Fall 2013 carondelet

THE REGION’S BUSINESS MAGAZINESPECIAL REPORT 2013

A New Vision of Healthcare

CarondeletHealth Network

THE REGION’S BUSINESS MAGAZINE

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Well-Being“We have to takeup the charge of the

health and well-being of our community if we are to have an impact on the

national cost of care.” – Jim BeckmannPresident & CEO

Carondelet Health Network


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Carondelet Health Network, a pio-neer in Southern Arizona healthcare, is building an innovative system of well-being designed to create a healthier community while reducing skyrocketing medical costs. At the heart of this evolution is a new health management philosophy – launched with the “Be Well” brand last year – that sets aside the traditional way of doing things and integrates a holistic approach to community care. Defined as “population healthman-agement,” the new approach provides the ability to keep healthy people well, identify and “course correct” those who may be at risk, better manage those who are chronically ill and work to eliminate gaps in care. As Jim Beckmann, president and CEO of Carondelet Health Network put it, even as the Affordable Care Act

has been driving dialogue about the need to address healthcare reform, Carondelet leadership believes that real change needs to begin within the indus-try. “We’re excited to be participating in one of the greatest opportunities of our time,” Beckmann said of the new phi-losophy. The history of Carondelet in Tucson dates back to the 19th century, when the Catholic Sisters of St. Joseph of Carondelet opened St. Mary’s Hospi-tal in 1880. Today, with nearly 30 facilities and medical offices throughout SouthernArizona, Carondelet is the leading pro-vider of healthcare services, serving a community of more than 1 million resi-dents and employing more than 4,000. From Tucson to Nogales, the region’s 12th largest employer is investing mil-lions of dollars in resources, technology

and innovative medical procedures – all designed to provide for the health and well-being of Southern Arizonans while raising the standard of care. Carondelet St. Mary’s Hospital has been revitalized as part of the investment, and is now home to the Carondelet Heart & Vascular Institute. Carondelet St. Joseph’s Hospital has been the focus of growth and expansion, and ground has been broken on the new Carondelet Health & Wellness Pavilion in Sahuarita. To develop its population health management approach, Carondelet is currently partnering with Healthways, a global leader in providing well-being improvement solutions that focus on this comprehensive model of care. It begins with an assessment of what’s needed to meet Carondelet’s goals and

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Well-BeingA New Visionfor Healthcare

By Mary Minor Davis

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ends with primary care physicians work-ing in tandem with their patients, other physicians, specialists and the patients’ extended community to ensure com-prehensive care and well-being that will transition care from “volume” to “value.” Traditionally, healthcare has been delivered in a kind of silo system, with the primary care physician identifying medical conditions and then referring the patient to specialists. Carondelet is removing those silos with this holistic approach, which takes into consideration all aspects of a per-son’s well-being – including financial,mental and physical – combined with the biometrics of the individual. “With this information, we can then stratify individuals within the population into three main groups,” explained Dr. Donald Denmark, Carondelet’s senior VPandchief medicalofficer. “The ‘at-risk’ group will, over time, drive costs, but studies have proven that intervention can help,” he added. “For individuals with chronic disease you employ intervention tactics focused on aggressive care management.” Chris Castellano, executive VP and chief strategy officer for Carondelet,added, “For example, patients most of-ten come to the St. Mary’s emergency room with stomach pain or dental pain. These issues can often be prevented or managed if people build trusting, valued relationships with a primary care provider or specialist. Without that op-portunity for intervention and manage-ment, those with chronic disease turn to ERs once their condition has worsened

“Changing the paradigm happens

one person at a time – with the rightsocial networks around them –

with a strong baseof primary care

physicians to lead the effort.” – Chris Castellano

Executive VP & Chief StrategyOfficer,CarondeletHealthNetwork

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Carondelet St. Joseph’s Hospital

Carondelet St. Mary’s Hospital

Carondelet Holy Cross Hospital


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In 1870, a group of seven Catholic Sisters from Missouri bravely set out on a mission to the untamed West to care for the people of Tucson. The Sisters of St. Joseph of Carondelet – a congregation established in France in 1650 – were asked by the bishop of Tucson to leave their home in Caronde-let, Missouri to teach in the barrios of Tucson and at Mission San Xavier del Bac. The journey lasted a month as the Sis-ters traveled by train, ship and covered wagon. They were greeted at Picacho Peak by soldiers, who provided them safe passage into town. On May 26, 1870, the Sisters arrived in Tucson, a town of a little over 3,000 souls. They were welcomed with celebra-tions and a fireworks display, and soon set up schools. A decade later, responding to the

needs of the injured workers of the Southern Pacific railroad’s westward ex-pansion, they were asked by the bishop to open Arizona’s first continuously oper-ating hospital – St. Mary’s. The 12-bed hospital was built in col-laboration with the Tohono O’odham tribe, who helped the Sisters build the little hospital from rocks and boulders. St. Mary’s cared for its first patients on May 1, 1880. Today, 143 years after their journey to Tucson, the Sisters of St. Joseph of Carondelet continue to care for the peo-ple of Southern Arizona. Sister Irma Odabashian, a patient ad-vocate at St. Mary’s, said the mission of the Sisters remains strong. “Our existence continues to be driven by the needs of the people we serve, which is our way of responding to the mission of Jesus – he taught, he healed,

he counseled, he loved,” said Sister Odabashian, one of eight Sisters of St. Joseph of Carondelet living in Tucson. The Sisters have led the transforma-tion from a small hospital on Tucson’s west side to the modern day Carondelet Health Network. They have overseen the growth of St. Mary’s, the addition of St. Joseph’s Hospital in 1961, Holy Cross Hospital in Nogales in 1981 and the many areas of specialization that thrive today. “We are still growing, and it’s very exciting,” Sister Odabashian said. “We are deeply immersed in the community of Southern Arizona. The needs of the people of Southern Arizona will continue to direct our future growth. We contin-ue to embrace courageously and with a strong faith the direction that current changes require of us in order to have a strong future.”

