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When medical treatments no longer offer a cure, Hospice Care offers a special way to care for you and your family who are faced with a life-limiting illness. Serving Washoe, Lyon, Storey and Carson Counties, our team is available 24 hours a day, seven days a week.   Hospice staff receive special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. When considering your options for end-of-life transition, our team is available to answer questions and discuss if Renown Hospice Care will meet your needs.  Your hospice care team includes Medical Director Registered Nurses Certified Nursing Aides Medical Social Workers Chaplains Registered Dietitians Trained Volunteers

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I am regularly amazed by medical advancements and innovation in the United States. However, even as we make significant progress in many areas of medicine, there is still much more work to be done in others. One such area is patient safety.   What is Patient Safety? When we talk about patient safety, we are discussing how hospitals and healthcare organizations protect patients from errors, injuries and infections. Anyone can make a mistake at work, but in healthcare these mistakes can result in serious outcomes. In 1999, the Institute of Medicine released a report that estimated 98,000 deaths per year result from medical examination or treatment. The most recent study in 2013 suggested these numbers could range from 210,000 to 440,000 deaths per year. Many of these deaths result from preventable medical errors. This is inexcusable and shows how much more work our industry still needs to do to improve patient safety. Making Patient Safety a Priority Patient Safety is our number one priority at Renown Health. We dedicate a lot of time to establishing, reviewing, and revising our processes to prevent errors. Despite the obvious importance of patient safety, this issue is largely left to individual hospitals and health systems to manage. There is a surprising lack of national attention around this truly important issue. However, a silver lining of the COVID-19 pandemic is that it is igniting interest in hygiene and infection prevention. Patients want to learn more about the processes that are in place to prevent the spread of infections. In addition to the many protocols that guide our treatment of injuries and illness, Renown Health has implemented the following measures to prevent the spread of communicable diseases: Requiring everyone entering Renown sites to wear a mask or face covering. Establishing new processes to help patients and visitors practice social distancing. Limiting the number of visitors in our facilities. Screening all employees and patients for symptoms. Enhancing our already-thorough cleaning and disinfection processes. I hope patient safety and infection prevention remain in the national spotlight long after the COVID-19 pandemic has ended. The healthcare industry must come together to develop stronger systems and regulations to minimize preventable medical errors. We have a responsibility to our patients to do better.

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National Healthcare Decision Day is forthcoming. Here’s an easy and free way to commemorate the occasion: openly discussing how we want to be cared for at the end of our lives. Join Renown Health’s experts at a workshop about making decisions about an advance directive. Among the random national holidays, this one has significance: April 16 is National Healthcare Decision Day. And experts agree that the best time to discuss your views about end-of-life care and to learn what choices are available is before a life-limiting illness or crisis occurs. By preparing in advance, you can help reduce the doubt and anxiety related to decision making for your family if you cannot speak for yourself. “Completing your advance directive is a gift you give your family,” says Mary-Ann Brown, RN, MSN, director of Palliative Care. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want the end of life.” What Are Advance Directives? An advance directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care. Find more information about advance directives and the form online. The Conversation The first step in completing an Advance Directive is to think about what’s important to you and talk to your loved ones. The Conversation Project provides helpful tools to guide you and your family through this challenging topic. Getting this information together will help you fill out and complete your advance directives. Some things to consider and discuss with your family include: When you think about the last phase of your life, what’s most important to you? Who do you want involved in your care? Who should make decisions on your behalf if you’re not able to? Where do you want or not want to receive care? Are there specific treatments you would or would not want? Complete Your Advance Directive Planning In order to complete an advance directive, you will need either two witnesses or a notary to sign the form. Be sure to note restrictions on the witness process. When an advance directive is complete, you should keep the original. Copies should be given to your agent named in the form, your family, your doctor(s) and the location that you receive care. Renown Health offers four advance directive workshops every month to cover the details of filling out this document. A healthcare team is available to answer questions and work through the process with you. A notary is also present to finalize the process, which means you can complete your advanced directives during this workshop. Find the workshop by calling 775-982-RSVP for more information. Advance Care Planning Workshop April 17, 1-2:30 p.m. | Free Join Renown Health’s experts for a workshop about making decisions regarding end-of-life care. You will learn how to fill out an advance directive, receive one-on-one assistance and have your documents signed by a notary. Workshops are typically held several times each month. To RSVP, call 775-982-7787

