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  • January 18, 2022

    By MedStar Team

    Structural racism is one of the most pressing issues facing healthcare today.  Unfortunately, academic medicine historically exacerbating the exploitation of vulnerable communities to achieve educational and research goals, especially in Black, Indigenous, and People of Color (BIPOC) communities. For example, many traditional research practices among marginalized communities highlight and, in most cases, magnify inequities in care. These can include:   

    • Community members are under informed about research methods and strategies. 

    • Researchers prioritize extraction of information from communities rather than community ownership of information.

    • Researchers accrue funding, prestige, and publications (in which academics’ voices predominate over the narrative perspective of community members) without similar accrual to participating communities.  

    • Researchers’ understanding of questions to be answered may lack cultural context because of their incomplete comprehension of community conditions.  

    The relationship between research institutions and many BIPOC communities is estranged and needs mending to dismantle racial disparities and inequitable research practices. As the area’s largest healthcare provider, MedStar Health is committed to do the work needed to address these issues in everything we do in order to advance health equity for everyone we serve.

    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

    (March 25, 1966 speech to the Medical Committee for Human Rights)

     

    Advancing Health Equity in Early Childhood and Family Mental Health Research

    MedStar Health investigators Arrealia Gavins, Celene E. Domitrovich, Christina Morris, Jessica X. Ouyang, and Matthew G. Biel recently published research emphasizing the need to co-learn and to co-develop research with community members themselves to prioritize benefits for both participants and researchers. “Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health” was published in the Journal of the American Academy of Child & Adolescent Psychiatry. This work was done through the Early Childhood Innovation Network (ECIN),  a community-based partnership between two academic medical centers (MedStar Georgetown University Hospital & Children’s National Health System) and several community-based organizations in Washington, DC that strives to provide support to families through caregiver and child mental health services, family peer support, child social and emotional learning, initiatives to address social determinants of physical and mental health for families, and place-based support to families within select communities.  

    In this study, researchers found that to begin to undo the inherent inequities within academic medical research, particularly in studies involving children and caregivers, investigators need to consider how best to build equitable, long-term partnerships with communities through Community-Engaged Research (CEnR) or more specifically, Community-Based Participatory Research (CBPR). CBPR offers an alternative to traditional non-participatory research with a collaborative, strengths-based orientation that equitably involves researchers, community members and other stakeholders in all phases of research while embracing their unique expertise. 

    Recently documented increasing rates of depression, anxiety, and suicide in BIPOC youth, compounded by the disproportionate impact of the COVID-19 pandemic on BIPOC communities, has heightened the urgency for progress in community-based research.

    The research team started to utilize CBPR practices to advance antiracism in their clinical research work in child and family health along with working with BIPOC communities. This approach to integrate CBPR practices into the development, implementation, and evaluation of community-based interventions seeks to support early childhood mental health in primarily Black communities in Washington, DC. 

    Making an Impact: Insights & Lessons Learned from CBPR

    Through this work of the EICN, the research team found five valuable lessons from applying CBRP principles to research collaborations in community settings. 

    Intervention Practices

    Lessons Learned and Applied

    ECIN launched a group-based mindfulness parenting program to explore how to support the emotional health of parents at a Head Start early education center with the intention to reduce caregiver stress and enhance caregiver-child relationships.

     

    Lesson 1: Invest the time to build trusting relationships

    Providers set up several discussion groups with community partners and medical center-based researchers to review proposed assessment tools to be used with children and families receiving psychotherapy services.

    Lesson 2: Involve community partners in the development of the intervention theory of change and measurement strategy

     

    Clinical staff organized peer specialists to provide support to families with young children through 3 evidence-based strategies: enhancing parents’ knowledge about caregiving with young children;optimizingparent use of existing resources; and increasing parents’ access to social supports.

     

    Lesson 3: Create interventions in partnership with community members

    Clinical staff providedearly childhood mental health consultation (ECMHC) in preschool classrooms to enhance educators’capacitiesto support early childhood development and to recognize early signs of mental health concerns

    Lesson 4: Interpret findings in partnership with community members

    ECIN membersparticipatedin formal antiracism training with external experts to incorporate antiracism principles into ECIN’s operations and into the culture of the Network. ECIN formed a Racial Equity Community of Practice (RECOP), that supports 8 intervention teams in developing practices that advance racial equity goals.

