2 Steps for total joint replacement 7 Going the distance for art in the healing environment Inside LATE SUMMER 2023 DEVOTED TO HEALTHFUL LIVING Expanding and advancing orthopedic care on the coast
2 HEALTH COMPASS LATE SUMMER 2023 Growing orthopedic services in our area By Nicole Williams, COO In 2008, Columbia Memorial Hospital opened its Specialty Clinic, including orthopedics and physiatry services, at a time when the U.S. housing bubble had just burst, leading to the worst recession in modern history. The CMH Health & Wellness Pavilion’s first and second floors also opened that year, with space for the Specialty Clinic completed on the third floor in 2009. Despite the financial downturn, CMH continued building on past successes and looking toward future growth. “Even during challenging economic times, our promise to you continues — bringing quality health care to the Columbia coast region,” wrote Terry Finklein, CEO at the time, in the hospital’s Community Report for 2008. Today, our promise is the same. Our new mission statement, “We help people live their healthiest lives,” and our Board’s strategic plan guide us as we make progress toward our goals. After 15 years of providing orthopedic care in the Pavilion, we are excited to launch an expanded program in 2023. A new era of robotic-assisted surgery In July, our Stryker Mako SmartRobotics system was delivered, making CMH the only hospital with this market-leading total joint technology on the Oregon and Washington coasts. We also welcomed a new orthopedic surgeon, Daniel Fabiano, MD, to the CMH-OHSU Health Orthopedic Clinic. We now have a total of six orthopedic providers — three surgeons and three advanced practice practitioners — to meet the community’s needs and provide 24/7 orthopedic coverage for patients. Our orthopedic team operated on our first Mako patients in August, beginning a new era of robotic-assisted surgical abilities right here in Astoria. With the BuildCMH Expansion Project moving forward, we’ll add more operating and recovery spaces, increasing patient access to specialty care in our region. We’re keeping our promise to you — delivering high-quality health care, right here at home. Steps for total joint replacement Are you considering a joint replacement surgery? CMH offers total knee, shoulder and hip replacements through our experts at the CMH-OHSU Health Orthopedic Clinic (total ankle replacements are available through the CMH-OHSU Health Foot & Ankle Clinic). Throughout the joint replacement process, you’ll meet with many members of the surgical team, including medical assistants, nurses, surgeons, physician assistants, physical and occupational therapists, and discharge planners. Your visits will be tailored to your needs. Here’s what else you can expect: 1 First, you’ll review your x-ray images with a surgeon in the clinic and partner with a surgical nurse coordinator after approval for surgery. 2 You’ll need to see your medical provider or establish care with one, as well as see your dentist within the six months prior to your surgery. You may also need to see more specialists to be prepared for surgery. 3 The surgery team will work with you to develop a plan. You’ll have a surgery coordination appointment and a pre-op appointment to sign consent forms and learn more about what to anticipate before, during and after surgery. 4 You’ll also complete a phone call with the anesthesia nursing team to discuss health history. 5 Before surgery, you will need to prepare your home or recovery space by removing hazards. 6 On the day of surgery, you’ll check in and be escorted to the pre-op unit. You’ll change into a gown and apply sterile wipes. A nurse will take your vitals, and an IV will be prepared. You’ll also meet with your anesthesia provider. 7 Surgery will take one to two hours. Your visitors will be shown where to wait. 8Afterward, we’ll help you manage pain with medications, elevation and ice. 9 When you can get out of bed and mobilize, you can return home. Then you’ll start outpatient physical and occupational therapy to help you recover and build your strength. Benjamin Sherman, DO, orthopedic surgeon, meets with a patient in the CMH-OHSU Health Orthopedic Clinic.
