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Immunizations save thousands of lives each year by preventing serious illnesses, hospitalizations, and deaths. They also protect those who can't be vaccinated, like young children and the elderly, through herd immunity. Dr. Vanessa Slots highlights the crucial role of vaccines. Immunizations Your Child Needs (and when) Birth to 6 Months Hepatitis B: Shortly after birth, first vaccine dose Diphtheria, Tetanus, and Pertussis (DTaP), Polio, Haemophilus Influenza (HiB), Pneumonia, Hepatitis B and Rotavirus: Ages 2, 4 and 6 months, boosters and vaccines One Year to 18 Months MMR and Varicella (chickenpox) vaccine: Age 1, first vaccine dose Hepatitis A, HiB and Pneumonia: Age 1, booster DTaP: 15 months, fourth vaccine dose Hepatitis, second dose: 18 months Flu Vaccine: 6 months and older, annually* *In the year after receiving their first dose, an infant will need a booster one month later. Four Years Old MMRV, DTaP and Polio, final dose: Four years of age Pre-Teen and Beyond Tdap and Meningitis: Before starting middle school, children receive these vaccines. They are also old enough to start the HPV vaccine, an essential vaccine for all young adults to protect against cancer, genital warts and cervical dysplasia.

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Northern Nevada's stunning lakes, including Lake Tahoe, with its average summer water temperature of 50 degrees, present a potential risk of hypothermia. Unlike mild 50-degree air, water at the same temperature poses severe, life-threatening risks, including rapid-onset hypothermia and drowning. Awareness of the symptoms and taking proper precautions are crucial to prevent cold-water drowning. The 4 Phases of Cold-Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

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Whether you're a parent, grandparent, caregiver, or sibling, it's vital to recognize that drowning is the second leading cause of death among children," states Dr. Leland Sullivan, of Northern Nevada Emergency Physicians. "While we diligently work to protect children from water-related accidents, there's a lesser-known threat that often goes unnoticed—dry drowning, also known as delayed drowning. Surprisingly, many people remain unaware of its existence and potential dangers. Dry drowning defined Dry drowning is a side-effect of a near-drowning experience and includes spasms of the vocal cords and larynx — known as a laryngospasm. This occurs when the body attempts to shut down the passage of any liquid into the lungs. Unfortunately, it can also shut down the passage of air into the lungs and force fluid into the stomach and lungs. Often the condition is not discovered until it's too late — severe cases can cause death within one to 24 hours after a water incident occurs. Who is susceptible? Novice or first-time swimmers are at increased risk, as are children with asthma and known breathing issues. In addition, children who have had pneumonia or experienced acute respiratory distress syndrome are also at greater risk. To reduce these factors, caregivers should be exceptionally watchful of inexperienced swimmers. According to Dr. Sullivan, children under the age of 5 are most susceptible to drowning and often drown in residential swimming pools. Infants less than 1-year-old most often drown in bathtubs. What are the signs of a dry drowning episode? If your child has a near-drowning incident, a few moments of coughing until they calm down is normal. However, you should know the more severe signs and symptoms to watch for during the 24 hours following the incident, including: Persistent coughing Difficulty breathing and/or shortness of breath Chest pains Extreme fatigue and/or lethargy Change in typical behavior Face becomes pale   What is the treatment and prognosis for dry drowning? Dr. Sullivan recommends that all victims of near-drowning incidents seek medical attention, even if they have no symptoms. If caught early, dry drowning can be treated. If you think your child is experiencing a dry drowning episode, go to the nearest emergency room as quickly as possible — do not attempt treatment at home. Healthcare professionals will work to supply oxygen to your child's lungs to restore and regulate breathing.

