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VOLUME VOLUMEVI V ISSUE 2 3
HouseCall ST. CLAIR HOSPITAL FAMILY BIRTH CENTER
Delivering Generations of Pittsburghers for 60 Years
QA & UPCOMING HEALTH INsUrANCE CHANGEs AT sT. CLAIr.
How You Might Be Affected. Please see page 18.
Three generations of the Chiappetta family of Mt. Lebanon
inside
3D Mammography I Health Insurance Q & A I 60th Anniversary Celebration I Community Outreach Free Mammography And Women’s Wellness Day I Ask The Doctor I History Minute
Family birth center
2 I HouseCall I Volume VI Issue 3
Welcome
to theWorld! The St. Clair Family Birth Center: delivering babies since 1954
At St. Clair Hospital’s Family Birth Center, no birth is routine, and no baby is ordinary. Every delivery is a miracle, and every baby, a wonder to behold. In the Family Birth Center, the care is outstanding, and the environment matches the beauty of the work that takes place there. It is an exceptional, special place within the Hospital, artfully designed to blend the comforts of home with the clinical safety and quality of a first rate, award-winning medical facility. For families of newborns, the Family Birth Center at St. Clair Hospital is a place of welcome.
W
hen St. Clair Hospital opened its doors in 1954, those doors led
straight to the Maternity Department, right off the main lobby on the First Floor. The placement of the department in such a prime
spot reflected its significance to the brand new hospital, which was initially
developed to provide emergency care, medical-surgical care, and maternity care to the people of the South Hills. Women would no longer need to be driven long distances to have their babies; they could have them close to home, in their own neighborhood. It was the fulfillment of a dream for the people of the South Hills. Sixty years later, St. Clair Hospital still places a high priority on offering the best quality obstetrical care to the women of the community. Over the decades, many things have changed in the care of mothers and babies, but St. Clair’s commitment to providing high quality obstetrical services stands stronger than ever. The maternity unit of 1954 has undergone relocations and transformations, evolving into the freshly renovated, sparkling, state-ofthe-art Family Birth Center that now welcomes more than 1,400 newborns a year into the world. Continued on page 4
Volume VI Issue 3 I HouseCall I 3
Family birth center Continued from page 3
clinical excellence comes First At St. Clair’s Family Birth Center, clinical excellence and patient safety come first. A highly credentialed team of board-certified obstetricians and
Dr. Griffin takes pride in the high quality of pediatric services at St. Clair. “Our team of expert pediatric hospitalists provides round-the-clock
pediatricians, plus a team of expert nurses, provides the highest quality,
coverage, so families can feel confident that their baby is in good hands
advanced care to mothers and babies. The Family Birth Center staff prides
and that any problems that might arise will be skillfully managed,” she
itself on its outstanding record of safe deliveries and healthy newborns.
says. “We have 70 pediatricians on staff here who come to St. Clair to
For obstetrician Stephanie S. Brown, M.D., St. Clair is an ideal facility
provide care for their newborn patients; our hospitalists stay in contact
for childbirth. “St. Clair is a very safe place to have a baby,” she says.
with them to assure a smooth transition from the Hospital. It’s important
“We have excellent outcomes.”
to all of us that our mothers take home healthy babies. Our entire team of
St. Clair is distinctive among hospitals for the quality and range of pediatric services that complement the excellent obstetric department.
obstetricians, nurses, pediatric hospitalists, and community pediatricians works toward that goal.”
Since 1994, St. Clair has had 24-hour, in-house pediatric coverage, led by Dayle B. Griffin, M.D., a board-certified pediatric hospitalist, plus a team of pediatricians with advanced training. A pediatrician attends every
First rate Facilities and a Warm, safe environment The Family Birth Center features 11 LDRP (labor, delivery, recovery,
C-section, premature birth, and high-risk birth, such as the delivery of
postpartum) rooms, plus eight post-partum rooms that blend beauty and
multiples, and manages the care of the infants who require care in the
functionality. The rooms are ingeniously designed to camouflage the
Family Birth Center’s Level II Neonatal Intensive Care Unit (NICU). The
technology without sacrificing safety or efficiency, and are fully equipped
NICU has a nurse-baby ratio of 1:1 to 1:3, depending on acuity, and a
for emergencies. The transformation from labor room to delivery room
maximum of six babies, who may need antibiotics, oxygen, monitoring,
happens expeditiously, and most of the time, the new family stays together
or more time to grow. Every infant born at St. Clair receives a hearing
in the same room. According to Linda McIntyre, RN, MSN, director of
screening and CCHD screening, a simple yet extremely important test
Women and Children Services, the Family Birth Center environment is
that helps in the early identification of critical congenital heart defects. “I think so highly of Dr. Griffin and her team,” says obstetrician Tera S. Conway, M.D. “Knowing that an excellent pediatrician is always here, immediately available, gives comfort to parents and enhances our quality of care.”
4 I HouseCall I Volume VI Issue 3
both aesthetically pleasing and therapeutic. “We have a beautiful environment with spacious rooms that are almost twice the size of the average hospital room. The décor is homelike and tranquil, with the amenities of a hotel and the clinical safety of a hospital. Our unit is private and secure.”
The Family Birth Center at St. Clair 14 obstetricians deliver babies • Reputation for overall excellence • Highly credentialed obstetricians and nurses • Level II Neonatal Intensive Care Unit • Leading-edge labor and delivery suites • 24-hour pediatrician coverage •
All of the Hospital’s LDRP rooms blend beauty and functionality.
