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Departamento destacado: Surgery & Procedure Scheduling
When it comes to intimidating procedures such as surgery, cardiac catheterization (Cath) or interventional radiology (IR), there can be a lot of unknowns. What can I expect on the big day? What will happen after I’m all done? Will I have to worry about my orders not being in the system? Who can I call if I have any last-minute questions? It’s easy for your thoughts to race as you approach your procedure date, but luckily, there is a team who puts your mind at ease. With Renown Health’s Surgery & Procedure Scheduling department, patients can breathe a sigh of relief knowing that all the nitty-gritty is taken care of before they step foot in the procedure room. This team operates in the mindset of a complex Tetris board – fitting in all the pieces to make sure every patient is set on the path for surgery success. Consistent Contact Our Surgery & Procedure Scheduling team has a unique history. Initially operating as two separate teams, over the last year, our leaders skillfully combined the two teams together under one umbrella. That allows the now singular team to have line of sight across every surgery and Cath or IR procedure plan and be better stewards of the resources they have at their fingertips to provide streamlined, more-connected care for patients. As one might imagine, with the merger of the two teams, the day-in-the-life of each team member is full of a variety of crucial checklist items to cross off – all supporting constant communication from patients to providers. On the surgery scheduling front, these team members are resource rockstars. From working with referring providers to get patients scheduled appropriately to ensuring rooms and equipment are available for every patient, this team makes sure everything and everyone is in place when the time comes to help create a successful procedure and the best possible patient experience. “In surgery scheduling, we handle inbound calls for the outside offices to get time scheduled for each patient in the operating room (OR),” said Lydia Sharkey, Senior Scheduler. “We make sure there are plenty of anesthesia resources and equipment for every surgery, including any important information that we need to schedule patients appropriately and adding all documents to the OR board. If we need to swap rooms or move patients around, we handle that process too.” Over on the IR/Cath scheduling side of things, this team is on the frontlines of patient communication. They are experts in helping patients navigate their procedure from start (seeing their provider and obtaining the proper referrals) to finish (the day of the procedure and post-procedure process). “My day is a little different than the hospital schedulers; our part of the team handles the outpatient aspect,” said Adrienne White, Senior Scheduler. “We are in constant contact with patients and the IR and Cath departments. We help them navigate their procedure, including what to expect during and after the procedure. We get them through the process as easily as possible and ease their minds, so they know what is going to happen every step of the way. It’s all about communication, communication, communication!” This department has a significant overarching role: make sure all documents and ancillary information is set up for all our clinical teams that help with surgeries and procedures. This critical work means that every process is followed, and no important details are left out. “No one wakes up and says, ‘I want to have surgery;” our team goes above and beyond to make sure every single detail is taken care of so that when patients arrive, everything is in place,” said Trisha White. “Our team works hard to ensure everything runs as efficiently as possible because we want to use our resources in the best way possible to serve our patients without delays. We make sure we receive all the orders, codes and insurance and that the teams that follow after us – including our pre-admit team and nurses – have all the information they need to do their job seamlessly." With all the work they accomplish daily – not to mention how they wholeheartedly support each other through it all – it’s no question that the entire team has a lot to be proud of. Besides helping make patient care possible, the team puts their departmental merger and the move to fully remote work at the top of the list. “We’re most proud of merging the surgery scheduling and procedure scheduling teams together and therefore more cohesive,” said Mary Gray, Senior Scheduler. “The merger has made our team blossom and be able to connect with and rely on one another even more. We aren’t afraid to speak up and say something. At the end of the day, we’re here to take care of the patient, but we also help each other out. Our morale has gone up, and everybody is happier. Even though we all work remotely, we are more connected and have a great work-life balance.” “Along with transitioning the two teams into one big team, the move to being fully remote was huge," added Patricia Cruz-Hernandez, Surgical RN Scheduling Coordinator. “We worked through all the glitches, and it was a seamless transition to move into a remote setting. What’s great is that it did not affect patients at all; everything still gets done exactly as it should.” No matter how busy the days may get, Renown’s surgery and procedure schedulers always remember one thing: they are incredibly grateful for their fellow team members. “We have a very efficient and hard-working team of women,” said Pam Chapa Valencia, Senior Scheduler. “I could not have handpicked better people for our team,” added Trisha