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Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

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COPD (chronic obstructive pulmonary disease) is a progressive lung condition often mistaken for typical aging signs, like shortness of breath and coughing. While smoking and pollution can contribute to its development, lifestyle changes and medications can help manage its progression. Diagnosis typically involves lung function tests, chest X-rays, or CT scans, with treatments available through a pulmonologist or primary care provider. Renown’s Pulmonary Rehabilitation Program offers insights into living with COPD. What is COPD? According to the COPD Foundation, it is an umbrella term used to describe progressive lung diseases including: Emphysema: Damage to the small air sacs in the lungs (alveoli). Chronic Bronchitis: Irritation and swelling of bronchial tubes, causing shortness of breath and coughing for long periods of time. Asthma (non-reversible): When asthma medications cannot reduce swelling in the airways. COPD Risk Factors Smoking is the most significant COPD risk factor, and the American Lung Association (ALA) says it accounts for nearly 90 percent of cases. If you are a smoker, it is essential to seek help and quit. Other COPD risk factors include: Air pollution Genetics Second-hand smoke Chemical, fumes or dust in the workplace How Can You Protect Yourself?  Stop smoking Renown Health provides support offering 4-week Smoking Cessation Virtual Classes, free of charge! Sign up today. Use natural cleaning products Many household chemicals, especially those containing bleach, can irritate the lungs – a condition called, chemical pneumonitis. Stay away from all types of smoke This includes smoke from fireplaces. Likewise, plan to stay indoors when it is smoky outside, or air quality is poor. Get active Of course, it’s never too late to start an exercise program. When exercising your heart pumps, circulating your blood and sending oxygen to every part of your body. Notably it strengthens your lungs, making it easier to breath. Talk to your doctor to see if you are healthy enough to begin exercising. Eat a healthy diet Surprisingly what you eat can affect your breathing. The American Lung Association encourages those with COPD to watch their sodium intake, eat smaller, more frequent meals (instead of three large ones), limit high fat foods and drink plenty of water. Avoid scented products Perfumes, aerosol sprays and plug-in air fresheners can trigger flare-ups. Get a flu shot Did you know chronic lung conditions, as well as, heart disease, cancer and diabetes, can be made even worse by the flu? Now is the time to get your flu shot for the season if you haven’t already. Renown’s Pulmonary Rehab staff is certified through the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR).  Recently, Renown Regional Medical Center successfully completed a disease specific COPD certification survey by The Joint Commission. For two accreditation cycles in a row, the COPD Program has had zero findings during the rigorous survey.

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In the United States, electronic cigarettes are the most popular form of tobacco product used among high school students. Approximately 21% of Washoe County area high schoolers report current use of e-cigarettes, higher than the national average of 14% reported in the most recent national data. While often viewed as a safer alternative to traditional cigarette use, e-cigarette use, commonly referred to as vaping, exposes users to nicotine and harmful chemicals that stunt brain development, results in lung damage and harms overall health. In partnership with Reno area school principals and nurses, the Renown Health – UNR Med Clinical Research Office was able to provide this year’s World Lung Day Anti-Vaping Program to Galena High School, Robert McQueen High School and Sage Ridge School, reaching hundreds of high school students.

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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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In today's fast-paced society, it is understandable for parents to want to take shortcuts in caring for their little ones. A s a result, It is tempting to leave a sleeping infant in a car seat or swing after a long day of errands or when you need a moment to catch your breath. But, as convenient as these devices may be, they pose a serious risk to your child's safety. Why Car Seats and Swings Pose Risks for Infant Sleep Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The American Academy of Pediatrics (AAP) states that “infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical.” If a parent must use a car seat or other sitting device, they should only do so for a short period of time and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The American Academy of Pediatrics (AAP) warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. This is because infants can easily slump over or become entangled in the straps, blocking their airway, and causing suffocation. Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The AAP states: Infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical. If a parent must use a car seat or other sitting device, they should only do so for a short period and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The AAP warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. In addition, infants can easily slump over or become entangled in the straps, blocking their airways and causing suffocation.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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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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Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing.     So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family.  Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.”    Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope.  Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks.   A Fighting Chance  Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family.  As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart.   To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.