‘Phenomenal nurses’ The Family Birth Center offers a warm embrace to newborn families,
Women in labor receive one-to-one nursing care, and as often as
with the reassurance of a highly competent, experienced, and caring
possible, continuity is provided by having the same nurse provide
nursing staff. “If you have your baby at St. Clair Hospital, you will receive
postpartum care for the mother and her baby. Mothers receive thorough
care that is clinically excellent, personalized, and family centered. You’ll
education in infant care and feeding, and strong support for breastfeeding,
leave here feeling confident that you can take care of your baby. You’ll feel
according to Sharon. “We have lactation consultants on staff and we
supported every step of the way,” promises Sharon Johnson, RNC,
promote the benefits of breastfeeding. We also have breastfeeding
clinical supervisor of the Family Birth Center. Sharon knows of what she
classes and a support group. We encourage skin-to-skin contact at
speaks: she has 32 years of obstetric nursing experience and gave birth
delivery, and first-day pumping. Our lactation consultants are available
to all three of her own children at St. Clair. “Our professional team is our
to mothers after discharge, and our staff nurses are available 24/7 by
greatest asset. We have the best nursing staff and great obstetricians.
phone to answer parents’ questions.”
The nurses are all RNs and are cross-trained to care for both mothers
Sharon says that obstetric nursing is uniquely rewarding. “There’s
and babies. We have a sub-group of nurses who are Level II neonatal
a bond between the nurse and the parents. Helping a couple through
nurses, able to stabilize and care for babies with special needs. We have
childbirth is an intense and intimate experience; it means something
great depth of experience on our staff and nursing education is a constant.”
to the parents that you were there helping them at this incredibly important event. It can be emotional: when you see a father crying at
“
I have fIrst-hand experIence and I can say that the qualIty of the care, the qualIty of
delivery, when you place a baby in a mother’s arms for the first time. You can’t help but be moved. Emotion is part of the job.” Dr. Griffin says that the Family Birth Center’s “phenomenal nurses” are versatile, dedicated, and committed to excellence. “Our nurses take time with the mothers and give them personal care and individualized teaching. It makes a difference.” n
the rooms, the personal attentIon, and the nurse-patIent ratIo
Continued on page 6
are second to none.
”
NEW MOM CATHERINE O’HARA, M.D., HOSPITALIST IN INTERNAL MEDICINE, ST. CLAIR HOSPITAL
New parents Catherine O'Hara, M.D. and Benjamin Susco, M.D. brought son Nathan back to the Family Birth Center to show him to staff, including Sharon Johnson, RNC, clinical supervisor of the FBC, and Linda McIntyre, RN, MSN, director of Women and Children Services. Volume VI Issue 3 I HouseCall I 5
Family birth center Continued from page 5
Proud Parents HouseCall met with four young families who shared their respective experiences in the Family Birth Center — Mt. Lebanon brothers Tim and Tony Chiappetta, Moon Township’s Wiley family, and physicians Catherine O’Hara and Benjamin Susco of Ohio Township.
“
It was amazIng. It was everythIng they say It Is, and more. I wIll never forget Beau’s BIrth. and I wIll never forget the way that the doctors and
nurses at st. claIr took care of us.
”
ELIZABETH CHIAPPETTA
im Chiappetta is a first-time father, and
T
he, too, was born at St. Clair Hospital —
people and they were the best,” says Tim. Adds Elizabeth,
the same place where his son Beau
“The nurses went above and beyond. Our nurse was there
entered the world on Tuesday, July 8.
the whole time, for a full 12-hour shift. We had missed the
Beau arrived a bit early, at 37 weeks and
Labor and Delivery class because Beau came early, but it
six pounds, but he was strong, stable, and feeding well
enough to go home with his mother, Elizabeth, two days
parents feel as they anticipate childbirth — especially the first time. But their fear and anxiety were eased by the
needed to be closely monitored for early signs of problems.
environment and the caring competence of the staff. “I had
Every week, she came to the Family Birth Center for a
a strong sense of trust there,” says Tim. “We had a
non-stress test. When the time came, however, things
relationship with our obstetrician, Dr. Lenart; she had a
went like clockwork: her water broke at 7:45 a.m., and
calming presence. She’s awesome. She blended a nurturing
Beau was born at 7:45 p.m., with obstetrician Deborah
bedside manner with clinical skill. It made us feel safe.”
Lenart, M.D., attending the delivery. Tim and Elizabeth, both attorneys, had elected to be surprised by their baby’s gender at delivery, and Tim recalls that the real surprise was
over to watch and be the first to see the gender — that was very cool.” The Chiappettas are completely satisfied with their childbirth experience at St. Clair and would not consider anywhere else. “I’m the youngest of four and we
7/8/2014
The Chiappettas acknowledge the vulnerability that new
later. It had not been an easy pregnancy for Elizabeth;
was halfway out the doctor pulled me
CHIAPPETTA
didn’t matter because our nurse taught us everything.”
with gestational diabetes and high blood pressure, she
the way they found out. “When the baby
Beau
the security is excellent. But it really comes down to the
were all born at St. Clair. When Elizabeth and I toured the Family Birth Center, we were blown away. It’s a top-notch operation in every way. St. Clair is as sophisticated as the big hospitals and
One of the strong points for Tim and Elizabeth was the Family Birth Center environment. “It’s family centered, spacious, and welcoming. I have a large family, and everybody came. At one point we had a large group of visitors in the room. No one complained. And it was remarkably quiet! You expect noise, babies crying all day — but it was quiet and peaceful.” For Elizabeth, a highlight was the abundant natural light that streamed through the large windows. “I could watch the sunset with my baby in my arms.” Elizabeth says that Beau, at four months, is a great baby. “At one month, Beau weighed eight pounds, five ounces and was sleeping through the night — almost. He would get up once.” That nighttime wake-up was Daddy’s special time with Beau: “We would rock and listen to a Beatles lullaby CD,” Tim recalls. “Our favorite song was Across the Universe.” n Continued on page 8
6 I HouseCall I Volume VI Issue 3
Over
100,000 babies have been born at St. Clair Hospital since 1954.
