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(From time to time, the blog features recipients of the IHA Iowa Hospital Heroes Award. These outstanding hospital employees come from across the state and work at hospitals of every size. They exemplify the courage, caring and community focus that are the hallmarks of the hospital mission in Iowa.)

drbarber_bag2The doctor’s bag is a symbol of a physician who meets the patient when and where they need help. The bag contains the tools he needs to help people in their most vulnerable times. At Buena Vista Regional Medical Center (BVRMC), Dr. Paul Barber carries a doctor’s bag every day as he makes his way around the hospital.

As part of the medical staff at BVRMC since 1995, Dr. Barber provides excellent care every day to his patients as a family practice and internal medicine doctor at UnityPoint Clinic Family Medicine Buena Vista.

Compassionate, caring, quality care takes time and Dr. Barber makes sure patients get it. When a new patient inquires about Dr. Barber, his staff tells them to be prepared, because they will sometimes have to wait. If the appointment before them needs more time, Dr. Barber gives it, but he is also going to do the same for you.

The priority Dr. Barber puts on seeing patients is evident on days when the phones constantly ring in the clinic with people wanting to get in that same day. Dr. Barber’s staff knows to keep scheduling people as he wants to see everyone who needs him, despite the staff’s after-work plans. Five o’clock is not closing time.

His staff also knows he values them and needs their help to provide the type of care he strives to provide. If someone praises him, he will respond, “It’s not me, it’s about us as a team.”

Dr. Barber knows long work days need a little humor so under that white coat you will find a variety of fun ties to fit the mood or holiday. Special red pants make their appearance for Valentine’s Day, 4th of July and Christmas. Of course, all are accompanied by his little black bag.

It’s with the attitude of not rushing through appointments and creating a fun environment during long days that Dr. Barber is our hero. His super powers are making people feel cared for and injecting a little humor during some of their toughest times.

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It all started with one Linn County woman, fighting breast cancer but looking beyond her own battle and trying to make a difference. And that’s just what Sandy Knight did, first by helping start a support group and a very successful screening program at the General Mills plant in Cedar Rapids, where she worked. Then she set her sights on a bigger goal: a fund to help disadvantaged women get screened for breast cancer.

That’s how the Especially for You Race Against Breast Cancer, which took its name from Knight’s support group, began in 1991. Sadly, Knight lost her battle before the inaugural five-kilometer race was run, but her generosity, determination and memory were well served when more than 1,000 people showed up on that first fall day.


More than 15,500 runners and walkers from 33 states participated in the 2016 Especially for You Race Against Breast Cancer in Cedar Rapids. (photo by Cole Cooper Von Presley Studios)

Now, 26 races later, the numbers are astounding. Just last week, more than 15,560 walkers and runners registered for the annual event, which has been sponsored by Mercy Medical Center-Cedar Rapids and General Mills from its inception. The 2016 turnout, which included 416 teams (more than 1,200 people participated on Mercy’s squad) and individuals from 33 states, was the third largest in race history, just shy of the record set in 2011 with 15,792 participants. Nearly 700 cancer survivors were part of the race.

Proceeds from race registrations benefit the Especially for You fund. This year, race registrations raised more than $481,000 for the fund, which, as Knight hoped, provides financial assistance for mammography, biopsies, ultrasounds and other breast-care services for area individuals in need. Since 2008, the Especially for You fund has helped more than 5,000 people receive more than 9,000 services in Linn County.

The success of Especially for You (EFY) has been bolstered by many community partners that have been inspired to hold their own events, for example:

  • The Airport National Golf Course Women’s Golf League raised $4,800 for EFY during their June tournament.
  • In January, Chili’s Grill & Bar donated a percentage of their sales from 2015 to EFY, totaling more than $652.
  • In December 2015, the Kirkwood Bookstore and EagleTech presented EFY with a check for $957 in proceeds from special pink and gray shirts.
  • The Kalona Breast Friends 5k was a benefit for EFY, with organizers stopping by in October to present a check for $4,500.

“The Especially for You Race is a year-round collaborative effort on the part of so many individuals,” says race director Michelle Cole.  “More than 350 volunteers typically log more than 3,200 hours preparing for the race and attending to every detail, which is paramount in pulling together such a successful event.  Our employees also play a huge role.  This year, Mercy was proud to have the largest team of participants, with 1,248 employees registering for the race.  We’re fortunate to have so much support on every level.”

“It’s bittersweet to attend the race,” said Cindy Young, Knight’s older sister, just before last year’s 25th EFY anniversary. “It’s been part of the healing process for us. We want to be there to pay tribute to Sandy. If she saw the scope of race today, I’m sure she would be astounded. It’s a remarkable tribute to her.”