White. “I feel so lucky to have the team that we have.” A Renown “Why” Our Surgery and Procedure Scheduling team members all have diverse stories to tell about their road to Renown and why they’ve stayed in the department for as long as they have. Whether they’ve been with us for two years or two decades, they all share the same strong calling to care for their community. “I always wanted to help people, and my grandma was a nurse,” said Pam Chapa Valencia, Senior Scheduler. “I loved hearing her stories, and it made me want to be involved in patient care.” “I have a caring nature, and a hospital nature seemed like the right fit – I've been here for 25 years,” added Mary Gray. Several of our schedulers recognized the influence Renown has within our community and the ability to grow professionally and personally, both of which were a driving factor in their decision to make our health system their long-term career. “I’m originally from southern California, and I moved here about eight years ago; my husband always talked so positively about Renown, especially with how big it is and how it has the only level II trauma center in northern Nevada, so my goal was always to get a job here,” said Lydia Sharkey. “It’s been a great environment to be a part of.” “I’ve been with Renown for 17 years, and I chose to come here because of the reputation of the services Renown provided and care they gave,” added Trisha White. “I also knew what opportunities there were for me professionally, and in doing so, we are taking care of our community. I’ve had the chance to grow within my own professional skills and leadership skillset.” A profound feeling of ‘home’ is a common theme among this department. These team members appreciate the sense of community Renown has, the strides we’ve made in expanding our reach and how our health system gives healthcare professionals who are new to the field a chance to succeed. “At the time, Renown was the only hospital that would train nurses, and as a brand-new nurse, I had no experience – Renown took a chance on me,” said Patricia Cruz-Hernandez. “I feel like this is home. Our health system is so community-based and people-first minded, keeping ‘mission over margin.’ We’re growing, we’re expanding, we’re everywhere!” “I was a part of a transition as the cardiology private practice I worked with became a Renown practice, and it was great,” added Adrienne White. “This transition enabled us to provide more services and better care to patients. I stay here because I see the leaps and bounds we’ve been able to make in terms of procedures, accessibility and patient experience.” As true advocates for both patients and each other, the team is proud to have found their niche – and the ultimate beneficiaries? Everyone undergoing a surgery or procedure at Renown. A Culture of Kindness and Gratitude When you meet the Surgery & Procedure Scheduling team, you are greeted with warm smiles and an enthusiastic “Nice to meet you!” You can’t help but smile back and feel the infectious kindness they exude. Renown operates with a People-First mindset, a vision that this department especially takes to heart. They emulate the exact definition of our “Collaboration” cultural commitment. “We’ve built very good relationships and rapport with the OR managers and board runners,” said Lydia Sharkey. “The communication that we have at all three locations is very solid.” “The OR leadership is always so willing to help out whenever they can, and the resources they’ve provided have been huge for us,” added Adrienne White. “All the teams that see the patients after us – especially the surgical pre-admit team and the case managers, are fantastic about collaborating with us and reaching out to solve any issues they may have,” added Trisha White. “We all work so well together, especially since we all impact patient care.” In any organization, strong and compassionate leadership is key to a thriving team. Luckily for our surgery and procedure schedulers, they have Trisha White on their side. They attribute a lot of their success to having a supportive leader who “gets it.” “Trisha has been a scheduler like us, so she completely understands when we’re having an issue, because she’s struggled with the same thing and knows where we are coming from,” said Mary Gray. “It makes us feel like we are not alone – I can always reach out to her, or any of my other coworkers, to ask questions and figure out a solution together.” Despite being a remote-only team that meets in-person only one or two times a month, this group never misses an opportunity to reconnect both online and offline. They frequently shout out their Culture Ambassadors, schedulers Pam Chapa Valencia and Roxanne Abundis, for their team’s high morale. “Even though we all primarily work remotely, our in-person days are some of my favorite days of the month,” said Trisha White. “We feel so uplifted, we laugh and we have fun. We love being with each other. Pam and Roxanne are our Culture Ambassadors, and they both have been amazing at planning fun things for our teams. They go above and beyond to make our team feel cohesive and included.” “Pam and Roxanne have been leaders in creating a fun environment and supportive culture for us,” added Lydia Sharkey. “Whether it’s creating care packages or making sure we all have a good time when we see each other in person, they deserve a lot of credit.” As this team excels in their roles and foster a culture rooted in kindness and gratitude, we can trust that Renown’s surgeries and procedures will continue to thrive, and patients will continue to benefit from their diligent efforts and commitment to efficiency. “We make the magic happen!” closes Mary Gray.
