Kootenai | Kootenai Health | Issue 3, 2022

Epic Care Electronic medical records keep Gracie-Mai’s care close to home ISSUE 3 | 2022 Health K H . O R G Keep your summer fun Play it safe and avoid injuries Leading in neurology Kootenai Health is now a Center for Comprehensive MS Care

2 On the Leading Edge of Restoring Lives When Julie fell during a family bike ride, she suffered a traumatic brain injury. Emergency surgery at Kootenai Health saved her life. Our Neuroscience program excels in brain and spinal robotic surgery. It also provides life-changing care for Multiple Sclerosis, Parkinson’s Disease, Alzheimer’s, stroke, epilepsy and ALS (Lou Gehrig’s disease). And our state-of-the-art Neurodiagnostics Lab and Epilepsy Monitoring Unit can pinpoint brain activity for precision treatment. At Kootenai Health, our Neuroscience specialties are on the leading-edge of technology, and are all here to help you restore what matters most. Like Julie, who is back creating family memories to last a lifetime. To schedule an appointment with one of our board-certified Neurologists or Epileptologists, contact Kootenai Clinic Neurology at 208.625.5100, or visit kh.org

KH . ORG 3 WHAT’S INSIDE Issue 3 | 2022 18 Extraordinary leadership in MS care 16 A Mayo Clinic connection 15 Expert hands healing hands 5 Helping babies sleep safely 6 Gracie-Mai’s Epic journey Follow Us 8 One connected team New electronic health record system provides a deeper integration between Kootenai Urgent Care and other Kootenai Health entities. 9 Meet our new providers Join us in welcoming seven newcomers to the Kootenai Health team. 14 Enjoy summer! Don’t let injury spoil your fun—relax while keeping safety in mind. 19 Keeping the “Health” in Kootenai Kootenai Health’s dedication to employee well-being earns top honors. 20 Every gift is an act of kindness Donations to the Foundation help keep our hospital and community strong. 22 Ask the Expert What are some important screenings for men’s health?

4 Securing a Healthy Future “Only by giving are you able to receive more than you already have.” —Jim Rohn Following the COVID-19 pandemic, many hospitals and health care organizations are still working to recover from the financial impact of reduced surgical volumes, exorbitant fees to hire traveling nurses and the ongoing challenge of staff members leaving health care altogether. Never has the need for—and potential impact of—local philanthropy been greater. Over the next two years, the Kootenai Health Foundation will be raising support for the expansion of the Kootenai Health Heart Center. This expansion will add a second electrophysiology lab for heart rhythm disorders, a second cardiac catheterization lab and nine new patient rooms. This project provides a meaningful opportunity to make enhanced local, state-of-the-art cardiac care services a reality. I am pleased to announce that Cara Nielsen is joining the Foundation to lead this work as its new president, following Julie Holt’s well-deserved retirement. Youcanmakeadifference As a community-owned hospital, every dollar earned here is reinvested in continuing and improving health care in our community. But we cannot do it alone. It was through the generosity of Foundation donors that we were able to purchase a much-needed second da Vinci surgical robot, cranial navigation, a KINEVO microscope for neurosurgery and, coming soon, a new unit specially designed for the care of geriatric patients. In 2019, Kootenai Health was also proud to celebrate the Community Cancer Fund’s opening of the hospitality center on the Kootenai Health campus. With half of the center being home to a Ronald McDonald House and the other half being home to Kootenai Health’s own Walden House, the center annually serves hundreds of families in need of free or affordable lodging while receiving care at Kootenai Health. Whether you have a heart to help cardiac patients, seniors, cancer patients or nurses working to enhance their skills, your support really does make a difference. Knowing those services will be available in the future, should you or a loved one need them, truly creates an opportunity to receive more than you give. Wishing you good health, Jon Ness, CEO Kootenai Health 2003 Kootenai Health Way Coeur d’Alene, Idaho 83814 KH.org (208) 625-4000 Kootenai Hospital District Board of Trustees Katie Brodie, Chair Robert Colvin, Vice Chair Teri Farr, Secretary and Treasurer Dave Bobbitt, Trustee Cindy Clark, Trustee Thomas deTar, M.D., Trustee Liz Godbehere, Trustee Steve Matheson, Trustee Robert McFarland, M.D., Trustee Administration Jon Ness, Chief Executive Officer Pam Bauer, President, Kootenai Care Network Karen Cabell, D.O., Chief Physician Executive Kelly Espinoza, Chief Nursing Officer Jeremy Evans, Chief Operating Officer Daniel Klocko, Executive Vice President of Human Resources Cara Nielsen, Kootenai Health Foundation President Ryan Smith, Chief Information Officer Kim Webb, Chief Financial and Administrative Officer John Weinsheim, Executive Vice President of Kootenai Clinic Executive Regional Editor Kim Anderson Regional Editor Kristina Orrego Cover photo Jerome Pollos Published as a courtesy of Kootenai Health four times a year. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Translation assistance services, free of charge, are available to you. Please call (877) 746-4674. Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (877) 746-4674. Ako govorite srpsko-hrvatski, usluge jezicke pomoci dostupne su vam besplatno. Nazovite (877) 746-4674. 2022 © Coffey Communications, Inc. All rights reserved. Health Tolli Willhite, Kootenai Health Community Relations Coordinator, Morning Glory

