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When it comes to your health, tests are not only common but often also required to receive the most ideal treatment plan. From your routine urinalysis to more complex hematology cases, these tests help open the doors to proper diagnosis. Thousands of patients are seen at Renown Regional Medical Center every year, which results in thousands of lab samples needing to be processed every day. So, who rises to the occasion?  Answer: The Core Laboratory team at Renown Regional. With the largest lab workload in our health system, the Renown Regional Core Lab is where compassionate care meets scientific excellence.  While under the care of the Core Lab Team, patients can rest assured that they are in the greatest of hands - literally and figuratively - with every scientist, technical specialist and lab assistant that serves in this department.  A Core Mission of Accuracy and Precision At Renown Regional, the only Level II Trauma Center in the region, the Core Laboratory works on a wide variety of lab tests to help providers diagnose, treat and monitor each patient’s condition. Those testing processes, known as “benches,” include: Blood Gas Chemistry & Immunoassay Coagulation Hematology & Differentials Urinalysis Working together in harmony, each member of the Core Lab team has an equally vital role in our health system, and all share a common goal.  “Our number one priority is to provide accurate results for our patients, ensuring that the providers have all the correct information they need to treat them,” said Lauren Anderson, Manager of Core Laboratory.  As one can imagine, there are several factors involved when it comes to ensuring those accurate patient lab results that Lauren mentioned above.  “Throughout the day in the core laboratory, there are many tasks to be performed for the accuracy and validity of our patient results,” said Jackie Blazquez, Sr. Medical Lab Scientist. “The medical lab scientists perform maintenance on the instruments daily while accommodating patient samples and releasing results. Our clinical lab assistants help the scientists with receiving samples, reviewing patient labels for any discrepancies, answering phone calls and assisting with the automated lab sample line.”  “The roles and responsibilities will vary depending on the bench assignment, but every bench will have one responsibility in common: performing preventative maintenance on our analyzers and running quality controls afterwards,” added Brittany Oliver-Stergiou, Medical Lab Scientist.  From start to finish, there is rarely a dull moment in Renown Regional’s Core Lab. In fact, this capable team can process up to 7,000 samples per day at this hospital alone.  "As a Medical Lab Scientist, for each instrument we use, we have to perform maintenance, calibration and quality control to ensure that the analyzer is ready for patient testing,” said Lauren Anderson. “Once the analyzers are ready for patient testing, we perform analysis on the samples, ensuring that the patient's results are consistent with their condition and no errors are found. Between our inpatient and outpatient centers, we run thousands of samples every day, prioritizing and juggling many tasks at once while producing accurate results.”  “Right when we get in, we are putting samples on the analyzers, reading results and calling critical alerts or recollects,” added Rosalina Lunsford, Medical Lab Scientist. “Our chemistry analyzers have all the analytes one can think of. Each individual chemistry test that the hospital uses is calibrated, quality checked and reviewed by our chemistry maintenance experts.”  Although there are many moving pieces when it comes to the work of our Core Lab experts, these team members work like a well-oiled machine in order to keep patient care at Renown Regional running efficiently.   “I start my shift by reviewing my pending worklist and verifying any outstanding STAT tests; then, I track all my untracked samples for easy retrieval, and I'll go through my pending worklist again to make sure that everything is on track for proper turn-around time,” said Lindsey Randle, Medical Lab Scientist. "I'll retrieve anything that may need further special testing, and before releasing results, I will check the sample for any interferences or contamination. This process is on a constant loop throughout my shift in addition to performing analyzer maintenance and quality control testing at timed intervals. This is all done to ensure that we are releasing precise and accurate test results so that patients can receive proper treatment.”  “We play a major role in keeping the hospital functioning,” added Rosalina Lunsford. “While the hospital doesn’t see us, we keep patient care moving. Core Lab is not stagnant; it is evolving each day. Tests are being added, machines are being updated and policies are changing. We see hundreds of patient results from different departments throughout the hospital. We analyze, question and conclude many times throughout the day and night.”  Think of discovering a diagnosis and monitoring a condition as an ongoing investigation. Our Core Lab professionals are key detectives in the investigation, playing an essential – and often life-saving – role in the diagnosis, treatment and maintenance of each patient’s condition.  “Oftentimes, we are the first to detect a patient's problem and escalate it to their provider,” said Lauren Anderson. “For example, looking under the microscope at a patient's white blood cells, Medical Lab Scientists may be the first to see a patient's leukemia and, with the collaboration of our pathologists, ensure that the next steps are taken towards diagnosis and treatment.