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The Unmatched Health Benefits of Snowshoeing
Snowshoeing is an excellent winter workout that can help burn calories, strengthen muscles and boost cardiovascular health. Explore the top 8 snowshoeing spots and experience this ultimate workout adventure! Significant Health Benefits: Exceptional cardiovascular workout – burn up to 1,000 calories per hour! Low-impact muscle building Endurance building Balance strengthening and agility Improves your sense of well-being by connecting to nature Prepping for Your Adventure There are some crucial details to think about when it comes to snowshoeing, especially if you are a beginner. Make sure to pick the right kind of footwear to go on top of your snowshoes; a pair of comfortable waterproof boots are a great choice and remember to wear lots of layers. Several local places rent snowshoes if you aren’t sure about spending money on a pair. Check out Bobos Ski and Board Patio or our local REI Co-Op. Check out REI’s Beginner’s Guide to Snowshoeing for reference. 8 Cool Snowshoeing Spots 1. Galena Creek Park Close to Reno, this beautiful, low-altitude park offers several trails. You’ll find various creeks and streams under cover of pristine ponderosa pines. From beginner to advanced, the differing trail systems provide a challenge for everyone! Head west on State Route 431 (Mt. Rose Highway) for about seven miles until you see the park sign on the right side of the highway. 2. Tahoe Meadows – Chickadee Ridge This local favorite not only gives fantastic views of Lake Tahoe but the best part? – friendly little chickadees will eat seeds right out of your hand! Be sure to pack plenty of sunflower birdseed, as that seems to be their favorite. From the trailhead parking lot, head southeast into the open meadow. Then follow the ridgeline to your right (southwest). Continue southwest up toward the top of the ridgeline to the west, and you’ll get to Chickadee Ridge in just under two miles. 3. Spooner Lake Trail The easy 2.5-mile loop around Spooner Lake is excellent for all skill levels. This alpine lake is surrounded by aspen trees which house varied bird species, so bring your binoculars! Dogs are allowed on a leash, and all-day parking is $10. 4. Kirkwood Ski Resort You’ll need a trail pass, but this South Lake Tahoe resort has various routes from beginner to advanced, with roughly 50 miles of terrain. Nighttime snowshoe treks during the full moon are also available throughout the winter. Kirkwood is located on Highway 88, close to Carson Pass. 5. Camp Richardson Heading north, you can find this well-established and favorite local snowshoeing spot. If you’re up for an adventure, you can trek up to Fallen Leaf Lake. It’s located off Highway 89 and near Fallen Leaf Road. 6. Dry Pond Loop This moderate, 6.5-mile loop near Washoe Valley has impressive views of Carson Valley, Washoe Lake, and the Mt. Rose Wilderness. If you like the sound of rushing water, most of the trail meanders along White’s Creek. This area is dog-friendly and kid-friendly, which makes it a family favorite. 7. Royal Gorge Soda Springs is home to this resort, which is well known for its cross-country skiing trails. Enjoy extensive trails leading deep into the trees with spectacular views. Find Royal Gorge from the Soda Springs exit on West Interstate 80. 8. Ash Canyon Creek Tucked away in the Carson Valley, these trails are filled with mountain bikes in the spring and provide excellent snowshoeing trails in the winter. Find it from Interstate 580 by taking the Highway 395 Business exit to Winnie Lane.
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Eight Lessons from an MD-PhD Candidate at UNR Med
Meet newly minted Dr. Majid Khan, PhD., a native of Reno, and current MD-PhD candidate and first-generation medical student at the University of Nevada, Reno School of Medicine, who is on his way to a career as a Neurosurgery. While most graduate students often choose between pursuing a medical degree (MD) or a doctorate in philosophy (PhD), Majid has boldly picked both. He is one of three medical students currently in the UNR Med MD-PhD Program run by Dr. Caroline Cobine, PhD and Dr. Violeta Mutafova-Yambolieva, MD, PhD. "Research is not merely an act of sitting at a computer and reading papers – it's about answering the thought-provoking questions about things we come across on a daily basis. By critically evaluating these ideas we can implement solutions to enhance various aspects of the medical field and patient care with an overall goal of improving patient outcomes," Majid said. Majid recognizes that modern research extends beyond academia and holds significant value for hospitals. “Research contributes to improving patient outcomes. By reviewing the data from peer-reviewed research studies, medical professionals can be better prepared to deliver effective care following the most up-to-date guidelines and data,” he said. Majid's journey to pursuing his MD-PhD with a goal of becoming a physician-scientist-surgeon began following a summer in the PathMaker Cancer Research Program at the Huntsman Cancer Institute at the University of Utah. "It was by fate that I stumbled into this field – ever since I saw my first brain surgery, I haven’t been able to look back," Majid said. Here are some of the valuable lessons that Majid has learned along the way. 1. Beyond the 9 to 5, Embrace both 5 to 9s To avoid burnout and nurture personal passions, make your time spent outside of work and school intentional. Harness any free time to reconnect with friends, pursue hobbies and engage with mentors and mentees. 2. Collaboration is Key Work collectively with colleagues locally, nationwide and even worldwide. Cultivate environments to share knowledge and innovation, as well as wisdom, which will evidently lead to more impactful outcomes. 3. Shine a Spotlight on Your Colleagues Acknowledge and celebrate your colleagues in group settings when you notice something outstanding that they’ve said or done – it could anything big or small. Shining the spotlight onto those who are making positive changes within the hospital can inspire a beautiful culture of academic healthcare, which ultimately improves patient outcomes. 4. Redefine Mentorship Mentorship does not need to be confined to traditional frameworks. Seek out guidance in unexpected and untraditional places; sometimes, the most enlightening lessons and opportunities emerge from the most unlikely sources. 5. Diversify Your Experiences Embracing a diverse range of experiences enriches one's medical acumen. You never know when a seemingly unrelated job or experience will help in a scenario in your career. 6. Live By the Mamba Mentality Follow the late Kobe Bryant’s approach to life and work, the Mamba Mentality. This includes planning long-term goals, placing meaning in everything, striving for constant personal growth, following your passions and focusing on the process rather than the end goal. 7. Make Time for Your Loved Ones Don’t forget who helped you get to where you are in your life, specifically your family, friends, teachers and mentors. By making time for the most important and loving people in your life, you will be surrounded by positivity which will help propel you to new heights. 8. Plan your Next Five Moves We all have the ability to come from nothing and become something. Take the time to plan out everything and execute your moves with careful precision. Majid has plans to return to the Biggest Little City after completing Neurological Surgery Residency Program. If you would like to get in touch with Majid, please reach out to him via email at majidk@med.unr.edu.