KH . ORG 5 By Kristina Orrego Kootenai Health’s commitment to infant safe sleep best practices, education and community outreach has earned it designation as a Gold Safe Sleep Hospital by Cribs for Kids®. This is the second time Kootenai has received the title. Cribs for Kids is an organization that provides cribs to babies whose mothers cannot afford them. They also educate mothers about the dangers of unsafe sleep environments. Medical Director of Pediatrics Vanessa Carroll, M.D., said over 3,000 infant deaths in the United States each year are attributable to sleep-related causes. “Kootenai Health is fully committed to infant safe sleep to reduce the risk of sudden unexpected infant death, accidental suffocation and strangulation in bed and unsafe sleep-related injuries,” Dr. Carroll said. “We recognize the importance of educating our families about safe sleep practices while in the hospital so they are empowered for success at home. Achieving this highest level of designation twice is a testament to the strength and commitment of our pediatrics, postpartum and neonatal intensive care teams to provide the best care and promote the safety of infants in our community.” Kootenai Health NICU Medical Director Brook Lang, M.D., echoed Dr. Carroll’s sentiment. “Maintaining the Gold Safe Sleep designation from Cribs for Kids at Kootenai Health is a testament to our nurses, physicians and ancillary staff members’ dedication to parent and family education for safe sleep and newborn development,” Dr. Lang said. Crib for Kids has a network of over 1,750 partners across the country who share the united goal to spread a clear, concise safe sleep message and reduce infant sleep-related deaths. Bedtime basics To learn more about creating a safe sleep environment for babies, visit cdc.gov/ vitalsigns/safesleep. Rest assured: Kootenai Health is a Gold Safe Sleep Hospital SLEEP SAFELY

6 care of her local pediatricians, her assigned pediatric rheumatologists at Seattle Children’s, and a nursing care team at Seattle Children’s outreach clinic in Missoula, Montana. Monthly lab work, infusions, therapies and follow-up appointments in Coeur d’Alene, Seattle and Missoula mean her family’s lives often revolve around her illness. A full-time job Stephanie said managing the sheer volume of chart information, results and insurance information felt like a full-time job. “I took it upon myself to keep her file with me at all times because there were so many hands in the pot. If I forgot something, or if something was lost, it’s just more waiting; maybe for days,” she said. “I felt like I had become her medical social worker.” Gracie’s current treatment plan calls for infusions every four weeks, which would have ordinarily required her family to travel to Seattle or Missoula. However, last November, the team at Seattle Children’s and Kootenai Health were able to put together a treatment plan so Gracie could complete the infusions locally, at Kootenai Health’s pediatric department. When the teams began this collaboration, they were reviewing her results, chart notes and care plans with cumbersome faxes and lengthy phone calls. But there was a change on the horizon. In March 2022, Kootenai Health completed a systemwide electronic health record upgrade to a new software called Epic. This update eliminated 11 separate electronic health records in use at Kootenai Health and put every test result and chart note into a single medical record. Even better, the Epic software is used at a majority of health care institutions in the nation, including Seattle Children’s Hospital. Now, Gracie’s information can be seamlessly and safely shared EPIC Journey Seamless care and commu ication: A single health record eases the stress of managing a chronic illness Gracie’s By Kelly Fry Photos by Jerome Pollos Almost a year after Gracie-Mai Coates was born at Kootenai Health, her mother, Stephanie Coates, noticed something wasn’t quite right. Gracie’s left knee was swollen without apparent cause—at one point swelling to the size of a softball. They had recently gone swimming, and Stephanie thought it might be an infection. After seeing many physicians for evaluation and spending a week in the hospital for tests and exploratory treatments, Gracie and her family didn’t have an answer. Her health care team referred her to Seattle Children’s Hospital for a more extensive evaluation. At 18 months, Gracie and her family finally had a diagnosis— juvenile rheumatoid arthritis, or RA. This was the beginning of the Coates family’s journey in managing a life-altering chronic illness. Now 11, Gracie completes a complex medical regimen each month with the goal of reaching remission. She is under the Gracie-Mai looks for her brother during a game of tag at a Post Falls park. Gracie-Mai attends a therapy session at Kootenai Health.

