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Transforminghealthcaretobestservethepeopleofourregion.SPECIALISSUE2013FacebookisaregisteredtrademarkofFacebookInc.YourRegionalHealthcareResourceThisspecialissuefocusesontheadvancesthattransformedConcordHospitalfromthecommunityhospital20yearsagotothehighlyrespectedregionalhealthcareresourceitistoday.CONTINUEDONPG2wehavecontinuedtoanticipatewhatisaheadarmingourroleasaleader.excerptfromConcordHospitalAnnualReport1993LeadershipMessageConcordHospitalisacharitableorganizationwhichexiststomeetthehealthneedsofindividualswithinthecommunitiesitserves.MISSIONSTATEMENTrearmedbyBoardofTrustees9232013 ADVANCESSPECIALISSUE20132CONTINUEDFROMFRONTCOVERThattransformationbroughtConcordHospitalanditspatientsalevelofadvancedmedicalcareunseeninacommunityhospitalhelpingattractskilledmedicalstaffandasaresultpatientsfromfarbeyondthe25communitiesintheHospitalsprimaryservicearea.WithresponsiveandattentiveleaderswhovaluethemedicalneedsofarearesidentswhotrustthemformedicalcaretheHospitalitselfexpandedandestablishedCentersofExcellenceinorthopaedicscancercardiacwomenshealthandurology.TheseexpansionsclearlymadeConcordHospitallargerenablingittoprovidethemedicalservicesneededtocareforitsneighbors.AdvancesinmedicaltechnologyP12aresupportedbystunningleading-edgeadvancesininformationtechnologyP4complicatedterritoryinwhichConcordHospitalisarecognizedandhonoredleaderinthenation.Largelyunseenbypatientsthosecrucialadvanceshelpguideourmedicalprofessionalstoprovidethebestandsafesttreatment.ConcordHospitalalsohasbecomealeaderinmedicaltrainingP8offeringafamilymedicineresidencyprogramthatbringseagernewdoctorsandtheirexpertisetoourcommunity.UnderpinningadvancesintechnologystaffandcareisacultureofcollaborationP18inwhichtheprofessionalswhotreatpatientsplayavitalroleinthedecisionsaboutthetechnologytheybelievewillbestsupportpatientcareandthekindsoftreatmenttooffer.ThatcollaborationdoesnotstopattheHospitalwalls.ItextendstomedicalprovidersthroughoutcentralandsouthernNewHampshireandbeyond.Ithelpedunite238providersat27locationsinanextraordinarypartnershipthatbecameConcordHospitalMedicalGroupCHMG.ConcordHospitalisabouttoundergoanothermajortransitionasitsPresidentandCEOMichaelB.Greenstepsdown.InlargepartConcordHospitalreacheditspositionofmedicalexcellencebecauseofMikesvisionbasedonmedicalneedsidentiedinthecommunityandhisinsistencethatmedicalstaffandleadershipbeengagedindecisionsthatmovedtheHospitalforward.ConcordHospitalJimandMarianneCookEmergencyDepartmentConcordHospitalWalk-InUrgentCareCHMGSpecialtyCarelocationsCHMGPrimaryCarelocationsThisissueofAdvanceshonorsthe21-yeartenureofPresidentandCEOMichaelB.Greenandacknowledgeswithgratitudethemanyadvancementsmadepossiblethroughhisvisionaryleadership.regionalearlyactivationcareteam 3MichaelLynchMDBOARDCERTIFIEDINEMERGENCYMEDICINEAtConcordHospitalwecontinuallyfocusonthemedicalneedsofourcommunityandthechanginghealthcareenvironment.WhethercareisreceivedataprimarycareprovidersoceourWalk-InUrgentCareCenterEmergencyDepartmentorduringaninpatientHospitalstayweremaincommittedtointegratingandimprovingcarecoordinationforeverypatient.MichaelLynchMDConcordEmergencyMedicalAssociatesPA 