Chicago Hospital News asked healthcare providers throughout the Chicagoland area to share profiles of leaders at their institutions. We have asked these leaders to share their thoughts and experiences on everything from their philosophy of success, work habits, to their views on challenges confronting the healthcare industry. The following are just a few of the many leaders who are making a difference in our community.

Sandy Jozaitis Vice President, Operations and Chief Nursing Officer Advocate South Suburban Hospital Proudest Accomplishment: My children First Job: When I was in high school, I provided day care for the elderly. Education: I have a masters of science in health administration. What skills do you need to succeed in your job: Patience and the ability to organize. Work habit you possess that you are most proud of: Organizational skills Most valuable lesson you learned in your career: Your most important resource is your people. The toughest part of your job: Time management Your philosophy of success: You are only as successful as the people who surround you. One of your goals: To obtain magnet status for the nurses of Advocate South Suburban Hospital. Person You Most Admire: Oprah Winfrey for her humanitarian efforts. Favorite Book: To Kill A Mockingbird Biggest Challenge Confronting Healthcare: The rising costs in all aspects of the industry, from insurance premiums and pharmaceuticals, to administering tests and physician’s malpractice rates. Suggestions on how you would solve a particular problem in healthcare: Promote wellness instead of disease. Your predictions on the future of health care: There will be a greater demand for services for our aging baby boomers. Best Thing About Healthcare in Chicago: The availability of care. Worst Thing about Healthcare in Chicago: The rising cost of malpractice insurance. What advice would you offer young people considering a career in Health Care: Health care offers such rewards – it’s one of the few professional careers where you know you are making a difference in people’s lives every day.

JoAnna White, RN Chief Nursing Officer Centegra Memorial Medical Center When JoAnna White, R.N., started at Centegra Memorial Medical Center in 1992 as the director of Medical Surgical and Telemetry Services she knew she wanted to make a difference in healthcare. That drive for wanting to always improve upon things has led JoAnna to make great strides in changing the way healthcare is delivered at the Woodstock hospital. Now serving as the 81-bed hospital’s Chief Nursing Officer (CNO), JoAnna has recruited a fine team of leaders who have worked in conjunction with their staff to achieve high levels of patient and physician satisfaction, something that the hospital had difficulties with in the past. Prior to the establishment of the CNO position, patient satisfaction hovered in the low 60th percentile and morale among employees was very low. But JoAnna saw these problems as opportunities to change. When JoAnna assumed the role of CNO, Centegra Health System (the parent organization for Centegra Memorial Medical Center) was going through a major cultural transformation. With the help of the new President and CEO, Michael S. Eesley, JoAnna and the other senior managers were given new tools to help them succeed in turning their hospitals around to be the healthcare system and employer of choice. One of those tools was the introduction of Servant Leadership, a management philosophy widely embraced by JoAnna and her peers. JoAnna led by example and served as a model for her staff to grow and lead their own teams to improvement. "As a leader, JoAnna has encouraged growth in her management team by allowing autonomy while also letting us know she is there if we need her," Laura Preston, R.N., director of Centegra Memorial Medical Center’s Intensive Services Department said. In addition to the Servant Leadership cultural transformation, Centegra also adopted a new values statement, ‘…to Serve with Genuine Respect, Passionate Caring and a Joyful Spirit.’ JoAnna once again led by example to help turn around employee moral by living closely to the new values of Centegra. According to Rich Parsons, manager of Centegra Sleep Services, "JoAnna’s positive demeanor and engaging smile focus on the goals of Centegra. Her friendly, professional approach to others has helped to elicit a passion in caring for our patients ‘to do the right things’ to serve everyone we come in contact with." Over the last three years, JoAnna has kept her focus on working with her teams to help the hospital keep inline with Centegra Health System’s corporate goals. And it is because of JoAnna’s passion, strong Servant Leadership skills and her ability to focus on achieving high outcomes, Centegra Memorial Medical Center has truly made a cultural transformation throughout and is the employer of choice in the community. Under JoAnna’s leadership, patient satisfaction has improved significantly with scores consistently in the 80th percentile (with over a 20 point increase). The nursing staff retention rate has reached 92 percent for all areas of the hospital, including the Emergency Department and in FY05, only 16 hours of agency help was used in the inpatient areas despite having an average occupancy of 88 percent. "JoAnna has lead her team toward a focused strategy to achieving high outcomes," Angela McAuley, Senior Vice President and Site Administrator for Centegra Memorial Medical Center said. "Her ability to control expenses in these challenging times as well as her consistent dedication to patient satisfaction has been an example for our entire organization. As administrator for Centegra Memorial Medical Center, I feel honored to have this Servant Leader, JoAnna White, as a peer."

Patricia Ahern President/Executive Director Rainbow Hospice Proudest Accomplishment: Raising two strong, successful children and doubling the size of Rainbow Hospice in the past 5 years. First Job: All I ever needed to learn about service – the Red E Cleaners in Rogers Park Education: RN, BA, MBA What skills do you need to succeed in your job: Innovative leadership, expertise in navigation of large-scale change, resilience, sensible problem solving skills, diplomacy, patience, humor, employees and volunteers who are smarter than I am. Work habit you possess that you are most proud of: I am a great multi-tasker Most valuable lesson you learned in your career: Stay in touch with people you admire along the way. The toughest part of your job: The rules and regs! I’m always wanting to color outside the lines. Your philosophy of success: Emerson said it best – "To laugh often and love much…to find the best in others; to give of ones self; to leave the world a bit better…to have played and laughed with enthusiasm…this is to have succeeded." One of your goals: Grow good people in all areas of life – at home, at work, in the community. Person You Most Admire: Eleanor Roosevelt Favorite Book: Managing at the Speed of Change by Daryl Connor Biggest challenge confronting healthcare: Our ability to meet the expectation of baby boomers. Suggestions on how you would solve a particular problem in healthcare: I think that patients and families should have real-time access to their medical records and write their own progress notes. Your predictions on the future of health care: Consumers will demand more service, empathy and creativity. Best thing about healthcare in Chicago: We have two fine health systems that are affiliated with Rainbow Hospice. Worst thing about healthcare in Chicago: There are too many uninsured and underinsured people and too many frail and isolated elderly and the whole community needs to care about them, not just healthcare. What advice would you offer young people considering a career in health care: Please join us. We need your dreams, your energy and your enthusiasm!

Mary Ann Anichini Director of Operation Excellence Presbyterian Homes, Evanston, IL Proudest Accomplishment: First and foremost, my family. Professionally, my proudest accomplishment has been my work through Operation Excellence to create culture change and a person-centered model designed to increase older adults’ autonomy, sense of control and meaningful relationships with those around them. First Job: Washing Bedpans at St. Francis Hospital Evanston. Education: BSN Loyola University Chicago; MS in nursing sciences What skills do you need to succeed in your job: When I took this job I knew how to research best practices. But then, I had to learn how to communicate best practices and energize staff to modify their routines. This meant learning more about facilitating groups, participant- centered learning, team concepts and culture change. Being an expert in nursing science has always been easy for me; understanding how an organization moves forward is more difficult. Work habit you possess that you are most proud of: Read one professional article every day. Most valuable lesson you learned in your career: The importance of listening. The toughest part of your job: Knowing when I have too many irons in the fire. One of your goals: To have long-term care so responsive to the needs and goals of the oldest among us, so that they may actively choose to live in this environment and are able to fully embrace the last years of their lives. Person You Most Admire: Abe Lincoln. He was a person who was able to lead people through what looked to be impossible territory. Favorite Book: My favorite book changes regularly. I love Creative Training Techniques by Bob Pike. Also Crucial Confrontations by Kerry Patterson and The Oz Principle by Roger Connors. And I must add The Leadership Challenge by James Kouzes and Barry Posner. Biggest Challenge Confronting Long Term Care: Listening to older adults and designing care according to what they define as desirable and meaningful. What advice would you offer young people considering a career in healthcare: Bring your intelligence and critical thinking skills, but don’t forget your passion, your heart and your spirit. This is a wonderful field!

