Behind the Scenes: Nurse Practitioners

Practical Healthcare for Rural Residents

Boundary Community Clinics is pleased to announce the addition of two new Nurse Practitioners as primary care providers. Beverly Yercheck, ANP-C who specializes in adult care and Janet Lukehart, FNP-C who specializes in family care will round out the schedule so that office hours will now be Monday through Friday. And yes, new patients will be accepted after April 1.

Welcome-Janet

Janet Lukehart, FNP-C

Beverly-Yercheck-ANP-C

Beverly J. Yercheck, ANP-C


Why an NP?

Living in a rural community can make access to healthcare challenging, especially with the growing shortage of medical doctors throughout the US, and especially in North Idaho. Originally trained to fill this void in the mid 1960’s, the professional designation of Nurse Practitioner (NP) was developed and has continued to grow.

Rural-Health-Day-2016-FBBAnnerAt a rural health clinic, the NP provides healthcare for individuals and families that include diagnosing and treating acute and chronic health problems, performing physical exams, diagnosing and managing minor trauma, ordering lab tests and other diagnostic services, prescribing medications, and teaching health promotion and disease prevention. Having a background in nursing and advanced training in medical care, NPs are in a unique position to provide complete care to their patients. As Medical Director, Susan Layeux, MD works with the NPs to provide the outpatient primary care that Boundary County residents require.  “It’s a practical solution for rural residents,” says Janet Lukehart. “Bev and I work closely with Dr. Layeux to ensure that our patients are taken care of in a timely fashion with the best healthcare available.”

BikeRodeo-NoYearEach year the clinic staff sponsors the Children’s Bike Rodeo held in conjunction with the Hospital Health Fair.  This year the event will be on Saturday, May 13, 9:30 am – 11:30 am near the Outpatient Services Lobby.  Not only will children be able to test their bicycle skills through the rodeo course, but also receive a free bike helmet while they last.

Boundary Community Clinics is proud to provide the vital health services you and your family deserve, delivered with professionalism and compassion – right here at home.

 

Behind the Scenes: Quality Care

Quality Healthcare Close to Home

By: Tari Yourzek, RN, BSN Chief Nursing Officer

Sitting in a meeting of my peers recently, I was struck by how much time we spend talking about quality and what it means in healthcare and specifically to Boundary Community Hospital. As a hospital we have chosen to be accredited by DNV-GL along with the other five hospitals in North Idaho. Within healthcare, DNV-GL helps hospitals achieve excellence by improving quality and patient safety through hospital accreditation, managing infection risk, management system certification and training. DNV-GL’s accreditation program is the only one to integrate the ISO 9001 Quality Management System with the Medicare Conditions of Participation (COP). By earning accreditation, Boundary Community Hospital has demonstrated it meets or exceeds patient safety standards (COP) set forth by the U.S. Centers for Medicare and Medicaid Services. The DNV-GL program is consistent with our long-term commitment to quality and patient safety. The ability to integrate ISO 9001 quality standards with our clinical and financial processes is a major step forward.

DNV-GL’s accreditation program, called NIAHO® (National Integrated Accreditation of Healthcare Organizations), involves annual hospital surveys and encourages hospitals to openly share information across departments and to discover improvements in clinical workflows and safety protocols. A few months ago, it was our Extended Care Facility’s turn for the annual survey. The Survey Team was extremely thorough, checking through all of the records and talking with our staff. The results were a 100% deficiency free survey – very rare for a nursing home.

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This experience brought home the realization that we have an outstanding staff at Boundary Community Hospital. The entire staff, both medical and non-medical, is committed to quality patient care and caring about the people of Boundary County, continuously making a conscious effort to improve our services. Their attitude toward a culture of quality is reflected in their efforts to stay ahead of standards of care, setting an example for other small rural hospitals.

How do you define quality healthcare? It’s been my experience that quality healthcare can be defined as providing best practice care with the most up-to-date resources by empathetic
and caring staff. That’s what we have and why Boundary Community Hospital has been recognized by the American Hospital Association as a high performing hospital for clinical quality.

Quality healthcare, close to home. It’s important.

Boundary Community Hospital salutes our staff for providing quality patient care and for their excellent service, attention to detail, thoroughness, and the compassionate care that they provide to the community.