4NearlytwodecadesagoConcordHospitalsleadershiprecognizedthatharnessingmedicalinformationandmakingitavailableelectronicallytocaregiversandpatientswouldhelpprovidebetterandsafercare.AllHospitaldepartmentsembracedtheapproachdevelopinganentirestaffthatisengagedinusingthetechnologywithonegoalimprovingthequalityandsafetyofpatientcare.TodayConcordHospitalisrecognizednationallyasaleaderinusinginformationtechnologytohelpkeeppacewithstrikingchangesinhealthcareadministrationandmedicaltreatmentaspatientsfacemorecomplexillnessesandmoreintricatetreatmentoptions.InformationtechnologyisingrainedineveryHospitaldepartmentbutforemostitensuresthesafetyofpatientsinallaspectsoftheirHospitalstayfromalertingnurseswhenpatientsunexpectedlyleavetheirbedstoalertingdoctorsifacontemplatedprescriptionmaycauseaseriousreaction.AtConcordHospitalinformationtechnologyisnotacomputerthathelpssavetimeandmoneyitsacomplexsystemthathelpssavelives.InformationTechnology2002-2013ConcordHospitalhasreceivedMostWiredrecognitionfor12consecutiveyears.MostWiredisanationalprogramwhichrecognizeshospitalswhoseuseofinformationtechnologyexcelsinfourcategoriesclinicalqualityandsafetyclinicalintegrationbusinessandadministrativemanagementandinfrastructure.ConcordHospitalisamongvepercentofthe6000hospitalsintheUnitedStatesthatconsistentlyachievethisrecognition.2010ConcordHospitalearnedtophonorsinanationalcompetitionforusinginformationtechnologytoachievesignicantimprovementsincaringforhospitalizedpatientswithdiabetesbyreducingvariationsintheircare.ThecompetitionsponsoredbyMcKessonCorp.showcasedachievementshospitalshavemadeinpatientsafetyandcareprocessesthroughtheuseofComputerizedProviderOrderEntry.201320054571INCREASEDPARTICIPATIONHavingremindersbuiltintotheElectronicHealthRecordofpatientsaged50-75helpedtodramaticallyincreasethenumberofpatientsreceivingcolorectalscreeningteststhatcouldultimatelyhelpsavetheirlives.The2013MostWiredSurveyisconductedincooperationwithMcKessonCorp.ATTtheCollegeofHealthcareInformationManagementExecutivesandtheAmericanHospitalAssociation.ADVANCESSPECIALISSUE2013 5ComputerizedProviderOrderEntryCPOEIn2007ConcordHospitalbecamethersthospitalinNewHampshiretoimplementComputerizedProviderOrderEntry.Thesystemallowsdoctorstoelectronicallyenterprescriptionandtreatmentordersreducingerrorsthatmayoccurfrommisinterpretationofhandwrittenclinicalorders.CPOEalsoprovidescaregiversalertstopotentialadversedrugreactionsandduplicatetestsandinsuresthatdoctorsareawareofevidence-basedtreatmentpracticesforanygivenpatientcondition.InformationTechnologyApproximately100000ordersamonthareenteredusingtheCPOEsystem.Nationallyweareamonganelitegrouprepresentingonlyvepercentofhospitalsinthecountrythatcandemonstrateimprovedqualitythroughoutoutpatientandinpatientsettingsthankstosuccessfulimplementationofadvancedcomprehensiveinformationtechnologysystems.excerptfromConcordHospitalAnnualReport2007LeadershipMessage 6ADVANCESSPECIALISSUE20132008ConcordHospitalwashonoredbytheAssociationofMedicalDirectorsofInformationSystemsAMDISforusinginformationtechnologysystemstoimprovethesafetyandqualityofmedicalcare.Measuredoutcomesincludedimprovingthequalityofdiabetesheartandstrokecareincreasingratesofcolorectalcancerscreeningsforappropriatepatientsandenhancingsmokingcessationcounseling.ElectronicHealthRecordConcordHospitalMedicalGroupCHMGhealthcareproviderselectronicallydocumenteachpatientsvitalhealthinformationtestresultshealthhistoryandend-of-lifetreatmentpreferencesbuildingahealthrecordthatisreadilyavailabletoall238CHMGprovidershelpingensuretimelysafequalitycare.ForpatientshospitalizedatConcordHospitalasuiteofintegratedsystemshelpsmedicalproviderssecurelymanageeachpatientscareimprovingqualitysafetyandefciency.ConcordHospitalMedicalGroupConcordHospitalSECUREACCESStoPatientInformationHealthRiskPromptHealthActionPrompt2009MikeGreenwasawardedtheCEOInformationTechnologyAchievementAwardbyModernHealthcaremagazineandHealthcareInformationandManagementSystemsSociety. 