•• C ~1 K

LAPAROSCOPY: SURG[RY AT8 AM, DINNER AT HOM[ WITH TH[ FAMILY BY6 PM.

The Implementation of Our Strategic Plan 2

Renovation and Remodeling Project 2

The Purpose of the New Addition 2

Duestion of the Day 3

The Time of Your Life 3

Technology for the 21st Century 3

Why do we need the 1/2 cent Sales Tax 3

Looking on the Inside 4

Workillg for a Healthier COllllllllllity

Proposed Phasing for Remodeling Project .4

Corporate Citizen 4

Employee News 4

Allied Health Meeting 4

Inside this issue:

Brit Messer. MBA. MHA. MSPHChief Executive Officer

McCurtain Memorial Hospital

The graph below shows oursteady upward trend over asixteen-month period from thepatient's pcr.>pective. Patientcomments give life to thesatisfaction data, and provide uswith better understanding.

The hospital board andmanagement of McCwtainMemorial Hospital arecommined to quality. Theyhave made strategic decisions toinvest into the hospitllinfrastructure, technology,satisfaction tools, like Press­Ganey, and into a hospital-wideprogram to create anorganizational culture ofquality.

To obtain moreinformation regardinglaparoscopy, search the web site"Laparoscopy.Com". To findout more infonnation aboutMcCurtain Memorial Hospital'slaparoscopic services visit ourwebsite at www.MMHok.comor to tlke a tour please call 208­3270.

also have several anicles in thisissue regarding our masterconstrnction plan and the newproduct lines that will bedeveloped along with the masterbuilding program.

Why do we feel our story isimportant? Although changefrom the starus quo is alwaysscary, we feel we are doing theright things to make sure aquality hospitll will be here foryour children andgrandchildren.

We have come to believethat just because we live in aremote, rural area with asubculture of drugs, violenceand poverty we will not throwour anns up in disgust and saychange is not worth the effon.We will not use this distonedlogic to settle for second-ratehealth care systems and ignorethe problems we have as asociety. The hospital willbecome part of the solution toour social ills by implementingour strategic plan and growinginto the 21\11 centwy. We willno longer remain obsolete.

McCurtain Memorial HoepilalPetierrt5atisfaetionTrends II1ll<OYir>g

Pr86S-Ganoty 5alistaetion Survey

-_._~--~---. __ .­w w w w w w w w ~ ~ ~ ~ ~ ~ ~ ~

Good" on the Press-GaneySurvey.

If we are ever to realize ourvision of becoming a qualityregional health care facility ofchoice, we must respond to theneeds of our customers, bothinternal and external. We mustuse feedback from Press-Ganeypatient satisfaction surveys forperfonnance improvement,reward and recognition as wellas risk management. Press­Ganey provides benchmarkingdata so we can see how wecompare to hospitals oflike sizeacross the nation, and to everyhospitll in our region. Press­Ganey also gives us a"windshield" view of how weperfonn on a weekly basis.

A General Surgical Suite at McCurtain Memorial Hospital

blood transfusion. Smaller reduced risk of acquiringincision. which reduces pain infections.

and shonens recovery time.less pain, leading to less painmedication needed. Shorterprocedure time with themajority of our patients beingdischarged home the same dayas surgery. Reduced exposure ofinternal organs to possibleexternal contaminants thereby

tain Memorial Hos~Idabel, Oklahoma

this, our new mission statementaffmns that we exist, "to assurethe availability ofhealthcare thatis safe, reliable, affordable, andas gOCK! as possible FOR OURPATIENTS." Our culture haschanged al the most basic levelin the organization. We nowrecognize that the patient is ourmain focus.

lbis issue explains what weare doing to grow into the 21"cenrury. We examine areas oftechnology, building andbuilding infiastructure as well ascultural changes throughout theorganization. We look at thechanges in technology in anarticle about our electronicmedical record and goingcompletely digitll in ourimaging depanment. We arenow able to send quality imagesanywhere in the world in amaner ofseconds.

We look at cultural changesin an article entitled, "Lookingon the Inside', and measure ourstrides in producing quality carein an anicle entitled, ''Qualityand Satisfaction and You'. We

listening; answering questions,and showing empathy andcompassion give organizationsthe extra edge leading to beneroutcomes. Patients basicallywant to feel welcome; to havesomeone listen; to be made toft.ocl important; and to be givenanswers and CJlplanations theycan understand.

Some of the top priorityissues nationwide for patientsatisfaction focus on effectivecommunication and empathysuch as:• Response to concems or

complaints• Stlff addressed emotional

""""• Involved you in yourtreatment

• Ability to answer yourquestions, and keep youinfonned

• Prompt response to cal1 bunonAt McCurtain Memorial

Hospital we strive to create aculture of quality with a focuson patient satisfaction. Weanempt to respond to specificconcerns, suggestions andcomplaints by blendingimprovement into our every daywork lives. Our goal is for ourpatients to want 10 mark "Very

our Gynecological and GeneralSurgery procedures areperfooned through a1""""""",.

