Fillmore County Hospital
trusted hearts touching lives
19 0 0 F STR EET , PO B OX 193
GENEVA , NE 6 83 61
w w w. my fch . o rg
FIL L MO R E CO UNT Y H OSPITAL
trusted hearts touching lives
APR IL 2 015
APR IL 2 015
CHIEF EX ECUTIV E O FFICER
Pa ul U t e m a r k
B OAR D O F TR USTEES
D e b o ra h H o a r t y , Ch a ir
D e nni s K im b ro u g h , S e creta r y
Lu cill e Ca p e k
Al a n Em s h off
R i ch a rd Wa l t e r
S U N D AY
M O N D AY
IN SIDE :
IMAGINE HOW FAR YOU’LL GO
Jim’s knee served him well for 84
years but Touchstone Orthopaedics
was able to give him more!
T U E S D AY
W E D N E S D AY
Easter
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F R I D AY
S AT U R D AY
RELAY BASKET
AUCTION &
BAKE SALE
H e re a re s o m e of t h e m a ny t hin g s h a p p e nin g a t FCH d u r in g
APR IL
T H U R S D AY
1
BREATH OF
FRESH AIR
9:00 a.m.
“Seniors &
Safety”
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starts at 8 a.m.
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STILL GOING
STILL GROWING
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page 2-3
4:30 P.M.
LECTURE SERIES
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19
26
Tapping for
Emotional
Freedom
6:00 p.m.
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DIABETIC
Support Group
2:00 p.m.
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PO DI ATRY
CLINIC
page 2
FCH ’ s NEW “ BALAN CE
& MO B ILIT Y CENTER ”
page 3
CALENDAR
O F EV ENTS
page 4
Dr. Kara Krejci
PO DI ATRY CLINIC
We are pleased to welcome Dr. Kara Krejci, DPM to our Specialty Clinic. Dr. Krejci is an associate in foot and
ankle surgery at Prairie Shoulder Elbow and Hand Center. She is Board Certified, on the American Board of
Podiatric Medicine, and has recently completed a one year sports medicine, trauma, and reconstructive fellowship at
Pennsylvania Orthopaedic Center.
Her areas of interest and expertise include:
•Ankle arthroscopy
•Correction of bunions and hammertoes
•Treatment of arthritic, nerve, skin and nail conditions
•Flatfoot and neurologic foot corrections
•Total ankle replacements
•Ankle fracture repair with use of external fixators
To make an appointment with Dr. Kara Krejci, call our Specialty Clinic at 402-759-4924.
www.myfch.org/opclinic.html
J
I M A G I N E H O W FA R Y O U ’ L L G O
im Ferebee’s knees served him well. They had carried him for 84 years,
since he was born in the same rural Nelson farmhouse where he still
resides. A retired farmer, he asked much of those knees over the years,
crawling on and off farm equipment, kneeling to fix tires, walking creek banks
and scrambling over fences to care for livestock.
Over decades, that’s a lot of clutching and braking, a lot of heavy buckets
lifted with those knees. He walked too many miles to count – not to mention
chasing after the two children he and his wife, Marian, raised, and the four
grandchildren who followed.
Then pain in his right knee took away what he still loved to do on the farm.
He placed chairs and barrels around the cattle lots so he could sit down while
walking out to fill water tanks. Falls became more frequent. He and Marian
restricted activities to align with what his doctors call “bone-on-bone pain.”
“My knee started to give out and drop me. Life just took its toll, I guess,” he
says as he waits to be discharged from Fillmore County Hospital, two days after
total joint replacement surgery on his right knee through the Joint Center for
Excellence, part of Touchstone Orthopaedic Care at Fillmore County Hospital.
Two days. Jim is dressed in street clothes, reclining on his hospital bed. His
bag is packed. His ride home will be here soon. At that point, he had already
surpassed recovery milestones that sometimes take up to 10 days, giving him
rock star status at the Joint Center, where, after six months of work, officials
recently cut the ribbon to officially launch the center and bring all aspects of the
orthopaedic program to a new level of streamlined care.
