November 10, 2008
CAMC gives patients room to relax
New MRI scanner is larger than most, easing claustrophobia

By Eric Eyre
Staff writer

This isn't your typical MRI. More than 60 percent of patients can receive a scan with their head outside the machine's "doughnut hole." There's more breathing room. No more claustrophobic feeling. Fewer patients have to be sedated. 

Best of all, parents can snuggle up beside children who need scans that can last anywhere from 15 to 40 minutes.

"There's room for mommy or daddy," said Alyce Taylor, an MRI technologist at CAMC Women and Children's Hospital in Charleston. "We had a 4-year-old boy sleep through the whole thing."

The hospital unveiled its new Magnetic Resonance Imaging scanner - called a Siemens Magnetom Espree - last week.

In the past, children and newborns at Women and Children's had to be shuttled across town in an ambulance to CAMC General or Memorial hospital for MRI scans.

"When it's 30 degrees outside and you have to pack them up in an ambulance and send them across town, it's not fun for anybody," said Andrew Weber, chief administrator at Women and Children's Hospital.

The CAMC Foundation paid for the new MRI, which cost about $1.8 million. The hospital spent another $1.2 million renovating rooms to house the massive scanner and monitoring equipment.

The hospital started using the machine several weeks ago. Patients have given the scanner rave reviews, hospital officials said.

There's more headroom than traditional MRIs. The new scanner is 70 centimeters (nearly 28 inches) in diameter.

About 20 percent of adult patients and 80 percent of children had to be sedated before receiving scans from older-model MRIs.

"With the older MRIs, your nose was practically touching the top," said David Ramsey, CAMC's chief executive officer. "Even if you're not claustrophobic, it can become claustrophobic."

The new MRI also can accommodate obese patients who dislike tight spaces. The scanner's table has a weight capacity of 550 pounds. The hospital already has used the machine to scan a 400-pound patient.

MRIs provide detailed images of the body, especially soft tissue such as the brain. The machines use powerful magnets, instead of radiation, to produce the images.

"It's excellent technology," said Cynthia White, director of medical imaging at CAMC. "You get excellent image quality, but you still have a large space. We've seen this technology come a long way."

The new MRI promises to become more kid-friendly next year.

The Foundation - CAMC's fundraising arm - plans to purchase "CinemaVision" headsets and goggles that will allow children to watch their favorite movies and cartoons on DVDs while receiving scans. The system costs $40,000, and the Foundation has raised half of that amount.

Adults also are expected to use the equipment to help them relax.

"It blocks out the loud noise and other scary things about getting an MRI," said Gail Pitchford, the Foundation's president. "It's a sort of virtual-reality 3-D experience."

Inside the boardroom

Inside the boardroom 
October 22, 2008

The CAMC board of trustees and CAMC Health System board of directors held regular monthly meetings this morning. Here’s a summary.

 Larry Hudson, chief financial officer, reported CAMC is nearly $8 million behind on it’s budget and unlikely to catch up by the end of the year. Two main financial factors to CAMC’s current situation are an increase in staff in 2008 (greater than was budgeted) and a rise in self-paying patients and charity care. As with a lot of other similar companies, CAMC is experiencing market losses in its investment portfolio along with the CAMC Foundation. 

 Bob Danielson, vice president, compliance, reported representatives from the Office of Inspector General conducted a site visit of CAMC in August. They gave positive reviews of CAMC’s compliance program and hotline. 

 The CAMC Board of Trustees approved the strategic plan, which includes the following pillars supporting CAMC’s vision: Best Place to Receive Patient-centered Care, Best Place to Work, Best Place to Practice Medicine, Best Place to Refer Patients, and Best Place to Learn (this pillar is new, but supports CAMC’s role as a teaching hospital).

 Brenda Grant, corporate director, planning, reported CAMC’s scores as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) initial public report. The percentage of patients who rated CAMC a “9” or “10” on a scale of 0-10 was 65 compared to 63 percent for other hospitals in West Virginia and a national average of 65 percent. The percentage of patients who said they’d definitely recommend CAMC was 73 compared to 64 percent for other hospitals in West Virginia and a national average of 68 percent.

 Heart and Soul
This morning the board recognized Clark Smith, a nursing assistant in behavioral health services at General Hospital, for his patient care outside the walls of his unit and hospital. The co-workers who nominated Clark say he “went above and beyond the call of duty by ensuring a chronically mentally ill patient was safely discharged.” The patient was discharged to the men’s shelter after being a patient for about 3 weeks. As is the case with many mentally ill patients he had no resources, no home, no family, no money and no photo ID. Clark took it upon himself to ensure the man got a locker at the homeless shelter to lock his belongings up, which were all donated to the patient by 6 east staff. The patient did not have money for bus fare or money for prescriptions for medicine to maintain his mental health. Clark also took the patient to the DMV to get a photo ID to maintain a spot at the homeless shelter. The shelter does not allow people to stay more than one night without a picture ID. “The 6 East staff was impressed and appreciative of Clark’s dedication to the patients of Behavioral Health Services,” wrote his coworkers in their nomination.

