New Midwives Join Renowned Practice

Gifford nurse-midwivesThis article was featured in our Spring 2014 Update Community Newsletter.

Gifford renews its decades-long focus on providing area women 24/7 midwifery care with the addition of two new midwives.

Certified nurse-midwives Maggie Gardner and April Vanderveer have recently joined Kathryn Saunders and Meghan Sperry at Gifford Ob/Gyn and Midwifery in Randolph and the Gifford Health Center at Berlin. Certified nurse-midwives are advanced practice nurses specially licensed to practice midwifery and board certified.

Nurse-midwives plays an essential role in providing women’s health care throughout life, including at birth. This unique commitment to midwifery care is what attracted Maggie and April.

“The institution’s commitment to midwifery goes beyond just the midwives in the office. It’s the nurses in the Birthing Center, the layout of the Birthing Center itself where moms labor, birth and stay post-partum in the same room, and the administration’s commitment to making the practice successful,” said Maggie of the state’s oldest Birthing Center of its kind.

The strongest component of Gifford’s unique program is woman-centered care.

“The team is committed to women-centered care and respect for each family’s unique needs during pregnancy and childbirth,” April explains.

“We have longer visits than many other prenatal clinics, meaning we take the time to really listen to women about their concerns and questions,” April said.

And as mindsets over birthing have changed, the practice has changed with it.

“We are the oldest midwifery practice in the state of Vermont with a solid commitment to birth with women, encouraging women to decide how they want to birth. We move with the times. That is, we have everything from non-medicated births and water births to women who desire medication such as epidurals,” noted Kathryn.

In 2013, 14 percent of midwifery patients chose to have an epidural and 10 percent chose an intrathecal. Sixty-five percent of patients had natural births.

“We believe in a woman’s body’s ability to have a natural birth, but we also respect women who choose otherwise,” Meghan said. “We do not judge. We care and are open to the ideas of our clients.”

Sharon Sports Medicine Facility, Team Expand

Sharon Sports Medicine FacilityThis article was featured in our Spring 2014 Update Community Newsletter.

Sports medicine provider Dr. Peter Loescher calls the newly expanded Sharon Health Center the “Taj Mahal of sports medicine.”

Nestled along Route 14, the Sharon Health Center got its start in 2005, was added on to in 2008 and this winter received its second and final planned addition of 2,600 square feet.

The new addition means expanded physical therapy gym space, a third physical therapy treatment room and four new exam rooms for a total of 12. There are also a transition to all digital radiology and other impressive new technologies.

“We have a state of the art gait analysis system, which will allow us to quantify gait imbalances, muscular imbalances and accurately create rehab programs to get injured athletes back to their sport and keep them moving and healthy,” Dr. Loescher said.

The new system, a Noraxon, includes a treadmill with a force plate and two cameras for recording and reviewing gaits.

A second important technology upgrade is wall-mounted flat screens in two treatment rooms utilizing ultrasound.

“Our rooms are spacious, and we now can view our ultrasound procedures and diagnostics on large, high definition flat screen view boxes, which enhances our accuracy and quality of patient care,” said Dr. Loescher, who on the day we visited used the ultrasound machine and new screen to look inside patient Alden Smith’s swollen right knee, which he injured playing basketball.

X-rays at Sharon have also been upgraded to be entirely digital, meaning no more cassette tapes that have to be read and slow down radiology technologists. The new system consequently is faster, requires slightly less radiation and creates a crisper, or better quality, image.

A final addition to the Sharon Health Center that has patients and providers alike pleased is new chiropractor Dr. Michael Chamberland. “He has saved the day,” said veteran Sharon chiropractor Dr. Hank Glass, who is appreciating the help, especially coming from a fellow sports medicine enthusiast. “It’s very difficult to find a sports medicine chiropractor,” Dr. Glass noted. “He’s already made a tremendous impact.”

As the lone Sharon chiropractor Dr. Glass was having to schedule patients too far out, meaning he might want to see a patient back in two weeks for needed follow-up care but his schedule simply wouldn’t allow it. Now patients are getting in and Dr. Glass is relieved. “I’m happy now because I’m doing a better job. I’m being a better doctor.”

Dr. Glass adds that Dr. Chamberland “fits right in.” “It’s like he’s been here forever.”

