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Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Senior Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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Mammograms are an effective means for early detection of breast cancer. Still, many women shy away from them for fear of pain or discomfort. Let us debunk a few mammogram myths that will remove your worries and encourage proactive breast health. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Myth 1: Mammograms Are Painful Reality: Although some women experience discomfort during a mammogram, most say it is not painful. Breast compression, which is important to get a clear image, can cause a sensation of pressure, but this lasts for a few seconds. Let your technician know how much pressure you can handle so you're not uncomfortable. Myth 2: Discomfort Persists Long After the Procedure Reality: The sensation of pressure developed through the compression process diminishes quickly after the procedure. Most women go about their day afterward without experiencing any residual pain.

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Cancer can develop at any age, and that’s why the experts at Renown are ready to help you stay ahead of breast cancer, especially if you're in your 20s or 30s. We're talking about early detection, signs to be aware of, and why being proactive is a big deal. Studies show there has been an increase in breast cancer in younger women. Although breast cancer is rare in women under 40, when it occurs, it tends to be aggressive. The tricky part? Many young women don't think it can happen to them, so they don't check for the signs as often as they should. Reviewed by Dr. Colleen O'Kelly-Priddy, MD, FACS, breast surgical oncologist at Renown Women's Health. Early Signs and Symptoms New or Different Lump in the Breast: A lump is probably the most well-known symptom. Breast cancer is usually painless and firm, but it can also be soft. If you find a new lump, don't panic, but don't ignore it either. Changes in Breast Size or Shape: Have you noticed that one breast looks a little different? Whether it's swelling, shrinking, bulging, dimpling, or seems off, it's worth mentioning to your doctor. Skin Changes: If the skin on your breast starts to thicken or turn red, it's time to pay attention. If your skin starts looking like an orange peel (thickened, with prominent pores), that warrants evaluation. Nipple Discharge: Spontaneous drainage coming from your nipple that isn't breast milk—especially if it's clear or bloody—should be checked out. Nipple Changes: If your nipple starts to invert, flatten, or look different, call your doctor. Breast Pain: Continuous pain in your breast or nipple that isn't linked to your menstrual cycle is another symptom to note. However, breast pain is very common and is only rarely a sign of cancer, so don’t panic. Swelling or Lumps in the Armpit: When it spreads, breast cancer usually first goes to the lymph nodes in the armpit, so swelling or lumps under your arm should be on your radar.

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In the fast-paced world of healthcare, productivity is always a focus. Care teams need accurate and timely information to make decisions that directly impact our patients. However, without a reliable system to analyze and deliver complex data, noticing areas for improvement and making impactful changes can become overwhelming. This is where the power of data and analytics comes into play.  Renown Health’s Enterprise Data & Analytics (EDA) department are the leaders of this transformation. This team cares for the caregiver by delivering key data and insights with thorough analytics. Their data-driven approach ensures we are moving towards consistent progress and excellence in patient care, creating a better healthcare experience for everyone.  Dedicated Data Deliverers From patient volumes to quality-of-care metrics, our EDA department drives a lot of decisions that directly affect our patients and caregivers. A day-in-the-life as an EDA team member is where creativity meets science.  “Data is the lifeblood of the department and my role,” said Clayton Pettit, Senior Data Analyst. “Every day, I'm working with data – figuring out how to get certain pieces of data, visualizing it to provide users with clear insights and helping users of the data glean those insights and analyze the data.”  “We are builders of data tools, collaborating with team members and IT teams,” added Michelle Ebesu, Data Analyst. “We problem solve and design the most efficient way to deliver data. We work on large projects, small report requests and answer reporting related questions. We investigate and research daily.”  According to this team, every day brings a blend of exploration, engagement and discovery. Their role within our health system is central to turning data into useful ideas that drive meaningful change for all.  “A day on the Enterprise Data & Analytics team involves responding to diverse requests, some well-defined and others more open-ended, requiring exploratory collaboration with stakeholders,” said Kevin Crofton, Senior Data Analyst. “We harness the vast institutional knowledge within our organization to inform our analytics projects. This collaborative approach not only enhances our insights but also extends their impact across various groups within the organization.”  “Each day in EDA is fast paced,” added Ryan Fernandez, Manager of Data Analytics. “Our days are filled with a variety of different tasks ranging from data wrangling, building visualization to tell a meaningful story, responding to urgent business questions with analysis, training other team members on how to use analytical tools, and constantly learning more about the different clinical service lines and how to interpret their data.”  No two days are the same in EDA. In fact, every day brings a new challenge. And the best part? They’re never alone. This team thrives on working together, emulating Renown’s cultural commitment of Collaboration to a tee.  “Every day is different,” said Susan McDonald, Senior Data Analyst. “On larger projects we collaborate together, with each person taking a piece. We'll meet daily to gauge progress, exchange ideas and assist each other when needed. We'll sometimes have to troubleshoot issues that may come up with some reports. We often meet with our end users to get further details on their needs or to present their requested reports.”  “Up until the last couple of months, my day-to-day was creating, updating and fixing reports for all aspects of Hometown Health,” added Ryan Zinck, Data Analyst. “For the past two months we have begun the development of what will be an extensive reporting system in PowerBI that's intended to serve most groups within the company.”  Working with digital healthcare information that impacts how a health system operates and makes needed improvements can be complicated, since information is entered in various ways like calculations, statistics or measurements. Susan McDonald said it best: “It’s like solving puzzles every day.”   “We are Business Intelligence,” said Michele Warner, Data Analyst. “We answer questions the business proposes. We write queries and design reports/dashboards. We dig into the tables that store the data that is input by everyone at Renown through EPIC and other applications. We tell a story that will help the business be more efficient, make better decisions, solve a problem or report to government agencies.”  “We dive deeper into the front-end data and analyze it to get more detailed information and insights regarding the performance and certain project,” added Boqun Yin, Data Analyst. “Then, our colleagues working at the front line can utilize it when making strategic business decisions.”  EDA takes the definition of trendsetting to a whole new level. With the unique ability to predict future trends, this department can provide crucial information that helps care teams on the floor care for their patients to the best of their ability today, tomorrow and forever.  “I deliver data on all sorts of topics for Renown,” said Clayton Pettit. “With this data, I help Renown see where we are and where we need to improve. Beyond that, the data I provide can help us see how we can improve, what things we need to focus on and processes we need to change.”  “Our organization needs up to date robust data to ensure quality and integrity so that it’s reliable, secure and accurate,” added Uriel Duran, Data Engineer. “We also provide analytics and insights that can provide/predict patient outcomes and trends. For our patients, improving patient care is critical – and that can be done with data.”  Making Your Lives Easier As stated by Brian, Howell, Manager of Data Engineering, “we’re here to make everyone’s lives easier.” And Brian is exactly right – the EDA department’s work impacts the people who care for patients. Their data analysis and engineering skills help our care teams answer questions, give them information they can make decisions with and inform them statistically about well they are doing, along with showing opportunities for growth.  “EDA professionals like to think of themselves as the ‘wizard behind the curtain,’ a nuance from the ‘All Knowing’ Wizard of Oz; we are custodians of the company's data and we take that responsibility seriously,” said Dr. Justin Coran, Chief Analytics Officer. “When we partner with our clinical or administrative counterparts, we can help evolve decision-making from emotional to rational. The shift to rational decision-making allows the company to understand cause and effect of their business or clinical decisions.”   “I work directly with our customers on a daily basis to determine how our department can help them achieve their goals,” added Brian Howell. “I have been involved in data for over 20 years and love the technology, ever-changing landscape and challenges.”  The proof of their influence is in the numbers and the words they hear from our front-line care teams, from a significant financial impact to words of enthusiasm from providers. This reinforcement encourages the EDA team to continue going above and beyond.  “My goal is to make life easier for our clinicians and staff who do provide direct care,” said Helen Bahrke, Senior Data Analyst. “I feel accomplished if my work helps other staff reduce their time spent running reports or finding the data they need. Some providers have their own research questions they are studying in their patient population. Helping them get the data they need so they can provide better and more efficient care makes me happy.”  “Though we may not be the most visible department at Renown, the work we do and content we output drives decision making at the highest level,” added Sean Gollos, Data Analyst. “We make it easier for physicians to track patients, provide key employee data to the HR department and help ensure our organization is compliant with several requirements set by our industry.”  “I have seen my work bring in millions of dollars so that Renown can provide better care where it’s needed,” added Sean Richards, Senior Data Analyst.  Both patients and providers can lean on the EDA department for support in helping unravel data that may seem complex to the everyday eye, which has a direct impact on productivity and care quality.  “We take care of those who take care of patients,” said Mark Templeton, Manager of Data Analytics. “From descriptive analytics to measurements and dashboards, we provide a lot of support to those who manage patient care and productivity.”  “Our team provides critical datasets and insights into specific medical data that informs decision making stakeholders, which indirectly impacts patient quality of care,” added Sergio Pascutiu, Senior Data Engineer.  The impact of this team’s expertise can be felt beyond the hospital floor. Renown Health Leadership relies on the EDA to deliver data that affects important decisions at the top organizational level.  “A typical day for me revolves around data integration and extract, transfer, load (ETL) operations,” said Ken Vogel, Data Engineer. “The data and reporting that we provide to our end users and Renown leadership drive the decisions that impact the organization as a whole, which in turn impacts our patients.”  “Renown Leadership has business experience and training in order to navigate the challenges and opportunities that constantly present themselves,” added Michael Jesser, EDA Project Manager. “EDA helps them test their proposals with real data. This has been the meat and potatoes for our department if you've got a question about any process then we'll find the data that helps you form a reasonable answer.”   "We provide timely information to Renown leadership so that they may optimize our operational efficiencies that allow for improved patient outcomes,” added Todd Nicholas, Data Engineer.  