Read More About Department Spotlight: Core Laboratory at Renown Regional Medical Center

When you visit your provider for your annual exam or to address a health concern, or if you’re admitted to the hospital for any reason, lab draws – including blood tests, urine samples and saliva swabs – are common. When it comes to lab draws when you’re sick with a virus, such as strep, flu, RSV or COVID, or routine tests for chronic conditions, such as blood glucose or hemoglobin A1C, the last thing you’d want to do as a patient is wait a long time to get your results back. You’re focused on getting your results, receiving the proper medication and feeling better as soon as possible. Luckily for patients at Renown Health, we have a talented team to meet that need.  Meet the Point-of-Care team at Renown, an important subset of the larger Core Laboratory department. With decades of collective experience in the field and some of the finest point-of-care technology at their fingertips, this team works with our healthcare teams to ensure you have access to fast, accurate test results to help you on a quicker road to recovery.  Pointed Towards Efficient Solutions Point-of-care testing can be defined as exactly how it sounds – lab testing at or near the patient or their care area, otherwise known as “at the point-of-care.” While our clinicians utilize this specialized equipment every day for point-of-care testing on patients, they rely on the Point-of-Care department for training, everyday guidance, quality checks, audits and leadership.   At Renown, Point-of-Care testing is used in nearly every nursing unit across our hospitals and 53 outpatient care locations, including primary care, urgent care, pediatrics and women’s health – alleviating some of the workload of our central lab. Because so many teams rely on this crucial technology and test processes, this team accomplishes a great deal each day, from checking equipment to ensuring test accuracy.  “Our day starts early, with our first team member opening the department at 5 a.m. and circulating on the nursing units to address broken point-of-care equipment issues or supply shortages that could impact patient testing,” said Joni Boury, Lab Program Coordinator. “Once the point-of-care scientists arrive, they will address any charting issues that arose overnight and ensure all test results are correctly charted in Epic. After critical issues are addressed, we visit the testing locations and performing audits to ensure all testing equipment is functioning, clean and being appropriately maintained.”  In order to provide these efficient tests – in minutes! – to patients anxiously awaiting their results, our first step is to make sure our equipment and processes are up-to-code. Point-of-care testing is regulated at both the state and federal levels, and this team never leaves a checkbox unmarked when it comes to testing regulations.  “As a part of the ambulatory side of the Point-of-Care team, I make sure that state and federal licensing is maintained so the practices that perform these tests can continue to perform in-office testing for patients,” said Wende Lane, Clinical Lab Assistant Lead. “I also round in these practices to make sure they are adhering to state and federal guidelines, as well as Renown policies.”  And it’s not just existing equipment that needs oversight – the Point-of-Care department also implements new equipment and processes across Renown. These team members are expert jugglers when it comes to this effort, handling training, collaborating with leaders, recommending the proper placement of equipment and much more.   "Each day, we work on our many deployments scheduled throughout the hospital and outpatient locations,” said Joni Boury. “That work includes meeting with leaders to ensure new spaces are correctly built to accommodate the point-of-care devices, configuring new equipment, training new leaders and device operators and ensuring appropriate ordering and charting of the test results.”  “In being able to perform these tests in the outpatient setting instead of having to send them somewhere else for a test, providers can begin treating their patients within a matter of a few minutes, rather than hours,” added Wende Lane.  For a small-but-mighty team of six employees, the heights this team reaches knows no bounds. They’ve celebrated many achievements and expansions this year, including offering new-and-improved PCR testing across various outpatient practices.  “Our team has had several notable accomplishments over the past year,” said Breanna Van Dyck, Medical Lab Scientist and Lab Program Coordinator. “We successfully rolled out a massive Cepheid PCR testing initiative to over 30 Renown outpatient locations within the community. This expansion significantly improved our testing capacity and accessibility and will help ensure timely and accurate diagnostic tests for respiratory viruses and strep to a broader patient population, including our rural practices.”  By combining cutting-edge technology with compassionate patient care, our Point-of-Care team members are essential to contributing to Renown’s goal of providing efficient, high-quality care tailored to each patient’s individual needs.  Take a Point-of-Care Tour! The Point-of-Care department covers a lot of ground around Renown, reaching Reno, Sparks, Carson City, Fernley and Fallon. Take a glance at the photo carousel below to put yourself in the shoes of our Point-of-Care team members on a regular day!