Tim and Elizabeth Chiappetta with baby Beau.
Volume VI Issue 3 I HouseCall I 7
Family birth center Continued from page 6
Tony and Emily Chiappetta with baby Mary Virginia and her big sister Caroline.
8 I HouseCall I Volume VI Issue 3
6/9/2014
MaryVirginia CHIAPPETTA
“
the entIre hospItal made us feel lIke they were
there for us. we were not just passIng through — It Became ‘our’ hospItal; we felt lIke we Belonged there. the secluded locatIon of the famIly BIrth
center makes you feel lIke you aren’t In a hospItal. you feel physIcally and emotIonally secure.
”
TONY CHIAPPETTA
ony Chiappetta and his brother Tim were born
of mind in knowing that we could get to the Hospital quickly and
just 15 months apart, so they grew up doing
easily. Since we both grew up here, St. Clair is familiar to us.
T
nearly everything together. Today, they live near
I originally chose St. Clair because my doctor, Stephanie Brown (M.D.),
each other and still do things together — they
delivers there. I’ve been with her for a long time. Her partner,
even became fathers just one month apart. “On
Dr. McGranahan, actually delivered both of my babies. I have
June 9, our daughter was born, and on July 8, Tim’s son was born;
both were born at St. Clair Hospital, like us, and they were baptized
complete trust, love and respect for these doctors.” Tony, an engineer, refers to the LDRP room where Mary was born as “the corner office.” It was the last room along the hallway,
together at St. Bernard’s Church in Mt. Lebanon.” Tony and his wife Emily welcomed Mary into the world five months ago. She was delivered by C-section, performed by obstetrician
quiet and private, enabling Emily to sleep when she needed to. “I could rest and recover there,” Emily says. “The LDRP room was
Shannon H. McGranahan, M.D. “Our first baby, Caroline, now 4,
beautiful, and it was great to remain in one place the entire time.
was also born by C-section at St. Clair. That time, it was
No shuffling around from place to place. The whole FBC is incredibly
unexpected, but the doctors and nurses helped us through it.
clean; everything is spotless and brand new. I urge people to check
Dr. McGranahan delivered both girls and she
out St. Clair. We received care that was high
was spectacular! She saved Caroline, and we
quality and very personal. Sometimes hospitals
owe her a debt of gratitude.”
have that revolving door feeling. St. Clair never felt that way. Every single nurse was
The Chiappettas say they had great
highly competent and the communication
experiences at St. Clair, both times. “The proximity to home and the accessibility are
among the staff was seamless. Nothing ever
great — no long drive, no parking worries,”
fell through the cracks. And there’s a great
says Tony. “Just a quick jump from home instead of a long commute and traffic.” For Emily, the convenience put her mind at rest. “We live in Mt. Lebanon and there was peace
St. Clair’s OB Department is ranked in the top
ten percent nationally in patient satisfaction.
coffee shop (Café 4) — Caroline loved it; the cookie selection met her needs. St. Clair offered everything possible to make our experience as nice as it could be.” n Continued on page 10
Based on independent research conducted by Press Ganey.
Volume VI Issue 3 I HouseCall I 9
Family birth center Continued from page 9
5/23/2014
Josie WILEY
“
the famIly
BIrth center met every sIngle need we had. I could not have asked for a Better oBstetrIcIan, Better nurses, or a Better hospItal. It was really perfect.
”
LISA WILEY
L
isa Wiley
It just felt right and I knew
was in the third trimester of her second preg-
nancy when she made a
courageous decision: she decided that she wanted
I was in good hands. I had trust in my doctors and they are all wonderful, but I was happy when Dr. Duncan showed up.” Lisa gave birth on May 23 to a girl named
a new obstetrician and a new hospital — St. Clair
Josephine, nicknamed “Josie”; she weighed six
Hospital — in which to deliver her baby. She now
pounds, eight ounces and got off to a great start,
says it was the best decision she could have made.
breastfeeding well right away. The Wileys loved
“I was planning to deliver at another hospital, and it
their experience at the Family Birth Center. “I liked
was late in my pregnancy. You have a relationship
the size — it was just right,” Lisa says. “When my
with your doctor by then and it’s almost time for the
older daughter was born, it was at a university
birth. But I attended the women’s group at our church
medical center in Indiana, and it was busy and
and the women raved about St. Clair Hospital’s
crowded. When I delivered, there was a group of
Family Birth Center and their obstetricians. They
medical students watching and nobody even asked
encouraged me to consider St. Clair and take a
me if that was okay. On the postpartum floor, no
tour. I liked it immediately. I met all the doctors in
one ever checked on me. My experience at St. Clair
the Paul Zubritzky (M.D.) group and loved them all.
was the opposite. The nurses were attentive and
I chose Paula Duncan (M.D.) for my doctor, and
competent. I loved having such personal care.
she’s amazing. She makes me feel like I can tell
When I delivered, it was just my doctor, two
her anything.”
nurses, my husband and me. Private.”
Lisa and her husband, Adam, a commercial
The Wileys live in Moon Township and Lisa
airline pilot, moved to Pittsburgh from the state of
works in Human Resources for a national firm.