Read More About A Fighting Chance at 24 Weeks Sloans Story

Health systems across the country recently celebrated Patient Access Week from April 2-8. Join us in recognizing our Patient Access team at Renown!  Fighting the Good Fight starts the moment a patient steps onto the grounds of our health system. When patients visit Renown on their healthcare journey, they look to the experts to not only help them navigate through the complexities of the process but also ensure their experience with us starts off on the right foot.  Renown Health’s Patient Access Representatives (also referred to as “PARs”) are the faces of this entire process. As the key links between patients, providers and insurers, they strive to create a welcoming and respectful environment for everyone. PARs are committed to providing all of Renown’s patients access to the quality care when needed. After all, it’s in their name!  A Friendly Face  PARs are the front faces of almost all clinical areas at Renown. As the starting point for much of the patient experience, the day-in-the-life of PARs can vary. Checking patients in and out, getting demographic information, verifying insurance, answering phone calls, fostering communication between patients and their care teams, scheduling patients for follow-ups, explaining financial responsibilities and our financial aid programs, creating an overall positive experience and environment, the list goes on – but they all remain united under one goal: setting patients off on the right foot as they access care through our health system.  “Each day, PARs are met with new patients who are seeking solutions to different concerns,” said Macy Betts, PAR for Renown Women’s Health. “We are the front doors to this department. We are not just checking patients in and out; we are the first step to the patients receiving the care they deserve.”  “We take pride in our work,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia, PARs for Renown Pediatrics. “Usually, we are the first point of contact within Renown, so we don’t take our role lightly. For example, when we see a newborn, we must ensure the registration has been verified, which consists of patient demographics, patient preferences and insurance verification. We need to be consistent and thorough because what we do affects every point of contact a patient may have within Renown.”  “As my team’s senior PAR, my day begins with gathering the outpatient therapy work queue numbers and assigning the team to work them,” added Logan Johnson, Senior PAR in Pre-Registration at Renown. “Our goal is to contact and schedule patients for physical, occupational and/or speech therapy as soon as possible so that they have the maximum benefit and can get back to a normal life as quickly as possible. Our encounters can make or break the entire experience.”  PARs never underestimate the power of good communication and compassion. Even during the busiest of times, our PARs work diligently to ensure all patients and their care teams fully understand the administrative side of whichever part of their journey they are about to embark on, lending a helping hand and a smile.  “Whether you’re communicating with patients, leaders or coworkers, communication is key,” said Jonathan Figueroa, PAR for the Renown Institute for Heart & Vascular Health (IHVH). “We try and make sure that we do everything possible to make their visit go as smoothly as possible.”  “Communication makes the world go round,” added Keith Madrona, Sherry Riley, Erika Rios and Andie Kilpatrick, PARs at Renown Urgent Care – Ryland. “Having a friendly attitude and demeanor is very important.  “The PARs in Labor & Delivery do so much more than just registering patients – from escorting expectant parents to their rooms, welcoming newborn babies, processing pre-estimates and more – and the patience and excellent communication I receive from other teams is what keeps me going,” added Nanci Barash-Vietti, PAR for Renown Labor & Delivery (L&D). “This is critical to the success and effectiveness of the PARs in our department.”  Shift changes for PARs mimic other teams at Renown, leveraging technology and both written and spoken communication to ensure the next shift begins successfully.  "When I come in, the night shift will give me a report on what is going on and what the schedule looks like during the day; then I log in to my computer and get everything that I will need for that day up on the screen,” said Allie Boracchia, PAR for Renown L&D. “Usually around this time we have a 7-8 a.m. induction scheduled for the first patient, so I will grab the pre-made packet that the night shift put together, the unit clerk will call the nurse to get a room number, and I take the patient to the room and have them sign all the forms. After the patient has the baby, then we admit them and finish registration. This is continuous all day long.”  Our PARs all agree that regardless of the setting, whether it be emergent or routine, every patient is looking for that advocate from the moment they enter through our doors.  “Being friendly, patient and understanding is a must,” said Sheryl Lundgren, PAR for the William N. Pennington Institute for Cancer. “It is so nice being able to brighten the days of patients who are living with a cancer diagnosis.”  “In the urgent care setting, a lot of the patients we see are not feeling their best, so it is important that we show them we care and are here to help make check in go smoothly,” added Sam Deithrich, PAR at the Renown Urgent Care – Los Altos.   “Patients are relieved that they are speaking to a real person that will help set up appointments,” added Rick Jordan and Celeste Landry, PARs in Lab Services at Renown South Meadows.   PARs embrace lifelong learning at Renown, especially as their roles differ day-to-day. They are always ready to jump in and assist on tasks that might be new for them, growing their skills on the job and never hesitating to say, “How can I help?”  “As a PAR, you are always learning new things, even when it seems like you know just about everything,” said Liz Cardenas-Ramos, PAR for Renown Endocrinology. “It’s been such a positive experience.”  “Giving yourself grace to learn and grow in Patient Access is the key,” said Maggie Savoie, PAR for Renown Primary Care – Fernley. “I find myself learning every day at Renown, and if you’re learning, you’re growing. Being able to take a breath and say, ‘this is a learning opportunity for me, and tomorrow I will be better a better PAR because I’ve gained this knowledge’ is an amazing way to stay positive in the position.”  “In L&D, we are all multi-tasking, and every day I am learning something new about my department and patients, as well as how to excel in my position,” added Nanci Barash-Vietti.  Renown PARs are the front lines to health care access, and they wear that badge with pride. Jeanette Flores, PAR in the Emergency Department at Renown South Meadows, sums up the role of Patient Access well: “Talk about first impressions!”  “I am proud of our team and the excellent care we give our patients,” said Dawn Linker, PAR for the Renown IHVH. “We want them to have a good experience.”  Impactful Accomplishments  The role of our Patient Access team members goes beyond the desk. A patient’s healthcare journey begins, and sometimes even ends, with the helping hands of our PARs, leaving a lasting positive impression of Renown.  "Our interactions with the patients make a difference before they see the provider, so we always demonstrate a welcoming and helpful atmosphere for the patients to feel like their needs are being met,” said Mary Dettling, PAR for Renown Endocrinology.  “I love seeing the difference we make in peoples’ lives,” added Shannon Leone, PAR for the Stacie Mathewson Behavioral Health & Addiction Institute. “We can get patients at their toughest and worst times. Watching them overcome their fears, traumas and addictions has been very rewarding.”  Our PARs don’t just make goals for themselves – time and time again, they surpass them, all in the name of patient experience and excellence.  “We have not only met our monthly point-of-sale scores, but we also have exceeded our stretch goal for the last eight months and our scores have been in the 50th percentile or higher,” said Jeanette Flores.  “Along with being the top point-of-sale collectors, we have also been known to be some of the sweetest and most helpful staff at South Meadows,” said Katie Morrill, PAR in the Emergency Department at Renown South Meadows.  As their teams grow, so does their impact on our patients. PARs are dedicated to providing the best customer service possible, and with their expanding teams, that service goes even further, even throughout the pandemic.  “A year ago, we only had one PAR; now, we have a full and amazing team,” said Alex Bucholz, PAR for Renown Advanced Wound Care. “We have come so far in a short amount of time.”  "During the pandemic, we have maintained a core group of individuals who come in every day and help keep this office and all its parts moving smoothly,” added Shannon Leone. “We have maintained a full patient load the last three years and never had to close our office for any reason. We have even had the opportunity to start our Medicated Assisted Treatment and Transcranial Magnetic Stimulation programs.”  "We successfully operated and maintained our pediatric COVID clinic, which is the only one within our five clinics,” added Tanya Quintanilla, Shari Longley and Nancy Arroyo Garcia. “We feel proud knowing our tiny humans are protected with the COVID vaccine.”  Like many other teams at Renown, our PARs are masters at teamwork. Despite any obstacles that may happen along the way, they are always there for each other to ensure every patient gets the care and attention they deserve.  “We call ourselves the ‘A-Team’ here in Pulmonary,” said Shannon Birnberg, PAR for Renown Pulmonary & Sleep Medicine. “We have persevered through changes, additions and departures. We are most proud of bringing different personalities to the team and being super strong and effective.”  “I have noticed the team always steps up whenever needed,” added Brittany Hughes, PAR for the Renown IHVH. “Everyone has a great attitude and is very positive!”  “While our team is fairly new, we are growing together, learning our strengths and weaknesses and always pushing for stronger unity,” added Angel Freer, PAR in the Emergency Department at Renown Regional.  When our PARs find ways to simplify a process or make a workflow run more efficiently, they don’t waste any time in making that happen. They take any opportunity to enhance patient experience.  “Our team came up with a solution on how to get patients registered faster,” said Jess Castillo-Marquez, PAR in Lab Services at Renown Regional. “We came up with modalities which assign each PAR their own procedure in which they will be registering for during their scheduled shift. It has been a great success, helping our productivity and keeping our patients satisfied with our service.”  “We are proud of our successful implementation of our new therapy workflow,” added Logan Johnson. “Patients are now waiting much less to be contacted about their care.”  Our PARs know that teamwork makes the dream work, and their commitment to the patients they serve – and the goals they continue to blow out of the water – continue to inspire them daily.   “You are only as strong as your team,” said Aundie Yonker, PAR in the Emergency Department at Renown Regional.

