A Message from the Medical Director of the Hospital and Medicine Divisions, Dr. Martin Johns

The following article appeared in our 2014 Annual Report.

Dr. Martin Johns

Dr. Martin Johns

One evening when I was on duty, a 911-call patient was brought into the emergency room. The patient was unresponsive and unable to communicate.

I pulled up the electronic medical record and was able to see that he had been given a new medication when seen at a Gifford clinic earlier that day.

Clearly he was having a delayed allergic reaction, and because I could see exactly what medication he was given, I could immediately give him the appropriate antidote. If I had not had access to the information in EMR, I would have had to guess and start trying different medicines to counteract the reaction.

When another patient was confused about what medications they were taking, I pulled up their most immediate office note on EMR and made adjustments based on what had been done within the previous 24-hour period.

An important aspect of the new EMR system is that it allows medical information to follow the patient through transitions of care across all Gifford platforms: inpatient care, outpatient care in community clinics, radiology, and emergency room visits.

In the past, important information could be unavailable or even lost during these transitions—a clinic might be closed for the day, or important information not yet added to a patient’s record. Now, anyone caring for a patient can view important information and also update the record (adding a newly developed allergy or immunization) or note changes in clinical status.

Gifford’s New Single Occupancy Rooms

The following article appeared in our 2014 Annual Report.

new private patient rooms at Gifford

Detail of the new private patient rooms, including two hospice (garden room) suites.

Jack Cowdrey“When you’re sick, you really want to be alone. And when you share a room it can be difficult to sleep when the other patient has visitors. When I was a patient in August I noticed that by the time a nurse rolled in the computer cart there was little room for anything else. It will be so nice to have the privacy and the extra space in the new rooms.”     ~ Jack Cowdrey, Former Board Member Dessa Rogers

“Single occupancy rooms will make it easier for us to get patients more involved in their care. The increased privacy will allow nurses to “sign off” to the next nurse coming on right in the room with the patient, so they can be informed and involved in the process.” ~ Dessa Rogers, RN, Nurse Manager, Medical Surgical & Rehab Unit Ben Cronan

“We bring radiology technology to the patients. It can be a challenge to navigate around beds, wheelchairs, walkers, and other equipment in the room, especially if the room is being shared. Sometimes we will wheel the portable x-ray in multiple times a day, and it can be disruptive to others in the room. The patients and family I talk with often share their difficulties with having two patients in one room. The new private rooms will really help with patient comfort, privacy issues, and visiting family and friends.” ~ Ben Cronan, Radiology Technologist

A Message from the Executive Director of Gifford Retirement Community Linda Minsinger

The following article appeared in our 2014 Annual Report.

Executive Director of Gifford Retirement Community Linda Minsinger

Executive Director of Gifford Retirement Community Linda Minsinger

Vermont has a huge need to figure out how to care for its seniors. Isolation is one of the biggest problems of aging in a rural area. Humans are meant to be with humankind. We proved that years ago when we tried to understand how much touch people need as a baby; when you don’t get it, you fail.

It’s the same with seniors. We want everyone to treasure our seniors as much as we treasure our babies.

Adult day care is a cost-effective way to help seniors age. Yet it has been underdiscussed and underplanned. The state of Vermont only wants one adult day-care center per county. That doesn’t make sense. Orange County has two sets of mountains. It takes me an hour and a half to get from Bradford to Randolph—that’s still in my county. It’s unfair to ask fragile seniors to sit on the bus for an hour and a half.

The state puts a lot of money into nursing homes, so there isn’t much left over for other programs. Adult day gets what we call “budget dust.” We should be trying to figure out how to have fewer people in nursing homes. Let’s tip this pyramid upside-down.

When someone is diagnosed with early-stage Alzheimers, that’s the time to start. The earlier you get them into social situations, the better it will be for them and for their caregivers in the long run.

Enhanced Response to Community Need

The following article appeared in our 2014 Annual Report.

Randolph VT hospitalAs many community hospitals find themselves contracting—or even closing—because of external pressures, Gifford is developing models that will expand services to respond to community needs.

“FQHC resources allow us to expand existing medical services and to create new paths to help patients with behavioral health and dental issues,” says Dr. Martin Johns, medical director of the hospital and medicine divisions. “These areas can impact a patient’s general health, and need to be part of standard primary care.”