Read More About Department Spotlight: Point-of-Care

Entering the emergency room (ER) is intimidating for any person, let alone when you’re unsure what condition or illness you might have. Many may also spend their time in the ER wondering if they will need to be admitted to the hospital.  Now, let’s say you don’t need to be admitted. That’s great news! But in order to figure out what’s going on in your body, you may need to stay a little longer – say, under 24 hours – for observation, tests or further treatment. This work is done swiftly by a specific team at the hospital to get you home sooner.  That team at Renown Health is the Clinical Decision Unit (CDU). These nursing and acute care professionals seamlessly fill in the gaps between inpatient and outpatient care, helping patients return home sooner through rapid tests and treatment.  Quick Interventions for Efficient Care The key goal at the forefront of the CDU’s patient care philosophy lies in their name: decisions. The team makes quick decisions in order to deliver timely, accurate assessments so they can treat patients efficiently and get them home. Not only do these efforts help reduce the amount of time patients have to stay in the hospital, but they also achieve cost savings for both the patient and our health system. And in cases where patients do end up needing to be admitted, the CDU walks them through everything they can expect during their stay.  The main duties of our CDU team include:  Observation and monitoring, where patients with conditions that are not immediately life-threatening but need closer monitoring Diagnostic testing, including blood work and imaging, to help providers gather critical information quickly Treatment and stabilization to receive treatments like IV fluids, medications or other therapies to prevent the need for inpatient admission Decision-making to determine whether the patient should be admitted for further care or discharged with follow-up plans  Think of the CDU as the ER and inpatient admission go-between. By diverting patients who don’t necessarily need emergency intervention away from the ER, the CDU helps relieve high patient volumes and reduce wait times.  “The CDU offloads patients from the emergency room who require slightly longer observation status to complete more complex testing or exams,” said Kristine Barnes, RN. “You could consider us a ‘limbo’ unit between the ER and admission to the hospital, if required.”  As with many other teams at Renown, every day is different for this team. They enjoy the variety of cases they see and solving the puzzles that present with patient care.  "The CDU is always fast moving, with discharges and admissions all day,” said Tyler Cathcart, Acute Care Technician-Advanced. “As an observation unit, we function as both an extension of the ED and PACU, with Medical, Telemetry and post-op patients. We have a wide range of patients and responsibilities to keep the unit moving quickly.”  “We see a variety of patients and enjoy the variety each day brings,” added Angie Marrale, Acute Care Technician-Basic. “A day in the life as a tech on CDU is full of surprises because we have such a wide variety of patients. It requires all team members to be attentive, hardworking and communicative in order to provide our patients with the care they need.”  If you’re ever looking for an example of a team that moves and acts quickly, the CDU is a shining example of that. Due to their hyper-focused attention, patients are able to embrace better outcomes and higher satisfaction.  “We move quickly to get today's group of patients comfortable, complete the tests ordered, make the appropriate interventions and get them discharged back home or transferred in less than 24 hours; then, we refill the unit, and each patient receives excellent, expedited care,” said Tyler Cathcart. “Efficient patient care within 24 hours is our goal, and we strive to meet that goal daily.”  A place to get extra care and attention without needing to stay for a long time while also having a team of professionals solely dedicated to figuring out what is going on in your body? Sign us up!

