Little Luke’s joins the fun at the FitOne unveiling Wednesday.

What do walk, steps, celebrate, and Olympians have to do with transforming health care through better health? 

Today, on the steps of the Idaho Capitol where it began 20 years ago, we announced the evolution of the St. Luke’s Women’s Fitness Celebration, an event St. Luke’s has supported for the past 12 years. 

The Celebration has been the largest women’s 5k walk/race in the country. We’re proud of what we have done to support women’s health and fitness. 

Celebration co-founder and Olympian Anne Audain has joined forces with St. Luke’s newest Olympian, Kristin Armstrong-Savola, and the St. Luke’s Women’s Fitness Celebration is now FitOne.

The FitOne colors fly over the Idaho Capitol.

Move for fun, get fit for life! What better way to show our commitment to improving the health of our communities?

We welcomed in FitOne yesterday with a giant hopscotch course. Coached by Armstrong-Savola, dozens of young and old participants jumped and raced their way along the course taped in front of the Capitol. Two sailors and a fireman got in the game as well!

Kristin Armstrong-Savola keeps up with the crowd!

 FitOne celebrates health and fitness and retains many of the great features of the Women’s Fitness Celebration while adding new elements, including a women’s-only 9k wave, a competitive stroller wave, and a family 5k wave (Now I can take the grandkids and we can all participate!). In 2014, a women’s-only half-marathon will be added. 

You’re not going to want to miss FitOne! You can register now at www.fitoneboise.org and save Saturday, Sept. 21, for this great community fitness celebration. And look for more information to come about the special events planned for the days leading up to the walk/run.

With Women’s Fitness Celebration founder Anne Audain and Kristin Armstrong-Savola, Olympic athletes and champions of community health.

St. Luke’s wants Idaho to have the healthiest women of any state. Better health for women means a more productive workforce, healthier moms, healthier babies, and lower overall healthcare costs. And since all of us men do better when we listen to women, we will be healthier, too!  Dr. McGeorge’s report follows.

Dr. Laura McGeorge

I am an internist, mother, sister, and daughter, and so I play many roles. As an internist in particular, I think of all the things that we can do to improve health. And this week is National Women’s Health Week, so I’d like to bring awareness to a half-dozen health basics that I think are very important.

We are all really busy in our lives taking care of others (our children, families, parents) and working. So many times I see women neglect themselves because they are so busy taking care of others. 

When we think of improving health, a lot of us think about what tests can be done to improve our health and prevent disease. Some tests are helpful, but many of the things that improve our health are things that we do, or don’t do, on a daily basis.

Here are six positive ways to take care of ourselves:

1.      Quit smoking.

Did you know that lung cancer is the leading cause of female cancer deaths in the United States? Eighty percent to 90 percent of those cancers are preventable by avoiding smoking. 

Heart disease is the leading cause of females’ deaths in the U.S., and tobacco use doubles or quadruples the risk that someone will have a heart attack or stroke.

Second-hand smoke, from a burning cigarette or exhaled air from someone else’s smoking, can increase the risks by up to 30 percent. Tobacco use can even increase the rate of stroke in young women, especially those taking birth control pills. 

Fortunately, there are many resources to help smokers quit. The Idaho Quitline is one of them.  Here is their link: http://www.healthandwelfare.idaho.gov/?TabId=324

2.      Go easy on the alcohol and avoid other addictive substances.

It is recommended that you drink no more than one drink a day. One drink is 1.5 oz. of liquor, 5 oz. of wine, or 12 oz. of beer. 

Substance abuse can increase your risk of infectious diseases such as HIV, sexually transmitted disease, hepatitis, and tuberculosis; behavioral health problems; and your risk of being a violent crime or domestic violence victim. 

And remember that prescription drug abuse is one of the leading types of abuse.

3.      Maintain a healthy weight and activity level.

Achieving and maintaining a normal body weight for your height and staying active can reduce your risk of heart attack, stroke, high blood pressure, most diabetes, many cancers including cancers of the breast, uterine, colon, pancreas, gallbladder, kidney, thyroid, and esophagus, falls, immobility, depression, and sleep problems. 

A normal body mass index, or BMI, is less than 25. Here is a link so you can calculate your own BMI: http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm

It is not easy to get to or maintain a healthy weight, but maintaining a healthy weight is crucial to good health.

4.      Play it safe around moving vehicles.

 I suspect that nobody would think it is OK to drink and drive, and yet so many people are willing to text and drive. 

Texting while driving has been reported to injure around half a million people per year, and it’s entirely avoidable.

And don’t forget to wear a helmet when biking or rolling!