Integrating behavioral and dental health into primary care
A special behavioral care team (a psychiatrist, psychologists, social workers, and care managers) has been created to help link access to behavioral health services to primary care. This group will work directly in concert with primary care providers in their offices, so services can be seamlessly added to a patient’s care plan as needed. The new enhanced behavioral health services model will be offered at Gifford’s Randolph campus early in 2015, and will then expand to the community clinics.

Gifford has established relationships with local dentists so that people coming to primary care providers with unmet dental conditions can receive care. This program will hopefully expand to include additional dental providers and other FQHC and federal programs services.

Rising to the challenge of increased substance abuse
Medical centers across the country are struggling to meet the needs of people with alcohol and substance dependency problems. FQHC funding is allowing Gifford to expand existing Vermont Blueprint for Health services so providers can better address the special needs of those who are opiate dependent and want to avoid substance abuse.

The Garden Room

The following article appeared in our 2014 Annual Report.

The Garden Room

Legacy photos (right) are one service the Last Mile Ride funds provide. These photographs, taken by a professional photographer, offer the family an opportunity to capture a few of those last few precious moments at the end of life.

The new private patient room conversion project will allow Gifford to create a second Garden Room suite for end-of-life patients.

This patient room, with French doors that open onto a courtyard garden, has an attached larger room where families can gather to support and comfort the patient and each other in this period of transition.

“A second garden room will double our capacity to care for end-of-life patients and their loved ones,” said John Young, Palliative Care certified nurse. “The Garden Room suite creates a space where families and loved ones can visit, share, interact, or just be present with each other at a time when that is needed. A dying loved one can rest, listen to music, be quiet or visit with loved ones in the attached less noisy and congested space.”

Last Mile Ride (LMR) funds support special services for patients in advanced illness and at the end of life, whether they are at home or staying in the Garden Room suite. These services include massage, acupuncture and Reiki for pain management, music therapy, and help with special wishes and one-time gifts. LMR funds also help make it possible for families and friends to focus on their loved one, providing food, transportation funds if needed, bereavement help, and professional photographs of this special time together.

For patients in this time of transition, the Garden Room adds an option to dying at home or in a nursing home. Dr. Cristine Maloney, lead provider for Gifford’s Palliative Care Program, notes that when families are caring for a loved one at home, the Garden Room can offer a comforting back-up option if things become too difficult.

“This chapter of a patient’s life has great power and poignancy, and surviving family and friends remember vividly how a death is handled,” said Maloney. “We want to help this go as well as possible and in keeping with a person’s goals and wishes.”

Gifford’s 2014 Highlights: October – December

The following article appeared in our 2014 Annual Report.

October

Gifford completes its upgrade to electronic medical records (EMR). Throughout the year, Gifford primary care and specialty care outpatient practices moved from paper to candidates' debateelectronic records as part of a federal initiative.

Gifford and the White River Valley Chamber of Commerce collaborate to hold the only local candidates’ debate for Senate and House of Representatives candidates.

Gifford's Woman to Woman FundGifford employee Teresa Bradley and her niece, Krista Warner, once again hold a bowling tournament in memory of Teresa’s mom and Krista’s grandmother, Ruth Brown. Money raised supports Gifford’s Woman to Woman Fund and brings awareness to the importance of mammograms.

Gifford announces it has met its state-approved operating margin for the 15th consecutive year.

Gifford meets operating margin

November

Major Melvin McLaughlin

Gifford loses one of the greatest heroes of our time, Major Melvin McLaughlin. Affectionately known as “the Major” and “Major Mac,” he spent the last 40 years volunteering at the hospital, encouraging staff and patients with words of love and friendship. He will be greatly missed, but never forgotten.

Hannaford gift certificate for Project IndependenceHannaford Supermarket in South Barre presented Project Independence with a gift certificate worth $1,500. The gift is used to offset the cost of groceries for the program which provides a daily breakfast, lunch, and snack for roughly 38 participants. When the store manager asked staff which nonprofit they should contribute to, the adult day program was at the top of their list.