Break the Chain of Infection

By: Connie Sue Clum, RN, MSN
Infection Prevention Nurse
Boundary Community Hospital

With the seasons changing, it is an excellent time to remind everyone that each of you play an important role in infection prevention.  Despite the variety of viruses and bacteria, germs spread from person to person through a common series of events.  Therefore, to prevent germs from infecting more people, we must break the chain of infection.

No matter the germ, there are six points at which the chain can be broken and a germ can be stopped from infecting another person.  The six links include:

  • The infectious agent is the pathogen (germ) that causes the disease.
  • The reservoir is the place in the environment where the pathogen lives. This includes people, animals and insects, medical equipment, your countertop or any object in your home, soil and water.
  • The portal of exit is the way the infectious agent leaves the reservoir. This could be through open wounds, aerosols, and the splatter of body fluids including coughing, sneezing, and saliva.
  • The means of transmission is the way the infectious agent can be passed on. This could be through direct contact like touching, ingestion into the stomach, or inhalation into the nasal cavity or lungs.
  • The portal of entry is the way the infectious agent can enter a new host. In contrast to the means of transmission (which is the movement of the germ from the object to you or another person), the portal of entry is the actual entering of the body.  This can be through broken skin, the respiratory tract (nose or lungs), mucous membranes (including the urine), and catheters and tubes.
  • Lastly, the susceptible host can be any person. The most vulnerable are those receiving healthcare, are immunocompromised, or have invasive medical devices including lines, devices, and airways.

Imagine all of these links in a circle.  A germ can travel around this circle very quickly.  The way to stop germs from spreading is by interrupting this chain (or circle) at any spot.  There are many ways to do this.

bch-chain-of-infection-graphicHere are some common sense tips to interrupt the chain and reduce your chances of spreading germs:

  • The most important is cleaning your hands You can use hand sanitizer but the best way to clean your hands is soap and water.
  • Getting your flu shot If you are over 65, you can get the Prevnar 13 (recommended to get first) or the Pneumovax vaccines to help prevent pneumonia.
  • Covering coughs and sneezes and staying home when sick are other important ways of stopping the spread of germs. Did you know coughing or sneezing into your elbow or shoulder is one of the best ways to cover your cough?
  • At home, cleaning and disinfecting high touch surfaces is important. High touch surfaces are items like countertops, sink and toilet seat handles, computer keyboards or any other surfaces that you touch frequently with your hands.

Be honest: Have you ever used your scarf or gloves to wipe your nose or cover a sneeze/cough when a tissue wasn’t available? Oh, my! And then with your runny nose-contaminated glove, you touch a steering wheel, doorknob, or seat—all the time spreading the germs to others. Remember to wash your gloves and scarves on a regular basis, preferably once per week or when soiled. Most germs will survive for two or three days on inanimate objects—some longer. They don’t have to look soiled or smell bad to be loaded with germs either!

Stopping the spread of germs is key to staying healthy.  Interrupting the chain at some point on the link, will keep you healthier this year.  Now you are an Infection Preventionist too!

Behind the Scenes – Laboratory

The Truth is in the Details
The Laboratory Scientist

What is one of the fastest growing professions in the United States?
Clinical Laboratory Science professionals.agar-60571

It has been estimated by the Bureau of Labor Statistics that 15,000
new Clinical Laboratory Science professionals are needed annually; fewer than 5,000 graduate each year!
Whether you call them Clinical Laboratory Scientists, Medical Technologists, or Medical Lab Scientists, the role of the individual doing clinical laboratory testing is crucial to the detection, diagnosis, and treatment of disease. Clinical Lab Scientists must be able to accurately perform and report all complex specialized laboratory analyses requiring advanced skills, technical expertise and broad use of independent judgement. They complete routine and “STAT” laboratory tests in chemistry, immunology, hematology, serology, immunohematology, urinalysis, microbiology
and coagulation.