This team thrives on challenges. Ryan Fernandez explains it beautifully: “I love challenges and learning new things, which is what happens almost every day being an analyst in healthcare, and that is what keeps me in this industry.”  Fighting the Good Fight for Today and Tomorrow Throughout the past year, the EDA department has been hard at work with many transformative projects that have improved several processes at Renown. What many may not know is just how large of a role these team members played in several of these endeavors, from a time-keeping platform upgrade for our employees to creating a one-stop-shop data warehouse.  As one can likely imagine, many of these projects are a large source of pride for this department, and deservedly so: “I am most proud of the Renown Regional Medical Center wall board conversion project, converting the patient lists that previously displayed to an Epic dashboard that displays data that is pertinent to the staff taking care of patients. The new wall boards provide at-a-glance information requested by nursing leadership.” - Michelle Ebesu “The last 12 months within EDA has been transformational. In May 2023, the data needed to run operations was scattered across 200 source systems and files, 20,000+ SQL tables and thousands of columns of data. Led by the vision of our executives, the team onboarded the technology (Microsoft Azure) and completed the development of a foundational Enterprise Data Warehouse (EDW) within 8 months, when the process usually takes 1.5-2 years. EDA produced Renown's first in-house developed risk stratification algorithm to optimize care for our Hometown Health members and produced a brand-new state-of-the-art reporting system for primary care.” - Dr. Justin Coran  “Our team contributed to the integration with the new UKG enterprise resource planning (ERP) system which comprises of a multi-tenant integration package that sources data from the UKG system.” - Sergio Pascutiu “I'm proud of the role our department has played in migrating from Kronos to UKG. It was a project that took over a year from planning to implementation, but our team had a key role that I think really opened people's eyes to how much they rely on the data that our team maintains.” - Sean Gollos Since this team’s work involves a large collaborative effort between the clinicians and themselves, according to them, the work that our care teams do generates “a gold mine” of health services data for them to dig through and answer crucial questions to create solutions, such as “What has happened in the past?” “What is currently happening?”  While figuring out the answers to those questions that will affect the future of healthcare at Renown, one solution often comes to the forefront: artificial intelligence.  “Under the direction of our new Chief Analytics Officer, the tool sets that EDA uses will expand into machine learning and artificial intelligence (AI),” said Michael Jesser. “We'll be answering questions about what is likely to happen or what data could influence an answer that we don't normally associate with the question. This is big – and getting bigger. EDA will put Renown at the forefront of this powerful future.”  “The new data science team that will onboard in 2025 will be able to utilize AI and machine learning (ML) applications that may impact patient care directly,” added Dr. Justin Coran. “EDA is looking forward to partnering alongside our clinicians and nurses to create the future in AI / ML healthcare products.”  Virtually everyone in the EDA department was excited about a career in high tech. To make matters even better, many of them had a passion for healthcare and the non-profit world.  “My healthcare experience led me to an understanding that there was a need for someone that understood healthcare workflows in the IT field, so I joined as an Epic analyst to help design those workflows and eventually found my way onto the EDA reporting team,” said Raffi Kilejian, Data Analyst. “The work-life balance, along with the fact that I work for a non-profit that gives back to the community are my main reasons for working for Renown.”  Other team members didn’t originally intend to use their technical talents in healthcare but are glad that they ended up taking the road to Renown. From the department’s strong culture to our health system’s impact on the community, this team consistently reports enjoying the work they do every day for Renown.  “I chose to work at Renown because of its stellar reputation as a leader in community-focused healthcare and the sense that individual contributions could genuinely drive change,” said Kevin Crofton. “Although I hadn't originally planned a career in healthcare, I've found a profound synergy in this department, where multiple disciplines converge to address diverse challenges. This welcoming and collaborative atmosphere has been key to our success. My transition into healthcare has been immensely rewarding, allowing me to apply my skills in ways that meaningfully impact our community's health and well-being.”  Finding “better ways to do things,” as the EDA team puts it, transcends the backend data. That philosophy also feeds into their departmental culture, always finding ways to bring each other together and uplift one another’s accomplishments and ambitions.  “I'm proud that we've been able to bring back some former valuable Renown employees,” added Brian Howell. “It is a testament to the culture at Renown that people recognize the meaningful work we do. I love working for a healthcare organization that makes a difference in people's lives."  “I was referred to Renown by a good friend during job hunting; since I started to work for Renown, I've seen the changes and effort that the EDA leadership has put into the development of the team,” added Boqun Yin. “I am glad to be part of this journey. That's why I choose to stay.”  “Renown also offers great benefits which I have taken advantage of, such as tuition reimbursement for my online MS in Analytics program I am currently enrolled in,” added Ryan Fernandez.  As proudly stated by Michelle Ebesu, “I believe in the values we have here at Renown.” And at the end of the day, this is what matters most to all who work in EDA.  “The opportunity to drive meaningful change and contribute to a mission that goes beyond profit—to truly focus on improving people’s lives—continues to inspire and keep me deeply committed to our cause,” closes Kevin Crofton.