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In recent years, workplace violence against healthcare workers has been on the rise. According to the Occupational Safety and Health Administration (OSHA), about 75 percent of nearly 25,000 reported annual workplace assaults occur in healthcare and social service settings. Those who don’t work in healthcare may be surprised to learn that violent altercations are so common in our field. Hospital settings can create fear and stress for patients and their families. Pain, mind-altering medications and drugs, and difficult prognoses can amplify these feelings. While inappropriate responses may be understandable, violence cannot be tolerated. As the leader of a health system, protecting our employees is an issue that I take seriously. Reporting Workplace Violence Unfortunately, sometimes employees don’t report dangerous incidents fearing they might be blamed, or not realizing it’s a reportable offense. At Renown Health, we take these events seriously. We have clear, mandatory policies and protocols for reporting and investigating violent incidents. Each incident is investigated to ensure follow through and accountability. We also teach de-escalation skills to our hospital security teams, clinicians, and other frontline employees. As an added layer of protection, Renown Health has a first-rate security team that closely monitors activity on our campuses, addressing potential issues before they escalate. Our organization values our partnerships with community organizations including local law enforcement agencies like the Washoe County Sheriff’s Office and the Reno Police Department. Renown Health maintains a close relationship with these partners, and we alert them when our care teams experience an increase in violent incidents. I also recognize that workplace violence is a national problem that demands collaborative solutions. That’s why I am also proud to serve as a member of the American Hospital Association’s Hospitals Against Violence Advisory Committee. Nurses, doctors, paramedics, and frontline health workers care for us every day. It’s our responsibility to support them by ensuring they feel safe at work.

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“Safety is Number One,” isn’t just a saying – it's a fact of life, especially at Renown Health. The safety of all patients, visitors, staff and volunteers is always the top priority, and our Security Department takes that commitment seriously. This team is devoted in their efforts to provide a safe environment for all, building cooperative and proactive security processes leveraging crime prevention techniques and state-of-the-art technology. Renown Security sets the safety and well-being bar high, and they continually exceed that standard day in, day out at all of our hospitals and urgent care, primary care and lab locations.  Specially Trained, Continually Present  Our Security Department isn’t staffed with your run-of-the-mill Security Officers; these team members surpass security and safety expectations. Think city and state police-level standards. You read that right – many of Renown’s Security Officers come from Nevada Highway Patrol, the Washoe County and Carson City Sheriff’s Offices, the state probation and parole board and more.   This team fosters specialized training in a collaborative environment. Every member of the security team has extensive training in compassion, empathy and de-escalation techniques to provide the highest levels of safety and security. They implement this training in all their daily duties, whether they are saying a simple ‘hello’ to a patient passing by or preventing harm to a staff member.  Before their shift begins, the team meets to debrief meeting to discuss major incidents that occurred on the previous shift. These meetings ensure the next shift is aware of situations to be on special alert for and individuals to look out for. After, the team members head off to their assignments.  “The day could be as mellow as greeting someone at the welcome table, or it could be as chaotic as de-escalating someone in distress,” said Emmanuel Fernandez-Orozco, Supervisor of Security at Renown Regional. “Regardless of the day, every experience is rewarding in its own way. The only thing that is promised is that every day will be different.”  While every Security Officer has varying experiences, one aspect of their job always stays the same: they are always on alert for any potential safety issue. Even on the “slowest” days, it is important for this team to stay vigilant in order to mitigate any potential risks. There are several security programs that the team uses to keep everyone at Renown safe and secure: Renown's security operations center team (also known as dispatch) monitors all cameras in real time, with security officers patrolling parking areas 24/7.   Security escorts are always available for any employee, patient or guest at every Renown location. Security Officers can escort anyone to their designated site, check surroundings for danger and monitor the person until they safely leave for their next destination.     Rescue officers are available for any Renown location where an employee feels unsafe.  Security maintains a strong relationship with the Reno Police Department (RPD) and assists with reporting and providing information that aids RPD in pursuing and deterring criminal activity.  “In security, we are a counselor, teacher and rule enforcement officer, all rolled into one,” said Bob Stone, Supervisor of Security for Renown Health. Talk about master multitaskers!  Protection is only one part of the job. Through positive and meaningful interactions with guests, patients, community and staff, regardless of where they are posted, the Security Department continually helps Renown achieve its mission of making a difference for the people they serve.  Devoted Dispatch Speaking of multitasking, no one does this better than the Security Dispatch Center. Security Dispatchers are the “eagle eyes in the sky” at Renown, keeping a close watch on everything that happens within every Renown location, as well as REMSA (including Care Flight). From overlooking the many cameras around campus and administering codes over the PA system to manning the radio and phones to ensure Security Officers are dispatched quickly, our dispatch team helps ensure every safety or security issue at Renown is immediately addressed.  When a call comes in, dispatchers like Jessica Fernandez, Security Dispatcher for Renown Health, go through a quick discovery process (sometimes in seconds) to figure out the details of the situation or code and what level of security is needed to assess and de-escalate.   According to Jessica, the ability to prioritize is something she values in her work. “80 percent of our duties are on the phone and the radios, and we are skilled in prioritizing concerns based on the sheer volume of calls we get,” she said.  Jessica and her teammates are proud of the outcomes from their calls. Their attentiveness to every nook and cranny at Renown and their quick response times to make them not only a valued partner to the Security Department but also a necessity to our health system.  