Mary Freyer Chief Operating Officer Little Company of Mary Hospital and Health Care Centers Proudest Accomplishment: Feeling confident that I am able to maintain a healthy balance with my family commitments and work commitments. First Job: Microbiologist at Little Company of Mary Hospital Education: BA in Medical Technology from Clarke College in Dubuque, IA and Masters in Health Administration from Governors State University in University Park, IL What skills do you need to succeed in your job: Organization, tenacity, patience, negotiator Work habit you possess that you are most proud of: Persistence Most valuable lesson you learned in your career: Have the "right" information The toughest part of your job: Continual changes in healthcare Your philosophy of success: There are always two sides to every story One of your goals: Knowing that I made positive impacts in my personal and work life Person You Most Admire: Mother Mary Potter, the Hospital's Foundress Favorite Book: How to Win Friends and Influence People by Dale Carnegie Biggest Challenge Confronting Healthcare: Emergency Room "patient flow" Suggestions on how you would solve a particular problem in healthcare: Get customer in particular patient feedback – "stand in the shoes of a patient" Your predictions on the future of health care: Spiraling costs of medicine, technology, construction, employee benefits Best Thing About Healthcare in Chicago: We have many healthcare facility choices Worst Thing about Healthcare in Chicago: Physician Medical Malpractice Premiums What advice would you offer young people considering a career in Health Care: Healthcare delivery is a way to contribute in helping many, many people to quality, safe healthcare.

Lake Forest Hospital President William G. Ries to Retire William G. Ries, president and CEO of Lake Forest Hospital, recently announced his retirement after dedicating three decades to a health-care management career at Lake Forest Hospital. Ries joined the hospital in 1975 after completing his graduate studies at Cornell University and an internship at Greater Southeast Community Hospital in Washington, DC. He has served as president and CEO since 1986. He will step down from his post in December 2006 to allow time for appointment of a successor and transition of leadership. "Bill’s leadership through the years has significantly advanced the growth and development of the hospital and its services to our communities," said Thomas Swarthout, chairman of the hospital’s Board of Directors. Under the hospital’s mission of expanding beyond the traditional focus on medical needs to the needs of the whole person, Ries pursued a strategy of diversification of services and outreach to all of Lake County. The hospital opened the first combined cardio-pulmonary rehabilitation program in 1987. The comprehensive Pain Treatment Center opened in 1987 for the treatment of chronic pain. In 1989 the hospital added the first linear accelerator to a radiation oncology department for the advanced treatment of cancer. In 1990 Lake Forest Hospital physicians were among the first in the area to utilize laser and laparoscopic surgery techniques to advance minimally invasive surgery. Focusing on wellness, the hospital opened a Lifestyle Center in 1988. Ries transitioned this center into the development of two comprehensive Fitness Centers – one in Lake Forest and one in Lindenhurst – with the idea the hospital should invest to keep people healthy as well as care for them when they are ill. Ries also oversaw the physical expansion of the Lake Forest Hospital campus with the addition of the Dearhaven Childcare and Learning Center in 1989, the A. Watson Armour III outpatient services center in 1991, the Cain Family Emergency Services in 2001, and the new Hunter Family Center for Women’s Health in 2004. "More impressive than our physical expansion, Ries has led the hospital to the highest levels of patient satisfaction in the area. Lake Forest Hospital is ranked in the top 5 percent of hospitals nationally in patient satisfaction in inpatient, outpatient and emergency care as reported by the independent Press Ganey survey," Swarthout said. During his career Ries has served on numerous boards and committees in health care and in Lake Forest. He is a past director of the Illinois Hospital Association, Multi-Hospital Mutual Insurance Co (Cayman) Ltd, National Center for Advanced Medical Education, United Way of Lake Forest/Lake Bluff and the Lake Forest Chamber of Commerce. Ries is currently a director of the National Committee for Quality Healthcare in Washington, DC, Vice Chair of the Professional and Technical Advisory Committee of the Joint Commission on the Accreditation of Healthcare Organizations and a member of the Regional Advisory Committee of the American Cancer Society. Ries is a diplomate in the American College of Healthcare Executives.

Condell Health Network President/CEO Announces Retirement After 30 years of service, Eugene Pritchard, president and CEO of Libertyville-based Condell Health Network, has announced his retirement effective midyear 2006. A search is currently underway to recruit a successor. "It has been a thrilling ride for all of us," Pritchard said, "We could never have made such gains without the great, knowledgeable group of employees, physicians, auxilians and volunteers we have at Condell." Pritchard’s philosophy of always looking forward and never looking back has served Condell well over the years, having grown from a simple hospital to a major medical center and network of healthcare services and facilities that provide jobs for more than 3,000 individuals. In 2004 Condell admitted 22,474 patients for hospital care and treated 42,636 patients in the Emergency Department. Condell Medical Center was ranked the 20th largest hospital in the Chicago area for 2004 by Crain’s Chicago Business. And with double-digit increases in patient days for the past seven out of eight years, there is no apparent end to Condell’s growth. "Condell is a unique organization with exceptional camaraderie and enthusiasm that has lifted us from last to first place as the hospital for Lake County – and we’re not finished yet," Pritchard said. Under Pritchard’s capable leadership, Condell has risen from being an average hospital in market share to number one in Lake County. In 2004 Condell had 33.6% market share of Lake County residents using Lake County hospitals – considerably more than any other Lake County hospital. With expert capabilities in all phases of cardiac care, neurosurgery, comprehensive cancer treatment and orthopedics, Condell always strives to provide care comparable to teaching hospitals while allowing patients to remain close to home. Pritchard was instrumental in bringing the open heart surgery program to Condell in 2000, and he also oversaw Condell Medical Center’s major expansion in 2003 – the largest healthcare facility project of its kind in Lake County history – which doubled the size of the Libertyville hospital. Also during Pritchard’s tenure, Condell began Condell Home Health Care and Hospice; two Centre Club fitness centers in Libertyville and Gurnee; four acute care centers in Buffalo Grove, Gurnee, Round Lake Beach and Vernon Hills; 12 Condell Medical Office Buildings across Lake County, Condell Imaging Center in Gurnee; the nationally renowned Day Center for Intergenerational Care; Condell’s Radiation Oncology Center; and Pediatric Alternatives in Creative Therapy (PACT), physical rehabilitation services for children. Despite economic ups and downs in health care over the years, and the accompanying buying and selling of hospitals by large corporations, Condell has remained independent. This status is a credit to Pritchard, a talented executive with an MBA from the University of Chicago and a vision he was able to bring to fruition through a budget-minded philosophy that has made Condell financially strong.