Laparoscopy is done tocheck for and possibly removeabnonnal growths (such astumors). Check for and treatconditions such asendometriosis, ectopicpregnancy, or pelvicinflammatOlY disease (PID) andinfettility. Most of our patientswith a presentation of ectopicpregnancy (a pregnancy withinthe fal10pian tube) are treated bylaparoscopy. Surgical treatmentofan ectopic pregnancy with thelaparoscope in most casespreserves the fallopian tubeinstead of removing the tube.Other procedures perfonnedwith laparoscopy are tuballigations. hernia repairs, bowelsurgery and to remove organssuch as the appendix,gallbladder, uterus, tumors and

"'"TItere are a nwnber ofadvantages to the patient withlaparoscopic surgery versus anopen procedure. These include,reduced blood loss, whichreduces the chance of needing a

March.2DD9

OUALITY AND SATISFACTION AND YOU

A VISION FOR THE FUTUREBy Brit Messer

We are embarking on ajowney at McCwtain MemorialHospital that is at the same timeexciting and fiightening. It isexciting because our journey istaking us to new heights; it is atthe same lime fiighteningbecause we are leaving thefamiliar.

This issue ofLandscapes andPortraits is designed to informour constituents about thechange that we hope to see overthe next few year.; and why thechange is necessatY for ourswvival and growth.

McCurtain MemorialHospital has stuck to the sameway of doing things for the last35 years. Often we have usedthe same technology and samemethodology ignoring thechanges in both areas. We havealso ignored the changes in ourdemographics and society atlarge. In many cases we havebecome obsolete.

MOSl ofall we have, over theyears, forgotten the importanceof our customers. Recognizing

Laparoscopy is directvisualization of the abdominaland pelvic cavity. It is a surgerythat uses a thin, lighted rube putthrough a cut (incision) in thebelly to look at the abdominaland female pelvic organs. Thelaparoscope is an instrumentsomewhat like a miniaturetelescope with a fiber optic lightsystem, which brings light intothe alx\omen. It is about as bigafOlUld as a fountain pen andtwice as long.

Terry Manin R.N. CNOR.the Perioperative Director ofMcCurtain Memorial Hospital'sSurgical Services Departmenthas over the past several yearsdeveloped and implemented astate of the art JaparoscopyOperating Room. Terry bringsover thirty years of experienceto McCurtain's SurgeryDepartment. Terry has heldeducational and managerialpositions at the ParklandMedical Center, Beth Israel­Deaconess Medical Center andthe Mayo Clinic. All of ourGynecologists and GeneralSurgeon have been perfonninglaparoscopic surgery for the pastfifteen years. In fact, most of

~""'~~M-'

"00\"Landscapes and Portraits In Health

As you sort through yourmail, you come across anenvelope with McCurtainMemorial Hospital as the rctumaddress. You find a letter fromBristol Messer, Chief ExecutiveOfficer, asking you to completethe enclosed satisfaction surveytelling us about the care youreceived recently at the hospitll.Upon closer inspection, you seethe name "Press-Ganey", andyou ask yourself, "Who isPress-Ganey?"

Drs. Press and Ganey,professors at the University ofNotre Dame, developed thecompany of Press-Ganey. It isthe leading company in thesatisfaction surveying market,and has contracts with over7,000 health care facilitiesacross the nation, includingMcCurtain Memorial Hospital

Patient satisfaction isincreasingly a component indetennining organizationaleffectiveness. We can no longerfool ourselves that it is just ourtechnical skills that our patientsvalue. There is a growingimportance of meetingindividual patient needs as partof a positive patient experience.Studies indicate patients feel

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Page 2 Landscapes and Portraits In Health

Life is full of unknowns out there but we have all learned that a little planning can go a long way in overcoming the pitfalls. So it is also true in business. McCurtain Memorial Hospital has laid out its directions for the future. The Management Board (McCurtain Memorial Medical Management, Inc.) and the Authority Board (McCurtain County Hospital Authority) working together have laid out a course for growth that addresses many of the healthcare needs of the residents in the county and surrounding service area and also assures the success and perpetuation of quality healthcare for citizens of McCurtain County. “The Authority Board is working with the Management Board to implement our strategic plan. With everyone working toward the same objective, we are making significant progress,” said Brit Messer,

