IN THIS ISSUE4 New names, same great care

6 Better medicine

april 2013

I heart St. anthony’SPage 2

One of St. Anthony’s cardiac teams: from left, Steve Parker, Radiology tech; David Morton, M.D., cardiologist; Lisa Slavik, R.N., B.S.N.; and Terri Marsh, R.N.

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is scared: you can see the panic and fear on their faces.”

Working fast, they consoled the family, telling them they understood Griffin was having a heart attack and that they would move him to the Cardiac Catheterization Lab as quickly as possible. Slavik prepped the patient with electrodes and IV drips while Marsh gathered the necessary background information.

“We try to spend less than five minutes in the ED, because they say time is muscle,” Marsh said.”The more time that’s lost, the more heart muscle they’re losing.”

“Your heart goes

out to the families

first. Every family is

scared: you can see

the panic and fear on

their faces.”

Terri Marsh, R.N.,

Cardiac Catherization

For top-notch cardIac care, I heart St. anthony’S Terri Marsh, R.N., Cardiac

Catheterization, was sound asleep in her warm bed in the Fenton area when her beeper went off during the wee hours of a cold January morning.

“Code stemi,” was the message, referring to a severe type of heart attack. Marsh was one of the members of St. Anthony’s heart care team on call that morning.

“I know when I get that page I have to get to the hospital in 30 minutes,” Marsh noted. She arrived in 15, and met with fellow team member Lisa Slavik, R.N., B.S.N., and their anxious patient and his family in the Emergency Department.

William “Bill” Griffin, 66, was ashen-faced. He hadn’t been in a hospital as a patient for 40 years. His wife, Ellen, sat beside him, still wearing her print pajama pants. Griffin had awakened about 2 a.m. at his home in Arnold, suffering dull chest pains. Initially he had brushed off the discomfort, thinking he had heartburn. But when he sat down at his computer and broke into a cold sweat, he knew it was much more serious than that. He stood up, and nearly passed out. On his hands and knees he crawled back to the bedroom to wake his wife, who dialed 911.

“Your heart goes out to the families first,” noted Marsh, 44. “Every family

They rushed Griffin into the cath lab, where they met fellow team members David Morton, M.D., and Steve Parker, Radiology tech RT (R). Over a period of several hours, the team managed to stabilize Griffin’s heart, and Dr. Morton put a stent in one of his arteries. It wasn’t easy: Griffin’s heart stopped twice and he was defibrillated, or shocked, 20 to 30 times to resurrect a flagging heartbeat and correct abnormal cardiac rhythms. Soon after, Griffin underwent cardiac bypass surgery. He returned home a few days later, and is a little tired but otherwise is doing well, his wife said.

“Everything fell into place, from the arrival of the paramedics to the cardiac team waiting for us,” Ellen Griffin recalled. “He shouldn’t have been here, according to what they told me. After talking to Dr. Morton, I could tell it was an experience for him, too. No mere words can ever express the depth of gratitude we both have for Dr. Morton, Terri, Lisa and Steve. There are many other nurses from the CVICU that we very much want to thank also for the excellent care they gave Bill during his stay at St. Anthony’s.”

Bill Griffin’s story is one of many patient successes to come out of St. Anthony’s Heart Specialty Center, which is working to become one of

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did you know?

St. Anthony’s...

• Is one of 30 heart care providers across the country selected recently to take part in a study of a device designed to prevent blood clots in patients with atrial fibrillation.

• Has a heart failure program, the only such program in the St. Louis area. Patients enrolled in the program have been proven not only to feel better and experience fewer related symptoms, but also to decrease drastically their hospital readmissions. The program also has improved heart function in some patients.

• Has on its staff cardiologist David Dobmeyer, M.D., of Heart Specialty Associates, one of the few doctors in the area who perform a procedure for repair of the Patent Foramen Ovale (a flap in the wall of the atrial septum that can lead to strokes in young, otherwise healthy patients) with a 10-minute catheter procedure that uses a device known as a septal occluder.

• Has a circulatory assist device, an Impella heart pump, that helps support the blood circulation of critically ill patients, allowing cardiologists to perform heart procedures in a much safer manner.

the country’s top-performing heart care programs. It was created in 2011 through a unique partnership between the medical center and The Heart Specialty Associates, a practice that now includes 13 of the area’s top cardiologists. The Heart Specialty Center provides a seamless continuum of care for cardiac patients: inpatient and outpatient, medical and surgical, prevention through rehabilitation.

