Expanded Behavioral Health Team Enhances Primary Care Services

This article was published in our Fall 2015 Update.

Gifford's behavioral health clinic hoursWith the unique ongoing relationship primary care providers establish with patients and families, they may be among the first to recognize that someone is struggling with depression, anxiety, or even substance abuse.

This year Gifford expanded the Behavioral Health team (it now includes a psychiatrist, a master’s level psychotherapist, a licensed drug and alcohol counselor, and a psychiatric nurse practitioner) to help primary care providers identify ongoing issues and help patients get the support and care they need.

“There are people in our community who are struggling with sadness, depression, are grieving a loss, or are overwhelmed by money issues. We want them to know that they can get help,” said Gifford’s Chief Medical Officer Dr. Martin Johns.

He notes that the new Behavioral Health team will complement the work of the Clara Martin Center, which handles more long term psychotherapy needs, and offers a depth of expertise that is unusual in a small rural hospital.

“Having behavioral health expertise onsite to assist in the emergency room if needed, or to consult on inpatient and outpatient care, will allow our primary care provider to help more patients manage mental illness issues,” he said.

Behavioral Health Director Dr. Peter Thomashow says his team looks closely at how biological, psychological, and social factors influence health. They offer individual, couples, and family psychotherapy and education and also collaborate with primary care providers to help them manage depression in patients.

“We are especially interested in helping individuals having difficulty coping with chronic medical illness,” said Thomashow. “Behavioral health needs to be integrated into a primary care plan, especially when treating chronic illness.”

The Behavioral Health clinic services include comprehensive evaluation and treatment for a wide range of psychiatric disorders for adults (age 18 and older) including:

  • Depression
  • Anxiety
  • Stress
  • Insomnia
  • Post-traumatic stress disorder (PTSD)
  • Bipolar disorder
  • Dementia
  • Substance abuse

BELOW IS OUR BEHAVIORAL HEALTH TEAM:

Peter Thomashow

James Tautfest

Cory Gould

Morgan Dion

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!”

Gifford Cancer Program Overview

Gifford's cancer program

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

Gifford cancer committeeEstablished in 1959, Gifford’s Cancer Program is accredited by the American College of Surgeons Commission on Cancer.

A dedicated cancer committee meets regularly to provide leadership for the program, including setting program goals and objectives, driving quality improvements and best outcomes for patients, and coordinating Gifford’s multidisciplinary approach to cancer treatment.

Operating out of our relaxing Ambulatory Care Unit, Gifford’s Oncology Department includes:

  • Cancer care from an experienced oncologist
  • Specially certified oncology nurses
  • Planning options for cancer treatment following a diagnosis
  • Outpatient chemotherapy
  • Treatments for some hematology conditions

The medical center is home to advanced diagnostic technology, including stereotactic breast biopsies; a breast care coordinator providing education and outreach; a patient care navigator; many surgical offerings; data management and quality oversight; and cancer prevention programs, including a “Prevention into Practice” model that works with patients and their health care providers to bring screenings to the forefront.

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

Dr. Laura Barber Joins Chelsea Health Center

Gifford welcomes experienced primary care physician to community health center team

Dr. Laura Barber

Dr. Laura Barber

Dr. Laura Barber, MD, has joined the Chelsea Health Center, bringing more than 20 years of experience caring for families as a primary care physician.

When the private primary care group practice she had led in Abilene, Texas recently dissolved, rather than affiliate with a larger healthcare organization, Dr. Barber saw an opportunity to move to New England, where her son and sister live.

“When I visited the Chelsea Health Center, I liked what I saw,” she said. “I like to get to know people over a period of time, to work with entire families. This is the kind of patient-centered care I want to be doing.”

Barber earned a BS from Newcomb College of Tulane University, and an MD at the University of Texas Medical School, San Antonio. She completed her family practice residency at the Hendrick Medical Center in Abilene Texas, stayed on in private practice, and has been president of Abilene Primary Care Associates since July of 1996.

Born in Fort Worth, Texas, Barber often visited a small rural Eastern Texas town that inspired her first dreams of becoming a physician.

“I loved science and working with people, and medicine combined these interests. As it turned out, I can’t imagine doing anything else,” she said. “My first dream was to set up a practice over the post office in that small rural town I’d come to love as a child.”

That Texan town was later ruined by strip mining, but Barber and her sister, who has owned a cabin in Tunbridge since the early 80’s, say the area around Chelsea brings back memories of the rural community they had loved as children and “feels like home.”

The move cross-country makes sense in other ways as well. One of Barber’s three sons is working with a technology firm in Nashua, NH. And Barber and her husband, avid history buffs, have purchased the historic Federal-style Denison house in Royalton Village.

“I was up until midnight the night we purchased it, rubbing orange oil and bees wax on the dry, old wood paneling!” she said.

Dr. Barber is board-certified by the American Board of Family Practice and a fellow of the American Academy of Family Practice. At the Chelsea Health Center she joins physician assistant and Chelsea native Rebecca Savidge, and is now seeing new patients. Call for an appointment at 802-685-4400.

