Methodist Hospital’s Very Important “VIP” Program

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VIP: Very Immunocompromised Patient. 

None one wants to go to the Emergency Room. The fact is, though, thousands upon thousands of people visit the ER every year. Patients come to us for treatment of the flu, broken bones, “tummy aches” and much, much more. We want you to feel safe and confident that you will receive the care you need.

But, what happens when treatment for a patient’s existing medical condition, such as chemotherapy or bone marrow transplant, causes the Emergency Room to be potentially less safe? Chemotherapy patients and bone marrow transplant patients have very low blood counts and are at a higher than normal risk of developing infections.  Conditions that bring others into the ER can be life threatening to these patients. Where do these patients go when they have an emergency? The answer: they still come to the Emergency Room at Methodist Hospital. In 2012, Methodist Hospital implemented the VIP (Very Immunocompromised Patient) Program to tend to the unique needs of our high-risk patients.

VIP cardWhat is the VIP Program? Simply put, we developed a Protocol that helps ER staff and physicians identify VIP patients allowing them to be seen and treated more quickly. This reduces the time these patients spend in the waiting room and allows rapid administration of antibiotics. The multidisciplinary team that developed and implemented the VIP Program created an identification card for patients called the “VIP Card.” The card includes the name and contact information of the patient’s treating physician so our ER physician can easily update them about the patient’s status. The VIP card is one component in what ultimately became the VIP Kit, which also includes a thermometer and hand sanitizer. VIP patients receive their kit from their physicians and are asked to present their VIP Card at the ER as soon as they arrive. If patients do not have their VIP Card or if they lose their VIP Card, they are instructed to tell ER staff that they are an oncology patient with a fever, which will also alert ER staff to the patients’ sensitive VIP status.

The VIP Program has resulted in success for a number of stakeholders. Physicians, ER nurses, oncologists and transplant physicians have found the program to be highly effective and very successful. Most important, patients and families are very satisfied with the VIP Program because it provides them with a level of assurance about what to do and where they can be connected to appropriate care in case of an emergency. The VIP Program has changed the behavior, culture and thought process behind how we treat our VIP patients. Methodist Hospital’s VIP Program received a 2013 ACCC Innovator Award. Sponsored by GE Healthcare, ACCC’s Innovator Awards recognize and honor exceptional cancer programs that exhibit forward-thinking strategic planning and have developed pioneering, replicable programs.

If you or a loved one has recently undergone chemotherapy or a bone marrow transplant, talk to your physician about Methodist Hospital’s VIP Program. For a more detailed look at Methodist Healthcare Cancer Network, a Sarah Cannon Partner, visit www.MethodistCancerServices.com.

Surviving the Holidays – Tips from a Dietitian

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Holiday Feast photo credit: flickr by ChatChowTV

Holiday Feast photo credit: flickr by ChatChowTV

Hello, All!

*deep breath*  Here we go…the Holidays.  Did you know that the average person puts on SEVEN pounds between Halloween and New Years?  There are so many things stacked up against us during this season.

First, there’s temptation.  Let’s face it, during the holidays, that little red guy that hangs out over our shoulder wins out almost every time, am I right?  At parties (oh the parties!), we submit to consuming waaay more food and booze than we ever would under non-festive conditions.  Plus, holiday foods = comfort foods = mega calories.  There’s candy everywhere you turn – at home, the office, the post office, the bank, in your kid’s pocket…And holiday marketing is just cruel (anybody want a Hershey’s Kiss or twelve?).

Also, we tend to be less active due to the discomfort from overeating, the cooler/rainier weather, and the emotional drain that the holidays have on us.  Incidentally, our altered emotional states – stressed, depressed, fatigued – often impel us to eat more as well.  Double whammy.

So, how do we navigate through this season without becoming part of the statistic?  Well…first and foremost, plan ahead. 

1)      Always keep a healthy snack on hand – a cereal bar, almonds, yogurt – for when temptation strikes.

2)      Choose your parties.  If you’re worried that you’ll have a hard time resisting temptation, limit your opportunities to be tempted!

3)      For the parties that you do choose to attend:

a.       Eat before you go.  Remember, fiber and protein will hold you over the longest.

b.      Bring a nutritious dish to share.  Salads and veggie trays are always a good idea.  Or, bring a healthier version of some of your favorites.  I’ve attached my recipe Roasted Sweet Potato Medallions with Apple-Cranberry Relish which makes a great substitute for the high-calorie, butter-laden, marshmallow-topped sweet potato casserole.  And, it can serve as a finger food at parties!

c.       Set limitations for yourself, and be specific.  For instance, I will fill half of my plate with vegetables.  I will not sample every dessert on the table; only the _____ (insert favorite treat here).

d.      Be prepared to say “NO!”  When coming up with a game plan, we tend to assume that we will only have to stand up to ourselves when faced with temptation.  However, well-meaning friends and family can be the biggest threat to our will power. If you’re comfortable with it, let your loved ones know what your plans are ahead of time. Then, visualize someone offering you one of your limitations and practice saying “no thank you.”  If they care, they’ll understand.