Your In-House De-Escalation Experts  Being in a hospital environment is undoubtedly stressful for any patient, and many factors can increase these emotions. The Security Department takes these feelings seriously and never hesitates to take appropriate action to ensure the safety of everyone at Renown. With the unfortunate rise of violence against healthcare workers, especially amid the pandemic, our first-rate security team has been crucial in countering violence with specialized de-escalation techniques.  The key to de-escalating, according to the Security Department, is to put yourself in the shoes of whoever you are working with. As stated by Bob Stone, the team approaches each situation by asking themselves: How would I want to be treated if I was in the same circumstance?  “Being empathetic to their situation and listening to what is going on in their lives is key to re-directing them accordingly,” said Bob. “Applying real-life experience to similar circumstances can make them feel like they are not alone. Educating people on hospital policies can also help them reduce their anxieties and solve the problems.”   Jhorddy Lopez, Security Officer at Renown Regional, approaches each situation with the mindset of knowing that each person’s reactions are different. “Different techniques need to be implemented every time,” said Jhorddy. “You have to use your best judgment call.”  Quick and effective judgment calls are a task that the Security Department has conquered. Rosie Garcia, Security Officer at Renown Regional, knows that using your best judgment means getting both sides of the story. “Whenever I need to step in and de-escalate a situation, I first speak with whoever is attending to the patient and gather information,” said Rosie. “Then, I always get the patient’s side as well. I want to understand how they’re feeling, so both the staff member and the patient can meet in the middle and come up with a collaborative solution.”  An example of the heroism and advanced de-escalation displayed by our Security Officers takes us back to last spring. In the middle of the night, a Care Flight helicopter transporting a patient and their family was about to touch down on the landing pad outside of Renown Regional. Right as the helicopter was about to land, an individual jumped over the safety barricade and onto the landing pad. Alexander Pico, a former Security Officer Lead at Renown Regional (who recently joined the Carson City Sheriff’s Department) immediately communicated with the individual to leave the area. The individual then went under the rear blade, which is the most dangerous part of the helicopter. Knowing that he had to risk his own life at this point to save another, Alexander ran around the back of the helicopter and tackled the individual, preventing catastrophic injury or even death. Steve Perkins now uses this example of a swift judgment call, which was captured on dispatch cameras, as training material for new staff.  Exceptional character, compassion and emotional intelligence are the attributes that every member of the Security Department holds. As noted by Steve Perkins, these attributes “allow for a quick assessment of each situation in order to de-escalate and move towards the best possible solution."  Securing the Job  The Security Department at Renown is actively hiring caring, dedicated team members who are ready to jump in and perform exceptional high-risk healthcare security services for our health system.  “We seek people with the right combination of ability and demeanor,” said Steve Perkins. "The training and skills development we provide result in a high caliber of success.”  Every team member in the Security Department is passionate about the same thing: helping others. And in a healthcare environment, this is important.  “Working a healthcare security job is far different than working any other security job,” said Jhorddy Lopez. “At a hospital, you get the chance to interact with people one-on-one. I get to experience the feeling of, ‘I can make a difference in this person’s life.’”  Any interaction can change the course of a person’s day, and the Security Department embraces this fact. “I really do love helping people so much, whether it be an elderly patient who needs help with their wheelchair or a situation where I need to step in and de-escalate,” said Rosie Garcia.   In order to succeed in this fast-paced department, being a collaborative team member is crucial. “A good coworker is a team player – someone that loves to work in a team atmosphere,” said Emmanuel Fernandez-Orozco.  Jhorddy Lopez reiterates this, adding that “communication and trust are also extremely important. Everyone has to have great communication skills and have each other’s backs.” For people like Bob Stone, having a special connection to Renown inspires him to serve. As someone who experienced two life-saving hospital stays here, he is proud to give back to the organization that gave so much to him. “It was only natural to return to a facility I was familiar with my entire life,” said Bob. “After serving as a paramedic and transporting patients into Renown from Plumas County, I knew I was not done giving back to the community. Renown was the place to do exactly that.”  All Genders Welcome  A common misconception about the security field is that it is strictly a “man’s job.” In Renown’s Security Department, that couldn’t be further from the truth.   As a female Security Officer, Rosie Garcia is a prime example of proving that idea wrong. As a master patroller and de-escalation expert, she ensures everything is running smoothly and that everyone feels safe at all times.  “When I first started here, I knew right away that nobody that works here is biased,” said Rosie. “Everyone is equal, and I am treated as an equal in this department. I know I can do the job as well as any man."  Both Rosie and her counterparts in the Security Department firmly believe that this line of work is for everyone, and they continually lift each other up and support one another.  “No matter your gender, as long as you have confidence and integrity, you will do well,” adds Rosie.  The Bottom Line If you are passionate about creating a secure environment to ensure patients get the care they deserve and employees receive the safety they merit, the Security Department is your team to join.  “I come into work with pride,” said Jhorddy Lopez. “Knowing that I can change someone’s life – that makes me proud to work here.”  “You’re in good hands with us,” closes Steve Perkins.