    Lesson 5: Embed an antiracism focus in research structures and processes

     

    The research team found this community-based approach to be helpful in conducting research that will have a long-lasting impact on not only the community, but also on members of the research team. During a time where BIPOC families are experiencing the effect of COVID-related deaths and grief, unemployment, housing instability, and police violence; researchers have an opportunity to be engaged in the community and work to eliminate racial inequities within academic medicine and research. 

    Journal of the American Academy of Child & Adolescent Psychiatry, DOI: 10.1016/j.jaac.2021.06.018

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  • October 29, 2018

    By Stephanie Jacobs, MD

    High blood pressure is a serious problem that continues to grow in our country. Among women of childbearing age, we see about 20 percent with high blood pressure, whether they know it or not. Many pregnant women are aware of preeclampsia, a type of high blood pressure that endangers both the mother and her baby. But actually, there are four main categories of high blood pressure, also known as hypertension, that are associated with pregnancy:

    • Chronic hypertension: high blood pressure diagnosed before the 20th week of pregnancy, which means the mother had high blood pressure before conceiving
    • Preeclampsia: high blood pressure that develops after the 20th week of pregnancy or after delivery and is a risk factor for serious complications
    • Preeclampsia superimposed on chronic hypertension: preeclampsia that develops in a woman who already had high blood pressure before she became pregnant
    • Gestational hypertension: high blood pressure that develops after the 20th week of pregnancy but does not have the same effects on mothers or babies as preeclampsia

    High blood pressure during pregnancy is a dangerous risk factor for serious and life-threatening complications, including heart attack, stroke, development of heart disease, and cerebral aneurysm, a weakened, bulging area in the wall of an artery in the brain that may rupture.

    Risks of High Blood Pressure During Pregnancy

    Mothers and babies tend to have normal, healthy outcomes in cases of gestational hypertension. However, the other types of hypertension can be very dangerous for the expectant mom and the baby without regular monitoring.

    Pregnant women with preeclampsia are at increased risk for a number of complications, such as organ or brain damage. Preeclampsia also can develop into eclampsia, which is when elevated blood pressure can result in seizures. Babies whose mothers have preeclampsia might be at risk for:

    • Bleeding in the brain
    • Premature birth
    • Low birth weight
    • Retinopathy of prematurity, an eye disorder that can lead to lifelong vision problems or blindness
    • Death

    The first stage of high blood pressure starts at 130 over 80, or 130 millimeters of mercury (mmHg) of systolic pressure and 80 mmHg of diastolic pressure. Most Ob/Gyns use a cutoff of 160 over 100 as an indication that a pregnant woman needs medical treatment for high blood pressure.

    In addition to the risks of high blood pressure, we also have to monitor these patients for dangerously low blood pressure. It’s normal for an expectant mom’s blood pressure to drop from the time of conception through the second trimester—about 28 weeks. This is because her blood vessels dilate, or expand, to allow more blood to flow to the baby through the placenta. However, a woman who is on medication for high blood pressure before pregnancy should work with her doctor to adjust her dosage to avoid passing out or not providing enough blood to her baby.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment


    Cardiology Care Can Pinpoint Hypertension Warning Signs

    An Ob/Gyn might refer an expectant mom to a cardiologist if she needs monitoring or treatment for high blood pressure beyond what the Ob/Gyn can provide. In addition to regular blood pressure monitoring, expectant mothers receive a number of tests to determine whether they have a form of high blood pressure or to make sure we are keeping it under control. These may include:

    • Blood tests to determine how well the liver and kidneys are functioning, as well as levels of blood cells called platelets (which help blood clot). Platelet levels that are too low can be a sign of preeclampsia.
    • Fetal ultrasounds to keep track of baby’s growth. If the baby isn’t growing well, it can be a sign of high blood pressure preventing nutrients from flowing through the placenta.
    • Urine tests to measure protein levels. Excess protein in the urine can be a sign of kidney problems associated with preeclampsia.
    Blood tests, ultrasounds, and urine testing help #cardiologists monitor expectant moms for #preeclampsia and other forms of high #bloodpressure during #pregnancy. via @MedStarWHC