CEO of McCurtain Memorial Hospital. The long-term objective is to transform McCurtain Memorial Hospital into a regional referral center, capable of providing many more services than currently provided. “The more services we can provide here, the less people will have to travel for healthcare,” said Messer. Messer envisions cardiology, orthopedics, urology, as well as other services such as rehabilitation in the near future. However, in order to be competitive he feels the hospital must be updated including remodeling and replacement of infrastructure. The building and all its systems are 30 years old he said. At a regular meeting of the McCurtain County Hospital Authority Board on April 29, 2008, the board voted unanimously to petition the County Commissioners for a special election to ask the voters to extend the 1/2

cent sales tax, according to Don Shaw, Chairman. The current tax was approved by the voters for a five year period which expires on June 30, 2009 and can be used only for the purchase of capital equipment, remodeling or construction. The funds supplied by the taxpayers since July of 2004 have been used to purchase $1,550,096 worth of capital equipment with $2.4 million allocated to construction for a total of $3,950,096. During this same period, the Management Board spent $2,356,087 on capital equipment and $1,105,222 on construction for a total of $3,461,309. These funds came from hospital operations. Both organizations together have spent $7,411,405 on capital equipment and construction since July 1, 2004, the start of the 1/2 cent sales tax. The Authority Board members are Don Shaw, Chairman; Pat Baggs, Vice-

Chairman; Dudley Parsons, Secretary/Treasurer; James J. Campbell, Jr.; and Jolene Cunningham. The Management Board members are Billie Tomlinson, President; Thomas Salyer, Vice-President; Desmond Brown; Jared Johnson; Irvin Jones, Secretary; Michael West and David White. The Master Construction Plan calls for remodeling and upgrading the entire facility for a cost of approximately twenty million dollars. The plan calls for this to be done over the next 2 ½ years in phases that will allow the hospital to continue providing services while construction occurs. “A modern facility will allow us to be competitive with our product lines. For instance, not everyone wants to deliver a baby in a 30-year-old OB unit. Things have changed and we must change with the time or become obsolete,” said Messer.

Orthopedics, Cardiology and Urology are three new product lines called for in the strategic plan. The timing of the implementation of those service lines will depend on the completion of construction and remodeling. In order to expedite the Master Construction Plan, the Management Board has decided to seek debt financing for this purpose. “We have retained the services of Lancaster Pollard to advise us on financing options for our Master Construction Plan,” said Billie Tomlinson, Chairperson of McCurtain Memorial Medical Management, Inc. which operates the hospital on a day-to-day basis. Lancaster Pollard is an investment banking, mortgage banking and financial advisory firm. The firm has offices in Atlanta, Austin, Columbus, Denver and Kansas City. “Debt financing would

allow us to control the timing of various construction phases better and would allow more money for capital equipment purchases,” said Tomlinson. “It will also allow more funds to be devoted to the development of our new product lines,” she said. However, she said there is still a need for the extension of the 1/2 cent sales tax for the purchase of capital equipment. Some of the capital equipment items which will be needed to develop the new product lines will cost as much as $3.5 million. A Magnetic Resonance Imaging Machine (MRI) will be needed for orthopedic services and will cost around $3.5 million. “I am pleased with the way the Authority is working with the Management Board on accomplishing our strategic plan,” said Tomlinson.

THE IMPLEMENTATION OF OUR STRATEGIC PLAN

McCurtain Memorial Hospital, seeks to borrow $19,630,000 by issuing tax exempt bonds which will be insured by the United States Department of Housing and Urban Development (HUD). It is expected the HUD mortgage will close in the near future. The HUD insured financing is forecasted to carry a borrowing rate of 6.25 percent consisting of interest of 5.75 percent and the mortgage insurance premium of .50 percent and be payable over 25 years. The proceeds of this financing will be used to renovate and expand the McCurtain Memorial Hospital and pay costs associated with the financing. The hospital alone will be responsible for

repayment of this debt. The project will focus on a physical rehabilitation center, inpatient rooms, a women’s center, surgery suites including orthopedics, ICU, Pharmacy, Laboratory and other miscellaneous areas. The following is a breakdown of costs by general category: Physical Rehabilitation Center Renovations - $1.83 million will be utilized to complete the relocation of the physical therapy department from the adjacent Medical Office Building into the hospital. The renovations will complete McCurtain Memorial Hospital’s Phase I construction and renovation,

which includes the construction of a $3.5 million three-story addition to the North end of the building. This phase provides a state of the art physical rehabilitation center including speech, cardiac, respiratory and occupational therapy. Remodeling of Inpatient Rooms - $3.62 million will be utilized to remodel all medical and surgical inpatient rooms. In order to minimize disruption of operations, McCurtain Memorial Hospital plans to remodel the rooms in ten to twelve unit clusters. Cardiology services will be part of this phase. Women’s Center - $3.37 million is earmarked for

renovation of McCurtain Memorial Hospital’s women health services, including obstetrics and the creation of a women’s health center which will focus entirely on women’s health issues for women of all ages. Surgery Suites - $3.23 million to fund a substantial renovation of McCurtain Memorial Hospital’s surgery department including the development of an orthopedic surgery and rehabilitation center.