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Clinical Research: Advancing Healthcare in Northern Nevada One Study at a Time
Did you know that the Renown Research Office has partnered with the University of Nevada, Reno School of Medicine Clinical Research Office to form the Integrated Clinical Research Office? This means we are able to provide more clinical research opportunities and expertise to our northern Nevada community than ever before. Over the past two years, we have significantly expanded our clinical trial offerings from 35 to 101 studies to meet the healthcare needs of our community members and keep care options local. Currently, we offer clinical research as a care opportunity in areas such as cardiology, pulmonology, endocrinology, oncology, pediatrics, neurology and immunizations. What is Clinical Research? Clinical research is simply medical research that involves human volunteers (participants). Research studies have to be reviewed and approved by ethics committees to ensure that the questions researchers want to answer are appropriate and that research participants are protected throughout the study. Often when we talk about clinical research, we are referring to a clinical trial. Clinical trials are a type of clinical research study that places research participants into groups to study the safety and effectiveness of new medications and devices on a specific health outcome. Clinical trials follow rigorous standards and must pass four phases of testing, where each phase works progressively to understand the correct dosing and effects in larger and more diverse groups of people. Why is Clinical Research Important? Did you know that all medications, diagnostic tests and medical devices prescribed and used today by physicians and health practitioners were once tested in clinical trials? Clinical research advances medical care by helping us understand how to prevent disease and to provide new and better treatments for a wide range of health conditions. At Renown Health, we know the importance of offering the latest opportunities in healthcare, especially when standard of care options have been exhausted. What Are Some Considerations for Participating in Clinical Research? Research volunteers are often drawn to participating in studies because they are interested in accessing the latest health care treatments and/or they want to contribute to scientific discovery. If you are interested in becoming a research volunteer, you should first make sure you fully understand what the study and researcher is asking you to do and consider whether you are comfortable with the study activities and commitments to time and travel such as for required study appointments. Remember, participating in a research study is completely voluntary. That means you choose whether to participate, and you can choose to stop participating in a research study at any time, for any reason. Where Can I Find More Information About Clinical Research? There are many resources you can access if you have questions or want to learn more about clinical research. Your healthcare provider can assist you in your healthcare journey by discussing care options and exploring if participating in a clinical trial may be right for you. The Nevada Division of Public and Behavioral Health recently launched their Clinical Trials Info for Nevadans webpage which provides information on finding clinical trials in Nevada, understanding the importance of diversity in clinical trials, and linked resources to learn more about clinical trials. The U.S. Department of Health and Human Services Office for Human Research Protections provides informational videos, questions to ask researchers prior to participating and information on regulations in place to protect research participants. Finally, at the Renown Research Office, we are always here to support your clinical research journey and can be reached at Renown-CRD@renown.org or 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.
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Strategies for Lasting Weight Loss
Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise Anti-obesity medications Weight loss surgery
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Celebrating Blood Sugar Balance This Holiday Season
As the holiday season draws near, we find more reasons to celebrate with loved ones. At Renown Health, we are kicking off the celebrations early this November with American Diabetes Month. Approximately 37 million Americans, including 270,000 Nevadans, have been diagnosed with diabetes with as many as 95% of those diagnosed living with type 2 diabetes mellitus (T2DM). What is Type 2 Diabetes? Type 2 diabetes is a chronic health condition that occurs because your body is not using insulin (a hormone made by the pancreas to help cells use the food we eat for energy) as well as it should, resulting in high blood sugar levels. It is important to obtain a diagnosis for T2DM and ensure it is well-controlled to prevent serious health complications. Those with diabetes are at higher risk for blindness, kidney failure, heart disease, stroke and amputation. Tips for Supporting Your Health with Type 2 Diabetes Know Your Blood Sugar Levels: Work with your healthcare provider to establish target blood sugar levels, and make sure to monitor your levels regularly as advised by your healthcare provider to prevent or delay health complications associated with T2DM. Focus on Your Plate: Eating foods such as fruits and vegetables, lean meats or plant-based proteins, healthy fats and whole grains supports diabetes management. If choosing healthy foods is difficult due to your busy schedule, cost or simply because you aren’t sure where to start, talk with your healthcare provider who may refer you to a registered dietitian. Registered dietitian nutritionists are certified nutrition specialists who can provide education and practical tips for eating to support your T2DM diagnosis with visits covered by many insurance plans. Prioritize Staying Active: Engaging in regular exercise is good for everyone, especially those living with T2DM. Exercise helps your cells become more sensitive to insulin and therefore supports healthy blood sugar levels. Always check with your healthcare provider prior to beginning a new exercise plan. Support Stress Reduction: Stress is unavoidable but can be managed through regular exercise, getting enough quality sleep (7-8 uninterrupted hours per night) and practicing meditation and other mindfulness techniques. Plan Ahead for Holiday Gatherings: There’s still room for celebration while focusing on blood sugar management. Consider bringing a healthy dish to your gathering, focus on filling your plate with vegetable sides and eating those first and incorporate a family walk after dinner. If traveling, pack nutritious snacks that support your health and keep you full. Lastly, enjoy the special dishes and desserts this season has to offer in single-serving portions.