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Janelle Wood’s life has been filled with moves across several states, travel, different jobs, multiple hobbies and best of all – her big family. She is very close to and proud of her entire family, including her six children, six grandchildren and extended family members. New Chapters Janelle was born in 1950 in Fayetteville, Arkansas. She lived there her entire childhood and attended the University of Arkansas, Fayetteville where she received her Associate degree in Accounting. She then moved a few different times to various states including Louisiana and Arizona. In 1981, she and her family moved to Reno where she worked for a construction and mining supply company. In 1993, they relocated to a small town in southern Georgia called Thomasville, where Janelle worked for another mining and manufacturing company. “I was ready for a change of scenery and wanted to explore living in a new area,” said Janelle. “I was intrigued by moving to a smaller town to raise my children.” She and her family lived there for about 10 years when she eventually got transferred to Chicago for her job, to work at the company’s headquarters. “I was once again excited for another change and was happy to experience living in a big city,” said Janelle. “I loved my job and getting to travel as much as I did.” Janelle worked for the company in Chicago until 2014 when she decided to retire and move back to Reno to be closer to her son, daughter and grandchildren. Living to the Fullest Today, Janelle lives in Damonte Ranch in south Reno. She loves spending time outdoors, especially in the mountains and by the water. Her other hobbies include reading, cooking, doing puzzles, playing computer games antique shopping and something very unique – exploring old graveyards. “I love how they’re full of history and each one is different – I also enjoy reading what the headstones say, and the stories they tell,” said Janelle. “When I travel, I like to explore the old cemeteries that are nearby.” Janelle’s son even bought her a book called 129 Cemeteries to Visit Before You Die. She’s been to a few of them. As for traveling, Janelle’s favorite destination she’s been to is Catalina Island – she loves the history there. She also loves Chicago, Portland, Seattle, Canada and Mexico. “I’m always up for going someplace new,” said Janelle .  Janelle Wood hiking to Rainbow Falls in Mammoth, CA When Christmas rolls around, Janelle loves to decorate. Her family finds it interesting just how crazy about Christmas she is. “I have 31 totes of Christmas décor and a dozen large decorations,” said Janelle. “My entire storage room is full of Christmas decorations. I start decorating the day after Thanksgiving and it takes me about 2 to 3 days to put everything up.” Janelle said Halloween is her second favorite holiday, which she also loves to decorate for. Family Values Above all else, Janelle’s favorite thing about being retired is having so much free time to spend with her children and grandchildren who live here in Reno. “I love helping my grandkids with their schoolwork and attending their sports and activities,” said Janelle. She has been volunteering at her grandchildren’s schools here in Reno ever since her now 14-year-old grandson started kindergarten. “Family is the highlight of my life,” said Janelle. She also makes sure to stay in contact and visit as often as possible with all of her family that lives out of state, including three of her children, one of her grandkids and some of her extended family. “One of my great nieces, Madison Marsh, was recently crowned Miss America, and another one of my great nieces, Madeline Bohlman, will be competing this summer for the title of Miss USA, as the current Miss Arkansas USA,” said Janelle. “I’m very proud of both of them for using their platforms to further such important issues; pancreatic cancer research and mental health, respectively.”

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When an appliance or fixture stops working at home, who do you contact? If your lights stop working, you call an electrician. Is your air conditioning unit out of order? Reach out to an HVAC (heating, ventilation and air conditioning) technician. What about if your sewer drains start backing up? Time to contact a plumber. And if your fire safety equipment needs servicing? Better call a fire safety technician.  Regular maintenance and repairs on the inner workings of your household are always important, and when something goes wrong, it can be distressing and inconvenient to you and everyone living with you. You feel the need to get the issue resolved as quickly as possible, right?  Now imagine that those needs are magnified – to the tune of hundreds of thousands of people every year. Who could potentially take on such a monumental task? Enter: Facilities Engineering at Renown Health. Crucial to ensuring our health system performs at its peak, these team members step in to make sure every patient, team member and visitor who walks through any of our doors are able to access the facilities they need and make their time with us as comfortable – and as successful – as possible.   The Silent Heroes  As our care teams move heroic mountains to save lives, another set of heroes emerge behind-the-scenes. As a strong backbone of our health system, the Facilities Engineering department plays a key role in maintaining the infrastructure that supports patient care, from ensuring the HVAC systems are functioning optimally to maintaining the plumbing and electrical systems that keep the lights on and the equipment running smoothly.  