KH . ORG 7 ConnectWith Kootenai Health’s MyChart What is MyChart? MyChart gives you secure online access to your medical record. You can use the internet to help manage and receive information about your health care. With MyChart, you can: • View your health summary from hospital or clinic visits • See your test results as soon as they are available • Request prescription renewals • Send and receive private messages with your care team Is there a fee to use it? MyChart is a free service for our patients. How do I sign up? You will be given a MyChart activation code during your next clinic visit. Use this code to log in and create your own username and password. Check it out Learn more about MyChart at KH.org/ patient-portal. between providers, whether across the street or around the globe. “There can be a frustration to have to repeat your story 12 times to 12 providers. With Epic, patients get to be patients and providers can see every note from every encounter around the country,” said pediatrician Vanessa Carroll, M.D., medical director of pediatrics at Kootenai Health. “Epic—and the patient tool, MyChart—has been a significant improvement for our patients and their parents.” Ablessing for the family For Stephanie, having everything in one place meant she could shift her focus from being a patient advocate to being a mom. “It gave me an opportunity to comfort Gracie-Mai and keep her distracted. Now, there’s just not that stress of making sure it’s all correct— that feeling that it all falls on me, and if I miss something, it will negatively impact us later on,” Stephanie said. “With this, everything is in one place. It’s nice for Gracie-Mai that I am able to just focus on her.” Being able to coordinate this service locally has been a blessing for Gracie’s family. “They treat Gracie like a hotel guest. They really care. Gracie loses enough school as it is, and last time, everything just went so smooth,” Stephanie said. “They really try to make sure they have a good rapport and that she is comfortable. She doesn’t dread going—it’s been good each time.” The team at Kootenai Health not only helped Gracie during her treatments, but also helped the family navigate the complexities of billing and insurance. “These treatments are a whole lot of money every month. It’s extremely difficult to navigate with everything else going on. We were looking at refinancing our house, selling a car—it was going to be financially devastating,” Stephanie said. “The nursing staff, and especially our social worker, was phenomenal. By the time we left Gracie’s last treatment, our social worker had us enrolled in a financial assistance program from the drug manufacturers that was going to help cover the costs.” The local availability of this service and the seamless connection between providers enables Kootenai Health to better serve the needs of our rapidly growing region. “It can be challenging at times to have a child with a chronic illness, so being able to provide this service is a huge benefit for the community,” MyChart Provided by Kootenai Health Gracie-Mai and her family—Stephanie Coates (mom), Jacob, 7 (brother), and Dustian (dad)—have a family outing. Dr. Carroll said. “Having everything in one place with Epic means we are truly one connected team, with patients at the center of it all.”

8 By Kim Anderson There is nothing like a primary care physician or provider (PCP) who knows your health history, understands your allergies and takes the time to talk to you as a friend. With life’s busy schedules, though, sometimes it’s hard to see your PCP as quickly as you would like. If your situation needs quick attention but isn’t so serious that you need to go to the hospital emergency department, a trip to urgent care might be just what the doctor ordered. Urgent cares specialize in quick treatment for minor emergencies. Ear infections, sprains, cuts, sore throats and more can all be cared for quickly and without the expense of a trip to the emergency department. Closer ties This past March when Kootenai Health implemented its new electronic health record system, Epic, it created an even closer tie between the hospital and Kootenai Urgent Care. “Epic gave us the ability to put Kootenai Health and Kootenai Urgent Care as well as Kootenai Outpatient Imaging, Kootenai Outpatient Surgery and every Kootenai Clinic practice on the same electronic health record system,” said Ryan Smith, Kootenai Health’s chief information officer. “Being on the same system means every time you see a care provider, they have access to all your information. If you go to the hospital and receive a medication, then a month later go to Kootenai Urgent Care, they can look up exactly what you were given, what the dose was and when you received it.” Fewerbilling statements With the change to the same electronic health record, Kootenai Urgent Care patients will notice another change. “Patients receiving care at any Kootenai Health facility, including Kootenai Urgent Care, will now receive one bill that includes the care they have received at any Kootenai Health facility for the month,” said Shelley Woodward, Kootenai Health’s executive director of revenue cycle operations. “This means patients have fewer separate bills to review and manage.” With this deeper integration, ONE CONNECTED TEAM Kootenai Urgent Care + Kootenai Health = Kootenai Urgent Care has also adopted Kootenai Health’s blue and green “spark” logo. “Our team has been eager to have a logo and colors that look more like Kootenai Health,” said Shelley Janke, executive director of Kootenai Clinic’s primary care division. “With everyone moving to the Epic electronic health record and closer alignment with Kootenai Health, the timing was finally right to make the change.” Save time Need to visit Kootenai Urgent Care? You can get in line before you leave home! Visit kootenaiurgentcare.com and click on “Get In Line Now.” Questions? Call (208) 625-3600.

KH . ORG 9 Me e t o u r n ew p r ov i d e r s Kootenai Clinic Appointment Center Need to nd a physician and schedule an appointment? Start here: (208) 625-6767. The Appointment Center can help you: • Determine the type of physician you need • Find an appointment that ts your schedule • Explain what to expect at your appointment Call the Appointment Center at (208) 625-6767 or request an appointment online at appointmentcenter.kh.org. Michael Carl, M.D. Kootenai Health Family Birth Center Tell us a bit about you and your family. I am originally from western Washington, where I grew up and completed my undergraduate degree at University of Washington in Seattle. My wife and I met in St. Louis, Missouri, while we were there for medical school. After completing our medical training in Cincinnati, Ohio, we decided to move to the Northwest to be back in my home state and enjoy all of the outdoor activities the area offers. Whydidyoupickyour specialty? Early on as a medical student, I knew I wanted to do pediatric medicine. It was not until a neonatology rotation during my pediatric residency that I knew specifically I wanted to specialize in the care of newborns. I found that infants have an incredible ability to heal and sometimes an unbelievable level of resilience, all while going through the most dynamic phase of life. Neonatology is an area of medicine that combines my interests in intensive care in an inpatient setting with family-oriented longitudinal care during a baby’s entire hospital stay. What canpatients expectwhen theyfirst meetwithyou? I always strive to achieve the best possible care and outcomes in conjunction with the entire neonatal intensive care unit team while using the most up-todate medicine possible. I believe that family inclusion in the decision-making process is of utmost importance for achieving that goal. What are someofyour hobbies? I enjoy hiking, snow skiing and biking, as well as traveling to national parks and international destinations. What drewyou toKootenai Health? I was drawn to Kootenai Health for its commitment to delivering excellent health care in a rapidly growing community. What isyour favorite healthy tip? Stay active. It is easier to remain that way than trying to increase your activity level later in life.