Carondelet’s History of HealingBy Gabrielle Fimbres

For a complete history of the Sisters of St. Joseph of Carondelet in Tucson, go to www.carondelet.org.

St. Mary’s School of Nursing, 1914St. Mary’s School of Nursing, 1914

Seven Sisters of St. Joseph of Carondelet

St. Mary’s Hospital, 1955

St. Mary’s Hospital, 1887St. Mary’s Hospital, 1887Tuberculosis Sanatorium, 1900s Tuberculosis Sanatorium, 1900s PH

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to a point where a higher level of care feels like their only option.” A trip to the ER is far more costly than preventive care. Under the new Carondelet/Healthways model, the value of care will be improved, reducing the number of treatable conditions entering the ER by boosting care before conditions become emergencies. Healthcare costs today are $2.5 trillion – making up 18 percent of the gross domestic product, Beckmann said. “As professionals, we have to take up the charge of the health and well-being of our community if we are to have an impact on the national cost of care,” he said. A key element of community health management is that it is built around a team concept. Physicians, specialists, clinicians, social ser-vice organizations, family members, employers and patients them-selves all play a role in making the model successful. The Healthways model promotes engagement at all levels, provid-ing individuals with simple, fun tools that encourage active partici-pation in and personal accountability for the management of one’s health and well-being. “Engagement is the result of motivation, inspiration,” Castellano said. “Changing the paradigm happens one person at a time – with the right social networks around them – with a strong base of pri-mary care physicians to lead the effort.” Beckmann and his team recognize that it will take time to imple-ment this change, both from the patient and the physician stand-point. Many Carondelet stakeholders and community members across Southern Arizona have already participated in the assessment, and Carondelet is implementing the program first within its own internal community of more than 4,000 employees. The organization has set a goal of a 5 percent improvement in the overall health condition within its own organization in 12 months – primarily among employees with chronic illnesses – as well as a decrease in employee absenteeism due to sick leave. Healthways claims increasing the well-being of a population – like a company’s employee base – can increase productivity, reduce ab-senteeism and improve job performance. “In the end it will require each individual and family to take action for their health,” Beckmann added. “That’s why this is going to take time, and the investment is significant – but the results will be also.” The energy that the program has generated is palpable when talk-ing to physicians about the new approach. “I’ve been a physician on staff at Carondelet for over 20 years,” said Dr. Amy Beiter, president and CEO of St. Mary’s Hospital. “We’re all very proud of this new direction we’re taking.” Beckmann said the new philosophy is in line with the mission of the Sisters of St. Joseph of Carondelet to serve “every dear neighbor with dignity and respect.” “We are fortunate in that we are grounded in the history of the Sisters,” he said. “This gives us a sense of purpose, greater than just being part of the medical community. We are able to maintain the legacy and mission of the Sisters, not only for today, but well into our community’s future.”

“I’ve been a physician on staffat Carondelet for over 20 years. We’re all very proud of this new

direction we’re taking.” – Dr. Amy Beiter, President & CEO, St. Mary’s Hospital


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Carondelet Health Network is partnering with Health-ways in building an innovative system of well-being, based on information garnered about Southern Arizona residents in the Gallup-Healthways Well-Being Index. We turned to Healthways’ CEO Mike Farris for details.

What is the Gallup-Healthways Well-Being Index?The Gallup-Healthways Well-Being Index was devel-oped to establish official statistics on the state of well-being in the United States and globally. It is the first-ever daily assessment of U.S. residents’ well-being, and was developed by scientists at Gallup and Healthways.By interviewing at least 500 U.S. adults every day, the Well-Being Index provides real-time measurement and insights needed to improve well-being, increase perfor-mance and productivity, and lower healthcare costs. There are more than 1.8 million completed surveys since inception in 2008, making this the world’s largest data set on well-being.

How does it work? The survey covers topics such as emotional health, life evaluation, physical health, healthy behavior, work en-vironment and basic access. The methodology relies on live interviewers conducting telephone interviews with randomly sampled respondents ages 18 and older. Lo-cation data allows researchers to map the responses.

How does information collected benefit communities?The information can be used to inform leaders about the well-being of their communities. Leaders can com-pare their community and population to other communi-ties and populations across the country. They can use this information to identify opportunities for well-being improvement, which has a direct impact on increasing performance and lowering healthcare costs.

What can Tucson take away?The Well-Being Index provides government officials, business leaders and residents of Tucson with the op-portunity to measure their current level of well-being relative to other cities. Carondelet’s partnership with Healthways enables leaders to create an action plan for improving well-being and execute programs to improve Tucson’s well-being.

What is the value of increasing a population’s well-being? Our research shows that a 1 point difference in well-being equates to a 1 percent difference in healthcare costs, a 2.2 percent difference in likelihood of hospital admission and a 1.7 percent difference in the likeli-hood of being admitted to the emergency room.

Research also indicates that well-being change is a sta-tistically significant predictor of change in many valu-able areas including individual productivity, unsched-uled absences and retention/turnover rates.

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Faces of Carondelet

Since 1880,Carondelet has

provided compassionatehealthcare to Southern Arizonans.

Today, the Carondelet HealthNetwork team of more than 5,000employees and physician partners carries on the mission of improving the well-being of the community and

providing the latest in technologyin nearly 30 locations throughout

Southern Arizona.


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Four women are driving the growth of Carondelet Health Network along the Interstate 19 corridor, from Tucson’s west side to the U.S.-Mexico border in Nogales. From the growing and reinvigorated Carondelet St. Mary’s Hospital in Tuc-son to Carondelet Holy Cross Hospital in Nogales, Ariz. – and everything in between – Carondelet is providing a broad scope of healthcare specialties to address a wide range of needs among a diverse population. Guiding the strategic roadmap between Tucson and Nogales is Chris Castellano, Carondelet’s executive VP and chief strategy officer.