Intensive Care Unit, Pharmacy, Laboratory, and Miscellaneous - $2.15 million will be spent on various updates and expansions to these departments. In order to

limit any disruption to existing services, individual projects will unfold as additions and renovations make available new or unused space. McCurtain Memorial Hospital, which was constructed in 1974, has not been remodeled since it was built. The Hospital also has many physical deficiencies, including the heating and cooling systems. Many patient areas are not compliant with new code restrictions; patient access areas are not ADA compliant; and space is too limited to effectively provide acute care services both in the inpatient and outpatient setting. The renovation and expansion will provide the Hospital the ability to remedy

the current physical deficiencies. It will also allow inpatient and outpatient health care services to be performed more efficiently, and will be more attractive to patients, physicians, and visitors allowing the hospital to be more competitive.

A RENOVATION AND REMODELING PROJECT THAT ESSENTIALLY PROVIDES A NEW HOSPITAL FOR McCURTAIN COUNTY

McCurtain Memorial Hospital aspires to assure the availability of health care that is safe, reliable, affordable and as good as it can be when it is needed by the people of McCurtain County. This aspiration cuts across economic, political, ideological, race, age, and gender demographics. Our project guarantees this aspiration for today, tomorrow, and for generations to come.

The two-story structure to the north of the existing facility was officially turned over to the hospital to occupy on December 30, 2008. The building of this structure was called for in our Strategic Plan for two very important reasons. The first objective was to move our existing Physical Therapy into the hospital (it is now located in the medical office building adjacent to the hospital.) The hospital does not currently have an inpatient Physical Therapy function on a routine basis and the board felt this represented a quality deficiency. They felt our patients should have access to PT for ambulation, exercise, and other reasons. The question was, “where do we put it?” The second objective was to create more space devoted to inpatient and outpatient care. Over the years, the hospital has utilized patient rooms for office space. When a person was hired, they were often given a patient room to be used as their office. In fact the entire Home Health

Department was accommodated in this fashion, utilizing several patient rooms. This approach might have been workable if our census and services would have continued to decline. But we now find that during busy times we do not have enough patient rooms to meet our needs. Although the hospital is licensed for 111 beds we have only about 40 that are usable. Many rooms are also not used because of lack of heating and air conditioning due to systems that are 30 years old and no longer working . The board decided that the solution to both issues, the lack of an inpatient Physical Rehabilitation Department and lack of usable patient rooms could best be resolved by building a new structure. The new two story structure allows us to build a state-of-the-art physical rehabilitation center in the existing hospital building and to increase our usable beds from about 40 to 84. Space that was formerly occupied by laundry,

housekeeping and materials management will now be used for our new physical rehabilitation center while they will be relocated to the first floor of the new structure. The new rehabilitation center will be one of the finest located in Oklahoma and will include occupation, respiratory, speech, and cardiac rehab as well as physical therapy. It will also provide a therapeutic pool to aid in providing water-assisted exercises for stroke, cardiac and post surgical patients. Further, the board felt that by providing this service at McCurtain Memorial, patients would be spared the burden of driving to distant places for rehabilitation.

THE PURPOSE OF THE NEW ADDITION

The second floor of the new structure will allow for the relocation of several functions that have been housed in patient rooms for years and free up valuable space to provide more inpatient and outpatient space. Why do we need more space you ask? In addition to needing more rooms during our busy seasons we will be

starting several new services following our remodeling. First is the creation of a Women's Health Center that will focus entirely on women's health issues for women of all ages. Secondly we will create an Orthopedic Surgery and Rehabilitation Center which will occupy rooms on the second floor and in our rehabilitation center. In addition we will be providing Cardiology and Urology Services also on the second floor. Our inpatient physical therapy services will also

allow us to offer skilled nursing care for patients who qualify. This program is commonly known as a “swing bed” program. The Hospital already qualifies and is approved for this service. The remodeling and renovation is also designed to provide more privacy for the patients and the nurse and will enhance waiting areas for visitors and family members. In addition, the hospital infrastructure will be replaced with modern and more efficient air, heat, and water systems. This will also

decrease our cost of energy. Hopefully, you now understand why the new North Tower was constructed. Without this space, it would be impossible to provide new and expanded services. Also, the North Tower had to be constructed first to allow for staging of the remodeling and renovation to follow. The difficulty is that the hospital must remain operational while the remodeling occurs.

The new North Tower at McCurtain Memorial Hospital. The first phase of our Master Construction Plan

You are about twice as likely to have a stroke in McCurtain County as in the average county in the state. This is no doubt connected to the fact that our incidence of heart disease is so high compared to the state according to the Oklahoma State Department of Health, Mortality Statistics, (2007).

A stroke occurs when the arterial blood flow leading to or in the brain becomes blocked or ruptures. Blood carries oxygen and nutrients to the neurons (nerve cells) in the brain, so when the blood flow stops the cells begin to die. In fact, for a person having a stroke, every minute without treatment costs the victim 1.9 million bran cells. As each second passes, more of their brain atrophies, according to the American Stroke

Association. Stroke is the third leading cause of death in the United States with over 900,000 strokes a year resulting in 150,000 deaths according to the American Heart Association.