Indiana just a year ago, with their two-year-old
She says things are going well; Josie is a good baby
daughter, Jainy. It was important to Lisa to have
and Jainy loves being a big sister. She encourages
that level of comfort with her doctor. “I was in a
other mothers-to-be to visit St. Clair just as she did,
new city; I didn’t know anybody. Dr. Duncan and her
so they can see for themselves all the resources and
partners made me feel welcome and cared about.
amenities there. “The Family Birth Center is a beautiful environment. I felt relaxed and catered to. I was never hungry; the food was good and came in
All Family Birth Center rooms are private, offering sleeping
large portions! I loved the bright, spacious room. The
accommodations for fathers
I was comfortable with her going there. More people
or other family members.
nurse took Josie to the nursery so I could sleep and should experience childbirth at St. Clair Hospital. It’s clean and beautiful and the doctors and nurses are amazing.” n Continued on page 12
10 I HouseCall I Volume VI Issue 3
Lisa and Adam Wiley with baby Josie and her big sister Jainy.
Volume VI Issue 3 I HouseCall I 11
Family birth center Continued from page 10
Benjamin Susco, M.D. and Catherine O'Hara, M.D. with son Nathan.
12 I HouseCall I Volume VI Issue 3
5/16/2014
Nathan SUSCO
“
the rooms are spotless, homelIke and prIvate. I was
amazed at how they are aBle to transform the room, to convert It to a delIvery room and then a recovery room — the process Is amazIng!
”
CATHERINE O’HARA, M.D.
ull-term and weighing in at a healthy, robust eight
F
integral part of the day. All of the nurses are on the ball, and are
pounds, three ounces, Nathan Thomas Susco
nice, warm people who made my family comfortable. Everyone
entered the world at St. Clair Hospital’s Family
was kind to my husband and always included him; there was even
Birth Center on May 16. His parents, Catherine
a bed for him in my room.”
and physicians, and their experience on the “other side” of the
celebrate Nathan turning 24 hours old, with family and friends
O’Hara and Benjamin Susco, are first-time parents
The family had a “birthday party” in their hospital room to
hospital bed was entirely positive. “Working at St. Clair, I knew that
in attendance. “The rooms are so spacious that we were able
the Family Birth Center was highly regarded, with a record of
to have a group of people in there without it feeling crowded,”
excellence,” Dr. O’Hara said. “I heard good things about it from
Dr. O’Hara recalls. “The rooms are spotless, homelike and private.
friends and colleagues, and I felt reassured by knowing that
I was shocked at how they are able to transform the room, to
pediatrician Dayle Griffin, (M.D.) would be there; she has a superb skill
convert it to a delivery room and then a recovery room — the
set and I knew the right steps would be taken if there was a problem.” As a hospitalist in internal medicine at St. Clair, Dr. O’Hara
process is amazing! And they do it quickly and efficiently. But everything was done that way. I had an epidural and the timing
recognizes high quality healthcare. She and her husband, a
was just right, the anesthesiologist came right away. The lactation
cardiologist in Pittsburgh, were expecting excellence, but their
counselor held a very informative breastfeeding class; she made
experience surpassed their expectations. “My obstetricians are
my husband a part of it, too.”
with Advanced Women’s Care of Pittsburgh, and I like all of
Nathan, known as “Nate” to his family, is thriving at six
them,” says Dr. O’Hara, who hailed Advanced Women’s Stephanie
months, and Mom is back to work now at the Hospital. She is
S. Brown, M.D. for averting what could have been a serious
happy to tell others of her experience. “Things are very well done
medical emergency during Nathan’s delivery when the baby’s
in the Family Birth Center. The nurses are the best of the best —
heart rate slowed and his oxygen levels were dipping. “You realize
the entire team. They make you feel like you are the only patient,
in times like those how much you truly trust your obstetrician in
and they do everything they can for you. They work long hours
caring for both your baby and you,” she says. “And I can’t say
and things can change quickly; they have to be ready for anything.
enough good things about the Family Birth Center nurses. My
They do it all with such grace. They were so good to Nate. I felt
nurses were phenomenal. They gave me skilled hands-on care,
that I received nothing but the best from everyone in the Family
and were so responsive to my and Nathan’s needs. They were an
Birth Center.” n Continued on page 14
Nathan, Josie, Beau and Mary — four beautiful healthy babies, all growing and thriving at home, thanks in no small part to the excellence of the care that they and their mothers received at St. Clair’s Family Birth Center. The best beginnings happen at St. Clair Hospital’s Family Birth Center, an ideal setting where the most advanced technology and medical capabilities are balanced by an environment that is safe, comfortable, and nurturing.
Parents-to-be are invited to
tour the Family Birth Center. Please call
412.942.5877. Volume VI Issue 3 I HouseCall I 13
Family birth center Continued from page 13
leading Physicians oFFer advanced care at st. clair hosPital Family birth center The Hospital’s obstetrics and pediatrics services are fully prepared with the appropriate equipment, resources, and expertise.
“ Q
uality of care. It matters immensely in every specialty, and the drive to improve quality is a priority for physicians and the healthcare industry. In obstetrics,
our team of expert pedIatrIc hospItalIsts provIdes round-the-clock coverage, so famIlIes can feel confIdent that theIr BaBy Is In good hands and that any proBlems that mIght arIse wIll Be skIllfully managed.