Renown is fortunate to have some of the most dedicated journeymen in the business. This team boasts many experts, including:  Plumbers Fire Safety Technicians Craftsmen HVAC Journeymen Electricians Boiler Operators Facilities Technicians As one can imagine, every day brings on a new challenge for our Facilities team members.  “Each workday is always different; it could be water, power or HVAC issues or anything in between,” said Nhil Dado, Supervisor of Facilities Services. “We are proud of the services we provide for the needs of patients and employees.”  “Every day, we have a variety of equipment to work on,” added Alfred Santos, HVAC Journeyman.  “Whether it’s facility upkeep, plumbing, HVAC or electrical, we want to help,” added Brian McCarty, Facilities Technician.  This department works around the clock to ensure that every aspect of our hospitals and outpatient care locations meets the highest standards of safety and efficiency, from routine maintenance and equipment improvements to emergency repairs. These are huge responsibilities – all of which they perform with pride.  “As an HVAC journeyman, we are responsible for making sure the air circulating in the hospital is clean,” said Christopher Bobis, HVAC Journeyman. “It is also our job to make sure the air is positive and negative in isolation rooms and ensure patients are satisfied with the temperature in their rooms.”  “In addition to performing regular maintenance tasks like changing air and water filters, we complete any random work order that may come up,” added Brett Courtney, Facilities Technician. “We also recently switched out our lighting at Renown South Meadows to LED lights, which helps with energy savings.”  “I overlook the boiler house equipment and coordinate the fixing of maintenance issues reported by hospital staff,” added Arnt Utnes, Boiler Operator. “We also respond to every single alarm."  It’s difficult for us to imagine what our health system would be like without the Facilities team providing us with the comfortable and safe environment our patients need and deserve. Luckily, we’re never alone in our efforts to keep us running, and this department expertly leads that charge.  “Along with writing down the PSI readings in the gas rooms and answering calls from dispatch and the boiler rooms, I go through all the daily work orders and complete them,” said Ken Carrillo, Facilities Technician. “It always feels good to see when we complete all the work orders for the day, especially as the next shift arrives.”  “We fix, replace and dispose of pieces that are no longer in service – bottom line, we help keep the building up and running,” added Alejandro Cardenas, Craftsman.  But it doesn’t stop there – Facilities Engineering is currently in the midst of creating a whole new fleet vehicle program to improve the operations of our many on-site vehicles, including trucks, forklifts and more.  “I am the point of contact for all things fleet,” said Michelle Bay, Administrative Assistant. “We are building a new fleet program and working closely with leadership to move the program forward. I am involved with setting up new fleet fuel cards and can set up the program in the best interest of our internal customers while looking to the future for growth.”  It’s clear that the Facilities team is indispensable to Renown. Through their expertise, professionalism and commitment to quality, they stop at nothing to keep our health system functioning at its highest level.

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Dana and Mark Combs met through mutual friends and had a long friendship before they became a couple in 2009. They were married in 2011 in a private ceremony at a small Reno chapel, and a few months later had a big celebration with their family and friends.   Encouraging Others to Succeed  Over the years, the happy couple has spent much of their time volunteering and giving back to others in their community. Twenty-six years ago, Mark became a bilateral lower limb amputee. For the past 10 years, he has been a prosthetic consultant, helping other amputees learn how to cope with various challenges and encouraging them to keep living life to the fullest. “Mark is great with helping people,” said Dana.   Dana also does a lot of rewarding work through a Philanthropic Educational Organization (P.E.O). She is an advocate for raising money to help women ages 18 and up gain an education. Dana also enjoys tutoring English as a second language.   Enjoying Quality Time, Hobbies & Travel When Dana and Mark aren’t helping others, they are spending time with their family and friends, their dog Mia (a 3-year-old Maltipoo) or enjoying one of their many hobbies. Some of Mark’s favorite things to do include playing Solitaire and strumming on his guitar.  “I love to garden and play crossword puzzles and word games,” said Dana. “I’m really looking forward to the springtime to spend more time in the garden.” She loves to work out and has a membership at the UFC gym in Reno through her Senior Care Plus gym benefit. Dana also has her own online Etsy store, where she sells homemade jam jars, candle holders and vintage dolls. “Last summer I sold my first edition Barbie that I got when I was 9 years old,” said Dana. “I made quite a profit on it.”