Jennifer Weininger: Enhancing the Lives of Weinberg Community Residents While Jennifer Weininger would still be considered a relative newcomer to the professional world, she has spent nearly half her life working in the area of gerontology and senior living. Weininger, 27, a native of Glenview and current resident service manager of personal care at Council for Jewish Elderly’s (CJE) Weinberg Community for Senior Living in Deerfield, first began volunteering at Glenview Terrace Nursing Center at the age of 15, and has been hooked ever since. "I’ve loved it ever since I can remember," says Weininger. "I learn a lot from the residents and they learn a lot from me. It’s never a boring day." In her two years working at the Weinberg Community, which includes Gidwitz Place for Assisted Living and the Friend Center for Early Alzheimer’s Care, Weininger, who graduated from the University of Illinois with a degree in health administration specializing in gerontology and also has a master’s in health administration, has overseen several cutting-edge programs aimed at enhancing the independence of residents. In February, Weininger helped initiate "Friend Extend," a continence management program for residents of the Friend Center. Weininger trains a staff of 20 on the best methods to deal with incontinence, an issue that can be uncomfortable for the residents and staff alike. Her training sessions cover individualized continence management, continence products, skin care management, subtle reminders of toileting issues and ongoing assessments to determine changes in daily living needs. "Most importantly, this program allows our residents to stay here longer and keeps them living in their own homes," Weininger explains. The immediate results have been positive, as staff has already seen a decrease in incontinence among participants. Another Weininger production is "SeniorFITness," a specialized fitness program introduced to the residents a year and a half ago, designed to enhance the ability of seniors to perform activities of daily living. More than 40 residents currently participate in the program that enlists the assistance of an exercise physiologist who works one-on-one with residents on their individual needs, including strength training and balance, and also conducts small group training. Weininger meets regularly with the exercise physiologist to monitor resident activity and presents progress reports to family members. She also brings in guest speakers to talk with residents about the importance of exercise and staying in shape. A resident who was not able to walk up the stairs to her daughter’s home began participating in the fitness program, Weininger explained, and several months later was able to walk up the entire flight by herself. "This is another way to improve the quality of life for our residents," Weininger says. "We want them to be able to continue doing the things they’ve done their entire life." Paula Bartolozzi, director of the Weinberg Community, explains that it is refreshing to see a young management professional succeeding in the area of health care for seniors. "It’s a field that sorely needs more young professionals in long-term care management like Jen," says Bartolozzi. "She approaches her responsibilities with enthusiasm and attention to detail and I am always looking for new ways to challenge her." If Weininger has her way, she will remain at the Weinberg Community and in the long-term care residential setting for the foreseeable future. "I want to work with residents forever," Weininger says. "If you miss one day of work, the residents start asking where you are. It’s like a family here, everyone looks out for each other."

Good Grief Submitted by David Samson, Chief Development Officer, Rainbow Hospice "The only cure for grieving is grieving." These are the words of Dana Reeve, widow of Christopher Reeve. Dana Reeve was able to communicate to millions what Rainbow Hospice has known for some time. And Betty Siuba, director of Bereavement Services for Rainbow Hospice, makes sure that grief support is available to anyone in the community coping with the loss of a loved one through death. Siuba oversees the management and implementation of what she believes to be the most extensive and comprehensive hospice bereavement center in the state of Illinois, with many programs offered free of charge. This past year more than 3000 Chicagoland residents have benefitted from these bereavement services. Now in her sixth year directing bereavement services for Chicagoland’s Rainbow Hospice, Siuba has grown and finely tuned bereavement programs offered to the community. In addition to genearl grief support groups for recently bereaved individuals, Siuba has directed efforts to offer loss-specific workshops and support groups for adults coping with the loss of a spouse, a parent, an adult child or a sibling. And she knows the benefit of collaborating with other organizations, as witnessed by the many partnerships created that include the Alzheimer’s Association, the Howard Brown Health Center, the University of Chicago and AARP. A recent addition to the services of Siuba’s bereavement work is the Grief in the Workplace program. "When a death does occur in the workplace, worksites are often thrown into chaos, especially if the death was unexpected and/or the result of a tragic incident," Siuba explains. And the program is growing in popularity. "We’ve been receiving an increased number of calls to provide this type of intervention." Siuba’s immediate task is to have her staff participate in trauma training. "I want to ensure that we have the resources to respond to the growing number of these requests." In addition to bereavement support groups for adults, The Bereavement Center of Rainbow Hospice also sponsors the Good Mourning Program for Children, Teens and Families, a unique service to grieving children. It is the longest-running and most comprehensive bereavement support program for children and families in the entire Chicagoland area. Siuba has assembled a staff that works with families to explore how to provide the very best kind of help. Through monthly and weekly support groups and special events, children, teens and families receive helpful information, advocacy, and emotional support as they face life-changing loss. This past year LOSS (Loving Outreach to Survivors of Suicide, the largest program in the Chicago area providing service to families who have survived the suicide of a parent, spouse, child, or sibling) named Good Mourning as its designated provider of services for dependent children. Good Mourning is also comprised of the Grief in School program, a comprehensive program that provides learning opportunities and support for educators and advocacy for bereaved children and their families through professional workshops, crisis response and de-briefing, and consultation. Siuba’s trained team of bereavement counselors are often one of the first called when there is a traumatic incident in one of the schools. Siuba, a Licensed Clinical Professional Counselor and a Licensed Social Worker holds a certificate in Business Adminstration and a Masters of Science in Community Mental Health.

Sharon Rostoker General Manager VITAS Innovative Hospice Care® of Chicagoland Northwest First job: Receptionist during the summer while in high school and college first career job: oncology nurse on a bone marrow transplant unit Education: BSN San Diego State University; MSN University of Miami Favorite book: The Bible—the only book I read over and over again What skills do you need to succeed in your job: Vision, patience, persistence, positive attitude, ability to motivate others. Work habit you possess that you are most proud of: Tenacity One of your goals: Professional: To bring quality hospice care to more terminally ill patients each day. Personal: To cruise the Amazon River. Person you most admire: Mother Teresa Most valuable lesson you have learned in your career thus far: How you say it is just as important as the message you are trying to convey. The toughest part of your job: Personnel issues—you can never keep people happy all of the time. Proudest accomplishment: Being general manager of VITAS Innovative Hospice Care® of Sacramento and taking the new program through licensure and certification, then being able to return to Chicago to run one of our largest hospice programs! Your philosophy of success: Success never comes through the efforts of one person. It takes teamwork and a shared vision to become all that we can be and do all that we can do to meet the needs of the patients and families we serve. Biggest challenge confronting healthcare: Rising healthcare costs Suggestions on how you would solve a particular problem in healthcare: Many of our healthcare costs are due to unhealthy choices that lead to obesity, smoking and lack of exercise. Companies should be mandated to help their employees develop lifestyle changes that would decrease chronic and debilitating illnesses. Best thing about healthcare in Chicago: Access to large teaching hospitals with leading-edge technology for treating most illnesses. Worst thing about healthcare in Chicago: Unequal access Your predictions on the future of healthcare: Someday we will have a nationalized healthcare system where preference would be geared toward those with the potential for the best outcomes. What advice would you offer young people considering a career in healthcare: Healthcare is a challenging but rewarding career where you can see the results of your efforts on a daily basis. Healthcare providers cannot be outsourced, so they will remain an integral part of the healthcare system. Healthcare will continue to offer opportunities for advancement, education, advocacy and self-fulfillment.