”
DAYLE B. GRIFFIN, M.D., MEDICAL DIRECTOR OF PEDIATRIC AND NEWBORN SERVICES, ST. CLAIR HOSPITAL
quality of care is of profound importance; both mother and baby are highly
vulnerable throughout the perinatal period. Quality obstetric care means safe, healthy
passage through pregnancy, labor, delivery, and the post-partum period for the mother, and the safe, uncomplicated arrival of a healthy newborn. Choosing an obstetrician and the highest quality hospital in which to give birth is the first “parenting” decision that mothers- and fathers-to-be must make. Prospective parents may want a homelike, comfortable environment, but they also want — and need — the reassurance of clinical excellence. A high quality obstetric service has to be fully prepared for maternal and neonatal emergencies, with the appropriate equipment, resources, and expertise to address every medical issue.
st. Clair Hospital OB/GYNs ADVANCED WOMEN’S CARE OF PITTSBURGH, P.C. Shannon H. McGranahan, M.D., FACOG Stephanie S. Brown, M.D. Patricia J. Bulseco, M.D. Deborah A. Lenart, M.D. Douglas H. MacKay, M.D. Kristen E. M. Peske, D.O. MT. LEBANON St. Clair Hospital 1000 Bower Hill Road, Suite 213 Mt. Lebanon, PA 15243 412.561.5666 PETERS TOWNSHIP St. Clair Hospital Outpatient Center–Peters 3928 Washington Road, Suite 230 McMurray, PA 15317 724.941.1866
14 I HouseCall I Volume VI Issue 3
At St. Clair Hospital, says Dayle B. Griffin, M.D.,
st. Clair Hospital OB/GYNs
medical director of Pediatric and Newborn Services at St. Clair, quality has many dimensions. “The first step in finding high quality obstetric care is choosing a good obstetrician and trusting that obstetrician. Your doctor wants the best for you and your baby. It’s essential that the hospital you choose has highly skilled nurses to help you through labor and delivery, and pediatric coverage, with full capabilities to manage emergencies.” Linda McIntyre, RN, MSN, director of Women and Children Services for St. Clair, says that the decision about where to deliver is highly individualized. “Prospective parents should explore their options,
ZUBRITZKY & CHRISTY OB/GYN
talk with their obstetricians, take tours, and ask
Paul M. Zubritzky, M.D. • Tera S. Conway, M.D. • Patrick T. Christy, M.D. • Paula A. Duncan, M.D.
questions. Get recommendations from friends, but make the decision based on personal needs and preferences. The ideal setting is one that provides high quality of care through advanced technology and an experienced staff, capable of dealing with
MT. LEBANON St. Clair Hospital Professional Office Building 1050 Bower Hill Road, Suite 205 Mt. Lebanon, PA 15243 412.942.1066
ROBINSON TOWNSHIP 6000 Steubenville Pike Suite 105 McKees Rocks, PA 15136 412.788.1330
KENNEDY TOWNSHIP 1767 Pine Hollow Road McKees Rocks, PA 15136 412.331.1623
any kind of complication, and meets your need for comfort and safety.” n
SOUTH HILLS OB/GYN ASSOCIATES, INC. Sandor Mecs, M.D. Robert C. Rankin, M.D. St. Clair Hospital Professional Office Building 1050 Bower Hill Road, Suite 206 Mt. Lebanon, PA 15243 412.572.6127
St. Clair maintains
24/7 in-house pediatric coverage staffed by specially trained pediatricians experienced in handling difficult deliveries as well as caring for newborns.
ARTHUR P. SIGNORELLA, M.D. Arthur P. Signorella, M.D. St. Clair Hospital 1000 Bower Hill Road, Suite 311 Mt. Lebanon, PA 15243 412.572.6595
st. Clair Hospital 24/7 In-House Pediatricians Pediatric hospitalists at st. clair hospital not pictured are:
Dayle B. Griffin, M.D.
Sheila Clarke, M.D.
Kendell R. German, M.D.
Meredith C.G. Broberg, M.D.
Melanie Austin, M.D. Donna Bosworth, M.D. Charles Brickner, M.D. Michael Fox, M.D. Satyanarayana Gedela, M.D. Shawn Kapoor, D.O. Ashley Loboda, M.D. Kultar Shergill, M.D. Damian Ternullo, M.D. Catherine Udekwu, M.D. Pushpa Viswanathan, M.D. Volume VI Issue 3 I HouseCall I 15
imProving care through advanced technology
NEW STUDY SHOWS THAT 3D MAMMOGRAMS GREATLY IMPROVE BREAST CANCER DETECTION comprehensive new study confirms that 3D mammography—
earlier and reduces false alarms that lead to “call-backs” — repeat
such as that used at the St. Clair Hospital Breast Care Center—
screening mammograms that can create unnecessary anxiety and fear.
A
is more effective in finding invasive cancer than traditional
two-dimensional mammography. 3D mammography offers women a remarkable new breast cancer screening technology that is enabling radiologists to detect small breast cancer lesions earlier and with much greater accuracy, especially in women with dense breast tissue. Digital 3D breast tomosynthesis, more familiarly known as 3D mammography, is the most advanced diagnostic imaging technology available for the detection of breast cancer. It combines traditional digital mammography with tomosynthesis, which is similar to a CT scan. It’s a state-of-the-art imaging tool that provides far more accurate images that
According to Sherri H. Chafin, M.D., a board-certified diagnostic radiologist who specializes in breast imaging and directs St. Clair’s Breast
“
thIs technology far exceeds standard two-dImensIonal testIng and makes It much easIer to detect Breast cancer .