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US physicians continue to struggle to maintain morale levels, adapt to changing delivery and payment models, and provide patients with reasonable access to care. The combination of these factors leaves a majority of physicians feeling that they lack time to provide the highest level of care. These findings are based on a biennial survey of more than 17,000 U.S. physicians commissioned by the nonprofit Physicians Foundation.

According to the research, titled “2016 Survey of America’s Physicians: Practice Patterns and Perspectives,” 80 percent of physicians report being overextended or at capacity, with no time to see additional patients. This remains steady with the findings reported in the 2014 survey from the foundation. Not surprisingly, 54 percent of physicians surveyed rate their morale as somewhat or very negative, with 49 percent saying they are either often or always feeling burnt out.

phys-1In response to these and other challenges, 48 percent of surveyed physicians plan to cut back on hours, retire, take a non-clinical job, switch to “concierge” medicine or take other steps that will further limit patient access – an increase from those who answered similarly in the 2014 survey. These patterns are likely to reduce the physician workforce by tens of thousands of full-time equivalents (FTEs) at the time that a growing, aging and more widely-insured population is increasing overall demand for physicians.

“Many physicians are dissatisfied with the current state of medical practice and are starting to opt out of traditional patient care roles,” said Walker Ray, M.D., Physicians Foundation president and chair of its research committee. “By retiring, taking non-clinical roles or cutting back in various other ways, physicians are essentially voting with their feet and leaving the clinical workforce. This trend is to the detriment of patient access. It is imperative that all health care stakeholders recognize and begin to address these issues more proactively, to support physicians and enhance the medical practice environment. ”

The survey was conducted online from April 2016 through mid-June 2016 by Merritt Hawkins, a leading physician search and consulting firm, on behalf of the Physicians Foundation. The findings are based on responses from 17,236 physicians across the U.S. The overall margin of error for the entire survey is less than one percent.

Impact of Physician Morale on Patient Access

phys-2This survey, conducted biennially since 2008, has consistently demonstrated that the professional morale of physicians is declining. In addition to challenges in morale, 62.8 percent of those surveyed are pessimistic about the future of the medical profession. About half of survey respondents would not recommend medicine as a career to their children. Close to one-third would not choose to be physicians if they had their careers to do over. This sentiment has larger implications outside of the profession itself, given that physicians manage larger clinical teams comprised of nurse practitioners, physician assistants and more who also play a pivotal role in health care economics.

Physicians identified regulatory and paperwork burdens and loss of clinical autonomy as their primary sources of dissatisfaction. Respondents indicated that they spend 21 percent of their time on non-clinical paper work duties, while about two-thirds (72 percent) said third-party intrusions detract from the quality of care they can provide.

What is also consistent in each biennial survey since 2008 is physicians’ primary source of professional satisfaction: the patient relationship. In the 2016 survey, 73.8 percent of respondents listed this as the most satisfying aspect of their jobs, followed by “intellectual stimulation” at 58.7 percent. Similarly, in a patient survey commissioned by the Physicians Foundation earlier this year, 95 percent of patient respondents reported they were satisfied or very satisfied with their primary care physician’s ability to explain information in a manner they understand, while 96 percent feel their physicians are respectful of them. Physicians noted that issues such as a lack of clinical autonomy, liability concerns, struggle for reimbursement and decreased patient face-time can all negatively impact the patient-physician relationship – thereby undermining physician satisfaction.

Challenges with Health Care Reform

As a central player in determining patient treatments and care plans, physician participation and leadership is critical to transforming health care from a system driven by the volume of services to one focused on the value of services. However, the survey indicates that the majority of physicians are not convinced to sufficiently engage or support the mechanisms of health care reform to achieve its stated aims.

phys-3Only 43 percent of physicians surveyed said their compensation is tied to value. Of these, the majority, (77.2 percent) have 20 percent or less of their compensation tied to value. Additionally, only 20 percent of physicians surveyed are familiar with the Medicare Access and CHIP Reauthorization Act which will greatly accelerate value-based payments to physicians.

Another perceived barrier is the new ICD-10 system, which added thousands of new codes intended to allow physicians to be more efficient, bill more precisely and improve patient care. However, the majority of physicians have not realized these benefits. Most surveyed indicated that ICD-10 has had little to no impact in practice efficiency, revenue or patient care.  Similarly, physician’s opinions of electronic health records (EHR) have not improved, with even more physicians stating that it detracts from patient interaction compared to findings of the 2014 survey. Only 11.9 percent of respondents indicated EHR has improved patient interaction, while the remaining 89.1 percent say it has had little or no impact or has detracted from patient interaction.