    Click to Tweet


    I also educate my patients to watch for swelling of the arms or legs—a common warning sign of preeclampsia. Many pregnant women have some degree of swelling, especially around the ankles, so it can be tough for women to know what’s normal, especially during a first pregnancy. As a general rule, swelling is a concern if they are swollen up to the knee and can press on the swollen area for five seconds and leave a mark, or if the swelling is associated with other symptoms such as breathlessness or difficulty laying flat at night due to breathing. Always err on the side of caution and check with your doctor if you are not sure whether something is normal or serious.

    Treatment Options for Managing Blood Pressure During Pregnancy

    High blood pressure during pregnancy often can be safely managed with medication, which can be scary for some women. I take patients through the data on medications that have been thoroughly studied and found to be safe for both pregnant women and their babies. Then, we discuss the risks of uncontrolled blood pressure. We work together to come up with the right plan for them, including regular Ob/Gyn and cardiologist visits, to keep both mom and baby safe.

    For preeclampsia, the only safe course of action for the mother is delivery of the baby. We work closely with patients’ Ob/Gyns to get their babies to fetal lung maturity, or the point at which the lungs can function well enough for the baby to breathe on their own. That’s usually at about 34 weeks of pregnancy.

    Though high blood pressure often doesn’t cause noticeable symptoms, it’s important for pregnant women to control their blood pressure. Hypertension without the right treatment can lead to heartbreaking complications for pregnant women and their unborn babies. If you are not sure about what you are feeling, ask your Ob/Gyn or a cardiologist for help.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment

  • October 26, 2018

    By MedStar Health

    As the weather gets colder, the odds of picking up a respiratory illness like a cold or the flu increase. While both can make you miserable, it’s important to understand the difference, especially if your symptoms worsen.

    Cold Symptoms

    A cold is a viral infection that typically affects the nasal part of the respiratory system. The infection is usually mild and goes away without treatment. Symptoms may include a runny nose, headache, and sneezing. About half of patients can also experience a cough or sore throat.

    A cough that persists after other cold symptoms have cleared up may indicate bronchitis, also called a chest cold, which is an inflammation of the airways in the lungs. Colds are most common in winter and spring months, and usually last about a week.

    Flu Symptoms

    The flu is caused by the influenza virus and usually results in symptoms that come on quickly and are more severe than cold symptoms. Symptoms of flu include sore throat, fever, headache, muscle aches and soreness, congestion, and cough. Most flu symptoms gradually improve over two to five days, but it's not uncommon to feel run down for a week or more.

    Anyone can get the flu, even healthy people, and serious problems related to the flu can happen at any age, but some people are at high risk of developing serious flu-related complications if they get sick.

    Those considered at high risk for complications from the flu include:

    • Individuals over the age of 65
    • People of any age with chronic medical conditions, such as asthma, diabetes, or lung or heart disease
    • Pregnant women
    • Young children

    Do I have a cold or the flu?

    Use this chart to help determine if you have a cold or the flu:

    When You Should See a Doctor

    Colds and the flu are not treated with antibiotics and rarely require a trip to the doctor. While the flu can occasionally be life-threatening for those at high risk of complications, for most people the best remedy for a speedy recovery from a cold or flu is usually rest and plenty of fluids. Colds and the flu are highly contagious, so you should stay home and avoid contact with other people.

    You should seek medical attention if you experience any of the emergency warning signs of flu sickness, especially if you are at a higher risk of complications. If you have any of these symptoms, visit a MedStar Health Urgent Care location for urgent care as soon as possible.

    What are the emergency warning signs of flu sickness?

    In adults:

    • Difficulty breathing or shortness of breath
    • Pain or pressure in the chest or abdomen
    • Sudden dizziness
    • Confusion
    • Severe or persistent vomiting
    • Flu-like symptoms that improve but then return with fever and worse cough

    In young children:

    • Fast breathing or trouble breathing
    • Bluish skin color
    • Not drinking enough fluids
    • Not waking up or not interacting
    • Being so irritable that the child does not want to be held
    • Flu-like symptoms that improve but then return with fever and worse cough
    • Fever with a rash

    Want to learn more about MedStar Health Urgent Care and its services? Click below to learn more and find a location near you.