”
SHERRI H. CHAFIN, M.D., VICE CHAIR OF MEDICAL IMAGING, ST. CLAIR HOSPITAL
Imaging Center, 3D mammography represents a major breakthrough in breast cancer diagnosis and treatment. “This technology far exceeds standard two-dimensional testing and makes it much easier to detect breast cancer,” she says. “I am finding breast cancers which I would not have found without it. It is useful for women with dense or fatty breast tissue. 3D mammography is a wonderful technology and a great advancement.” Dr. Chafin’s experience with 3D mammography is validated by the most current research findings. An article in the June 25 issue of the Journal of the
facilitate the early diagnosis and treatment of breast
American Medical Association revealed the results
cancer. The 3D mammogram finds small cancers
of a 13-center study: the addition of tomosynthesis to digital mammography was associated with an increase in breast cancer detection rates and a decrease in recalls. 3D mammography works by taking a series of X-ray images in an arc around the breast. In a traditional mammogram, the machine is stationary and takes images from two angles only; with 3D, the X-ray tube moves in a circle around the breast while the pictures are taken, and a special computer combines the images into a three-dimensional picture, in a
Diagnostic radiologist Sherri H. Chafin, M.D. “reads” 3D mammograms at the St. Clair Hospital Breast Care Center. 16 I HouseCall I Volume VI Issue 3
“stack” of very thin, layered slices, almost like the pages of a book. It allows the radiologist to look at each slice, one thin layer at a time, and see clear, detailed, highly focused
regular screenIng Began In the u.s. In 1990. the mortalIty rate dropped By 30 percent almost ImmedIately. In 2014, early detectIon remaIns the key to survIval.
images. The thin layers
density as a risk factor for breast cancer. Women with dense breasts are likely to be diagnosed with breast cancer at later stages, when treatment is more difficult and a successful outcome less likely.
reduce the “overlapping” effect that can
Although 3D mammography is strongly
do you KnoW your density?
make interpretation of the images a
recommended for women with dense or fatty
challenge. The breast, explains Dr. Chafin,
breasts and other high risk factors, St. Clair
is a complex structure, consisting of breast
Hospital has taken the unique step of offering
tissue, fatty tissue, glandular tissue, milk
3D mammography to all patients. “At St. Clair,
Women who are concerned with their
ducts, blood vessels, and ligaments. In a two-
anyone who wants it can have it,” Dr. Chafin
heart health know how important it is to
dimensional image, all this tissue overlaps,
says. “3D mammograms are done at the
know their numbers: their blood pressure,
which can create distortions that may delay
Breast Care Center at our Outpatient Center
cholesterol level, and weight.
diagnosis. Small tumors can be overlooked
in Village Square in Bethel Park. Our patients
and go undiagnosed for another year or
can get same-day screening results. They can
longer, while they grow and spread.
wait right in the comfortable waiting area,
Furthermore, normal tissue can appear
post-mammogram, for their results.”
abnormal, and this leads to call-backs. Breast density is a risk factor for breast
Every year in the U.S., 40 million screening mammograms are performed, and most of
Now there is another number that women need to know: their breast density. This number indicates how dense the breast tissue is, and that’s important because it affects the accuracy of mammogram interpretation and is a
cancer. (Please see sidebar at right.) “Dense
these are traditional, two-dimensional digital
breast tissue and fatty breast tissue have
mammograms. More than 4 million women
nothing to do with weight or obesity; it also
will be called back for repeat screenings to
has nothing to do with the size of your
clarify the findings. The American Cancer
amount of fatty tissue and connective/
breasts,” says Dr. Chafin. “It’s like a fingerprint,
Society, American Congress of Obstetricians
glandular tissue in the breast. It is
it’s simply how you are made. Women
and Gynecologists, and the American College
determined by the radiologist who reads
of any age can have dense breasts; they
of Radiology agree that annual breast screening
the mammogram, and, in Pennsylvania,
should find out about the density of their
should begin at age 40, and earlier if a
the law now mandates that women be
breasts at their first mammogram. If no
woman is at greater risk for developing
informed of their number, on a scale
one tells you, ask. There is a Breast Density
breast cancer.
from one to four. The number is assigned
scale, mandated by the Breast Density Notification Law.”
Regular screening began in the U.S. in 1990. The mortality rate dropped by 30 percent
Pennsylvania is one of 19 states that currently have a Breast Density and Reporting
almost immediately. In 2014, early detection remains the key to survival. n
Act. The law was enacted in January of this year in recognition of the significance of breast
To schedule a 3D mammogram at the Breast Care Center, please call 412.942.8150.
factor in breast cancer risk. Breast density refers to the relative
according to the percentage of breast tissue that is composed of fatty versus dense tissue, with a rating of “one” indicating very fatty breast tissue and a “four” indicating very dense breasts with little fat. Most women do not know their
SHERRI H. CHAFIN, M.D.
breast density number, but should ask
Dr. Chafin specializes in diagnostic radiology at St. Clair Hospital, where she is Vice Chair of Medical Imaging and directs St. Clair’s Breast Imaging Center. She earned her medical degree at the Penn State Hershey Medical Center and completed her residency at Allegheny General Hospital. Dr. Chafin is board-certified by the American Board of Radiology. She practices with South Hills Radiology Associates.
about it at their annual mammogram.
To contact Dr. Chafin, please call 412 .942.3101.
Dense breasts raise the risk of breast cancer in two ways: they make cancer harder to detect, and density is itself a risk factor for cancer.