Finally, physician assessments of Affordable Care Organizations (ACO), which covers 15 percent to 17 percent of the U.S. population, have not changed appreciably since the earlier 2012 biennial survey. The percent of physicians that agree ACOs are likely to enhance quality and lower costs decreased, while there was an increase in physicians who feel ACOs are unlikely to increase quality or decrease cost.

Additional Key Findings

• Employed physician respondents see 19 percent fewer patients than practice owners
• 46.8 percent of respondents plan to accelerate their retirement plans
• 20 percent of respondents now practice in groups of 101 doctors or more, up from 12 percent in 2012
• Only 17 percent of survey respondents are in solo practice, down from 25 percent in 2012
• 27 percent of respondents do not see Medicare patients, or limit the number they see; this number is 36 percent for Medicaid patients

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Queenster Nartey (left), a senior majoring in biological chemistry who graduated from Grinnell College in May 2016, and Shannon Hinsa-Leasure (right), associate professor of biology at Grinnell College, count the number of bacterial colonies on samples collected from copper and non-copper surfaces at Grinnell Regional Medical Center.

A research partnership between Grinnell College and Grinnell Regional Medical Center (GRMC) concluded that using copper alloy materials in a hospital setting substantially decreased the hospital’s bacterial burden. These results could reduce the number of health care-associated infections.

Shannon Hinsa-Leasure, PhD, associate professor of biology at Grinnell College, and a research team with undergraduate students Queenster Nartey and Justin Vaverka, published their results in the American Journal of Infection Control.

The new study shows for the first time that copper maintains the reduced bacterial load in both occupied as well as clean, unoccupied rooms. The research found significantly fewer bacteria on copper alloy products such as grab bars, toilet flush valves, IV poles, switches, keyboards, sinks and dispensers.

Hinsa-Leasure’s team conducted research over 18 months at Grinnell College and GRMC with more than 1,500 samples. During the study, patient rooms were cleaned daily and subjected to a final, or terminal, cleaning upon patient discharge. High-touch areas were swabbed in occupied and unoccupied rooms and aerobic bacterial counts were determined for comparison purposes. GRMC’s move to copper surfaces was initiated to improve patient safety and reduce risks for infection.

DCF 1.0

Grinnell Regional Medical Center

High-touch surfaces throughout a hospital can serve as reservoirs for pathogenic microorganisms, including Staphylococcus aureus, Clostridium difficile and vancomycin-resistant enterococci. These and other pathogens can survive from days to months on dry surfaces, making it difficult to maintain the suggested standard for surface-level cleanliness.

“This study is the first to demonstrate that copper alloy surfaces maintain reduced bacterial numbers in unoccupied and occupied patient rooms,” Hinsa-Leasure said. “This is in contrast to control rooms, where bacterial numbers rebound following terminal cleaning to levels comparable to those found in occupied control rooms. This is key to protecting newly admitted patients from contracting infections through commonly touched surfaces, even when they are considered clean, and is integral to an effective infection-control strategy.”

For the research, half of the patient rooms at GRMC were fitted with copper alloy and its germ-killing properties on high-touch surfaces. Because of the research findings, additional rooms will soon have the same life-saving features to reduce risks of acquiring an infection while admitted at the hospital.

GRMC has not had any health care-acquired infections in the past 12 months, except for three urinary tract infections. However, health care-associated infections are a serious concern in the medical industry. Of the 35.1 million discharges of inpatients in the US each year, an estimated one in 25 patients admitted to a hospital contracts a health care-associated infection. In 2011, an estimated 10 percent of the 722,000 patients who contracted health care-associated infections died from the infection.

To decrease microbial pathogens, some hospitals have begun installing metal surfaces that are naturally antimicrobial, including copper alloy, which kill a majority of bacteria within two hours. Copper compounds have been used for medicinal purposes for thousands of years, yet copper alloys were just recently recognized by the Environmental Protection Agency as having antimicrobial effectiveness, driving the increased study and use of copper alloy surfaces.

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

6 months in, tri-state residents express frustration with new Medicaid system
During a meeting Thursday night, area families and health care providers expressed frustration and shared their struggles with Iowa’s transition to a privatized Medicaid system. About 50 people attended a listening and help session Thursday night at the Northeast Iowa Community College Town Clock Business Center. The event was hosted by Senator Pam Jochum (D-Dubuque). Attendees were given the opportunity to share their experiences with the new Medicaid structure, as well as meet with representatives of the managed care organizations that have been overseeing the program since April. (Dubuque Telegraph Herald)