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One of the most crucial aspects of maintaining health and wellness is staying proactive about regular cancer screenings. Early cancer detection significantly increases the chances of successful treatment and survival. The multidisciplinary care team at the William N. Pennington Cancer Institute at Renown Health provides compassionate care and support to the community for early detection and diagnoses. This comprehensive guide outlines the various cancer screenings available for breast, colorectal, lung, cervical, prostate and skin cancer. Breast Cancer Screening Who Should Get Screened? Mammograms are recommended starting age 40 for those considered at average risk for breast cancer. Women with a family history or other risk factors should discuss appropriate screening options with their healthcare provider. Women under 40 with a family history should discuss risk factors with a healthcare provider. Screening Methods Mammogram: This provides an X-ray of the breast and can detect tumors that are not yet palpable. Breast MRI: This type of scan is recommended for women at high risk for breast cancer due to genetic factors or family history. Screening Breast Ultrasound: This scan can help in identifying masses in denser breast tissue that might not be visible on mammogram. It is recommended in addition to a mammogram for patients at a higher risk for breast cancer. What to Expect During a mammogram, the breast is compressed between two plates to capture X-ray images. Some pressure or discomfort may be felt, but the procedure is brief and critical for early detection. Colorectal Cancer Screening Who Should Get Screened? Adults aged 45 to 75 should undergo regular colorectal screenings. Some adults under 45 may need to be screened earlier depending on family history or other genetic risks. Those over 75 should consult with their healthcare provider to determine if continued screening is necessary. Screening Methods Colonoscopy: This procedure uses a flexible tube with a camera to examine the entire colon. Fecal Immunochemical Test (FIT): A non-invasive test that detects hidden blood in the stool. CT Colonography (Virtual Colonoscopy): Uses Computed tomography (CT) imaging to provide detailed views of the colon. What to Expect A colonoscopy can detect changes or abnormalities in the large intestine (colon) and rectum. Screening is usually advised every ten years, but if you are at risk, screening may be recommended every 3 to 5 years after your initial colonoscopy. Colonoscopy preparation includes bowel cleansing the day before and sedation during the procedure. FIT is a simple at-home test requiring no special preparation. Lung Cancer Screening Who Should Get Screened? Adults aged 50 to 80 with a significant smoking history (20 pack years or more) and who currently smoke or have quit within the past 15 years. Screening Methods Low-dose Computed Tomography (LDCT): A CT scan with low radiation doses to create detailed images of the lungs. What to Expect LDCT is a non-invasive scan that requires you to hold your breath for a few seconds. Cervical Cancer Screening Who Should Get Screened? Women aged 21 to 65 should undergo regular screenings. Women aged 21 to 29 should have a Pap test every three years. Women aged 30 to 65 should have a Pap test and HPV test every five years, or a Pap test alone every three years. Screening Methods Pap Test (sometimes called a Pap Smear): Collects cells from the cervix to detect precancers. HPV Test: Identifies high-risk human papillomavirus (HPV) types that can cause cervical cancer. What to Expect The Pap test involves collecting cells from the cervix using a small brush. Some discomfort may be felt, but the procedure is brief and crucial for early detection. Prostate Cancer Screening Who Should Get Screened? Men aged 50 and older should discuss screening options with their healthcare provider. Men at higher risk (African American men and those with a family history of prostate cancer or are a BRCA2 gene carrier) should begin discussing screenings  at age 40. Screening Methods Prostate-Specific Antigen (PSA) Test: Measures PSA levels in the blood. Digital Rectal Exam (DRE): A physical examination where the provider feels the prostate through the rectum to detect abnormalities. What to Expect The PSA test is a simple blood test. The DRE may cause slight discomfort but is quick and essential for early detection. Skin Cancer Screening Who Should Get Screened? Anyone with a suspicious lesion or abnormal area on their skin. Individuals with more than 50 moles or dysplastic moles. Those with a personal history of melanoma or history of other skin cancers. Those who have more than one member of immediate family with a history of cancers (melanoma, breast cancer, pancreatic cancer) or a family member who was diagnosed with melanoma before they were 50 years old. Positive gene testing for BRACA2, Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2 or EPCAM). Screening Methods Skin Exam: A visual examination by your provider to check for unusual moles, birthmarks, or other skin changes. Biopsy: Removal of a small sample of skin for testing if an abnormal area is identified. What to Expect A skin exam is non-invasive and visual. A biopsy involves minor discomfort and local anesthesia if needed. Expert Advice Although the cadence of these skin screenings may or may not be annual, as one's age increases, the risk of many cancers rises. Everyone benefits from attentive sun protection, including avoiding direct sun between 10 a.m. and 4 p.m. by seeking shade and wearing hats, clothing and sunscreen. When purchasing sunscreen, look for SPF 50, UVA/UVB broad spectrum. Questions to Discuss with Your Healthcare Provider What is my risk level for different types of cancer? Which screening tests do you recommend for me and why? What are the potential risks and benefits of each test? How often should I get screened? What steps to follow if a test result is abnormal? Importance of Cancer Screenings Regular cancer screenings are vital for maintaining your health and catching cancer early, when it is most treatable. Renown Health is dedicated to guiding you through the process and providing the highest quality of care. Consult with your healthcare provider to determine the appropriate screenings for your specific needs and to take proactive steps toward a healthier future.

