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© Niyazz via Canva.com Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

Read More About 6 Healthcare Action Items for the LGBTQIA+ Community

Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.

Read More About CEO Blog: Improving Health Through Genetics and Big Data

In Nevada, we are so fortunate to have a number of not-for-profits and philanthropists who are supporting our mission at Renown Health; we couldn’t do it without them. In the world of healthcare, we are doing well in driving community benefit programming through operations. However, the things our communities need investments in are so much broader than we might be able to afford on our own. That is why it is essential for us to be supported by the people who are so in love with this community and want to assure we get the kinds of services and care for those who can’t afford it or add new services that are contemporary and leading edge that have not been offered here before. Establishing Behavioral Health & Addiction Institute We are so excited to receive a very generous donation from Chuck and Stacie Mathewson for the Stacie Mathewson Behavioral Health & Addiction Institute. This institute is so sorely needed in northern Nevada. Renown Health has a very important role in being able to bring attention to this important problem of mental health and addiction challenges in northern Nevada. Keeping Pediatric Care Close to Home One of the most important areas where philanthropy comes in handy for us at Renown Health is by assuring that we have the foundational programs that we would not be able to afford with operations alone. For example, the William N. Pennington Foundation’s generous gift has allowed us to create 15 pediatric specialty areas here in northern Nevada so children who have an illness or injury no longer need to leave town. The William N. Pennington Foundation supported Renown Children’s Hospital in a way that we never would have been able to support on our own. We are eternally grateful, and their gift — that 100,000 children are assured access to contemporary health and healthcare services — is beyond comprehension.

Read More About How Philanthropy Helps Address Gaps in Care

Renown Health is one of the country’s first health systems to lift visitor restrictions for patients with COVID-19 and encourage the family to be at the patient’s bedside. Read Darlene and Dave’s story to understand why we’re updating our visitor policy. Dave and Darlene Randolph found joy in exploring antique shops and garage sales to find damaged or discarded vintage pieces. Dave would spend many hours scraping, cleaning, sanding, and refinishing items, transforming them into functional, beautiful pieces of furniture. Every piece in their home rekindles a memory and has a story to tell. On Thanksgiving, when Dave was too ill to gather around their antique dining room table, Darlene called the ambulance. Ailing with COVID-19 for two weeks, Dave had not been improving. When the EMTs reached her home and asked Darlene what underlying conditions he had, she said, “all of them.” David was seriously ill. Hospitalized for COVID-19, their communications options were limited. The only way Darlene could communicate with Dave was on a video call or by telephone. Dave spent 17 days hospitalized at Renown Regional Medical Center in Reno. Darlene spent 17 days waiting by the phone for more information on his condition. Darlene said he had “up days and down days,” but thought he might be home, sitting at their antique dinner table for Christmas. Sadly, Dr. David Randolph lost his battle with COVID-19 on December 13, 2020, and died as he slept in a hospital bed. When Darlene wrote his obituary for the newspaper, she gave thanks to the “tremendous nurses and doctors at Renown Regional Medical Center, for providing his care during a time when the family could not be with him.” Taking Action to Inspire Change Darlene wished she could have been there. Over their 45-year marriage, she had always been there. Darlene said, “I had always been at his bedside, as his advocate, to help communicate and straighten things out.” As a registered dietician, she worked in hospitals, knew the protocol, and knew that Renown had a restricted visitor policy to stop the virus’s spread- to other patients, staff, and their family members. Still, she wished she could have spent more time with him. On Christmas Eve, she sat down and wrote to Renown leadership. “As the wife of a COVID patient who recently passed away in your hospital, I want to express my thanks to you and your staff for the care he received in the last days of his life. I am aware that the nurses and staff are working under dangerous conditions and risking their health and lives by caring for multiple COVID patients. The staff is gracious, concerned, and doing everything they can.” She continued, “I know procedures are changing every hour to try to stay ahead of this dangerous virus, and I am sharing my experiences, hoping they will be helpful when establishing policies that impact families.” Darlene explained that despite receiving assurances that Dave’s nurse or a doctor would call daily, sometimes they would forget. She explains in her letter, “how important it is, in these times when the family cannot visit, and has only infrequent communication and is anxiously waiting at home for information about their loved one, how much it means to get a call from someone caring for him at the hospital. If there is a way you can help assure nurses have time to make calls or assist patients in making calls because it is an important part of patient care.” A Person-Centered Visitor Policy After receiving her letter, Renown leadership called Mrs. David Randolph to thank her, offer his sympathies and ask if Renown could help in any way. Darlene asked if he might reconsider allowing families to visit hospital patients during treatment for COVID-19. As the COVID-19 situation has evolved, the policy has as well. Renown hospitals and medical practices now encourage limited visitors for all patients, including those diagnosed with COVID-19. Renown also has extra safety measures to protect the health of patients, visitors and healthcare employees. Darlene is very pleased that her letter inspired this shift in visitor policies for patients with COVID-19. She says, “I have always tried to think of ways I could help other families. Especially those senior couples where one has been hospitalized and the other is home. My wish is to help others.” Renown Health Visitor Policy Renown Health patients may identify two healthy adult “patient supporters” to accompany them on their hospital stay. For more details, visit our Patient Supporter Guidelines page.