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Patty Warren A Woman of Strength and Resilience
Meet and get to know Patty Warren, our featured Sterling Silver Club member this fall. You may recognize her from the latest Senior Care Plus commercial on television, where she joins a coffee chat discussing the many benefits of being a Senior Care Plus member. She’s one of the kindest souls you’ll ever meet – and has a positive outlook on life that we should all strive for. Patty's Story Patty was born and raised in a small Kansas town called Baxter Springs, where she grew up with an older brother, an older sister and two younger sisters. She and her siblings all enjoyed playing sports like softball and basketball, in addition to playing instruments. Patty developed a love and passion for music at a young age that carried into her adulthood. “I wanted to be an opera singer,” said Patty. “I decided to go to college at Pittsburg State University in Kansas where I majored in vocal performance.” After college, Patty moved to Manhattan in New York City to audition to be an opera singer, but she soon realized it wasn’t what she wanted to do after all. She eventually decided to work in the brokerage industry. After living and working in New York for three years, Patty moved back to Kansas where she later met the love of her life, Michael. “In 1992, I had put a dating ad in the local newspaper,” said Patty. “I received over 30 responses, and I went out on quite a few dates.” Then she had her first date with Michael, and the two of them quickly realized how much they liked each other. He asked her to marry him on Valentine’s Day in 1993, and they went on to get married in front of the Justice of the Peace on May 3, just a few months later. “We had a small wedding so that we could move into our first home together,” said Patty. A few years later in 1999, Patty and Michael moved to Arizona, where they lived for 22 years. Patty worked at Edward Jones Investments for 18 of those 22 years and loved her job and the people that she worked with. She retired in January 2021 during the pandemic, and three days later she and Michael moved to Sparks, Nevada.
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Understanding and Managing Childhood Asthma
Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."
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Sepsis: Causes & Symptoms
According to the Global Sepsis Alliance, 1 in 5 deaths worldwide are associated with sepsis. If not recognized early and treated promptly, sepsis is the final common pathway to death from most infectious diseases worldwide, including viruses such as COVID-19. We spoke with Jeremy Gonda, MD, a critical care physician from Renown Health’s Sepsis Committee to increase public awareness of this preventable medical emergency. What is sepsis? Sepsis is a response to infection—bacterial, viral or fungal—and can start anywhere in the body and spread into the bloodstream. The body is trying so hard to fight an infection that it begins releasing chemicals into the bloodstream that cause inflammation and the shutdown of multiple organ systems. “It carries a very poor prognosis in general unless you catch and treat it very early,” said Dr. Gonda. “Any infection can lead to sepsis. Typically your immune system takes care of the infection. It doesn’t progress, but in cases where the infection becomes severe, or the immune system doesn’t function properly, people can certainly die. So there’s, unfortunately, a very high mortality rate associated with sepsis.” According to the Centers for Disease Control and Prevention, each year at least 1.7 million adults in America develop sepsis. While you can recover from sepsis if caught early, many sepsis survivors suffer from long-term physical and psychological effects. What are the signs of sepsis? One way to spot sepsis is to use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die” S – Skin mottled or discolored Keep in mind that sepsis symptoms can vary depending on where the infection starts. “Patients may experience urinary burning if they have a urinary tract infection or a cough and shortness of breath if they have pneumonia first,” said Dr. Gonda. “However, often symptoms are more generalized or subtle such as fevers, confusion and malaise.” How do you develop sepsis? When germs enter your body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Areas of infection that more commonly result in sepsis include: Lungs, such as pneumonia Kidney, bladder and other parts of the urinary system Digestive system Bloodstream (bacteremia) Catheter sites Wounds or burns Who is most at risk? People with compromised immune systems are at greater risk for sepsis, such as “The very young, the elderly and any people who may have conditions that suppress your immune system,” said Dr. Gonda. “For instance, if you have diabetes or if you’re an organ transplant patient who is on immunosuppressant therapy, you’re at somewhat higher risk.” Sepsis is often considered a hospital-acquired infection, but a study in The Journal of American Medical Association found that 80% of sepsis cases occur outside of a hospital. That’s why it’s especially important to remember any infection can lead to sepsis, and anyone can develop sepsis from an infection. What do I do? Timing is critical in the case of sepsis and septic shock. According to a study on septic shock patients, there is a 7.6 percent decrease in survival for each hour treatment is delayed. On the other end, if treatment is given within an hour of the first drop in blood pressure, the survival rate is 80 percent. Because sepsis can be so deadly, it’s important to seek medical attention as soon as possible. “If you’re not getting any better, if you think symptoms are progressively worsening – you should definitely be evaluated by a doctor,” said Dr. Gonda. You can help #StopSepsis by getting involved at worldsepsisday.org.