Read More About Department Spotlight: Clinical Decision Unit

When it comes to intimidating procedures such as surgery, cardiac catheterization (Cath) or interventional radiology (IR), there can be a lot of unknowns. What can I expect on the big day? What will happen after I’m all done? Will I have to worry about my orders not being in the system? Who can I call if I have any last-minute questions? It’s easy for your thoughts to race as you approach your procedure date, but luckily, there is a team who puts your mind at ease.  With Renown Health’s Surgery & Procedure Scheduling department, patients can breathe a sigh of relief knowing that all the nitty-gritty is taken care of before they step foot in the procedure room. This team operates in the mindset of a complex Tetris board – fitting in all the pieces to make sure every patient is set on the path for surgery success.  Consistent Contact Our Surgery & Procedure Scheduling team has a unique history. Initially operating as two separate teams, over the last year, our leaders skillfully combined the two teams together under one umbrella. That allows the now singular team to have line of sight across every surgery and Cath or IR procedure plan and be better stewards of the resources they have at their fingertips to provide streamlined, more-connected care for patients.  As one might imagine, with the merger of the two teams, the day-in-the-life of each team member is full of a variety of crucial checklist items to cross off – all supporting constant communication from patients to providers.  On the surgery scheduling front, these team members are resource rockstars. From working with referring providers to get patients scheduled appropriately to ensuring rooms and equipment are available for every patient, this team makes sure everything and everyone is in place when the time comes to help create a successful procedure and the best possible patient experience.   “In surgery scheduling, we handle inbound calls for the outside offices to get time scheduled for each patient in the operating room (OR),” said Lydia Sharkey, Senior Scheduler. “We make sure there are plenty of anesthesia resources and equipment for every surgery, including any important information that we need to schedule patients appropriately and adding all documents to the OR board. If we need to swap rooms or move patients around, we handle that process too.”  Over on the IR/Cath scheduling side of things, this team is on the frontlines of patient communication. They are experts in helping patients navigate their procedure from start (seeing their provider and obtaining the proper referrals) to finish (the day of the procedure and post-procedure process).  “My day is a little different than the hospital schedulers; our part of the team handles the outpatient aspect,” said Adrienne White, Senior Scheduler. “We are in constant contact with patients and the IR and Cath departments. We help them navigate their procedure, including what to expect during and after the procedure. We get them through the process as easily as possible and ease their minds, so they know what is going to happen every step of the way. It’s all about communication, communication, communication!”  This department has a significant overarching role: make sure all documents and ancillary information is set up for all our clinical teams that help with surgeries and procedures. This critical work means that every process is followed, and no important details are left out.  “No one wakes up and says, ‘I want to have surgery;” our team goes above and beyond to make sure every single detail is taken care of so that when patients arrive, everything is in place,” said Trisha White. “Our team works hard to ensure everything runs as efficiently as possible because we want to use our resources in the best way possible to serve our patients without delays. We make sure we receive all the orders, codes and insurance and that the teams that follow after us – including our pre-admit team and nurses – have all the information they need to do their job seamlessly."  With all the work they accomplish daily – not to mention how they wholeheartedly support each other through it all – it’s no question that the entire team has a lot to be proud of. Besides helping make patient care possible, the team puts their departmental merger and the move to fully remote work at the top of the list.  “We’re most proud of merging the surgery scheduling and procedure scheduling teams together and therefore more cohesive,” said Mary Gray, Senior Scheduler. “The merger has made our team blossom and be able to connect with and rely on one another even more. We aren’t afraid to speak up and say something. At the end of the day, we’re here to take care of the patient, but we also help each other out. Our morale has gone up, and everybody is happier. Even though we all work remotely, we are more connected and have a great work-life balance.”  “Along with transitioning the two teams into one big team, the move to being fully remote was huge," added Patricia Cruz-Hernandez, Surgical RN Scheduling Coordinator. “We worked through all the glitches, and it was a seamless transition to move into a remote setting. What’s great is that it did not affect patients at all; everything still gets done exactly as it should.”  No matter how busy the days may get, Renown’s surgery and procedure schedulers always remember one thing: they are incredibly grateful for their fellow team members.  “We have a very efficient and hard-working team of women,” said Pam Chapa Valencia, Senior Scheduler.  “I could not have handpicked better people for our team,” added Trisha White. “I feel so lucky to have the team that we have.”  A Renown “Why” Our Surgery and Procedure Scheduling team members all have diverse stories to tell about their road to Renown and why they’ve stayed in the department for as long as they have. Whether they’ve been with us for two years or two decades, they all share the same strong calling to care for their community.  “I always wanted to help people, and my grandma was a nurse,” said Pam Chapa Valencia, Senior Scheduler.  “I loved hearing her stories, and it made me want to be involved in patient care.”  “I have a caring nature, and a hospital nature seemed like the right fit – I've been here for 25 years,” added Mary Gray.  Several of our schedulers recognized the influence Renown has within our community and the ability to grow professionally and personally, both of which were a driving factor in their decision to make our health system their long-term career.  “I’m originally from southern California, and I moved here about eight years ago; my husband always talked so positively about Renown, especially with how big it is and how it has the only level II trauma center in northern Nevada, so my goal was always to get a job here,” said Lydia Sharkey. “It’s been a great environment to be a part of.”  “I’ve been with Renown for 17 years, and I chose to come here because of the reputation of the services Renown provided and care they gave,” added Trisha White. “I also knew what opportunities there were for me professionally, and in doing so, we are taking care of our community. I’ve had the chance to grow within my own professional skills and leadership skillset.”  A profound feeling of ‘home’ is a common theme among this department. These team members appreciate the sense of community Renown has, the strides we’ve made in expanding our reach and how our health system gives healthcare professionals who are new to the field a chance to succeed.  “At the time, Renown was the only hospital that would train nurses, and as a brand-new nurse, I had no experience – Renown took a chance on me,” said Patricia Cruz-Hernandez. “I feel like this is home. Our health system is so community-based and people-first minded, keeping ‘mission over margin.’ We’re growing, we’re expanding, we’re everywhere!”  “I was a part of a transition as the cardiology private practice I worked with became a Renown practice, and it was great,” added Adrienne White. “This transition enabled us to provide more services and better care to patients. I stay here because I see the leaps and bounds we’ve been able to make in terms of procedures, accessibility and patient experience.”  As true advocates for both patients and each other, the team is proud to have found their niche – and the ultimate beneficiaries? Everyone undergoing a surgery or procedure at Renown.  A Culture of Kindness and Gratitude When you meet the Surgery & Procedure Scheduling team, you are greeted with warm smiles and an enthusiastic “Nice to meet you!” You can’t help but smile back and feel the infectious kindness they exude.  Renown operates with a People-First mindset, a vision that this department especially takes to heart. They emulate the exact definition of our “Collaboration” cultural commitment.  “We’ve built very good relationships and rapport with the OR managers and board runners,” said Lydia Sharkey. “The communication that we have at all three locations is very solid.”  “The OR leadership is always so willing to help out whenever they can, and the resources they’ve provided have been huge for us,” added Adrienne White.  “All the teams that see the patients after us – especially the surgical pre-admit team and the case managers, are fantastic about collaborating with us and reaching out to solve any issues they may have,” added Trisha White. “We all work so well together, especially since we all impact patient care.”  In any organization, strong and compassionate leadership is key to a thriving team. Luckily for our surgery and procedure schedulers, they have Trisha White on their side. They attribute a lot of their success to having a supportive leader who “gets it.”  “Trisha has been a scheduler like us, so she completely understands when we’re having an issue, because she’s struggled with the same thing and knows where we are coming from,” said Mary Gray. “It makes us feel like we are not alone – I can always reach out to her, or any of my other coworkers, to ask questions and figure out a solution together.”  Despite being a remote-only team that meets in-person only one or two times a month, this group never misses an opportunity to reconnect both online and offline. They frequently shout out their Culture Ambassadors, schedulers Pam Chapa Valencia and Roxanne Abundis, for their team’s high morale.  “Even though we all primarily work remotely, our in-person days are some of my favorite days of the month,” said Trisha White. “We feel so uplifted, we laugh and we have fun. We love being with each other. Pam and Roxanne are our Culture Ambassadors, and they both have been amazing at planning fun things for our teams. They go above and beyond to make our team feel cohesive and included.”  “Pam and Roxanne have been leaders in creating a fun environment and supportive culture for us,” added Lydia Sharkey. “Whether it’s creating care packages or making sure we all have a good time when we see each other in person, they deserve a lot of credit.”  As this team excels in their roles and foster a culture rooted in kindness and gratitude, we can trust that Renown’s surgeries and procedures will continue to thrive, and patients will continue to benefit from their diligent efforts and commitment to efficiency.  “We make the magic happen!” closes Mary Gray.

