Quality Improvement Initiatives

This article was published in our Cancer Program 2014 Annual Report.

Rebecca O'BerryBy Rebecca O’Berry, vice president of surgery and operations

In 2014 the Cancer Program has focused on improving our screening efforts for colorectal cancer, the one cancer that can be prevented. Our two quality improvement goals for 2014 were to improve the tracking process we use for hemoccult cards given to patients and to increase the number of people screened for colorectal cancer.

Historically, less than half of the hemoccult cards given to patients are returned to the physician’s office for testing. We implemented a follow-up plan to increase our return rate and modified the system we use to track these cards. Our efforts were successful, and we were encouraged to explore bringing in a different test that is easier for patients to perform at home. This new laboratory test will be part of our quality initiative for 2015.

Throughout the organization we worked to increase the number of patients who receive some kind of colorectal screening. In the target age group of 50-75, our screening numbers increased from 59 percent (in 2013) to 90 percent (in 2014). This is a significant improvement, and shows how effective a targeted educational effort on the benefits of some form of colorectal screening can be! Unfortunately a large number of our patients still refuse to undergo colorectal screening. In 2015 we will work to improve patient access to screening by increasing the variety of our testing methods.

In 2014 we also increased our social services support for patients undergoing cancer treatment. To ensure that everyone has the help they need while moving through treatment, our patients now have easy access to a social worker and our Blueprint team. We also created a binder to collect all the information needed by someone undergoing cancer treatment.

The MagView program implemented at the end of 2013 has helped our radiology department track screening mammography in a more systematic way. This program keeps all a patient’s information in one location, and allows a much faster turnaround time for notification of results. The time a patient must wait to receive a mammography result notification letter is now less than two days!

Our providers are excellent communicators and have put a lot of time and energy into community education about prevention, early detection, and treatment of cancer. We work closely with our local senior centers to provide education sessions that are open to the public. Topics covered in these community outreach efforts include: skin cancer screenings and education (in several locations); discussions on breast cancer, bladder and prostate cancer, and colorectal cancer. We will continue to provide this education in the upcoming year.

In 2014, 53 new cancer cases were identified, with breast cancer continuing to be the most prominent followed by lung, colon, and prostate. A total of 41 of those 53 cases were discussed at Tumor Board meetings.

2014 Gifford cancer statistics

Click here to read our full Cancer Program 2014 Annual Report.

Gifford Auxiliary Gives $1 Million to Hospital’s Capital Campaign

Funds raised through sales at popular volunteer-staffed community Thrift Shop

Gifford Auxiliary

Members of Gifford Medical Center’s Auxiliary at their quarterly membership luncheon on November 15, 2015. (Photo credit: Bob Eddy)

Gifford Medical Center’s Auxiliary announced a million-dollar gift to the hospital’s Vision for the Future campaign at the organizations quarterly membership luncheon on November 15, 2015.

Funds for the generous gift were raised through sales at the popular volunteer-staffed Thrift Shop in Randolph.

The Vison for the Future campaign is raising funds to support a multi-phased project that built the new Menig Nursing Home in Randolph Center (which opened last spring), 25 private inpatient rooms (which will open mid-December), and an updated and more centrally located Birthing Center in the hospital (planned to open next spring). The campaign needs just $800,000 to close the $5 million campaign, and hopes the Auxiliary’s gift—created through hard work and small-dollar sales—will inspire others to invest in the hospital’s future.

“This gift represents an overwhelming generosity of time and resources,” said Gifford Administrator Joseph Woodin, who noted that over the years the Auxiliary has supported strategic projects (including the original Menig Extended Care wing, the Philip Levesque Medical Building, and the employee day care center) as well as annual departmental “wish list” items not included in the hospital budget. “The Auxiliary is a key part of Gifford’s success, and truly adds tremendous value to our community.”

The Thrift Shop first opened its doors in 1956 and has been providing clothing and household items to bargain hunters and those in need ever since. The 148-member Auxiliary runs the Thrift Shop, with some paid staff and many dedicated volunteers who sort through donations, clean and mend clothes, price items, stock shelves, and staff the store. Each year the Auxiliary also funds scholarships for college students pursuing health careers, financial aid for students enrolled in LNA programs, and supports other community outreach programs.

Auxiliary President Margaret Osborn says the Thrift Shop’s success can be measured in terms of money raised, but also by the enthusiasm of the volunteer workers, the creativity of employees, and the many community customers and donors.