Margi Carlson General Manager VITAS Innovative Hospice Care®, Chicagoland South First job: Respiratory Therapist Education: Registered nurse, diploma 1973; bachelor’s degree in healthcare administration, 2004 Favorite book: The Giving Tree by Shel Silverstein What skills do you need to succeed in your job: To listen, hear the needs of the community, customers and staff, and respond. A blend of business management and compassion for the needs of people at the end of life. Organizational ability to multitask and manage change without chaos. Patience, knowing that hospice care is unpredictable. Human resource management to oversee the ever-changing employment market. Sales, customer satisfaction and oral and written communication skills. Creative business planning to be ahead of trends. Ability to take the large corporate vision and make it applicable to our local program. Ability to manage compliance issues. Ability to communicate with local, state and national policy makers and leaders. Ability to manage conflict and crisis. Ability to teach and influence staff to continue to meet expectations. Work habit you possess that you are most proud of: Flexibility and diligence—I give whatever it takes to meet the needs of patients, families, and staff. I consistently make time to be in the field, either alongside team members or in a coordinated separate role, to really know the needs of our customers and better understand the concerns of our teams. There is no clock on the wall in my office, because in hospice care there is no predictability that can be determined by a clock. I love this hospice story, which occurred earlier this year: A family was distressed and I received a call at the end of a Friday. Despite a lengthy telephone conversation, with family members, it was evident that more was needed. The team manager and I, in collaboration with our vice president of operations, determined that we needed to visit the patient’s home that night. The patient lived about and hour from our office. We arrived at the door and met the family at about 7:30 p.m. The sincerity of our action helped the family to allow us to help them, and we left the home about midnight after much intervention. Over the weekend we spent more time in the home with the patient and family. As I vacuumed their living room and dining room, I made the patient’s daughter promise never to tell my husband what I was doing, since he believes I do not know how to vacuum. The family laughed and embraced our entire team. A usual view of a general manager? Perhaps not, but our goal of having the patient, family and staff supported was achieved. I loved that day; to me it represents success through sincere, compassionate attention to the immediate needs of a patient and family, and it creates long-lasting memories. In our program, this is a classic story of service recovery. One of your goals: A goal or a dream? Some eight years ago, I jotted a concept for a grief support book on a napkin, making my goal to write and publish that book. Person you most admire: My husband, Dennis, who has offered his support and understanding as my need to nurse and serve has taken precedent over hot meals and housework on many occasions over the past 26 years. Most valuable lesson you have learned in your career thus far: To relax and enjoy the path. I have learned to view my leadership as a conductor of an orchestra, not as a ranking officer, and have proven over and over that the outcome of excellence and satisfaction is certain. The toughest part of your job: When, in spite of all of our collaborative efforts, we fall short of our goals, both in terms of care and performance. Proudest accomplishment: Helping to build the management team and program in my current position. We are accomplishing care at the highest volume and level of excellence in the history of the program. Your philosophy of success: Do the right things consistently for the right reason. Biggest challenge confronting healthcare: Access to healthcare for uninsured and underinsured individuals. Best thing about healthcare in Chicago: Availability of world-renowned medical professionals and facilities. Worst thing about healthcare in Chicago: Not all people have access to the world-renowned medical professionals and facilities. Your predictions on the future of healthcare: Tighter regulations, rising costs to consumers and the eventual need for redesign of the healthcare delivery system. What advice would you offer young people considering a career in healthcare: Just do it! If they are serious, they need to understand that there are countless opportunities in healthcare for both professionals and paraprofessionals. Education programs offer flexibility in class schedules and matriculation between program levels, which supports professional growth and systematic accomplishments. One thing is certain: healthcare will be an ongoing need in our world, and we need people who have the ability, integrity and passion to help balance what in my day we referred to as the "art and the science" in healthcare.

Alma Phillips General Manager Vitas Innovative Hospice Care® of Chicagoland Central First job: Home healthcare Education: Bachelor’s degree in management, master’s degree in business administration Favorite book: Any mystery by James Patterson What skills do you need to succeed in your job: Excellent communication, analytical and interpersonal skills. The ability to effectively communicate expectations to staff is a critical skill for any manager, but it is even more so in the delivery of hospice care. Staff must be compassionate and demonstrate an understanding of the patient’s needs as well as provide the care that their patient needs according to Medicare regulations and standards. Therefore, it is incumbent upon me as the general manager to present information in a format that is easily understood by the clinical staff and thereby reflected in the delivery of quality patient care. Work habit you possess that you are most proud of: The ability to see a project through to completion; working a problem through in search of a reasonable solution no matter how much time I have to dedicate to it. One of your goals: To ensure that residents in the Chicagoland area are knowledgeable of and have access to quality end-of-life-care—especially the African-American and Latino communities, which traditionally have lower utilization of hospice care. Person you most admire: My dad had a very strong work ethic and an equally strong commitment to his family. I am very proud to share those same levels of commitment. Most valuable lesson you have learned in your career thus far: It has been my experience that in order to affect a positive outcome you cannot force your values or opinions on others. You must instead meet them where they are in their thought process. I have found this to hold true whether I am meeting with patients and families to discuss end-of-life healthcare options or with a staff person regarding performance issues. The toughest part of your job: In my role as general manager I must create a balance between patient care and the financial aspects of running a business. I must have the staff necessary to ensure that our patients receive the treatment and care they need to keep them comfortable while still balancing the budget. Proudest accomplishment: The completion of my MBA and using that knowledge to make a difference in the lives of others through my work with VITAS. Your philosophy of success: To have the opportunity to do work that you enjoy, to establish goals and to remain focused on meeting them. Biggest challenge confronting healthcare: Third-party reimbursement continues to be a concern for healthcare providers, especially in hospice care, which is heavily regulated by Medicare. Also, there are still commercial insurance companies that have a limited hospice benefit or none at all. Suggestions on how you would solve a particular problem in healthcare: It is my opinion that reimbursement issues would be somewhat resolved by a national healthcare plan or system that would provide equal access to all. Best thing about healthcare in Chicago: The many large healthcare institutions that offer extensive research in areas such as heart disease and cancer. Worst thing about healthcare in Chicago: There is not always equal access to healthcare for all. Many of the uninsured or underinsured have to seek treatment in less than stellar institutions. What advice would you offer young people considering a career in healthcare: Healthcare is something you have to want to do in order to do it well. If your greatest concern is making a great deal of money, you might choose another profession. Although healthcare can be extremely trying, especially from a hospice perspective, it can also be very rewarding when you hear a family say, "We could not have made it through this tough time without the wonderful care you provided."

Dr. Richard Harris IPC – The Hospitalist Company The other day, I’m performing a rectal exam on a patient. The patient asks, "Hey, doc, can you please use two fingers for the exam?" Bewildered, I ask him why. He replies, "So while you’re in there, you can get a second opinion!" A barroom joke? A comedy routine? Nope. This really happened to Dr. Richard Harris, a hospitalist with IPC-The Hospitalist Company, while he was caring for a patient at Hinsdale Hospital. In practice as in life, a sense of humor can pull you through. A good laugh is cathartic. Humor bonds you with others. The patient knew this and so did Dr. Harris who works hard at building strong levels of trust and confidence with the patients he cares for during their inpatient stay. No stranger to the Chicago area, Dr. Harris received his medical degree at Chicago Medical School and completed his residency at Scripps Clinic and Research Foundation in La Jolla, CA in 1997. He is a member of the American College of Physicians and the American Medical Association and is board certified in internal medicine. Dr. Harris has been a practicing hospitalist in Chicago for a little more than a year. IPC itself has been providing hospitalist services at many Chicago-area hospitals for the past six years and anticipates that its physicians will collectively average more than 10,000 patient encounters a month by the end of the year. The fastest-growing medical specialty in the country, "hospitalists are here to stay," says Dr. Harris. He anticipates that every hospital across the country will have embraced a hospitalist program within the next ten years (nearly half of all hospitals already have). These acute-care specialists work in close consultation with the primary care physician to manage an inpatient’s entire hospital stay, from admission to discharge. "IPC is spearheading this effort not only here in Chicago but around the rest of the country as well," he says. "It is very exciting to be a part of this positive change." As he touts the benefits of hospitalist medicine to colleagues, referrals sources and friends, Dr. Harris points out that hospitalists are "better for both patients and medical economics." Studies support his belief as increasing evidence documents that hospitalists enhance quality of care, reduce healthcare costs, create greater patient satisfaction, and overall drive the delivery system towards better, more efficient care. Some might view Dr. Harris as somewhat of an activist for hospitalists as he lists the benefits to primary care physicians for referring their hospitalized patients to a hospitalist. "By allowing a hospitalist to care for their inpatients, primary care physicians can alleviate the need to be on-call, work on weekends and break up their days shuttling between their office practices and the hospital," he says. "Yet primary care physicians don’t have to relinquish the trust they have with their patients. If they choose, they can still make rounds, but they can be more of a social visit than one of acute patient care. And they know that the patient will return to their practice once they are discharged." As a physician leader within Hinsdale Hospital, Dr. Harris is active on three hospital committees – the Emergency Department Patient Care Committee, the Pharmacy and Therapeutics Committee, and the Infectious Control Committee. He believes that physician involvement is vital to helping make the healthcare system become more effective. "There are two types of people: those who become frustrated with the way things are but don’t act and those who initiate change for an improved patient-care environment," he says. Clearly, Dr. Harris prides himself on being one of the latter. Within IPC itself, Dr. Harris manages the group of hospitalists who work at Hinsdale, La Grange Memorial and Good Samaritan hospitals. "It is my role to make sure that the needs, concerns and desires of this group of hospitalists are addressed," he says. In doing so, he has nurtured a team of physicians committed to working together for the good of their patients and has clearly established himself as a leader within the Chicago medical community. And along the way he reminds them to never lose sight of the funny side of life.