Read More About Department Spotlight: Surgery & Procedure Scheduling

Northern Nevada's stunning lakes, including Lake Tahoe, with its average summer water temperature of 50 degrees, present a potential risk of hypothermia. Unlike mild 50-degree air, water at the same temperature poses severe, life-threatening risks, including rapid-onset hypothermia and drowning. Awareness of the symptoms and taking proper precautions are crucial to prevent cold-water drowning. The 4 Phases of Cold-Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

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Celebrate Leap Day by leaping into the world of Pathology at Renown Health! Think of discovering a diagnosis like solving a mystery: the condition is the suspect, the nurses are the frontline police force and the doctors are the lieutenants or captains finalizing the results of the case. You may notice that one crucial role is missing on this list – the detectives. In the diverse network of healthcare, the detectives are a significant part of each patient’s mystery-solving care team and represent many roles across our health system. When it comes to figuring out the elaborate details of a growth, disease, organ abnormality or cause of death, one team of detectives, quite literally, goes as deep as possible. Those detectives are the team members within Renown Pathology. For each specialized field within medicine or surgery, the Pathology department is here to play a crucial role in accurate diagnoses. With each slide examined and each test meticulously conducted in their bright laboratories, these dedicated professionals shape a path towards wellness and recovery.  Meet Your Anatomy Experts  Whether you have a chronic disease that needs consistent testing, a high-risk birth that requires placenta testing, a suspected cancerous tumor that needs a biopsy or a gall stone that must be removed (or anything in between), Renown’s Pathology team steps in to provide biological answers to your body’s questions. This department offers the most comprehensive in-house diagnostic testing in the region, from routine histology to full pathology.  As the busiest pathology department in northern Nevada, this team boasts the fastest turnaround times from respected experts, including:  Pathologists Pathology Assistants Histotechnicians Histotechnologists Clinical Lab Assistants Let’s break down the complex nature of these team members' jobs by walking through their everyday responsibilities at work!  Pathologists  Pathologists are medical doctors who specialize in the study and diagnosis of disease. With every slide they scrutinize and every sample they analyze, pathologists unravel the mysteries of disease with precision and compassion. Their responsibilities include interpreting laboratory tests, analyzing tissue and fluid samples (obtained from a variety of different sources, including biopsies and surgeries), staging cancer diagnoses and providing diagnostic insights that guide treatment decisions.  “Our job is to help the patients and their doctors figure out what’s wrong,” said Dr. Christie Elliott, Pathologist and Medical Director of the Clinical Laboratory at Renown Regional Medical Center. “As the bulk of our cases deal with cancer, almost every day we start with a tumor board alongside fellow surgeons, oncologists, radiologists and geneticists. From there, we order extra studies, run through our cases to make diagnoses, review slides and ensure all information goes into the charts, which is especially important as 70% of data in medical charts is from the lab. A patient’s history is everything.”  Pathology Assistants With the steadiest of hands, pathology assistants, also known as PAs (not to be confused with physician assistants), guide the diagnostic journey from patient specimen to diagnosis. They can typically be found processing surgical and biopsy specimens (includes accessioning, gross examination, description, and sampling for microscopic analysis), preparing tissue samples for microscopic evaluation, helping the pathologist determine a cause of death for autopsies by conducting organ dissections and maintaining detailed records of all diagnostic findings.  “As a PA, I still impact patient care without being directly patient-facing,” said Andrew Whitner, Pathology Assistant. “I handle 300-350 small tissue blocks a day. During dissections, I identify landmarks, document what I see and turn those landmarks into slides, looking for things that don’t look normal.”  “Our job is 90% all about gross specimens, and we also do eviscerations for autopsies,” added Leslieann Haffner, Pathology Assistant. “We are trained on what normal looks like; our goal is to find the abnormal.”  Histotechnicians Histotechnicians work behind the scenes to help transform ordinary tissue into extraordinary windows of insight, revealing the inner workings of the human body. As vital members of the Pathology team, histotechnicians embed tissue specimens in paraffin wax blocks (a process that preserves the tissue's structure for examination), cut thin sections of tissue from the paraffin blocks using a microtome, mount tissue onto glass slides and stain the tissue slides using histological stains to highlight structures or cells.  “With all the patient specimens we work with, we get to see a lot of organs and learn what is causing the abnormalities,” said Reiny Hitchcock, Histotechnician. “I enjoy the opportunities to expand my knowledge, especially while working alongside the doctors.”  “Our job can change by the week,” added Jessica Fahrion, Histotechnician. “One week I’ll be in the grossing room, and the next week I might be training in cytology." Histotechnologists In a world where every slide holds the key to a patient's future, histotechnologists are the champions of progress. One career ladder step above histotechnicians, these team members often have a broader scope of responsibilities, including more complex laboratory procedures, developing and validating new techniques, managing laboratory operations, interpreting results and troubleshooting technical issues. You can count on histotechnologists for validating antibodies and handling orders from pathologists, oncologists, emergency physicians and more.  “My day always involves looking into cases, reading reports, getting orders together and working with pathologists to help them with their diagnoses; I also work a lot with immunohistochemistry, helping out with routine slides,” said Charles Koeritz, Histotechnologist. “I especially enjoy doing validations, which help maintain the integrity of lab testing and our diagnostic processes.” Clinical Lab Assistants Our pathology clinical lab assistants are the masters at “filling in the blanks,” assisting in whatever area needs it most, especially in cytology and the grossing room. They are essential aspects of the Pathology team, collecting and storing specimens for further testing, assisting in managing test results, gathering data, managing supply inventory and more.  “As a Clinical Lab Assistant, I can be scheduled anywhere, from tissue cassetting to grossing,” said Ellie Somers, Clinical Lab Assistant. “Working in cytology is one of my favorite parts of my job. It’s very rewarding to work with the doctors to uncover what treatments will help each patient. We do cytology very well here.” The Bottom Line Even though the Pathology department doesn’t always experience a lot of patient face-to-face time, they interact with patients in a different way – by uncovering the story that is the inner workings of the human body, one slide and one sample at a time.  “It’s important to remember that the slide IS a patient,” said Dr. Elliott. “We are constantly learning from every case so we can continue to provide the best patient care possible.”  Take a Photo Tour of the Pathology Lab!