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© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

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Stepping into the Renown Transfer and Operations Center (RTOC) means stepping into a transformative hub of excellence where lives are saved and healthcare is reimagined. As a cornerstone of Renown Health's commitment to exceptional patient care, the RTOC serves as a dynamic nerve center that seamlessly coordinates medical resources, ambulance rides, hospital bed space, remote home systems, hospital transfers and emergency preparedness. In this best-in-class facility, the boundaries of what is possible in healthcare are constantly pushed, and new horizons of patient care are discovered.   Staffed with a dedicated team of skilled professionals, the RTOC harnesses the power of advanced technology and compassionate expertise to ensure that patients receive the highest level of care and support, no matter where they are. Through a synchronized network of communication, coordination, and compassionate care, the RTOC team ensures that patients receive the critical support they need when it matters most, working tirelessly to redefine what it means to deliver world-class healthcare.   A National Standard  Charged with the goal of overseeing the placement and transportation for every patient, the RTOC officially launched in 2021 as northern Nevada’s first and only transfer center of its kind and a nationally celebrated facility. As Renown’s highly coordinated care logistics system, this team uses the cutting-edge technology at their fingertips to customize healthcare to the needs of every patient, manage patient flow and drive healthcare innovation.  “Compared to where we’ve started to where we are now, it’s a 180-degree difference,” said Kelli McDonnell, Manager of RTOC. “When we first started building our facility right before the pandemic happened, we took what was six conference rooms and classrooms and turned it into a command center that organizations across the country admire and come to Reno to see what we do. Mel Morris, the Director of RTOC, was recruited exclusively to build our facility with her history of building successful hospital command centers. Many people didn’t realize what a transfer center was or that Renown was the only center in the region – and we only continue to grow.”  This best-in-class facility, and the masterful team behind it, handles:  Coordinating all incoming patients transferred from neighboring hospitals and 27 counties across northern Nevada, Lake Tahoe, northeast California and neighboring states. Matching patients to the most appropriate bed placement using diagnostic, triage and Epic electronic medical record clinical information in conjunction with medical staff expertise to outline a plan of care that determines the best bed assignment given the patient’s needs.  Coordinating video-enabled Telehealth monitoring capabilities for Renown’s four Intensive Care Units (ICUs), as well as Renown patient Telehealth and virtual visits. Monitoring Remote Home systems with Masimo during the COVID-19 pandemic, where some patients received hospital-level care in the comfort of their own homes while Renown clinicians monitored and evaluated their data and plan of care.  Serving emergency and disaster management for area hospitals, first-responders and the community with local, regional and statewide emergency and disaster management for sudden-onset emergencies.  The RTOC is home to many different critical roles for our health system, including Transfer Center Nurses, Ride Line Coordinators, RTOC Coordinators and more, many duties of which each team member cross-trains on to be able to fill in whenever needed. While their roles may differ, their commitment to their patients remains the same – and they all work together to achieve the same outcome: delivering the right care, at the right time and place.  “As an RTOC Coordinator, we do a variety of different things,” said Anna Schaffer, RTOC Coordinator. “We do triage coordination to help our nurses and hospitalists get patients in the emergency department admitted, and we also do bed control to find patients appropriate bed placement. Communication is important, so we always make sure to stay closely connected with the charge nurses on those floors.”  “We start with a basic ‘need to know’ and place patients accordingly,” added Karly Brown, RTOC Coordinator. “We get surgery numbers, ICU capacity and discharges and find beds for all patients as quickly as possible. We have the advantage of being able to see the entire hospital.”  “I primarily schedule transportation for patients at the hospital who are either going home or going to a skilled nursing facility,” said Sarah Clark, Ride Line Coordinator. “I get requests from case managers to schedule rides, and I work with REMSA and other ambulance services to schedule them. It relies a lot on appropriate and efficient communication and critical thinking.”  Patients in facilities across northern Nevada and northeastern California, especially the rural communities, look to the RTOC to help guide ambulances, bed coordinators and hospital staff in finding care for our rural patients.  “As a transfer center nurse, I facilitate incoming patients from rural facilities in Nevada and surrounding areas in California,” added Meg Myles, Transfer Center Nurse Specialist. “There are days we may take up to 30 direct admissions from these areas.”  “We are the point of contact for inter-facility transfers, whether we are sending patients out or bringing them into Renown,” said Lisa Lac, Transfer Center Nurse Specialist. “We take phone calls from those rural areas, identify what services are needed, connect them to the appropriate provider and coordinate any transfers.”  “Simply put, we are the bed wizards,” said Addison Rittenhouse, RTOC Coordinator.  The RTOC team continues to break barriers and push the boundaries of medical excellence through leveraging the technology at their fingertips and their unwavering dedication to the health of our community. Inspiring a new era of medical possibilities, these team members have achieved a multitude of accomplishments for both their department and their patients since the birth of the center.  “We have significantly reduced the time it takes to get patient admit orders in, thanks in part to the new Triage Coordinator role, and we provide easier access for patients to transfer to us from other facilities,” said Beth Rios, RTOC Coordinator. “We have taken a bigger role in helping the smaller hospitals in our area in caring for patients and improve patient throughput.”  “As a team, we’ve done a lot of work in creating an engaging and positive environment, and our internal morale committee has been a huge help with that,” said Kelli McDonnell. “We’ve been working tremendously over the last year and taking all the feedback that we received from the Employee Engagement Survey to make improvements. We had 100 percent survey participation within five days, which is incredible.”  “I am so proud of our escalation and problem-solving skills,” said Becca Dietrich, RTOC Coordinator. “When an issue is raised to us, we will always find a timely solution on our end so our care teams can focus on the issue in front of them. We are the eyes in the sky, seeing movement everywhere.”  Each day in the life of our RTOC team members is a testament to their commitment, resilience and timework, making a profound impact on countless lives.