“This million dollar gift reflects our community’s enthusiasm for re-gifting their possessions through the thrift shop, helping to ensure that we have high-quality local hospital care and good merchandise at prices everyone can afford—from fire victims to frugal shoppers,” said Osborn. “We provide an effective, simplified process that gets unused goods out to those who can use them. At the same time we offer tremendous opportunities for people with vitality and skills who want to give time to community service.”

Woodin also notes the many layers of the Thrift Shop’s community contributions. “We are so fortunate to have this unique community resource,” he said. “It helps the hospital, it helps people with limited resources, it keeps unused items from cluttering homes and out of the landfill, and it offers everyone the joy that comes with finding a good bargain. That’s a universal gratification!”

To volunteer or learn more about the Thrift shop, call (802) 728-2185. For more information about Gifford’s Vision for the Future campaign, call Ashley Lincoln at 728-2380 or visit http://www.giffordmed.org/VisionfortheFuture.

Finding Patient-Friendly Colorectal Cancer Screening Options

This article was published in our Cancer Program 2014 Annual Report.

Gifford cancer program

One of our program goals for 2014 was to screen more people for colon cancer to help decrease the number of later-staged colon cancers found in our patients. Providers and nursing staff talk with patients during office visits about cancer screening services available at Gifford, and the benefits of detecting cancer early—especially with colon cancer, the “preventable cancer.”

A typical colorectal cancer starts as a slow-growing polyp in the lining of the colon or the rectum. These precancerous polyps and early cancers can be detected (and removed) during a colonoscopy, which is the preferred colon cancer screening test. But many patients delay or refuse colonoscopy screening, and we still want to encourage those people to at least have a fecal blood cancer detection test with their annual physical.

The hemoccult cards traditionally used for this screening required a patient to collect multiple samples at home and bring them back to their provider’s office. Even with an improved follow-up system to remind people to return their cards, less than half of the tests made it back to Gifford. Many patients reported that the dietary restrictions, multiple sample collecting, and the embarrassment of having to carry the card back to their provider caused them not to complete the test.

Cancer program staff explored other screening options and found a test that detects blood in the stool more accurately, is easier for patients to use and, more importantly, can be discretely mailed back to the lab for analysis. The FIT (Fecal Immunochemical Testing) cancer detection test is now offered as part of annual physicals at Gifford.

Click here to read our full Cancer Program 2014 Annual Report.

Expertise, Personalized Care, and Comprehensive Support Close to Home

This article was published in our Cancer Program 2014 Annual Report.

Brenda CaswellWhen someone is given a cancer diagnosis, their world is turned upside down. Suddenly there is a lot of information to absorb, many tests to take, and hard decisions that have to be made quickly—all when people are feeling most vulnerable.

Travelling to receive treatment and follow-up cancer care can be expensive, exhausting, and complicated to organize. At Gifford patients with cancer have treatment options that can relieve these stresses.

Most cancers—especially breast, colon, prostate, and bladder cancers—can be treated here in our community hospital with caregivers that patients know and trust, close to the family and friends who will support them during treatment.

“Our goal is to make sure people know that they can receive the same quality of care offered at larger hospitals close to home, with a support network they know,” said Rebecca O’Berry, vice-president of Surgery and Operations at Gifford. “Battling a cancer diagnosis is hard enough—I’m thankful that we can provide quality cancer care locally and decrease our patient’s travel time during treatment.”

First accredited by the American College of Surgeons Commission on Cancer in 1965 (we received our most recent 3-year accreditation in December of 2014), our cancer program has been delivering quality cancer care to our community for nearly fifty years. Our oncology services include cancer care from an experienced oncologist, hospital specialists and surgeons, and specially certified oncology nurses; lab and diagnostic services; advanced diagnostic services, including stereotactic breast imaging; outpatient chemotherapy; preventive cancer screenings; and a strong palliative care program. Our multidisciplinary approach to each patient’s care includes identifying social service needs as well as appropriate medical expertise.

Experience, expertise, and compassionate care close to home

“With cancer, making the right diagnosis and getting the right treatment is key,” says Dr. Richard Graham, a Gifford urologist who treats prostate, bladder, and renal cancers. “Experience with specific cancers is also important. We have the expertise and technology to diagnose a lot of rare cancers, but we are small enough to see patients as individuals: You are not a number here.”

Graham notes that he saw an increase in patients whose small cancers were treated with cryosurgery and laparoscopic surgery in 2014.

Personalized support for the cancer care each patient chooses

When a patient chooses cancer treatment that is not offered here, our providers make referrals and collaborate with outside oncologists so things go smoothly. Patients have the option to receive post-operative care and chemo treatments close to home.