Dr. Chamberland started in March.

Sprinkle on Support: Nutrition Counseling

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Cindy Legacy

Cindy Legacy and dietitian Stacy Pelletier

For six months leading up to her bariatric surgery, Cindy Legacy of Randolph met with registered dietitian Stacy Pelletier and has kept in touch in person and via e-mail since. Cindy lost 30 pounds before her surgery and another 80 pounds since, for a total 110 pounds of weight loss. More importantly, she experienced a major improvement in her
health, in part thanks to Stacy’s continued help.

“She is a wonderful, wonderful , wonderful support person. I wanted to succeed. She wanted me to succeed. She listened to what I had to say and made me feel like she really cared about what I was trying to do. There was no judgment. She’s like a security blanket. I can go and say, ‘What do I do?’”
~ Cindy Legacy

One Cup of Sugar: Primary Care

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

one cup of sugar

When Donna Shephard of Rochester came with her husband, Dick, for an appointment at Gifford primary care on her 72nd birthday in April, nurse Dorothy Jamieson had cake, cupcakes, a crown and lei waiting as a surprise. Donna, who has Parkison’s and regularly visits Gifford, was appreciative of the birthday surprise but more so of the care that Dot
routinely provides.

“I love her. She’s the best nurse that you (could) ever see. You don’t get them like that. She’s so gentle and nice and friendly. She puts a smile on anyone’s face.”
~ Donna Shepard

Donna Shephard

Nurse Dorothy Jamieson with Dick and Donna Shepard

Two Servings of Efficiency: Surgical Services

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Arnie Williams

Arnie Williams, nurse Cindy Loomis and medical secretary Carol Young

Arnie Williams of Tunbridge had a hernia that needed a quick fix. His primary care doctor sent him straight upstairs to the general surgery office without an appointment. He was seen that day, a Wednesday, and was in surgery Friday morning. Medical secretary Carol Young got him in and nurse Cindy Loomis was by his side.

“I couldn’t have been treated better, physically and emotionally. Everyone has been so good to me… When you have something wrong with you and you’re in good hands, you feel very secure. You can just relax and let them do their job. It makes everything better.”
~ Arnie Williams

A Message from the Board Chair

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Gus Meyer

Gus Meyer

The theme of this year’s Annual Report is a Recipe for Success. Without question, Gifford had that recipe in 2013! We continued to gain great recognition for what we’ve done, while taking major strides to position ourselves to do even more in the future.

In 2013, as we awaited permits for the senior retirement community, we undertook important expansions to the Kingwood and Sharon health centers. Ultimately, the senior retirement Act 250 permits and Certificate of Need were granted, making us ready to break ground for the new nursing home in the spring of 2014, with independent and assisted living options to follow. Moving the nursing home will enable us to renovate our inpatient unit, with single-patient rooms that will significantly improve health safety and comfort for patients using that facility.

In addition, we earned designation as a Federally Qualified Health Center. This will enable us to expand our core commitment to primary care, including new initiatives and collaborations to extend dental and mental health services to underserved areas.

gallon of leadershipAs we have pursued these plans for the future, Gifford has continued its commitment to patient care and furthering the health of our communities. We are extremely proud that Dr. Lou DiNicola was given the Physician Award for Community Service by the Vermont Medical Society. We are delighted that Major McLaughlin was named the national Outstanding Senior Volunteer. We are humbled by the continued recognition of the Menig Extended Care Facility.

As we reflect on these accomplishments and look forward with tremendous anticipation to 2014, it is an honor for the Board to serve an organization that continually goes above and beyond. Even as we experience constant change in today’s health care environment, we have great confidence that Gifford’s ever-evolving recipe will generate success this year and for many more to come.

Gus Meyer
Board Chair

A Message from the Administrator

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Joe Woodin

Joe Woodin

This has been another successful year for Gifford, and it is due to our continued ability to take care of so many different patients, from so many different communities. Ultimately that is our mission and focus, and for me constitutes our Recipe for Success. We continue to offer treatment and services over a wide geography, and “how” we do that is as important as “what” we do. We strive to bring personal attention into the clinical delivery system through relationships and flexibility. Sometimes we do these things very well, and sometimes we learn and grow from our experiences and shortcomings. In all instances we are indebted to the many communities and friends who utilize us and give us feedback and support.

