June 2009

Grinnell Regional Medical Center welcomes Gene S. Gessner, MD, as the new pain specialist serving the Grinnell Regional Pain Clinic. Gessner will split his time between his Coralville-based practice and GRMC on a permanent basis. Grinnell Regional Pain Clinic is located on the second floor of the Ahrens Medical Arts Building, next to GRMC.

“Some patients may remember Dr. Gessner, since he worked as an interim pain specialist at GRMC in 2008,” says Todd C. Linden, CEO and president of GRMC.” We were very happy with his clinical skills and professionalism. We’re extremely pleased that he has chosen to make Grinnell a permanent home to practice. The depth of his experience provides excellent continuity for our patients.”

Gessner began seeing patients at Grinnell Regional Pain Clinic in June to fill the needs of patients after the departure of Bojan Pavlovic, MD. In July, he will expand clinic hours to full time for patients of the pain clinic.

“When I practiced at GRMC in 2008, I was able to get a great sense of the community, the hospital’s business operations, and the staff. I really like GRMC and am excited to practice pain medicine here,” explains Gessner.

Gessner has been in practice for more than 10 years, including his private practice, Pain Clinic, LLC, in Coralville. Prior to opening his own practice, he was a staff anesthesiologist and partner in Cedar Valley Medical Specialists, in Waterloo.

Dr. Gessner completed his medical degree, internship, and anesthesiology residency at the University of Iowa College of Medicine and the UI Hospitals and Clinics. He also earned a pain management fellowship from the University of New Mexico School of Medicine.
 
To schedule an appointment with Gessner at the Grinnell Regional Pain Clinic, contact your primary care physician or call 614-236-2338.

Critical care at Grinnell Regional Medical Center gained an added expertise this week as the medical center launched the eICU, short for electronic intensive care unit, monitoring system.

The program, offered through Mercy Health Network, uses a system of computers, two-way cameras, and video links to transfer information between the dedicated ICU staff caring for the patient in Grinnell and the critical care doctors and nurses at the Mercy eICU clinical operations room in Des Moines. These cameras provide an additional level of care for the most ill patients at GRMC.

“An eICU brings 24/7specialized support to our sickest patients,” says Beth Kirton, RN and GRMC’s ICU nurse manager. “Our ICU staff and hospitalist are excellent clinicians so this new equipment adds monitoring service. We plan to use this on select patients in the ICU or Emergency department who meet set criteria. It’s like an extra set of eyes on those patients who could change their health status quickly.”

The eICU is a portable monitoring unit placed at the bedside that can report real-time vital signs, heart rhythms, medications, lab test results, and radiology test results to the Mercy eICU staff. A camera can zoom in on the patient or equipment to provide visual observation, allowing the Mercy eICU staff in Des Moines to monitor the patient, the IV or ventilator for changes in patient status. Physicians and ICU staff at GRMC will determine when the eICU is appropriate for a patient based on his or her condition.

GRMC is one of a handful of hospitals in Iowa to embrace this added level of care to improve patient care and quality offered by Mercy, and the first hospital outside the Mercy Health Network.

 “We supplement the ICU nursing staff with the technology to continuously monitor the patient. Our monitors look at heart rhythms and respiration. The equipment provides a trend line and variance every five minutes,” says Michael Witte, DO, medical director for Mercy eICU Connect. “We can identify when a patient’s condition is changing even in very subtle ways. With critical care patients, generally the quicker we can respond to a change the better the outcome.”

At GRMC this technology is used differently than other Mercy hospitals.

“We wanted help with our coverage of the ICU during the night time and weekends. This was an important piece in our ability to recruit an internal medicine specialist. With the current shortage of internists and the constantly growing demands on the family practice physicians, this technology provides a bridge in care. And, I’ll add, it’s an excellent addition to our ability to give the best care,” Kirton says.

Grinnell Regional Public Health has confirmed three cases of Pertussis, commonly known as whooping cough, in the Brooklyn area. A number of possible cases are being tracked. Pertussis is a highly contagious respiratory tract infection caused by bacterium. According to the Centers for Disease Control and Prevention, this illness initially resembles an ordinary cold, but whooping cough may eventually turn more serious, particularly in infants. Whooping cough is most contagious before the coughing starts. The best way to prevent it is through vaccinations.

“We ask area residents to be mindful of the signs and symptoms of whooping cough,” explains Patty Hinrichs, Grinnell Regional Public Health manager. “Pertussis is spread through the air by infectious droplets and is highly contagious. Unfortunately, an individual is most contagious during the first stage of the disease when the illness appears like a common cold.”

The initial signs of Pertussis are a runny nose, sneezing, low-grade fever, and a mild cough (all similar symptoms to the common cold). The incubation period of pertussis is commonly seven to 10 days, with a range of 4–21 days. Persons with pertussis are most infectious during the first two weeks after onset of the cough (approximately 21 days).

The best prevention is vaccination. All infants should receive DTaP vaccine as part of their routine immunization unless they have a medical reason not to. Public health recommends that individuals age 11 years and older should receive Tdap vaccine in place of a one-time routine booster dose of adult Td vaccine.

