Health networks try to balance increased demand with lack of caregivers

Health networks are looking at creative ways to support an increasing demand for mental health treatment at a time when healthcare workers are in short supply.

Some are using hybrid models of care that use partial inpatient treatment with outpatient support, some are increasing space for inpatient care, and most are using telemedicine to keep the lines of communication open between patients and caregivers.

Dr. Courtney Chellew, a psychiatrist at Lehigh Valley Phyicians Group-Muhlenberg, said there was a big increase in demand for care even prior to the pandemic. The demand has increased even more since the start of the pandemic. The problem, she said, “is there is a severe shortage of providers in the country right now.

“We are trying to look at ways to handle referrals to deliver outpatient and inpatient care in a timely manner,” she said.

Dr. James A. James III, vice chairman of psychiatry and behavioral health at St. Luke’s University Health Network, agreed. “We continue to hire exceptional people, but we can’t keep up with demand.”

Being pulled in two directions, employee shortage and increased demand for services, means patients may not get services as quickly as they would like, he said. They might sit in the emergency room longer than doctors would hope.

“We are trying to work with the ER to get interventions as soon as we can,” James said. In addition to arming emergency room staff with videos about depression, anxiety and other disorders that patients can view while waiting, James said SLUHN has hired a nurse navigator who develops care programs, connects patients with caregivers, follows up with patients to ensure they are taking prescribed medications, and finds ways to get patients help without inpatient stays.

Stephanie Lee, CEO, Tower Behavioral Health, said, “we are aware of the increased need for care.” The network has three adult inpatient units and one adolescent unit but between January and July of this year, demand has increased by more than 30 %, she said.

“Nearly half of our patients had to be deferred to get a bed. We stay in touch with them to make sure treatment is available once they are released,” said Dr. Eduardo Espiridion, chairman of Department of Psychiatry at Tower Health’s Reading Hospital.

Tower Health has a plan to grow to 144 beds in the behavioral health inpatient units. “We have to open slowly because of the need for support staff,” Lee said. “We started with 12 beds and now we have 80 open beds.” She said the beds in four of the six units planned are in use. The others will be opened in two units as soon as nurses, doctors and support staff are hired.

Dr. Rory Marraccini, vice chair of psychiatry at LVHN-Cedar Crest, said he works with primary care physicians to get patients treatment. LVHN is using virtual visits for consultations which, he said, helps those patients who have trouble getting to a facility for a variety of reasons.

“We are trying to hone in on consultant work. Where it may have traditionally been inpatient treatment, we now work with more outpatient programs,” he said, as long as there is no risk of harm to the patient or others.

Using a community outreach approach, Marraccini said, “we are able to offer good care and keep people out of inpatient treatment.”

Dr. Chellew added that LVHN is investing in psychiatric care. “It (demand) has grown so much; we are doing our best.”

To that end, LVHN has initiated a psychology residency program and psychology fellowships. “We may be able to keep the people that are in the programs,” she said. “With the fellowships, we can provide better services to teens and kids.”

Dr. Chellew said schools are an important resource. “We are integrating into schools to work with students, families and staff,” she said. Currently LVHN works with five local school districts. But the school closures were an issue.

“The students lost access to their caregivers, and, at the same time, virtual learning contributed to psychiatric symptoms,” she said.

Lee agreed. Students and adults alike had to deal with quarantine, job loss, loss of family members, and the children lost the peer-to-peer interaction schools gives them.

According to the Henry J. Keiser Family Foundation, a healthcare watch group, 39 % of children suffered academically, 36 % showed social and emotional stress and 26 % sought help for mental and behavioral issues due to the pandemic.

Lee said the high demand for services hit individuals with established care particularly hard because they lost their services. “These people need to keep up their treatments,” she said. “There were more hospitalizations, but many were limited to telecommunications.”

While teleconferencing can help, Lee said patients are isolated which can exasperate symptoms.

Dr. Marraccini said telecommunications have been key. “We are able to offer good care and keep people out of inpatient treatment by using this technology,” he said. The increase in patients with depression and anxiety will probably continue even when the pandemic subsides. “Sometimes symptoms don’t show up right away. The challenge is to be as creative as possible to deliver needed care.”

All the caregivers agreed that the pandemic has highlighted the need to talk about mental health issues and start to look at psychological illnesses the same way physical ailments are treated. “The more people that seek help, the more the stigma will go away,” Dr. Chellew said.

Area health networks now offer COVID-19 vaccine to children ages 12 to 15

Area health networks, including Lehigh Valley Health Network, St. Luke’s University Health Network, and Geisinger Health System, will now offer the COVID-19 Pfizer vaccine to children ages 12 to 15.

This vaccine is the first and, thus far, the only COVID vaccine approved for this age group, according to Bethlehem-based SLUHN.

“Timing is critical, as children and parents prepare for various social, group activities like athletics, vacations and, in a few months, a return to school, all of which raise risks for virus transmission,” says Dr. Jennifer Janco, SLUHN chief of pediatrics. She has been receiving inquiries from parents looking for the vaccine for their children, which is encouraging for her, she says.