7MedicationBarCodingSystemThiscomplexsystemensuressafetyandqualitytreatmentbytrackingmorethan1.2millionmedicationdosesayearatConcordHospitaltoconrmtheverightstherightpatientreceivestherightdoseoftherightdrugattherighttimethroughtherightroute.Ifanyoftheveareinaccuratethecaregiverreceivesanalertpotentiallyavoidingadangerousdrugerror.SinceJuly201099ofthemedicationdosesweadministerusingbarcodingensuretheverights.99InformationTechnology 8ForrestD.McKerleySimulationandEducationCenterADVANCESSPECIALISSUE2013AdvancedTrainingandGraduateEducationConcordHospitalvaluesthecrucialrolethatcontinuousimprovementandeducationplaysinenhancingpatientcarecosteffectivenessandpatientsatisfaction.Ourcommitmenttohelpingtrainnewdoctorsnursesandothermedicalprovidersandensuringthosealreadyprovidingclinicalcarestayup-to-dateinacomplexmedicalenvironmentareimportantelementsintheHospitalsroleasaregionalhealthcareresource.TheNHDartmouthFamilyMedicineResidencytheStatesonlyfamilymedicineresidencyprogrambringsnewdoctorstothecommunitymakingprimarycaremoreavailableforarearesidents.TheHospitalworksdirectlywithnursingschoolstoprovideclinicalandclassroomtrainingandofferscomprehensivetrainingforsurgicaltechnicianswhoparticipateinmanytypesofsurgery.Currentmedicalstaffmembersndopportunitiesforcontinuingeducationandadvancedcerticationtomakethebestuseofmedicaltechnologyinmanyareasincludingmanagingtraumaandstroke.ThetrainingproducesthetalentedhealthcareproviderswhowillbeleadersandinnovatorsasConcordHospitalandthemedicalworldsharpenthefocusonkeepingpeoplewellinsteadofonlytreatingthemwhentheyareill.Patientsbenetbecausetheirhealthcareprovidersareimmersedinaculturethatpromotesandpracticesthebestpossibletrainingtechniques.TeacheshealthcareprovidersrstrespondersmilitarypersonnelandSWATteamslife-savingskillsteamworkcommunicationcrisismanagementandclinicaldecision-making.High-techhumanpatientsimulatorsblinkspeakbreathehaveaheartbeatandmirrorhumanresponsetoproceduressuchasCPRandothermedicalinterventions.Promotesexcellenceinmedicalcareimprovespatientsafetyandtreatmentbyhoningclinicalteamperformancewithrealistictrainingscenarios.PhotocourtesyofCAEHealthcareCaesaristhenewesthumanpatientsimulatorbuiltfortraumaanddisasterresponse.OurForrestD.McKerleySimulationandEducationCenteracquiredCaesarthroughConcordHospitalTrustfundraisingeorts. Wehavecreatedanenvironmentwhichreinforcesteamworkpersonalandprofessionalgrowthcreativityresourcefulnessandaccountability.Aboveallwewanttobuilduponourcommitmenttoyou.excerptfromConcordHospitalAnnualReport1996LeadershipMessageSince2007nearly7000healthcareproviderencountershaveoccurredattheCentertrainingindividualsinskillssuchascardiaclifesupportpsychiatricemergenciesandtrauma.ManyArmyandNationalGuardpersonnelalsohavereceivedadvancedmedicaltrainingbeforebeingdeployedtoserveintheglobalwaronterrorism.AdvancedTrainingandGraduateEducation9 NHDartmouthFamilyMedicineResidencyConcordHospitalofferstheStatesonlyfamilymedicineresidencyprogramtheNHDartmouthFamilyMedicineResidency.WearetrainingfamilyphysicianswhowillcareforourcommunitysfuturegenerationsasmanyofourResidencygraduateschoosetopracticeintheConcordarea.AnevengreaterbenetistheseResidentsaredevelopingtheirexpertisewhilealsoaddressingacommunityhealthneedaccesstoprimarycarefortheuninsuredandtheunderinsuredatConcordHospitalFamilyHealthCentersinConcordandHillsboro-Deering.27115familyphysicianshavegraduatedsince199764arepracticinginNH44inunderservedareas27areonConcordHospitalsmedicalstaandpracticingintheConcordareaLauriAnnMaitlandDOMPHConcordHospitalMedicalGroupFamilyTreeHealthCareWarnerCompletedherresidencytrainingwithNHDartmouthFamilyMedicineResidencyin2001.TolearnhowtheFamilyMedicineResidentshelpfulllourmissioneverydaywatchourcommunitybenetsvideoatconcordhospital.org.ADVANCESSPECIALISSUE201310 