For the survivors, life can be forever changed. Problems with movement can turn once simple tasks such as feeding and dressing themselves into major challenges. Problems with speech and memory can force formerly productive workers into early retirement. When brain cells injured by a stroke can’t work, the part of the body they control can’t work either. Injured and dead brain cells can’t heal or replace themselves. However, there are some exciting possibilities in Stem Cell research on the horizon that may give hope to stroke victims. Today, however, recovery from

a severe stroke usually takes months or years of medical treatment, rehabilitation therapy and most of all a determined effort by the survivor.

There are two main types of stroke. One is caused by blood clots or other particles (ischemic strokes), and the other by bleeding from a burst blood vessel (hemorrhagic stroke). Ischemic strokes are the most common. The good news is that the early medical care at the first symptom of a stroke can greatly help the outcome. We see many stroke victims in our emergency department and our doctors have many techniques at their disposal, including surgery, aspirin, blood thinners and clot-busting drugs that can stop some strokes in progress. The earlier the diagnosis the greater the options. But someone having a

stroke may not be in the position to help themselves. They may either deny the symptoms of a stroke or may not be physically or mentally able to get help. That is why it is up to you, to learn the symptoms of a stroke and get help fast.

Learn to recognize the signs of a potential stroke. According to the American Stroke Association (a division of the American Heart Association) symptoms of a stroke may include:

Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause

Any of the above symptoms may be temporary and last only a few minutes. This may be due to a ‘mini-stroke’ called a transient ischemic attack (TIA). TIAs are extremely important indicators of an impending stroke. Don’t ignore them. If symptoms appear, call 911 to get medical attention immediately.

A stroke is another one of those ‘lifestyle’ diseases meaning that certain lifestyle habits tend to increase the risk of having a stroke. There are some risk factors beyond your control like age, sex, and heredity. However, some risk factors you can control or treat are:

High blood pressure Tobacco use Diabetes Mellitus Carotid or other artery disease Atrial fibrillation or other heart disease A history of TIAs (Mini-strokes) A high red blood cell count Sickle cell anemia High blood cholesterol

Physical inactivity Overweight and obesity Excessive alcohol intake Some illegal drugs

THE TIME OF YOUR LIFE….. RECOGNIZING A STROKE

McCurtain Memorial Hospital recognizes that strokes are a serious problem for our constituents and stands ready anytime to provide any assistance possible. The biggest priority is treating the disease as soon as possible. That’s why we ask everyone to recognize the symptoms of a stroke and call 911 immediately.

Question of the Day – Religion or Politics?

One of the most

contentious areas of science and American politics is the controversy surrounding human stem-cell research; particularly embryonic stem cell research.

Limits on stem-cell research, which prevented federal funding and were imposed by congress and

former President George W. Bush for ethical and religious reasons, have had a chilling effect on both academic and corporate research involving such cells. Proponents of stem-cell research say restrictions have delayed development of promising new treatments while critics contend that harvesting stem

cells from embryos destroys human life.

This month, the Food and Drug Administration cleared the way for the first-ever human trail of a medical treatment derived from embryonic stem cells. “This is the dawn of a new era in medical therapeutics,” said Thomas B. Okarma,

President of Geron Corp., a California biotechnology company who got the green light from the FDA to conduct a study of its stem-cell treatment for spinal cord injuries in up to 10 patients. “The hope that stem-cell therapy will repair and regenerate diseased organs and tissue goes beyond what

pills and scalpels can ever do,” said Mr. Okarma. The question of the day is this: Should the Obama administration lift all restrictions on stem-cell research and start funding medical research?

McCurtain Memorial Hospital would like your opinion. E-Mail your

response to adm@mmhok.com, write us at 1301 E. Lincoln Road, Idabel, OK 74745 or call 508-208-3100 after 5 pm and leave a message. Your response may be chosen for publication in the next issue of Landscapes and Portraits in Health.

Landscapes and Portraits In Health Page 3

McCurtain Memorial Hospital is striving to be a technologically advanced hospital. Over the course of the last 12 months we have introduced new technologies that are commonly found only in the largest health care systems.

Paul Trotta, RT ( R ) (CT), Radiology/ CT Technologist

We began by implementing a PACS in our radiology department. PACS, which stands for picture archiving and communication systems, is a method of medical imaging dedicated to the capture, storage, retrieval and distribution of medical grade images. These images can be standard x-rays, ultrasounds, CT’s, or MRI’s. Just recently, McCurtain Memorial announced the introduction of digital mammography to its already established list of digital images. This essentially digitizes the images and stores them on powerful computer servers for quick access and archival.

There are three major reasons for a hospital to use PACS in their Radiology department. The first reason is the cost. Using a digital system would mean that x-ray films no longer need to be printed and reviewed by the physicians. This savings is something that can be passed along to everyone involved. The second reason is the portability. This portability insures safe storage of the data. In the event of a disaster, all the files in a PACS server are backed up and stored in a safe location so it is more difficult to lose the information. Film jackets

cannot be replaced or recreated, but electronic data can. The third reason is the most impressive and most common reason for choosing such a system; the speed of the system. Image capture and review can be accomplished in a fraction of the time with computerized assistance. This method also reduces the need for “retakes” due to over or under exposure. Retakes not only increase time but also can increase risk to the patient. The system can lighten or darken the exposure and even change settings instantly to sharpen images.