Joining her are:

• Dr. Amy Beiter, president and CEO of St. Mary’s

• Debbie Knapheide, VP, COO and chief nursing officer at Holy Cross

• Tawnya Tretschok, VP of physician practices

They carry on the work of the seven Sisters of St. Joseph of Carondelet, who arrived in Tucson in 1870 with the mis-sion of educating and caring for our residents. Castellano joined Carondelet in 2012, bringing with her 25 years in healthcare leadership in Tucson. She is inspired by the new vision of care developed by

Carondelet leaders working closely with her. “The current complexities in the healthcare ecosystem create bold and exciting new opportunities for all of us,” Castellano said. “If you look at growth patterns in Tucson and along the path of I-19 and combine that with St. Mary’s location, we see a synergy that creates the opportunity to view things differently.” St. Mary’s, which has undergone $20 million in recent improvements – inside and out – is now home to Carondelet’s Heart & Vascular Institute. Among the Tucson companies behind the growth are Chestnut Construction and Diversi-fied Design & Construction.

Driving Force inDriving Force in Healthcare Healthcare

“Never have I been more excited about our direction than I am today.” – Dr. Amy Beiter, President & CEO, St. Mary’s Hospital

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From left – Dr. Amy Beiter, President & CEO, Carondelet St. Mary’s Hospital; Debbie Knapheide, VP, COO & Chief Nursing Officer, Carondelet Holy Cross Hospital; Chris Castellano, Executive VP & Chief Strategy Officer and Tawnya Tretschok, VP, Physician Practices.

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By Mary Minor Davis

Healthcare Healthcare Of the 73 primary care physicians in the Carondelet network, 23 work along the I-19 corridor. Additionally, Caron-delet specialists make “house calls” – in a way. They often drive to the system’s medical practices in Green Valley and Nogales – and soon to Sahuarita – to see patients close to home. Tretschok, one of the newer mem-bers of the Carondelet team, said the concept of bringing specialists into local communities provides convenience for residents who can’t make the drive to Tucson regularly. That synergy is tied to the growth

and expansion that exists in the neigh-borhoods as you drive south. Caronde-let Medical Mall at Green Valley, Holy Cross in Nogales and the network’s newest facility, soon to be constructed in Sahuarita, provide a connection that extends from Tucson to the border. The $6.5 million Carondelet Health & Wellness Pavilion in Sahuarita is scheduled to open in late 2014. The 14,000-square-foot, state-of-the-art fa-cility will celebrate the region and its heritage with a nod to the 17th century Spanish Colonial architecture that once dotted the landscape.

Carondelet contracted with Freeman-White and Diversified Design and Con-struction to build the facility. Construc-tion is set to begin in January 2014, with completion in November 2014. Features of the pavilion include:

• A lobby with a glass-enclosed chil-dren’s playroom, family waiting room and a separate waiting area for indi-viduals looking for a quieter environ-ment.

• 27 exam rooms

• Nine physicians specializing in internal and family medicine and pediatrics

• Visiting specialists

• Mobile imaging onsite

Carondelet Health & Wellness Pavilion rendering


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As part of Carondelet Health Net-work’s approach to holistic community care, the Carondelet Heart & Vascular Institute has moved into the network’s legacy facility, St. Mary’s Hospital. About $17 million in renovations to the interior of the hospital have resulted in the creation of the institute known as CHVI – 96,000 square feet dedicated to patients seeking the latest in cardiac and vascular care. The new facility features some of the latest in technology and tools, including resources to enhance minimally inva-sive cardiac and vascular surgical pro-cedures and support scientific research undertaken by many of Carondelet’s na-tionally recognized heart and vascular specialists. A dedicated cardiovascular intensive care unit, a specially appointed hospital wing with all private rooms, outpatient cardiac rehabilitative services, new op-erating suites, catheterization labs for electrophysiology procedures and a non-invasive cardiac testing area are some of the amenities that offer comprehensive support, ensuring the highest quality in care, according to Carondelet adminis-trators and physician leaders. In addition to providing the newest technologies, CHVI’s location within St. Mary’s Hospital provides greater access from Interstates 10 and 19, helicopter access for emergencies and room to grow. One of the most advanced features is the addition of a 1,000-square-foot hybrid operating room, supporting the ability of surgeons and cardiologists to perform the latest in minimally invasive cardiovascular procedures. Dr. Derek von Haag, medical direc-tor of cardiothoracic surgery at CHVI,

is a leader in minimally invasive cardiac surgery. He notes that there are many unique aspects of the new hybrid OR, particularly live audio/video streaming capability, which allow other physicians to remotely observe surgeries and learn more about these advanced procedures from CHVI specialists. According to von Haag, this makes the institute a “major destination for car-diac care,” not only for patients, but also physicians. “Our goal is to teach other physicians around the country what is possible,” von Haag said.

Dr. Scott Berman is medical director of vascular surgery at CHVI. He has been at the forefront of vascular surgery in Southern Arizona since the mid-1990s. He began the first minimally invasive en-dovascular program in the area, and his commitment has resulted in new proce-dures for patients with vascular disease. In 2000, Berman’s practice – Tucson Vascular Surgery – and St. Mary’s Hos-pital performed Southern Arizona’s first endovascular stent graft for abdominal aortic aneurysm repair. In 2006, he placed the first endovascular stent graft

for the treatment of thoracic aneurysm disease. While more minimally invasive vascu-lar procedures are being conducted in the United States, fewer than 10 percent of vascular surgeons perform them, and not all of the time. “There is nothing more satisfying than seeing a patient walking, eating a regu-lar diet and being discharged home on the first day after a procedure,” Berman said. “This is in stark contrast to tradition-al open surgery that would require days in the intensive care unit, a week in the hospital and months for full recovery.” Today, Berman and von Haag are part of Carondelet Heart & Vascular Institute Physicians, a local medical practice that employs cardiologists, cardiothoracic surgeons and vascular surgeons. A prac-tice that employs an array of specialists working side by side and consulting with one another about cases is unique in Tucson. The goal is to provide patients with a comprehensive “team approach” to their care. Stanley Curd was the first patient at the new CHVI. Curd lived with a pro-lapsed mitral valve for years until his cardiologist, Dr. Kirk Gavlick, highly rec-ommended that Curd see von Haag for a valve repair. In November 2012, Curd underwent a minimally invasive procedure that required only a 3-inch incision. He ex-perienced a shorter length of stay and three weeks later, he was walking two miles. Within a month, the 72-year-old was back at the gym, working up to his regular two-hour workout regimen. “I was really impressed with both of my doctors,” Curd said of his experience.