10 Molly Howlett, D.O. Kootenai Clinic Hospital Medicine Why did you pick your specialty? I spent a number of years working in the ICU and now just focus on general hospital medicine. I picked hospital medicine because I like taking care of the sickest patients. The variety of patients and medical problems in the hospital is the best. No two days are alike. What canpatientsexpect whentheyfirstmeetwithyou? When my patients first meet me, they might be a bit surprised by my laugh. No one plans on coming to the hospital, no one likes being in the hospital, so I figure we should just make the best of a terrible situation. You can either laugh or cry—or do both at the same time. But in the end, having a smile always makes a person feel a little bit better. What are someofyour hobbies? Hobbies that I enjoy are any outdoor activities, especially if they involve snow and mountains. I really don’t connect with lake sports, but the lake sure is pretty. What drewyou to Kootenai Health? I grew up in the Colorado mountains and have lived in Spokane for a number of years now. Moving to Kootenai Health is a step closer to the mountains. What isyour favorite healthy tip? Do something every day that makes you uncomfortable, and try to eat food that looks like it came from a farm, not a bag. Brett Eliuk, D.O. Kootenai Heart Clinics Tell us a bit about you and your family. My wife, Carrie, and I recently relocated from Michigan. We have three older children: Blake (20), Maddie (18) and Caitlin (16). Whydidyoupickyour specialty? I enjoy all aspects of cardiology. It is a very rapidly progressing specialty that has a lot of studies and research to guide us in caring for patients, so I can give people actual data, not just what I think is best. I enjoy the high-intensity emergency situations and the procedures that can make significant improvements in a patient’s life and well-being, in addition to the yearly health maintenance visits where we chat about our families and lives. Cardiology affects all people at various stages and ages, and everyone is affected differently. Just when I think I’ve seen it all, I’m surprised again. What canpatients expectwhen theyfirstmeet withyou? I like to get to know each patient and their life experience as we figure out their symptoms and heart issues. I think it helps to understand their knowledge level, prior health care experiences, beliefs and wishes so we can create a good care plan together. These are decisions we should make together. I feel my job is not to tell you what to do but rather to explain it well and guide you to make a safe, informed decision that you can be comfortable with and that coincides with your beliefs. What are someofyour hobbies? The majority of my free time is spent with my family. We like traveling, hiking, boating and hanging out with friends. I also enjoy hunting and fishing. I’m looking forward to exploring northern Idaho. What drewyou toKootenai Health? At the end of training, we almost took a position in Colorado but chose to stay in Michigan because our family was young. We have great friends and family out West and frequently traveled out to see them, every time wondering why we didn’t live there. I was looking for a change now that my children are older and was referred to Kootenai by a good friend. Kootenai Health has many beliefs and care models that match my own. The Coeur d’Alene area has many great people and places that fit my family’s lifestyle. What isyour favoritehealthy tip? I usually tell people, “Do your thing; live your life.” If you have issues that are getting in the way of that, then let us know so we can work on making it better. Schedule an appointment: Call (208) 625-5250.

KH . ORG 11 Greg Landry, M.D. Kootenai Clinic Vascular Surgery Tell us abit aboutyouand your family. My wife and I met in high school in Wisconsin. For the past 30 years, we lived in Portland, Oregon, where I was the chief of vascular surgery at Oregon Health & Science University. My wife is an artist who has exhibited nationally and internationally. My wife’s sister and brother-in-law have had a house in Coeur d’Alene for the past 10 years, and we visited them frequently and grew to love the area. When we had the opportunity to buy the house next door to them three years ago, we didn’t hesitate. It is great to be close to family in such a beautiful place. Whydidyoupickyour specialty? As a kid I remember watching M.A.S.H. on TV and being drawn to the characters performing surgery. I always knew that surgery was the profession for me but didn’t gain an appreciation for the different subspecialties until my residency. I loved the complexity and variety of vascular surgery and decided early on in my residency to pursue it. The technological advances in vascular surgery over the past 30 years have been amazing, and it has been fun to be a part of it. What canpatients expect when theyfirstmeetwith you? My approach to vascular care is very holistic. Vascular health starts with a healthy lifestyle, a healthy diet and exercise. I also believe a good doctor has to be a good listener to really understand what is going on with people and how heart trouble is impacting their lives. I take my role as an educator seriously and work hard to make sure patients understand what is going on and what their options are. I believe in the concept of shared decision making and will work tirelessly to help patients make the best decisions for their health and wellness. What are someofyour hobbies? My wife and I enjoy all of the winter and summer outdoor activities that Idaho has to offer. We love cooking as well as traveling for food and art. I am an avid windsurfer, so if you see someone windsurfing on the lake this summer it will probably be me. What drewyou to Kootenai Health? When we bought our house here three years ago, it was with the idea that we would retire here. When the position for medical director of vascular surgery came up, I was immediately intrigued by the opportunity of coming sooner. Once I met the people here and saw what a dedicated and dynamic medical community existed here, it became an easy choice. What isyour favorite healthy tip? As I am writing this, an 80-to-1 long shot just won the Kentucky Derby. Don’t sell yourself short. Anything is possible. Schedule an appointment: Call (208) 625-5222.