Donna Myers, RN, MSN, CNP Nurse Practitioner, Palliative Care Program Horizon Hospice and Palliative Care, Chicago Donna has served as the care coordinator and lead practitioner for Horizon’s new home-based palliative care program during the past year. Proudest accomplishment: Reaching the milestone of caring for 100 patients in our new palliative care program – and helping to improve the quality of so many lives. First job: Med-Surg Unit, Augustana Hospital, Chicago Education: RN, Augustana Hospital School of Nursing; BSN, DePaul University; MSN, Rush University. What skills do you need to succeed in your job: As a home-care provider, learning to "read" the patient and family is a critical skill. It requires careful listening and observing to identify their strengths and needs, determine how best to approach them, how much information they want, what level of support and instruction they need. If I get this part right, I earn the family’s trust, and the patient will get better care. What work habit do you possess that you are most proud of: I am very adaptive, which serves me well because my patients and their families come from a wide range of circumstances. I always start by asking them what they want to accomplish. What is the toughest part of your job: In a very small number of cases, the patient has symptoms that cannot be controlled, no matter what we do. Although this is extremely rare, it is very frustrating. Who is the person you most admire: I most admire a healthcare provider who cares for one of my children. She combines a skillful, professional manner with an approachable, "down to earth" personality. Like her, I try to extend both competence and compassion to my patients. What is the biggest challenge confronting healthcare: I am concerned about the economics of healthcare and the loss of funding for critical programs. We need to make healthcare funding a priority and to improve access to care, especially for the working poor and the mentally ill. Best thing about healthcare in Chicago: The huge variety of healthcare settings and levels of care – from excellent academic medical centers to busy neighborhood clinics. Worst thing about healthcare in Chicago: Even with all our capacity, we still have many medically underserved areas. What advice would you offer to young people considering a career in healthcare: I highly recommend a healthcare career. It is tremendously rewarding and versatile. There aren’t many jobs where, at the end of every day, you have the satisfaction of knowing you’ve really helped people through a difficult experience.

Dr. Lon McPherson Vice President of Medical Affairs Provena Saint Joseph Medical Center Proudest Accomplishment: I led the development of a community-wide Electronic Medical Record where patients could go between practices and still have their medical record, medications, allergies and testing available. First Job: Dishwasher, age 15. Education: University of Illinois, Urbana (B.S., Biochemistry), Rush Medical College (M.D.), Georgetown University Hospital (Internal Medicine) What skills do you need to succeed in your job: Communication, erudition, compassion, organization. Work habit you possess that you are most proud of: Reviewing the day at the end of work. Most valuable lesson you learned in your career: Listen deeply and pay attention to what is being said. The toughest part of your job: Finding enough hours in the day. Your philosophy of success: To look where fields meet and find solutions at their friction points. One of your goals: To advance the coordination of health care delivery in my community. Person You Most Admire: My wife, for her humor and compassion. Favorite Book: A Soldier of the Great War by Mark Helprin Biggest Challenge Confronting Healthcare: Effective coordination of resources to bring the right care to the right patient at the right time in the right place. Suggestions on how you would solve a particular problem in healthcare: Communication technologies need to be fully exploited to reinforce the weakest link in health care - the hand-off of patients from one provider to another. What we use now is antiquated, inaccurate, and inefficient. Your predictions on the future of health care: Community hospitals will partner with advanced centers to bring very sophisticated health care technology to the local physicians. Best Thing About Healthcare in Chicago: Dynamism. Worst Thing about Healthcare in Chicago: The system is fractured, divided. What advice would you offer young people considering a career in Health Care: There is always constant change - adapt.

Edward L. Malindzak Vice President of Human Resources Provena Saint Joseph Medical Center Proudest accomplishment: A fantastic trio of daughters from my 30-year marriage to my best friend. First job: A pots/pan washer. Education: BS from DePaul University; MBA from DePaul University What skills do you need to succeed in your job: It is important to have good communication and listening skills in human resources. Work habits you possess that you are most proud of: I am able to focus on the goal I am working towards. Most valuable lesson you learned in your career: Always listen to the entire discussion before making decisions based on the discussion. The toughest part of your job: This can also be to focus on the goal at hand. Your philosophy of success: Listen carefully, analyze facts, and react and express cautiously. One of your goals: To have our organization recognized as the Employer of Choice in healthcare in Illinois. Person you most admire: Abraham Lincoln Favorite Book: Stranger in a Strange Land – Heilein Biggest Challenge Confronting Healthcare: The Nursing and clinical staff shortages healthcare organizations are facing. Suggestions on how you would solve a particular problem in healthcare: We must make the staffing pool larger through school/healthcare partnerships. Your predictions on the future of healthcare: Even with the challenges, it is positive - what other place in the world would you want healthcare in? Best thing about healthcare in Chicago: Quality initiatives! Worst thing about healthcare in Chicago: The competition for staff instead of cooperation. What advice would you offer young people considering a career in health care: It is a great place to be. Compare it to other careers - not just the pay, but the good to your community! Despite the grumbles, it is satisfying work.

Terrence Wright Vice President of Facility Management and Planning Provena Saint Joseph Medical Center Proudest Accomplishment: My family and career. First Job: Self employed - mowing lawns, washing cars. Education: BSME, MBA, RPA, FMA What skills do you need to succeed in your job: Communications and commitment. Work habit you possess that you are most proud of: Tenacity and a focus on problem solving. Most valuable lesson you learned in your career: Honesty and comprehensive problem solving in a timely manner. The toughest part of your job: Time management and investment of assets in the most effective manner. Your philosophy of success: Success is best achieved by first setting your own realistic standards and establishing goals to surpass the standards set by others. One of your goals: To continue to learn from my mistakes and to be humble in all that I do. Person You Most Admire: My father. Biggest Challenge Confronting Healthcare: Explosions in technology. Suggestions on how you would solve a particular problem in healthcare: Limit medical malpractice claims. What advice would you offer young people considering a career in Health Care: If you are interested in a dynamic career and have a strong desire to multi-task, this is the field for you.