A Gallon of Leadership

A Gallon of Leadership

This has also been a year marked with stress over health care reform and the roll-out of both a national and state-wide insurance product (i.e. Vermont Health Connect). Although the state has done a better job than the federal government in implementing the insurance exchange, there is still much uncertainly about these new programs, with people looking for answers and assurance that this is the “right direction.” That uncertainty, however, does not find its way into our planning for the future. Gifford has always relied upon a simple understanding that if we focus on patient care, quality and insuring access to everyone, regardless of their ability to pay, we will be successful. Maybe it’s that three-ingredient recipe that has helped sustain us over these past 110 years (since our founding in 1903). While others are employing sophisticated forecasting techniques and prediction models, we are just trying our best to be your medical home and guide.

I hope you enjoy this report, and the many stories that highlight our efforts this past year. We are grateful for the legacy we have inherited, and continue to build upon that
success each and every year.

Joseph Woodin

Gifford 108th Annual Meeting Paints Strong Picture of Uniquely Successful Small Hospital

Gifford Administrator Joe Woodin

Joseph Woodin, Gifford’s administrator, speaks at Saturday’s Annual Meeting of the medical center’s corporators. Woodin outlined a year of success.

If there was any doubt that Randolph’s local hospital – Gifford – stands above when it comes to commitment to community and financial stability, it was wholly erased Saturday as the medical center held its 108th Annual Meeting of its corporators.

The evening gathering at Gifford featured an overview of the hospital’s successful past year, news of spectacular community outreach efforts, a video detailing employees’ commitment to caring for their neighbors and a ringing endorsement from Al Gobeille, chairman of the Green Mountain Care Board and the evening’s guest speaker.

Diane and William Brigham, corporators, arrive at Gifford’s 108th Annual Meeting

Diane and William Brigham, corporators, arrive at Gifford’s 108th Annual Meeting.

For Gifford, 2013 brought a 14th consecutive year “making” budget and operating margin, new providers, expanded services including urology and wound care, expanded facilities in Sharon and Randolph, a designation as a Federally Qualified Health Center and all permits needed to move forward on the construction of a senior living community in Randolph Center and private inpatient rooms at Gifford.

The Randolph medical center also collected a ranking as the state’s most energy efficient hospital, an award for pediatrician Dr. Lou DiNicola, national recognition for Outstanding Senior Volunteer Major Melvin McLaughlin of Randolph and, noted Board Chairman Gus Meyer, continued national accolades for the Menig Extended Care Facility nursing home.

Al Gobeille

Al Gobeille, chairman of the Green Mountain Care Board, speaks at Gifford’s 108th annual corporators meeting on Saturday evening at the Randolph hospital.

“In the meantime, we’re faced with an ever-changing health care landscape,” said Meyer, listing accountable care organizations, payment reform initiatives and a burgeoning number of small hospitals forming relationships with the region’s two large tertiary care centers.

For some small hospitals, these shifts cause “angst.” “We like to think it brings us possibility,” said Meyer. “As both a Critical Access Hospital and now a Federally Qualified Health Center, Gifford is particularly well positioned to sustain our health as an organization and continue to fulfill our vital role in enhancing the health of the communities we serve.”

Joan Granter and Irene Schaefer

Joan Granter, left, and Irene Schaefer, corporators, arrive at Gifford’s 108th Annual Meeting.

The FQHC designation brings an increased emphasis on preventative care and will allow Gifford to invest in needed dental and mental health care in the community, Administrator Joseph Woodin said.

Gifford is but one of only three hospitals in the country to now be both a Critical Access Hospital and Federally Qualified Health Center.

“Congratulations! You’re a visionary,” said Gobeille in addressing Gifford’s new FQHC status. “It’s a brilliant move. It’s a great way to do the right thing.”

And Gifford is doing the right thing.

Gobeille was clear in his praise for Gifford’s management team and its commitment to stable budgets, without layoffs or compromising patient care.

Community investment

Marjorie and Dick Drysdale

Marjorie and Dick Drysdale, corporators, arrive at Gifford’s 108th Annual Meeting.

Gifford’s commitment also extends to the community.

In a major announcement, Woodin shared that thanks to the William and Mary Markle Community Foundation, Gifford will grant a total of $25,000 to schools in 10 area towns to support exercise and healthy eating programs.