As a mother, I try to remember that I am the biggest role model for my children. If I text while driving or don’t wear my bike helmet, even once, they will follow my lead.

5.      Get recommended screenings.

The U.S. Preventive Services Task Force is a national body of experts that looks at medical evidence and makes recommendations on screening tests. These are some of their recommendations for average-risk people:

• Breast cancer screening: The decision to screen before age 50 is an individual one and should be made in consultation with your physician. It is unclear if screening for women 75 or older is beneficial. The task force recommends mammograms every two years in women age 50 to 74. Other professional organizations have slightly different screening guidelines, so talk this over with your healthcare provider. 
• Cervical cancer prevention and screening: Pap smears should be done every three years in women age 21 to 65 who do not have a history of precancerous pap smear results. Most women who have had a hysterectomy do not require pap smears. The Human Papillomavirus (HPV) vaccine series is recommended for girls at age 11 or 12. This vaccine reduces the likelihood of getting the HPV virus which can cause cervical cancer.
• Colorectal cancer screening: Screening is recommended for ages 50 to 75 years old. Screening can occur with fecal occult test cards, sigmoidoscopy, or colonoscopy. Check with your doctor to see what’s right for you.
• Osteoporosis screening:  Most women should have a bone density test at age 65.

Your risks may be different, so you should discuss your screenings and what’s appropriate for you with your care provider.

6.       Get your shots.

It is rare for anyone to have a medical reason to NOT get an influenza vaccine. Most, if not all, people will contract the flu at some time. 

The majority of healthy people will be inconvenienced by influenza, but even healthy people can become very ill, or even die, from influenza. The annual vaccine is recommended for everyone age 6 months and older. It is even recommended for pregnant women.

Other vaccines to discuss with your health-care provider are tetanus-whooping cough (Tdap), HPV, pneumonia, shingles vaccine, measles-mumps-rubella (MMR), meningitis, hepatitis, and others. Recommendations differ depending on your age and medical history. 

Here is a link to the CDC website to learn more:  http://www.cdc.gov/vaccines/schedules/

Why is it important? It’s all about you!

Please make your health and healthy habits a priority so you are well and can be a role model for others. Help each other out by taking care of each other.

If we are not well, we won’t be in as good a position to help take care of the ones we love!

Thousands of dollars were raised for breast cancer education and awareness programs, and breast cancer survivors got the hero treatment from families, friends, and the community. 

St. Luke’s volunteers and staff members brought information and turned out to support our patients with cancer. Our booth volunteers included representatives from St. Luke’s Mountain States Tumor Institute, Breast Care Services in the Treasure Valley, McCall, and Wood River, St. Luke’s Men’s Health, the Women’s Fitness Celebration, and the Health Window.

Thanks to everyone for their show of support for those who face breast cancer!

I recently had the fortune of bumping into a colleague from my residency training days who wondered if I would be willing to take part in a statewide suicide prevention roundtable. 

Dr. Leslie Nona

I told her that as a general internist, my qualifications seemed limited: admitting patients who had attempted suicide during my inpatient hospital duty; two very sad losses of my own clinic patients to suicide; and a terrifying call that I received from a suicidal patient while in clinic.  

While I feel comfortable with the wide range of organ system problems of adults, it dawned on me that I know too little about this often-preventable cause of death. I agreed to join the roundtable, and I feel I learned far more than I contributed. I hope to share some information that will be helpful to everyone, particularly those of us in health care who have frequent contact with those at risk.

Here are the statistics. Suicide is the second-leading cause of death for Idahoans ages 15-34, and sadly, we have the sixth-highest overall rate in the nation – 49 percent higher than the national average.

 In the past five years, 1,352 people completed suicide in this state, and far more than that attempted it; for every person who dies by suicide, 30 more attempt it. Men outnumbered women, but there was a significant peak among women between ages 35 and 64. Suicides among middle-aged people have increased 31 percent nationally in the past 10 years, according to the Centers for Disease Control.  Suicide is now the fourth-most-common cause of death in that group, behind cancer, heart disease, and unintentional injury.

These deaths and attempts affect countless people, including family members, friends, coworkers, and entire communities. I believe suicide has touched many of us.

Suicide attempts in Idaho are estimated to cost $36 million annually. Suicide completions cost more than $850,000 in just the medical care for those who have attempted suicide and ultimately succumb, despite intervention, and $343 million in total lifetime productivity lost. And of course, this is nothing in comparison with the human cost. 

This statistic is very meaningful for me:  up to 45 percent of those who die by suicide have visited their primary care physician within a month of their death. This was true of my two patients.