 Nick Carpenter, a night shift charge nurse on 2 East at Memorial was recognized because of the compassion he showed toward a certain patient. At a young age the patient was a car accident victim that left him paralyzed and a bilateral amputee. His family brought him to the hospital, dropped him off at the ER. He has not heard from his family since. During his recent stay, the patient became emotionally distraught and suicidal. One night, Nick took time out of his shift to sit and talk with this patient in length. Nick gave him emotional support by lending a listening ear and reassurance that he would find somewhere and someone else to take care of him. The patient had been trying to communicate by e-mail with a WV Advocate on finding him better living arrangements, but was not having any success. Nick brought in one of the unit’s portable computers, accessed the patient's personal e-mail and responded to his current e-mails from the WV Advocate. “Thanks to Nick showing so much compassion, this patient has a better outlook on his life and situation,” his coworkers wrote in their nomination of Nick.

-Dave 

 
January 21, 2008

Born addicted: Drug abuse among pregnant women is on the rise
by Eric Eyre
Staff writer

Drug use among pregnant women in West Virginia appears to be increasing rapidly, crowding hospital newborn intensive-care units and prompting state lawmakers to search for a solution. 

The number of newborns treated for drug withdrawal doubled from 2003 to 2005, according to a new study from the state Perinatal Partnership. In 1999, 14 babies were discharged from hospitals after being treated for withdrawal. The number rose to 119 in 2006. 

"It's a huge problem," said Dr. Stefan Maxwell, chief of pediatrics and director of Neonatal Intensive Care Services at CAMC Women and Children's Hospital in Charleston. 

Cabell Huntington Hospital had the most drug-addicted newborns, followed by CAMC and Martinsburg's City Hospital, according to the report. Women who abuse drugs while pregnant are more likely to have babies with birth defects, developmental disabilities, low birth weights and drug withdrawal symptoms - sweating, shaking, extreme fussiness and vomiting. 

The babies usually are treated with methadone or morphine. 

"We put them on methadone to control withdrawal and slowly wean them off," Maxwell said. "It may take weeks to do it." 

Doctors believe hospitals are underreporting the number of newborns who must be detoxified because some drugs can't be identified through normal testing, and some mothers aren't tested at all. 

"The information is spotty," said Maxwell, who served as chairman of the committee that issued the report. 

Last week, state lawmakers introduced a bill that would require doctors and midwives to perform uniform health screenings of pregnant women statewide. The results of the screenings would be kept confidential, and women who admit to using drugs during pregnancy wouldn't face criminal prosecution, according to the proposed legislation. The state Bureau of Public Health would develop the screening tool. 

"We're going to be able to identify the problem early, get them in a treatment program and keep the information confidential," Maxwell said. 

The public health bureau reported that 373 pregnant women in West Virginia were treated for substance abuse in 2006. Of those, 214 received treatment at behavioral-health centers and 159 at methadone clinics. Drug use among pregnant women was spread across the state, not isolated to a specific region. 

In a survey, obstetric nurse managers at West Virginia hospitals said pregnant women most commonly used marijuana, followed by opiates and cocaine. 

Nearly 90 percent of hospitals reported that they had discharged infants who'd had to be detoxified, according the study. 

"There are hospitals saying we don't have a problem. That isn't possible," Maxwell said. "Part of the reason is the right questions aren't being asked." 

In some cases, infants whose mothers abused drugs don't demonstrate withdrawal signs until the third to fifth day after birth, the report said. By that time, they're already at home. 

Also, some doctors' offices and clinics don't ask or test pregnant women for drug use, fearing that the mothers won't seek prenatal care if they must disclose their addiction, according to the study. 

Most babies born from drug-addicted mothers must be treated in newborn intensive-care units. A previous Perinatal Partnership study found that some West Virginia hospitals were turning away babies in distress because of a shortage of neonatal intensive-care beds. 

To meet the demand, West Virginia University Hospitals and Cabell Huntington Hospital recently added beds for sick babies. Still, many rural hospitals and clinics report that they have a difficult time finding beds at larger hospitals for high-risk mothers and infants, the report said. 

In addition to mandatory testing, Maxwell's committee recommended that West Virginia examine what other states are doing to address the problem, and study the extra costs of treating babies whose mothers are addicted to drugs. 

"We still don't know what the prevalence in the state is exactly," Maxwell said, "but it's an increasing problem - and it's all over the state." 
To contact staff writer Eric Eyre, use e-mail or call 348-4869.