11AdvancedTrainingandGraduateEducationLeanOurstaffleadershipandmedicalstaffaretransforminghowtheyapproachtheirworkandultimatelyhowourpatientsarecaredforthroughtheimplementationofLean.WithrootsoriginatingfromtheToyotaProductionSystemTPSLeanisaphilosophyofstructuredimprovementaimedatincreasingthevalueofourpatientsexperiencebyimprovingqualitysafetytimelinesseffectivenesssatisfactionandnancialimpactwithconstantfocusondeliveringthebestmostcompassionatecarepossible.OurcurrentLeanworkinvolvesthePeri-OperativeprocessspecialtypracticeandsurgicalservicesandtheEmergencyDepartment.SurgicalTrainingConcordHospitalenhancessurgicaltrainingbyservingasthecorerotationsiteforDartmouth-HitchcockMedicalCenterssurgicalandurologyresidents.SeveralConcordHospitalsurgeonshaveprovidededucationsupportandtrainingtomorethan150residentphysicians.NursingEducationWetakeprideinbeingpartofalifelonglearningjourneyforournurseshelpingthemapplytheirnursingschooleducationwhentheyarehiredandenhancingitwithadvancedtrainingthroughouttheircareer.ConcordHospitalseeksoutthemostskilledknowledgeableandcompassionatenursestobepartofourhealthcareteamandsupportsthemthroughtrainingandrecognitionofajobwelldone.OurNurseResidencyProgrameasesthetransitionofnewlygraduatednursesfromtheclassroomtotheclinicalworldoftheHospital.NewnursesgraduallyassumeresponsibilitiesandapplynursingskillswithexpertguidancefromourNursePreceptorscontinuingtheirtrainingandensuringqualitycareandsafetyforpatients.ConcordHospitalAdvancementinNursingProgramCHAINrewardsexcellenceinnursinginclinicalcareleadershipandeducationhelpingtheHospitalrecruitretainnurtureanddevelopahighlycompetentandengagednursingstaff.TheCHAINprogramencouragesnursestovoicetheirsuggestionsonpatient-focusedimprovementsandsafety.MyRN3focusonpatientfallspreventionallowedmetoworkcollaborativelywithmostofourinpatientunitsoneortstoeliminatepatientfallsriskthroughinterventionalmeansforbetteroutcomes.RyanKosowiczRN3 ADVANCESSPECIALISSUE201312Applyingthenewestmedicalscienceandtechnologyhelpsphysiciansensurehealthcareexcellence.AtConcordHospitalitsalsohelpingsavelives.State-of-theartdevicesareaddingunprecedentedprecisiontohelpdoctorsdiagnoseandtreatamultitudeofdiseasesandailmentsincludingcancercomplexheartabnormalitiesobstetricandgynecologicconditionsorthopaedicinjuriesandslow-healingwounds.Thatprecisionenablesdoctorstoapplyhighermoreeffectivedosesofradiationtoghtcancermeaningfewertreatments.Itenablessurgeonstoperformproceduresthroughtinyincisionsmeaningsafersurgeryandshorterrecoverytime.Medicaltechnologyalsomeansarearesidentsarereceivingspecialtycareandadvancedtreatmentrightintheirowncommunity.AnditprovidesanothermajorbenetallowingConcordHospitaltoattractthemosttalentedmedicalprofessionalsmakingourhighly-trainedmedicalstaffevenbetteratprovidinghigherqualitycompassionatecare.EectiveUVDisinfectionInourongoingefforttoimprovepatientsafetyConcordHospitalbecamethersthospitalinNewHampshiretouseinnovativegerm-killingtechnologytoreducepatientinfections.TheXenexroomdisinfectionsystemusesultravioletlighttokillanygermsleftbehindafteratraditionalthoroughcleaning.TechnologicalAdvancementsConcordHospitaldisinfectsanaverageof20-25roomsadaywiththeXenexsystem.Inmid-2013ConcordHospitalsetanationalrecordforusingthetechnologycleaning62roomswithonemachineina24-hourperiod.MarkGrinSupportSpecialistConcordHospitalEnvironmentalServices 