And 81 percent of these had not sought prior subspecialty psychiatric help. This is magnified in the rural parts of the state, where 65 percent of people get their mental health care from their primary care provider. 

I now understand how important it is that those in primary care be aware that, at any given time, 2 percent to 4 percent of their patients are having suicidal thoughts. Whether we are comfortable with it or not, we are the front line.

As emphasized by Kathi Garrett, the chair of the Idaho Suicide Prevention Council, suicide is a complex outcome, often with many paths. I try to keep this in mind. It is a process that generally happens over time, with the possibility for intervention when risk factors are considered.

What are the risk factors? Depression, substance abuse, PTSD/anxiety, chronic pain, and physical illness, especially involving traumatic brain injury.

I am now much more thoughtful about these patients, screening routinely and referring to mental health services when I am concerned.

What about the actively suicidal patient who calls in? Or your friend, family member, or neighbor? 

I will be the first to tell you that I wish I had more expertise. Do I call the police? EMS?

Open since late last fall, the Idaho Suicide Prevention Hotline has made it part of its mission never to drop a call, and to provide consultation to clinics and responders. 

Their number is 1-800-273-8255 (TALK), and their volunteers are very skilled at de-escalation and referral. I keep this number readily available, as I know enough to know I may need them as a resource.

I also highly recommend that providers download the Western Interstate Commission for Higher Education (WICHE) Suicide Prevention Tool Kit for Primary Care Providers. This is an excellent resource to educate and prepare clinicians and staff members.

Other helpful resources are:

• From Crisis to Hope, Maintaining the Momentum, Idaho Council on Suicide Prevention, Report to Governor C.L. “Butch” Otter, December 2012; and
• Idaho Suicide Prevention Plan:  An Action Guide, 2011.

These and the WICHE Tool Kit are available online. And www.idahosuicideprevention.org is the site to check for more information about the hotline and its services.  Donations are always welcome. If you have an interest in training and volunteering for the hotline, email syoung@mtnstatesgroup.org or call 208-258-6992.

I would like to thank the Idaho Council on Suicide Prevention for providing the information presented, particularly Chair Kathi Garrett and John Reusser of the Idaho Suicide Prevention Hotline. I would also like to thank my friend, Neva Santos, who asked me to join the prevention roundtable in the first place. 

And many thanks to Dr. Pate for asking me to be a guest in this space as we recognize National Mental Health Awareness Month. I couldn’t feel more strongly that mental health deserves more attention in Idaho, and I am grateful for the chance to talk about this very meaningful health issue. Dr. Pate, thank you again for your interest in mental health.

Those who know me know that I am a tremendous supporter of nurses, and particularly supportive of Magnet hospitals because of what that designation means concerning the culture of nursing  –  shared governance, continued development and promotion of professional practice, continuing and advanced education, nursing research, incorporation of evidence-based best nursing practices, and excellence in the delivery of nursing services, among other things.

I was honored to be asked by Joanne Clavelle, DNP, RN, NEA-BC, our Treasure Valley chief nursing officer, to write a chapter for a book co-authored by one of her professors. 

That book, Nursing Leadership from the Outside In, by Greer Glazer and Joyce Fitzpatrick, was released April 28. 

What follows is an excerpt from the chapter I wrote, titled, “Perspectives on Nursing Leadership:  From a Physician Chief Executive Officer.” I believe that nurses will be critical to the success of our transformation, and we will need strong nurse leaders. By sharing this, I mean to inspire those current and future leaders.

The Nurse Leader of the Future

Just as health care is preparing to go through the biggest change in nearly 50 years, so too, the role of the chief nursing officer/nurse executive will change dramatically. The chief nursing officer/nurse executive will be critical in redesigning the health care delivery system of the future.

What will change? Everything! First of all, the very care management model must change. It is too fragmented, too inconvenient, too ineffective, and too physician-centered.

What will the new care management model look like? The reimbursement system must eventually change from fee-for-service to payment for value. 

When this happens, physicians will no longer be rewarded for personally-performed services, but rather for obtaining better outcomes (improved indicators of health/disease management and lower total cost of care) for a panel of patients. This will be the change that will be needed to help move towards team-based care in the outpatient/ambulatory arena.

This will mean that physicians will now utilize physician assistants and advanced practice nurses in the management of their patients. Once this happens, patients with chronic medical diseases can be actively managed in between office visits, decreasing the current fragmentation that characterizes our model of care. The chief nursing officer/nurse executive will be critical in the creation and implementation of this new care model.

The above changes to the care model are inevitable. However, those health systems that want to be the best will further adapt the care model to be patient-centered and family-centered. This is another area for leadership from nursing and quite a number of other disciplines. 