The best way to explain this would be by example. Imagine you are taken to our Emergency Room for chest pains. Historically, our ER physicians order a chest x-ray. You are taken to the Radiology department and your images are taken. This part has not changed. Prior to the implementation of the PACS, your films would have to be run through a developer and printed to films. Then the films would be carried to the Radiologist to be interpreted. Finally, the films would be carried to the ER physician for further review to determine the proper course of action. This whole procedure could take up to 10 minutes. If your chest pain is related to a heart attack, 10 minutes is a long time. With our PACS, your x-ray is taken on a digital cassette and loaded into a cassette reader, or CR, for archival. As soon

as these cassettes are read, the images can be viewed by the Radiologist AND the ER physician simultaneously at workstations designated for x-rays with monitors which rival the detail and clarity of the old films. This entire process takes only about 60 seconds before the ER physician can see the images. That is one-tenth the time. In some cases it can be the difference between life and death.

Another advancement McCurtain Memorial Hospital has implemented is the Electronic Medical Record, or EMR. An EMR is just what it says; an electronic record of the medical chart. This is a chart utilized by the medical staff as a method of capturing all relevant health information and storing it in one central location. Just like PACS, there are benefits to a hospital having an EMR. Again, cost is one benefit. With a full electronic medical record, there is no need to have a paper chart or folder holding all the medical information. Safety is another important benefit. It is stored on servers, like the PACS, so it is also backed-up and archived safely off-site, just like the PACS. Paper charts are difficult to replace but electronic data can be recovered. Portability is perhaps the most fascinating aspect of an EMR.

Let’s look again at the example of your visit to the ER. At the same time that your ER physician is reviewing the chest x-ray, the

cardiologist on call is notified. The cardiologist can log into McCurtain Memorial’s secured system from anywhere in the world with an internet connection and pull up the same chest x-ray. It can be done at the same time the ER physician is looking at it. From here the cardiologist can also review any other tests ordered, any results already reported and even look over any of your past medical history without having to wait for results to be faxed to them. This portability improves patient care and gets the necessary information out quickly to everyone and anyone who has a stake in your well-being.

This system does not stop at just the ER. Imagine next, you are then admitted to McCurtain Memorial’s inpatient floor. Your primary care physician is able to check out your visit to the ER and then your stay on the floor. Your doctor is able to monitor your progress at any time throughout the day or night simply by logging into the EMR system. This enables real-time access to lab tests as the results come in or access to any nurse documented changes to your condition. This is one more step to improve quality of care while staying at McCurtain Memorial Hospital.

The advancements do not stop there. Currently, we are working on another exciting aspect of the EMR. This stage is called CPOE, or Computerized Physician Order Entry. CPOE is a system where the

physicians themselves will enter orders directly into your chart. This is different from standard order entry, as it will eliminate paper orders. Currently, physicians write orders in the medical chart on a piece of paper. This paper is then reviewed by the nursing staff and the orders are distributed to the appropriate department. Utilizing CPOE will not only eliminate the paper, but it will greatly reduce the potential of errors generated by handwriting or transcription. This is one of the leading causes of patient care errors in hospitals.

TECHNOLOGY FOR THE 21ST CENTURY

This can best be described by going back to your admission from the ER. The next day, your primary care physician can look at your chart online with the EMR. He or she can at that point, regardless of their location, make changes to your diet, changes to your medications, and order any other lab or radiology exams. These orders would not need to be called in or faxed to the floor. The orders would be input by the physician and each corresponding

department would be notified instantly of the request or change. The doctor would also get a confirmation stating the orders were successful; eliminating any guesswork as to when or if the nursing staff received the message.

All these exciting new technologies at McCurtain Memorial Hospital are focused on improving the quality of care delivered at McCurtain Memorial Hospital. Each system is designed to save time, protect you and your information, and reduce the chances of error, not to mention the reduction in cost. McCurtain Memorial Hospital is committed to bringing you the most up to date and current technologies designed to improve your safety and quality.