COLUMBIAMEMORIAL.ORG LATE SUMMER 2023 3 As of July, CMH is the only hospital on the Oregon and Washington coasts to have a Stryker Mako SmartRobotics system. The Mako has been the market leader in robotic technology for total joint surgeries since it launched in 2006. Thanks to the Mako’s advanced technology, orthopedic surgeons with the CMH-OHSU Health Orthopedic Clinic can complete total hip, total knee and partial knee replacement surgeries with a more comprehensive view of a patient’s anatomy. As a result, they can be more precise. Patients who are planning to have a Mako-assisted joint replacement need to get a CT scan before their surgery. Combining the CT results with the Mako’s software gives the surgeon a 3D view of the patient’s musculoskeletal structure, helping them know exactly what to expect before they even enter the operating room. “A 2D x-ray is the standard imaging required for a typical, manual total joint procedure,” says Douglas Abbott, MD, CMH-OHSU Health orthopedic surgeon. “With the CT scan programmed into the Mako, we get a 3D view, which helps guide us to position the replacement parts with increased precision. Alignment can be better matched to the patient, with a goal of quicker recovery and better outcomes.” Advanced technology will also enhance the BuildCMH Expansion Project The BuildCMH Expansion Project, breaking ground in late 2024, will be augmented with the progressive Mako surgical technology, in addition to providing more space for surgical services. Plans for the hospital’s expansion include an additional operating room, making a total of four major ORs at CMH, with the possibility and space to add a fifth to accommodate future surgical growth. There will also be another OR reserved solely for C-sections; a dedicated interventional radiology procedure space; and two endoscopy suites, doubling current capacity for endo procedures. The new patient and operating rooms will be noticeably larger in square footage — able to support the most modern technologies. Pre- and post-surgical rooms will double in number to 16, adding to efficiency and allowing providers to see more patients. “Our data shows that patients are still leaving the area for major surgeries that can be done here, close to home,” says Chris Laman, vice president of strategy. “With the increase of capacity within our surgical specialties, we’ll be able to serve more patients, more quickly, with the same highquality health care our patients have come to expect from the providers and caregivers at CMH.” MOVE ON FROM PAIN Make an appointment with the CMH‑OHSU Health Orthopedic Clinic by calling 503-338-4075. Robotics + BuildCMH Better orthopedic care
4 HEALTH COMPASS LATE SUMMER 2023 Despite the economic downturn in 2008, CMH was hard at work constructing its Health & Wellness Pavilion and creating space for the new Specialty Clinic, including orthopedic services. When it opened later that year, the Specialty Clinic had one surgeon and a physiatrist (a nonsurgical specialist) on staff. In that same time frame, CMH and Pacific Coast Imaging were the first to bring a state-of-the-art MRI scanner to the area, adding it to the most comprehensive inpatient and outpatient diagnostic imaging facility in the Columbia coast Meet our orthopedics and sports medicine team Douglas Abbott, MD Joined CMH: 2011 Fellowship: The Sports Clinic (Laguna Hills, California) Board certification: American Board of Orthopaedic Surgery Special practice interests: Arthroscopic surgery; joint replacement; orthopedic surgery; shoulder and knee reconstructions; and sports medicine Daniel Fabiano, MD Joined CMH: 2023 Fellowship: Matthews Orthopaedic Clinic/ Orlando Regional Medical Center (Orlando, Florida) Board certification: American Board of Orthopaedic Surgery Special practice interests: General orthopedics; complex shoulder and knee replacements; sports medicine; and total and partial joint replacements Benjamin Sherman, DO Joined CMH: 2021 Fellowship: Andrews Institute for Orthopaedics & Sports Medicine (Gulf Breeze, Florida) Board eligibility: American Osteopathic Board of Orthopedic Surgery Special practice interests: Sports injury and shoulder instability; ACL, rotator cuff and labral tears; meniscus preservation; minimally invasive surgical techniques; and clinical research region and laying the groundwork to develop CMH’s orthopedic offerings even more. Over the past 15 years, the clinic, now known on the orthopedic side as the CMH-OHSU Health Orthopedic Clinic, has grown tremendously, seeing 5,903 patient visits in 2022 — and it is on track for seeing over 6,900 in 2023. With a third surgeon having joined the current team this July, there are three surgeons and three advanced practice practitioners here to serve the community’s needs. Patients no longer need to travel to larger metropolitan areas for all-inclusive orthopedic care, total joint surgeries or rehabilitation Enhancing orthopedic care on the coast