12 Taylor Laverdiere, PA-C Kootenai Urgent Care Tell us abit aboutyouandyour family. My husband and I have two fur babies. We met eight years ago and have been married for four years. We are excited to finally be done with school and start our careers. Whydidyoupickyour specialty? I have always been drawn to acute care. My husband is in emergency medicine. For me, urgent care provides the perfect balance of family and life. What canpatients expectwhen they firstmeetwithyou? Working in medicine, especially acute care, can take a toll. I try to always meet patients with a smile on my face and hope my empathy and compassion are felt. What are someofyour hobbies? I like to work hard and play harder! In the summertime we paddleboard, mountain bike, hike and fish. When the snow comes, we enjoy snowshoeing and downhill skiing. What drewyou toKootenai Health? I was born and raised in North Lake Tahoe. We visited Coeur d’Alene a few times in the past. As we neared the end of our training, we felt this area provided both the recreational lifestyle and medical facilities we were looking for. What isyour favoritehealthy tip? I use Pinterest to find quick and healthy meals. Christian Menard, M.D., Ph.D. Emergency Medicine Tell us abit aboutyou andyour family. My wife and I have three children, ages 8 to 11, and five dogs. My wife started a dog rescue when we moved to Houston. She has rescued 4,000 dogs to date. We fostered over 200 dogs in the process. Three of them failed to launch and helped create our oversized pack. We’re excited to get the family settled in Coeur d’Alene where we can all spend more time outdoors together. Whydidyoupickyour specialty? In truth, I probably was influenced by the show ER in my teens and 20s, although I expected to resemble Doug Ross more than Mark Green. The fast pace, variety and high acuity resonated with me then—and still do. What canpatients expectwhen theyfirst meetwithyou? They can expect me to take the time to sit with them and to listen to them. If they come to the emergency department (ED) with a problem, I will make every effort to quickly and compassionately care for them. Often patients come to the ED because they don’t know where to get help. When the ED can’t fully solve their problem, I will still make the time to explain the limitations of what we can provide and to direct them to more appropriate resources.

KH . ORG 13 What are someofyour hobbies? I spend most of my time outside of work with our children. I especially enjoy taking my daughter to her riding lessons, playing baseball and basketball with my boys and taking them skiing. In theory, I enjoy golf, but I only find the time to play a couple of times a year. We’re looking forward to getting the family out on the lake in Coeur d’Alene, and we love traveling with them. What drewyou to Kootenai Health? Our children had gotten old enough that it became important to move where we could spend more time outdoors, being active and enjoying natural beauty. We would have been happy in the mountains or near the ocean. The Kootenai job became available, and I was impressed that the hospital was community-owned. I am excited to direct a department that answers to the patients it serves. What isyour favorite healthy tip? Don’t smoke, and be active. Caleb Netting, M.D. Kootenai Clinic Orthopedics Tell us abit aboutyouandyour family. I’m married with two kids. I grew up in Kelowna, British Columbia. After I moved out East for school, I realized how much I missed the Pacific Northwest. There are more orthopedic surgery opportunities in the U.S. than in Canada, so being dual citizens, we decided to move to the U.S. My first job out of fellowship was in Lewiston. We liked Lewiston, but both my wife and I felt that the Coeur d’Alene area was a slightly better match. Growing up swimming in the Okanagan Lake in Kelowna, I’m particularly partial to a place with access to nice clean lakes. Whydidyoupickyour specialty? I had various reasons for choosing orthopedics. One was that I came from a physics background as an undergraduate, and I appreciated the mechanical thinking involved. The second was that sports has always been a big aspect of my life, so I was interested in the musculoskeletal side of medicine. And lastly, I believe that staying active and moving is the key to health. Ultimately, orthopedics is about keeping people moving. What canpatients expectwhen theyfirst meetwithyou? I try my best to be understanding and nonjudgmental. I try to be optimistic but also realistic. I offer my services when I think it will help, but I am honest when I think they won’t. That’s a fine balance and a goal I try to achieve. What are someofyour hobbies? I like exploring, being active and getting outside—ideally all three at the same time. My favorite day would be a hard hike on a beautiful trail that I’d never done before. What drewyou toKootenai Health? One was the region. It reminded me of where I grew up, and I wanted my wife and kids to be able to experience the same thing that I had as a kid. The second was the fact that I would be working for a nonprofit community hospital. I like being in a salaried position, where I can make decisions based on the best interest of my patients and not worry about the financial implications. What isyour favoritehealthy tip? Active commuting: If every day you walk, bike or run to work, then at least you’re getting some exercise. That’s infinitely better than no exercise. Schedule an appointment: Call (208) 625-6111 for the Coeur d’Alene clinic or (208) 625-6700 for Post Falls.