It starts with looking at everything we do from the standpoint of the patient and those who provide the support system for the patient, both in the inpatient and outpatient settings.

For example, how effective is our patient education? For the patient who has been admitted to the hospital, are we really effective in educating the patient when they are ill, on sedating medications, and sleep-deprived? In the physician’s office, how much of the information we provide patients will actually be understood and retained? 

We need to utilize technology and develop education that can be listened to/viewed at home and that has a stop and replay function. We need content that can be shared with all caregivers and that can be forwarded to a family member out of town. 

Patient-centered and family-centered care is far more than just education. It also has to do with how we treat patients. Are we having all of our day surgery patients and their families show up at 6 a.m. even when we know some of these patients will not have surgery until late morning or early afternoon? If a single mother became ill in the evening, could she schedule a visit with her physician online for the next day so that she could still get her children off to school and know that she could get home in time to be there when the children returned home from school? 

Are we engaging patients and their caregivers in the patient’s care or still treating the patient as a recipient of care? More than that, are we changing our care processes to activate patients (those with the capacity and competency required) so that they take accountability for their care and utilize us as consultants and advisors to them? 

Nurses and nurse leaders can and must lead this change in the care model together with physicians and other providers.

There will be many new roles for nurses and the chief nursing officer/nurse executive must help develop these roles, help nurses be trained and further educated for these roles, and must develop new ways of assuring the competency of staff for these new nursing roles. 

Besides the increased use of advanced practice nurses in the team-based care of patients, nurses will have a new and expanded role in population health. We must find ways to promote health and intervene in the lifestyle management and preventive care of those high-risk individuals who are not yet patients. 

With a movement towards providers assuming greater risk for the health care of a population, the focus will be on trying to avoid costly illnesses and trying to care for those with chronic diseases in the lowest cost environment for which the desired outcomes of care can still be achieved. 

This means an expansion of home health and palliative care and the development of new roles for nurse educators, patient navigators, and health coaches. Nurses will be even more involved in wellness, prevention, and screenings with special focus on at-risk populations. 

While some primary care and specialist physicians will continue to manage patients with chronic disease in their offices, I believe we will see more chronic disease management being conducted by nurses, physician assistants, advance practice nurses, nutritionists, and other providers in patient-centered medical homes or chronic disease centers of excellence coordinated by teams and evaluated by compliance with evidence-based practices, bundles of care process measures, and metrics of disease management outcomes. The chief nursing officer/nurse executive will play a critical role in the design and oversight of these programs.

Finally, I believe that there will be pressure to increase the types of services available to patients at home and work, and for those patients that must be seen, to increase accessibility to care through extended hours of offices/clinics. 

For those patients who cannot be cared for at home or in an office setting, use of urgent care clinics will be promoted over that of emergency rooms for appropriate cases. This coordination likely will involve more nurse triage and call centers. 

Finally, for those patients who do end up in hospitals, I believe we will have to move towards true 24/7 operations, a significant challenge for our nurse leaders.

Those who know me know that my work is more than a job; I am driven to fix what is wrong with health care.

I am going to show you three of the reasons for my passion and sense of urgency.

Last weekend, I had the privilege of being the chair for the Boise March for Babies walk and the team captain for the St. Luke’s MaxWell Moose Marchers. 

My two daughters joined me for this important event and the walk. To the right you see my older daughter in the foreground (She was due to deliver the day of the walk! What a trouper!) and my youngest daughter to her left pushing the stroller with my twin grandsons, who are 3 months old. 

Well, Presley was born Tuesday, April 30, at 1:56 a.m., and weighed 8 lbs. 13.5 oz. 

Here she is, two days later.

 And here is a picture of Presley and her two cousins That is David on the left, Presley in the middle, and David’s twin brother, Jax, on the right. 

 These grandkids are three very important reasons I am working so hard to transform health care. There was a time when both of my daughters went without health insurance, between jobs, and it was frightening for me, knowing all that could go wrong. 

My daughters can afford insurance only because their employers offered it. Even then, they have both had medical bills they could not afford to pay.  

I don’t want my grandchildren to ever go without insurance, not be able to afford health insurance, or put off care because they can’t afford it. 

My entire team is working very hard to make sure that we find ways to lower health care costs and make it affordable for all Idahoans. 

I want more for my grandchildren. I want them to have great health. Right now, health care providers spend their time improving the health of sick and injured patients, because that is how the current reimbursement system works. I want a health care system that works to keep my grandchildren healthy through education, prevention, screenings, and wellness programs.   