Volume VI Issue 3 I HouseCall I 17
Q & a: health insurance
QA & Revised 11/1/14
As you navigate the new health insurance landscape, make sure St. Clair is in your network. Health insurance in our region is changing rapidly, from the Affordable Care Act to the scheduled end of the Highmark-UPMC agreement. Fortunately, St. Clair Hospital makes navigating these changes easier because St. Clair participates with every major insurer in almost every product.* THAT MEANS ST. ClAir iS AN iN-NeTwork Provider FOR THESE INSURERS AND PRODUCTS. And, if you choose a health insurance product (like a high deductible health plan) that requires you to share in the cost of paying for services, you’ll be pleased to know ST. ClAir iS ofTeN THe loweST CoST Provider. So, when you choose a health plan, make sure you have one of the nation’s 100 Top Hospitals®, close to home, in your network.
in advance of annual health insurance enrollment deadlines, housecall answers key questions:
Q: WILL ST. CLAIR HOSPITAL PATIENTS BE AFFECTED WHEN THE CONTRACT BETWEEN HIGHMARK AND UPMC EXPIRES ON DECEMBER 31, 2014? 18 I HouseCall I Volume VI Issue 3
A:
No. Hospital and physician services provided at St. Clair Hospital will not be affected by the expiration of the contract between Highmark and UPMC.
QA & Q: WHAT ABOUT SERVICES PROVIDED AT ST. CLAIR’S EMERGENCY ROOM, ITS URGENT CARE CENTER, AND ITS OUTPATIENT CENTERS?
A: Again, nothing will change as a result of the expiration of the contract between Highmark and UPMC on december 31, 2014.
Q: WHAT TYPES OF SERVICES DOES ST. CLAIR HOSPITAL OFFER?
A: St. Clair Hospital and its medical staff provide a wide range of advanced clinical services, as well as women’s and children’s care.
Q: WHAT ABOUT CLINICAL SERVICES SUCH AS RADIATION ONCOLOGY AND MEDICAL ONCOLOGY IN WHICH ST. CLAIR PARTNERS WITH UPMC CANCER CENTERS? WILL THOSE SERVICES BE AFFECTED?
A: No. St. Clair’s clinical service partnerships and joint ventures with UPMC will remain in-network.
Q: WHAT ABOUT OTHER COMMERCIAL INSURERS? IS ST. CLAIR IN-NETWORK FOR THEM, AS WELL?
A: Yes. other than the exception listed*, St. Clair is in-network for every major health insurer, including Highmark, UPMC Health Plan, Aetna, Cigna, Coventry Health America, and United Healthcare.
Q: WHAT ABOUT MEDICARE ADVANTAGE PLANS,
Q: WHO SHOULD A PATIENT CONTACT WITH ADDITIONAL QUESTIONS ABOUT HEALTH INSURANCE COVERAGE AT ST. CLAIR HOSPITAL?
A: Please call the Customer Service line at 412.344.3408 to speak to a St. Clair representative.
AND MEDICAID MANAGED CARE PLANS? IS ST. CLAIR IN-NETWORK FOR THOSE PLANS?
A: St. Clair makes choosing a Medicare Advantage plan, or a Medicaid Managed Care plan, easier because St. Clair and its physicians participate with every major insurer in every product. St. Clair is in-netWorK for all of these Medicare Advantage and Medicaid Managed Care plans.
Q: IF A PATIENT WANTS TO SWITCH TO A ST. CLAIR-AFFILIATED PHYSICIAN, HOW CAN HE OR SHE FIND A PHYSICIAN?
A: Please use our physician finder at www.stclair.org/physicians/directory, or call 412.942.6560.
* St. Clair Hospital does not participate in the UPMC Advantage Select HMO/PPO/EPO products offered by UPMC Health Plan on the federal health insurance marketplace (www.healthcare.gov). St. Clair Hospital will be out-of-network for patients who select these products.
Volume VI Issue 3 I HouseCall I 19
annual Fundraiser
sT. CLAIr HOsPITAL CELEBrATEs ITs
60th Anniversary AT THE 17TH ANNUAL sUMMEr sWING EvENT
St. Clair Hospital’s annual Summer Swing event exuded a special vibe this year as the Hospital continued its year-long celebration of its 60th Anniversary. St. Clair, which opened its doors in February 1954, played host to a record-setting 550 guests in July at Summer Swing, the Hospital’s signature fundraiser. To help set the tone for the 60th Anniversary, guests were greeted at the main entrance to St. Clair Country Club by a number of vintage automobiles of the era, and junior volunteers dressed in the fashionable styles of the mid-1950s. Guests posed for photos with the classic cars before moving indoors to enjoy an evening of fine foods, live music, and a silent auction featuring an eclectic selection of items sure to make those
Posing with a proclamation from Congress recognizing St. Clair Hospital’s 60th Anniversary are: Chairman of St. Clair Hospital Foundation Board of Directors Gary J. Zentner; Thomas M. Medwig, Chairman of the Board, St. Clair Health Corporation; U.S. Rep. Tim Murphy; and Melvin D. Rex, Chairman of St. Clair Hospital Board of Directors.
who missed the party green with envy. To receive an invitation, or to be involved in the Friday, July 17, 2015 version of Summer Swing, just drop us a request at schfoundation@stclair.org. n
Jerry and Susan Dioguardi represented Summer Swing Gold Level Sponsor Aetna. 20 I HouseCall I Volume VI Issue 3
Orthopedic Surgeon Derrick J. Fluhme, M.D. (3rd from left), and Ophthalmologist Roger P. Zelt, M.D., pause with other Summer Swing guests for a quick snapshot.
St. Clair Hospital Chief Medical Officer G. Alan Yeasted, M.D. with Summer Swing Committee Chair Vicki McKenna and Hospital President and CEO James M. Collins in front of St. Clair Country Club.
Washington County Commissioner Diana Irey Vaughan and her husband, Robert, in front of one of several classic cars from the 1950s that greeted guests at Summer Swing.
St. Clair Hospital Junior Volunteers Johnny Sieber and Chloe Hoffman arriving in a 1955 Buick Special.