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Managing Your Uncontrolled High Blood Pressure
Renown Health, the region's leading cardiology care provider, is offering a clinical trial for eligible patients struggling to control their high blood pressure. Nearly half of adults (119.9 million) in the United States have hypertension, or blood pressure that is higher than normal. Hypertension can put you at risk of other life-threatening disease, such as a heart attack or stroke. There are methods that cardiologists use to manage high blood pressure, but only 1 in 4 adults with hypertension (27.0 million) have their blood pressure under control.* Some patients with high blood pressure experience resistant hypertension, which does not respond well to multiple antihypertensive medications given at the same time. This means that there are many important opportunities for healthcare professionals to explore new ways to treat hypertension. At Renown Health, we lead the region in cardiology care with our technological expertise and patient-centered approach. That is why our cardiology team is partnering with the Renown Research Office to offer the RADIANCE Continued Access Protocol (RADIENCE CAP) clinical trial to eligible patients. RADIANCE CAP is a non-randomized study designed to allow for continued access to ultrasound renal denervation therapy via the Paradise System, and to allow for the on-going collection of safety and effectiveness data in patients with uncontrolled hypertension despite the prescription of antihypertensive medications. The body’s complex communication system between the brain, heart and kidneys can sometimes become overactive, increasing your blood pressure through messages in the nervous system. Renal denervation is a minimally-invasive procedure which reduces activity from the nerves in your kidneys to lower blood pressure. This is the third in a series of renal denervation clinical trials Renown Health has offered to patients with resistant hypertension over the last several years, with over 40 local participants. “All the participants that I have had the pleasure to work with on these studies are very excited and grateful to have this option for helping control their blood pressure” states Lisa English, Lead Clinical Research Coordinator for Cardiology studies at Renown Health. “I love getting to know each one of them and helping on their healthcare journey. We have an amazing team of providers and staff at Renown that go out of their way to make patients experiences positive and the studies successful.” Dr. Michael Bloch, Cardiologist and Principal Investigator for the RADIANCE CAP study at Renown Health’s Institute for Heart and Vascular Health adds, “Despite lifestyle modifications like diet and exercise and the widespread availability of effective and well-tolerated medications, approximately 50% of all people with hypertension have inadequate blood pressure control putting them at risk for stroke, heart failure and kidney disease. As a one-time durable procedure, renal denervation with the Paradise endovascular system from ReCor Medical, Inc. may help millions of patients improve their blood pressure control without necessarily needing to increase their medications.” Our teams of expert providers and researchers are here to support you on your healthcare journey. Talk to your provider about the RADIANCE CAP clinical trial at your next appointment to see if participation may be right for you.
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Department Spotlight Clinical Research
May 20 is National Clinical Trials Day. Celebrate with us by recognizing the Clinical Research team at Renown Health! The root of every medication, treatment and procedure in healthcare can be traced back to research. From the beginning of the history of medicine, research has always played a crucial role in improving the lives of patients around the world, leaving a permanent mark on how we expand our medical capabilities to this day. Renown Health’s Clinical Research team, in partnership with the University of Nevada, Reno School of Medicine (UNR Med), are leading that effort in our very own community. As our in-house leaders of clinical trials, this team is dedicated to advancing the science of medicine to help further our bottom line of making a genuine difference in the health and well-being of the patients they serve. Trial by (Medical) Jury Every day looks different for the Clinical Research team, especially when it comes to interacting with patients, providers and “sponsors,” which are the organizations providing the treatment for the study. One fact always remains true: communication and collaboration are key, especially among the team who act as the face of this process. Meet Lisa English (pictured above on the far right in a blue shirt), a Lead Clinical Research Coordinator at Renown who serves as the study "project manager." One aspect of Lisa’s day-to-day is seeing patients through their clinical trials from start to finish. It all begins with the setup. “Before we can launch a study, there is a lot of back-and-forth dialogue between everyone involved to ensure the best fit,” said Lisa. “Sponsors will come to us with novel treatments, such as medications or devices, and the inclusion criteria that patients need to meet in order to qualify for the study. We then immediately jump into working with the providers, looking closely at the science and comparing the treatments to what is on the market already.” From there, Lisa coordinates conversations between the providers, sponsors and study teams to gauge everyone’s capacity based on the length of the study, ensuring everyone involved has the time to dedicate to the process. Next, the providers identify patients that meet the criteria for the study, and together, the team decides where the patient visits will happen and discusses any potential barriers that may affect patient retention. The budget is clearly defined at this stage, set up to make sure no patient is ever billed for medical costs incurred as a result of the study. Often, research participants are seen within the specialty clinics throughout the health system, while other times the Clinical Research Coordinators see patients at the recently centralized Clinical Research Office at Renown Regional Medical Center. This location provides an essential public-facing space for the community to learn more about clinical trials and demonstrates the breadth of resources available at Renown to sponsors to strengthen external partnerships and research funding opportunities. Once the study officially begins, team members like Lisa will set patients up for a “screening/qualifying visit.” During this appointment, she makes sure patients get scheduled for their