God forbid they become patients, I want to know that their health information will be available to every provider involved in their care. I want their parents to be able to access their health records online, and to be free to email their physician and not be reluctant to ask a question because they don’t want to call and bother the physician.

I want their care to be coordinated among all the caregivers and I want to know that someone will continue to manage their care even between visits or after a hospital discharge. 

This is what we are working toward at St. Luke’s. We have accomplished some of these things, but we still have a long ways to go.

But, I can tell you this for sure. I wake up thinking about these grandkids every day. And the next thing I start thinking about is what more can we do to fix health care and accelerate the change.

These two projects were selected from numerous submissions and were among four chosen for Qualis Health’s Awards of Excellence in Healthcare Quality. They represent significant achievements in meeting the Triple Aim of better health, better care, and lower costs.

These two examples highlight just some of the excellent improvement work in clinical care that is occurring at all of our sites and being shared among them. The changes are visible. And these relationships will expand as we develop our accountable care skills and abilities.

St. Luke’s is improving care because it is the right thing to do. We strive to be patient-focused and to put into practice St. Luke’s core values: integrity, compassion, accountability, respect, and excellence. 

It is an exciting time, and together, with staff, physicians, and community partners, we are making a difference in our journey to transform health care, one patient at a time.

Here are the winning St. Luke’s initiatives:

St. Luke’s Wood River’s Diabetes Care Improvement Project

Rural, critical access hospitals face challenges in providing the scope of services, expertise, state-of-the-art technology, and integrated care available in bigger communities, where hospitals see more patients and often have additional resources. This can make complex, evidence-based care of an ever-growing diabetic population difficult. 

When St. Luke’s Wood River identified diabetes as a primary focus for population health in 2010, they conducted an audit of clinic patients, comparing themselves with national benchmarks to identify gaps.

Nancy Dettori, RD, CDE, teaches a patient how to read nutrition labels to help manage her diabetes.

They found opportunities when it came to heightened awareness of the American Diabetic Association (ADA) standards of care, expanded scope of service to address their pediatric and pre-diabetic populations, and state-of-the art technology for improved patient safety and to improve the control of diabetes.

With the help of an Idaho Medicare Rural Hospital Flexibility Program grant in 2012, St. Luke’s Wood River formed a partnership with St. Luke’s Family Medicine clinic and St. Luke’s Center for Community Health (SLCCH) and collaborated with other sites across the System to put an expanded education program in place.

They made sure that certified diabetes educators and diabetes self-management training (DSMT) were available through the clinic, appointed a physician champion of the project, conducted additional training, and improved their use of technology.

Among the results:

• Improved practice of testing hemoglobin A1C levels to at least twice annually from 63 percent to 81 percent of patients.
• Increased the number of referrals to DSMT.
• Improved diabetes care competency scores for clinic nursing and SLCCH support staff.
• Improved insulin delivery options and effectiveness due to Medtronic Diabetes insulin pump training, and improved management of complex glucose patterns.
• Decreased patient travel time due to purchase of two continuous glucose monitoring systems used for diagnostic purposes. Patients previously had to drive to Twin Falls or Boise for the tests.
• Selection and implementation of a pediatric self-management curriculum.
• Enhanced expertise in adult weight management.
• Improved average hemoglobin A1Cs from 9.3 down to 7.4 among diabetics with self-management.

Wood River’s Clinical Leadership Task Force now is integrating components of the project in the hospital setting. A new audit process is helping clinic nurses identify patients needing call-backs for labs and exams. And Wood River has launched an eligibility fast-tracking pilot project for patients with financial challenges who need support services.

Other changes brought about through Wood River’s efforts have included work throughout St. Luke’s Health System on software programming to promote easier analysis of continuous glucose monitoring system data, development of resource material to address body image issues associated with type 1 diabetes among adolescents, and collaboration with the new St. Luke’s Diabetes Education and Management (DEaM) team for ongoing standardization and improvements.

St. Luke’s Treasure Valley’s Transitions of Care: Something to ToC About

Hospital admissions are a time of significant change, and the potential for introducing error or confusion to the care of a patient during or after hospitalization is high. The St. Luke’s Transition of Care (ToC) Team is a multi-disciplinary group focused on improving the care of patients as they move from the community to the hospital and back.  

Recently there has been much attention on readmission rates. St. Luke’s readmission rates are below national average, but the ToC team decided to look into the drivers of readmissions for opportunities to improve transitions of care.   

Various elements were examined, including readmissions by condition, time frame for readmission, patients’ discharge disposition at the time of readmission, communication with community providers, and opportunities with medication reconciliation. More than 250 readmitted patients were also interviewed to understand their perspectives on what could be done better. 