Did you know? The Carondelet Heart & Vascular Insti-tute, while far more sophisticated, is a return to Carondelet’s cardiovascular and cardiothoracic pioneering roots.

In 1959, St. Mary’s was the first hos-pital in Arizona to perform open heart surgery, and the first hospital in the state to use a heart-lung machine. St. Mary’s implanted Tucson’s first pacemaker in 1960.

Heart & Soul of St. Mary’s By Mary Minor Davis

The expansion provides access to the newest advancements in medical tech-nology. “Collectively, we can incorporate this technology into the healthcare delivery system,” which in turn provides quality care with lower risk and shorter hospital stays, fewer emergency room visits and reduction in healthcare costs, Tretschok said.

Carondelet also partners with organi-zations along I-19 in collaborative op-portunities to educate and raise aware-ness of health issues with residents. Clinicians hold educational health seminars in Rancho Sahuarita. The net-work will be collaborating with Sahua-ritaUnified SchoolDistrict to providestudents with hands-on career shadow-ing opportunities. Carondelet sponsors summer camps for kids, kindness initia-tives and programs including Walk with

a Doc. These programs are all aimed at increasing the community’s well-being holistically – body, mind and spirit. Knapheide manages the “very, very busy” Holy Cross Hospital. With St. Mary’s being the closest hospital to Nogales – 66 miles to the north – Knapheide said providing community care in Santa Cruz County is crucial. Diabetes education and manage-ment, obstetrics and gynecology, plus

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emergency services make up the bulk of patient care. Under the proactive team approach, Knapheide said the full continuum of care – primary care, acute care and chronic care management – will keep the community healthier. “It’s amazing how we’ve already turned a lot of the business (at Holy Cross) from inpatient to outpatient treatment,” Knapheide said. Outpatient care is less expensive and more appealing for patients who can recuperate in their own homes. “We have a patient-centric vision of identifying what our patients need and thendefiningwhatweneedtodoasateamtoprovideforthoseneeds,” she said. As the longest serving executive leader with Carondelet, Be-iter, with 20 years of service at St. Mary’s, has seen tremendous change in local healthcare. “Never have I been more excited about our direction than I am today,” she said. Watching a traditional healthcare practice move from operating in “silos” to the holistic, community-wide approach is “the right thing to do,” Beiter added. “The focus is now on the value of the care provided, as op-posed to the volume a hospital produces – from volume to value,” shesaid.“Patient-centriccarewillbringtremendousbenefits.” She cites the multi-disciplinary team approach that will pro-vide one-stop service. She gave the example of The Breast Cen-ter at Carondelet St. Mary’s – a physician-led program in which doctors from across the breast cancer continuum are working in tandem to support the needs of each patient. There’s no discon-nect from screening to survivorship for breast cancer patients, she said. Similar approaches are also in place at Carondelet Heart & Vascular Institute and Carondelet Neurological Institute at St. Joseph’s Hospital. If passion and excitement are prescriptions for success, these women who stand at the forefront of Carondelet’s approach to community care will ensure that success is reached. They each said Carondelet’s innovation has reinvigorated their personal commitment to healthcare and renewed their dedication to the patients and the communities they serve. Beitersaidtheapproach“reflectstheheartandthequalityof care on the part of everyone at Carondelet. It’s an outward dem-onstration of what we’ve always known. We are all proud of the direction we’re taking.” Said Castellano, “Our values, vision and mission set the con-text and provide fertile ground for innovation. Adapting and cre-ating our new future is one way to honor our 133-year legacy in this community.”


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The Breast Centerat St. Mary’s The Breast Center at Carondelet St. Mary’s helps set the revitalized hospital apart by providing com-prehensive breast care to Southern Arizonans. The center is a multi-disciplinary, integrated group of independent radiologists, pathologists, medical and radiation oncologists and breast sur-geons whose focus is the prevention, early detection and prompt treatment of breast disease. A patient navigator, experienced in breast health education, helps guide patients who have been diagnosed with breast cancer. “We encompass the whole scope of breast dis-ease and – more specifically – breast cancer,” said Dr. Gerlinde Tynan, medical director of The Breast Center and the Breast Health Program at St. Mary’s. “Everything from the screening mammogram through biopsy, surgery to chemotherapy and ra-diation treatment, support groups and educational resources is handled under our auspices,” Tynan added. The Breast Center opened in 2012, the same year that the National Cancer Institute estimated there were 229,060 new cases of breast cancer diagnosed in the United States, with 3,400 in Ari-zona. Imaging services are offered onsite, including digital mammography, breast ultrasound, bone densitometry, breast MRI and interventional breast procedures – stereotactic, ultrasound and MRI-guid-ed breast biopsy. The Breast Center is unique in Southern Arizona in its use of high-tech imaging software, said Ra-diologist said Dr. Christopher Reed, radiologist. Physicians also offer patients the latest technology in treatment options including 5-day brachytherapy radiation, genetic testing, immediate breast recon-struction, cryoablation of fibroadenomas and par-ticipation in clinical trials. Also setting The Breast Center apart is the speed with which patients proceed from initial screening to follow-up treatment – usually 2 to 3 days between screening, diagnostic workup and surgical consult appointments. Each new cancer case is presented during a weekly conference and a custom treatment plan is created by the team of doctors. “Like any other area in medicine, we have patients asking, ‘Are you going to tell this to my doctor?’ The thing about The Breast Center is all your doctors are already there. The radiologist, the pathologist, the oncologist – we’re all familiar with your records,” said Dr. Robert Gin, a radiation oncologist. “It’s a team approach. Everything is integrated.”