“Our team members in the Heart Specialty Center are extremely dedicated and absolutely top-notch, as Mr. Griffin’s care has shown,” said Dr. Morton, who also serves as chief medical officer of St. Anthony’s. “It

requires that whole team, going from EMS to the Emergency Department to the cath lab, to make it work. All of those pieces have to be working together and in sync.”

At any one time, three members of the 19-staff-member Heart Care Team are available on call, said Ellen Smith, director of Cardiovascular Interventional Medicine.

“We also have one team member as a backup to call others in the event that there are two heart attacks at the same time, which happens more often than you’d think,” Smith said. “In that case, we call everyone and ask them to come in. I have never had a time that the staff won’t come in to save a life.”

Caregivers cannot dwell on the gravity of the situation – and the possible consequences involved—until their work is done, Marsh said.

“You kind of go into an auto mode – you know you have to prioritize and get things done, because there’s so much at stake,” Marsh said. “You have to remain calm: panic creates chaos. It just works like an engine. We have the best nurses down here – it’s a hard job.”

And for Marsh, the mission is personal. Nine years ago, her father died of a massive heart attack on the driveway outside his home. Her mom, Barbara Marsh, spent 16 years in Cardiac Cath and is now retired.

“For me, my job has a whole different meaning,” she said. “If I can save somebody’s parent, save them from knowing that hardship, that’s why I do this.”

The next morning was probably the best day of Marsh’s 25-year career at St. Anthony’s. The heart team had finished its work, and Marsh was working in the electrophysiology lab when a call came in: Dr. Morton wanted to see the three team members. He motioned them into the waiting area where the Griffin family was sitting, and introduced them to the family as the caregivers who saved Griffin’s life.

“That was the best thing I have ever seen a doctor do,” Ellen Griffin recalled. “He gave his team the credit.”

The family, in turn, thanked the team.

“It was something I’ll never forget, that day, seeing the family’s faces and realizing how appreciative they were,” Marsh said. “It touched my heart that what we do matters.”

It certainly does, Griffin recalled days later.

“How can you ever repay someone who saves your life?” he asked.

Facing page: Steve Parker, Dr. Morton, Terri Marsh, Lisa Slavik - one of St. Anthony’s cardiac teams.

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HEART PAVILION RENAMED JOHN K. PRUELLAGE HEART & VASCULAR CENTER

new nameS, Same great care

On Feb. 4, St. Anthony’s Heart and Surgical Pavilion was renamed in honor of John K. “Jack” Pruellage, a dedicated member of the medical center’s board of directors from 1996 through his death in May 2012.

The state-of-the-art center is home to St. Anthony’s Heart Specialty Center and boasts four cardiac catheterization labs, three Interventional Radiology suites, two electrophysiology labs, one endovascular operating room and the Heart Evaluation and Rapid Treatment (H.E.A.R.T.) Unit (see accompanying story), said Ellen Smith, director of Cardiovascular Interventional Medicine.

“What I think sets us apart is our staff and physicians,” Smith noted. “Even those for whom St. Anthony’s was not their first choice, by the time they are discharged they often point out that it was an awesome experience and they will tell others. We are a hidden gem, and we love our patients and our work.”

St. Anthony’s Electrophysiology Lab was the first in the Midwest to have the Carto3 heart mapping system, which allows surgeons to build a three-dimensional model of each patient’s heart. Cardiologist Greg Botteron, M.D., does the

majority of the mapping for atrial fibrillation.

“We get patients from all over the Midwest because of Dr. Botteron’s excellent outcomes and reputation,” Smith said. “What sets us apart more than anything else is our physicians. David Dobmeyer, M.D., for instance, is doing highly complex procedures, such as Atrial Septal Defect (ASD) repair, Patent Foramen Ovale (PFO) repair, carotid stenting, and catheter-based treatment of peripheral vascular disease. In collaboration with Dr. Botteron, Dr. Dobmeyer will begin enrollment soon in a national study to examine the efficacy of a cardiac device that will take the place of blood thinners in patients with atrial fibrillation.”