“At age 10 the vaccine that a person received at age five is ineffective. We encourage anyone 11 to 64 to receive a new vaccination to help ward off the illness,” Hinrichs says.

The vaccine will not prevent the disease if someone has already had an exposure to the bacteria causing pertussis. It will help prevent disease from new exposures. Vaccine is available from area healthcare providers and Grinnell Regional Public Health office.

Antibiotics are somewhat helpful in treating pertussis. The most common treatment is azithromycin that is given to all household members and other close contacts of the patient to minimize transmission, regardless of age and vaccination status. All close contacts younger than seven years of age should complete their DTaP vaccine series if they have not already done so.

Grinnell Regional Medical Center is considering affiliating with Mercy Health Network in Des Moines. Under the proposed agreement, GRMC would contract services and share best practices with Mercy network hospitals. The proposal does not call for a change of ownership or a merger; the GRMC board of directors would retain control over the medical center. Decisions about the proposed affiliation could come as early as the end of June.

A task force comprised of GRMC board members, physicians, and administrators began looking at the merits of a system affiliation about a year ago. The task force reviewed proposals from four different organizations and recently recommended that GRMC consider the proposal it received from Mercy. The task force is now seeking questions and feedback from the full board of directors as well as GRMC physicians, with plans to take the recommendation to a vote for the full board at the June board meeting.

“By tapping into the resources at a larger health organization like Mercy Health Network, GRMC will have the opportunity to draw on the network’s expertise,” says Susan Witt, chair of the GRMC board of directors and a member of the affiliation task force. “The goal is to ultimately improve and enhance the quality, efficiency, and scope of care GRMC provides to the communities it serves.”

Todd C. Linden, GRMC president and CEO, calls the potential affiliation a “logical one in which both sides recognize what they can offer the other.” He stresses that the proposal is not a merger and that assets will not be exchanged.

“Each organization would continue to operate as a legally separate entity,” he explains. “The GRMC board of directors would retain full control of the medical center. In addition, an affiliation with Mercy would not eliminate GRMC’s other relationships with other healthcare organizations and visiting specialists. Physicians would continue to make referrals for specialty care to the providers they believe make the most sense for their patients. Patients would still choose where they go for additional care.”

The GRMC board of directors and administrators believe that an affiliation with Mercy has the potential for cost savings and sharing ideas for improvement on a continuous basis, which is important for GRMC after a number of difficult financial years.

For example, through an agreement with Mercy, GRMC could lower costs through shared contracting, improve revenues through strength in payor negotiations, share continuing education costs and attorney fees, and improve quality and service through shared best practices and innovations.

“GRMC has been a bit of an island,” Linden says. “By affiliating with Mercy, GRMC would be tapping into a system of 13,000 employees. GRMC would be able to hone in on the complexities of health care today at a depth that a medium-sized independent hospital cannot do in today’s economic world and complex healthcare delivery system. The affiliation will allow GRMC the opportunity to connect physicians, gain assistance with physician recruitment, and take advantage of Mercy’s purchasing group among other things while still maintaining control and our independence.”

Mercy Health Network is an integrated system of member hospitals and other health and patient care facilities united through various relationships. The network already includes 11 owned hospitals, 29 affiliated hospitals, 98 physician clinic sites, and more than $1 billion in revenues. While Mercy Health Network provides integrated financial and management services to operate network facilities, it does not own or control the majority of its affiliates.

Three Grinnell area residents joined the Grinnell Regional Medical Center’s Foundation Board, taking on three-year terms on the board that make decisions about fund-raising efforts and the management of the endowment.

Victor Wilson, MD, Pete Brownell, both of Grinnell, and Pat Supple, Montezuma, have joined the 24-member board, which provides guidance and leadership for the medical center’s fund-raising activities. Wilson retired from Surgical Associates in 2003, after a 30-year career as a surgeon in Grinnell. Brownell grew up in Montezuma and now heads Brownells, Inc., in Montezuma. Both Brownell and Wilson began serving on the board in April. Pat Supple, Montezuma, accepted a position on the GRMC Foundation board in the fall of 2008. He is an agent with PHI insurance and has been in agricultural business most of his life, for more than 35 years after graduating from ISU.

“GRMC’s foundation board guides the medical center’s fund-raising activities to support the hospital and its programs,” says Mindy Uitermarkt, director of development. “The board’s primary mission is to help build the medical center’s endowment for the future. These individuals bring a unique strength to the board to help guide decisions that will build our endowment.”

In 2008, after five founding members stepped down from the board, the GRMC foundation board changed the executive committee and created two-year officer positions, similar to the GRMC Board of Trustees.

The 2009 officers are Todd Reding, chair; George Drake, chair elect; Ed Hatcher, past chair; and Nancy Walters Smith, secretary/treasurer.

Other foundation board members are: Dan Agnew; Orville Bloethe; Warren Bower, MD; Jenny Erickson; Julie Gosselink; Jack Gustafson, Joanie Heimsoth; Clark Jensen, OD; Mark Kennett, Sally Lang; Dianne Latimer; Todd C. Linden; Joanne Manatt;  Sally Smith; Jim Urfer; Dave Vander Linden, and Wally Walker.