St. Anthony Breaks Ground On New Assisted Living Complex
St. Anthony Regional Hospital (SARH) and Nursing Home announced the development of a new assisted-living facility this week at a ground breaking ceremony in Carroll. The planned 36-unit facility, named Garden View, will complement current St. Anthony Senior Living offerings and will be located on the southeast side of the St. Anthony campus. Ed Smith, St. Anthony President and CEO, says this facility brings many benefits to Carroll. The facility has a number of amenities that future residents will be able to enjoy, such as a chapel, a salon, library and even a pub. St. (KCIM)

St. Luke’s Hospital provides support for mothers facing postpartum depression
1 in 5 mothers will face postpartum depression in their lifetime. A new baby can bring a lot of changes in a mother’s life including emotional. St. Luke’s Hospital offers a support group to help mothers facing anxiety and depression by talking in a casual setting with others who are going through similar experiences. Postpartum is a step above the common “baby blues.” I can cause a mothers to spiral into a deep depression which only progresses without treatment. St. Luke’s Maternal Child Education Coordinator Deb Oldakowski said there’s one thing a mother dealing with this needs to remember. (KCRG)

Volunteers start work on Lullaby Lane
Parents grieving an unexpected miscarriage will soon have a permanent place to memorialize their child. At Elmwood Cemetery, members of this year’s Leadership North Iowa class spent Tuesday morning helping to lay pavers in a path for Lullaby Land. Parents who lost children to miscarriage under 20 weeks will have the option of having their child’s name and date of loss engraved on a paver there to be installed in the pathway. When finished, it will be a space for “people be able to memorialize their child,” said Mercy Medical Center Bereavement Coordinator Andrea Campbell. (Mason City Globe Gazette)

Miracle Riders take off from Sioux City for the first time ever to raise money for children
Sioux City witnessed a first this week as Miracle Riders rode out on motorcycles for St. Luke’s Miracle Network. Their thousand-mile journey helps to raise money for babies and their families. “We’re trying to raise $50,000 to buy two new crib units,” says lead Miracle Rider Matt Thompson. The ride will be anything but boring as the motorcyclists have asked patients to give them fun challenges along the way. “We’ve put a call out to all the children in Siouxland and the children at the hospital to think of ideas for us like scavenger hunts for us riders to do, ” said Thompson. (Siouxland Matters)

National News

Medicaid backlog cost Kansas at least $2.3 million and counting
Kansa has spent an additional $2.3 million on staffing to handle thousands of backlogged health insurance applications for people with low incomes or who are severely disabled, according to an audit. The audit looked into ongoing problems with the state’s Medicaid application backlog. Medicaid is the state and federal health insurance program. Kansas has a privatized Medicaid system called KanCare. The audit also discovered that as of mid-August, nearly 35,000 people have renewal applications pending and are waiting to find out if they will continue to receive services. (Wichita Eagle)

Neighborhoods influence health, for better and for worse
Doctors are waking up to a reality: To save lives, it simply isn’t enough to provide the best clinical care. As health care transitions from fee-for-service care to population health management, providers must look beyond the walls of hospitals and into the communities where people live their daily lives. Providers need to collaborate with community leaders and organizations providing social services, making themselves part of the neighborhoods they serve. Many hospitals and clinics are already experimenting with innovative approaches that link the clinic to the neighborhood. (Wall Street Journal)

‘Genius Grant’ winner is a genius at inspiring students
When the phone rang, Rebecca Richards-Kortum thought it was a telemarketer. Instead, it was the MacArthur Foundation calling her at home to tell her she’d just won a grant totaling $625,000, often dubbed the “genius grants.” They’re given out each year to 20 to 30 people who show “exceptional creativity.” In announcing Richards-Kortum as one of this year’s 23 fellows, the MacArthur Foundation noted her commitment to “improving access to quality health care for all the world’s people. Richards-Kortum is not only developing novel solutions but also training and inspiring the next generation of engineers and scientists to address our shared global challenges.” (NPR)

House panel advances six public health bills
The House Energy and Commerce Committee advanced a half-dozen public health-related bills Wednesday. The six bills were approved unanimously by the committee on voice votes, and covered a range of topics from mental health first aid to classifying some synthetic drugs. In the Senate, similar bills are working their way through the committee process. “Collectively, these bipartisan bills will improve the health of Americans across a large spectrum of issues,” Chairman Fred Upton (R-Michigan) said in a statement. The six bills now await action on the House floor. (Morning Consult)

McConnell releases stopgap spending bill, anti-Zika funds
The Senate’s top Republican on Thursday unveiled legislation to prevent a government shutdown next weekend and provide more than $1 billion to battle the Zika virus. It also would provide $500 million to help Louisiana rebuild from last month’s devastating floods. Majority Leader Mitch McConnell said the stopgap measure was “clean” of controversies. But Democrats immediately blasted the proposal for failing to fund one of their top priorities: money to help Flint, Michigan, repair its lead-tainted water system. (PBS Newshour)

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