Heart disease is the leading cause of death in the United States, for both men and women. St. Anthony’s 13 cardiologists on staff have board certifications in cardiology, echocardiology, electrophysiology and peripheral vascular treatment.

“In the community, we are considered one of the better heart services,” said cardiologist David J. Morton, M.D., chief medical officer of St. Anthony’s.

Dr. Dobmeyer agreed. “We do everything here that the university

hospitals do, except pediatrics and transplants,” he said. “We do all sorts of coronary interventions, and have a response time for heart attack patients that’s considerably faster than the national average. We take pride in being able to offer the people of South County and the surrounding area state-of-the-art and cutting-edge cardiac therapies. We would not be able to do this without the commitment and dedication of St. Anthony’s Medical Center and its exemplary staff of nurses and technologists.”

Although the work is stressful, the payoff is worth it, said Kate Lee, R.N., Cardiac Catheterization.

“After you get the artery open, all the color goes back to their faces, and they’re feeling better, you derive a certain satisfaction – that could be my father or grandfather,” Lee said.

Patty Mitchell, a scheduler for the cath lab, joined St. Anthony’s in 1982 in SPD Central Supplies. At the time, the hospital had only five floors and one cath lab.

“It’s fast-paced and very busy,” said Mitchell, who has worked in the cath lab since 1989. “I have great co-workers: they are the best.”

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RAPID TREATMENT UNIT TO OPEN IN LATE SUMMER

Facing page: The Heart and Surgical Pavilion at St. Anthony’s Medical Center recently was renamed in honor of John K. “Jack” Pruellage, who served as a dedicated member of the medical center’s board of directors from 1996 until his death in May 2012.

Right: Tamara Taylor, ANP, and Connie Kray, R.N., manager of the H.E.A.R.T. Unit, discuss a patient’s care.

Patty Mitchell works with a patient to schedule an appointment for a cardiac cath.

To treat patients who aren’t having an active heart attack, but need further evaluation before heading home, the eight-bed Heart Evaluation And Rapid Treatment Unit (H.E.A.R.T.), opened in May 2012 in the Physicians Office Center.

The H.E.A.R.T. unit’s patients are referred from the urgent care centers, Emergency Department and physicians’ offices. Nurse practitioners, R.N.s and techs on staff 24 hours a day, seven days a week, treat cases of chest pain, heart failure, and atrial

fibrillation or irregular heartbeat. “It’s basically dedicated to the

outpatient treatment of heart problems in an attempt to decrease readmissions and allow us to better take care of heart failure specifically, but also other cardiac problems,” said David Morton, M.D., chief medical

officer. “It’s going to become the nucleus for a heart failure program for the whole hospital, which is being developed now by cardiologist Charles Carey, M.D.”

Baseline protocols are followed, such as IVs, electrocardiograms and lab tests, to ensure the patient’s condition doesn’t require emergency intervention.

“A lot of times, those patients are out in three to four hours, whereas a normal hospital stay might involve a couple of days,” said Connie Kray, manager of the H.E.A.R.T. Unit.

In August, an expanded, 10-bed unit – the Lewis Rice Heart Evaluation and Rapid Treatment Unit - is scheduled to open, Kray said.

The new unit is being funded by contributions from friends, colleagues and family of the late John K. Pruellage, a board member of St. Anthony’s who served as a champion of the medical center and provided wise counsel and dedicated leadership that helped the medical center to thrive as an independent health care provider.

Kray first joined St. Anthony’s Coronary Intensive Care Unit in 1978, when there were only about two cardiologists on staff and the cath lab had yet to be built. She continues to do some procedures.

“Our census is definitely going up,” Kray said of the H.E.A.R.T. Unit. “It’s truly amazing what we can do

now. It’s been quite an adventure. I really have seen over the years that, compared to other community hospitals, we’re way ahead. We’ve had people come from other cath labs in other hospitals to observe, and they say, ‘Wow, you do that?’

“We have some excellent cardiologists, and our staff is just wonderful,” Kray added. “The patients love it here.”