“Adapting and creating our new future is one way to honor our 133-year legacy in this community.” – Chris Castellano

ExecutiveVP&Chief StrategyOfficerCarondelet Health Network


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Dr. Robert P. Goldfarb, Consulting Neurosurgeon & Chairman, Carondelet Neurological Institute

From left – St. Joseph’s President & CEO Tony Fonze and Dr. Donald M. Denmark, Chief Medical Officer at St. Joseph’s Hospital & VP for Carondelet Health Network

From left – St. Joseph’s President & CEO Tony Fonze and Dr. Donald M. Denmark, Chief Medical Officer at St. Joseph’s Hospital & VP for Carondelet Health Network

Rehabilitation Pool at St. Joseph’s Hospital

Labor & Delivery and Couple Care offered at St. Joseph’s Hospital Women’s PavilionLabor & Delivery and Couple Care offered at St. Joseph’s Hospital Women’s Pavilion

Dr. Eric P. SiposNeurosurgeon & Medical DirectorCarondelet Neurological Institute

Dr. Eric P. SiposNeurosurgeon & Medical DirectorCarondelet Neurological Institute



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New Chapel Place of HealingAt the heart of Carondelet St. Jo-seph’s Hospital is a serene spot where families and patients can go to find peace and give thanks.

After years of fundraising and months of construction, the Fred & Olga Pace Spiritual Center at St. Joseph’s Hospital opened in April 2013, featuring a healing garden, spaces for quiet reflection and the centerpiece – the hospital chapel.

“The chapel and the spiritual cen-ter offer us all a very special place where we can rejoice and be thankful for the wonderful things that happen in our lives – but also we can find consolation and peace during times of confusion and loss,” said Tony Fonze, presi-dent and CEO of St. Joseph’s.

The spiritual center and chapel, built by W.E. O’Neil Construction Company and designed by Swaim Associates Architects, were made possible by private donations from the community and fundraising ef-forts by Carondelet Foundation.

Most of the windows were sal-vaged from the hospital’s last cha-pel – which was built in 1984 – and restored by the original artist, Mary Myers. Only the meditation room window is new, and was designed and fabricated by My-ers along with stained glass artist Teresa Karjalainen.

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We’ve all heard that healthcare is go-ing to change dramatically in the next few years. At Carondelet St. Joseph’s Hospital, it already has. Patients are seen as customers, con-sumers with a choice. Hospital adminis-tration and staff want to keep these pay-ing patrons happy – as happy as one can be when in need of a hospital. To pull that off, St. Joseph’s President and CEO Tony Fonze says that patient-firstphilosophyhastorundeepthrough-out the culture of the hospital. “A hospital is really like a little city, and you have many of the same services, problems and issues that a city would have,” Fonze said. “We have facilities that we have to manage, environmental services, very extensive food and restau-rant services, security – except the popu-lation of our city consists of people who are often in a very vulnerable, frightened and sometimes dangerous part in their lives.” Besides this patient-as-consumer phi-losophy, Fonze reels off a list of “prod-ucts and services” to back up this new version of St. Joseph’s – dedicated

state-of-the-art units, including the new Joint Replacement Center, Carondelet Neurological Institute and the Women’s Care Pavilion – with a neonatal inten-sive care unit, as well as robotic surgery suites. Also included are a regional eye center and the O’Reilly Care Center for behavioral health. Fonze has what could only be called an interesting resume, with career stops as a Grand Canyon helicopter pilot and a software business executive before landing in healthcare. Along the way, Fonze said he picked up a style that rec-ognizes service as a product and the cus-tomer as a consumer with a choice. He and Dr. Donald M. Denmark, chief medicalofficeratSt.Joseph’sanda senior VP for Carondelet Health Net-work, present this approach as a natu-ral evolution, something that just makes sense both in terms of the quality of healthcare and as a way to do business. “Doctors understand that this is more of a competitive market than it has ever been and that we have to accommodate our customer base,” Fonze added.

Patient-first Philosophy at

St. Joseph’sBy Dan Sorenson

“A hospital is really like a little city… except the population of our city consists ofpeople who are often in a very vulnerable,

frightened and sometimes dangerouspart in their lives.” – Tony Fonze, President & CEO

Carondelet St. Joseph’s Hospital

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Among the specialized units at Caron-delet St. Joseph’s Hospital is the new Joint Replacement Center, with an expert staff of joint specialists – a dedicated unit with 20 private rooms and pre- and post-operative programs credited with greatly improving patient outcomes. “What most people want from a hos-pital is to know what they’re getting into,” said Dr. Edward Berghausen, a fellowship-trained joint replacement sur-geon. St. Joseph’s Joint Replacement Cen-ter provides that information about ev-ery stage of the upcoming procedure – from two weeks before admission to discharge and through physical therapy. In addition to the overview, patients are screened for other medical problems that could affect the success of a joint replacement. “We set expectations and educate patients. It not only engages them, it empowers them because now they are a more active part of their care,” said Kyle Bennion, St. Joseph’s senior director of product management. A week or two before surgery, Berghausen said, a nurse practitioner assesses “that you’re fully prepared for surgery. If there is a deficiency, she’ll make sure you receive the right treatment before surgery. We believe that this has had a great impact on our outcomes – patients are prepared for surgery.” Berghausen said patients are over-whelmingly positive about the thorough-ness of the program and being involved in their own outcomes. He said the

health evaluation and repeated meetings with the surgeon and staff improve their comfort level on the day of surgery. “What I’ve frequently heard from pa-tients who have gone through this pro-cess is that they have never been more thoroughly evaluated,” Berghausen said. “Our patients experience a 30 per-cent improvement in mobility after joint replacement – walking, standing for lengths of time, maneuvering through a store – that type of everyday activity,” Bennion said. Berghausen attributes success rates to the big-picture approach to joint replace-ment, not just the expertise of the center’s surgeons. “The surgical procedure involves so many other people than the surgeon – it involves the nurses, the physical thera-pists, the operating room staff,” he said. “The one thing I can provide for my pa-tients is safety. That’s the part I think the surgeon should take charge of.” Bennion credits the collaboration of surgeons from several orthopedic prac-tices who all participated in the design of the Joint Replacement Center for the program’s success and the many positive responses from patients. “Why is our program unique? For several reasons,” Bennion said. “Our surgeons represent five or more different practices. And they have come together to help in the design. That is unique to our region. And it makes our program stronger.”