Lake Forest Hospital Names VP/CFO Sean Barden has begun his new duties as vice president/chief financial officer at Lake Forest Hospital (LFH). He brings more than 20 years of health-care-related financial experience to his new position, which includes oversight of the hospital’s finance, patient accounting, purchasing, information systems and risk management functions. In announcing Barden’s appointment, LFH President Bill Ries said, "Sean has the right combination of strong technical financial capability, collaborative style and excellent communication skills." Barden comes to Lake Forest from Greensboro, NC, where he served the past four years as corporate controller for Moses Cone Health System. His duties there included general accounting, financial reporting, budgeting, audit and payroll. Prior to that, Barden held various finance and operational management positions including vice president of finance at Winchester Medical Center in Winchester, VA, and director of finance at Sentara Bayside Hospital in Virginia Beach, VA. He has a master’s degree in business administration from West Virginia University and a bachelor’s degree from Old Dominion University. Barden has been a guest lecturer at Shenandoah University and is active in a number of professional organizations including the Healthcare Financial Management Association. He’s served on the board of directors of the American Cancer Society (Winchester, Va., chapter) and the Lord Fairfax Health Council, which evaluated regional health policy in northern Virginia. Barden has been active in Relay for Life and other community events.

Vietta L. Johnson, MD, MPH, FAAOS, CWS Chair, Division of Orthopaedic and Podiatric Surgery, Provident Hospital of Cook County Medical Staff President, Provident Hospital of Cook County Clinical Assistant Professor, Department of Orthopaedics and Rehabilitation, Loyola University Medical Center Chair, Regulatory Committee, Provident Hospital of Cook County Proudest Accomplishments: Professionally- Humanitarian work in Africa and the Bahamas; First African American Woman to graduate from a surgical program at St. Vincent’s Hospital and Medical Center, New York City; Induction into the Bahamas Academy of Medical Sciences; My patients. Personally- The birth of my daughter. First Job: Teaching reading to inner city public school children who where in danger of not being promoted. Supervising and teaching after school athletics. Education: High School, Stuyvesant High School, New York City; College: Princeton University, Princeton, NJ; Medical School: Harvard Medical School, Boston, MA; School of Public Health: Harvard School of Public Health (Health Policy and Management), Boston, MA; Orthopaedic Residency: St. Vincent’s Hospital and Medical Center, New York City; Foot and Ankle Fellowship: University of Maryland, Baltimore, MD. What skills do you need to succeed in your job: Strong academic preparation; common sense; genuine concern for people; personal fortitude. Work habit you possess that you are most proud of: Thoroughness. Unequivocal morals and ethics. Most valuable lesson you learned in your career: Have faith in yourself and GOD. The toughest part of your job: Finding and balancing the time to do clinical, administrative and leadership jobs. Paperwork! Your philosophy of success: It’s not what the institution can do for you, but what you can do for the institution. You are never wrong for doing what is right. Helping people when no one else is willing or able. Your goals: Designing shoes. Clinical research. Continue to be an enthusiastic lifetime learner. Person you most admire: My Mother- Argie Johnson. She is a sharecropper’s daughter, who grew up with two pairs of socks and excelled to be a nationally recognized figure in public school education. Her morals and ethics are unwavering and I have witnessed this first hand. Lastly, because she has ALWAYS had faith in me even when I did not have faith in myself. Harriett Tubman, for her fortitude and leadership. Favorite book: The Road Less Traveled. The Bible. Biggest Challenge confronting healthcare: Access and affordability. Suggestions on how you would solve a particular problem in healthcare: Physicians, nurses and frontline line care givers should be leaders in management, administration and policy formation. Fewer middlemen (insurance companies, administrators). Realization of both of these scenarios would place more of the global decisions made in healthcare to those who have a frontline view and help redistribute the finances. Your predictions on the future of health care: I hope that more of the future global decisions made in health care will be focused on and made with the patient’s and care givers welfare in mind. With this the system should be able to provide appropriate and improved care. Best thing about Healthcare in Chicago: The Public Healthcare system. Worse thing about Healthcare in Chicago: Resource limitations and distribution. What advice would you offer young people considering a career in Healthcare: We need bright, motivated, energetic and enthusiastic people to enter Healthcare and not be discouraged on pursuing such a career.

Linda St. Julien Vice President of Operations and Chief Nursing Executive Advocate Trinity Hospital It is 4:30 on a Friday afternoon. Most of the workplace is slowing down and in weekend mode, except Linda St. Julien, who is somehow full of energy and focus. She exudes passion and commitment for everything she does. In her 25 years of service, St. Julien has maintained her focus on caring for the patient, and that has taken her up the ranks to her current position as Vice President of Operations and Chief Nursing Executive for Advocate Trinity Hospital, located on the Southeast side of Chicago. Nursing can be a rocky and tumultuous field. Not everyone can do it. And not everyone can do it with heart. Armed with this knowledge, she uses it as the foundation upon which she tackles challenges and strives to build a tradition of excellence at Advocate Trinity. Her philosophy is that patient care must come from the heart. "It’s got to be more than just a job," she says definitively. This is easier said than done. The nursing shortage has impacted healthcare on all levels, including the delivery of patient care. St. Julien considers this challenge the biggest one of her job and uses it as the catalyst for innovation and growth. She deems one of her greatest accomplishments at Advocate Trinity to be creating a culture of quality and excellence in delivery of care. While some may be willing to substitute quality with a quantity of nurses, St. Julien says no way. Nurses that come to Advocate Trinity must be critical thinkers and nurses who put their emphasis on patients as opposed to merely completing a task. "I wouldn’t want people to go into jobs just because there’s a shortage, but because they truly desire to care for patients," she says. "Recruitment is high on my list but retention is critical." In order to address the shortage at Advocate Trinity, St. Julien focuses on what she calls a "win- win" strategy. As a nurse, she says that she realizes that nurses must not only feel needed, but also valued and heard. She says that good nurses will also want to know that opportunities exist to be involved in decision-making processes and to advance their knowledge. To that end, many changes, some costly and time consuming, have been implemented that address these needs. However, St. Julien remains focused and positive stating, "It is to our advantage to take the time, money and effort to ensure that we have processes in place that can meet these needs. If we attract a nurse who desires growth and who is focused on patient care, we also better enable our hospital to fulfill its’ mission, values and philosophy." Recruitment and retention efforts are largely driven by at Trinity include a shared governance council, comprised of nurses involved in the recruitment and retention process. The opinions and suggestions of the nurses are a critical component of targeted human resources efforts and key leadership and development opportunities. However, Advocate Trinity has not come to a resting place in their efforts. "We have to continuously think outside the box," says St. Julien. Key to St. Julien’s success is her ability to listen to and rely on her team. She knows that excellence does not come about by one person. "It’s important to always understand the value of those around you, realizing that it’s not just about you- regardless of your status, it doesn’t matter. We’re not born in these jobs we’re in, we have to learn them. Sometimes people forget that their skills were learned." Her goal is clear and simple: provide quality care to the community. "We (nurses and caregivers) impact the lives of this community, my job impacts the outcome and the fate of this community."