Dr. Lou DiNicolaPediatrician Dr. Lou DiNicola receives the Green Mountain Pediatrician Award from the American Academy of Pediatrics Vermont Chapter. He was acknowledged for over 38 years of service as a Gifford pediatrician. Along with a plaque, Dr. DiNicola was presented a 7-foot-long handwritten scroll describing what makes him special.

December

Gifford once again invests $40,000 into the regional economy through the Gifford Gift Certificate program.

Gifford’s 2014 Highlights: July – September

The following article appeared in our 2014 Annual Report.

July

Gifford concert seriesThe White River Valley Chamber of Commerce and Gifford once again partner to offer concerts and now a farmer’s market on Tuesday evenings throughout the summer in the Gifford Park. Two community barbecues — one by Stagecoach and one by the Randolph Center Fire Department — also draw a crowd.

podiatrist Dr. Samantha HarrisPodiatrist Dr. Samantha Harris joins the Gifford Health Center at Berlin, providing full spectrum surgical and non-surgical podiatric care.

Gifford’s midwives hold an open house to introduce their new team to the community.

August

Dr. Kenyatta NormanAfter working at Gifford since January as a locum tenens physician, orthopedic surgeon Dr. Kenyatta Norman makes her position permanent.

A “Heartsaver CPR” certification course is offered to the community.

Last Mile RideJP’s Flea Market, formerly the Randolph Antique and Artisans Fair, is held in the Gifford park on Aug. 9. Cars line the street looking for deals and meals.

The ninth annual Last Mile Ride raises a record $60,000 for end-of-life care. This year’s event is spread over two days and attracts a record 386 Sue Schoolcraftparticipants.

Sue Schoolcraft of Randolph gains media recognition statewide for her work to make personalized quilts for Menig residents. Her work is supported by the Last Mile Ride.

ob/gyn Dr. Sean TubensOb/Gyn Dr. Sean Tubens joins the Gifford Ob/Gyn and Midwifery team from his hometown of Baltimore, bringing total laparoscopic hysterectomies to Gifford for the first time.

September

Dr. Melissa ScaleraDr. Melissa Scalera, an Ob/Gyn, joins Gifford’s women’s health team, providing complete gynecologic and obstetrics care in Randolph.

Colorado couple, sports medicine physician Dr. Nat Harlow and family nurse practitioner Christina Harlow, join Gifford’s Sharon sports medicine and Randolph primary care practices respectively. Dr. Harlow is fellowship trained. Christina holds a doctor of nursing practice degree.

Dr. Jeff LourieFamily nurse practitioner Jeff Lourie joins the Gifford Health Center at Berlin.

Project Independence of Barre officially merges with Gifford.

Gifford’s 2014 Highlights: April – June

The following article appeared in our 2014 Annual Report.

April

Gifford volunteersGifford employee Cindy Legacy, who shared her weight loss story in the 2013 annual report, starts a popular “Weight Loss Support Group” at Gifford on Wednesday evenings.

Gifford volunteers are celebrated at a luncheon. In 2013, 120 volunteers gave 16,678 hours to Gifford or 2,085 eight-hour days. Auxiliary volunteers working at the Thrift Shop gave another 6,489 hours or 811 eight-hour days. The celebration’s theme was “Hats Off to You.”

May

Gifford is named a Top 100 Critical Access Hospital in the nation by iVantage Health Analytics. iVantage used what it calls a Hospital Strength INDEX to compare Gifford against 1,246 Critical Access Hospital nationwide on 66 different performance metrics.

Starr StrongStarr Strong retires from the Chelsea Health Center after 21 years. She was the first physician assistant Gifford ever hired. An open house recognizes both Starr’s contributions and welcomes new providers to the clinic, which is packed for the event.

Sen. Bernie Sanders (I-Vt.) and officials from the Health Resources and Services Administration release a video holding up Gifford as a national model for primary care.

Casa RinaldiSharon Health Center staff members cut a ribbon on their newly expanded health center. Added are 2,600 square feet and a sign beside the front door declaring the building “Casa Rinaldi” in honor of podiatrist Dr. Rob Rinaldi who helped create the vision behind the popular sports medicine clinic.