14 By Kristina Orrego Summer in the Inland Northwest finds most of us looking for every opportunity to enjoy the long days and sunshine. Fun in the sun might include swimming, hiking or bicycling. There’s no shortage of outdoor activities and recreational options, but topping the list is one important factor they all have in common: staying safe by taking steps to prevent injury. Kelly Bourland, RN, Kootenai Health’s injury prevention coordinator, said injury prevention is not to be taken lightly, because injuries can result in long-term consequences, especially head injuries. Wearing a helmet appropriate for your activity can mean the difference between a minor bump and a trip to the hospital. Wear the right gear Not all helmets are created equal. Helmets are generally designed for specific activities and take into account the rate of speed and likely areas of impact. This is why helmets for bicycling, snowboarding, dirt bikes and street bikes are different, and they each fit differently. “For example, a bicycle helmet should fit snugly all around with no spaces between the foam and head,” Kelly said. “The chinstrap should be centered under the chin; no more than one or two fingers should fit between the strap and chin. Be aware that there are different helmet sizes—such as toddler, child and youth—therefore, it’s best to try on helmets in person at the store.” When it comes to driving all-terrain vehicles (ATVs) and utility-terrain PLAY SAFE vehicles, it’s also important to wear the right clothing, which means longsleeved shirts, long pants and boots. “You shouldn’t be wearing flip-flops on an ATV,” Kelly said. “And I can’t emphasize enough the importance of wearing a helmet.” It is also important to drive within your abilities, stay away from alcohol while operating an ATV and stay on well-maintained trails. When hiking or off-roading, make sure someone outside of your group knows your schedule, route and when to expect your return. “If others know your route and schedule, they have an idea of where to look for you if something does happen,” Kelly said. During activities like boating, tubing and paddleboarding—anything involving water—wear a life jacket. Life jackets should fit tightly with all buckles latched. The life jacket should not rise above the wearer’s ears while arms are raised above the head in a “touchdown” signal. Kootenai Health is proud to take an active role when it comes to injury prevention. Volunteers give presentations every spring to children in kindergarten through second grade about helmet and water safety. “If the students have a helmet, we ask them to wear it so our volunteers can assess those helmets for damage and fit,” Kelly said. “If a child does not have access to a helmet or the helmet is a poor fit or damaged, we provide them with a new helmet at no cost. Helmets are purchased with grants through the Kootenai Health Foundation.” Kootenai Health’s water safety presentations emphasize the need for children to stay away from water unless accompanied by an adult, the importance of taking swimming lessons and learning to float. Kootenai Health partners with the Joshua Collingsworth Memorial Foundation to teach young children the importance of water safety with Josh the Baby Otter. “Hopefully it resonates with them and they remember what to do to stay safe,” said Kelly. Safety hub Visit KH.org/injuryprevention for additional resources, videos and information about injury prevention and community safety events. and Enjoy Summer

KH . ORG 15 By Kristina Orrego Our hands are parts of our bodies we can sometimes take for granted. They’re the tools with which we cook a delicious meal, create art or express how we’re feeling. But what happens when we can’t use our hands the way we once could? That’s when physicians like Caleb Netting, M.D., a new orthopedic surgeon at Kootenai Health, come into the picture. Here are two common conditions he sees in patients. Carpal tunnel syndrome and trigger finger Carpal tunnel happens when a nerve in the hand has become compressed, which often leads to pain and numbness. Carpal tunnel is often linked to doing certain activities or general overuse, but it can also be the result of an injury or certain medical conditions. Nonoperative ways to treat carpal tunnel, like steroid injections and wearing a night splint, can help relieve symptoms. In rare instances, Healing HANDS they can be fully effective. “In my experience, the symptoms usually recur or worsen despite these treatments,” Dr. Netting said. When those approaches fail to bring relief, Dr. Netting recommends a surgery called carpal tunnel release. “Because you have this one nerve that shares space in the wrist with nine other tendons, if there’s not enough room in there, it can get compressed,” he said. “At a certain point, the nerve can get permanently damaged. Then even if you do the decompression, you might not recover all of your nerve function.” Carpal tunnel release is usually successful as long as the nerve hasn’t suffered this permanent damage. Trigger finger is a condition that occurs when the tendons in the finger start to stick in the sheath they slide through. “The more they stick, the more inflamed they get,” Dr. Netting said. “And the more inflamed, the more they stick. A steroid injection is often useful to reduce the inflammation, breaking this vicious circle.” Generally, this steroid injection is the remedy for trigger finger. However, for some people, trigger finger release—a small surgery where part of the tendon sheath is opened up—is needed. “This surgery involves making a small incision in the palm over part of the tendon sheath called the A1 pulley,” Dr. Netting said. “Then a small portion of the tendon sheath is cut open to allow the tendon to glide freely.” Outcomes of surgery For both of these procedures, patients may have some soreness in their palms for up to three months. Generally after six weeks, they don’t have many limitations. It is reasonable for people to return to light duties anywhere from the next day to two weeks after these surgeries. For heavy labor, up to six weeks may be needed. For most patients, the discomfort or pain in the palm is more manageable than the conditions themselves. “For carpal tunnel release, the nighttime burning pain often resolves immediately after surgery,” Dr. Netting said. “For trigger finger, the finger shouldn’t catch or ‘trigger’ anymore after surgery.” Dr. Netting has taken an optimistic and realistic approach to his practice and aims to treat patients who need hand surgery sooner rather than later. “I can’t necessarily give you a perfect hand back after you have advanced damage, but there are certain options that will help provide improvements to where you are today,” he said. Seek relief To schedule a visit with Dr. Netting, call Kootenai Clinic Orthopedics at (208) 625-6111 or the Orthopedics office in Post Falls at (208) 625-6700. Help for two common conditions Caitlyn Kubale, MA, and orthopedic surgeon Caleb Netting, M.D., examine a skeletal hand at the Post Falls Orthopedics office.