Based on their review of data and the interviews, the team determined that improvements in the areas of medication reconciliation, standardization of the discharge process/transfer of information, collaboration with community providers, improved processes for providing patient education, and improved communication with primary care providers were keys to improving the patient’s transition.

St. Luke’s pharmacists have been instrumental to the ToC team’s work, helping to improve processes for filling medication prescriptions when patients are discharged.

After pinpointing the opportunities, the team worked on solutions. A standardized process for medication reconciliation at discharge was developed and initiated. This step alone has resulted in error reduction in medication reconciliation from 18 percent to 10 percent in the pilot unit.    

The ToC team helped promote a tool, piloted by one of the nursing units, to standardize education regarding patients’ new medications. Use of the tool resulted in a significant improvement in HCAHPS scores, with patients scoring the pilot unit in the top 1 percent nationally. The teaching guide is now being used in other units and hospitals across the System.

A care transition program with the heart failure clinic, bridging the gap between hospital and home for  patients admitted for heart failure and myocardial infarction, has also been developed. Home visits within 72 hours of discharge to assess patients’ health status, align goals, evaluate patients’ educational needs, and provide medication reconciliation have reduced readmission rates in the intervention group to 17 percent compared with 21 percent for a control group, which amounts to a 19 percent relative improvement.

Other steps include a new inter-facility, nurse-to-nurse hand-off in collaboration with the Elks Rehabilitation Hospital. This process provides a standardized framework for communication with

Transitions of Care team members schedule follow-up appointments.

community partners about a patient’s condition prior to transfer, ensuring better care. A campaign to improve communication of discharge summaries from inpatient physicians to primary care doctors is also under way. The hospitalists have already improved the percentage of summaries signed within 72 hours from 70 percent to 80 percent.

And a standardized process for scheduling follow-up appointments prior to a patient’s discharge, now being piloted in partnership with St. Luke’s Connect and St. Luke’s Internal Medicine clinic, ensures early access to follow-up care and timely intervention if a patient’s condition is unstable, improving the health of the patient and reducing cost by avoiding preventable readmissions.

Congratulations to the many passionate people within St. Luke’s who work so well and so collaboratively to deliver better care at lower cost. That’s what I believe Qualis has seen and is recognizing in these initiatives. And there’s more where that came from! Thanks to all!

MaxWell Moose Marchers were easy to spot in their St. Luke’s blue shirts!

In all, 1,380 volunteer walkers signed up to support the March of Dimes’ efforts to improve the health of babies by preventing birth defects, premature birth, and infant mortality.

And the MaxWell Moose Marchers were out in force! About 160 St. Luke’s physicians, employees, and family members took part, and helped to raise at least $31,026.

That’s me in the middle.

I was honored this year to serve as St. Luke’s team captain, blessed to have two tiny moose in tow, and proud of my older daughter Lindsey, who was due to have her baby Saturday but held off long enough to take part in the walk! 

My daughter, Laurie, and her husband, Clif, a St. Luke’s nurse, also joined us for this great cause and posed for a picture with the boys alongside MaxWell.

Please join the fun for the Twin Falls walk this coming Saturday. Registration starts at 9:30 a.m. and the 3.1-mile walk starts at 10 a.m. Twin Falls Visitor Center, 3591 Blue Lakes Blvd N., Twin Falls.

For more photos, click here.

At St. Luke’s Heart, efforts to combine outcomes and other data for a first-ever report on our cardiac, thoracic, and vascular services prove what our talented physicians and staff members in those areas have known for some time: We’re doing outstanding work on behalf of our patients and the communities that we serve.

Dr. Marshall Priest, executive medical director of St. Luke’s Heart, and his team have put together the first of what Dr. Priest envisions will be a series of updates issued every two years regarding our heart work.

The “Programs, Services, Outcomes, and Referral, 2013” report is patterned on similar information Dr. Priest had seen from the Mayo Clinic, Cleveland Clinic, and other highly reputable health organizations and systems.

Dr. Marshall Priest

“I thought, ‘You know, we do great work here. Why don’t we put it out?’” he said.

This first report was more an affirmation than it was a surprise. We had the data, but aggregating it allowed Dr. Priest and the team to really get a sense of their performance.

“What it did was bring to light and reinforce how well we do things compared with our peers nationally,” he said. “We did a deep dive into all the things we do here, in terms of our workflows and our outcomes.

“I think transparently, we put out there exactly who we are and what we do.”