lab work, imaging scans and anything else the provider may need to make an executive decision on whether or not the patient is a good candidate for the study. “I build it all in Epic,” said Lisa. “The study information, directions, requirements and next steps are all loaded in Epic for easy tracking. We are also required to input any notes in the sponsor’s electronic data capture website. All the information I track is inputted without protected health information (PHI), so every patient is completely anonymous.” After the patient officially qualifies, the study goes full steam ahead. Team members like Lisa and the providers receive continual updates from sponsors on the status of the study. “Throughout the entire process, I make sure patients get scheduled for everything that meets the requirements for the study,” said Lisa. “I meet with patients one-on-one to discuss their needs and concerns and ask questions about the study, organize their appointments and charts and deal with any issues or pivots that may arise. It’s very important that every patient fully understands what is going to happen with their care.” The Clinical Research department strives to serve as a care partner to patients, providers and clinics they work with. The majority of our Clinical Research Coordinators are trained phlebotomists and medical assistants, performing their own assessments such as lab draws and electrocardiograms (ECGs) to streamline the research visit process and reduce resource constraints on the clinics and health system. Lisa typically sees a couple of patients per week, depending on the study and where patients are in the cycle. Depending on the complexity of the trial, patients may see the research team only one time or several times over many years. Typically, clinical trial patients are seen in clinic every 2-4 weeks. There are many tasks required before, during and after a research visit to ensure everything runs smoothly, so Clinical Research Coordinators dedicate an average of 5-11 hours of work per patient, per visit. Regardless of patient load, each employee in the Clinical Research department – as well as participating teams across Renown and UNR Med – always step in to help each other out. According to Lisa, the environment is immensely supportive. “We have a program here at Renown to train employees who have never done clinical trials,” said Lisa. “We love seeing people get more engaged with the important work we do, and every department has been great at collaborating with us. Everyone brings a different perspective.” At the end of the study, Lisa gathers all the information and collects notes into a zip drive or paper binder for archiving. The sponsor lets the Clinical Research team, providers and patients know whether they are on the trial drug or on the placebo. The teams use the data gathered during the study to publish a report or present at conferences, promoting the critical research done to better the lives of patients in our community, and potentially, the world. “I appreciate the time everyone gives us to make sure our research is successful,” said Lisa. “It feels great to work together to make a difference, improve healthcare quality and save lives.” Behind-the-Scenes, Yet on the Frontlines The impact of research studies transcends hospital walls, and this can all be attributed to the dedication of our Clinical Research department. The constant collaboration between this team, lab science, medical assistants and providers, cardiology technologists, sonographers, finance teams and our partners at UNR Med is crucial to safeguarding the success of the studies. Devoted to keeping research close to home, Renown and UNR Med teamed up to form the Clinical Research Office (CRO) in 2021. With the strength of northern Nevada's largest not-for-profit health system and Nevada’s first medical school, this team is dedicated to giving our community access to the latest care innovations. “At UNR Med, we are working with students, residents and academic faculty; on the Renown side, we are working with clinicians and community participants,” said Amber Emerson, Manager for Community Outreach and Research Engagement for UNR Med. “Everything we do is data-driven,” added Kristen Gurnea, Manager of Clinical Research for Renown. “Our main goal is to optimize our impact and provide a community benefit for our patients. The scope of our roles in the Clinical Research office is very diverse.” To help meet the growing need locally for healthcare and cutting-edge treatment solutions, the CRO has continued to grow, expanding its research capabilities and helping bring new medications, medical devices and more to patients across northern Nevada and northeastern California. “Once upon a time, our team had only six members; today we have grown to a team of 25,” added Diana Torres, Research Resource Analyst for Renown. “We used to be considered one department, including Medical Education, and we have since branched off into our own cost center. We branched off even further and created a separate Genetics department that runs the Healthy Nevada Project. Throughout this process, the Clinical Research department was always the main point of the umbrella.” “We participate in hospital-wide outreach and marketing, and we feel this has really helped us get the word out about our department,” added Raul Arellano, Research Resource Analyst for Renown. “In fact, we doubled our clinical trial portfolio from last year.” The CRO currently operates over 100 clinical trials locally in cardiology, endocrinology, infectious disease, neurology, pediatric and adult oncology, pediatric sub-specialties and pulmonology. Behind the curtains of in-person research, the CRO is home to several experts who help turn our research studies into a reality, from budgeting and billing to barrier-breaking and building relationships. “I help with barriers patients and Clinical Research Coordinators are facing, building connections and relationships inside and outside of our health system,” said Kristen Gurnea. “I enjoy handling all the supporting pieces that are required for studies to happen.” “My role changes every day,” added Jenna Berger, Administrative Assistant for the CRO at Renown. “Some days, I’ll be helping coordinate patient stipends and going through document management to ensure we have all necessary signatures. Other days, I will be planning events – like Clinical Trials Week – for our department and creating marketing materials and fliers.” “Our day-to-day involves going over anything related to research financials,” added Diana Torres. “We handle sponsor billings, process efficiency and collecting revenue for research contracts, and we collaborate closely with our Finance department and Revenue Integrity in order