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Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise  Anti-obesity medications  Weight loss surgery

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According to the Global Sepsis Alliance, 1 in 5 deaths worldwide are associated with sepsis. If not recognized early and treated promptly, sepsis is the final common pathway to death from most infectious diseases worldwide, including viruses such as COVID-19. We spoke with Jeremy Gonda, MD, a critical care physician from Renown Health’s Sepsis Committee to increase public awareness of this preventable medical emergency. What is sepsis? Sepsis is a response to infection—bacterial, viral or fungal—and can start anywhere in the body and spread into the bloodstream. The body is trying so hard to fight an infection that it begins releasing chemicals into the bloodstream that cause inflammation and the shutdown of multiple organ systems. “It carries a very poor prognosis in general unless you catch and treat it very early,” said Dr. Gonda. “Any infection can lead to sepsis. Typically your immune system takes care of the infection. It doesn’t progress, but in cases where the infection becomes severe, or the immune system doesn’t function properly, people can certainly die. So there’s, unfortunately, a very high mortality rate associated with sepsis.” According to the Centers for Disease Control and Prevention, each year at least 1.7 million adults in America develop sepsis. While you can recover from sepsis if caught early, many sepsis survivors suffer from long-term physical and psychological effects. What are the signs of sepsis? One way to spot sepsis is to use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die” S – Skin mottled or discolored Keep in mind that sepsis symptoms can vary depending on where the infection starts. “Patients may experience urinary burning if they have a urinary tract infection or a cough and shortness of breath if they have pneumonia first,” said Dr. Gonda. “However, often symptoms are more generalized or subtle such as fevers, confusion and malaise.” How do you develop sepsis? When germs enter your body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Areas of infection that more commonly result in sepsis include: Lungs, such as pneumonia Kidney, bladder and other parts of the urinary system Digestive system Bloodstream (bacteremia) Catheter sites Wounds or burns Who is most at risk? People with compromised immune systems are at greater risk for sepsis, such as “The very young, the elderly and any people who may have conditions that suppress your immune system,” said Dr. Gonda. “For instance, if you have diabetes or if you’re an organ transplant patient who is on immunosuppressant therapy, you’re at somewhat higher risk.” Sepsis is often considered a hospital-acquired infection, but a study in The Journal of American Medical Association found that 80% of sepsis cases occur outside of a hospital. That’s why it’s especially important to remember any infection can lead to sepsis, and anyone can develop sepsis from an infection. What do I do? Timing is critical in the case of sepsis and septic shock. According to a study on septic shock patients, there is a 7.6 percent decrease in survival for each hour treatment is delayed. On the other end, if treatment is given within an hour of the first drop in blood pressure, the survival rate is 80 percent. Because sepsis can be so deadly, it’s important to seek medical attention as soon as possible. “If you’re not getting any better, if you think symptoms are progressively worsening – you should definitely be evaluated by a doctor,” said Dr. Gonda. You can help #StopSepsis by getting involved at worldsepsisday.org.