Among the takeaways:

• Our surgical aortic valve replacement outcomes are among the best in the country.
• Our “door to balloon time” in treating heart attacks is about half the national standard. St. Luke’s is averaging 48 minutes; the national standard is 90 minutes.
• Our vascular surgeons are among the top 5 percent in the nation.
• Our new Transcatheter Aortic Valve Replacement (TAVR) procedure is yielding excellent outcomes. St. Luke’s is one of only four hospitals in the Pacific Northwest, and the only hospital in Idaho, to perform the procedure. Dr. Robert Duerr, TAVR program director, and his team have seen terrific results with the 14 patients to date.
• Dr. Matthew Schoolfield, surgical director of St. Luke’s Thoracic Oncology program, is seeing equally strong outcomes with his video-assisted thoracic surgeries (VATS). Dr. Schoolfield, who also conducts endobronchial ultrasound diagnosis procedures, and his group are the only team in Idaho performing this type of surgery.

St. Luke’s, it turns out, is a great place to be a heart patient. And that’s no accident; it’s the result of strategic hiring, tight teamwork, long-term relationships, and passionate and committed physicians who have wanted to be part of what St. Luke’s has built over time.

Dr. Priest is himself an example of the building of St. Luke’s Heart and the evolution of heart care in Idaho and nationwide. He came west from the University of Alabama, Birmingham, in 1979. St. Luke’s was then only the downtown Boise site; the hospital doors weren’t locked and there was one security guard. And then there are the changes in treatment.

“We have recognized in that period of time that a blocked artery causes a heart attack. We did not know that when I came here,” he said. “There have been remarkable improvements in anesthesia, the techniques of heart surgery, the outcomes are better …”

Dr. Priest helped to found the Boise Heart Clinic with Dr. J.W. Smith, then Idaho Cardiology Associates, which became part of the St. Luke’s Health System in 2007. That alignment and the efforts of previously unaffiliated specialists who have joined up with St. Luke’s have been a boon for the region’s heart patients.

“We came to St. Luke’s to ask for it,” Dr. Priest said. “It wasn’t that St. Luke’s put out tentacles to grab us.

“That brought the heart surgeons and the vascular surgeons to the table,” he said. “There’s a huge trust factor across the specialties.”

The System’s resources have allowed St. Luke’s Heart to provide services that wouldn’t otherwise be possible, including Dr. Andrew Chai’s Heart Failure Clinic. Such a clinic would not have been possible for Dr. Chai to establish outside a system setting. And St. Luke’s patients are experiencing better health and better outcomes, and patients, providers and St. Luke’s Health System are seeing lower costs, as the result of Dr. Chai’s work and that of Dr. Schoolfield.

System resources also support a fall educational conference. This year, about 200 primary care physicians attended the conference, which is free to them, and had the opportunity to hear from specialists and receive continuing education credits close to home.

Alignment has improved care through both educational efforts and tighter relationships among physicians.

Dr. Robert Duerr, Transcatheter Aortic Valve Replacement program director.

“We have been able, and we continue, to standardize our care processes, and if people aren’t aligned, you can’t do that,” Dr. Priest said. “Without question, what we have been able to do in our service line, we would not have been able to do if we had not integrated.

“It’s not that we don’t have vigorous discussion about these things, but by and large, people are all aligned. There are a number of leaders,” he said. “We really have an aligned group.”

This week, Dr. Priest and St. Luke’s Heart will hear from Dr. Brent James, the chief quality officer at Intermountain Healthcare who has pioneered the types of improvements that St. Luke’s is interested in adopting. It’s the sort of change Dr. Priest and the team welcome and are documenting.

“I’m really proud to be part of this system,” Dr. Priest said. “The more we dive into this, the more pride I have in this organization. I love this organization. I love the people I work with.”

I presented this Forum 15 times across our System over a three-week period. In addition to our past venues, I had the pleasure of debuting the Spring Forum at St. Luke’s Elmore on their first day as part of the System. Another new venue was Nampa, where I had the chance to see folks from Saltzer Medical Group, Fruitland, and Eastern Oregon Medical Associates in Baker City, Ore. It was so exciting to be able to brag on the great work done by EOMA and to see how excited employees of Saltzer Medical Group were to be part of the St. Luke’s family.

If you did not attend one of the forums, you missed some stories and my favorite part, the Q&A. Each year, we become more and more aligned, more deeply, through our ranks. And it’s so rewarding to note all the “ah-ha” moments, where all that we have been talking about and planning for is being understood as we connect the dots between our strategy and the real-life examples of our initiatives and early successes. And incorporating video segments of leaders in the forums now for the past year has provided me with an opportunity to showcase some of my outstanding executives and team members for everyone to see and hear from.