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Rich, dark and super chocolaty, these sweet potato brownies are perfect for those following a paleo, vegan, gluten-free or dairy-free lifestyle.

Read More About Recipes Healthy Flourless Sweet Potato Brownies

Over the past year, the safety of healthcare providers has received more public attention than ever before. Throughout the COVID-19 pandemic – and particularly in the early days – the public learned about the vital role of personal protective equipment (PPE) and other important processes that keep healthcare workers safe and healthy. However, people may be surprised to learn that germs and viruses are just one of the many risks that healthcare professionals face every day.  Many people are fortunate enough not to have to worry for their physical and mental wellbeing when they go to work. Unfortunately, this is not the case for countless healthcare workers across the nation, for whom workplace violence is a daily concern. According to the American Hospital Association, healthcare workers are four times more likely to experience serious workplace violence as people in other industries. This is particularly troubling knowing that healthcare workers have dedicated their careers to serving others, putting their communities first day in and day out. Responding to the Challenge of Workplace Violence At Renown, we have no tolerance for abuse against our employees. As an organization, we have several systems in place to support and protect our staff. During staff orientation, we provide classes to prepare employees to prevent and de-escalate verbal or physical abuse. We also offer ongoing education to train our staff to respond to violent situations. If an incident does occur, our violence prevention task force reviews incidents and ensures the impacted employees receive resources and counseling to help them process what has occurred.   As a leader, I am continually impressed by our team’s desire and ability to support one another. However, I know that it is my responsibility to protect our team. No one should have to face harassment or abuse – in any form – in their workplace, and I think about the risks our employees face every day. I believe so much in this cause that I volunteer on the American Hospital Association’s Hospitals Against Violence steering committee, which works to understand the causes behind violence against healthcare workers and develops tools and processes to prevent these incidents from occurring.