13TechnologicalAdvancementsManyhospitalspursuenewtechnologybutfewhaveaseectivelyimplementedaswideanarrayoftechnologywithasmuchcollaborationandsuccessaswehaveatConcordHospital.Itstartswithourpeople.excerptfromConcordHospitalAnnualReport2008LeadershipMessageRadiationOncologyAdvancementsOurPaysonCenterforCancerCarecontainssomeofthemostadvancedtechnologieswhichaidouroncologyexpertsinadministeringdosesofradiationtodestroycancercellstargetedtoavoiddamaginghealthytissue.StereotacticBodyRadiationTherapyLikethespokesonawheelwiththetumoratthecentermanylowdosesofradiationpassthroughnormaltissueandconvergeatamuchhigherdoseatthetarget.Withmoreprecisetargetingmoreprecisemethodsofkeepingthepatientimmobilelowerdosesofradiationpassingthroughnormaltissueandahigherdoseofradiationdeliveredtothetumorpatientsrequirefewertreatmentssufferlessdamagetosurroundingtissueandseecureratesequaltosurgeryinselectedpatients.imagesshownrightTargetingProstateCancerWhenthePaysonCenterbecameoneoftherstinthenationtouseResonantMedicals3Dultrasoundguidedradiationtherapyprostatecancerpatientsbenetedrightaway.Thesystemallowsradiationoncologiststovisualizetheexactpositionofatumorbeforeeachtreatmentanddeliverpreciseexternalbeamradiationtherapytothespecicarea.BrachytherapyInthisminorsurgicalproceduretinyradioactiveimplantsorseedsareplaceddirectlyintheprostateglandprovidingpreciselytargetedradiationtocanceroustumorswithamuchlowerriskofdamagingsurroundinghealthytissue.Radiationoncologistsandurologistsworktogethertoimplanttheseedseachofwhichissmallerthanagrainofriceandoftenresultinprostatecancerpatientsavoidingmajorsurgerysufferingfewersideeffectsandexperiencingresultsatleastasfavorableassurgery. ADVANCESSPECIALISSUE201314ElectrophysiologyCardiologySuiteCardiacpatientsfromthroughoutcentralNewHampshirehaveagreaterchanceofhavinganimprovedqualityoflifeandreturningtonormalactivitiesthankstotheElectrophysiologyCardiologySuiteatConcordHospital.Advancedtechnologyhelpsitsexpertphysiciansperformproceduresthatpreviouslywerefoundonlyinmajoracademicorresearchhospitals.TheSuiteopenedin2011expandedtheHospitalsabilitytotreatavarietyofcomplexheartconditionswithouttheneedforopen-heartsurgery.Patientswithirregularheartrhythmscausedbyextratissueinsensitiveareasoftheheartnowbenetfromtreatmentsincludingradiofrequencywhichburnsthetissueandcryoablationwhichfreezesthetissuetorestorenormalheartrhythms.Dr.AdamChodoshrightsimulatesperformingaprocedureintheElectrophysiologyCardiologySuite. TechnologicalAdvancements15UrologyTechnologyAtConcordHospitalCenterforUrologicCarestate-of-the-arttechnologyhelpsdoctorsprovidesafeandeffectivetreatment.NavigationalBronchoscopyThissophisticatedtechnologyallowsdoctorstodiagnoseperformbiopsiesandpossiblyremovesmallsuspiciousnodulesinapatientslung.ItusesGPS-likecomputertechnologytohelpavoidsurgerywhileaccessingthegrowthsandgivesdoctorstheopportunitytoplacemarkersortargetsaroundnoduleshelpingradiationoncologistshoneinduringtreatment.MalepatientswithenlargedprostateshavetheoptionofminimallyinvasivelasersurgerywithGreenLightLaserTherapyorHolmiumLaser.InsteadofelectricalshavingoftheobstructiveprostatetissuewithaTransurethralResectionoftheProstateTURPlaserenergycanpreciselyvaporizeandsealtheexcessprostatetissue.LasertechnologyallowspatientstohavelessbleedinganddecreasedhospitalizationtimecomparedtoTURPwithmostpatientsgoinghomeseveralhoursaftersurgery.Kidneyandureteralstonesareamongthemostpainfulconditionspatientscanexperience.In2007ConcordHospitalbecametheonlyhospitalinNewHampshirewithadedicatedon-sitelithotripterprovidingpatientsaccesstopromptsafenon-invasivetreatmentusingpreciselytargetedshockwaves.NormalProstateEnlargedProstateImageprovidedcourtesyofCovidien.2013Drs.ScottFabozziaboveinsetleftandRonaldYapaboveinsetrightofConcordHospitalCenterforUrologicCare. ADVANCESSPECIALISSUE201316TherapeuticHypothermiaPatientsarrivingatConcordHospitalwithseriousheartattackshaveagreaterchanceofrecoverythankstoadvancedtreatmentthatcoolsacomatosepatientpreservingbrainfunctionandinterruptingacomplicatedprocessthatcausesthebraintodeteriorateevenafterheartbeatisrestored.Treatmentstatisticsshowthatpatientswhoarecooledfor12-24hourswiththerapeutichypothermiaareupto49percentmorelikelytobeabletoresumetheirnormalactivities.Since201124patientssurvivedaseriousheartattackandweredischargedfromtheHospitalthankstothislife-savingtechnique.SurgeonsatTheOrthopaedicInstituteatConcordHospitaluseX-rayguidancethroughoutanteriorhipreplacementsurgerysoweknowtheexactpositionoftheimplantsasweproceed.Thisenablestheimplanttobeplacedmorepreciselyandhopefullyhelpthemlastlonger.ThisapproachisnowusedforthevastmajorityofhipreplacementcasesatTheOrthopaedicInstitute.AstudyperformedbysurgeonsatConcordOrthopaedicsfoundpatientsrecoverytobegreatlyenhancedaordingthemshorterHospitalstayslessneedforbloodtransfusionsandshorterrecoverytimes.JereyWileyMDConcordOrthopaedics TechnologicalAdvancements17Robotic-AssistedSurgeryArobotnameddaVincihasrevolutionizedmanysurgeriesatConcordHospitalenhancingtheskillofsurgeonsandoftenprovidingpatientstreatmentwithlesspainlessriskofinfectionandshorterrecovery.ConcordHospitalwasthersthospitalinNewEnglandtoacquirethedaVinciShigh-denitionSurgicalSystemwhichhelpssurgeonsperformproceduresthroughsmallincisionsforeverythingfromhysterectomiesandpelvicreconstructiontoprostatebladdercolonandkidneycancersaswellaslungtumors.Ourcommitmenttoongoingtrainingandqualityassuranceprogramsensureappropriateuseofthetechnologyandhigh-qualityoutcomes.Since2007morethan1000patientshavebenetedfromhavingdaVinciontheirConcordHospitalhealthcareteam.Dr.WilliamSantisaboveinsetofConcordHospitalCenterforUrologicCare.AnteriorHipReplacementAtTheOrthopaedicInstituteatConcordHospitalsurgeonsusestate-of-the-artequipmenttoperformmuscle-sparinganteriorhipreplacementsinwhichtheyaccessthedamagedhipfromthefrontversusthroughthebuttocksorside.Surgeonshaveperformednearly2000anteriorhipreplacementsatConcordHospitalinthelastveandahalfyears. ADVANCESSPECIALISSUE2013Simplyputacollaborationistheactofworkingwithothersonajointproject.Inthelast20yearsConcordHospitalmedicalprofessionalsthroughouttheregionbusinessesandcitizensupportersoftheHospitalhavetakenittoawholenewlevel.ForsomemedicalproviderscollaboratingwithConcordHospitalbeganasamatterofsurvivinginuncertaineconomictimes.Forothersitwasawaytoexpandservices.Forallitwasandstillisawaytonurturesustainandelevatethecareavailableinthecommunityanddoingwhatisrightforpatients.ForareabusinessesorresidentswhosupporttheHospitalanditspartnersasvolunteersornancialdonorstheircollaborationisawayofgivingbackofsayingthanksforthelife-alteringandlife-savingservicestheyhaveaccesstoinourcommunity.FortheHospitalsmedicalstaffleadershipandBoardcollaborationhassimplybecomepartofthejob.TrustingeachotherandboundbymutualrespectthemedicalstaffseniorleadershipandBoardofTrusteesworkcloselytogethertoestablishthemodelthatcementsallourjointprojects.WorkingtogethertheyhavecreatedanexpectationintheHospitalinthecommunityandbeyondthatcollaborationworkingwithothersisessentialtoprovidingthebestpossiblehealthcareforpatients.BasedontrustandthatexpectationtheHospitalandthecommunitysmedicalprofessionalsalsobecamewillingpartnershelpingeachothersucceed.ConcordHospitaltransitionedfromthecommunityhospitalof20yearsagototherespectedregionalhealthcareresourceoftodaybyaligningpartnersthroughcollaborationandtransparencyratherthanusingacompetitivemodel.ItsahallmarkthathasallowedtheHospitalanditsmedicalpartnerstokeepapatient-centeredfocuswhileadjustingtocolossalchangesinhealthcare.Itsaprescriptionforthemtocontinuetobuildpositiverelationsinsupportofevenbetterheathcareforthecommunitiesweserve.CollaborationsTeleStrokeWiththeclocktickingtowardpermanentbraindamageforeverystrokevictimConcordHospitaljoinedwithMassachusettsGeneralHospitalMGHinahigh-techpartnershipthatspeedsdiagnosisandtreatmentduringapatientscrucialrstmomentsattheHospital.TheTeleStrokevideoconferencesystemallowsdoctorsatConcordHospitalandneurologyspecialistsatMGHtoworktogethersharinglabresultsandCTscansexaminingthepatientandrecommendingtreatmentideallywithinahalf-hourofapatientsarrival.18 