Laboratory tests provide a virtual “snapshot” of a patient’s health status at any given time. It is estimated that 60 to 80 percent of physicians’ diagnoses are the product of a lab test; decisions regarding a patient’s diagnosis, treatment, hospital admission and discharge are influenced by laboratory test results.bacteria-808158

Here at Boundary Community Hospital we have our own full-service, Idaho-licensed, inspected and accredited Clinical Medical Laboratory that operates 24 hours a day, 7 days a week. Our highly-qualified, certified Medical Laboratory Scientists perform diagnostic laboratory testing looking for bacteria, parasites, and other microorganisms; analyzing the chemical content of fluids; matching blood for transfusions; and testing for drug levels in the blood that show how a patient is responding to treatment while utilizing state-of-the-art analyzers, all with computer integration and interlinked computer communications with other health care facilities and our reference lab.

State-of-the-art equipment in the hands of our skilled workforce is not the whole story in the Boundary Community Hospital Lab. As a medical laboratory in a rural community, we realize that each specimen and result affects our friends and neighbors’ lives. We are committed to keeping the community healthy and well-served.

In the near future, we will need to invest in new equipment or upgrades for existing machines. These updates are examples of our commitment to providing the best, most accurate tests in a timely manner. As always, Boundary Community Hospital is committed to providing accessible, high-quality, cost-effective services to everyone in our community.

Boundary Community Hospital salutes the team of Laboratory Scientists and Phlebotomists and thanks them for their excellent service, attention to detail, thoroughness, and compassionate care they provide to their patients.

Behind the Scenes – Radiologic Technologist

Seeing Inside You – The Radiologic Technologist

Boundary Community Hospital has a reputation for quality and excellence in providing superb diagnostic imaging, thoughtful patient care and professional radiological interpretations. It is the highly-skilled, well-trained team of Radiologic Technologists that bring their expertise and patient-centric focus to ensure that Boundary County benefits from this major investment at the hospital. Our caring team continues to upgrade their certifications so that as new equipment is purchased, their skills stay cutting edge and they maintain the highest level of care.

HandThe Radiologic Technologists have regular office hours during the week and are on call 24/7 so that they can respond in an emergency and get you the tests you need right away. The most common tests performed by the Radiologic Technologists include Digital Radiography and Computerized Tomography (CT).

Digital Radiography is a form of X-ray imaging, where digital X-ray sensors are used instead of traditional photographic film. Advantages include time efficiency through bypassing chemical processing and the ability to digitally transfer and enhance images. Also, less radiation can be used to produce an image of similar contrast to conventional radiography.

Computerized Tomography (CT) combines a specialized x-ray machine and a computer to produce images one slice at a time, like a spiral ham. The scan, completed while you lie on a table, is performed by a Radiologic Technologist from an adjoining room who you will communicate with through a speaker system. The procedure is painless and usually takes about thirty minutes. Once your scan is finished, the Technologist presents the cross-sectional, multi-dimensional images to the Radiologist for interpretation. Our Technologists are busy studying to get their certifications so that they are ready for the new 64 Slice CT Scanner coming this summer. This new technology CT Scanner will provide better, finer images for more accurate diagnoses.

 

Board-certified Specialists provide expertise in special equipment used in several diagnostic situations.Baby

Ultrasound – Board-certified by the American Registry of Diagnostic Medical Sonographers with Certifications in OB/GYN, Abdominal, Breast and Vascular Imaging, the experienced Registered Diagnostic Medical Sonographer, or Ultrasonographer, manages the state-of-the-art ultrasound equipment used to examine the fetus during pregnancy, visualize certain gynecological functions in non-pregnant women, reveal information about tumors and cysts, evaluate the gallbladder and related organs, and for noninvasive evaluation of vascular disease.
Mammography – Board-certified by the American Registry of Radiologic Technologists with advanced certification in Mammography, our experienced Radiologic Technologist performs mammograms by appointment only. A mammogram is an x-ray of the breast. A diagnostic mammogram is used to diagnose breast disease in women, and occasionally men, who have breast symptoms or an abnormal result on a screening mammogram. Screening mammograms are used to look for breast disease in women who are asymptomatic; that is, those who appear to have no breast problems.
MRI – When the Mobile MRI rolls into place on Thursdays at the hospital, it comes with a Radiologic Technologist that specializes in magnetic resonance imaging. This non-invasive, revolutionary process enables doctors to “see” right through bone as well as evaluate soft tissue inside your body, without surgery and without the radiation that is used in x-rays and CT scans.

