
• Takes strain off the pancreas

6 | Learn more about heart care at www.trch.org, keyword: cardiology

• Burns fat
• Improves muscle strength
• Improves your chances of
surviving a heart attack
• Lifts your mood through
releasing “happy feeling”
endorphins

So why not exercise? “The

benefits clearly outweigh the
excuses,” Dr. Burwell says.
Just be sure to check with
your doctor before embarking
on a regular routine,
especially if you’ve been
inactive or in poor health.
“Once you’ve made exercise
a habit,” he adds, “you won’t
want to live without it.”

The cardiac rehabilitation specialists at TRCH

recommend 30 minutes of exercise per day.

| 7
BecomeaPart
ofYourCommunity A Closer Watch
The GE Centricity Perinatal system enhances
A sante is a community-
supported organization.
To support the work of Rogue
care for mother and baby.

Valley Medical Center or Three
Rivers Community Hospital,
to honor someone, or to learn
about planned gis, contact
the Foundation in Medford at
(541) 789-5025, in Grants Pass
at (541) 472-7300, or online at
www.asante.org—click on
make a donation.
M
odern technology allows Family Birth
Center nurses to be everywhere at once.
The GE Centricity Perinatal (CPN) system
monitors a baby’s health inside the womb during labor
and tracks the mother’s contractions. Each private
birthing suite at Three Rivers Community Hospital
(TRCH) comes equipped with this advanced monitoring
device, which feeds to a central surveillance screen at
the nurses’ station.
“The CPN system gives us the ability to see what’s
happening with all of our patients at all times,” says
Rashell McClintock, clinical nurse manager for the
Family Birth Center. “It gives patients a sense of comfort
and security, knowing that even when a nurse isn’t in
the room, someone is watching and ready to respond
when needed.”
The CPN system is also an electronic recordkeeping
tool. Nurses can enter patient data electronically, right
in the patient’s room. This enables nurses to spend more
time tending to moms and babies. Moreover, physicians
can tap into the system from their offices to check on
laboring patients.
Thanks to the Asante Foundation, this technology
will soon extend to the operating room. Plans are under
way to install a CPN monitor dedicated to cesarean
patients, enabling better, real-time communication
between Family Birth Center caregivers and the surgery
team. “By providing continuous fetal surveillance in the
operating room, we can better assess what to be prepared
for,” Rashell says. “It’s the eyes and ears of what’s
happening in the Family Birth Center.”
To learn how you can help support TRCH, contact
the Asante Foundation at (541) 472-7300.