COLUMBIAMEMORIAL.ORG LATE SUMMER 2023 5 Kristi Daniels, PA-C Joined CMH: 2019 Board certification: National Commission on Certification of Physician Assistants Special practice interests: Orthopedics; sports medicine; joint replacements; and pediatrics Ryan Larsen, PA-C Joined CMH: 2009 Board certification: National Commission on Certification of Physician Assistants Special practice interests: Orthopedic surgery and pediatric orthopedics Stephanie Parmley, NP-C Joined CMH: 2022 Board certification: American Academy of Nurse Practitioners Certification Board Special practice interests: Holistic care and health care improvements in quality and safety Getting on the road to recovery more quickly Now fully staffed with providers, the clinic can provide 24/7 orthopedic coverage for the region. That’s a service that has not been regularly available on the coast. It means if a patient falls and breaks a hip over the weekend, they won’t have to wait until Monday — or potentially be transferred — to have their fracture repaired, helping them get on the road to recovery more quickly. Since 2008, the Imaging Department has also experienced continual expansion — offering MRI and CT scans, ultrasounds, mammography, interventional radiology and other services. The Rehabilitation Services department, including a physical therapy team of more than 15 practitioners, has also expanded at CMH. Patients with musculoskeletal issues and concerns no longer need to travel to larger metropolitan areas for allinclusive orthopedic care, total joint replacement surgeries or the rehab needed afterward. CMH’s increasingly robust program includes a class that covers what patients can expect with total joint replacements; visits with a clinical social worker to address needs before and after a procedure; and discharge planning that incorporates ordering the equipment needed for recovery, as well as scheduling follow-up clinic appointments. In July of this year, CMH acquired a Mako SmartRobotics system. The next closest Mako units are in the Portland, Oregon, or Olympia, Washington, areas. The Mako is the market leader in robotic surgery, offering surgeons more precision and patients more personalized procedures, quicker recovery times and better outcomes. “One of our Board’s goals is to provide services that allow our community members to remain local for specialized care,” says Erik Thorsen, CEO. “Having advanced technology like the Mako means that patients needing total joint replacements can have all of their appointments and procedures, from pre- to post-op, here on the coast — with no need to make the long drives back and forth to major metros.” FIND A PROVIDER See our patients’ ratings and reviews and read more about our caring providers at columbiamemorial.org/provider-directory.
6 HEALTH COMPASS LATE SUMMER 2023 From an early age, Daniel Fabiano, MD, felt a calling to the medical profession. After his brother experienced multiple fractures in adolescence, Fabiano developed an interest in orthopedic surgery. Numerous visits to emergency rooms and doctors’ offices provided him with great insight into the medical world. “In addition, my own experience with Grisel’s syndrome further emphasized the pivotal role of health care practitioners in a patient’s life,” Fabiano says. “The confluence of knowledge and compassion demonstrated by the nurses, hospital staff and doctors inspired my commitment to this noble pursuit.” Following his childhood spent on the East Coast, Fabiano went on to get his bachelor’s and master’s degrees in chemical engineering, attending Hahnemann University School of Medicine (now known as Drexel University College of Medicine) in Philadelphia to earn his medical degree. He completed a residency in orthopedic surgery in Chicago before a fellowship in sports medicine and knee and shoulder reconstructive surgery in Florida. Honing his skills For the past 28 years, he has practiced orthopedic surgery in Iowa. He says that orthopedic surgery provides the extraordinary opportunity to use both mental acuity and physical skills to contribute to a patient’s journey to improved health. “As a physician and surgeon, I have found an immense sense of fulfillment,” Fabiano says. “It’s a profound honor when individuals entrust their health and well-being to my care, allowing me to apply my training and expertise for their benefit.” Nearly three years ago, Fabiano began incorporating the Stryker Mako SmartRobotics system into his practice. He has successfully completed more than 500 Mako procedures, continually fine-tuning his skills with state-of-the-art technology. With the ability to complete joint procedures using minimally invasive solutions, surgeries are more accurate and take up less time in the operating room, he explains. “I like doing robotic surgery — it would’ve been hard to give that up and go somewhere that didn’t have that,” he says. “No other robotic technology compares to Stryker’s. It’s pretty much becoming the standard. It’s very exciting for me that CMH is starting its own program — that shows me that the hospital wants to be on top of its game at all times.” Enjoying work and life Fabiano and his wife have spent many memorable vacations in the Pacific Northwest and were thrilled to move to an area with opportunities for hiking, outdoor activities and more. He says despite CMH only having 25 beds, it is substantial for a Critical Access Hospital and goes above and beyond what other CAHs offer. “CMH resonates with my professional ethos and boasts a holistic, patient-centered approach, access to leadingedge technology, robust primary care and a comprehensive spectrum of specialist services,” he says. “It has quite an impactful presence.” Get to know Dr. Fabiano Orthopedic surgeon with expertise in robotic surgery joins CMH