Porr Receives ACHE Healthcare Executive Regent's Award Robert Porr, northeast regional director at Solucient, is the recipient of the 2005 American College of Healthcare Executives (ACHE) Healthcare Executive Regent's Award. The Healthcare Executives Regent's Award recognizes ACHE affiliates who have significantly contributed toward the advancement of healthcare management excellence and the achievement of the goals of ACHE. Porr is the senior administrator, 105th Medical Group, Stewart Air National Guard Base, Newburgh, NY. During the spring of 2004, Porr served as deputy commander of the 447 Expeditionary Medical Support Squadron (EMEDS) at Baghdad International Airport in support of Operation Iraqi Freedom. During this time, Porr directly coordinated air evacuation activities for more than 80 wounded American soldiers. He also provided for the safety and security of detainees while their medical needs were being met. From August through September 2001, Porr coordinated all logistics for the 105th Medical Group's humanitarian deployment to the Cuscatlan region of earthquake-torn El Salvador. He acquired all necessary resources for the mission's medical providers, who treated more than 6,500 patients in a 10-day period. Within 48 hours of his return from El Salvador, he was sent to respond to the World Trade Center (WTC) attacks. Porr supported operations Noble Eagle, Resolve Hope and Enduring Freedom as the Air National Guard liaison to the New York City Mayor's Office of Emergency Management. During a critical six-week period, he coordinated all logistics for personal protective equipment resources used by the New York Police Department (NYPD), the Fire Department City of New York (FDNY) and for the thousands of other workers supporting the rescue and recovery efforts at Ground Zero and at the Staten Island Landfill. Porr also managed logistics and procurement at the WTC Forensic Recovery Project at the Staten Island Landfill. Porr is the recipient of several awards for his work including the U.S. Army Corps of Engineers Safety and Occupational Health Award for Excellence and an NYPD Detective Bureau Certificate of Exemplary Conduct. He has been recognized by the Federal Bureau of Investigation for "meritorious and dedicated service." Porr has more than 30 years of experience in healthcare in clinical, marketing and consulting capacities. He received his bachelor's degree from Marymount Manhattan College and earned his master's in business administration from Baruch College of New York. He has lectured as an adjunct professor of business management at Marymount Manhattan College.

Teaching the Non-Medical Side of Medicine Establishing a Bond Between Caregiver and Patient What’s as important as the medical care we give our patients? According to Avram Kraft, M.D., Associate Professor of Clinical Surgery at Northwestern University’s Feinberg School of Medicine and Director of the Center for Compassion in Medical Care at Evanston Northwestern Healthcare (ENH), it’s the compassionate way we interact with them. Dr. Kraft seeks to teach ENH employees and other healthcare professionals the importance of compassion in conjunction with medical care. "Compassion is a personal expression that shows care and concern about another person’s suffering," explains Dr. Kraft. "When healthcare workers communicate compassionately, it provides the patient with a real sense of bonding with an ally who wants to participate in their healing." Dr. Kraft practiced surgery for 20 years at Highland Park Hospital before establishing the Center for Compassion in Medical Care at ENH. Following a model developed at the Schwartz Center at Massachusetts General Hospital, Dr. Kraft wanted to teach healthcare workers the "soft side" of medicine, including ethics, communication and compassion. "By exploring all issues that affect one’s healthcare – physiological, spiritual, psychological and cultural – our Center teaches the skills that enhance communication and the relationship between any caregiver and their patients," says Dr. Kraft. To help accomplish this, the Center offers Schwartz Rounds, a monthly case-based multidisciplinary open forum providing healthcare professionals with an opportunity to learn about timely social, emotional and spiritual issues that occur every day in healthcare and impact a patient’s well being. Schwartz Rounds emphasizes the need for healthcare workers to see the big picture of a patient’s life during their care because each patient’s spiritual and cultural viewpoints are just as important as their medical condition when mapping a treatment plan. "I remind program participants that ‘the patient remembers who you were at their bedside, not which test or antibiotic you prescribed,’" says Dr. Kraft. Past Schwartz Round topics have included: "Whose Futile Care is it Anyway?"; "Do you Hear Me – Communicating With the Unconscious Patient?"; and "Decisions at the Edge of Viability – Hope? Despair?" "Dr. Kraft’s interest in maintaining the highest standard of practice in all areas of the organization has made him an asset," explains Tom Tynan, LCSW, Director of Medical Social Work at Evanston Northwestern Healthcare. "From the Ethics Committees to hospice and support groups, Dr. Kraft goes out of his way to demonstrate empathy, compassion and respect for patient rights." Dr. Kraft also teaches future healthcare practitioners the importance of compassionate care through two classes at Northwestern University’s Feinberg School of Medicine. First-year medical students are required to take a class on communication skills and later follow up with a program during their third year about how to deliver bad news with compassion. Dr. Kraft would like to see a program such as Schwartz Rounds implemented in all healthcare organizations. Currently, there are Schwartz Rounds programs at 60 medical centers across the United States; Evanston Northwestern Healthcare was the first clinical center in the Midwest to implement Schwartz Rounds. "This is just the beginning; a small pebble thrown in a big pond. Hopefully the ripple effect will have an impact that will translate into improved clinical care in the future."

Geriatrics and End-of-Life Challenges by Patricia Bloom, MD Patricia Bloom, M.D., is a Family Practioner/Geriatrician and is the new Medical Director of Park Ridge and Chicago-based Rainbow Hospice. She shares her thoughts on the challenges and opportunities that exist in the field of geriatrics and end-of-life care. In addition to serving as Medical Director, Dr. Bloom is also on the faculty of the Rainbow LIFE Institute which provides end-of-life education to physician residents from seven area hospitals. By far the biggest challenge facing geriatricians is the increasing aging population. As Baby Boomers begin to transition into a new generational stage, the increase in the population of older Americans is stunning. What makes it even more of a challenge is that people are living much longer. In the early 1980’s patients who were 80 years old were considered old. Nowadays it is common to be providing care for people well into their nineties. Add to this the reality that there are fewer doctors entering the field of geriatrics to provide care for this frail population. And it doesn’t appear to be getting any better. Government is not responsive to this phenomenon and, reimbursement levels, controlled by Medicare, are on the decline. Medicare determines the amount of what a physician can bill a patient. Instead of increasing this amount, it is being decreased. There is very little incentive for internists to choose geriatrics because it simply is not cost effective. Those in private practice face the reality of decreasing reimbursement levels while keeping overhead in check. It’s a big disconnect. Where are we going to get the physicians to care for all these patients? Therein lays our greatest opportunity – education. The pool of geriatricians may not be so deep, but there is an ocean of family practice physicians. I see a real opportunity to teach family practice physicians how to care for the geriatric population. Not only would this add to the age balance of patients seen by family practice physicians, it would alleviate some of the pressures of ensuring the geriatric population are receiving quality medical care. The opportunity of education translates well across the board. In addition to educating family practice docs, we could be doing better with young internists by exposing them early on to caring for geriatric patients, specifically in nursing homes where we are seeing an ever-increasing number of admissions. Increasing exposure of geriatric patients also increases a young doctor’s comfort level in dealing with an aging population, especially in the area of hospice and end-of-life care. Regarding hospice care, one of the greatest challenges we continue to face is the short length of stay. The average length of stay of a hospice patient is only 42 days. The median length of stay is only 10 days. This translates to a crisis mentality of providing care for people at the end of life. This is a direct contrast to the fact that 9 out of 10 Americans would rather die at home and that only 17% of those eligible actually use their hospice benefit. The opportunity, of course, is to encourage earlier referrals from doctors and discharge planners…to have discussions with patients and families earlier in the progression of a person’s illness. And, of course, education plays an important role in this area as well.

Challenges and Opportunities in the Field of Skilled Nursing / Geriatric Nursing by Mary Bohlen, Nursing Director, Advocate South Suburban Hospital One of the biggest challenges or questions in caring for our elders is: how do we provide the best quality, individualized care to our older population while holding down costs? Those of us in health care are aware that reimbursement rates are not keeping up with the endless demand for capital. Yet, quality care comes at a price - whether it is used for salaries to recruit or retain staff, investment in equipment and technology, meeting increasing regulatory requirements or just day-to-day expenses. According to the Administration on Aging, persons 65 years or older numbered 35.9 million in 2003 (the latest year for which data is available). At that time they represented 12.3% of the U.S. population, about one in every eight Americans. By 2030, there will be about 71.5 million older persons, more than twice their number in 2000. People 65+ represented 12.4% of the population in the year 2000, but are expected to grow to be 20% of the population by 2030. With the burgeoning wave of aging people in the United States, I see the entire field of gerontology as a huge opportunity. Care providers who are savvy to the needs, wants and desires of a population who is used to having and making choices will be the big winners in the bid for being the provider of choice. The face of health care delivery and daily operations will have to change to meet the opportunities this group represents.