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By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve.

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According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens.   What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes.   What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting   For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.

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Pictured above: A section of Renown’s Labor Assessment Area.  When patients expecting a new child are about to give birth, nerves can be especially heightened. Questions flood their minds: Is the baby actually on the way? What’s going to happen next? Are we ready to push?   Lucky for them, at Renown Health, the guesswork can finally end with Renown’s Labor & Delivery unit Labor Assessment Area. This unique space is a triage area that helps make more precise labor diagnoses by determining exactly what stage expectant parents are at in the labor process.  Funded by a state grant more than a decade ago, the six-bed Labor Assessment Area sees 500-600 patients per month – from patients entering the unit directly, unsure if they are in active labor, to patients who are sent over from elsewhere experiencing labor symptoms, such as high blood pressure and water breaking. The area also serves as a pre-operation space for patients getting ready for procedures such as C-sections. The six cubicles that are enclosed with doors and curtains ensure each patient gets the private, one-on-one care they need. Furthermore, rather than sitting in a waiting room, this area allows expectant parents a comfortable place to prepare for labor.  “We are a unit that prides ourselves on getting patients into beds very quickly,” said Debbie Hawley, Associate Nurse Manager in Renown’s Labor & Delivery unit. “This area has allowed us to triage more effectively and allow more patients to collaborate with their provider in a quick manner.”

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