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  • October 25, 2018

    By Edward F. Aulisi, MD

    "Measure twice, cut once.” It’s a simple expression that reminds us to be precise, and it applies in many situations—even complicated neurosurgical procedures.

    Traditional imaging systems made adhering to this old adage a challenge for neurosurgeons. Large, stationary computed tomography (CT) scanners offer limited usefulness during surgery that made surgeries take longer and sometimes led to the need for multiple procedures.

    Enter the Airo Mobile Intraoperative CT system—a portable, high-definition imaging system that has redefined our neurosurgical processes. We are the first hospital in Washington, D.C., to use this revolutionary system, and we now can offer faster, more precise neurosurgery with better outcomes and less radiation exposure than ever before. Having this advanced technology has allowed us to care for patients when other hospitals couldn’t.

    Mobility matters in CT scanning

    The huge, stationary scanning machines of old limited us to either scanning patients before their procedures or transporting them from the operating room to the imaging lab mid-surgery, then back to the operating room.

    With the Airo scanner, we bring the scanner to the patient instead of the other way around, and just one person can move it. We can create accurate CT images of the brain or spine right up to the time surgery begins and also can scan in real time during the surgery to guide us more effectively during complex procedures, which often leads to quicker, more precise surgeries.

    Having the CT scanner in the operating room also lets us instantly learn whether a procedure is successful. With the old scanners, because of infection-control procedures, we had to wait until the patient was out of surgery and recovering the following day before we could do a follow-up scan. The old scanners were not surgically sterile, which caused delays in scanning.

    If we found anything wrong during follow-up, we then would have to take the patient back into surgery. Now, we can scan the patient immediately after the surgery, while they are still asleep, to make sure we have a successful outcome or make any revisions during the same procedure. This technology already is resulting in more patients seeking neurosurgery at MedStar Washington Hospital Center.


    The Airo mobile CT scanning system’s real-time, highly accurate #CTscans during complex #neurosurgery leads to faster procedures and better patient outcomes. https://bit.ly/2AsmJ13  via @MedStarWHC

    Click to Tweet


    Patient success story

    Among the most outstanding examples is a patient who had gone to several centers looking for the right team for his spine surgery. He chose us because we had the Airo scanner, and the device was extremely helpful for his procedure. This patient’s surgery involved the use of pedicle screws, which are inserted into small projections of bone called pedicles that join the front part of the spinal bones to the back part.

    The patient’s pedicles were so small that it would have been a complicated process to get his screws into just the right position with our old scanning system. But the Airo system let me see where those screws needed to go in real time during the procedure, so I was able to get them in exactly the right place on the first approach. Just two and a half weeks after his surgery, the patient was walking without a walker or cane, and he and his wife were getting ready to go on a much-deserved vacation.

    Call 202-877-5026 or click below to make an appointment with a neurosurgeon.

    Request an Appointment


    Precise imaging for more accurate results

    Tiny distances that are almost imperceptible to the eye are critical when it comes to neurosurgery. The Airo scanner creates images that are accurate down to less than a millimeter. Such precision is vital for delicate procedures such as pituitary surgery , and we are the only center in the country to my knowledge that that uses the Airo for that purpose.

    While our old scanners gave us flat, two-dimensional images, the Airo scanner can integrate CT scans with magnetic resonance imaging (MRI) scans to create three-dimensional images. We overlap the MRI and CT scans on our imaging screens and mark the exact path of the procedure. This highly detailed system gives us a better look at tumors or other anomalies with up-to-the-second results.

    Less radiation for improved patient safety

    We take every precaution to limit our patients’ exposure to radiation, which can lead to a slightly increased risk of cancer with high, frequent doses.

    The Airo CT scanner allows us to adjust the radiation dose a patient receives based on the area we have to scan. We can go from the full CT scan dose down to 20 to 30 percent of the standard dose, depending on what we need to see. That translates to much less radiation than we would typically have to use for the kind of scans we need for surgery.