Collaborations19Thebestwaytopreserveourcommitmenttovalueandmaintaintheappropriateinuenceasacommunity-orientednot-for-prothealthcareorganizationwillbeforustojointogetherwithotherorganizationsthatshareourvaluesandspeakwithonevoicetopromoteandsustainourcommitmenttoserveourcommunitiesinaresponsiblefashion.excerptfromConcordHospitalAnnualReport1994LeadershipMessageSince2012wehaveworkedcollaborativelywithMassachusettsGeneralHospitalintreatingmorethan55strokepatients.Testyourknowledgeonthesignsofstrokeandhowtoreduceyourrisk.Visitconcordhospital.organdtypestrokequizinthesitesearch. ADVANCESSPECIALISSUE201320regionalearlyactivationcareteamREACTIn2010ConcordHospitalLRGHealthcareandLakesRegionEmergencyMedicalServicesformedREACTtheRegionalEarlyActivationCareTeam.WedidsobecausewerealizedthatpatientsmostatriskforcardiacarrestorpermanentheartdamagestoodabetterchanceofsurvivingifrusheddirectlytoConcordHospitaltheclosesthospitalofferingcardiaccatheterizationandinterventionaltreatmenttoopenseverelyblockedarteries.ThecollaborationturnedmedicalservicescompetitorsintopartnerswithacommongoalDoingwhatisrightforpatients.LakesRegionEmergencyMedicalServicesAmbulatorySurgeryCentersNotallpatientswhoundergosurgeryneedtobehospitalized.Thankstoseveralpatient-centeredConcordHospitalcollaborationsmanypatientsareabletoreceivetheirsurgicalcarelocallyoftentimesinamoreefcientandcost-effectivemanner.Ourcurrentsurgerycentercollaborationsinclude2000CapitalOrthopaedicSurgeryCenterlocatedintheConcordOrthopaedicsbuildingonourcampusandinDerryinpartnershipwithConcordOrthopaedics.2000ConcordEyeSurgeryCenterinpartnershipwithConcordEyeCareP.A.andConcordOphthalmologicAssociatesP.A.2004ConcordAmbulatorySurgeryCenterCASCinpartnershipwithConcordOtolaryngologyMaryHitchcockMemorialHospitalandseverallocalphysicians.2004ConcordEndoscopyCenterajointventureofConcordHospitalConcordGastroenterologyphysiciansandMaryHitchcockMemorialHospital.CommunityMedicalPractices 21CollaborationsNationalTopPerformerinPatientSatisfactionPatientsconsistentlygivehighmarkstoConcordHospitalandthecareourprofessionalsprovide.EventhenationalrmthatadministersindependentperformancesurveyshasnoticedawardingtheHospitala2010PressGaneySummitAwardforscoringinthetopvepercentnationallyinpatientsatisfactionforthreeconsecutiveyears.Theachievementisnoaccident.ConcordHospitalworkstirelesslytoengageallHospitalstaffwithkeenattentiontoeachpatientsneeds.HospitalleadersdontjustlistentheyhearthestaffandtakeeveryopportunitytovalueandappreciatetheworktheydotocontinuallyimprovetheHospitalsqualitycompassionatecarewhichresultsinhighpatientsatisfaction.Thenationalgoalistoopenapatientsblockedarterywithin90minutesofreachingahospital.ConcordHospitalREACTpatientsaverageis61minutes. ADVANCESSPECIALISSUE201322CumulativeRadiologyTrackingWithCTscanshelpingdiagnoseagrowingvarietyofailmentsradiologistsatConcordHospitalandConcordImagingCenterbeganworkingtogethernearlytwodecadesagotostorepatientsscanhistories.ArmedwiththisinformationdoctorsatConcordHospitalorinthecommunitycannowreviewtheirpatientshistorybeforeorderingaCTscanavoidingunnecessarytestingandradiationexposure.Itsahealthsafetyservicerarelyfoundinothercommunities.GettheBeatConcordHospitalConcordHospitalTrustandareacommunitiesbegancollaboratingin2011inarst-of-itskindprogramintheStatethatissavingheartattackvictimsbyprovidingeffectiveCPR.ThroughitsGettheBeatmatchinggiftfundConcordHospitalTrusthelpedprovide27LUCAS2andAutoPulseChestCompressionSystemstoredepartmentsandrescuesquadsin14communitiesinourprimaryservicearea.UsedtohelptreatheartattackvictimsonthewaytotheHospitaltherevolutionaryportableCPRdevicesprovideconsistentandcontinuouschestcompressionssometimesforextendedperiodstoapatientwhosehearthasstoppedbeating.ThisinnovativetechnologyishelpingsavevictimswhopreviouslywouldhavediedbeforereachingtheHospital.AreaCommunities 