Healthy Lifestyles Online – July 14 Edition

LeConte’s Healthy Lifestyles is a health and wellness publication printed twice a month in local newspapers serving Sevier County and South Knoxville. And here online! We hope you find this information healthful.

Table of Contents

LeConte Medical Center Receives NICHE Designation
LeConte Medical Center Recognized for Excellence
Summertime is Back-to-School Time!
Back-to-School Jitters
Important Back-to-School Vaccination Information for Tennessee Students
Bullying: What You Can Do
Peninsula Outpatient Centers
Making the Grade
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LeConte Medical Center Receives NICHE Designation

Organization Moves to the Forefront of Elder Care

LeConte Medical Center has received designation as a NICHE Hospital. The NICHE (Nurses Improving Care for Healthsystem Elders) designation indicates a hospital’s commitment to elder care excellence.

The NICHE designation signals LeConte Medical Center’s dedication to providing patient-centered care for older adult patients. Through LeConte’s participation in the NICHE program — a leading elder care nursing program — the hospital is able to offer evidence-based, interdisciplinary approaches that promote better outcomes, positive experiences, and improved care for older adults. This leads to greater satisfaction rates for patients, their families and staff.

“NICHE is essentially about providing exemplary care to all patients 65 and older. With this designation, we have the ability to provide specialized training and education to the nursing staff with emphasis on achieving high standards of care for the older adult,” explained quality manager Mary Nypaver, PhD, RN.

The mission of NICHE is to provide principles and tools to stimulate a change in the culture of healthcare facilities to achieve patient-centered care for older adults. 

Another important link that NICHE recognizes is the importance of families and patient-directed care.  Families provide a vital link between the patient and staff. Nurses are in a unique position to work with families as partners to provide quality care to older adult patients. It is also important to have informed, involved patients who understand and participate in their care. Emphasizing patient-directed care is critical to improving safety, efficiency, and quality. 

“Being designated as a NICHE facility allows LeConte Medical Center to gain access to evidence-based resources to address the needs of hospitalized older adults,” explained chief nursing office Jennifer DeBow, RN, BSN. “As the age of the hospitalized patient continues to increase, it is important for us to know how to best meet these patients’ specific needs.  Being designated as a NICHE facility allows us to develop and advance the quality of care provided at LeConte Medical Center.”

The NICHE Program helps nurses and staff meet the specialized needs of older adult patients by sharing best practices, providing state-of-the-art training and tools, and sharing information, knowledge and expertise.

“LeConte Medical Center shows a tremendous commitment to meet the most critical challenge of our times – quality care of older adults,” says Barbara Bricoli, MPA, executive director – NICHE. “The hospital’s dedication to drive continuous improvement processes and enhance care marks them as leaders in the field.”

LeConte Medical Center is one of five hospitals in the state of the Tennessee to hold the NICHE designation. Two other Covenant Health facilities, Fort Sanders Regional Medical Center and Fort Loudoun Medical Center, also hold the NICHE designation. For more information about NICHE visit www.nicheprogram.org.

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LeConte Medical Center Recognized for Excellence

LeConte Medical Center is among just six hospitals in the country which received a VHA 2015 Excellence Award for Clinical Effectiveness for achieving exceptionally high levels of performance compared to national benchmarks. 

To determine the winners of the Clinical Effectiveness Award, VHA evaluated qualifying member hospitals that achieved exceptionally high scores on several key national measures including case-mix adjusted length of stay, case-mix adjusted cost per admission, 30-day readmission rates for acute myocardial infarction, heart failure and pneumonia, and performance in the patient experience, quality outcomes and efficiency domains for VHA’s value-based purchasing program. 

“Hospitals across the country are focused on making the transition to a value-based model for care delivery while also working to ensure they are meeting new performance measures for clinical effectiveness,” said Byron Jobe, VHA executive vice president, service and delivery. “VHA’s Clinical Effectiveness Award recognizes member organizations that have been most successful in making this critical transition while continuing to deliver high quality care in the communities they serve.” 