    Blazing new trails in neurosurgical imaging

    We’re able to take advantage of this extraordinary imaging system because of our Center for Image-Guided Neuro-Integrative Surgery (CIGNIS) . Through CIGNIS, we partner with spine surgery device manufacturer K2M, which works closely with Brainlab, the Airo system’s manufacturer. Our hospital is an alpha site for the Airo CT scanner, meaning we train the companies’ customers, as well as U.S. and international neurosurgeons, on how to use the system in the operating room.

    Neurosurgery, as well as medicine in general, is about not being satisfied with the status quo. We are all looking for breakthroughs that will allow us to treat patients who were once thought incurable and to improve care for everyone. The Airo Mobile Intraoperative CT system is one such advancement that takes our patient care to the next level.


    Call 202-877-5026 or click below to make an appointment with a neurosurgeon.

    Request an Appointment

  • October 23, 2018

    By Ami A. Chitalia, MD

    Breast cancer is one of the most daunting diseases in women’s health, as it affects about one in eight U.S. women at some point during their lives. Fortunately, there are several ways women can help prevent the disease.

    Lifestyle modifications are the most effective way women can decrease the risk of breast cancer. And while mammograms won’t reduce breast cancer risk, these screening tests can help identify breast cancer at an earlier stage when it is easier to treat and cure.

    LISTEN: Dr. Chitalia discusses reducing breast cancer risk in the Medical Intel podcast.

    Lifestyle changes to decrease breast cancer risk

    1. Eat a healthy diet

    Women should maintain a healthy and well-balanced diet that includes whole grains, fruits, vegetables, and lean proteins. Fruits and vegetables contain phytochemicals, which protect our cells from damage that could lead to cancer. Whole grains, meanwhile, can help reduce inflammation, which can damage the body’s healthy cells and tissue and weaken the immune system. Eating a healthy diet also provides energy to stay active.

    2. Exercise regularly

    Exercising has been shown to reduce breast cancer risk in postmenopausal women. We recommend exercising at least 30 minutes a day, four to five times per week. This can be any exercise—from walking to running—that makes you sweat or breathe faster.

    Women who exercise regularly and have a healthy diet generally maintain a healthy weight, which decreases breast cancer risk when compared to women who are overweight or obese.

    Women who exercise regularly and eat well generally maintain a healthy weight, which decreases breast cancer risk when compared to women who are overweight and obese, says Dr. Ami Chitalia. via @MedStarWHC

    Click to Tweet

    3. Avoid tobacco use and secondhand smoke

    Smoking is linked to a number of diseases, including a higher risk of breast cancer, specifically in young women who are premenopausal. Furthermore, we’ve seen links between heavy secondhand smoke and breast cancer risk in postmenopausal women, although definitive research is still pending. However, because we know secondhand smoke is unhealthy and is a factor in numerous other diseases, we advise women to avoid it whenever possible.

    4. Limit alcohol use

    Excess alcohol intake has been associated with an increased risk of breast cancer. In fact, compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15 percent higher risk of breast cancer. It’s estimated that the overall risk increases 10 percent for each additional drink women consume daily.

    Mammograms and other screenings

    Mammograms, or imaging tests used to screen the breast tissue for cancer, are an effective tool to detect breast cancer in its early stages when it is most easily treatable. Screenings typically begin between ages 40 and 45 for women at average-risk, but women with a family history might need earlier or more frequent mammograms. Shared decision-making with a doctor to discuss different screening options is the best approach to personalize a breast cancer screening plan based on a woman’s particular situation.

    Breast self-exams (BSE) are an effective way for women to be aware of any changes to their breasts. Women can read tips from the National Breast Cancer Organization on how to check their breasts, so they can report any changes in feeling or appearance to their doctor. Doing BSEs on a monthly basis is a good idea, typically about a week after your period, or when the breasts are the least tender.

    We see many women who were referred to us by their primary care provider or Ob/Gyn after they visited them upon finding a lump. The doctor typically makes sure they have a diagnostic mammogram (which gives immediate results) with or without an ultrasound, skipping the screening mammogram (which can take up to two weeks for results) in order to speed up the process of determining whether the lump is cancerous. This has helped us make a diagnosis early and create a management plan.