Dennis Keane, MD Medical Director for Rehabilitation Services Alden of Waterford Alden of Waterford isn’t just a pretty face. Behind the cascading waterfall at its entrance, behind the fine dining and the ice cream parlor, a top-notch rehabilitation program treats patients with diagnoses ranging from hip fractures and strokes to neurological and pulmonary disorders. Waterford Rehab recently celebrated its fourth anniversary. A key element of Waterford’s success is the fact that its program is modeled after the acclaimed Marionjoy Rehabilitation Hospital model, says Dr. Dennis Keane, Waterford’s medical director for Rehabilitation Services and a member of the Marionjoy Medical Group (MMG). "Marionjoy stands for clinical excellence and using a team approach," he says, "and that’s what we’ve created here at Waterford." A physiatrist with more than 12 years experience, Keane conducts rounds at Waterford two or three times a week and attends weekly meetings with members of the therapy and nursing staffs, social service and, when appropriate, other physician specialists. "With this multidisciplinary team, we are continually addressing a variety of issues to get the best possible outcomes," he says. "This includes not only the patient’s progress in therapy, but if the patient seems to be plateauing or declining, I look into medical reasons for the decline. As a team, we also take into consideration the patient’s emotional needs, pain management, safety issues, equipment needs and discharge planning. Together, we go the extra mile." Until now, the majority of rehab patients at Waterford have been recovering from pneumonia, stroke, heart problems and other such debilitating conditions. In the future, due to a change in Medicare rules that affects the types of patients that can be admitted to acute rehab hospitals, Keane predicts that Waterford will be treating more orthopedic patients, such as those recovering from hip or knee surgery. By July 2007, the rule change will be completely phased in. "This will make pain management in the rehab setting even more important," says Keane, who is board certified in pain medicine as well as in physical medicine and rehabilitation, and in electrodiagnostic medicine (EMG). "When the ortho patient’s pain is controlled, they tend to get out of bed faster, have fewer medical complications, experience a quicker functional recovery and, thus, often return home sooner." Pain management therapy, which is an integral part of the rehab program at Waterford, can include breathing and stretching exercises, as well as pain medications. "We incorporate pain management protocol into the patient’s therapy schedule," says therapist Kane. "It’s yet another skilled service that we provide." Part of the "uniqueness of Waterford’s rehab program," adds Keane, "is the way it addresses emotional and psychological issues that can affect a patient’s ability to recover." Finally, says Keane, the patient and the patient’s family are the biggest beneficiaries of the team approach. "As a team, we work with the patient and family to maximize their safety and recovery, and to enable them to return home with an appropriate level of support and maximum functional independence."

Kamran A. Hashemi, MD Medical Director Alden – Long Grove Kamran A. Hashemi, M.D., traces his rather unusual outlook on healing to his work with ‘Doctors on Call’ in New York City. "I treated a lot of patients who, according to traditional medical wisdom, shouldn’t have gotten better," he says. "But at home, away from the hospital, they did quite well." Today, Dr. Hashemi is applying this observation to the Advanced Care Unit (ACU) he oversees at Alden-Long Grove. Using a team approach, Dr. Hashemi says," has turned the ACU into a true step down unit where each patient is visited daily by a doctor until they are able to go home. We take medically-complex patients and do advanced treatments in-house." Empowers Nurses In recent months, nursing protocols at Long Grove have been revamped to allow patients to stay in the ACU rather than being sent to a hospital emergency room, as often happened in the past. "This is good for the patients, because the ACU provides an excellent level of care," says Dr. Hashemi, an internist who was an emergency room physician before he opened his practice in Barrington two years ago." It also empowers the ACU nurses because, with the new protocols, training and the daily involvement of physicians, they have the confidence to deal with more complicated medical procedures." Highmarks Dr. Hashemi, who is the hospitalist for Alpine Family Physicians, a group with about 30,000 patients, believes his work isn’t finished when a patient is discharged from the hospital. "I follow my patients and Alpine’s patients when they are transferred to an extended care facility," he says. In fact, that’s how he got involved with Alden. "Alden opened this fantastic subacute unit at Long Grove, and it meshed well with my own philosophy of healing," says the father of three whose hobbies include writing fiction and gourmet cooking. "Alden asked me if I’d like to get involved, and before I knew it I was working on all sorts of projects." The ACU team approach—in which doctors, nurse practitioners, nursing staff and therapists are involved in patient care on a daily basis—is becoming the model for other Alden subacute units. "There are many things we can do for patients in the facility that actually enhance their ability to go home," says Dr. Hashemi, who personally conducts daily rounds and coordinates patient care in the ACU. The new ACU, he reports, is already getting high marks." The feedback from the local hospitals has been phenomenal, and the patients and families love it," says Dr. Hashemi. "This is an extremely powerful win-win for everyone."

New Director Brings Experience and Passion for Behavioral Health Services at ALDEN Morrow "We may not have crystal chandeliers, but, what I can promise is quality programming and highly skilled and trained staff." Asking Michael Mutterer what he hopes to bring to ALDEN’s new Behavioral Health Services as the corporate Director is like experiencing July 4th fireworks. "I am committed to education because mental illness is often misunderstood. Education has already started at Alden, with in-services for corporate and facility staff. In the near future, we will offer sessions to the community." Mutterer’s commitment to education and mental health is evident in his own background. He received his Master of Arts in Counseling Psychology in 1995 from The Adler School of Professional Psychology, Chicago, IL. In 1993 he attended Edgewood College, Madison, WI. He is a Licensed Clinical Professional Counselor (LCPC), a Licensed Nursing Home Administrator, (LNHA) and a Licensed Practical Nurse (LPN). His certifications include, Certified Alcohol and Drug Abuse Counselor (CADC), National Certified Counselor (NCC), Certified Counselor for the Mentally Ill Substance Abuser (MISA II), Certified Non-Violent Crisis Prevention Trainer (Associate Level) "Another important component in meeting the needs of these under-served patients is quality programming. We may not have crystal chandeliers, on our units, but, what I can promise is quality programming and highly skilled, trained staff." The first initiative is underway at ALDEN Morrow located at 5001 S. Michigan Ave, Chicago, IL 60615. "Our program includes a distinct unit that has been upgraded and designed to be homelike, secure and familiar. We incorporate structured programming to create a daily routine that can help to mitigate behaviors, confusion and disorientation." stated Mutterer. Specially-trained staff are dedicated to providing, 24-hour care that is tailored to promoting independence, self esteem and the abilities and personal preferences of each resident or patient and, above all, to treating each individual with respect and dignity. Mutterer has assembled a full complement of mental health professionals including LCSW’s, LCPC’s and Bachelor’s level case managers. "Our program is multi-faceted and includes; Symptom Management, Social Skills Training, Independent Living Skills, Stress and Anger Management Skills, Vocational Skills and Medication Management, A Relapse Prevention Program, A Token Economy Program and Individual & Group Therapy. "We want to be a resource, so if ALDEN is unable to accept a behavior management referral, we will help with other placement options." Michael Mutterer, Director of Behavior Management Services, can be reached at (773) 924-9292.