“Their achievements exemplify the hospitals’ dedication to providing exemplary clinical care and a culture of continuous improvement.”

“We look at concepts and principles of highest quality at the lowest cost, and this is enhancive to the bottom line for the patients,” stated Stephen Dill, MD, Cardiologist, LeConte Medical Center chief of staff. “And we try to bring it all together in an environment that is very conducive to the best patient practices.”

LeConte Medical Center also received an achievement award for hospitals participating in the VHA Hospital Engagement Network (HEN) that achieved a Partnership for Patients goal of 40 percent reduction in harm or 20 percent reduction in readmissions in two or more areas of focus when comparing Q1-Q3 2014 performance to baseline performance. 

“The awards provide well-deserved recognition to Covenant facilities for outstanding accomplishments,” said Dave McDonald, area senior vice president/executive officer, VHA Central Atlantic region. “Their achievements exemplify the hospitals’ dedication to providing exemplary clinical care and a culture of continuous improvement. We congratulate their outstanding achievement and celebrate their success.”

“LeConte Medical Center is focused on the family members of our patients and includes them throughout the hospital in the education of our patients,” said Kristi Ramage, RN, surgery manager. “To be recognized for what you take pride in, for what you do every day that’s just amazing. It takes a village, it’s not just one of us, it’s not just nursing, it’s the whole hospital.”

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Summertime is Back-to-School Time!

For most children, school is on the bottom of the summer vacation priority list, far below swimming, camps, picnics, and play. But parents need to know it’s also a great time to start getting ready for a new school year.

“If a child is getting ready to start in the school system initially, parents need to schedule a check-up and make sure immunizations are up to date,” says pediatrician Laura A. Powell, MD. “A good time to do that is in the summer, so there’s not that crazy rush when you suddenly realize school starts in a couple of weeks.”

The check-up – often referred to as a “well child visit” – gives pediatricians like Dr. Powell a chance to conduct a thorough examination, checking everything from physical development to vision and hearing.

For Every Age and Stage

Kindergartners aren’t the only ones who can benefit from these well child visits. Older students need them, too. For example, doctors can help prepare a student for coping with medical issues that have the potential to keep kids from having a productive and comfortable school day, such as asthma and allergies.

“Older children are often required to have physicals for sports,” Dr. Powell says, “and sometimes extra immunizations are required for them, as well.”

Dr. Powell says one of those is the Hepatitis A vaccine, which only became a requirement a few years ago. In addition to the initial immunization, a booster shot is required.

“The coming generations of children will have already had that vaccination when they start school because we’re giving it to babies at one year and 18 months now,” Dr. Powell says, “but there’s a lot of catch-up for older kids.”

Also, high school students who choose certain career paths may need immunizations before they’re allowed to work in technical areas of a chosen field. 

Learning Disabilities

If you suspect your child may have a learning disability, the first place to go is the doctor’s office. “We do play a role because the schools need a medical form in order to offer help and resources,” Dr. Powell explains.

In some cases, parents can avoid a lot of trouble and concern by letting the pediatrician rule out possible medical causes first. What might be perceived as a learning disability may be a problem with hearing or vision. 

“We do vision and hearing screens,” Dr. Powell says. “If you can’t see the board well and you can’t hear the teacher in a crowd of kids, you’re not going to pick up the instructions and do as well.”

Getting Ready to Get Up Early

Keep an eye on the calendar, and about two weeks before school starts it will be time to start a new habit. That habit is getting up in time for school.

“If your children have had a fairly free schedule, you can’t just switch them from sleeping till 10 a.m. one day to getting them up at 7 a.m. to get ready for school the next,” Dr. Powell says. On the first day of school, Dr. Powell says kids should be able to get up early enough to eat a good breakfast before they leave home. 

“It is hard to change habits and sleep cycles,” Dr. Powell says. “Some kids are naturally early risers, but some take a little more time to adjust.”

Dr. Powell says starting a school sleep schedule early is a good practice for students of all ages. Adolescents and teens tend to be later sleepers, so they need time to adjust, too.