    Experts in breast care

    We care for women who seek breast cancer screenings at MedStar Washington Hospital Center with state-of-the-art equipment and imaging techniques, including MRI-guided biopsies, which only are offered at selected imaging centers. Additionally, we offer comprehensive care where a team of breast cancer experts—nurse navigators, radiologists, surgeons, radiation oncologists, and medical oncologists— make sure a patient’s experience is as smooth and comfortable as possible.

    For the average woman, reducing the risk of breast cancer begins with gaining the knowledge and empowerment to make healthy lifestyle choices. With the guidance and support of a multidisciplinary team of health care providers, women can reduce their breast cancer risk and ensure any cancerous breast tissue is caught early, if it ever develops.

    Call 202-877-3627 or click below to make an appointment with a breast cancer specialist.

    Request an Appointment

  • October 19, 2018

    By Shawn R. Smith, MBA, CPXP

    We aim to enhance patient experiences at MedStar Washington Hospital Center (MWHC) through a trickle-down approach, from staff to patient. Our philosophy is quite simple in that having fully engaged staff leads to better care, which results in a memorable experience for our patients. We call this the MWHC Experience. To monitor our progress, however, we need patients’ feedback about their experiences.

    Patient experience is one of the most important aspects of health care, because it represents the overall satisfaction a person has upon leaving the hospital. Patients generally have three types of experiences:

    1. Clinical experience: This is the care you receive from our doctors, nurses, and other healthcare providers while you are with us, including surgical procedures, tests, medications, treatments, and more.
    2. Environmental experience: This includes how quiet your room is, the quality of our food, how clean and tidy patient rooms and waiting areas are, your wait time to see a doctor or learn results from a test and other conditions.
    3. Emotional experience: This includes how well we address your concerns, fears, and hopes during an encounter with us. Providers’ bedside manner plays a role in the emotional experience, as well as what we do to relieve stress and uncertainty for you and your loved ones during our time with you. More importantly, it is about how we connect with you as individual.

    These experiences are not mutually exclusive. For example, having a comfortable room contributes to a positive environmental experience. However, a patient isn’t likely to have a good emotional experience if their wait times were too long or they felt scared which impacts their overall satisfaction.

    Many healthcare organizations are seeking the best way to measure the patient experience and mirror it with patient safety. Some hospitals launch patient experience programs, but these can be flawed because the patient experience must be an integral part of the hospital’s entire mission, not a standalone program.

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    How the staff/patient experience connects

    We want to establish a reliable system in which we consistently care for patients and families through random acts of kindness. The first step to doing this is creating an environment where our associates and providers feel important, cared for, and are engaged, which helps motivate them to provide exceptional patient care through every interaction, every day

    One way we empower our associates is through our CenterStar recognition program, which recognizes staff who go above and beyond the call of duty. Nomination forms for the CenterStar program are available throughout the hospital, so feel free to ask for one if you’d like to share positive feedback about a staff member.

    We monitor our service to patients is through consistent communication to track their satisfaction. We depend on patients to tell us where we might need to improve and what we are doing well. The most direct way to provide feedback is to talk to a staff member, nurse or doctor. If one of our associates can’t help, you can call 202-877-4YOU (4968) to speak with a patient advocate.

    Some patients receive the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey after they are discharged. This survey is required by the Centers for Medicare and Medicaid Services and can be answered by mail, telephone, mail with telephone follow-up, or active interactive voice recognition (an automated telephone system that interacts with callers and routes calls to the appropriate recipients, if necessary). The survey asks patients for opinions about:

    • Communication with doctors and nurses
    • Cleanliness and quietness of the hospital
    • Discharge information
    • Pain management
    • Staff members’ responsiveness to patients’ needs
    • Whether patients would recommend the hospital to others

    The HCAHPS survey, which is handled by a third-party company, has raised the bar for the kind of experiences hospitals provide. In recent years, the survey has shifted to incorporate both clinical care and experience-based concerns and conversations, which is a huge step forward. We also welcome direct feedback from letters and conversations during rounding.