COLUMBIAMEMORIAL.ORG LATE SUMMER 2023 7 Another CMH caregiver has decided to go the distance for the BuildCMH Expansion Project. Chris Laman, CMH’s vice president of strategy, will run an ultramarathon on Sept. 16 in Central Oregon. He plans to run the Mountain Lakes 100, a 100-mile race, to raise money for the CMH Foundation and for art to enhance the expanded hospital’s healing environment. Laman was inspired to do the fundraiser by two of his colleagues, Randy McClelland and Aaron Brown, DO. McClelland skateboarded for 24 hours to raise money for art in the hospital expansion. Dr. Brown completed a 180-mile bike ride in England to raise funds for Lower Columbia Hospice. “Randy came up with this idea of wanting to raise money for art in the hospital. I am super passionate about art and its ability to heal people, so I wanted to be part of this,” Laman says. Art from local artists Laman previously worked as CMH’s director of Pharmacy and Cancer Care Services. In that role, he and McClelland helped bring new artwork to the CMH-OHSU Knight Cancer Collaborative ahead of its opening in 2017. “My experience in the Cancer Center has made me acutely aware of the impact art can have on a patient’s comfort level,” Laman says. “Having that level of comfort eases anxiety and puts them in a better position to receive care.” Laman expects the expansion will need significantly more art than what was purchased for the Cancer Center. CMH will commission local artists to create unique pieces for the hospital. “The hospital has been so committed over the past 15 years to work with local artists,” Laman says. “We’re not going to send money to artists in New York. We will purchase the art from local artists so (that the investment) goes back to the community.” Ready to run Laman’s run will begin at Olallie Lake, then continue toward the Pacific Crest Trail, where most of the run will be held. “Seventy miles of it is on the Pacific Crest Trail,” Laman says. “I’ve hiked most of the Pacific Crest Trail before and am excited to be out there again.” He started prepping for the race in January. He regularly runs before and after work, as well as during weekends. In June, he went for a 50-mile test run, which he completed in 10 hours. “I’m very excited to do something I love and have it support the BuildCMH Expansion Project and our patients,” Laman says. PLEDGE YOUR SUPPORT If you would like to donate to the fundraiser, please visit columbiamemorial.org/ ultramarathon, where you can donate any amount per mile completed. Going the distance for art in the healing environment An ultramarathon for a cause
Stretch your legs with the Great Columbia Crossing Need a reason to get your heart pumping and your legs moving? How about the chance to view Astoria from a whole new perspective? The Great Columbia Crossing 10K Run/Walk, sponsored by the CMH-OHSU Health Cardiology Clinic, takes place Sunday, Oct. 8. This annual event gives 3,500 participants access to cross the AstoriaMegler Bridge, which is North America’s longest continuous truss bridge. It is family-friendly and open to runners and walkers of all skill levels. 2023 marks the 41st year of the race. The Cardiology Clinic has proudly sponsored the Astoria-Warrenton Chamber’s race for more than 11 years, and we are thrilled to support it once again. We’ll see you on the bridge Oct. 8! Get registered Visit greatcolumbiacrossing.com to register for the race. The cost is $45, with a price increase to $50 on Sept. 4. Hurry — the race almost always sells out! COLUMBIA MEMORIAL HOSPITAL 2111 Exchange St. Astoria, OR 97103 Nonprofit Org. U.S. Postage PAID Salem, OR Permit No. 86 Find us on social media! @cmhcommunity @cmhcommunity linkedin.com/company/ columbia-memorial-hospital @cmhcommunity Cover photo by Austin Miller, Videographer and Graphic Designer. CMH HEALTH COMPASS is published as a community service by COLUMBIA MEMORIAL HOSPITAL, a Planetree Gold-Certified Person-Centered Care Facility. 2111 Exchange St., Astoria, OR 97103, telephone 503-325-4321, website: columbiamemorial.org For information about CMH HEALTH COMPASS: Sarah Bello, MBA, Marketing Manager Robert Holland, MD, PhD President, Board of Trustees Erik Thorsen, MBA, CPA, FACHE Chief Executive Officer Nicole Williams, MPA, FACHE Chief Operating Officer Christopher Strear, MD, FACEP Chief Medical Officer Information in CMH HEALTH COMPASS comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Models may be used in photos and illustrations. 2023 © Coffey Communications, Inc. All rights reserved. Jarrod Karnofski, DPT, ATC, MSHCA Vice President, Ancillary and Support Services Judy Geiger, RN, MBA Vice President, Patient Care Services Christopher Laman, PharmD, MBA Vice President, Strategy Brandon Parker, MBA, CPA Vice President, Finance Nicole Perez, BSHA, MSITM Vice President, Health Information Services
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