Carondelet’s Joint Replacement Center is One New, Hip Place

By Dan Sorenson

“Our other customer is your primary care physician, the person who is go-ing to take care of you once you are discharged,” Fonze continued. “Or, if you’re not quite ready to go home and are going to be discharged to a skilled nursing facility, it could be the doctor there. “So what we’re working toward now is customizing the care that we give to the other doctor,” he said. “We have an automatic mechanism to notify them if their patient has been admitted or dis-charged. But what we’re adding to that is follow-up on how the patient is doing.” Bringing the primary care physician and the patient’s family or significantother into the communication loop can improve outcomes for patients, Den-mark said. And after discharge, the communi-cation continues with the primary care physician. Denmark and Fonze said this post-discharge care began as an effort to reduce re-admissions of recently dis-charged Medicare patients. “We’ve put a program in place and we’ve actually had very positive results,” Denmark said. “One of the things it fo-cuses on is making sure there is an effec-tive handoff to either another provider or set of providers. Sometimes, these people have simple yet complicating is-sues – they don’t have transportation so they can’t get to another caregiver or an-other service. Sometimes solving simple problems keeps patients healthier and out of the hospital.” Denmark said a crucial part of this post-discharge care involves a partner-ship with the Pima Council on Aging.

BizHEALTHCARE



“Sometimes solving simple

problems keepspatients healthier

and out of the hospital.” – Dr. Donald M. Denmark

Chief MedicalOfficer&SeniorVP,Carondelet St. Joseph’s Hospital

Biz

PHO

TO:

TOM

SPI

TZProgram Coordinator Jamie Wagoner holds Joint Camp for patients at the Joint Replacement Center.

Program Coordinator Jamie Wagoner holds Joint Camp for patients at the Joint Replacement Center.


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http://hallrender.com/resources


BizHEALTHCAREcontinued from page 136

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Just over five years ago, if you needed emergency neurosurgery in Tucson on some nights, you might have been out of luck – or racing time in a helicopter or airplane headed for Phoenix, Flagstaff or San Diego. Tucson didn’t have sufficient on-call neurosurgeons and hospital neurosurgi-cal operating facilities that were staffed 24/7. “It turned out to be a little bit of a lot-tery. If you got injured on Monday, there might be a neurosurgeon available. But if you got injured on Tuesday, there might not,” said Dr. Robert P. Goldfarb, consulting neurosurgeon and chairman of the Carondelet Neurological Institute. “You’ve heard of the Golden Hour – the hour following the onset of a neuro-logical illness or injury, when care may change the outcome significantly. That hour was often passed while an emer-gency room doctor tried to find both a neurosurgeon and a hospital that were available to treat an emergency neuro-surgical condition,” he added. Neurosurgeons are scarce, Goldfarb added, because training for neurosur-gery is intense, requiring seven to nine years after medical school. “But in a city of 1 million, we had to do better.” That’s when Carondelet Health Net-work and Western Neurosurgery col-

laborated on a vision to develop a neurological institute with the latest in technology and 24/7 coverage in neu-rosurgery and neurology. Carondelet has not stopped improving neurological services and coverage for Tucson – recently recruiting to the team Dr. Emun Abdu, the first vascular neuro-surgeon in Southern Arizona. Soon after her arrival, a patient came to St. Joseph’s showing significant signs of an acute stroke, unable to move her left side or speak, and unresponsive to initial medical treatment. Abdu per-formed a clot extraction and within days, the patient was able to walk, talk and eat without impairment. “Our vision was nobody should have to leave Tucson under emergency condi-tions to seek help elsewhere,” Goldfarb said. Unique to the institute are state-of-the-art operating rooms. “The technology we have at our disposal allows sub-mil-limeter precision during complex brain and spine surgery,” Goldfarb said. That kind of accuracy allows surgeons to minimize damage to other parts of the brain while reaching surgical targets that might have otherwise been considered inoperable. Included in the OR is a CT scanner. “We were the first in the U.S. to have

the most advanced Brain Suite technol-ogy,” Goldfarb said. “They had some of this technology in Singapore and Mu-nich, and we were the first to have all of this technology together. Our operat-ing rooms have become something of a showpiece, with neurosurgeons visiting us from other major neurological cen-ters.” That has attracted neurosurgeons from all over the world wanting to see CNI’s operating rooms, Goldfarb said. And that technology helped with staff recruit-ing – including one of Goldfarb’s part-ners, Dr. Ryan Kretzer, formerly of Johns Hopkins Hospital in Baltimore. “My expertise is in minimally invasive and complex spine surgery, including adult degenerative deformity and spinal oncology,” said Kretzer. “Dr. Goldfarb’s goal in recruiting me to Tucson was to provide more complex spinal surgery techniques that weren’t previously pro-vided.” With 14 neurologists and neurosur-geons, Carondelet Neurological Institute provides comprehensive neurological expertise and services with a focus on advanced technology and optimal out-comes, Goldfarb said. “The bottom line – the institute is a truly unique asset to Tucson,” he said.