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Respiratory syncytial virus, also known as RSV, is a common respiratory virus that impacts the lungs and breathing pathways. The virus can be dangerous for infants and young children and is also concerning for older adults. While most older kids and adults only experience cold-like systems and recover in a week or two, an estimated 58,000-80,000 children younger than 5 years old are hospitalized due to RSV each year, and in 2022 healthcare organizations across the country are experiencing higher infection rates than in years past.  "We are experiencing a strong RSV season and do not expect it to go away anytime soon," said Dr. Kris Wilson, Division Chief of Renown Children's Primary Care. "Infants who are infected with RSV almost always show symptoms of runny noses and cough. Call your healthcare provider immediately if your child is having difficulty breathing, is not drinking enough fluids, or is experiencing any worsening of these symptoms.” Symptoms of RSV: Runny nose  Decrease in appetite/inability to drink Dry diapers, an indication of dehydration  Cough, which may progress to wheezing or difficulty breathing Irritability (most common in very young infants) Decreased activity (most common in very young infants) Decreased appetite (most common in very young infants) Apnea, pauses in breathing for more than 10 seconds (most common in very young infants) What to do if you think your child has RSV: Call your pediatrician! If you suspect your child might have RSV, consulting their healthcare provider is the best first line of defense. From here they will help you build an appropriate treatment plan for child. Keep in mind that many pediatrician offices offer 24/7 call lines.  If your child is experiencing retracted breathing (when the area between the ribs and in the neck sinks in when a person attempts to inhale), dehydration (not drinking and decrease in wet diapers) or apnea (pauses in breathing for more than 10 seconds) please call 911 or go to the closest emergency room.

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Ring in the New Year and the rest of the holiday season by celebrating Renown’s Float Pool team!  After coming out of the COVID-19 pandemic, it's no mystery that healthcare across the country has shifted and adapted to the growing needs and new demands of our patient populations. Renown Health is no different. As the largest not-for-profit health system in the region, we are no stranger to change, even when change presents challenges. Who do we call on when a unit needs more team members in the eleventh hour? Who can help when our patient volume spikes up with seconds to spare?  This is where the Float Pool at Renown comes to the rescue. Skilled in a wide variety of healthcare specialties, from acute care nursing and critical care to care aiding and patient safety, this is the team that can seamlessly step in to provide crucial patient care to the units that need it most, whether a team is understaffed for the day or needs extra all-hands-on-deck for a specific patient or procedure. Float Pool team members are equipped to work in virtually any clinical area at Renown, making a genuine difference with every patient they encounter.  A Pool of Relief Teams across Renown can breathe a sigh of relief knowing that Float Pool has their back in times of need. As the backbone of our health system, these dedicated team members possess a wealth of clinical knowledge and the ability to navigate diverse medical environments. Their flexibility allows them to fill staffing gaps and provide essential support to many different units.  “We fill in the gaps of staffing to make everyone's day better,” said Patti Crepps, Critical Care Float Pool RN. “A float nurse has to be flexible and able to adapt to different situations and places – basically, ‘go with the flow.’ Patient care is basically the same all over; we make patient care possible by being familiar with all the various specialties and providing the specific care needed depending on the population we are taking care of on that shift.”  “Float Pool staff members are like healthcare chameleons, transitioning between different departments,” added Shelby Riach, Acute Float Pool RN. “We incorporate flexibility, teamwork and a commitment to ensuring patients receive the best care, regardless of the setting or circumstances.”  This team thrives in uncertainty; in fact, no workday is the same in Float Pool – and that’s exactly the way they like it. Working with many different teams across a multitude of specialties, these Care Aides, RNs, Critical Care Techs, Patient Safety Assistants (PSAs), Certified Nurses Assistants (CNAs) and more enjoy facing change, while they all share a goal of providing the best patient care possible.  “No day looks the same; since we are the Float Pool, we are assigned a different assignment on Smart Square every day, whether it be as a care aide, a patient safety assistant, a unit clerk or patient transport,” said Melina Castenada, Care Aide. “If we are assigned as a care aide on the floor, we help assist with call lights and help with whatever nurses and CNAs may need, including feeding, transporting, walking, helping patients use the restroom, etc. When we are assigned as a PSA ‘sitter,’ we sit for the patient to help keep them safe. If we are assigned as unit clerk, we help answer phones and direct patients appropriately, file paperwork, answer call lights if needed and assist with office work.”  “I love that every day is a different floor with different tasks and a different atmosphere,” added Julia Chappell, Critical Care Technician. “I find out which floor that I will be on right before my shift starts and head to the floor to find out my assignment for the day. Depending on the specialty, such as the medical-surgical floor versus an intensive care unit (ICU), my daily job tasks can vary.”  When it comes to high-risk patients, who require special attention, PSAs within Float Pool step in to help.  “The PSA role within Float Pool largely consists of adverse event prevention for our high-risk patients, and being a Float Pool employee allows us to work wherever we are needed,” said Dimitri Macouin, Patient Safety Assistant. “Whether it be in the emergency department, neurology or pediatrics, the PSA will be the eyes and ears for the nurses working with this patient population.”  “Great strides have been made to ensure that PSAs remain vigilant and are recognized as an integral part of the patients' care team rather than 'just a sitter,’” added Karla Phillips, Patient Safety Assistant.  Float Pool also oversees our Discharge Lounge, which offers patients and their families a dedicated space to reconnect and prepare for their discharge from the hospital.  “The increase in utilization of the Discharge Lounge is something we are very proud of,” said Kara Abshier, Care Aide. “We assist in discharging patients from all over the hospital to help the floor and get new patients into rooms.”  Every day brings a new challenge for Float Pool. As these team members wake up with uncertainty, they are ready to embrace the diverse demands of caring for patients of all ages.  “The fact that Float Pool exists is amazing,” said Hannah Luccshesi, Acute Float Pool RN. “We wake up with no clue as to whether we will be working with babies, children or adults and then fill in the needs of the hospital.”

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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.

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Stepping into the Renown Transfer and Operations Center (RTOC) means stepping into a transformative hub of excellence where lives are saved and healthcare is reimagined. As a cornerstone of Renown Health's commitment to exceptional patient care, the RTOC serves as a dynamic nerve center that seamlessly coordinates medical resources, ambulance rides, hospital bed space, remote home systems, hospital transfers and emergency preparedness. In this best-in-class facility, the boundaries of what is possible in healthcare are constantly pushed, and new horizons of patient care are discovered.   Staffed with a dedicated team of skilled professionals, the RTOC harnesses the power of advanced technology and compassionate expertise to ensure that patients receive the highest level of care and support, no matter where they are. Through a synchronized network of communication, coordination, and compassionate care, the RTOC team ensures that patients receive the critical support they need when it matters most, working tirelessly to redefine what it means to deliver world-class healthcare.   A National Standard  Charged with the goal of overseeing the placement and transportation for every patient, the RTOC officially launched in 2021 as northern Nevada’s first and only transfer center of its kind and a nationally celebrated facility. As Renown’s highly coordinated care logistics system, this team uses the cutting-edge technology at their fingertips to customize healthcare to the needs of every patient, manage patient flow and drive healthcare innovation.  “Compared to where we’ve started to where we are now, it’s a 180-degree difference,” said Kelli McDonnell, Manager of RTOC. “When we first started building our facility right before the pandemic happened, we took what was six conference rooms and classrooms and turned it into a command center that organizations across the country admire and come to Reno to see what we do. Mel Morris, the Director of RTOC, was recruited exclusively to build our facility with her history of building successful hospital command centers. Many people didn’t realize what a transfer center was or that Renown was the only center in the region – and we only continue to grow.”  