Read More About Workplace Violence: Protecting Healthcare Workers

Renown Health President and CEO Dr. Tony Slonim is in the running for national recognition for his innovation and leadership in healthcare here in northern Nevada. Tony Slonim, M.D., DrPH, FACHE, is on an elite list featuring 150 of the biggest and brightest names in healthcare, and is in the running to make Modern Healthcare’s 50 Most Influential Clinical Executives The 50 Most Influential People in Healthcare awards & recognition program honors individuals in healthcare who are deemed by their peers and the senior editors of Modern Healthcare to be paving the way to better health through their executive responsibility, leadership qualities, community service and achievements inside and outside of their organization. Dr. Slonim’s Leadership and Impact Dr. Slonim leads Renown Health’s charitable mission of “making a genuine difference in the health and well-being of the people and communities we serve,” based on the principles of caring, integrity, collaboration and excellence. Through his many efforts, the integrated healthcare system now includes four hospital campuses, 120 sites of primary, urgent and specialty care, affiliations with Stanford Medicine, the University of Nevada, Reno School of Medicine, St. George’s University in Grenada (SGU) School of Medicine, and a health plan that serves more than 160,000 members. He is also leading Renown’s approach to the evolving COVID-19 situation, helping Renown’s physicians and staff to enact the emergency preparedness plans Renown has been developing for weeks to create additional capacity for inpatients and to continue to deliver high quality care during the anticipated surge in COVID-19 cases in northern Nevada. Under Dr. Slonim’s leadership, the commitment, expertise and unparalleled care of the more than 7,000 caregivers and employees at Renown is ensuring our community is safe as we continue to monitor and respond to the changing situation. Local and National Scale A strategically motivated, outcomes-oriented physician executive, Dr. Slonim has advanced health and healthcare both at the local and national level. During his career at major healthcare organizations and academic institutions, he has developed a national profile as an expert in patient safety, accountable care, health care quality and innovative care delivery models focused on improving health within the community. He is an academic leader and tenured professor, holding appointments as clinical professor in the departments of internal medicine and pediatrics at the University of Nevada, Reno School of Medicine.  Dr. Slonim is the former chair of the American Hospital Association’s Systems Council representing more than 300 integrated health systems nationwide. In 2017, Dr. Slonim was appointed editor-in-chief of the American Association for Physician Leadership’s bi-monthly Physician Leadership Journal, having served as a life-long champion for advancing physician leadership, mentor-ship and peer coaching.   Dr. Slonim leads Renown Since joining Renown as CEO and President in July 2014, Dr. Slonim has completely reoriented northern Nevada’s largest locally governed, not-for-profit healthcare network. He launched a five-year strategic plan focused on population health and embraced the national triple aim initiatives of improving quality care and patient satisfaction while reducing costs.     Dr. Slonim works to establish a culture of health through innovation and transformation. He regularly convenes leaders, employees, doctors and community partners to work to improve care, and to fulfill a life-long vision of inspiring better health in our communities. He has raised funds to create Institutes of Child Health, Behavioral Health & Addiction, Healthcare Innovation and Healthy Aging. With a personal passion for population health, Dr. Slonim created the Institute for Healthcare Innovation and launched the nation’s first community-based, population health study that currently has more than 50,000 participants and is returning clinical results on the first three genetic conditions identified. The Healthy Nevada Project is a collaboration with global leader in environmental data, Desert Research Institute, and personal genomics company, Helix. The Healthy Nevada Project combines genetic, environmental, social and clinical data to address individual and community health needs with the goal of improving health across the state and the nation.     He has embarked upon a new strategic planning effort to position Renown Health to thrive in an ever-changing landscape. He has engaged Board members, physicians, community members and employees in a process that capitalizes on Renown’s strengths and continues to improve the health of the communities and people we serve. Looking beyond issues of competition and market share to the more fundamental questions of survival and sustainability, he aims to add value in a turbulent and continuously changing environment. Through his leadership, the organization has embarked upon a new strategic plan to “Exceed People’s Expectations for Access and Affordability.”