“We have a team that assesses and evaluates these patients and does the transition and handoff. The community-based team then looks after the patient’s needs,” Denmark said. “As a result of this collaboration with the Pima Council on Aging, we have significantlyreducedre-admissionrates.The re-admission rate for this popula-tion of Medicare patients has gone from about 22 percent to approximately 7 percent,” Denmark said. Registered nurse Amy Salgado is the clinical coordinator for St. Joseph’s Carondelet/Pima Council on Aging Transitional Care Navigation Program. Salgado knows St. Joseph’s, having

worked her way from volunteer in 1995 to head of this program. She’s a be-liever in getting everyone who can helpinvolved, inside and outside of the hospital. “We’re out there for (patients), for the home health agencies, for the nursing homes and for the families,” she added. Sometimes the job means using her clinical experience. Sometimes it in-volvesgoingtoapatient’shomeorfind-ing a way to help them afford the medi-cations they need. “When a patient leaves and they can’t get their prescription because it’s too ex-pensive, who do they call? So, I call the doctor in the hospital and say, ‘You just discharged this patient yesterday. Their

medicine is going to cost them $80. Can you find something different that theycan afford?’ ” she said. Associates like Salgado recognize they play multiple roles at St. Joseph’s – as champions for their patients’ needs, torchbearers of the healthcare system’s commitment to serve with quality and compassion and representatives of a service-oriented industry. “Our product here is everything we do – it’s not just surgery, it’s not just in-patient care,” Fonze said. “If you come in here you’re likely to have a whole range of services. Your impression when you leave is every aspect of that. We all own the whole product.”

When Time Matters MostBy Dan Sorenson


http://www.swaimaia.com


Supporting theVision

1. Community members break ground for St. Joseph’s Chapel in the Fred and Olga Pace Spiritual Center 2. Southern Arizona’s first mobile CT scanner, donated to St. Joseph’s Hospital by the Armstrong-McDonald Foundation 3. From left – Toby Allen, 2013 event chair, Bill Hussey, president of The Centurions and June Hussey get gussied up for The Great Outlaw Brouhaha 4. From left – Norbert Jankowicz and Fred Fruchthendler, Carondelet Foundation board chair, at the lighting of the new cross at St. Mary’s Hospital, donated by Jankowicz in memory of his wife 5. Sisters of St. Joseph of Carondelet volunteer for Habitat for Humanity

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Photo: George Howard Photo: Tom Spitz

Photo: Tom Spitz

Photo: Tom Spitz


BizHEALTHCARE


By Steve Rivera

Since 1993, Carondelet Foundation has supported the mission and vision of Carondelet Health Network, generating more than $50 million in private sup-port. Governed by a 35-member board of trustees, the foundation builds and strengthens relationships in support of Carondelet Health Network, raises pri-vate funding tobenefitCarondeletandhelps tell the Carondelet story. “At Carondelet Foundation, we work to showcase the network and help people to better understand the depth of services Carondelet provides,” said Richard Imwalle, senior VP and CEO of Carondelet Foundation. Imwalle, who was a familiar face at the University of Arizona Foundation before joining Carondelet four years ago, calls Carondelet “a quiet jewel in the community.” The impact of private support is evi-dent throughout the network. One of the more recent projects was a $1.3 mil-lion campaign to fund the St. Joseph’s Chapel in the Fred and Olga Pace Spiri-tual Center. The chapel was dedicated in April 2013. “This is a critical time for philanthropy in healthcare,” said Fred Fruchthendler, president of Jacob C. Fruchthendler & Co. and chair of the Carondelet Foun-dation Board of Trustees. “Carondelet Foundation is committed to doing its part – securing private funding and rais-ing community awareness to help meet network needs.” Other donor-funded projects include major facility renovations and improve-ments, purchases of medical equipment and supplies, and programmatic support such as the Van of Hope – a 38-foot mo-tor home that provides mobile medical services to Tucson’s homeless popula-tion. Carondelet has enlisted Arizona bas-ketball coach Sean Miller as a network spokesperson. Miller also serves as hon-orary chairman of the Carondelet Neu-rological Institute Board of Advisors. “He has been really committed to learning about the people and programs

of Carondelet,” Imwalle said. “He is a dedicated member of our team.” Another key network partner in Carondelet philanthropy is a group of well-known and enthusiastic volunteers, The Centurions. From the early, feel-good fundraisers to gatherings of thousands of locals out for a major party for a good cause, The Centurions have come a long way in the group’s 45-year history of providing support to Carondelet. “Some of the members who are 90 years old and have been there from the beginning tell stories of starting out very simply,” said Bill Hussey, president of the board for The Centurions and na-tional sales manager at Clear Channel Outdoor. “We now have so many great sponsors.” It’s turned into a labor of love for more than 100 active members of The Centurions, some of Tucson’s most prominent business and civic leaders.

There are more than 200 members in all. “The Centurions are fabulous and notjustbecausetheyputonthosefirst-rate parties,” said Imwalle. “They want Carondelet to be the very best in what we do.” It’s those parties that make things happen for Carondelet and keep The Centurions loving what they do. This past May, its rodeo-themed event saw about 4,000 people gather to help raise more than $300,000. In all, The Centurions have raised more than $5 million for Carondelet, with more to come. “Anything to help” has been the un-officialcatchphraseof TheCenturionssince the group formed in 1969 to raise money for what was the St. Mary’s Hos-pital Burn Center. “As the town grew and the needs grew, we decided to raise money for all of Carondelet,” Hussey said. Funding from The Centurions has benefittedanumberof importantproj-ects, including Carondelet Hospice & Palliative Care. In 2012, the group helped St. Mary’s with a major renova-tion that Imwalle said gives the facility the “look of a new hospital” to match the state-of-the-art medicine and tech-nology that is found inside. “A lot of what we raise goes to unfund-ed projects, some that otherwise would not be implemented, like immunization and diabetes programs,” Hussey said. “We are really happy to raise funds and sponsor those programs.” Hussey said The Centurions are em-barking on a commitment that would push fundraising efforts to $6 million in total.Theofficialnewswon’tcomeoutfor more than a year but he’s optimistic it will come to fruition. Until then, The Centurions and Carondelet Foundation will continue to work as they always have. And it is those people – and the hundreds of other network volunteers – that Imwal-le appreciates.