Soon, the H.E.A.R.T. Unit staff will focus on follow-up care with patients who have been identified by their physicians as high-risk for readmission, Kray said. They will be asked to return within two or three days of discharge for a free visit, during which they will see a nurse practitioner, have their medications checked, lungs listened to, dietary education reviewed and weight measured. Rapid weight gain is a sign of fluid retention and worsening heart failure.

After the patient returns home, the staff will call him or her once a week for a month. The patient is expected to follow up with his or her physician and/or heart failure clinic in seven to 10 days after discharge.

“Our main focus is heart failure patients, to get them education and to help them stay well,” Kray said. “It’s a win-win situation. The patient gets education and a better quality of life, and the hospital saves money. It will be nice to see that we’ve made a difference.”

6 spotlight | april 2013

better medicine

Q: DR. MORTON, IN 2012 YOU WERE APPOINTED CHIEF MEDICAL OFFICER, AND ARE CHARGED WITH FACILITATING INTERACTIONS BETWEEN MEDICAL STAFF, ADMINISTRATION AND THE BOARD OF DIRECTORS TO ASSURE EFFECTIVE AND EFFICIENT DELIVERY OF MEDICAL CARE. IN ADDITION TO YOUR DUTIES AS THE MEDICAL CENTER’S CHIEF MEDICAL OFFICER, YOU CONTINUE TO PRACTICE AS AN INTERVENTIONAL CARDIOLOGIST. HOW DOES YOUR PRACTICE AFFECT YOUR DUTIES AS CHIEF MEDICAL OFFICER?

A: As chief medical officer, I’m responsible for overseeing the clinical activities in the hospital and quality programs, as well as being directly responsible for the cardiac service line. As a practicing physician, I think I have a better insight into the day-to-day clinical activities. My practice keeps me connected with some of the quality issues, and it allows me to be more effective in working to improve them.

Q: IN 2011, THROUGH A UNIQUE HOSPITAL/PHYSICIAN PARTNERSHIP, THE HEART SPECIALTY CENTER WAS ESTABLISHED AT

ST. ANTHONY’S, WITH A GOAL OF BECOMING ONE OF THE TOP CARDIAC PROGRAMS IN THE COUNTRY. PLEASE TELL US HOW THE CARDIAC TEAM IS PROGRESSING TOWARD THIS GOAL.

A: That’s always going to be our goal, to get to the top and stay there. The Heart Specialty Center is basically St. Anthony’s cardiac service line, and it requires that we continue to keep up with the latest advancements in cardiac surgery and groundbreaking treatments for heart failure, abnormal heart rhythms and heart attacks, all those different pieces. Really, having the ability to provide the highest level of care to patients, that’s our bottom line. That’s what we’re here for, and that’s what motivates all of us.

Q: ST. ANTHONY’S CARDIAC PROGRAMS BOAST SEVERAL “ONLIES.” ONE OF THESE IS THE OUTPATIENT HEART FAILURE PROGRAM, THE ONLY ONE OF ITS KIND IN THE REGION. CAN YOU TELL US MORE ABOUT THIS PROGRAM?

A: Patients with heart failure account for 43 percent of the funds spent by Medicare, according to the Centers for Medicare and Medicaid Services. St. Anthony’s Heart Failure Program is meant to be a comprehensive one to treat inpatients and outpatients with heart

O v er s eein g da y -tO -da y clin ica l a ctiv ities :A conversation with David Morton, M.D., chief medical officer

“Really, having the ability to provide the highest level of care to patients, that’s our bottom line. That’s what we’re here for.”

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failure. It will serve as a community resource to help nursing homes take care of patients, and provide ongoing support to primary care patients. Treating an acute heart flare-up in the hospital is easy; treating long-term heart failure is a much more complicated endeavor.

Q: WE’D LOVE TO KNOW MORE ABOUT YOUR FAMILY AND HOBBIES. ALSO, IS THERE ANYTHING YOU’D LIKE OTHERS TO KNOW ABOUT YOU THAT ISN’T COMMON KNOWLEDGE? FOR INSTANCE, ONE OF OUR CO-WORKERS HAS HEARD YOU ENJOY SWIMMING WITH SHARKS?

A: I like to play golf and sail in the Caribbean. I’m a divemaster, as is my son, Luke. He and I dive together, and yes, I’ve done some shark dives. Sharks won’t bother you: they don’t really see you as food. My favorite place to dive? Probably the Great Barrier Reef.