Read More About Dr Slonim a National Healthcare Leader

Do you know your blood pressure numbers? Dr. Michael Bloch explains how maintaining healthy numbers are important for good quality of life and increasing longevity. High blood pressure, or hypertension, affects 85 million Americans – that’s one in three people. Left untreated, it can lead to serious and sometimes life-threatening health concerns such as vision loss, kidney disease, heart failure, heart attack and stroke. But what is it, exactly, what makes it go up and why is that increase in pressure so dangerous? All About Blood Pressure In order to function properly, your body requires a continual supply of oxygen rich blood, which is goes to organs and tissues via blood vessels called arteries. Your beating heart produces the force (or pressure) your vessels require to move blood. This is your blood pressure. Your blood pressure numbers reflect two forces at work – the pressure created as blood is pumped throughout the body (systolic) and the pressure when your heart is at rest in between beats (diastolic). A normal, healthy reading shows a systolic level at 120 or below over a diastolic level of 80 or less: 120/80. An increase in pressure occurs slowly over time, straining the circulatory system and forcing the heart, blood vessels and tissues to work harder. This friction damages blood vessel walls and lets plaque buildup from LDL cholesterol, setting the stage for hardening of the arteries. As more and more plaque builds up, your blood vessels narrow, further raising blood pressure, damaging the circulatory system and increasing your risk of serious health conditions. The Silent Killer High blood pressure is known as a “silent killer,” as most people with it have no symptoms. In fact, one in six of those affected don’t even know they have the condition. That’s why it’s so important to know your numbers. The only way to find out if you have high blood pressure is to have it measured, either by a health professional or using a home monitor. If your numbers are high, there are things you can do to help lower it – it is treatable, but not curable. You can manage it with medications and lifestyle changes including: Adhering to the Mediterranean diet Decreasing sodium intake Avoiding excessive alcohol consumption Increasing exercise and activity levels Losing weight Prevention and Genetics Even better? High blood pressure doesn’t just happen. You can prevent the condition altogether. How? Know your numbers and know your risk. Look at your family medical history. Genetics certainly increases the risk of it, but those same lifestyle choices that can improve poor blood pressure can also prevent you from developing it. So if your numbers are good, keep them that way – eat well, move your body, maintain a healthy weight and drink alcohol in moderation.

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Over the past year, the safety of healthcare providers has received more public attention than ever before. Throughout the COVID-19 pandemic – and particularly in the early days – the public learned about the vital role of personal protective equipment (PPE) and other important processes that keep healthcare workers safe and healthy. However, people may be surprised to learn that germs and viruses are just one of the many risks that healthcare professionals face every day. Many people are fortunate enough not to have to worry for their physical and mental well-being when they go to work. Unfortunately, this is not the case for countless healthcare workers across the nation, for whom workplace violence is a daily concern. According to the American Hospital Association, healthcare workers are four times more likely to experience serious workplace violence than people in other industries. This is particularly troubling knowing that healthcare workers have dedicated their careers to serving others, putting their communities first- day in and day out. What is Considered Workplace Violence? The World Health Organization (WHO) defines workplace violence as, “Incidents where staff are abused, threatened, or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being, or health.” WHO considers both physical and psychological harm, including attacks, verbal abuse, bullying, and both sexual and racial harassment, to be workplace violence. Responding to the Challenge of Workplace Violence At Renown Health, we have no tolerance for abuse against our employees. As an organization, we have several systems in place to support and protect our staff. During staff orientation, we provide classes to prepare employees to prevent and de-escalate verbal or physical abuse. We also offer ongoing education to train our staff to respond to violent situations. If an incident does occur, our Violence Prevention Task Force reviews incidents and ensures the impacted employees receive resources and counseling to help them process what has occurred. We are among the first in the nation to have instituted a Zero Tolerance policy on workplace violence. This policy is in place to let our employees know that we have their backs in preventing workforce violence and we will address it assertively if the environment becomes unsafe. As a leader, I am continually impressed by our team’s desire and ability to support one another. However, I know that it is my responsibility to protect our team. No one should have to face harassment or abuse – in any form – in his or her workplace. I believe so much in this cause that I volunteer as Chair of the American Hospital Association’s Hospitals Against Violence steering committee, which works to understand the causes behind violence against healthcare workers and develops tools and processes to prevent these incidents from occurring. Violence was already a concern facing health care organization leaders prior to the COVID-19 pandemic. Now, the ongoing health crisis has elevated tensions. Health care is an industry like no other, with our most precious resource being our employees. As a community, as patients and family members, we have an obligation to ensure that all healthcare workers are safe while they go about their work. This starts with understanding, communication and unequivocal support for the profession. This month we launched the Be Kind campaign across Renown, a reminder to all of the importance of values like patience, kindness and gratitude. If you would like to join us in recognizing a healthcare hero, please submit your thoughts here. Thank you for working with us, and all healthcare providers, to create and maintain places of health and healing for all – and for kindly caring for those who care for you.

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