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August is National Make-a-Will month. We talked to Renown Health Foundation Planned Giving Officer, Abbey Stephenson, to learn more about wills, trusts, and estate plans and why you should feel motivated this month to get started. Did you know that 2/3 of Americans don't have a will or trust? If this is you, don’t worry, you’re not alone. Although there are laws in place to determine who inherits your assets if you die without a will or trust, having a will or trust ensures your assets go where you want them to go after you are gone. They can also help minimize disputes between family members and heirs about who gets what. In Nevada, the laws that govern who gets what if you die without a will or trust can be found in Chapter 134 of the Nevada Revised Statutes. There are other documents that people often prepare at the same time as their will or trust – like an advance health care directive and durable power of attorney for assets. These documents all together are called an estate plan. Although they have other purposes too (like nominating a guardian for a child, planning for disability or avoiding probate, which is a court process), wills and trusts are documents that say who will receive your assets after you are gone. The most common type of trust is often called a revocable living trust or a family trust. People who have a trust usually still have a will, although it is a shorter form of will called a pour-over will. It’s a good idea to talk to an estate planning attorney about whether or not a trust makes sense for your family or circumstances.  Now that you’re ready to get started, here are some mistakes to avoid: 1. Failing to plan Not setting aside the time to plan may be the biggest mistake. Failing to prioritize preparing or updating your estate plan means your last wishes and desires may not be fulfilled. The right documents memorialize what you would like to happen upon your disability and death so that other people can know and follow your wishes with respect to your care and your assets.  2. Failing to coordinate beneficiary designations Certain types of assets like life insurance and retirement accounts are not covered by your will or trust and need to be addressed separately. These types of assets are referred to as non-probate assets because they transfer under contract principles and don’t require court supervision or probate to be distributed to the named beneficiaries. By completing beneficiary designation forms provided by the retirement account custodian, insurance company or financial institution, you can direct your assets to one or more beneficiaries. 3. Failing to title your assets properly Asset titling refers to how you own your asset – such as in your individual name, jointly with someone else, or in a trust or entity. For example, assets titled for two people with a “right of survivorship” will automatically go to the surviving owner. Review your asset titling and make changes, if needed, to ensure your property and assets are passed down the way you intend. 4. Failing to include charities meaningful to you In addition to providing for family members and other important people in your life, you many also choose to give to charities meaningful to you in your estate plan. When you include a charity in your estate plan, that gift is called a planned gift and many charitable organizations, including Renown, recognize such donations through their legacy giving societies. As you prepare to make your own will or a more comprehensive estate plan, we recommend you consult with a lawyer. Here are some free resources that may be helpful too:  Renown Health Foundation is proud to sponsor the Family Estate Planning Series put on by PBS Reno and the Community Foundation of Northern Nevada. The free, 8-week course of 90-minute, in-depth workshops is a great place to learn much more and to help you get started in the planning process. The next course begins on September 7, 2022. More information can be found here. Renown Health offers periodic advance health care directive workshops where attendees can learn about, complete, and sign their directive. The next workshop is scheduled for September 14th. More information can be found here. The American College of Trust and Estate Counsel provides information on a number of commonly asked estate planning questions here. If you are interested in including a charitable gift to Renown in your estate plan, we would be happy to talk to you about how your gift will make a difference for our mission. Please contact Abbey Stephenson at abbey.stephenson@renown.org or visit renown.org/LegacyGiving to learn about Renown Health Foundation’s Legacy Giving Society and ways to give.

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