So don’t underestimate the importance of getting ready for school before the bell rings and the first class is in session. Start healthy habits early, and schedule an appointment with your child’s pediatrician or family physician “just to make sure they’re developing okay, that their bodies are ready for sports, and to check for any learning issues that we can help with,” Dr. Powell says. 

For more information, or to schedule a well child visit, call (865) 446-7000.

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Back-to-School Jitters

It’s easy for parents to forget what it’s like to be a kid on the threshold of a new school year. It can be daunting, especially for first-timers.

Pediatrician Laura A. Powell, MD, says the best thing you can do for your child is talk openly about the changes ahead. Here are some other tips for making a smooth transition into the new school year.

Start at home. Help your child find a good place to study, and go shopping for a few at-home study supplies. Serve your child’s dinner in a lunch box.

Make the trip. Hop in the car and show your child the route to school. Arrange a visit to see the inside of the school and meet the teacher.

Get together. Contact kids who are going to the same school, and arrange some relaxed social time.

Don’t forget healthy habits. Make sure your child is eating a healthy diet and getting an adequate amount of sleep. A couple of weeks before the first day of class, start the sleep schedule your child will need for school.

Be there. Whether your child verbalizes it or not, and whether your child is in kindergarten or high school, the start of a new school year can be stressful. Make a point of being available to spend time with your kids, offering plenty of love and support.

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Important Back-to-School Vaccination Information for Tennessee Students

Students in the state of Tennessee are required to have all essential vaccinations prior to the start of a new school year. Most schools are required to send students home if they do not have the required shots on the first day of school. Important years to remember that require vaccinations are:

• When attending childcare centers, including Pre-K programs
• Kindergarten
• 7th Grade
• Any students newly enrolled in Tennessee schools

If you have a child in one of these categories, make sure you schedule an appointment with your pediatrician or local health department before the first day of school.

Of all the things kids can do to get ready for school, getting vaccinated is one of the least favorite. It also happens to be one of the most important!

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Bullying: What You Can Do

Many children who are bullied or bully others suffer from anxiety and depression, or experience physical symptoms like stomachaches, headaches or problems sleeping. The emotional and physical damage of bullying or being bullied by classmates or other peers puts children at risk for engaging in violent behaviors, including frequent fighting and carrying a weapon.  These problems continue into adolescence and adulthood, which cause the bullies and bullied to be more prone to thoughts of suicide. 

While bullying is often thought of as physical violence toward another, it also includes name calling, spreading rumors, deliberate exclusion, unwanted physical contact and racial slurs. Cyberbullying means these aggressive acts can happen on a child or teen’s computer or phone, without any supervision. 

“Every child deserves a safe experience at school,” John Kupfner, MD, Peninsula child and adolescent psychiatrist, said. “There is a lot of confusion about what being bullied means for children. An isolated incident of ‘being mean’ is a normal part of childhood with which your child must cope in order to develop socially. When being mean is repeated, includes threats to safety or is emotionally abusive, that is bullying.” 

If you suspect your child is being bullied, look for the following signs:

• Physical injuries
• Inventing reasons to avoid going to school or other activities
• Changing routines or routes to school
• Sudden disappearance of belongings

It is essential that you respond to your child’s situation with a bully. The worst reaction you can have, experts say, is to tell them to go back to school and respond with aggression. This reaction simply perpetuates the cycle of violence and fighting. The bully is made aware that your child is upset, and one or both children are likely to get hurt. 

Instead of responding to bullying with threats or violent actions, take specific steps as a parent to help your child deal with a bully. Dr. Kupfner explained, “Any parents who hear that their child is being targeted or threatened by a peer should immediately contact the school’s principal or guidance counselor. Do not accept any resolution that does not completely abolish the behavior.” 

In addition to going to the school administration, here are some suggestions to help your child resolve conflicts.

Encourage your child to tell you about the bullying. Sometimes children are reluctant or embarrassed to discuss it, as it may make them feel weak. 

Don’t shrug it off, blame your child or act as if you’re disappointed in him or her. Being a victim can harm self-esteem and create serious emotional problems. Your reaction is important.