Brenda Caswell, a Randolph mother of five, regularly comes to Gifford for medical care and annual mammogram screenings. She missed three years of annual visits because of her pregnancy and the birth of her youngest child, and when she resumed her check-in’s her provider insisted that she get a mammogram.

“My provider didn’t let me out of the office without scheduling a mammogram,” Caswell says. “She knew me, knew that my mom had had breast cancer, and knew that regular screening was especially important for me.”

A small tumor was detected, and after a biopsy and two consultations with Dr. Ciccarelli, she decided to have mastectomy and reconstructive breast surgery through a program offered at a larger hospital. Dr. Ciccarelli’s team made referrals and helped her arrange treatment. When her cancer was found to be more invasive than originally thought, she had to plan for chemotherapy after surgery. Then, when post-operative complications required a week of inpatient care right before the holidays, she knew she wanted to be close to home and with her family.

“I was able to be at Gifford, just down the street from my home,” Caswell said. “The doctors were wonderful—they collaborated with the oncologists who were treating me, sharing blood counts and test results. It was a very smooth process.”

Click here to read our full Cancer Program 2014 Annual Report.

Wiemann Lamphere Architects to Design Gifford Senior Living Project

Wiemann Lamphere Architects

(L to R) Gifford Retirement Community Executive Director Linda Minsinger, VP of Operations and Surgical Services Rebecca O’Berry, and Facilities Director Doug Pfohl

Gifford will work with Wiemann Lamphere Architects as they move into the second stage of building independent living apartments at the new Morgan Orchards Senior Living Community in Randolph Center, Vermont.

The Colchester, Vermont design firm will build on Gifford’s original design concept to create a vibrant neighborhood for the 25-acre campus, which includes the new Menig Nursing home and planned future assisted living.

“Wiemann Lamphere has worked on many housing projects and brings specific expertise in designing for seniors in independent living facilities,” said Gifford’s Vice President of Operations and Surgical Services Rebecca O’Berry. “They are an energetic and enthusiastic team who approached our project with creative ideas on how to encourage community interaction while incorporating nature and energy conservation into the design.”

The three-story, 49-apartment building will use internal common spaces (including a proposed dining room, library, fitness area, lounges, and sunroom) to encourage community interaction, and external gathering spots (a proposed campus green, orchard, gardens, and extensive nature trails) to strengthen the neighborhood feel of the campus.

Groundbreaking for the independent living apartments is anticipated in the spring of 2016, with an anticipated move-in date in late spring 2017.

“We are pleased to be working with Gifford to develop much needed senior housing opportunities in central Vermont and look forward to making the most of the wonderful views on the site,” said Weimann Lamphere President David P. Roy. “We have a passion for sustainability, and a drive to create healthy, invigorating spaces for people to live their lives to the fullest.”

To learn more about the Morgan Orchards Senior Living Community, visit www.giffordmed.org/IndependentLiving or call 802-728-2787.

Erica Sears Exhibit at Gifford Medical Center’s Art Gallery

Erica Sears exhibit

“Goodbye to the Sun,” an abstract in acrylic by Randolph artist Erica Sears

Eleven new pieces by Randolph artist Erica Sears will be displayed in the Gifford Gallery in a month-long show that will run through December 12, 2015.

Sears, who graduated from Randolph Union High School in 1985, received her bachelor’s degree in fine arts from Otis Art Institute of Parsons School of Design in Los Angeles, where she lived for 15 years before returning to Randolph in 2000.

Sears has been making, selling, and teaching art for over 25 years. Her work has been displayed in Los Angeles and throughout the region at Chandler, First Light Studios, Gifford, in Bethel, and at the White River Craft Center. Currently a large three-panel painting of hers hangs in the Upper Ester Mesh Gallery at Chandler (part of its permanent collection), and her work is on display at the Black Krim Tavern on Merchants Row in Randolph. You can see more of Erica’s work at Etsy.com at her shop “Erica Sears Art”.

“I love color and texture, so when I create I get to play and let my imagination run wild,” says Sears. “I will make art with pretty much anything. This show is a selection of paintings with and without collage that range in size from 5″x10″ to 4′x5′.”

This is her third Gifford show, and is a vibrant collection of abstract works in paint and collage that visually express the colors and emotions of the seasons and daily experiences of the artist.

This exhibit is free and open to the public, and will be displayed through December 12, 2015. The gallery is located just inside the hospital’s main entrance at 44 S, Main St. (Route 12) in Randolph. Call Gifford at (802) 728-7000 for more information.

Gifford Birthing Center Welcomes Two Certified Nurse Midwives

Two certified nurse midwives have joined Gifford’s Birthing Center team: Ali Swanson, who comes to Randolph from a practice in Winnipeg, Manitoba, and Vermont native Susan Paris. Established in 1977, Gifford’s Birthing Center was the first in Vermont to offer an alternative to traditional hospital-based deliveries, and continues to be a leader in midwifery and family-centered care.