to accomplish this. It’s important for us to make sure all billing on both the sponsor and patient side is taken care of, especially because patients should never receive a bill for medical services they receive for the trial. A year and a half ago, we started doing budget negotiations for research contracts,” said Diana Torres. “We are proud to help clinical teams with any training they may need on these negotiations as well as billing reviews and allocations.” Seeing patients progress during a study and transform before their eyes inspires the CRO team to continue doing what they do every day. “I’ve been here for many years, first working on the floor as an oncology nurse and transitioning to oncology research in 2005,” said Anna Winchell, Cancer Protocol Nurse for Renown. “I love getting to know the patients and seeing them progress into a healthy lifestyle.” Medical students and residents at UNR Med also play a significant role in the research process, advancing medicine by exploring causes and novel treatments for a wide range of conditions, including HIV, muscular dystrophy, gastrointestinal disorders, infectious diseases and more. Medical research at UNR Med is headed by committed research coordinators, community outreach managers, grants managers, pharmacists and physicians. “I oversee scientific review and help the physicians that come to us for those resources,” said Amil Trujillo-King, Medical Research Coordinator at UNR Med. “I guide medical students in their research protocols and help with different projects to improve research activities for both students and medical residents.” It takes a village to make clinical research happen. Because of that, the ACRO cannot thank the following teams enough for moving mountains for the future of medicine: Renown Health and UNR Med leadership for demonstrating the integrated health system’s commitment to expanding access to clinical research in our community within both the Renown / UNR Med affiliation and Renown active strategic plans. Renown Pharmacy especially Research Clinical Pharmacist Tim Morton, who supports all clinical trial medication dispensing and patient education across all clinical trials at Renown. Accounts Payable for having a huge impact on patient and employee reimbursement. Renown Medical Group for their participating providers, especially in oncology, cardiology, pulmonology, pediatrics, endocrinology and neurology, who are involved in research year after year. Marketing and Communications for helping with printed materials and raising awareness for clinical research at Renown and UNR Med. An Affiliation to Last Through the Ages A collective, shared vision of exploring community health – that is the impetus behind the affiliation between Renown and UNR Med. By leveraging resources across both institutions, the CRO has maximized their impact, giving the people of northern Nevada greater access to new interventions and treatments and promoting an impassioned culture with patients, providers, residents and medical students. “Community-based research always sat well with me,” said Amber Emerson. “As Renown and UNR Med, we have this unique opportunity to shape clinical research here in northern Nevada. We always make sure we present research in a meaningful way that speaks to the work we produce and demonstrates the opportunities we offer. After all, participating in clinical research doesn’t mean our patients are ‘guinea pigs’ – quite the opposite! They are partners in their health care, and we support them through providing access to novel treatments.” “Research is my passion, and my career has spanned broadly from grants administration to study coordination,” added Valerie Smith, Clinical Research Center Administrative Manager at UNR Med. “I am excited to be at the forefront of research frontiers in northern Nevada.” Through robust engagement and collaboration with healthcare providers, department administrators, internal research team members and leadership, the strength of this affiliation is unmeasurable. The CRO’s ultimate goal is to have clinical trials be the standard of care for every condition that Renown and UNR Med treats. Clinical research participation is all about patient autonomy, shared decision-making between patients and their providers and advancing medicine to save lives. From their beginnings as a small group of passionate researchers to their present reality as a leader in the research space in northern Nevada, their efforts do not go unnoticed. “The success of our department is inspiring,” said Amil Trujillo-King. “Renown and UNR Med supports the wellbeing of all employees and contributes directly to the growth of the department.” “When I first joined Renown in Patient Access, I didn’t realize that we had a research department; with a strong healthcare background in my family, I knew I wanted to grow in my career, and our expanding Clinical Research office was that next step,” said Raul Arellano. “With our affiliation with UNR Med, it’s especially inspiring to be able to apply what I learned as a Patient Access Representative to help further outcomes for our patients through managing our finances.” Through their unwavering commitment to research excellence and patient-centered care, the CRO will continue to pave the way for groundbreaking medical discoveries and improved outcomes for patients for years to come. “Fundamentally, we’re working to build a culture of research in our community because we believe it is the right thing to do. Our community deserves to have access to clinical trials and novel care close to home with a dedicated team to support them every step of the way,” closes Kristen Gurnea.
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Senior Care Plus Loves Pickleball
Senior Care Plus is pleased to announce we are now a proud sponsor of Jam On It Pickleball, open to the community seven days a week at the Reno Sparks Convention Center. We’re excited to help promote this fun activity to our members, employees and the public. Pickleball has many wonderful health benefits – particularly for seniors. It’s a low-impact game that raises the heart rate, improves hand-eye coordination and increases mobility. In addition to the obvious physical benefits, pickleball is a great social activity. Getting out of the house and playing a fun, easy-to-learn game with others is a great way to make new friends while improving your physical and mental health! Ralph Barbato, a Senior Care Plus member from Reno, is a huge fan of pickleball and all it has to offer. “Pickleball has made such a positive impact on my life. I love the physical and mental health benefits along with the social aspect – it’s a great way to meet new people and I’m excited to have it in our community,” said Ralph.