Gifford annually at this time of year also hands out a grant and scholarship. The 2014 Philip Levesque grant in the amount of $1,000 was awarded to the Orange County Parent Child Center. The 2014 Richard J. Barrett, M.D., scholarship was awarded to Genia Schumacher, a mother of seven and breast cancer survivor who is in her second year of the radiology program at Champlain College.

The continued use of “Gifford Gift Certificates,” encouraging local spending during the holiday, invested about $40,000 in the regional economy in December. “These small stores appreciate it. It really does make a difference,” noted Woodin, who also detailed Gifford’s buy local approach and many community outreach activities in 2013, including free health fairs and classes.

The community in turn has invested in Gifford. The medical center’s 120 volunteers gave 16,678 hours in 2013, or 2,085 eight-hour workdays. Thrift Shop volunteers gave another 6,489 hours, or 811 workdays. And the Auxiliary, which operates the popular Thrift Shop, has both invested in equipment for various Gifford departments and made a major contribution toward the planned senior living community that will begin construction in May.

Elections

David and Peggy Ainsworth

Outgoing Gifford board member David Ainsworth arrives with wife Peggy to Saturday’s 108th Annual Meeting of the Corporators.

The night also brought new members to the Gifford family.

Corporators elected two new of their own: Matt Considine of Randolph and Jody Richards of Bethel. Considine, the director of investments for the State of Vermont, was also elected to the Board of Trustees and Lincoln Clark of Royalton was re-elected.

Leaving the board after six years was Sharon Dimmick of Randolph Center, a past chairwoman, and David Ainsworth of South Royalton after nine years.

‘Recipe for Success’

“Recipe for Success” was the night’s theme and built around a fresh-off-the-press 2013 Annual Report sharing patient accounts of Gifford staff members going above and beyond. The report, now available on www.giffordmed.org, credits employees’ strong commitment to patient-care as helping the medical center succeed.

Taking the message one step further, Gifford unveiled a new video with staff members talking about the privilege of providing local care and the medical center’s diverse services, particularly its emphasis on primary care. The video is also on the hospital’s Web site.

David Ainsworth and Sharon Dimmick

Gus Meyer, chairman of Gifford’s board, honors retiring board members David Ainsworth and Sharon Dimmick.

Health care reform
Shifting resources to primary and preventative care is a key to health care reform initiatives, said a personable and humorous Gobeille, who emphasized affordability.

“We all want care. We just have to be able to afford care,” he said. “In the two-and-a-half years I’ve been on the board, I’ve grown an optimism that Vermont could do something profound.”

Gobeille described what he called “two Vermonts” – one where large companies providing their employees more affordable insurance and one where small businesses and individuals struggle to pay high costs. “The Affordable Care Act tries to fix that,” he said.

The role his board is playing in the initiatives in Vermont is one of a regulator over hospital budgets and the certificate of need process, one as innovator of pilot projects aimed at redefining how health care is delivered, and paid for, and as an evaluator of the success of these initiatives as well as the administration and legislators’ efforts to move toward a single-payer system.

Audience members asked questions about when a financing plan for a single-payer system would be forthcoming (after the election, Gobeille said), about how costs can be reduced without personal accountability from individuals for their health (personal accountability absolutely matters, he said) and how small hospitals can keep the doors open.

Gobeille pointed to Gifford’s record of financial success and working for the best interests of patients and communities as keys. “I don’t think Gifford’s future is in peril as long as you have a great management team, and you do,” Gobeille said.

A Message from the Medical Directors

The following was published in our 2012 Annual Report.

medical directorsReflections on the past remind us of our roots and of how health care has changed in the past decades. Chief among those is the increasing role mid-level providers, such as nurse-midwives, nurse practitioners, and physician assistants, play in health care. Today, we have diverse physician-led health care teams in every area of medicine to encourage and support wellness.

Mid-level providers are extremely instrumental at birth, during hospital stays, in the primary care setting, specialty clinics, and even for our surgical patients. This team approach to care improves provider access and quality of care.

At Gifford, we are transitioning with great success to a team-based approach and are taking steps to ensure continued access to high-quality health care.

In 2012, some of those steps included new radiology services and technology, such as more interventional offerings, an upgraded 64-slice CT scanner, and a fluoroscopy room.