Ali Swanson

Ali Swanson

Ali Swanson grew up just north of Chicago and received a BA from the University of Wisconsin at Madison, and a Bachelor of Science in Nursing, and a Master of Science in Nursing from the University of Illinois at Chicago. Her clinical interests include adolescent health and waterbirth.

After working as a midwife in the inner city of Chicago for two years, she was attracted to the Canadian midwifery model (where midwives function as autonomous providers who assist in childbirth in homes, hospitals, and free standing birthing centers) and obtained her Canadian licensure. She most recently was a registered midwife at the Winnipeg Regional Health Authority. Wanting to relocate to Vermont, she is excited to have found a community hospital where she can draw on her experiences in both hospital and out-of-hospital settings.

“Birth is a life-changing event and a very unique experience,” says Swanson. “It is all about trust and a woman’s relationship to her body, her family, and her midwife. I want to help a woman experience it in a way that is supportive and comfortable for her.”

Susan Paris

Susan Paris

Susan Paris, raised in Jeffersonville, Vermont, always knew she wanted to help women with labor and delivery. “Midwifery is in my bones,” she says.

She received a BS from Johnson State College, an Associate in Nursing from VTC, and a Master of Science in Midwifery from the Midwifery Institute of Philadelphia. She most recently worked as a labor, delivery, recovery, and postpartum nurse at Martin Memorial Health Center in Florida, and has also worked at Copley Hospital and the University Medical Center of Vermont. Paris says she brings a supportive and friendly approach to her work, and also a sense of humor—“It’s supposed to be fun too!” Her clinical interests include the prenatal and birthing experience, well-women care, and adolescent care. She is pleased to be back in Vermont and part of a team that offers women a broad skill set and choices in style as well as personality.

“With childbirth you need to have many ‘tools,’ available and consider many options –you never can predict how the process will go,” said Swanson. “I want to help women along the path they’ve chosen, but I’m always prepared to adapt and be ready to move in a different direction when needed.”

The Birthing Center team brings extensive knowledge and skill to their work: four licensed midwives and three board-certified obstetricians/gynecologists with expertise in high-risk pregnancy and birth collaborate when needed to provide compassionate, 24-hour care. At each step of the process they work to personalize the process, helping women choose their best options for a positive and rewarding birth experience.

Ali Swanson and Susan Paris are currently accepting new patients. To learn more about the Birthing Center, please call 728-2257.

Personalized Care, a Healing Space Near Home

Vision for the Future co-chair experiences first-hand the importance of quality local care

This article was published in our Fall 2015 Update.

Lincoln ClarkLincoln Clark, Gifford trustee and co-chair of the Vision for the Future campaign, has been actively raising funds for the new Menig Nursing home and the subsequent private patient
room conversion at the hospital.

In an odd twist of fate, the Royalton resident recently experienced first-hand just how important quality local care and private patient rooms can be to both the patient and their family.

While on an annual fishing trip with his son in northern Maine, Clark fell and broke his hip as they were taking their boat to get the motor serviced. After a 178-mile ambulance ride to Portland, ME, he found himself facing surgery by a surgeon he’d never met.

“I spent approximately four minutes with him prior to the operation. I was doped up to the gills, and I couldn’t understand his precise and very technical description of the procedure,” Clark said. “The next day he was off-duty so his partner, a hand surgeon, looked at my wound.”

That same day a care management representative visited to say that he would be released the following morning—they were looking for a rehabilitation facility that could take him.

Clark asked if he could go home to his local hospital, and was told that Medicare would only pay for an ambulance to the closest facility (to pay for an ambulance to Vermont, would cost him thousands of dollars). He was transferred to a facility in Portland the following morning.

“The new room was sectioned off with brown curtains, the bed pushed up against a wall, and there was a 3-foot space at the bottom of the bed for my wife, Louise, to sit,” he said. “It was smaller than most prison cells! My roommate’s family (six of them) was visiting, and they were watching a quiz show on TV at full volume.” This was the low point.

Overwhelmed, the Clarks struggled to figure out the logistics of a long stretch in rehab for Lincoln, and the hours-long commute for Louise, who had to maintain their house in Royalton.

After an unimpressive start in the rehab physical therapy department, they made an unusual but obvious choice: Louise packed Lincoln into the car and they made the 4-hour drive to Randolph.

“I wanted to be at Gifford. I knew the physical therapy team was first rate, and I was confident I would get the kind of therapy I needed to get me out of the hospital,” Clark said.