For those of you who work at St. Luke’s, thank you for all you do to provide outstanding care and caring to our patients in all ways, directly and indirectly.  For those of you who do not work at St. Luke’s, but are our stakeholders, thank you for your commitment and support; it is vitally important. And for those of you who don’t work at St. Luke’s and are not stakeholders, enjoy and be inspired!

Here are some of the things I’ve heard from Forum attendees:

“I thought it was informative and very professional. Enjoyed the interspersing of video clips.”

“It was nice to see the different doctors that are ‘owning’ process improvement and benchmarking best practices.”

“I was glad he brought along components of his leadership team.”

“Thanks.”

“The meeting last night was great! I enjoyed the patient focus and the drive that St. Luke’s has to create a better community. Not just treating patients but educating patients on better health is a message that is very powerful.”

“This is a weird corporate structure. The leadership is actually concerned more about their people than the bottom line. I like it, but it is weird.”

“Dr. Pate, I wanted to let you know that I have heard such amazing feedback related to your forums and I am excited to attend this afternoon personally. … Last night my mother, who works at Saltzer, had the opportunity to attend your forum in Nampa. I just received this email from my mother and although the note is brief, its statement is grand! ‘Great meeting last night and very informative! Dr. Pate seems very passionate  about health care for all.  I can’t believe how much medicine has changed over the years since I was little and what the future brings. This is exciting!’ My mother not only gets to hear my perspective on our great System, but now gets to experience it personally. Thank you so much for your perspectives, your commitment, and most importantly, your open passion about the mission of what we do each day. Thank you for inspiring us to commit to achieving exceptional patient experiences and exceptional outcomes!”

“Dr. Pate, I just came from today’s Spring Forum, and on the walk back, I felt the need to send you a note of thanks. … I have only been here at St. Luke’s for about six months now, but each time I hear you speak or read items on your blog, I am more impressed. In my career in the Air Force, and during my early tenure at Albertsons, I was blessed by having some great leaders as examples. I must say you rank right up there with the best of them! I want you to know that you do have support out here, and that I personally appreciate your effort to improve the health care for all of us here in Idaho. … Anyway, my point was to thank you for the opportunity of listening today. It’s no small investment of your time and St. Luke’s Health System resources, and I do appreciate it! Thanks!”

“Thank you for your exceptional leadership. I am proud to be a St. Luke’s employee!” 

“Dr. Pate, I wanted to thank you for your presentation at the Shoreline Employee Forum. I had met with my team the following day, and we all agreed your discussion was so powerful! We really appreciated your candid and heart-felt comments, and believe we now have a better understanding of your immense efforts.  Frankly, you and the information you shared really made us all feel even more proud to work for such a wonderful organization.  Your leadership is so inspirational. Thank you!”

“Good morning … Attending Dr. Pate’s employee forum last Wednesday made me realize that I want to be a part of St. Luke’s commitment to creating a better quality of life for people in every community, with each and every encounter and with every personal interaction. I really appreciate what St. Luke’s has given to me as an employee, and I believe in the vision and mission of our leadership and its Foundation. I trust and believe in your judgment as to how my contribution, although very small, can be used for the greatest good of the communities we serve. Thank you for letting me be a small part of the tremendous job you do for all of us in Idaho!”

“Thanks so much for coming up. Feedback was an A+. Tough crowd to impress. It means a great deal that you take the time to do this.”

“Dr. Pate, I really appreciate your transparency, accessibility, and amazing leadership. I am more proud to work at St. Luke’s today than when I started 14 years ago. We are all fortunate to have you leading our wonderful organization. Thank you for all you do!”

“Dr. Pate, I attended the Spring Forum in Nampa last night. Great job. It is obvious you are passionate about health care, but you care about people and it is evident. P.S. Pretty sweet twin grandsons.”

“The presentation today was well done and nicely organized.  I particularly enjoyed the several physician initiatives and programs that you highlighted.  I had to leave a little early and did not have the opportunity to congratulate you in person on a superb program.  The taped presentations of your leadership team also were effective and got our message across clearly. Thank you for the continuing excellent effort and good work.”

“Hi Dr. Pate, I want to thank you again for the time that you take to so thoughtfully communicate directly to our teams. I can’t tell you how meaningful it is for our team and community to hear directly from you. Your message was very well received and has made an impact on helping people see the value of our alignment. I am also seeing people really begin to understand and embrace our vision and strategy. I had numerous staff and board members remark to me how powerful it is for them to see you speak from your heart. They get the opportunity to personally see and feel your passion and commitment and it is contagious! … Thank you for your heartfelt convictions to make health care better for all of us. Keep showing that personal conviction and nothing can stop us! Best regards.”