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Renown Health strongly supports and advocates for innovative medical technology. Our diverse lineup of medical equipment enables our care leaders to provide quality care to every patient. But what if a piece of technology breaks down? What happens when our care teams are ready for technological upgrades? Where do employees go when they have a question about a complicated piece of equipment?  Enter the Clinical Engineering department. This sophisticated team is staffed with intelligent, science-minded individuals who are ready to jump in and help at any given second. From newborn incubators to robots that clean the hospital floors, these team members are the med-tech masters that keep our health system running.  Equipment Experts  Upon entering the Clinical Engineering department’s workshop, you are welcomed with an abundance of high-tech equipment undergoing repairs and upgrades. The department takes care of more than 26,000 pieces of equipment throughout the entire healthcare network, including the technologies at the University of Nevada, Reno School of Medicine, which they just took over this past year. To the average person, this may seem overwhelming; however, for this team, this is the exact environment they thrive in to make the technology magic happen.  “I am motivated and engaged every day at work,” said Tony Martinez, Supervisor of Clinical Engineering for Renown. “Our department is fast-paced and rewarding, and that’s a big plus.”  While some team members enter the department as equipment generalists, this team offers training to develop their skills on certain pieces of equipment, eventually becoming specialists.   “Every month, we encourage our colleagues to undergo specific training on more delicate equipment,” said Tony. “Once we get to that point in their training, we assign different equipment to our team members every month. They pick up the experience very quickly.”  As a Clinical Engineering Technician for Renown, Rylie Nickerson took advantage of the training and educational opportunities offered to her and is now a ventilator specialist especially for Renown’s neonatal intensive care unit (NICU). “Regardless of whether I’m working on ventilators or on another piece of equipment I’m assigned to, I’m always thinking about how I can help the patients, nurses and doctors,” said Rylie.  Raul Hernandez, a Clinical Engineering Specialist for Renown, is the go-to person for anesthesia, heart-lung bypass, red cell saver and life support equipment. He embraces the fact that, regardless of whether you are a specialist or a generalist, there is no typical day working in this department. “Every day brings different challenges,” said Raul. “I really enjoy the mental exercises I do every day. They keep me grounded and focused.”  On top of their day-to-day work and any special projects or emergencies that come up, the team is on an ongoing preventative maintenance schedule. Think of this work like your car’s oil change – routine maintenance to prevent something from breaking down in the future. “At any point, we might have 100-200 extra pieces of equipment to handle during preventative maintenance,” said Taylor Gray, a Clinical Engineering Technician for Renown. “We are always helping each other through any issues.”  Our Clinical Engineering team shows exactly what it means to be collaborative. Even though their to-do lists are ever-growing, this team never feels alone. They know they can always lean on each other for support, regardless of the workload.  “We always have each other’s backs,” said Taylor. “I feel so happy and satisfied in my job, and my coworkers are a large part of that.”  Celebrating the Genuine Difference  The Clinical Engineering department is driven by their desire to help and take care of the entire health system, and in turn, make a genuine difference for the communities we serve, from the medical staff to the patients.   “The satisfaction you get in our field when we impact patients’ lives and their healing process is so motivating and engaging,” said Tony Martinez. “It’s a great feeling.”  The team knows the common saying ‘Walk a mile in someone’s shoes’ very well; so well, in fact, that they take it to the next level, doing everything they can to prevent frustrations and extended down times. “We try to walk a mile in someone’s shoes before they get angry,” said Reagan Jordan, Director of Clinical Engineering for Renown. “Your satisfaction is our mission, and our team continually works to improve their outcomes every day.”  This department is where the entrepreneurial spirit and science-focused mind meet. For people like Raul Hernandez, who came from a business background as well as decades of medical technology experience, Renown helps him bring both his personal and business skills into focus. “This environment is very beneficial for Renown, me, and of course, the patients,” added Raul.  Being members of a team that is committed to excellence and purpose inspires them to reach new heights in patient care.  “I am constantly reminded of the positive impact we have by witnessing the individual experiences we have and hearing the enthusiasm and thankfulness in their voices,” said Raul. “It gives me a great sense of pride to work at Renown.”  "There is a strong feeling of mutual respect here,” added Ed Trejo, a Clinical Engineering Technician at Renown. “We are always here to help.”  The proof is in the data. The Clinical Engineering team scored as one of the top departments in the recent Renown employee engagement survey, with their results sitting at more than 94 percent.   “This speaks to not only our department leadership but also the team as a whole,” said Reagan. “I am extremely proud of them. Despite the pandemic, they are knocking it out of the park.”  