23CollaborationsConcordHospitalMedicalGroupThisfar-reachingcollaborationjoins238medicalprovidersin27locationswithacommongoalprovidingthebestandmostconvenientmedicalcaretoresidentsofCentralNewHampshire.Theeffortthatbeganasawaytohelpcompetingfamilypracticessurviveinthechallengingmid-1990sevolvedintoaprimarycareandspecialtynetworkwhoseproviderstreatapproximately80000patientsayearclosetohome.In201295percentofthearearesidentsreportedtheyhadaccesstoregularmedicalcare.238providersin27locationsTheCHMGAdvantagePlymouthNewLondonWarnerPenacookHillsboroHopkintonPembrokeEpsomLaconiaWolfeboroCONCORDRussellStrongMDConcordHospitalMedicalGroupConcordSurgicalAssociatesIfyoureaConcordHospitalMedicalGrouppatientandwanttocollaboratewithyourhealthcareprovidersonyourhealthsignuptodayforonlineaccessthroughPatientatconcordhospital.org. NonProtOrg.U.S.PostagePAIDPermitNo.256ManchesterNH250PleasantStreetConcordNH03301603225-2711concordhospital.orgAdvancesispublishedasaserviceforourcommunitymembersandfriends.2013ConcordHospital250PleasantStreetConcordNH03301Phone603225-2711TTYTDD603228-7135Assistivehearingorvisualdevicesandlanguageinterpretersareprovidedfreeofchargetopatientsandtheircompanionsuponrequest.ForaddresschangestoberemovedfrommailinglistortoreceiveConcordHospitalpublicationselectronicallypleasee-mailyourrequesttopublicaffairscrhc.org.IAconcordhospital.orgEJenniferDearbornWDavidTirrell-WysockiADDDoreenSt.LaurentPHOTOGRAPHYIMAGESCoverimagePg20centerinsetsPg21photosandBackcoveraerialimagebyRixonPhotographyPg3101115161723physicianphotosandPg19photobydavewhitephoto.comPg3architecturalphotoBruceTMartin.AllRightsReservedandcompositecloudskyThinkstockPg8HPSandCaesarphotoprovidedcourtesyofCAEHealthcarePg9photosbyJosephSt.PierrePhotographyPg12bottomXenexenvironmentshotcourtesyofDavidLaneUnionLeaderandphotoofM.Grifnbydavewhitephoto.comPg13insetleftimagecourtesyofVarianMedicalSystemsInc.AllRightsReserved.Pg15ProstateillustrationscourtesyofGreenLightAmericanMedicalSystemsInc.AllRightsReserved.Pg15topNavigationalBronchoscopyillustrationImageprovidedcourtesyofCovidien.2013Pg16Therapeutichypothermiaimage2012C.R.BardInc.Usedwithpermission.BardisaregisteredtrademarkofC.R.BardInc.Pg17HANAAnteriorHipphotoisownedpropertyofMizuhoOSIPg17daVinciSHDSurgicalSystemillustrationcourtesyof2013IntuitiveSurgicalInc.Pg19DNVcerticationsymbolpropertyofDNVHealthcareInc.Pg21AwardimagecourtesyofPressGaneyPg22bottomLucas2devicephotocourtesyofJOLIFE.2013AllotherphotosThinkstockInc.Duringhis21yearsleadingConcordHospitalMikeGreenbelievedpassionatelyintheHospitalslong-termcommitmenttomeetthehealthneedsofindividualsandfamiliesprovideamedicalsafetynetformanyassureaccesstomedicalcarebroadlyandmostespeciallyprovidethehighestqualitycarepossibleforallresidentsintheregion.TheMichaelB.GreenLegacyEndowmentwillprovideperpetualsupportfortwovitalcommunityhealthresourcesthePaysonCenterforCancerCareandtheConcordHospitalFamilyHealthCenters.Theserviceswhichwillbefundedthroughtheendowmentthatbearshisnamewereestablishedduringhistenure.Theysupporttheneedsofvulnerablepopulationsandrequireongoingnancialsubsidyandphilanthropicinvestmenttobeviable.FormoreinformationaboutthecampaigntobuildthisEndowmentortocreateyourownlegacyendowmentpleasecontactPamelaPuleoat603230-6064orppuleocrhc.org.