CT-Head-SampleBoundary Community Hospital’s Diagnostic Imaging Department is 100% digital and fully integrated with Kootenai Health, Sacred Heart Medical Center, Deaconess Medical Center, Bonner General Hospital, Benewah Community Hospital and Shoshone Medical Center through The Northwest Hospital Alliance Picture Archiving and Communications System (PACS) so that our images and reports can be shared and viewed with other facilities and your physician. This system eliminates the use of hard copy x-rays, making faster image interpretation and more accurate diagnoses possible.

At Boundary Community Hospital, our goal is to provide the community with timely modern radiology services that are second to none. You can expect fast and friendly service from the moment you schedule your exam to the moment your physician receives the results. Your health is important to you, and so is your time.

Boundary Community Hospital salutes the Diagnostic Imaging team of Radiologic Technologists and thanks them for their excellent service, attention to detail, thoroughness, and compassionate care they provide to their patients.

Behind the Scenes – Health Unit Coordinator

Health Unit Coordinator in Acute Care

Leesaweb The first face you see when you enter the lobby for the Emergency Department and Acute Care and the last face you see when you are leaving, the Health Unit Coordinator (HUC) team member is a key patient contact that many may not know. These caring, observant, detail-oriented, multi-taskers are willing and able to ensure that the patients (“their patients”) and their families have their needs met. Due to the demands of the position, finding and training new team members is difficult and involves extensive training. Luckily, at Boundary Community Hospital, we are fortunate to have eight individuals that proudly represent the hospital in this capacity, many of whom have worked here for years.

According to Ann Coughlin, HR Director: “This job takes a special skill and excellent interpersonal skills as they are dealing with family members and patients during stress-filled times.”

The Health Unit Coordinator’s responsibility is to perform clerical duties for both the emergency department and the acute care nursing stations, and they serve as a receptionist for all patients, visitors and persons requiring information and assistance. Sound like a typical office position? The reality is not so cut and dried. Many of the phone calls handled by the HUCs involve responding to emergency situations and making arrangements for transport via ambulance, fixed wing, or helicopter, while also preparing necessary transfer documents for the receiving facility. As many of our HUCs are also trained certified nursing assistants, you may also see them assisting in Code Blue situations by recording the events or assisting in any way that they can. They also assist with answering patient call lights in the hospital, as well as delivering meals to patients and assisting nursing staff with other patient needs.

MelenieTearful children being held in their mother’s arms checking in to see the emergency physician, the HUC needs to quickly assess the urgency of the situation and call for immediate assistance if appropriate. Once that assessment is complete, the HUC then needs to properly identify the patient, verify insurance information, get permission slips signed, and enter the necessary demographics to ensure accurate accountability and efficient healthcare processing. The HUC oftentimes travels to the patient bedside to complete the necessary paperwork so that the registration process does not impede the provision of the care the patient requires.

The same attention and care provided to the patient is also provided to family members, many of whom are distraught after following the ambulance here. Our HUCs swing into action providing comfort and information to the family members, and may also obtain information about the patient including medical history, lists of medications, and other vital information that can be passed on to the emergency room staff.

During your stay in the hospital, you will often see the HUCs following up on additional tests and therapy ordered. They also work closely with your insurance company to obtain proper authorizations to ensure that your stay is approved and they meet daily with the hospital utilization review team to make sure you are receiving the care you need. Like a traffic cop, the HUC makes sure things are flowing smoothly through all of the steps involved in your stay. The job doesn’t end there, once the patient departs, the HUC once again reviews the documentation to ensure that all of the medical record forms are complete and then they are scanned into the electronic record.

Lana Herzinger, HIM Director and supervisor of these HUCs, shared the following. “Truthfully, the HUCs would be better labeled with the title of ‘hub’, with many ‘spokes’ joining at their center, e.g. physicians, nursing staff, patient financial services, and medical records, and they are crucial to the smooth movement of the acute care and emergency department wheel. Everyone knows to go to their ‘hub’ to find the answers they need.”

Anya
Boundary Community Hospital salutes the ED/Acute Care Health Unit Coordinator Team (Kim B., Leassa B., Anna R., Randi G., Anya K., Cory M., Jayme S., Melenie H.) and thanks them for their excellent service, attention to detail, thoroughness, and compassionate care they provide to the patients, employees, and visitors.