For this department, coming to Renown is easy; staying at Renown is even easier.  “Staying at Renown is the easy choice,” said Raul. “And this team is only going to grow.”  Workflow Whizzes and Kindness Champions  “Rolling with the punches,” as Tony Martinez says, comes naturally to the Clinical Engineering team. With the constant workflow of equipment coming into the shop, every team member has learned how to be experts at prioritizing, especially based on the needs of our organization.  Even though their jobs can bring a lot of intensity, this department’s positive attitude radiates throughout the hospital. Upon entering the workshop, everyone is greeted with a smile from every team member, along with an immediate willingness to dive into the complex world of engineering.  “The experience of helping other people with their unique needs is invaluable,” said Taylor Gray.  If this work environment sounds enticing, great news – the Clinical Engineering team is growing. Motivated, aspiring engineers with a passion for healthcare and an associate’s degree in a related field are welcome.   Military experience is also valued very highly in this team. As many of our military servicemen and servicewomen gain specialized engineering experience while enlisted, the military-to-engineer career ladder at Renown is especially strong. In fact, according to Paul Joseph, a Clinical Engineering Technician at Renown, the majority of their teammates come from a military background.   Above all, being capable of prioritizing on the fly, thinking critically, having an open-mined outlook and being self-driven are the top skills that this department values. As Ed Trejo states, “If you’re willing to wear different hats, you will do very well here."  “Go with the flow, and expect the unexpected,” added Rylie Nickerson.  Those who join this team feel at home. The warm embrace of the team’s kind nature and the supportive environment they all foster inspires an efficient workflow that helps our entire hospital system function at the top of its game. At the end of the day, everyone who joins the team, or anyone who even interacts with the team in any capacity, will be in good hands.  Mandy Noriega, a Clinical Engineering Technician for Renown, closes these thoughts with a great reminder to each and every one of us: “After all, teamwork makes the dream work.”

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If CPR (cardiopulmonary resuscitation) is performed in the first few minutes of cardiac arrest, a person’s chance of survival can double or even triple. Troy Wiedenbeck, MD, cardiologist with the Renown Institute for Heart & Vascular Health, explains how you can be ready to perform it in case of an emergency. According to the American Heart Association, over 350,000 out-of-hospital cardiac arrests occur in the U.S. This highlights the importance of CPR to everyone, not just medical personnel. Most people do not have heart trouble at a hospital or fire station, they have it going about their everyday lives. And when someone has a heart attack outside of a hospital, their survival often depends on receiving help from a bystander. Signs of Heart Trouble First, how do you know when someone is experiencing cardiac arrest? The signs and symptoms of cardiac arrest are immediate and drastic, including: Sudden collapse No pulse Not breathing Loss of consciousness And sometimes, patients can experience symptoms beforehand, such as fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath or vomiting. CPR Change Many of us know CPR as both mouth-to-mouth and pumps to the chest, but the rule now is hands-only. Can you explain the change? Hands-only CPR is exactly what the name says -- it's CPR without mouth-to-mouth. The American Heart Association recommends using only your hands. So if you see someone suddenly collapse, it’s recommended to call 9-1-1 and push hard and fast in the center of their chest. Doing this will get blood flowing back to the brain, lungs and other organs for someone having heart problems. Performing CPR on Adults vs. Children Hands-only CPR is just as effective as mouth-to-mouth and chest compressions for teens and adults who may have gone into cardiac arrest. Remember, it’s important to act fast. First, call 9-1-1 and then start chest compressions right away. If you perform CPR on someone within the first few minutes, it can double or triple their chance of survival. Keep in mind, for infants and children younger than 12 years old, regular CPR with mouth-to-mouth, as well as chest compressions, is still recommended. Two Steps to Save a Life If you see a teen or adult suddenly collapse follow these two steps: Call 911 so care providers can begin to respond. When calling 911, be specific about your location, especially if you are calling from a cell phone. Knowing the street address, building, floor and closest entry point can save precious time for first responders. Answering the dispatcher’s questions will make sure help arrives fast, and at the correct location. Push hard and fast in the center of the chest. The goal during CPR is 100 to 120 compressions per minute, about the same tempo as the song “Stayin’ Alive,” or “Thriller.”  For hand placement, it’s also important to put the heel of your hand on the center of their chest and place the other hand on top. Push down on their chest at least two inches. It may seem severe at the time, but pushing this hard can truly save a life. Continue performing compressions as long as possible. If you tire, have someone take over compressions, if possible, and take turns until medical help arrives. For information on a CPR course in Reno, please contact REMSA at 775-858-5700.