Supporting the of CarondeletVision

Jim Click on Carondelet“Carondelet Health Network was the first board of directors I ever served on. Our son, Chris, was born at St. Joseph’s Hospital near Christmas 1971. It was the most wonderful experience Vicki and I have ever had at a hospital. As a result of our pleasant and caring stay, we wrote a letter to St. Joseph’s stating that I hoped that we could treat each and every one of our customers as well as we were treated at St. Joe’s. A few days later, Judge Evo DeConcini contacted me stating that he had an award for me. My award was to join the Carondelet Annual Gifts Committee. I can’t tell you how easy it was to call people and ask them to donate to St. Joseph’s. Forty-two years later, Carondelet is still providing outstanding medical services – not only on the eastside and westside, but in No-gales, as well. Carondelet is one of the best hospital networks in the country.”

Jim Click, Jr.President, Jim Click Automotive Team


Carondelet Health Network’s mission embraces caring for Southern Arizona’s most vulnerable residents and providing preventive care for those at risk of devel-oping chronic illness. In fiscal year 2013 (July 2012- June 2013), Carondelet provided more than $69 million in community benefit in Tuc-son and Southern Arizona – in the form of public programs, community services, educational outreach, charity care and uncompensated care. That amount increased from about $52 million just two years ago, speak-ing volumes about the growing need in Southern Arizona, said Donna Zazwor-sky, VP of community health and continu-um care at Carondelet Health Network. Community benefit, which is a re-quirement of nonprofit hospitals, covers Carondelet’s unpaid costs to public pro-grams, traditional charity care and other programs – all with the goal of improv-ing the health of at-risk, uninsured, low income and homeless Southern Arizo-nans. “We want our community to be well,” Zazworsky said. “We are helping our community stay healthier.” Among the programs provided through community benefit are diabetes education, obesity awareness, telemedi-cine, healthcare for the homeless and other services. Carondelet recently teamed up with The University of Arizona Medical Center and Tucson Medical Center to conduct a community health needs as-sessment, helping to pinpoint the most critical areas of need. This effort en-gaged key stakeholders, demonstrating how the community can work together for a stronger future. Diabetes education has been an im-portant mission of Carondelet’s for de-cades throughout Southern Arizona, providing education and medical care to children, seniors and adults. “Southern Arizona is an epicenter of diabetes,” Zazworsky said. “One in eight people in Pima County have dia-betes.” For more than 20 years, nurse prac-titioner and certified diabetes educator Gwen Gallegos has helped maintain the

health of people with diabetes – or at risk for diabetes – in Nogales. “She is teaching people how to eat right, how to manage their health,” Za-zworsky said. “If you have diabetes in Nogales, you know Gwen.” Carondelet provides free information sessions for people with diabetes in Tuc-son as well, with the goal of providing basic lifestyle information and referrals into more extensive self-management programs that will help prevent life-threatening – and costly – complications down the road. Carondelet has worked with more than 200 local houses of worship to pro-vide obesity awareness and prevention in Pima County, helping 57 of these faith communities establish a health ministry, Zazworsky said. Carondelet also partners with El Rio Community Health Center, Primavera Foundation and others to provide ser-vices to homeless adults and children through the Southern Arizona Health Village for the Homeless. Through the Van of Hope, healthcare providers travel throughout Southern Arizona to provide primary care and behavioral health ser-vices to homeless people. Carondelet also offers a post-hospital program with a few shelters to provide follow-up care for people who were re-cently hospitalized and are not safe to be back on the streets. “They say it takes a village – and that is what we have helped to create,” Zaz-worsky said. Carondelet provides community health outreach workers to assist unin-sured and homeless patients who come to their emergency rooms in obtaining primary care visits, assistance with Ari-zona Health Care Cost Containment Sys-tem applications, food stamps and other programs. “It can be a very difficult system to navigate,” Zazworsky said. “That is the mission of Carondelet, to provide to the community and particularly the more vul-nerable. We have seen more vulnerable people in the last two years – people who fell off the system and had nowhere to turn. We have really had to step up those efforts.”

Care for Those in NeedBy Gabrielle Fimbres

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“Our board members are successful, engaged representatives of Southern Arizona’s business and civic communi-ties,” Imwalle said. “They recognize the highly dynamic nature of healthcare and want to make a difference.” Making a difference is a key. So is tell-ing the story of Carondelet. Imwalle said without people – volunteers like Foundation trustees and The Centuri-ons – telling the network’s story, Caron-delet wouldn’t be what it is today. “Trustees and other volunteers are important ambassadors who carry the message of Carondelet’s commitment to excellence,” Imwalle said. “And their diligence and enthusiasm is matched by Carondelet leadership. Our Presi-dent and CEO Jim Beckmann and his management team have a vision for this place that inspires even stronger com-munity partnerships.” Fruchthendler agrees. “The commu-nity and Carondelet are in this changing world of healthcare together,” he said. “Carondelet Foundation is proud to help navigate the challenges and be a partner in creating better living through better health.”

Carondelet Auxilians Members of the St. Mary’s and St. Jo-seph’s Hospital Auxiliaries join founda-tion trustees and The Centurions in their volunteer service to Carondelet. A famil-iar sight to hospital patients, physicians, visitors and personnel, auxilians work at hospital information desks, manage gift shops and provide visitor escorts and clerical services. The auxilians have raised more than $7.5 million over the past 59 years and have donated nearly 6 million volunteer hours. Combined membership in the auxiliaries is nearly 400 volunteers.

More than 2,200 people showed up for a free flu shot clinic offered by Carondelet.

PHOTO: COURTESY CARONDELET HEALTH NETWORK “Carondelet

Foundation is committed to doing its part – securing private

funding and raising community awareness to help meet network

priorities.” – Fred FruchthendlerBoard Chair, Carondelet Foundation


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