16 By Elizabeth Brewer, M.Ed. Kootenai Health is proud to have been a member of the Mayo Clinic Care Network since 2014. This connection has given Kootenai Health access to different and valuable Mayo Clinic resources. In the past eight years, through the Mayo Clinic Care Network eConsult program, hundreds of patients have been able to work with specialists who may not be available locally. Kootenai Health and Mayo Clinic team up to find answers to puzzling heart troubles An eConsult is a way for physicians and their patients in our community to tap into the knowledge and expertise of Mayo Clinic physicians and specialists. Cliff Hampton, M.D., Kootenai Health neurologist, said it’s been beneficial to send imaging studies to Mayo Clinic for a second look through the eConsult process. “I appreciate being able to run a case by the Mayo subspecialists to support my diagnosis and treatment,” he said. “This is particularly important when there is a case that could use input from a subspecialty that we don’t have available in our region.” Subspecialty is sometimes used to describe increasingly more diverse medical specialties. For example, cardiology is a specialty that deals with the heart. A pediatric cardiologist is a subspecialist who cares for children with heart issues. Agoldenopportunity One of Dr. Hampton’s patients, Kristina Breneman, recently benefited from the input of Mayo Clinic subspecialists. Kristina is a wife, mother and northern Idaho resident who has a complex medical history—in the past few years, she has had several major surgeries and faced a wide range of debilitating symptoms. She thought she’d been improving after her last surgery, only to be blindsided by a new set of symptoms. Kristina worked with Dr. Hampton and a Kootenai Heart Clinic cardiologist to find an answer. After some monitoring and evaluation, Dr. Hampton sought an eConsult with the Mayo Clinic. “Dr. Hampton is such a great listener and communicator,” Kristina said. “I really appreciated that he was working with the Mayo Clinic to help treat me.” Most of the time, a Mayo consultant can answer questions during a session and save the patient a trip across the country to one of their locations. Occasionally, they will ask to see the patient in

KH . ORG 17 If you have questions or concerns about your own medical condition, speak with your Kootenai Health provider. He or she can help determine if a Mayo Clinic eConsult would be beneficial. person, which was Kristina’s case. “It was like getting a golden ticket to Willy Wonka’s chocolate factory. When you get this opportunity, you take it,” Kristina said. It took a couple of months to arrange the visit, but once Kristina and her husband arrived in Rochester, Minnesota, they spent nearly a week visiting different specialists, completing lab work and tests and receiving education. “The first appointment was with the neurologist I was referred to,” she said. “It was a two-hour review of my health history while he gathered information and teased out different symptoms in order to decide what other specialists to include on the team for my case.” Apathway forward Following that initial meeting, Kristina had visits with four other specialists to help diagnose her condition. In between appointments she had lab work completed, with results delivered in real time to her cellphone via an app. No stranger to the complexities of health care, Kristina was impressed by how quickly everything came together. “In four days’ time, I had seen a number of specialists. We started with 40 different potential conditions, all of them possibly life-threatening. I went home with seven different new or confirmed diagnoses, thankfully none of which are life-threatening.” In her estimation, this process may have taken years without Kootenai Health’s partnership, connection to the Mayo Clinic specialists and access to specialized tests that weren’t available locally. Kristina and her husband made one additional visit to the Mayo Clinic a few months later to see one last specialist and attend a daylong education session together. While her condition can be painful and requires a lot of daily management, she is grateful to have answers and a path to move forward. When asked what the experience meant to her, Kristina said: “These possibilities and the unknown hang over your head and disrupt your life. I wanted to understand what was happening to me and why. This process let me lay to rest my fears and made me better equipped to manage these conditions. It gave me hope.” Kristina Breneman of Ponderay, Idaho, enjoys a stroll through a wooded area.

18 By Kristina Orrego Kootenai Clinic Neurology’s commitment and advanced approach to treating patients with multiple sclerosis (MS) has earned it the designation of being a Center for Comprehensive MS Care through the National Multiple Sclerosis Society’s Partners in MS Care Program. The National MS Society is at the forefront of cutting-edge MS research—driving change through advocacy, facilitating professional education, collaborating with MS organizations around the world, and providing services designed to help people with MS and their families thrive. Ateameffort This recognition is a direct result of the efforts of Multiple Sclerosis Clinic Director Nina Bozinov, M.D., MS, and her experienced team. Together they have consistently demonstrated the wealth of knowledge and attention to detail needed to treat people living with MS. “This is the highest designation for an MS center, and it emphasizes the collaborative team approach to MS care,” Dr. Bozinov said. “It has truly been a team effort to build our MS center, and we continue to strive to make improvements in our patient care every day.” Kootenai Clinic Neurology is the only recognized Center for Comprehensive MS Care in Idaho and the only one located between Billings, Montana, and Seattle, Washington. The center’s presence is even more vital, as there is a higher incidence of MS patients in the Inland Northwest. “This recognition is a testament to the collaboration of our multidisciplinary team. Our physician and nurses who specialize in MS care work alongside pharmacists, rehab specialists and our lab to ensure comprehensive care for our patients,” said John Weinsheim, executive vice president of Kootenai Clinic. Easing lifewithMS National MS Society President Melissa Mathews also spoke to the center’s outstanding work within our region on behalf of their organization. “We are proud to partner with Kootenai Clinic Neurology to enhance coordinated, comprehensive care for the people who live with MS in northern Idaho and its surrounding areas. In earning this recognition, Kootenai Clinic Neurology has demonstrated extraordinary leadership in MS care, making a tremendous impact on the nearly 1 million people living with MS in our country,” Mathews said. Need a referral to Kootenai Clinic Neurology? Talk to your primary care provider. More information is available at KH.org/neurology/multiple -sclerosis. To learn more about MS and the National MS Society, visit nationalMSsociety.org. Extraordinary Leadership in MSCare Kootenai Health has achieved a Center for Comprehensive MS Care designation—the only recognized center in Idaho The Kootenai Clinic Neurology team are (front row): Kaysha Padilla, CMA; Nina Bozinov, M.D., MS; Autumn Ramsrud, PharmD, CSP, MSCS; Cindy Smith, PharmD, CSP; (back row): Kaeli Newbold, RN, BSN, MSCS; Katie Gwin, RN, BSN, MSCS; Tyler Cress, PharmD, MSCS; and Angie Critchfield, CPhT