New technology is also offered, such as a state-of-the-art Noraxon gait and movement analysis system, and a large wall-mounted monitor for a better look at live ultrasound imaging.

senior living facility groundbreakingGround is broken on a much-anticipated senior living community in Randolph Center. More than 100 are on hand to witness the start of the first phase of the project — a new, 30-bed nursing home to replace the current Menig Extended Care Facility.

A second “Infant and Child CPR” course is held, along with a second “Home Alone and Safe” course, a second “Babysitter’s Training Course” and another “Quit In Person” group smoking cessation series.

“Low Impact Water Aerobics for Chronic Conditions” is offered at Vermont Technical College’s pool for free for those with an economic need and chronic condition who are struggling to exercise.

June

Project IndependenceGifford announces that it will merge with Barre adult day program, Project Independence, at the end of September. Project Independence is the state’s first adult day program and serves 23 towns in Washington and northern Orange counties, providing an essential community resource.

The non-profit organization was facing financial struggles following flooding in 2011. A merger with Gifford means shared staff and reduced costs for the organization, allowing it to keep operating. The boards of both non-profits agreed to the merger in May.

Gifford renovationsGifford is the first hospital in Vermont to “go live” with the Vermont Department of Health interface for syndromic surveillance. The interface is part of federal meaningful use criteria.

Renovations begin on Gifford’s third floor specialty clinics to group medical secretaries, nurses, and patient waiting for improved efficiency and a modern model of care.

Gifford’s 2014 Highlights: January – March

The following article appeared in our 2014 Annual Report.

January

Gifford's first baby of 2014The first baby of the year is born to Casandra Perry of Bethel. Baby Bryden is welcomed on Jan. 2 at 3:48 a.m.

A “Matters of the Heart” series is offered monthly all year long for heart patients, or anyone looking to improve his or her heart health. Also offered: Chronic Conditions Support Group, Caregiver Support Group, Diabetes Group Education Classes, childbirth classes, and a new Mood Disorder Support Group.

A “Quit In Person” tobacco cessation class helps those addicted to smoking or other tobacco products to quit.

A “Chronic Pain Healthier Living Workshop” is offered at the Randolph House. The six-week free series addresses coping with chronic pain.

Alison WhiteExperienced nurse leader Alison White joins Gifford as vice president of patient care services – a role that oversees the Hospital Division, including inpatient care, the Birthing Center, Ob/Gyn and Midwifery, the Emergency Department, Menig nursing home, and Adult Day Program.

After considerable input from providers, staff, and clergy, the Gifford board passes a policy implementing the Patient Choice at End of Life law. The policy allows willing primary care providers to prescribe lethal prescriptions but prohibits use of such prescriptions in the hospital setting.

February

An educational event shares Gifford’s “Vision for the Future” with Corporators. The vision focuses in part on constructing a senior living community in Randolph
Center.

Gifford Medical Center AuxiliaryThe Gifford Medical Center Auxiliary awards $19,000 to various Gifford departments, including equipment for inpatient units, pulse oximeters for primary care offices, play equipment and furniture for The Robin’s Nest Child Enrichment Center, and a handheld scanning device for Materials Management.

Dr. Robert CochraneExperienced hospitalist Dr. Robert Cochrane joins Gifford’s hospitalist (inpatient care) team.

An “Infant and Child CPR” class helps new parents and families learn lifesaving techniques.

A “Home Alone and Safe” course teaches children 8-11 how to respond to home alone situations.

March

A “Babysitter’s Training Course” is held for area pre-teens and teens seeking greater expertise in safe child care.

Dr. Michael ChamberlandChiropractor Dr. Michael Chamberland joins the Sharon Health Center sports medicine team.

A “Healthier Living Workshop” series begins, providing the chronically ill free information on improving their health.

A second “Quit In Person” tobacco cessation class is held, this time at the Gifford Health Center at Berlin.

Vermont Health ConnectGifford’s Health Connections office and Blueprint for Health team partner with Bi-State Primary Care to offer free help signing up for Vermont Health Connect. Help is available each weekday, but on March 6 and March 13 extra “navigators” come to Gifford to help even more people sign-up in advance of a March 15 deadline.

Diabetes Education ExpoGifford’s annual Diabetes Education Expo is merged with a Health Fair for all chronically ill and offered on March 14.