“Jim’s recovery is pretty remarkable. Most patients stay (in the hospital) at
least three days. He walked a mile on the new joint in two days, which also
usually takes three or four. It sets the expectation bar high for us in this
program,” said Marcus Ruhl, care coordinator.
Jim is a poster boy of sorts for what the Joint Center team wants to achieve:
empower each patient with ample knowledge about their surgery and
recovery, provide them with advanced surgical care and personalized attention
and support their recovery with everything from research to a supportive ear
– returning them to their homes and an active lifestyle quicker.
FCH’s Joint Center is the only one in Nebraska, and one of about 150
nationally, created on the Marshall Steele model, which emphasizes data
collection, patient outcomes, patient-centric care and care team coordination.
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TRUSTED HEARTS TOUCHING LIVES
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2015
What’s important about that? To the hospital it means a program that is both
efficient and focused on patient care and satisfaction.
But to the patient, coming to the Joint Center for procedures means “a bit of a
spa-like feel where some orthopaedic surgery broke out,” quips Josh Reiners,
PA-C. “It’s a pampered, anything-you-need-type-of-stay.”
Orthopaedic Surgeon Dr. Travis Stoner often jokes with patients that he is
“just the carpenter,” working on their joints. Ruhl, who serves as the patients’
liaison and point of contact, jokes “I guess I’m the butler. We need a butler.”
Humor. That’s one of the first things patients will notice about the Joint Center team.
They find a way to get patients excited about joint replacement, to get them laughing.
Yes, Dr. Stoner has advanced surgical expertise and completed a prestigious
Fellowship at Cleveland Clinic’s Orthopaedic and Rheumatologic Institute, which
is ranked among the top three nationally, but his patients and co-workers are more
likely to tell you that he does a great Mrs. Doubtfire impersonation.
Or that he and Reiners always make sure to greet their more senior female
patients with a robust “Good Morning young lady…”
IMAGINE (cont.)
Their traits of enthusiasm, energy, humor, faith and
compassion aren’t synonymous with all orthopaedic programs. Reiners took
his picture for the hospital calendar jumping into the air with a whooping grin
and arms above his head. Stoner is known for his humble, honest, unhurried
manner, taking the time to talk hunting and family with his patients.
Their performance, however, is all business. The Joint Center ranks No. 1
(lowest) among the 150 Marshall Steele programs nationally in the category of
complications and re-admissions – rated 0 percent in each, Ruhl said. FCH is
the smallest hospital in Nebraska with a fulltime orthopaedic surgeon on staff,
but recently the Joint Center performed its first knee replacement revision
surgery on site (a more complex surgery than a standard knee replacement).
“This community always had gone to Omaha before for that type of procedure.
It is unique to be able to do that at a Critical Access Hospital,” Reiners said.
“The theme here is that people are
better prepared, everything is guided
and they are never alone,” Marcus said.
Both accomplishments lend patient confidence and bolster the Joint Center’s
goal to become the regional choice for joint care.
“We recognize that many of our patients are healthy people choosing surgery
to better their lives. We want to be the choice. We want them to know they
don’t have to drive to urban centers to get these things done,” Ruhl said.
The focus on the patient experience is another strength of the center. Over the
past six months, the team worked to better integrate with departments hospitalwide, such as Senior Behavioral Health Services. If Joint Center patients prescreen for tendencies towards anxiety or depression, mental health providers
work with them so they can go into surgery with confidence. Before discharge,
providers also teach patients coping strategies for pain.
The patient education component is extensive, said Ruhl, who meets oneon-one with each patient a month before surgery, where he conducts a home
assessment to gauge potential fall risks, and forms a discharge plan to ensure
the patient looks ahead to the return home.