This best-in-class facility, and the masterful team behind it, handles:  Coordinating all incoming patients transferred from neighboring hospitals and 27 counties across northern Nevada, Lake Tahoe, northeast California and neighboring states. Matching patients to the most appropriate bed placement using diagnostic, triage and Epic electronic medical record clinical information in conjunction with medical staff expertise to outline a plan of care that determines the best bed assignment given the patient’s needs.  Coordinating video-enabled Telehealth monitoring capabilities for Renown’s four Intensive Care Units (ICUs), as well as Renown patient Telehealth and virtual visits. Monitoring Remote Home systems with Masimo during the COVID-19 pandemic, where some patients received hospital-level care in the comfort of their own homes while Renown clinicians monitored and evaluated their data and plan of care.  Serving emergency and disaster management for area hospitals, first-responders and the community with local, regional and statewide emergency and disaster management for sudden-onset emergencies.  The RTOC is home to many different critical roles for our health system, including Transfer Center Nurses, Ride Line Coordinators, RTOC Coordinators and more, many duties of which each team member cross-trains on to be able to fill in whenever needed. While their roles may differ, their commitment to their patients remains the same – and they all work together to achieve the same outcome: delivering the right care, at the right time and place.  “As an RTOC Coordinator, we do a variety of different things,” said Anna Schaffer, RTOC Coordinator. “We do triage coordination to help our nurses and hospitalists get patients in the emergency department admitted, and we also do bed control to find patients appropriate bed placement. Communication is important, so we always make sure to stay closely connected with the charge nurses on those floors.”  “We start with a basic ‘need to know’ and place patients accordingly,” added Karly Brown, RTOC Coordinator. “We get surgery numbers, ICU capacity and discharges and find beds for all patients as quickly as possible. We have the advantage of being able to see the entire hospital.”  “I primarily schedule transportation for patients at the hospital who are either going home or going to a skilled nursing facility,” said Sarah Clark, Ride Line Coordinator. “I get requests from case managers to schedule rides, and I work with REMSA and other ambulance services to schedule them. It relies a lot on appropriate and efficient communication and critical thinking.”  Patients in facilities across northern Nevada and northeastern California, especially the rural communities, look to the RTOC to help guide ambulances, bed coordinators and hospital staff in finding care for our rural patients.  “As a transfer center nurse, I facilitate incoming patients from rural facilities in Nevada and surrounding areas in California,” added Meg Myles, Transfer Center Nurse Specialist. “There are days we may take up to 30 direct admissions from these areas.”  “We are the point of contact for inter-facility transfers, whether we are sending patients out or bringing them into Renown,” said Lisa Lac, Transfer Center Nurse Specialist. “We take phone calls from those rural areas, identify what services are needed, connect them to the appropriate provider and coordinate any transfers.”  “Simply put, we are the bed wizards,” said Addison Rittenhouse, RTOC Coordinator.  The RTOC team continues to break barriers and push the boundaries of medical excellence through leveraging the technology at their fingertips and their unwavering dedication to the health of our community. Inspiring a new era of medical possibilities, these team members have achieved a multitude of accomplishments for both their department and their patients since the birth of the center.  “We have significantly reduced the time it takes to get patient admit orders in, thanks in part to the new Triage Coordinator role, and we provide easier access for patients to transfer to us from other facilities,” said Beth Rios, RTOC Coordinator. “We have taken a bigger role in helping the smaller hospitals in our area in caring for patients and improve patient throughput.”  “As a team, we’ve done a lot of work in creating an engaging and positive environment, and our internal morale committee has been a huge help with that,” said Kelli McDonnell. “We’ve been working tremendously over the last year and taking all the feedback that we received from the Employee Engagement Survey to make improvements. We had 100 percent survey participation within five days, which is incredible.”  “I am so proud of our escalation and problem-solving skills,” said Becca Dietrich, RTOC Coordinator. “When an issue is raised to us, we will always find a timely solution on our end so our care teams can focus on the issue in front of them. We are the eyes in the sky, seeing movement everywhere.”  Each day in the life of our RTOC team members is a testament to their commitment, resilience and timework, making a profound impact on countless lives.

