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In the United States, electronic cigarettes are the most popular form of tobacco product used among high school students. Approximately 21% of Washoe County area high schoolers report current use of e-cigarettes, higher than the national average of 14% reported in the most recent national data. While often viewed as a safer alternative to traditional cigarette use, e-cigarette use, commonly referred to as vaping, exposes users to nicotine and harmful chemicals that stunt brain development, results in lung damage and harms overall health. In partnership with Reno area school principals and nurses, the Renown Health – UNR Med Clinical Research Office was able to provide this year’s World Lung Day Anti-Vaping Program to Galena High School, Robert McQueen High School and Sage Ridge School, reaching hundreds of high school students.

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In this article reprinted with permission from the Galena Times,  Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’  There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens.   The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states.    What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.

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At Renown Health, our commitment to the experience of all our patients and guests is not just a mission – it's a way of life. Our unwavering dedication to creating exceptional experiences for the communities we serve is what sets us apart. Every day, we strive to build a service culture of excellence, one that ensures that every person who walks through our doors has an extraordinary encounter that exceeds their expectations.  Renown’s Patient Experience department is the team that fulfills this mission and more. These passionate individuals intimately understand that top-of-the-line service involves the entire healthcare continuum, from the first phone call when scheduling an appointment to the final discharge and follow-up instructions and everything in between. With this collective dedication, Patient Experience is consistently on a journey to redefine what it means to leave a lasting impact in the minds of patients, setting a new standard for healthcare excellence in our community.  Our In-House Jack-of-All-Trades  It takes a village to ensure every patient and guest continues to have a positive experience at every Renown location and maintains trust in our providers and employees. Our Patient Experience team serves as the mayors of that village, encompassing four main aspects of healthcare service:  Service Excellence: Compiles, reviews and resolves patient complaints and concerns to help with service recovery and identify opportunities for improvement. Volunteer Services: Enhances the patient experience by leveraging dedicated youth, adult and college-aged volunteers in a variety of volunteer programs, including pet therapy, healing arts, hospice and more. Language Access: Provides qualified interpretation and translation services to assist our limited- or non-English-speaking populations. Data Management: Uses patient experience data, research and surveys to prioritize system, location and unit-specific service needs to improve clinical and quality outcomes.  “Because our department has many segments, no day is the same, which keeps the work week exciting,” said Shelbi Whitehead, Manager of Patient Experience. “Whether we are hosting a pet therapy parade for patients, de-escalating and rounding with upset patients to provide service recovery, offering interpretations for our Limited English Proficiency (LEP) patients, or managing data for the organization, we have one goal in mind: to enhance the experience for our patients and guests at Renown Health.”   Cultivating a sense of community and fostering trust in our health system, the Service Excellence team steps in to ensure no concern goes unnoticed and every opportunity to make a positive chance is addressed.  “My day consists of listening to patient concerns, connecting with different department leaders and providing support, and working on projects to improve processes,” said Julianne Revilla, Customer Experience Specialist. “To help enhance the patient experience, I round with patients on different floors to know more about their stay and experience with us. If they have any issues or concerns, I let floor staff know and do our best to resolve the issue in the moment.”  “My team and I have an amazing opportunity to work with multiple leaders throughout the organization to resolve any patient concerns and provide valuable feedback on how patients are doing while using services that we offer,” added Ricky Garcia Sanchez, Senior Patient Experience Specialist. “A typical day will involve calling patients, rounding with patients, communicating with leaders to resolve events, handling grievances and staying in compliance with Centers for Medicare and Medicaid Services (CMS) guidelines.”  “It’s all about hearing what is upsetting them and letting them know that we care about them,” added Shay Morgan, Customer Experience Specialist. “We ask ourselves, what is the main concern the patient has, and what is it they are seeking? From there, we do our internal investigation through Midas and send it to leadership, and then we find a reasonable and appropriate solution or response to let the patient know we are looking into their concern.”  As the only not-for-profit health system in the region, Renown depends on the dedicated service of our volunteers. Our Volunteer Services team deploys volunteers across many programs who make a significant difference in the lives of patients and their families.  “On a typical day, I may be going between the volunteer information desks assisting that team with anything that comes up while they are helping guests,” said Wendy Peukert, Volunteer Coordinator. “We find wheelchairs for departments, provide guest escorts, deliver flowers and mail to patients, locate doctors’ appointments or anything else that helps someone that walks in the door. We ensure all our programs go smoothly by planning ahead while also being flexible to be ready for anything that comes our way and by keeping communication open with our volunteers. Patients and guests being greeted by friendly, knowledgeable volunteers who show empathy and care is my goal!”  “Some of my best days at Renown are volunteering with my dog Moose, who is a certified therapy dog, and watching the healing he provides to patients and employees,” added Shelbi Whitehead.  At Renown, we believe that language should never be a barrier to receiving care. Our Language Access team ensures that this goal is realized through providing expert interpretation and translation services.  “Renown has many different resources we use to ensure LEP patients and visitors receive a positive, quality visit to our health system,” said Seth Rubin, Supervisor of Language Access. “With signage strategically placed at front desks and check-in areas, patients can point to their preferred language, and we can use the Language Line iPads, phone lines or a dual-role Qualified Medical Interpreter to communicate with the patient or visitor. Within EPIC, we can also set a patient’s preferred language indicating to Renown staff what language to use with the patient and prepare forms in that language. I always ensure all patients are provided with these proper language services, and I also help with employees taking our online interpreter certification course, as well as help when a department needs new Language Line equipment. Additionally, I enjoy meeting with community groups to stay informed on community updates, events and trends around language, immigration and more.”  Renown values and utilizes the opinions of our patients across all corners of our health system Maintaining service transparency is a promise, and that promise is fulfilled by our Data Management team, who use all the research and survey tools at their disposal.  “My daily work includes a lot of updating scorecards across the network, working with the tech teams to ensure the patient data is getting to the right places, training leaders, analyzing market data and maintaining the reports that go to every corner of Renown,” said Brooke Cyphers, Market Data Analyst. “Through a partnership with our patient satisfaction survey vendor, PRC, Renown ensures data integrity, neutrality and credibility in surveying patients in all our care areas. The data from completed surveys are compiled and disseminated to our providers and leadership at all levels with the goal of transparency and patient-centric practice. These surveys are incredibly important to process improvement directly targeted at addressing areas that have been mentioned by our patients. I love it when people reach out to dive into a particular initiative they want to track or an issue they want insights on.”  In their relentless pursuit of excellence in service across many programs, the Patient Experience team remains steadfast in their commitment to delivering the highest quality care and experiences.

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