    Using feedback to improve

    Our goal of having both happy patients and staff requires feedback, so we can learn and grow from patients’ experiences. When we receive CenterStar recognition notes for our associates, we celebrate them as a team. Everyone in a recipient’s department takes a moment to reflect on how they helped a patient have a good experience. Meanwhile, it makes them feel appreciated and reminds them of how valuable their work is.

    Additionally, we use the HCAHPS survey, patient rounding, and letters as tools to improve patients’ experiences. Again, most of the results are shared with department supervisors and we work together to review them and identify where we are excelling and ways we can improve.

    We will continue looking to adopt evidence-based, best practices to make sure we lead the healthcare market when it comes to both staff and patient experience. At MedStar Washington Hospital Center, we want our staff to feel engaged and fulfilled, eager to improve the health of every person we interact with. With your feedback, we plan to continue our progress as we aim to keep raising the bar for health care in our community.

  • October 17, 2018

    By MedStar Health

    Conventional pain medications may not take away all of your pain. If you’ve suffered a severe injury or had a major operation or medical procedure, chances are you were prescribed opioids to manage your pain. The goal is to control your pain while you heal, and it’s normal to still feel some pain. Taken under the strict supervision of your healthcare provider, opioid medications are safe and effective. But caution is required, because of their addictive qualities and the added concern of the opioid overdose epidemic that is plaguing our state. Here are important facts you should know about opioids and safety tips for properly using, storing, and disposing of them.

    What are opioids?

    Opioids are a class of drugs used to reduce pain. Opioids are often prescribed to treat severe pain for serious medical conditions, such as cancer. This article does not address taking opioids for these serious conditions, but focuses on treatment for an episode of acute pain, such as you may experience following surgery or an injury. Common types of opioids are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone.

    What are the side effects of overuse or addiction?

    • Tolerance—meaning you might need to take more of the medication for the same pain relief
    • Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped
    • Increased sensitivity to pain
    • Constipation
    • Nausea, vomiting, and dry mouth
    • Sleepiness and dizziness
    • Confusion
    • Depression
    • Itching and sweating

    How much medicine should I take?

    Follow the directions on the bottle. It is not safe to take a larger amount (dose) or more frequently than your doctor prescribed for you. Taking less is OK if it controls the pain. As you heal, you should be taking less as time goes on. These medicines can have serious side effects and can cause you to become addicted. Taking any medicine in a larger amount or more frequently than prescribed could cause you to overdose or die. You may take opioid medicines for moderate to severe pain. You also can try other things, like using heat or ice, which may also relieve your pain. Talk to your healthcare provider about other medications and what is likely to work best for you.

    You should notice that you need less opioid medicine as you start to feel less pain. You should reduce the amount of opioid medicines each day as your pain gets better. This may mean taking a smaller dose each time, or waiting for a longer amount of time between each dose you take. This is called tapering. If you feel like your pain is not at a comfortable level, or is getting worse, call your doctor.

    Where should I keep my medicines?

    Keep these medicines in a safe and secure place, away from other people in your family, children, visitors, and pets. Do not let other people take or use your medicines. This is not only very unsafe, it is against the law.

    How do I stay safe while taking these medicines?

    • Do not drive, operate machinery, or drink alcohol while taking opioid pain medicines.
    • Check with your doctor before taking any other medicines that you did not talk about before you left the hospital.
    • Tell a friend or family member that you are taking these medicines and to call 911 if they are worried you are more sleepy than normal or it is hard to wake you up.
    • Your doctor may give you naloxone (Narcan®), which is a medicine that can quickly reverse an overdose of opioid pain medicines. Tell a friend or family member that you have this and to be ready to give it to you after calling 911.

    What should I do with my opioid medicines after I stop using them?

    If you are no longer using your opioid medicines, get rid of what is leftover. Here are safe ways to do this:

    • Find your local drug take-back program or your pharmacy mail-back program.
    • Go to FDA.gov/Drugs/ResourcesForYou and follow the instructions from the federal Food and Drug Administration.
    • If you cannot get the leftover medications to a take-back program right away, flush them down the toilet.

    For more information on opioids, go to CDC.gov/DrugOverdose/Opioids.

    Want to find out what MedStar Health is doing to address the opioid overdose epidemic in Maryland? Click the button below to learn more.

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