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This Department Spotlight is dedicated to Jason Simpson, Manager of Respiratory Services at Renown Children’s Hospital.  Take a moment to breathe deeply. Inhale in, exhale out. We rely on our lungs to provide us with the air we need to live a healthy life – and this essential bodily function is something that many of us don’t think twice about since it comes easily for us. Now, imagine yourself as someone who is living with severe asthma, chronic obstructive pulmonary disease (COPD) or someone who was recently diagnosed with a frightening respiratory condition like COVID-19 or pneumonia. The simple act of breathing can prove to be an intimidating venture requiring the care of a professional. Who are the people that take on the challenge?  Meet Renown Health’s Respiratory Care Services department. Serving patients across 13 service lines, three acute facilities, outpatient locations and telehealth, our respiratory specialists – including respiratory therapists, respiratory care aides, inpatient COPD respiratory therapy navigators and educators and more – use their expertise to help restore the vitality of all their patients with every inhale and exhale, shaping a healthier livelihood one lung at a time.  The Guardians of Respiratory Wellness  Whether they are managing lifelong respiratory conditions or offering crucial support in emergencies, the Respiratory Care team strives to enhance the quality of life for every patient. As an indispensable member of the clinical team at Renown, our respiratory therapists work collaboratively with doctors and nurses to tackle a wide range of tasks, tailoring care for each patient’s unique needs.  “Respiratory care is involved with all stages of life, from beginning to end,” said Sarah Kurtz, Respiratory Therapist. “We work closely with nurses and doctors and perform arterial punctures, breathing treatments, weaning maneuvers for patients on life support, intubations and much more. We assess patients constantly to see if their care needs to be upgraded or if they can be weaned to get them back home with their families.”  “You start your morning researching your assigned patients,” added Tim Start, Respiratory Specialist. “We go over lab values and chest radiographs and decide the best plan of care for each patient. Our objective is to improve their respiratory status by giving them medications and doing breathing exercises. We participate in other forms of care with nurses, such as activities of daily living (ADLs) and mobilization. We work as a team, and that enables us to provide great patient care.”  For patients living with COPD, enjoying all that life has to offer comes with a separate set of obstacles. According to the Centers for Disease Control and Prevention (CDC), over 200,000 people across the Silver State are living with this chronic condition. Luckily for them, Renown has a specialized team to help these patients optimize their life and manage their condition with individualized treatment and education.  “We run a report every morning to identify all the patients currently admitted who have a history of COPD, take respiratory medications or smoke,” said Amber Beck, Inpatient COPD RT Navigator. “After looking through their charts, we visit with the patient (and possibly their family) at the bedside to help them better understand how to manage their breathing issues.”  As a vital part of the Respiratory Care team, Renown’s respiratory care aides help ensure the seamless operation of our respiratory care services. These dedicated professionals provide essential support to respiratory therapists not only during intricate procedures but also outside of face-to-face patient care by transporting equipment, restocking supplies, assisting in the mobilization of patients and more.  “We are responsible for the maintenance of unit supplies and making decisions regarding levels of stock to be maintained,” said Dia Ramos, Respiratory Care Aide. “We also transport equipment, refill the oxygen tanks on the floors and intensive care units (ICUs), order and stock respiratory care supplies, mobilize patients and assist the respiratory therapists during bronchoscopies in the ICUs. In addition, we clean respiratory equipment like mechanical ventilators, continuous positive airway pressure (CPAP) and bilateral positive airway pressure (BiPAP) machines, high flows and aerosol poles.”  Once the COVID-19 pandemic hit, a special spotlight shined upon respiratory care teams across the country for the heroic care they provided patients in respiratory distress. While their roles in health systems have gained a better understanding nationwide, this team understands it is vital for them to educate the community about the important jobs they hold for our patients.  “Respiratory care can be under the radar,” said Pam Umek, Respiratory Specialist. “Once, when I told someone that I am a Respiratory Therapist, they said, ‘Oh, like a yoga breathing instructor?’ I then explained all the things we do: intubation, extubation, bronchoscopies, transports, traumas, codes, rapid responses, pediatrics/NICU, breathing medications/therapies, open heart rapid ventilator weaning … needless to say, that individual walked away with a better understanding of not just Respiratory Care Services but also the enormous effort it takes to care for our community.”  The accolades and achievements continue to pour in, from national awards and certifications to implementing different jobs in care units to optimize the patient care experience.  “We have earned and continue to maintain the Joint Commission Disease-Specific Certification for COPD,” said Amber Beck. “We are well below national averages for 30-day readmissions, lengths of stay and mortality due to COPD. Sandy, one of our COPD Coordinators, was a recipient of a patient advocacy award from the American Association of Respiratory Care and FACES Foundation.”  “We have started implementing Respiratory Care Aides in the critical units, starting with the Cardiac ICU,” added Dia Ramos. “We work as one team and are always helping each other with their tasks.”  Education and mentorship are at the core of Renown’s mission to make a genuine difference in the health and well-being of every patient. Nurturing the next generation of medical professionals – including respiratory care professionals – is a task that the Respiratory Care team takes seriously.  “It has been great being able to help educate students in different disciplines,” added Pam Umek. “We have been able to offer shadow shifts to students in emergency medical services (EMS), nursing and medical school. These opportunities help students entering the medical field have a better understanding of the many ways we can help care for our respiratory patients.”  From the moment of birth to the final stages of life, Renown is fortunate to have a Respiratory Care team that tirelessly ensures every breath counts, safeguarding their role as a trusted partner within our health system.  A Tribute to Jason Simpson, Healthcare Hero