8 | To make a gi, go to www.asante.org/give

Heart-healthy Fruit Crisp
Diet advice and recipe from Cheryl Kirk, MS, RD, LD, CDE, Diabetes Education, Three Rivers Community Hospital
F
ruit season is here, and
it’s a great time to enjoy
a delicious fruit dessert
made with a healthy recipe that
is low in fat and calories. It’s a
perfect ending to a day on the
Rogue River.
Fruit is good for you. According
to the 5 A Day diet program
sponsored by the U.S. Department
of Health and Human Services,
fruits are one of the original fast
foods. Eating fruit every day reduces
the risk of cancer, heart disease,
diabetes, obesity, hypertension,
and other chronic diseases.
So pick up some fresh berries,
apples, or peaches at your local
growers’ market or supermarket and
enjoy the bounty of summer with
this delicious deep-dish fruit crisp.
Deep-Dish Fruit Crisp
FILLING
6 cups fresh or frozen fruit
(blueberries, blackberries cherries, peaches,
raspberries, apples, or any combination)
¼ cup flour
¼ cup firmly packed brown sugar
2 teaspoons grated lemon zest
TOPPING
½ cup uncooked oatmeal
¼ cup flour
½ cup firmly packed brown sugar
2 tablespoons butter blend or
soft tub margarine (cold works best)
½ teaspoon ground cinnamon
¼ teaspoon nutmeg
¼ teaspoon ground allspice
For more healthy recipes, go to www.trch.org, keyword: recipes
INSTRUCTIONS
• Preheat oven to 350º.
• In a 9-inch deep-dish pie pan, stir together
the filling ingredients.
• In a small bowl, combine the topping
ingredients with a fork, cutting the butter into
the other ingredients until the mixture
is slightly crumbly. Sprinkle over the fruit.
• Bake for 30 to 35 minutes or until
golden brown.
Serves 9. Each serving has 193 calories, 3 grams (g)
protein, 43 g carbohydrate, 5 g fiber, 30 g sugar,
0 mg cholesterol, 2 g fat, and 30 mg sodium.
✃
| 9
Dishing Out the Dose Lifeline dispenser helps keep tabs on medications.
A
ge can bring multiple health
problems—and multiple
medications. Faced with
a rainbow of pills and varying
instructions on how and when to
take them, it’s easy to get confused.
In fact, one out of every 10 hospital
visits for seniors happens as a result
of medication mistakes. Three Rivers
Community Hospital (TRCH) is
helping seniors stick to their drug
plans with a new tool called the
Philips Lifeline Medication Dispenser.
“This is a great solution for folks
who want to remain independent
in their own homes,” says Lori
Stonecipher, Lifeline program
coordinator for TRCH. Lifeline
experts install the dispenser in the
patient’s home. Caregivers load it
with the necessary medication. When
the patient hears a reminder from
the machine, he simply presses a
10 |
button to take the right pills at the
right time.
“Caregivers can’t always be with
their loved one when it’s time to take
a pill. The dispenser helps reduce
stress on the family, knowing that the
senior is getting accurate guidance
on how and when to take their
medication,” Lori says.
Lori describes one patient who
needed two pills a day: one on an
empty stomach and another, an
hour later, with food. The patient
often missed doses and forgot how
to take each pill. These mistakes
could have jeopardized her health
and independence, but the dispenser
helped regulate her medication plan
so she could remain in her own home.
For more information about
Philips Lifeline and the medication
dispenser, call Lori Stonecipher at
(541) 956-6201.
Stay Safe in the Sun
G
rants Pass enjoys spectacular sunny
weather that’s perfect for outdoor
activities. But the sun also delivers
harmful radiation made up of ultraviolet type
A (UVA) and B (UVB) rays that can cause skin
cancer as well as photodamage, which leads to
premature aging of the skin.
UVB rays damage the outer layer of skin,
causing sunburn and skin cancer. They are
blocked by window glass and vary in intensity
during the day and with the season.
UVA rays damage the deeper layers of skin
and are the dominant tanning ray. Tanning
is really injury to the skin’s DNA. The skin
darkens in an attempt to prevent further
damage. UVA rays cause premature skin
aging and also skin cancer, mostly malignant
melanomas. UVA rays are not blocked by glass
and are equally potent year-round and at all
times of the day.
You Need Sun Protection Outdoors
There are two types of sun protection products
By Richard Schultz, MD, Dermatology
applied to the skin: chemicals that absorb
UVB/UVA rays and physical compounds
that block or deflect UVB/UVA rays. Physical
compounds are often opaque and cosmetically
less appealing. Products that offer the best
UVA protection contain zinc oxide, avobenzone,
or ecamsule.
The American Academy of Dermatology
recommends the following steps to stay
safe in the sun:
• Generously apply a broad-spectrum, water-
resistant sunscreen with a sun protection
factor (SPF) of 30 or more to all exposed • Seek shade when appropriate, remembering
skin, preferably 30 minutes before sun the sun’s rays are strongest between 10 a.m.
exposure. Remember, SPF is the product’s and 4 p.m.
ability to block only UVB, not UVA rays. • Have children play in the shade and use
• Reapply every two hours, even on cloudy protective clothing and sunscreen.
days, and after swimming or sweating. • Use extra caution near the water and sand;
• Wear protective clothing such as a long- both reflect damaging sun rays.
sleeved shirt, pants, a wide-brimmed hat, • Get vitamin D safely through a healthy diet
and sunglasses that block UV rays. that may include vitamin D supplements.
For more information call the office of David F. Young, MD, PC, at (541) 479-3367 | 11
Asante Community NONPROFITORG
Health Education Series USPOSTAGE

PAID
PERMITNO
SWRAMSEYAVE MEDFORD
OR

Come. Learn. Enjoy. GRANTSPASSOR -

Discover healthy living at our ongoing

Community Health Education series.
For a monthly calendar, visit our Web site:
www.trch.org/classes-events

Photo courtesy of Bruce Trowbridge

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specific conditions, consult your physician.

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TRCH

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Three Rivers Community Hospital is a member of Asante Health System, a Medford-based, locally owned and governed healthcare system serving a nine-county region.