ABOUT DR. MORTON

A South County native—his mom still lives in the family home on Telegraph Road—Dr. David Morton is a Mehlville High School graduate. He earned his medical degree from the University of Missouri-Columbia in 1982 and completed his residency at the Bowman Gray School of Medicine of Wake Forest University and the North Carolina Baptist Hospitals, Inc. in 1984. He completed his cardiology fellowship at the University of Cincinnati School of Medicine in 1986 and is board certified in internal medicine and cardiology, as well as interventional cardiology. Dr. Morton is the former president of Metro Heart Group, formerly the area’s largest cardiology group. In 2011, Dr. Morton and

10 colleagues, and their nurses, technicians and staff partnered with St. Anthony’s to create Heart Specialty Associates. The hospital/physician partnership includes general cardiologists, noninvasive and invasive cardiologists, interventional cardiologists and electrophysiologists, and has as its goal to develop the most comprehensive heart care program in the region and one of the best in the country. Dr. Morton and his wife, Kathy, live in west St. Louis County.

Spotlight is published quarterly by the Marketing department at St. Anthony’s Medical Center.

Editor: Robbi Courtaway, ext. 6894Graphic design/layout/photography: Christy Siebert, ext. 6835

St. anthony’S employee wellneSS heart care FUnd targetS IndIScrImInate kIller

“Heart disease takes the lives of far too many people in this country, depriving their families and communities of someone they love and care for - a father, a mother, a wife, a friend, a neighbor, a spouse. With more than 2 million heart attacks and strokes a year, and 800,000 deaths, just about all of us have been touched by someone who has had heart disease, heart attack, or a stroke.”

Kathleen Sebelius, secretary, Department of Health and Human Services

St. Anthony’s Heart Care Fund committee includes, front row: Denise Kimble, Courtney Baxter, Patricia Reed, Rebecca Wilson; middle row: Kathleen Williams, Megan Gluesenkamp, Cecilia Mancuso, Mary Lawrence, Nancy Houlihan, Mary Ann Winkeler; back row: Jamie Nobbe, Katie Rayfield, Liana Kopchak, Connie Kray, Alicia Cummiskey;Not pictured: Janice Aubuchon, Danielle Clapper, Michael Goldmeier, David Morton, Kristin Neusel and Kory Stout.

Every day, 2,200 people in our nation die of cardiovascular disease, the leading cause

of death in the United States. And St. Anthony’s employees are at the forefront of a campaign to call awareness to, and to raise funds to target, this equal-opportunity killer: the Employee Wellness Heart Care FUNd.

In spring 2012, St. Anthony’s staff raised more than $35,000 for the American Heart Association’s Heart Walk campaign. That generosity led to the idea that some of those funds could be used to benefit the medical center, our staff and the surrounding community, while still making a substantial donation to the American Heart Association. Recently, St. Anthony’s Charitable Foundation and the Employee Wellness Heart FUNd Committee joined forces to launch the 2013 Employee Wellness Heart Care FUNd.

The FUNd’s goals are to encourage St. Anthony’s employees to have fun together in heart-healthy ways; and to raise money for great causes:

• 25 percent to the American Heart Association Heart Walk

• 25 percent to St. Anthony’s employee wellness programs

• 50 percent to fund community healthy initiatives, including Automatic External Defibrillators (AEDs), Phase 3 Cardiac Rehab and CPR Anytime kits for the South County community.

The committee’s fundraising goal this year is $30,000. Employees raised $2,000 in February by making donations to wear red on “Wear Red Day,” Feb. 1.

“Your donations to this fund will be put to work directly to the benefit of those in our community who need it most, bringing them lifesaving technology, preventative care, counseling and personalized rehabilitation,” said Liana Kopchak, development coordinator for St. Anthony’s Charitable Foundation. “It is so exciting to see different departments racing to see who can raise the most money for heart care patients and our community. Plans for T-shirt sales, bake sales, a trivia night, kickball tournament and a NCAA pool are underway, and our five-week employee walking bootcamp kicked off on April 4.”

For all the latest heart FUN, check back often at iheartstanthonys.org. And be sure to join St. Anthony’s team on May 4 for the American Heart Association’s Heart Walk at Busch Stadium.