Two weeks later the patient returns for a class, which emphasizes the role of the
caregiver. By the time surgery day arrives, each patient knows what is ahead down
to the smallest detail, from what type of pain medicine he or she will receive to
how far the knee or hip should bend/move the morning after the procedure.
“The theme here is that people are better prepared, everything is guided and
they are never alone,” said Ruhl. Before discharge, patients and their coach
receive personalized T-Shirts, along with a cup and a relaxation CD. They
often return for their Physical Therapy and the quarterly catered “reunion
lunch” where they meet up with other patients from their time at the center and
the staff who cared for them. From the initial contact to the last, Ruhl records
patient data and outcomes, which are used as research and performance standards
to continually better the program.
“Transparency is key. We keep track of not only their numbers but their story,”
Ruhl said. “What brought them here? What went right? What could have gone
better? We have to know what is working and what is not.”
The program’s reputation is currently drawing patients from over an hour’s drive
of Geneva, including Jim from Nelson. He left the center with minimal pain
medicine, already bending his knee to 124 degrees, well past the standard goal
of 90. One month post-surgery, he said he has no pain from the knee whose pain
previously had prevented him from walking more than a few feet at a time.
“I’m very pleased with Dr. Stoner’s work and the service I got from the
Fillmore County Hospital.” Once he is cleared for more activity he is looking
forward to doing things his knee made him miss out on for several years, like
checking cattle or traveling the sandbar by his farm in search of arrowheads.
And simply walking. “I love to walk. Now I can get back to it,” Jim said.
- Rebecca Svec for FCH
Balance
& MOBILIT Y CENTER
“According to the U.S. Centers of Disease
Control, one-third of Americans 65+
falls each year. However, falling is not an
inevitable part of aging. You can improve
your balance through training and proper
testing is the first step to improving balance
issues,” says Chad Phinney, Physical Therapist for FCH.
If you have experienced a recent fall, feel unsteady on your feet,
have spells of dizziness, or have other reason to believe you
might have a balance problem, you should talk to your doctor. While your
family physician may not be a balance specialist, he or she can refer you to
a qualified medical professional who is equipped to do a complete balance
assessment to determine the underlying cause(s) of your problem.
“Fillmore County Hospital is the first hospital outside of Omaha, NE to
establish a “Balance & Mobility Center” equipped with a state-of-the art
computerized balance testing system. It helps our team focus and integrate
a multidisciplinary, evidence-based approach towards providing costeffective care for this historically under treated population,” says Mr. Paul
Utemark, CEO
Assisted by the medical history provided by your doctor, the specialist will
perform specific tests to determine your ability to maintain your balance,
as well as your risk of falling. Computerized equilibrium tests can evaluate
the sensory and motor parts of your balance system. Sensory tests assess the
three sensory systems (inner ears, eyes, and sense of touch in your feet and
joints) that contribute to balance control. Motor tests measure your ability to
execute coordinated movements, both voluntary and involuntary, to maintain
your balance problem and will help the balance specialist customize your
treatment.
Please call our Physical Therapy department at 402-759-3167 to learn more
about our balance system.
Balance Self Test
Have you fallen more than once in the past year?
Do you take medicine for two of the following diseases: heart disease,
hypertension, arthritis, anxiety or depression?
Do you feel dizzy or unsteady if you make sudden changes in movement, such as
bending down or quickly turning?
Do you have black-outs or seizures?
Have you experienced a stroke or other neurological problem that have affected
your balance?
Do you experience numbness or loss of sensation in your legs
and/or feet?
Do you use a walker or wheelchair, or do you need assistance to get around?
Are you inactive? (Answer yes if you do not participate in a regular form of
exercise, such as walking 20-30 minutes at least three times a week).
Do you feel unsteady when you are walking or climbing stairs?
Do you have difficulty sitting down or rising from a seated or lying position?
If you check one or more of the questions, you could be at risk. However, the
best way to determine if you are at risk is to talk with your physician who
might recommend that you get a balance screening test.
2015
. TRUSTED HEARTS TOUCHING LIVES
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