The clinical trial data submitted to the Food and Drug Administration demonstrated 100 percent effectiveness at preventing disease in this age group, reports Allentown-based LVHN. which now represents nearly 20 percent of current COVID-19 infections reports Allentown-based LVHN.

“We at Lehigh Valley Reilly Children’s Hospital are encouraging parents to get their child vaccinated for their safety, as well as the safety of their family,” says Dr. J. Nathan Hagstrom, chief of pediatrics at LVHN’s Reilly Children’s Hospital.

Anyone under the age of 18 will need to be accompanied by a parent or legal guardian to get vaccinated. The COVID-19 vaccinations provided by the health networks are free.

St. Luke’s Warren Campus turns 100 years old; celebrating the history of Phillipsburg’s community hospital

St. Luke’s Warren Campus is celebrating the 100th anniversary of the community hospital on May 13. 

The hospital has a long and vital history to the Phillipsburg community, according to St. Luke’s University Health Network. Organized healthcare in the area began on May 13, 1921, with the founding of the Maternity Hospital and Infantorium, a facility for delivering babies and treating young patients. Soon thereafter, Warren Hospital was built on Wilbur Avenue.

Over time, the city’s population grew and diversified, and the hospital outgrew its walls. A new facility on Roseberry Street was built in 1958 with federal funding, community contributions and support from a corporate booster, the nearby Ingersoll-Rand, Co.

The hospital’s Family Medicine Residency Program welcomed newly-minted doctors to the hospital in 1981 for training, creating a vital, local source of physicians with expertise in this specialty, according to SLUHN. Later came facility expansions and development of specialty programs, such as behavioral health units, cancer care, a vascular lab and a cardiac catheterization lab.

By the time Warren Hospital, as it was then known, had entered its 10th decade however, its outlook had dimmed. The health care industry was rapidly evolving, and the hospital was struggling to keep up with the pace of change.

Then, in 2012, Warren Hospital made the decision to join St. Luke’s University Health Network.

Scott R. Wolfe assumed the role of hospital president. Leading the hospital’s dramatic turn-around and its integration into St. Luke’s University Health Network has been a high point of his career, Wolfe said.

Now, St. Luke’s Warren Campus and its satellite locations provide a wide array of medical services to area residents, regardless of their ability to pay, from primary care to cancer care.

The hospital also offers an expanded emergency room, modernized infusion center and refurbished inpatient units as well as a state-of-the-art intensive care unit and catheterization lab.

As part of St. Luke’s, the Warren Campus employs over 600 people today, and a medical staff of over 80 primary care and specialty physicians.  Roughly 95,000 patients are seen on an outpatient basis at the hospital each year, according to SLUHN. Another 5,000 people are admitted as inpatients each year and 25,000 people visit the St. Luke’s Warren emergency room annually.

“St. Luke’s goal is to keep people healthy and close to home…” Wolfe said. “St. Luke’s Warren Campus greets its second century with unbridled optimism and a renewed commitment to ensuring that quality care is accessible to this community and beyond far into the future.”

97% of physicians in St. Luke’s network now vaccinated against COVID-19

As of May 6, 97% of St. Luke’s University Health Network physicians were fully vaccinated against COVID-19, according to the Bethlehem-based health network.

To drive up the employee vaccination rate, the network launched an extensive, sustained internal communications campaign to educate employees on the importance of vaccination to achieve herd immunity, according to the health network.

This campaign included regular town hall meetings led by St. Luke’s president and CEO Richard A. Anderson and other senior leaders, who provided detailed vaccine updates, as well as testimonials from employees who were sickened by but survived COVID -19.

“Our employees recognize that COVID-19 is a public health crisis,” said Dr. Jeffrey Jahre, vice president of medical and academic affairs and section chief emeritus of infectious diseases. “In order to protect our patients, families and communities, our employees stepped up to perform their civic duty, they got the shot.”

St. Luke’s opens new OB/GYN practice in Hamburg

St. Luke’s University Health Network will offer OB/GYN services in Hamburg beginning May 6. Obstetrician-gynecologist Dr. Hazel A. Tuazon will see patients at the new office in St. Luke’s Health Center at 9 Dave’s Way in Hamburg in Berks County.

Dr. Hazel A. Tuazon

Board certified in gynecology and obstetrics, Dr. Tuazon completed her residency with Bethlehem-based SLUHN and has since remained with the network.  She specializes in routine care, high-risk pregnancies, minimally invasive surgeries, family planning, contraceptive management options and treatment for menopause.  Tuazon is fluent in English and Tagalog, a language spoken in the Philippines.

“As a young mother, I appreciate the challenge of juggling family and other responsibilities,” Tuazon said in a statement. “While we’re busy taking care of everyone else, we have to make an effort to prioritize our own health. By opening my office in Hamburg, we are making it easier for women to do that and receive the high-quality care they need. We take the time to get to know our patients and what makes them unique. We really listen to them and understand their needs, goals and motivations at every life stage.”

10 area hospitals earn an A rating for safety, one receives a D

10 hospitals in the greater Lehigh Valley earned an A grade in the spring 2021 Leapfrog Hospital Safety Grade report, including three Lehigh Valley Hospital campuses, and six St. Luke’s hospital campuses.