Born addicted: Drug abuse among pregnant women is on the rise

Hospital newborn intensive-care units, such as this one at CAMC Women and Children's Hospital in Charleston, are seeing a sharp increase in babies with withdrawal symptoms because their mothers used drugs during pregnancy. .. 

August 1, 2007

Putnam General one year later
CAMC turned what looked like the end into a strong new beginning

A year ago today, after more than 100 people filed suits against surgeon John King and Putnam General Hospital, officials of the parent corporation dropped a bombshell:

Hospital Corporation of America announced that it would close Putnam General Aug. 29 and pay its 300 employees only through the end of September. 

The hospital that had been the pride of Putnam County was likely to survive only as an urgent care center.

Putnam County stood to lose a valuable asset.

Instead, it gained one. Thanks to a lot of hard work by a lot of good people, Charleston Area Medical Center purchased Putnam General and promised to upgrade its equipment and staffing.

CAMC President and Chief Executive Officer David Ramsey recently recapped for members of the Putnam Rotary Club where things stand now:

In October, Putnam General had 286 employees, and 75 percent of its nurses were "agency" people paid on an hourly basis. Today, the hospital has 323 employees and is hiring regular employees.

Of the hospital's 68 beds, 53 are "up and running."

Two years ago, Putnam General did 4,493 procedures. That will rise to an estimated 4,558 this year.

Outpatient visits, which dipped below 40,000 in 2005, could exceed 50,000 this year.

A single-slice CAT scanner that did a scan in 40 minutes has been replaced by a 65-slice scanner that does the job in eight minutes.

CAMC will spend nearly $2.2 million on building and equipment at Putnam General this year.

CAMC was recently rated in the top 5 percent of hospitals nationwide for hospital-wide clinical excellence over 32 different procedures. It was ranked by U.S News and World Report among the top 50 hospitals in the nation for heart treatment and heart surgery.

It has more than 550 physicians on its active and associate medical staffs, more than 140 residents in training, and runs 300 or so clinical research projects each year -- to name just a few strong points.

A year ago, Putnam County seemed poised to take a giant step backward. By becoming part of CAMC, it tapped into a tower of strength instead.

At work a few years ago with Huntington-based Komax, Sarah Williams had an unusual experience while delivering printer supplies to a customer's office.

A secretary told Williams she'd found a tumor larger than a golf ball on her breast. Williams sat and prayed with her.

"You don't ordinarily - when you're dropping off toner - get a story like that," she said.
It turned out the woman's lump was benign. However ..."Three days after I prayed for her," Williams said, "I found the lump.

"She wasn't as fortunate as the other woman. Williams' malignant tumor led to a lumpectomy, removal of lymph nodes in her left breast and 36 radiation treatments. Still, she avoided a full mastectomy, or removal of all of her breast tissue.

More women might avoid such disfiguring procedures in the future. Dr. Mark Choueiri and Dr. Paul Bown at Charleston Area Medical Center Memorial Hospital recently have performed "skin-sparing mastectomy.

"The procedure dates back to 1983, but is uncommon in West Virginia, Choueiri said.

A skin-sparing or "keyhole" mastectomy, involves cutting around the nipple, with another incision cutting bilaterally or below the nipple, according to Dr. Abdalla Bandak at CAMC's Plastic Surgery Center. This allows surgeons to save most of the overlying skin, rather than cutting across the entire breast.

"To me, it's not a new practice," Bandak said, "but it is the gold standard now.

"While the procedure fights breast cancer, it's cosmetic in nature, Choueiri said. "The older I get, the less it matters," Williams, 50, laughed about keeping her left breast. "I think it really depends on your age.

"She opted for the least invasive surgery, and merely bears a hollow indention. While she's been free of cancer four years, she'll never be completely free of thoughts about it.

"Every swelling, every ache, every pain," she said. "The thought runs though your mind that this is more cancer."

During skin-sparing mastectomy procedures, a plastic surgeon replaces the lost breast tissue with a saline implant, or back or abdomen muscles.

Choueiri explained that muscles can be flipped up or from around the back. The surgeon can save blood vessels connected to the muscle or remove it completely. Using these "free flaps," blood flow is restored as vessels are sewn up to the new area, he said.

Bandak said plastic surgeons also can use fat and tissue from the abdomen area other than muscle. The initial surgery lasts longer than more traditional mastectomies.

"It is more time-intensive for the surgeon," Choueiri said. "It's more time-intensive for the patient.

"Skin-sparing mastectomies are not for women with what Choueiri called "inflammatory breast cancer." That is, if skin is saved, the cancer's left behind.

Smokers, women with advanced stages of cancer, the morbidly obese and patients with other medical conditions, such as hypertension, might not be candidates for a skin-sparing mastectomy, Bandak said. He encourages women to consult with a plastic surgeon before a mastectomy or lumpectomy. That way, they can better weigh the best reconstructive option available.