Alan Jacobs Exhibit at Gifford Medical Center’s Art Gallery

Alan Jacobs

Oil on canvas abstract by Alan Jacobs

Twelve vibrantly colored abstract paintings by Vermont artist Alan Jacobs are currently on display in the Gifford Medical Center art gallery. The exhibit will run through September 23, 2015, and is free and open to the public.

Jacobs, a retired psychiatrist and psychoanalyst and self-taught artist, describes his process as being “more determined by a conversation between fingers, paint, canvas, and unreflective thought and impulses than by any conscious ideas.”

After moving to Vermont several years ago, he began to paint at the suggestion of his artist daughter. He started working with pastels, but moved on to oil on canvas. Jacobs
says that he trusts the viewer to connect and react to the recurrent colors and images in his work in their own unique way.

Jacobs’ work was displayed earlier this year in VTC’s Hartness Library.

Gifford Welcomes Dr. Jonathan Bjork

Dr. Jonathan Bjork

Dr. Jonathan Bjork

Podiatrist Jonathan Bjork has joined Gifford Medical Center’s Randolph and Sharon clinics.

A board-certified podiatrist, he received a BS from St. Olaf College, a Doctor of Podiatric Medicine from Des Moines University, and completed his Podiatric Medicine and Surgery Residency at the William S. Middleton VA hospital in Madison, Wisconsin.

While in medical school, Bjork chose to specialize in podiatry because it would offer opportunities for a varied practice: performing surgery, working in a clinic, helping patients with rehabilitation, and treating sports injuries. He brings widespread clinical interests to his work, from rear foot and ankle surgery, flat foot reconstruction, and heel spur resection to diabetes-related infections, sports injuries, and treatment for bunions and hammertoes.

“I like to develop good, ongoing relationships with patients so I can get to know their needs and expectations,” said Bjork. “This allows me to consider a patient’s specific concerns when treating injuries or infections.”

Bjork and his wife have family near Boston and were looking to settle in a small town where they could raise their 4-month-old son. They have purchased a home near the hospital with a yard (space for a golden retriever) and easy access to the outdoor activities they love: skiing, mountain biking, and hiking.

“Randolph is a very warm and welcoming community,” said Bjork. “It is smaller than Platteville, Wisconsin, where I grew up, but it reminds me of my home.”

Bjork is the newest member of Gifford’s team of podiatrists, which includes Dr. Nicolas Benoit (Randolph), Dr. Samantha Harris (Berlin), and Dr. Paul Smith (Sharon). He is now accepting new patients at our Randolph and Sharon locations—call 728-2777 to schedule an appointment.

Gifford Medical Center Earns EPA ENERGY STAR Certification

Randolph hospital joins list of top 25 percent of energy-efficient hospitals nationwide

Gifford exteriorGifford Medical Center was notified this week that it has earned the U.S. Environmental Protection Agency’s (EPA’s) ENERGY STAR certification. The national certification signifies that the building meets strict energy efficiency performance levels set by the EPA and performs in the top 25 percent of similar facilities nationwide for energy efficiency.

Gifford’s Director of Facilities Doug Pfohl notes that while this EPA ranking does not include buildings outside of the main medical center campus in Randolph, energy efficiency has been incorporated into all improvements and new building projects at Gifford since the 1980’s. The hospital has previously ranked high in the national Healthier Hospitals Greenhealth program.

“It was a hospital goal to achieve ENERGY STAR rating this year, and we are very excited to be one of the first in Vermont to do so,” said Pfohl. “We needed an EPA rating of 75 or higher to qualify, and we actually achieved a rating of 81.”

Hospitals apply for the EPA rating by looking at energy use per square foot, taking into account factors such as number of hospital beds, number of employees, and climate. They are then ranked nationwide. Gifford’s ENERGY STAR rating was given after much coordination with Efficiency Vermont, creative design staff, and conservative energy upgrades. A detailed on-site inspection in July proved successful, with a rating above 75.

Gifford exterior“I’d like to congratulate Gifford for achieving this prestigious certification,” said Liz Gamache, director of Efficiency Vermont. “We were pleased to work closely with them to help identify ways to reduce their energy costs and consumption; they are setting a great example for other medical facilities in the state.”

While Gifford has steadily improved energy efficiency throughout the entire organization through low-occupancy settings for heat and electricity, improving kitchen ventilation equipment, and installing internal and external LED lighting, Pfohl said two recent large improvements contributed significantly to the hospital’s high rating:

• A new energy-efficient 90-ton chiller replaced an aging 50-ton unit, and structures were put in place for three new chillers to accommodate future air-conditioning upgrades; and

• An energy recovery unit was installed to capture return air and recondition it for re-use; this “climatized” air requires less energy to re-heat or re-cool.

ENERGY STAR was introduced by the EPA in 1992 as a voluntary, market-based partnership to reduce greenhouse gas emissions through energy efficiency. Facilities with ENERGY STAR certification use an average of 35 percent less energy than typical buildings and release 35 percent less carbon dioxide into the atmosphere. For more information about ENERGY STAR Certification for Commercial Buildings, visit www.energystar.gov/labeledbuildings

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

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.