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June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

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When it comes to our heart, keeping this vital source of life in tip-top shape is of utmost importance. Echo technologists or echocardiographers, otherwise known as "echo-techs," are charged with that mission, providing critical information that leads to life-saving interventions to keep our hearts beating strong.  Adrianne Little, echocardiographer at Renown Health, breaks down the echo-tech's role in the health system, the educational path it takes to get there and the unique perks that come with the profession.  What does an echo tech do?  “Echo techs play a key role in the diagnosis and treatment of patients,” said Adrianne. “We are members of the cardiovascular imaging team that perform ‘heart ultrasounds’ or echocardiograms. Although we are most commonly known as echo techs, our official title is either ‘cardiac sonographer’ or ‘echocardiographer.’”  Echo techs use imaging technology and sophisticated ultrasound equipment to produce images of the heart. These images show how well the heart functions, as well as the valves, chambers and blood flow. Echocardiograms are used to diagnosis and treat a variety of heart conditions such as murmurs, arrhythmias and heart failure.   At the end of the day, the main goal of echo techs is to help our cardiovascular team provide the quickest and most accurate diagnoses to help with patient management and help them receive the highest standard of care.  “When it comes to looking at the heart, we are part of the front-line team," said Adrianne. “We provide real time critical information that leads to life saving interventions down the road.”

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Your heart is the muscle in charge of pumping blood to your entire body. This vital organ is made up of chambers, valves and blood vessels. Your heart valves work similarly to a one-way door: they open and close, controlling blood flow in the correct direction through the heart chambers.   For patients who have been diagnosed with a heart-related condition like aortic valve stenosis (narrowing), it is important to know treatment options. Most might think open-heart surgery is the only way to treat a heart valve, but many hospitals, including Renown, also offer a minimally invasive procedure called a Transcatheter Aortic Valve Replacement (TAVR). Dr. Abhilash Akinapelli of Renown Institute for Heart & Vascular Health shares his answers to the top five TAVR questions:  1. What causes aortic valve stenosis?  Aortic valve stenosis can be caused by a variety of factors. The main reasons being wear and tear of the valve due to aging; genetically abnormal heart valve (bicuspid aortic valve); long-standing high blood pressure; and other reasons like radiation exposure.   2. Am I a candidate for TAVR?  Renown’s heart care teams are made up of your primary care provider, cardiologist and cardio thoracic surgeon. They will evaluate if patients are a good candidate for the TAVR procedure by performing a variety of screenings and tests. Some of these include:   Echocardiogram  Electrocardiogram (ECG or EKG)  Chest X-ray Exercise tests or stress tests  Cardiac computerized tomography (CT) scan  Cardiac catheterization  3. What are the advantages of the TAVR procedure?  The Transcatheter Aortic Valve Replacement (TAVR) procedure is much less invasive than open heart surgery, otherwise known as a Surgical Aortic Valve Replacement (SAVR). Patients can typically return to their normal lifestyles within a week after leaving the hospital.   During the TAVR procedure, a stent valve mounted on a balloon is advanced to the heart through the blood vessels in the groin without any incision. Once in position, the balloon will be inflated to firmly expand the new valve inside the diseased old valve, pushing it away to the sides. Once the new valve is in place, it begins working immediately and the deflated balloon is removed. The surgical procedure is approximately one hour long. Patients can get up and walk after four hours and will be discharged the following day if no complications arise. Compared to a SAVR, recovery time is much shorter and less risky for patients above the age of 75. A big advantage for anyone who fits under the criteria for a TAVR.  4. Is the procedure painful?  The TAVR procedure is not surgery, but you will still be asleep during the procedure. Since no incision is made, it is essentially a painless procedure. Patients may experience slight discomfort such as aches and pains at the entry site of the catheter.   5. Can I have an MRI and X-rays done after having a TAVR valve?  Yes, patients can have MRI scans and X-rays after TAVR.   For further questions and information about the TAVR procedure, please consult with your Renown heart care team at 775-982-2452 or through MyChart.

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