The Leapfrog Group, a national nonprofit that publishes the health care quality assessment twice a year, grades hospitals from A to F based on publicly available information on hospital errors, accidents, injuries and infections.

Lehigh Valley Health Network’s Cedar Crest, Hazleton, Muhlenberg, and Pocono campuses all earned A grades. Over at St. Luke’s University Health Network, the Allentown, Anderson, Monroe, Quakertown, Sacred Heart and Bethlehem hospital campuses all garnered A ratings.

St. Luke’s Gnaden Huetten campus earned a B.

In Berks County, Reading’s Penn State Health St. Joseph earned an A grade. Also in Reading, Tower Health Network’s Reading Hospital received a B for hospital safety from Leapfrog.

St. Luke’s Easton campus did not fare as well with a C rating while Tower Health’s Pottstown Hospital rated worse, with a grade of D.

The full report can be read here- https://www.hospitalsafetygrade.org/


New St. Luke’s residency program merges athletic training and occupational medicine

Most days you can find athletic trainer Nilvia Vazquez on the brewery floor at Breiningsville’s Samuel Adams, teaching employees how to properly lift a case of Hard Seltzer or performing ergonomic assessments and reviewing workplace injuries.

St. Luke’s University Health Network’s resident Athletic Trainer Nilvia Vazquez works with Sam Adams at the Fogelsville brewery – photo submitted

As the first resident in St. Luke’s Athletic Training: Prevention and Wellness residency program, she is preparing for a career in creating healthier and safer workplaces.

In fact, workplace musculoskeletal disorders cost companies more than $60 billion each year in medical expenses and lost production time, according to Kyra Dodson, manager of occupational medicine, prevention and wellness for St. Luke’s.

Mike Malchitsky, senior health and safety manager at Samuel Adams, has seen positive results across safety, production and general employee well-being since Vazquez began her residency at the brewery, he said.

Vazquez, who is approaching the completion of her year of residency training, much of it spent at Samuel Adams, said she considers “injury prevention at work (to be) the simplest, yet the most powerful tool we can utilize to ensure a safe workplace.”


St. Luke’s new FDA-approved procedure breaks up heart blockages like kidney stones

Dr. Christopher Sarnoski, medical director of the structural heart program at Bethlehem’s Saint Luke’s University Health Network, is breaking up heart artery blockages using a method similar to those used to break up kidney stones.

The technique, approved by the FDA in February, according to SLUHN, involves threading a thin wire into a patient’s coronary artery and positioning a special balloon called the Shockwave IVL at the site of the blockage.

: IVL is a novel application of lithotripsy, an approach that has been used for decades to safely break up kidney stones. It’s now available to treat problematic calcium in the coronary arteries that can reduce blood flow in the heart. – submitted

IVL stands for intravascular lithotripsy. This procedure can open up the vessel to increase heart function and decrease chest pain and shortness of breath, according to the health network.

Before the new technology was approved, fragmentation of these particles was done with atherectomy devices, or so called “Roto-rooter drills,” the health network said, and posed a slight increased risk of blood vessel rupture.

Dr. Sarnoski calls the new technology potentially “game-changing,” and ideal for high-risk patients who cannot undergo heart bypass surgery or conventional treatments.


St. Luke’s opens clinic for COVID long haulers

St. Luke’s announced the opening of their COVID Recovery Clinic at a virtual press conference on April 15. The Clinic, offered network-wide at the Bethlehem-based St. Luke’s University Health Network, is dedicated to the treatment of post-COVID patients with extended symptoms.

One in four people diagnosed with COVID-19 have lingering symptoms in the months following their initial diagnosis and “recovery,” according to the physicians at the Clinic.

The clinic, offered network-wide at the Bethlehem-based St. Luke’s University Health Network, is dedicated to the treatment of these post-COVID patients with extended symptoms.

These individuals may have been told by their physicians or friends and family that what they are feeling is all in their head, health network officials said.

“We know that it is real,” said Dr. Jeffrey Jahre, vice president of medical and academic affairs and section chief emeritus of infectious diseases for St. Luke’s, at an April 15 press conference announcing the clinic. Symptoms like extreme fatigue, difficulty breathing, brain fog and anxiety can continue for months for some patients, he said, with extreme fatigue being the most prevalent complaint.

The COVID Recovery Clinic provides patients with the care of medical specialists, including physical therapists, cardiologists, and experts in cognitive and memory training.

“…St. Luke’s is committed to helping these patients get access to the most appropriate care so they can find relief,” said St. Luke’s senior regional medical director Dr. Dennis McGorry, who is spearheading the program. “We have developed a very organized way of dealing with these issues.”

Patients with persistent symptoms that last more than a month are advised to go their primary care physician who will be able to evaluate them and may refer them to the clinic for treatment, he said,.

Treatment for these extended symptoms can help make sure that a more serious complications, such as blood clots or a heart condition are not missed, he said.

Receiving the vaccine can sometimes provide relief for such patients, Jahre said. Because of this, the health network advises those who have had COVID be vaccinated.