Volume VI Issue 3 I HouseCall I 21
community outreach
ST. CLAIR OFFERS FREE SCREENINGS AT HEALTH FAIR a s part of its ongoing commitment to the communities
it serves, St. Clair Hospital recently conducted a free
health fair at Focus On Renewal (FOR) in McKees Rocks. FOR was formed in 1969 to focus on the economic, social, and healthcare needs of the Sto-Rox community, and has been the place to turn for social services since. At the health fair, numerous men and women from the area underwent free screenings — including glucose and cholesterol, respiratory, stroke, and bone density — by clinical personnel from the Hospital. Registered dietitians, cancer experts, and other health experts from the Hospital provided one-on-one counseling to participants at education tables. n
free MAMMogrAPHY ANd woMeN’S wellNeSS dAY beNefiTS UNiNSUred woMeN s a kick off to Breast Cancer Awareness Month, St. Clair Hospital
The free mammograms were a response to a St. Clair Hospital
a
Community Health Needs Assessment, which showed a higher
Women’s Wellness Day for area women 40 and older who do not have
incidence of breast cancer in women residing in the South Hills
health insurance.
compared to much of the nation.
Breast Care Center recently hosted a free Mammography and
The women were provided free transportation to the Breast Care Center where, following their mammograms, they were treated to breakfast, hand massages and one-on-one meetings with clinicians specializing in nutrition, exercise, smoking cessation, and more. An interpreter was on hand for Spanishspeaking participants. All of the women left with a gift bag featuring, among other things, pink umbrellas and bandanas. n
22 I HouseCall I Volume VI Issue 3
asK the doctor
Ask the Doctor Q A
JEFFREY R. WILSON, M.D.
i’ve just learned that i have kidney stones. what are my treatment options?
Rates of kidney stones are rising. Up to one in 11 Americans will be afflicted with kidney stones in their lifetime. Genetics, diet, hydration status, urinary tract infections, chronic medical problems, and certain medications can contribute to stone formation. Stones can occur in any part of the urinary system, including the kidneys, ureters, or bladder. Treatment of kidney stones depends on several factors, including their location, size, and composition. Small stones in the kidneys often do not have to be treated through surgery, unless they are causing symptoms. Stones moving from the kidney into the ureter may cause the classic symptoms of flank pain, nausea, and sometimes blood in the urine. They may pass with hydration and medication; however, many require surgical treatment. In addition, any stone in the ureter causing fevers and flu-like symptoms requires immediate relief of the obstruction. There have been drastic advances in urologists' ability to treat stone disease. Several decades ago, open surgical procedures were performed, with large incisions and long convalescence. Nowadays, open procedures are almost never required. Instead, minimally invasive techniques such as extracorporeal shock wave lithotripsy (aka "lithotripsy" or ESWL), ureteroscopic stone ablation using a laser (URS), and percutaneous nephrolithotomy (PCNL) are able to treat stones of nearly all sizes, shapes, and locations. ESWL and URS are best used for smaller stones under 1.5cm, and both usually are done as outpatient surgery. ESWL uses shockwaves to break up stones into passable fragments. URS uses lighted telescopes under direct vision to target stones, which are then fragmented using a laser. Often, fragments are then removed using a specially designed basket. Both procedures are performed under a light anesthetic, and patients often are able to return to regular activity in a few days to a week.
Larger stones present a unique challenge. Previously, they were treated with open surgery, long hospital stays, significant recovery periods, and sizable incisions. Now, advanced PCNL techniques allow minimally invasive instruments to be used. Instead of a several day hospital stay, most patients are discharged home in 1-2 days, have about a 2-inch or less incision, and recover in about 2 weeks. Sometimes very large stones require a second procedure to completely clear the kidney. After your stone procedure, it is important to modify lifestyle factors to decrease the chance of future recurrences. These modifiable factors include increasing fluid consumption, limiting salt, reducing protein consumption, and making sure to get enough, but not too much, calcium. Also, your urologist may send your blood and urine for tests to determine if medications can help prevent future stone formation. No two kidney stones, and the cause of their formation, are exactly alike. Treatment should be tailored to the individual patient for optimal management. Diet changes, medications, and minimally invasive surgery are all critical components of a treatment strategy. n
JEFFREY R. WILSON, M.D. Dr. Wilson earned his medical degree at The Ohio State University College of Medicine. He completed residencies in general surgery and urology at The Ohio State Universityaffiliated hospitals. He practices with St. Clair Medical Services Sholder and Bordeau Urologic Associates in Mt. Lebanon and Peters Township. To contact Dr. Wilson, please call 412.572.6194.
Jeffrey R. Wilson, M.D.
Volume VI Issue 3 I HouseCall I 23
St.Clair Hospital 1000 Bower Hill Road Pittsburgh, PA 15243 www.stclair.org
General & Patient Information: 412.942.4000 Outpatient Center–Village Square: 412.942.7100
HouseCall
Physician Referral Service: 412.942.6560 Urgent Care–Village Square: 412.942.8800
is a publication of St. Clair Hospital. Articles are for informational purposes and are not intended to serve as medical advice. Please consult your personal physician.
Make sure St.Clair is in your Health Insurance Network
Medical Imaging Scheduling: 412.942.8150 Outpatient Center–Peters Township: 412.942.8400 Follow us on twitter at: www.twitter.com/stclairhospital
history minute
See page 18 for answers to key questions regarding the region’s changing health insurance market.
QA & Ultra modern in every respect, St. Clair Memorial Hospital boasts many innovations and the latest in scientific equipment to provide the best in medical, surgical, and emergency service. It is the first hospital in this area to have oxygen piped directly to each patient’s room. Jets in the wall connect with the oxygen apparatus while the patient relaxes comfortably behind zippered plastic screens.