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Renown Health recently wrapped up the twentieth annual Nursing Excellence and Excellence in Critical Care Conferences, the conference theme was the Courageous Calling and over 400 nurses from specialty fields across the region attended to learn, reflect, build relationships and obtain continuing education units (CEUs).   Celebrating The Courageous Calling During the first day of the Nursing Excellence Conference, local and national leaders presented topics including redefining resilience, documentation liability, transgender healthcare and caring for the homeless population. Among the list of impressive speakers were Chief Nurse Executive at Renown Health, Melodie Osborn, and Nora McInerny, writer and host of the "Terrible Thanks for Asking" podcast.   On day two,speakers focused on the critical care specialties within nursing, including intensive care, emergency room, pediatric intensive care and neonatal intensive care. Topics covered included post-COVID-19 pulmonology with Dr. Graham, traumatic brain injuries with Dr. Demers, COVID-19 reflections with Anicia Beckwith, a discussion about "Mis C” with Dr. Healy, innovations in imaging with Dr. Rangaswamy and cardiology with Dr. Danaf. Thank you to our sponsors and raffle donors for making this event possible: Erik Olson and Larry Duncan, Jana Elliott, Melodie Osborn, Becky Haase, Lori Tuntland, Dr. Akbar, Dr. Lous, Mel Morris, Grand Sierra Resort, Renown Health Gift Shops, Renown Health Directors of Nursing, Renown Health Marketing & Communications Department, Renown Health Dermatology, Laser, & Skin Care and Renown Health Foundation.   Learn more about finding purpose in the health of our community when working at Renown Health here.

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One of the most pressing issues in modern medicine is the need to improve rural healthcare. This challenge hits particularly close to home, as Renown Health is the only provider covering 100,000 square miles in northern Nevada, an area that’s mostly rural. People in rural areas suffer from chronic diseases such as heart disease, cancer and respiratory disease, at higher rates than the general population. One of the largest contributors to these health disparities is a lack of access to health services. Many rural communities have fewer providers and care facilities. This forces residents to travel farther to receive preventive care and medical treatment. We must identify ways to better support the health needs of the millions of Americans who live in rural communities. Ideas for improving rural healthcare Health systems must identify innovative ways to leverage existing resources and new technologies to care for patients in these communities. For example, telehealth can help diminish a person’s need to travel long distances to receive specialty care. Similarly, online classes can help educate patients about preventive behaviors. Remote monitoring technology also allows patients to track their health conditions from home. Additionally, we can address physician shortages by empowering health professionals such as nurse practitioners, physician assistants and technologists to care for patients. These providers receive excellent training and have demonstrated success in improving health outcomes. Renown Health cares for people from diverse backgrounds and we are dedicated to caring for patients in every community we serve. Renown Telehealth We’re leading the region in using video conferencing technology to provide the best care possible – no matter where you are. Renown Telehealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs. Learn More

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Parkinson’s disease – you may have heard of it because Neil Diamond and Ozzy Osbourne were recently diagnosed with it. Or perhaps you know Michael J. Fox is a strong advocate and funds research through his foundation. Neurologist Jonathan Spivack, MD, discusses this disease, while physiatrist Stephanie Jones, DO, explains how physical therapy can help as a supplemental treatment. According to the Parkinson’s Foundation about ten million people worldwide currently have this disease. What is Parkinson’s Disease? “Parkinson’s disease is a neurodegenerative disease that progresses slowly and definitely, though at variable rates,” explains Dr. Spivack. “Symptoms go beyond the classic motor changes. It results from a loss of specific dopamine-producing brain cells. Specifically, this loss is likely due to a mix of genetic and environmental factors,” he adds. Dopamine allows communication between particular nerve cells responsible for movement. If you have Parkinson’s dopamine levels gradually drop, causing a loss of motor skills. Generally, most patients with the disease are over age 65. Early Signs and Symptoms Diagnosing Parkinson’s can be difficult as some of the symptoms happen during the natural aging process. The Parkinson’s Foundation identifies the following 10 early signs of PD: Tremors or shaking of your hand, fingers or chin Small handwriting Loss of smell Sudden movements during sleep Stiffness when walking or moving Constipation Softer or lower voice volume Mad facial expression Feeling dizzy or faint Hunching or stooping posture A single sign may not point to the disease, but if you (or a loved one) has multiple signs, talk to your healthcare provider.

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