Behind the Scenes – Materials Management

Materials Management

Shirley Mayo and Josh Smith might be behind the scenes but they are EVERYWHERE in the hospital ensuring that the item you need is where you need it, when you need it.

Materials Management

The behind the scenes circulatory system of Boundary Community Hospital

From the moment a product comes in the door of the Receiving Department and then is used in patient care, it has been touched several times by Materials Management.

At the heart of the system, the Materials Manager is responsible for finding the best product, negotiating the best price and getting it delivered at the right time. Pumping the products through the system is the shipping and receiving department which is responsible for tracking and moving each item into location where it is ready to be used as the need arises. Everything from the new Ultrasound equipment, to personal protective equipment custom-fitted to each staff member, to infection prevention supplies, to surgical equipment, band aids, pens, and Kleenex, passes through the capable hands of this expert team.

In addition to keeping things flowing, they ensure that housekeeping closets are stocked, printer cartridges are tracked and replenished, forms and materials are printed on the Risograph, pages are laminated, and products are stocked and available throughout the hospital. Inventory control and expired product disposal fall under their expertise. Every piece of equipment is tagged with an asset label and every item is assigned a stock number and tracked in the Meditech system. Special orders are no problem, as long as you have the proper authorization and a signed requisition.

Boundary Community Hospital salutes the Materials Management Team and thanks the Department for its excellent service, attention to detail, thoroughness and care it takes of the residents, patients, employees and visitors.

February 2016 Employee of the Month

Alisa-Yount-February-EOMBoundary Community Hospital congratulates the February Employee of the Month Alisa Yount, Pharmacy Technician. According to Jed Bateman, Pharm-D, “If you could describe what the ideal co-worker would be, you would likely describe somebody just like Alisa. She is hard working, dependable, and does an excellent quality of work, always looking out for the interests of both patient and hospital. She is self-motivated and very thorough. She has brought a positive change to the work, even on those days when it would be easy not to.

Her inquisitive nature constantly drives her to find a better way to do things, or continue searching for an answer when others have given up. She is also a very caring and loyal co-worker, always trying to help those around her have a better day.”

Behind the Scenes – February 2016

Nutrition Services

Dessert Cart prepared especially for our residents. Yummmm!

Dessert Cart prepared especially for our residents. Yummmm!

Sponsor of “Wear Red Day” at the Hospital on February 5th, is the Nutrition Services Team who are planning a special lunch in the cafeteria as well as Heart Healthy treats for employees who wear Red.

At Boundary Community Hospital we know our residents. Each of us expects to eat foods we like in our own homes; our residents and patients deserve the same. The Nutritional Services Department provides breakfast, lunch, dinner and an array of daytime and bedtime snacks to our residents in the nursing home and patients in the hospital. We also cater barbeques in the summer, full buffets on holidays, resident birthdays and other special event meals all year long. In addition, a cafeteria lunch service is available for staff, guests and families during the week. “Home Cooking” is emphasized including fresh baked rolls and desserts.

About Nutrition Services

The Health Care Team at Boundary Community Hospital Food and Nutrition Services Department consists of a Registered Dietitian, a Dietetic Technician, Certified Food Safety Cook, and Certified Food Handling Aides who provide nutritional support to residents, patients and community members. Our Dietitian provides outpatient nutritional counseling and sponsors a local diabetic education support group which meets monthly in conjunction with the Panhandle Health District.

Food safety is no accident and it is of paramount importance to this facility. All employees conform to the best sanitation practices in the food service industry to ensure the safety of the food served to our clients.

At Boundary Community Hospital we identify possible hazards that either exist now or could develop, and implement procedures to control or eliminate them. To that end, we have the Hazards Analysis Critical Control Points (HACCP) system. The HACCP is a proactive food safety system that works to prevent food contamination, and monitors all aspects of the flow of food in our facility.
Boundary Community Hospital consistently earns superior ratings from state and federal inspectors.

Boundary Community Hospital salutes the Nutrition Services Team and thanks the Department for its excellent service, attention to detail and nutritional care it takes of the residents, patients, employees and visitors.

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