Explain that children who intimidate others are usually unhappy or have been bullied by others, and that it’s not your child’s fault.

Use role-playing to show your child what they can say or how they can say it when responding to a bully.

Teach them that it’s okay to calmly alert an authority figure about the bullying.

If your child is targeting or threatening his or her peers, contacting the school administrator is also the correct action. “Work out the consequences for repeated bullying behaviors at school and talk to the parents of your child’s friends to make sure they are aware the bullying situation is happening,” Kupfner said. “Consequences for continuing bullying behavior should also result in consequences or loss of privileges at home. Explain to your child the seriousness of threatening or harming others and make it clear that the same consequences will happen if the behavior continues.” 

Because bullying can cause long-term emotional problems, your child may need an individualized plan for rebuilding self-esteem and coping with other personal issues due to conflict. Peninsula Outpatient Centers offer support groups and therapy for children and adolescents, including an Intensive Outpatient Program located on the Knoxville campus. For more information, visit www.PeninsulaBehavioralHealth.org, or call (865) 970-9800.

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Peninsula Outpatient Centers

For people experiencing mild to severe mental health issues, Peninsula Outpatient Centers provide a wide range of services including individual and group therapy, support groups and medication management. With outpatient centers in Knox, Loudon, Sevier and Blount counties, Peninsula serves individuals age 12 and older across East Tennessee. Each patient meets with Peninsula clinical staff at his or her first appointment to determine the best course of treatment. A patient’s plan may include daily medication, therapy or a combination of both.

The physicians at Peninsula Outpatient Centers may recommend an Intensive Outpatient Program to provide more concentrated care than traditional outpatient sessions. For six to eight weeks, participants in the Adult or Adolescent Intensive Outpatient Programs come to the Knoxville outpatient center four to five times a week to address issues that need intense treatment but do not require continuous care. These conditions include depression, anxiety disorders, anger management, ADHD, relationship problems, grief and loss and self-injurious behavior.

Alcohol and drug treatment is available through the Adult Intensive Outpatient Program at the Peninsula Lighthouse campus.  For women suffering from addiction, Peninsula Outpatient offers Women in Treatment, a program for uninsured women age 18 to 64. Through this program, women can work on self-esteem, trauma, communication techniques, body image issues and other topics that are vital to well-being and happiness.

If you or a loved one is experiencing any symptoms of mental health issues, call Peninsula Outpatient Centers at (865) 970-9800 or visit www.PeninsulaBehavioralHealth.com.

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Making the Grade

For your child, heading back to school means seeing friends every day again, joining new clubs and getting back to team sports. It also means hitting the books, which can cause major stress and pressure. 

In teens, stress stemming from balancing schoolwork and other activities can manifest in many ways. It can affect your child physically and emotionally. Long term stress causes anger, irritability, fatigue, headaches and stomachaches. 

Your child may not tell you if he or she feels stressed. Watch out for these symptoms:

• Restlessness or agitation
• Fatigue
• Withdrawal from family and friends
• A lack of interest in once-favorite activities
• A drop in grades or other problems at school
• Trouble sleeping

To help your child cope with stress, let him or her know you’re interested in their problems, no matter how big or small. Listening closely and not interrupting is essential. While you may want your child to succeed in school, support him or her in the long term. “Just like in athletics, encourage your child to work as hard as possible and reward the effort, not the results,” John Kupfner, MD, Peninsula child and adolescent psychiatrist, said. “Reassure your child that his or her best is what is being rewarded, not the result on an individual test or grade.”

Distraction from stressful studying can also relieve your child’s worries. Plan a physical activity for your child, like bike riding or a long walk. Exercising outdoors can naturally boost your child’s mood. Watch a funny movie together or encourage your child to write in a journal. Most importantly, set a good example. Children often emulate how their parents deal with stress.

If your child is struggling with stress, Peninsula Outpatient Centers may be able to help. Visit www.PeninsulaBehavioralHealth.org or call (865) 970-9800 for more information.