Fortunately, a room was open and he spent ten days at Gifford this summer. He worked on his laptop in the Auxiliary Garden, met with people in his room, and was even wheeled to the conference center to attend board and committee meetings. Once discharged, he was able to continue his therapy as an outpatient.

“After this experience I really can see how important a private patient room is,” he said. “And I can attest that the letters to the board, the positive comments patients make on surveys, and the occasional letters to the editor don’t begin to describe all that it means to be cared for by Gifford’s staff. This is just a great hospital!”

The “Preventable Cancer:” Spreading the Word about Colorectal Screening

This article was published in our Cancer Program 2014 Annual Report.

preventing colon cancer

The providers in Gifford’s Cancer Program regularly visit senior centers, nursing homes, church meetings, and other community gatherings to offer skin cancer screenings, give free talks on cancer prevention and the importance of early detection, and host educational discussions of breast, bladder, prostate, and colorectal cancer.

In talks like “Everyone’s Got One: A Discussion of the Colon and How to Keep it Healthy,” surgeon Dr. Olveto Ciccarelli uses humor to help people learn about the importance of colorectal cancer prevention and screening.

“Everyone has these organs, but people are reluctant to talk about problems with their colon or their rectum,” said Ciccarelli. “Men especially find it difficult to discuss these matters, but this is one area where medical science has proven that cancer can be avoided, lives extended, and quality of life improved.”

This is especially true with colorectal cancer, which was a program focus for 2014. Colorectal cancer is called the only “preventable cancer” because it is the one cancer where regular screenings can help to keep cancer from forming. A colonoscopy detects any slow-growing polyps that may form in the colon so they can be removed before becoming cancerous. Because early colorectal cancer often has no symptoms, screening is even more important because it can detect existing cancer when treatment is most effective.

Still, colorectal cancer is the third most common type of cancer in men and women in the United States. The good news is that deaths from colorectal cancer have decreased as more people take advantage of screening tests like colonoscopies, specialized X-rays, and tests that check for cancer in the stool.

So far, Gifford has had significant success with our efforts to increase colorectal screening rates for our target age group of 50-75 (an increase to 90 percent in 2014 from 59 percent in 2013).

We will continue to spread the word in our community. With colon cancer, it is simple: Regular screening could save your life.

Click here to read our full Cancer Program 2014 Annual Report.

Project Independence

The following article appeared in our 2014 Annual Report.

Project Independence

Adult Day participants at both of Gifford’s locations enjoy many activities: sing-alongs, live performances, arts and crafts, exercise, games — even visits from a therapy dog!

Another senior-health initiative came to fruition in 2014 when the boards of Gifford and Project Independence, an adult day center located in Barre, unanimously
agreed to a merger in May after studying the relationship for more than a year.

The merger took place at the conclusion of Gifford’s fiscal year on September 30.

Project Independence got its start in 1975 when a nursing home activity director, Lindsey Wade, encountered residents who didn’t seem to medically belong there. Wade envisioned a social adult day program, a new concept at the time. An active board and an interested city brought to life Project Independence on Washington Street, and in the decades since, its model has expanded statewide. There are currently 14 adult day programs in Vermont.

Today’s Project Independence serves 23 towns in Washington and northern Orange counties, welcoming an average 38 seniors and the disabled each weekday. The project includes meals, showers, medication management, and ample activities, providing participants with a fun and safe day care experience while also allowing them to stay at home—a far more affordable model than nursing-home care.

But an ongoing struggle for funding—combined with property damage caused by flooding in 2011 and a sewer issue during Barre’s “Big Dig”—prompted small, standalone Project Independence to seek help in the form of a partner. The board was drawn to Gifford because of the adult day program in Bethel, the medical center’s mission of supporting seniors, and its commitment to community.

Under the full-asset merger, Project Independence retains its name, location, and fund-raising dollars. Its board will become an advisory board to provide local perspective and experience, and employees will become part of Gifford, opening the door to enhanced benefits. Project Independence will be helped by Gifford’s staff, from financial to billing to nursing help, as well as its buying power as a larger organization.

“When someone has a humble request for help as it relates to the delivery of health care services, we take that seriously,” said Gifford Administrator Joe Woodin, praising Project Independence’s board, values, volunteers, and hardworking team. “For us, that’s extraordinarily appealing and we’re thankful that they’ve asked us.”

Joining with Project Independence is in keeping with Gifford’s mission and provides support to a needed service that will no doubt grow as the state looks for more affordable ways to care for a growing senior population, said Gifford Board Chair Gus Meyer.