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Health systems across the country recently celebrated Patient Access Week from April 2-8. Join us in recognizing our Patient Access team at Renown!  Fighting the Good Fight starts the moment a patient steps onto the grounds of our health system. When patients visit Renown on their healthcare journey, they look to the experts to not only help them navigate through the complexities of the process but also ensure their experience with us starts off on the right foot.  Renown Health’s Patient Access Representatives (also referred to as “PARs”) are the faces of this entire process. As the key links between patients, providers and insurers, they strive to create a welcoming and respectful environment for everyone. PARs are committed to providing all of Renown’s patients access to the quality care when needed. After all, it’s in their name!  A Friendly Face  PARs are the front faces of almost all clinical areas at Renown. As the starting point for much of the patient experience, the day-in-the-life of PARs can vary. Checking patients in and out, getting demographic information, verifying insurance, answering phone calls, fostering communication between patients and their care teams, scheduling patients for follow-ups, explaining financial responsibilities and our financial aid programs, creating an overall positive experience and environment, the list goes on – but they all remain united under one goal: setting patients off on the right foot as they access care through our health system.  “Each day, PARs are met with new patients who are seeking solutions to different concerns,” said Macy Betts, PAR for Renown Women’s Health. “We are the front doors to this department. We are not just checking patients in and out; we are the first step to the patients receiving the care they deserve.”  “We take pride in our work,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia, PARs for Renown Pediatrics. “Usually, we are the first point of contact within Renown, so we don’t take our role lightly. For example, when we see a newborn, we must ensure the registration has been verified, which consists of patient demographics, patient preferences and insurance verification. We need to be consistent and thorough because what we do affects every point of contact a patient may have within Renown.”  “As my team’s senior PAR, my day begins with gathering the outpatient therapy work queue numbers and assigning the team to work them,” added Logan Johnson, Senior PAR in Pre-Registration at Renown. “Our goal is to contact and schedule patients for physical, occupational and/or speech therapy as soon as possible so that they have the maximum benefit and can get back to a normal life as quickly as possible. Our encounters can make or break the entire experience.”  PARs never underestimate the power of good communication and compassion. Even during the busiest of times, our PARs work diligently to ensure all patients and their care teams fully understand the administrative side of whichever part of their journey they are about to embark on, lending a helping hand and a smile.  “Whether you’re communicating with patients, leaders or coworkers, communication is key,” said Jonathan Figueroa, PAR for the Renown Institute for Heart & Vascular Health (IHVH). “We try and make sure that we do everything possible to make their visit go as smoothly as possible.”  “Communication makes the world go round,” added Keith Madrona, Sherry Riley, Erika Rios and Andie Kilpatrick, PARs at Renown Urgent Care – Ryland. “Having a friendly attitude and demeanor is very important.  “The PARs in Labor & Delivery do so much more than just registering patients – from escorting expectant parents to their rooms, welcoming newborn babies, processing pre-estimates and more – and the patience and excellent communication I receive from other teams is what keeps me going,” added Nanci Barash-Vietti, PAR for Renown Labor & Delivery (L&D). “This is critical to the success and effectiveness of the PARs in our department.”  Shift changes for PARs mimic other teams at Renown, leveraging technology and both written and spoken communication to ensure the next shift begins successfully.  "When I come in, the night shift will give me a report on what is going on and what the schedule looks like during the day; then I log in to my computer and get everything that I will need for that day up on the screen,” said Allie Boracchia, PAR for Renown L&D. “Usually around this time we have a 7-8 a.m. induction scheduled for the first patient, so I will grab the pre-made packet that the night shift put together, the unit clerk will call the nurse to get a room number, and I take the patient to the room and have them sign all the forms. After the patient has the baby, then we admit them and finish registration. This is continuous all day long.”  Our PARs all agree that regardless of the setting, whether it be emergent or routine, every patient is looking for that advocate from the moment they enter through our doors.  “Being friendly, patient and understanding is a must,” said Sheryl Lundgren, PAR for the William N. Pennington Institute for Cancer. “It is so nice being able to brighten the days of patients who are living with a cancer diagnosis.”  “In the urgent care setting, a lot of the patients we see are not feeling their best, so it is important that we show them we care and are here to help make check in go smoothly,” added Sam Deithrich, PAR at the Renown Urgent Care – Los Altos.   “Patients are relieved that they are speaking to a real person that will help set up appointments,” added Rick Jordan and Celeste Landry, PARs in Lab Services at Renown South Meadows.   