Gifford holds its 108th Annual Meeting of its corporators, announcing achievements of 2013, unveiling a new video about Gifford, and hearing a special presentation from Green Mountain Care Board Chairman Al Gobeille. Corporators elected Matt Considine of Randolph to the board and re-elect Lincoln Clark of Gifford corporatorsRoyalton. Grants were announced, including $25,000 in William and Mary Markle Community Foundation funds to 10 area towns’ schools to support exercise and healthy eating programs. The Philip D. Levesque Memorial Community Award, in memory of Gifford’s late president, is awarded to the Orange County Parent Child Center.

Gifford staff raise $520 for the March of Dimes by wearing “Blue Jeans for Babies”.

April VanderveerGifford’s mammography and nuclear medicine departments earn three-year, national re-accreditations from the American College of Radiology.

Certified nurse-midwife and women’s health nurse practitioner April Vanderveer joins Gifford’s 24-hour midwifery team.

Guiding the Future of Rural Health Care

The following article appeared in our 2014 Annual Report.

Gifford volunteers

Back (left to right) Linda Morse, Peter Nowlan, Sheila Jacobs, Paul Kendall, Matt Considine, and Lincoln Clark. Front: Jody Richards, Barbara Rochat, Gus Meyer, Dr. Ellamarie Russo-DeMara, Randy Garner, Sue Sherman, Joe Woodin, Carol Bushey, and Linda Chugkowski. Not pictured: Bill Baumann, Fred Newhall, and Bob Wright.

Volunteer board leads Gifford with vision, passion and energy

2014 was a year of great excitement for Gifford, as several projects moved from the planning stage into actual implementation. Our FQHC status, new senior living community, and the much-needed upgrade for inpatient rooms are all visible signs of Gifford’s readiness for quality community care in a larger landscape of changing healthcare reform.

Each of these accomplishments was built on years of behind-the-scenes planning. None of them would have been possible without the dedicated work of our 16 volunteer board members, who last year alone collectively gave more than 2,500 hours of their time to meetings and subcommittee activities. Board members bring passion and energy to the challenge of balancing the work that translates our mission (providing access to high-quality care to all we serve) with anticipating and planning for future healthcare needs.

“Gifford is woven into the fabric of this community. For more than 100 years generations have had the benefit of local access to quality care,” says board secretary Robert Wright, who was born at Gifford and now lives in Brookfield. “Gifford has been able to maintain that identity and also grow with the times, attracting highly skilled people and successfully investing in the equipment and facilities needed to provide the quality of care that people expect.”

Board members are recruited from across the community and have worked in various businesses and civic organizations. This diverse perspective keeps Gifford’s vision grounded in the community it serves, with a distinctive small town commitment to quality.

Board work is demanding, but members say learning about the hospital and participating in decisions that will shape the future of healthcare in their community is rewarding.

“It is by far the most rewarding volunteer activity that I have ever done,” says Randolph resident Randy Garner. “Gifford has shown me the model of being an actively engaged board member, and seeing the results of the board’s actions is extremely gratifying.”

Others want to give back to their community: “I joined the board because Gifford is community focused, a small town hospital that provides excellent healthcare and uses the latest technology,” says Northfield resident Linda Chugkowski. “I feel proud and privileged to be promoting the hospital during these troubled health care times.”

The job description for a Gifford board member might read: part planner, policy-maker, visionary, realist, promoter, cheerleader, and community advocate. It requires the ability to bring a pragmatist’s eye to sustaining robust primary care and a visionary’s openness to future possibilities. When asked what makes the institution unique, you’ll get the clear answer of a realist:

“Gifford is unique in that they are a small Critical Access Hospital and FQHC facility with niches that they do better than anyone else, like primary care, podiatry and sports medicine,” says Brookfield resident Carol Bushey. “They will never compete with the large hospital, but they will continue to do what they do better than anyone long into the future.”

But new possibilities and future community roles for Gifford are always part of the planning:

“I am excited to see the direction Gifford is going with the senior living community and hope that this continues to all levels so Randolph will have a place where folks can comfortably live out their lives,” says Garner. “Gifford will continue to be on the forefront of quality care with a small town feel.”