The primary need of the ½ cent sales tax is for the purchase of needed capital equipment. These purchases will not only replace worn out, obsolete equipment but will assist in providing new capital equipment for new services which will be offered at the hospital. Modern equipment and technology is needed for our continual survival and for the delivery of quality care. We are fortunate at McCurtain Memorial Hospital to have been able to operate profitably over the last five years. Most rural hospitals like ours can not make that statement. In fact, many are closing or cutting back on

services. However, in order to assure that our hospital continues to be profitable, we must spend some money improving our operations. The three major components of a hospital include facilities, equipment and qualified personnel. All three of these are necessary for the successful (profitable) operation of any hospital. The ½ cent sales tax focuses on the equipment. The building (facilities) component is being addressed by the Board through their pursuit of $20 million in debt financing to essentially provide the community with a new healthcare facility. The qualified personnel piece is

being provided by the hospital through their extended emphasis of quality care and customer satisfaction (see related article) and physician recruitment. The equipment is the piece for which your help is needed. The hospital will be starting three new services following the remodeling and renovation. They will need equipment for orthopedics, for cardiology and for urology. Although the hospital has been profitable, it does not have the wherewithal to tackle the remodeling ($20 million) and purchase equipment also. New and replacement equipment will run into the millions over the seven year period of the

extended sales tax. Taxpayers will not be responsible for the $20 million borrowed by McCurtain Memorial Medical Management, Inc., the operator of the hospital on a day to day basis. Even in the unlikely event of a default, the taxpayors are not responsible. The ½ cent sales tax revenue will not be used for any day-to-day expenses like salaries. Contrary to the beliefs of some, the taxpayers do not pay anything toward salaries at the hospital. The only thing the taxpayers hav ever paid for is the purchase of some equipment over the last five years from proceeds from the ½ cent sales

tax. Here are some of the facts about the sales tax proposistion: The Tax Will:

Be only a temporary extension of an existing tax. The tax would be extended from July 1, 2009 and last for only 7 years. Be used by the hospital to pay for equipment and/or capital improvements only. Be countywide. This will include all tourists, too. It is estimated that 30% of this tax will be paid for by purchases made by non-residents. Be fully accounted for by the McCurtain County

Hospital Authority; a five member board appointed by the County Commissioners.

WHY DO WE NEED THE ½ CENT SALES TAX?

The Tax Will NOT:

Be used to pay for employee salaries. Increase during the seven years. Be used for any hospital operating expenses. Be spent for any other purpose except what is authorized by the proposition.

One Tuesday, March 3rd, you will have the opportunity to vote on the continuation of the ½ cent sales tax that will benefit the hospital, our patients, and the community. Please Vote Yes.

Page FourLOOKING ON THE INSIDE

landscapes and Portraits In Health

Organizations grow andchange just as most people do.Without growth and change,organizations become stagnantand eventually die out.McCurtain Memorial Hospital isout to prevent that fromhappening to your hospital, anecessary and vitally imponantpart of your communityheallhcare.

Not only are we updatingthe physical facilities andexpanding service lines in thenear future, we are giving ourhospital an "internal" makeover.We are continually looking forways to improve how weprovide service to you, ourcustomer. Sometimes Ihisrequires stepping out of the boxf.,r enough to look on the insideand perhaps gain a beneT

perspective of how ourcustomers see us. Our goal,particularly during this growthand construction period, is tocontinue providing 9!!!ili!Ymedical care to our patients.

We are committed toproviding our customers withthe best experience they canpossibly have in a healthcaresctting. As Deanna Campbell,our own Director of Quality

Control puts it, "Meaningfulquality experiences are not justadequate service. They arecreated through a deliberatecommitment to moving beyondwhat'scxpected."

With this in mind, we arestriving to create an atmosphereand culture that is caring andpleasant to our customers, guestsand employees alike. Culturerncctings in every department,

mal1llgemenl classes offered toemployees, quality controlprograms, employee wellnessprograms, a walking track opento the public and even thisnewsletter as a communication1001 are all ways we endeavor toaccomplish this.

In addition, we realize theimportance of listening to ourcustomers. Through the use ofPress-GaTlCy swveys and patient

advocacy we make everyattempt to address yourconcerns. We understand Ihevalue of constructive criticismand our intention is to learn andgrow from it. We encourageyou to help us to help you andlook forward to setVing you andyour families.

PROPOSED PHASING FOR REMODELING PROJECTDne of the difficult issues associated with remodeling ahospital is that it still must be operational while the remodeling is occurring. The schematic drawings below show how the phasing will occur in five different stages.

=\;l-The 1st floor remodeling will consist entirely of Phase I. This willconsist of the completion of our rehabilitation center which includesphysical therapy, spmhtherapy, cardiac rehabilitation, respiratDry.speech, and occupational therapy.The rehabilitation center will also provide aquatic therapy for

orthopedic, post surgical and reconstructive patients.Due to the increase in laboratory volume, it is necessary to

remodel and expand the laboratory to handle additional volume andnew procedures. The lab is also located on the first floor (seeabove).

The second story remodeling includes four different phases because the entirefloor will be remodeled while being in use at the same time.Phase I includes a 2 story addition atop an existing structure which will become

part of the expanded surgical department allowing us to perform orthopedicsurgery. Phase 1will also indude remodeling the patient rooms on the right wing.Phase 2 will include remodeling of the existing surgery suites and the 2nd floorcenter wing patient rooms. Phase 3 will consist of the development and relocationof a new pharmacy which is currently located on the 3rd floor.