Based on legislation passed in 1998, health providers cover all stages of reconstruction of the diseased breast, procedures to restore symmetry and complications, Bandak said. Williams, of Culloden, said that at times, she was her own worst enemy: expecting too much, too soon, from her chemotherapy and surgery. Losing her hair was tough, but she's persevering.

"As the years go by," she said, "the stronger I get."

To contact staff writer Davin White, call 348-1254.

Drug-addicted and abused women, young children with weight problems, and other patients benefit from an annual fundraising gala sponsored by the CAMC Foundation.

The gala, scheduled for April 21, funds "Prevention First" programs at CAMC Women and Children's Hospital in Charleston.

"We have used that money to support programs not paid for any other way," said Sally Llewellyn, administrator at CAMC Women and Children's.

The hospital-sponsored programs tackle mental-health needs, cancer support and family life and childbirth education.

They address domestic violence, obesity and bereavement for mothers who have lost children, drug abuse and the need for exercise. The programs also make yoga classes and massage therapists available, educate on car-seat safety and provide psychological testing.

Llewellyn and Denise Burgess, director of Women and Children's Family Resource Center, said they see, more than ever, expectant mothers and those who've recently given birth addicted to hard-core drugs such as OxyContin and methamphetamines.

Llewellyn said she has seen the number of expectant or newly delivered drug-addicted mothers being admitted rise from one or two a month to three or four per week.

The class for drug-addicted mothers offers one-on-one counseling and care for newborns. About 65 percent to 70 percent of the fundraising proceeds pay for these programs.

Organizers say 30 percent to 35 percent of the dollars raised also help offset the costs for Women and Children's patients lacking health insurance or underinsured and needing counseling or other services at the Family Resource Center, Llewellyn said.

Last year's total fundraising effort for Prevention First collected $260,000, according to Stephanie Meadows, development officer for the foundation.

This year's goal is $283,000.

The theme of this year's event at Edgewood Country Club is the "Roaring '20s," Meadows said. Guests are asked to wear 1920s attire, and will be treated to actors playing gangsters and music from the band Chez-Zam.

A silent auction features artwork, trips and private parties, including a Jamaican barbecue. The average vacation package is worth $3,000, Meadows said.

Meadows said the foundation also hopes to match with donors who might like to advertise their business at the gala and be recognized for making a charitable donation.

To contact staff writer Davin White, call 348-1254.

March 29, 2007

CAMC to get extra money for losses

By Eric Eyre
Staff writer
Charleston Gazette

Charleston Area Medical Center expects to collect an extra $2.3 million later this year to help offset financial losses at General Hospital’s trauma center and intensive care units for newborns and children at Women and Children’s Hospital.

The state Legislature pledged to distribute additional money as part of a budget bill that helps CAMC and three other West Virginia “safety net” hospitals, which provide care to large numbers of low-income Medicaid patients. State lawmakers increased the funding by about 50 percent over last year.

The federal government will kick in $3 for every dollar the state distributes.

Last year, CAMC hospitals lost $14 million in its specialized-care units for Medicaid patients.

“This will make up about half of the loss coming from safety net patients,” said Robert Whitler, CAMC’s vice president of government and community affairs, after a board of trustees meeting in Charleston Wednesday. “We’ll still have a loss, but less of a loss. This is a huge step forward.”

The state’s other teaching hospitals — Cabell-Huntington Hospital, St. Mary’s Hospital in Huntington and West Virginia University Hospitals — also will receive the extra funding in July. Gov. Joe Manchin is expected to sign the budget bill, which provides the additional funding.

Whitler said West Virginia is one of only a few states that doesn’t compensate hospitals for all financial losses brought on by Medicaid patients in trauma, neonatal and pediatric intensive care units. Statewide, the teaching hospitals lost more than $29 million last year providing care for those patients.

In 2006, CAMC received about $5.1 million from the state and federal government to help offset losses for Medicaid patients. This year, CAMC hospitals expect to collect $7.4 million.

Also Wednesday, CAMC’s chief financial officer said the hospital system was in danger of losing up to $2 million because of a proposed federal change that would reduce the discount on prescription drugs that CAMC provides at its pharmacy for employees.

Only a handful of hospitals across the country qualify for the prescription drug discount, said CAMC vice president Larry Hudson.

“With the change in rules, we couldn’t qualify [for the discount],” Hudson said. “It’s a lot of money. It’s crucial for us.”

About 90 percent of CAMC employee prescriptions are filled at the in-house pharmacy. CAMC has more than 5,000 employees.

CAMC CEO David Ramsey has written a letter to federal Office of Pharmacy Affairs, asking that the discount not be revoked.

Hospital officials said CAMC would absorb the $2 million loss and not increase prices of prescription drugs for employees if the federal government makes the change.

To contact staff writer Eric Eyre, call 348-4869.