The midwifery team has expanded to the Twin River Health Center in White River Junction. Gifford’s approach to obstetrics and gynecology has grown to include more complicated cases.

The Blueprint Community Health Team has expanded and behavioral health is increasingly a part of Gifford’s offerings. Thanks to a generous gift from the Auxiliary, new CarePoint EKG transmission technology is available between our Emergency Department and ambulance services to identify heart attacks in the field and determine the best and fastest course of treatment.

Urology offerings have also grown and the Cancer Committee continues to expand. The Sharon Health Center sports medicine team has welcomed a nurse practitioner and second chiropractor.

These improvements are examples of the changes and quality upgrades we, as part of the health care team, can affect in an institution of the size and mindset of Gifford for the betterment of the community. Meld these improvements with Gifford’s foundation of patient care and advocacy, and we have a formula for success for decades to come.

Ovleto Ciccarelli, MD, Surgery Division
Martin Johns, MD, Hospital Division
Joshua Plavin, MD, MPH, Medicine Division

“I Am Humbled by the Courage I Witness” – Starr Strong, PA-C

Starr Strong, PA-C

Starr Strong, PA-C

Starr Strong was born in Brookfield and still lives there today. Married to John Button of Chelsea, the couple has two grown children. In her free time, Starr enjoys gardening, skiing, kayaking, and hiking.

Starr has been a physician assistant for 31 years, including 19 years at the Chelsea Health Center as well as at Gifford’s Randolph and Bethel practices and Vermont Technical College’s student health center.

Her greatest love, professionally, is the Chelsea Health Center and the long-term relationships she has forged with generations of families there. At a rural practice, she says, people matter and she is able to spend time with her patients. “It is a privilege in life to make a place your own, to grow a life that is bigger than just yourself,” she says.

Below is her story as told in her own words, as featured in our 2012 Annual Report.

“When I was young, it took me a long time to sort out what I wanted to do with my life. Through traveling and experiments with lifestyles, I discovered a new profession – physician assistant – that appealed to me. It fit my personality (rebellious) and, I hoped, my potential. In 1979 I told my potential educators that I wanted to be a family practitioner in a rural health center. Three decades later, that vision has evolved into a challenging and fulfilling life.

Starr Strong, PA-C

Top left: Strong examines a curious Xabian Bring in 2009. Bottom: A 1996 portrait of Strong reviewing a patient chart with a co-worker.

My family’s ancestral home is a humble hill farm in Brookfield. I’ve known all my life that it is my true home. In 1981 when I was completing physician assistant (PA) school, I met with Phil Levesque, Gifford’s president at the time. He told me that Gifford didn’t have a place for me and he doubted that the Medical Staff would accept a PA in the years to come. I kept knocking on the door, and nearly 20 years ago I got an opportunity to “try it” in Chelsea. I was the first PA at Gifford, the first non-physician provider in Chelsea, and the only woman to practice there.

“The door” in Chelsea was opened to me largely by the gracious support of Dr. Brewster Martin who became my teacher, mentor, advisor, very dear friend, and, eventually, my patient. Brewster was the wisest person I have known and his influence on my life is immeasurable. I promised him that I would practice in Chelsea for 20 years and I am nearly there. During our lunchtime chats we shared the deepest thoughts and concerns in our hearts, and we shared funny stories. It was a privilege to be his friend and I miss him every day.

Family medicine is at least as much about relationships as it is about science. The depth of that trust can be built through years of commitment and listening. I am fascinated by the richness of families and individual’s lives, their dignity and fears, joys and sorrows. I am humbled by the courage I witness, and am grateful for the privilege of such trust.

Just like with Brewster, some of my fondest and most challenging experiences are with those I know best. I especially treasure my relationship with Judy Alexander, a woman who is my patient, friend, and co-worker. She has taught me a lot about humor and the joy of sarcasm, and she strengthens my love of play. Her courage in facing the battle of her life keeps me grounded, humble, and ever so appreciative of the fullness of life. I treasure that we will walk this road together as far as it takes us.

I love this place.”

~ Starr Strong, PA-C
Chelsea Health Center physician assistant

Judy Alexander and Starr Strong

Friends and co-workers Judy Alexander and provider Starr Strong share smiles and laughter.