At the holiday gathering:

1)      Don’t mingle by the food!

2)      Fill up on fruits, veggies, lean meats, nuts and crackers.  And watch the dip intake!

3)      Be mindful of your alcohol consumption.

a.       Alcohol adds empty calories!  Stick to clear liquor/club soda, light beer and non-sweet wine.

b.      Alcohol lowers your inhibitions → Plans go out the window!

c.       Drink before your meal or during; not both.

d.      When mingling, keep a club soda in hand.  Hosts won’t offer refills, and it’s much harder to eat when you’re already holding something.

4)      Skip foods that you can eat throughout the year, i.e. mashed potatoes, rolls, etc.

5)      Cut back portions.  Just a taste will often do the trick!

6)      Don’t deprive yourself!  If you don’t allow yourself any treats, you’re more likely to splurge the next chance you get.

Bonus Tips:

1)      Avoid temptation.  Don’t bring things home with you (leftovers, candy, etc.)!

2)      Be realistic about your goals.  You may be setting yourself up for failure if you expect to lose weight this season.  Look at your social obligations and evaluate the reasonability of your goals.

3)      Weigh yourself weekly for a reality check!

4)      Remind yourself:  Dieting is NO fun!  It’s much harder to undo damage than to prevent.

5)      Forgive yourself and move on.  If you do find yourself overindulging, avoid the tailspin of a defeatist mentality.  Yes, you broke your plans.  This does not make you a bad eater!  If you had one bad meal/day, be “good” for the next four and you’ll be on track 80% of the time!  (Doesn’t that sound nicer than “I blew it?”)

Happiest of Holidays to you all!

Molly Seys, RD, LD
Clinical Registered Dietitian
Methodist Texsan Hospital

Special Training for Hospital Staff Emphasizes Emotional Needs of Survivors of Sexual Assault

The statistics are shocking;

-        Sexual assault claims a victim every 45 seconds

-        One in every four women will be sexually assaulted in her lifetime

-        One in every seven women will know someone who has experienced sexual assault

Since its inception in 1998, the Sexual Assault Response Team at Methodist Specialty and Transplant Hospital has provided specialized care to more than 11,000 patients, ages 13 and older who arrive as victims, but emerge as survivors.

At the helm of this pioneering effort in health care is Shelley Botello, RN, BSN.  Botello has worked to unite hospital staff and law enforcement to form an extraordinarily comprehensive approach to caring for the physical and emotional needs of patients who arrive at the unit while providing the District Attorney’s office the evidence needed to improve sexual assault conviction rates.

As a result of the program’s unique approach and success, Botello has been invited to share information about the program with U.S. Military officials and over two dozen countries around the globe.

Through her work at Methodist Specialty and Transplant Hospital, Shelley Botello’s nontraditional approach to the care of sexual assault survivors has changed medical and law enforcement communities both here and abroad, and it is empowering individuals to join the fight against sexual assault.

Recently, Nurse Botello visited Guatemala to train local law enforcement and healthcare workers on her program.

Strategy For Preventing Sexual Assault During Fiesta

Sexual Assault Nurse Examiner Offers Tips on Ways to Diffuse Situation that Can Lead to Sexual Assault

Fiesta is a time when San Antonians party hearty.  So, if a group of girlfriends are out for Fiesta and one is drinking too much and decides to accept a ride home with a man she just met, is there anything her friends can and should do to intervene in this situation to prevent a potential sexual assault?

xboxpartygirls4Shelley Botello, RN, BSN, CA-CP SANE, SANE-A, and program coordinator for the Sexual Assault Response Team at Methodist Specialty and Transplant Hospital, a campus of Methodist Healthcare, says there is.  Bystander intervention is a new philosophy and strategy for preventing sexual assault and it’s gaining momentum as a way to effectively help a friend or stranger who may be at risk. This approach encourages people to identify situations that might lead to a sexual assault and then safely intervene to prevent an assault from occurring. By intervening with a method that de-escalates the situation, such as humor or distraction, a bystander can diffuse problem behaviors before they escalate.

“The girlfriends in our example can intervene and put their friend in a cab or take her home themselves,” said Botello.  “They also might intervene earlier when the man offers to buy her another drink—turning the perpetrator away from the opportunity to commit a sexual assault.”

Experts are encouraging the use of bystander intervention because it discourages “victim blaming” and shifts responsibility to both men and women.  Also, it encourages individuals to step in when they see people who are not making good choices for themselves or are in potentially dangerous situations.

According to Botello, Saturday is the busiest day for sexual assaults, followed by Friday and Thursday—all prime party times during Fiesta.

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