PARs embrace lifelong learning at Renown, especially as their roles differ day-to-day. They are always ready to jump in and assist on tasks that might be new for them, growing their skills on the job and never hesitating to say, “How can I help?”  “As a PAR, you are always learning new things, even when it seems like you know just about everything,” said Liz Cardenas-Ramos, PAR for Renown Endocrinology. “It’s been such a positive experience.”  “Giving yourself grace to learn and grow in Patient Access is the key,” said Maggie Savoie, PAR for Renown Primary Care – Fernley. “I find myself learning every day at Renown, and if you’re learning, you’re growing. Being able to take a breath and say, ‘this is a learning opportunity for me, and tomorrow I will be better a better PAR because I’ve gained this knowledge’ is an amazing way to stay positive in the position.”  “In L&D, we are all multi-tasking, and every day I am learning something new about my department and patients, as well as how to excel in my position,” added Nanci Barash-Vietti.  Renown PARs are the front lines to health care access, and they wear that badge with pride. Jeanette Flores, PAR in the Emergency Department at Renown South Meadows, sums up the role of Patient Access well: “Talk about first impressions!”  “I am proud of our team and the excellent care we give our patients,” said Dawn Linker, PAR for the Renown IHVH. “We want them to have a good experience.”  Impactful Accomplishments  The role of our Patient Access team members goes beyond the desk. A patient’s healthcare journey begins, and sometimes even ends, with the helping hands of our PARs, leaving a lasting positive impression of Renown.  "Our interactions with the patients make a difference before they see the provider, so we always demonstrate a welcoming and helpful atmosphere for the patients to feel like their needs are being met,” said Mary Dettling, PAR for Renown Endocrinology.  “I love seeing the difference we make in peoples’ lives,” added Shannon Leone, PAR for the Stacie Mathewson Behavioral Health & Addiction Institute. “We can get patients at their toughest and worst times. Watching them overcome their fears, traumas and addictions has been very rewarding.”  Our PARs don’t just make goals for themselves – time and time again, they surpass them, all in the name of patient experience and excellence.  “We have not only met our monthly point-of-sale scores, but we also have exceeded our stretch goal for the last eight months and our scores have been in the 50th percentile or higher,” said Jeanette Flores.  “Along with being the top point-of-sale collectors, we have also been known to be some of the sweetest and most helpful staff at South Meadows,” said Katie Morrill, PAR in the Emergency Department at Renown South Meadows.  As their teams grow, so does their impact on our patients. PARs are dedicated to providing the best customer service possible, and with their expanding teams, that service goes even further, even throughout the pandemic.  “A year ago, we only had one PAR; now, we have a full and amazing team,” said Alex Bucholz, PAR for Renown Advanced Wound Care. “We have come so far in a short amount of time.”  "During the pandemic, we have maintained a core group of individuals who come in every day and help keep this office and all its parts moving smoothly,” added Shannon Leone. “We have maintained a full patient load the last three years and never had to close our office for any reason. We have even had the opportunity to start our Medicated Assisted Treatment and Transcranial Magnetic Stimulation programs.”  "We successfully operated and maintained our pediatric COVID clinic, which is the only one within our five clinics,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia. “We feel proud knowing our tiny humans are protected with the COVID vaccine.”  Like many other teams at Renown, our PARs are masters at teamwork. Despite any obstacles that may happen along the way, they are always there for each other to ensure every patient gets the care and attention they deserve.  “We call ourselves the ‘A-Team’ here in Pulmonary,” said Shannon Birnberg, PAR for Renown Pulmonary & Sleep Medicine. “We have persevered through changes, additions and departures. We are most proud of bringing different personalities to the team and being super strong and effective.”  “I have noticed the team always steps up whenever needed,” added Brittany Hughes, PAR for the Renown IHVH. “Everyone has a great attitude and is very positive!”  “While our team is fairly new, we are growing together, learning our strengths and weaknesses and always pushing for stronger unity,” added Angel Freer, PAR in the Emergency Department at Renown Regional.  When our PARs find ways to simplify a process or make a workflow run more efficiently, they don’t waste any time in making that happen. They take any opportunity to enhance patient experience.  “Our team came up with a solution on how to get patients registered faster,” said Jess Castillo-Marquez, PAR in Lab Services at Renown Regional. “We came up with modalities which assign each PAR their own procedure in which they will be registering for during their scheduled shift. It has been a great success, helping our productivity and keeping our patients satisfied with our service.”  “We are proud of our successful implementation of our new therapy workflow,” added Logan Johnson. “Patients are now waiting much less to be contacted about their care.”  Our PARs know that teamwork makes the dream work, and their commitment to the patients they serve – and the goals they continue to blow out of the water – continue to inspire them daily.   “You are only as strong as your team,” said Aundie Yonker, PAR in the Emergency Department at Renown Regional.

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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