Finally, Phase 5 calls for the remodeling of patient rooms on the second floor. leftwing.

-i!!!'--

The third floor remodeling will include the completion of the two storynew construction which will house a 5 unit lCU department (Phase 1.Green).

Phase 2 will include the third floor center wing patient rooms (whichwill be done at the same time as the 2nd floor center wing). Phase 4 isdesigned for a new DB/Women's department Bnd Phase 5 includes theremodeling of the third floor left wing which crsates new lDRP rooms or'birthing suites' which allows the mother to stay in one place during herenlirestay

WE BELIEVE THAT IN AODITION TO OUR MANOATE TO PROVIOE THE BEST CARE POSSIBLE TO THE CITIZENS OF MCCURTAIN COUNTY. WE ALSO HAVE AROLE TO PLAY AS ACORPORATE CITIZENI'lease conSI(ler the tollowmg:

· This tax is not an expense, but an investment in healthcare.

· The money will assist the hospital to grow and provide additional services like onhopedics, cardiology, urology and physical rehabilitation right here in McCunain County.

· A strong hospital will attract future economic devclopmcnt and growth in the county.

· By investing in McCunain County's health care system we will have a healthier population, more productive people and improved quality of life.

· Investing in our hospital will assure that it will continue to be a strong economic force in our community with a payroll ofover $8 million annually.

· Investing in our hospital is investing in jobs with over 250 employees currently on the payroll.

· Investing in our hospital is investing in future job growth. Perhaps for your children or grandchildren.

· These benefits far outweigh the cost of 50 cents for each $100.00 of taxable purchases.

The Sales Tax Renewal.

Please Support Your community

on March 3rd and Vote YES For

EMPLOYEE NEWSDID YOU KNOW?

In January, Brenda Parton, CDO and Pam Johnson, CNOattended the Certified Healthy Business AwardsRecognition Luncheon at the Governor's Pavilion inOklahoma City where the hospital received the-Certificate of Merit Award- in the second highestaward category. After further review, the OklahomaHealth Department's Turning Point Council hasdetermined that McCurtain Memorial Hospital wasinitially not given credit for all its healthy businessinitiatives and actually should have received the highesthonor of -Excellence Award" during the awards luncheon.Larry Olmstead, Director of the Oklahoma Turning PointInitiative apologized for the error and congratulatedMcCurtain Memorial for being honored in the highestcategory among only 4 other businesses statewide. Aplaque recognizing McCurtain Memorial's ExcellenceAward will soon arrive.

PEOPLE AND PLACESo Barbara Battiesl. Bright Beginnings. attended a workshop

entitled 'ParenlS as Teachers ~ Issues in Working with TeenParentS' February 2nd & 3,.l in Tulsa.

o Parents Suppon Group Meeting was held February l3'hat 3 pm at the Kidz Konage

o Nonh Tower Open House was held on February 13th

NEW HIRES.. Jackie Morgan. Registration... Jill Ebahotubbi. LPN, Home Heallh

ANNIVERSARIES.:. Margie (Business Services) and Hud Pratt. 22 years on February Sth.:. Dana (CID) and Christine Stowell. 13 years on February 14[1,.:. Rose (Home Health) and Harold Strange. February 14[1,

CURRENT EVENTS• Blood Drive with OBI at MeCunain Memorial Hospital

on March 3«1 from noon to 6 pm.• Wellness Testing for McCunain Memorial HospiWI

cmployccs will be held in March.

PLANNING FOR THE FUTUREA recent meeting of officials from Southeastern Oklahoma State

University and McCunain Memorial Hospital to discuss a joint venture toprovide a clinical training program for laboratory technicians.

Lcft to Right: Marsha Grecn. RN. MS. Consultant with Somhcastcm Oklahoma StatcUniversity (SOSU); Dr. Doug McMillan. Vicc President for Educational Omreach andProject Development at SOSU; Jane Harding. Idabel Sitc Coordinator for EastcrnOklahoma State College (EOSC); Dr. Karen Harrison. Vice President for AcademicAffairs for EOSC; Drit Messer. CEO of McCurtain Memorial Hospital; Druce King.Academic Advisor at SOSU. McCurtain County Campus; Dave Davis. LaboratoryManager at McCunain Memorial Hospital: and Dr. Cathy Stewan Lightsey. Instructor atSOSU. McCunain County Campus.

1

Landscapas and Purtraits in HaalthPublished for the employees and friBnds

McCurtain Memorial Hospital

Brit MessBr, CEOlesliB McGovern. Design Bnd Layou

Editorial Board

Wanda AdamsKena Allen

Martha AndersonFrank DrobilPam JohnsonPaula Knox

Julie MatthewsJahni TaplsyRay WhitmoreTom Williston

Published by McCurtain Memorial Hospital.Idabel. 0

All Rights ReservedCopyright ZOOS

Contact Infonnation:Phone 580-208-3100

Fa" 580-208-3199

E-mail: adm@mmhohoWebsite: MMHohom