KH . ORG 19 By Caiti Bobbitt When you think of the word health, the first thing that comes to mind is often the body’s overall well-being. At Kootenai Health, it is the organization’s mission to expand upon that to include a healthy body, mind and work environment. Coming off of a difficult couple of years that proved to be especially challenging for health care workers, Kootenai Health is honored to have been recognized for its focus on and dedication to employee well-being. GallupExceptional WorkplaceAward For the fifth time, Kootenai Health has been recognized as one of the most engaged workplace cultures in the world with the 2022 Gallup Exceptional Workplace Award (GEWA). Gallup’s survey results showed that Kootenai Health was successful in continuing to engage and develop its people, in spite of the significant challenges presented by the pandemic. “At Kootenai Health, we recognize our employees are our greatest asset,” said Jon Ness, Kootenai Health’s chief executive officer. Top honors for dedication to employee well-being “When leadership creates an environment in which all employees have the opportunity to do their best work every day, everyone wins. Employees have the satisfaction of utilizing their greatest strengths, leaders benefit from having an engaged and productive team and, most importantly, our community benefits by receiving the best care possible.” HealthyWork EnvironmentAward Additionally, Kootenai Health has been recognized by the Sigma Theta Tau International Honor Society of Nursing (Sigma) as the clinical honoree for the 2022 Healthy Work Environment Award. Only two organizations are recognized annually for this award; one clinical setting and one academic setting. “The importance of receiving this award cannot be overstated,” said Roxanne Gadberry, Kootenai Health’s nursing education manager. “This is one of the most prestigious awards in nursing!” Roxanne credits this recognition to Kootenai Health’s careful attention to prioritizing the needs of patients and staff. Joy inMedicine The Gallup Exceptional Workplace and Healthy Work Environment Awards complement Kootenai Health’s ongoing efforts to also support physician and advanced practice provider well-being—an effort for which the organization was honored with the American Medical Association (AMA) 2021 Joy in Medicine™ Health System Recognition Program late last year. The AMA distinction recognizes health systems with a demonstrated commitment to preserving the wellbeing of health care team members by engaging in proven efforts to combat work-related stress and burnout. The awards are also validation of the hospital’s work and commitment to its employees and community. Join our dream team Looking for a fulfilling career? See current job openings and learn about working at Kootenai Health at KH.org/careers. Keeping the ‘HEALTH’ KOOTENAI in

20 By Kristina Orrego Sometimes after patients have endured a health scare that was quite possibly the most terrifying ordeal of their lives, they’re compelled to give back to the facility that saved their lives. Other times, people see the ways that Kootenai Health has benefited a loved one. Donors can also be community members who give with the motive of wanting to see services in their community flourish. “Every gift is an act of kindness and deeply appreciated,” Julie Holt, former president of Kootenai Health Foundation, said. “There are also plenty of ways to give—donors can make a one-time gift, make pledges over any given period of time or talk with the Foundation about an estate gift.” Kootenai Health donors, in particular, are very generous. “It has a huge impact,” Julie said. “Whether you give $25 or $1 million, it helps the hospital continue to provide the absolute best services to our community and our patients.” I s an Ac t o f K i ndne s s ’ Donations to the Foundation help keep our hospital and community strong ‘All thanks toour donors’ In recent months, the Foundation has begun work on a campaign for the Heart Center expansion, part of Kootenai Health’s strategy of expanding cardiac services to meet the needs of an ever-growing patient population. The expansion will add a second electrophysiology lab for heart rhythm disorders, a second cardiac catheterization lab and nine new patient rooms. It’s slated to be completed by fall 2023. “Another advantage of giving to the Foundation is that donors are able to designate where their funds go,” Kali Singleton, supervisor of Foundation development, said. “It makes a huge difference for our donors to be able to tell us exactly what they want to support,” she said. “Even if it’s $5 a month, they can have funds go to the Cancer Patient Support Fund, the Heart Center, staff education or any other program that is meaningful to the donor.” Kali’s work includes researching the Foundation’s priorities—those that would enhance care, maximize patient satisfaction and make Kootenai Health a premier workplace for prospective staff members and physicians. “Donor support helps Kootenai Health provide innovative health care for our community, which also makes us an employer of choice,” said Kali. “In 2019, we were able to acquire the da Vinci surgical robot. The da Vinci allows surgeons to place their eyes and hands within a console and control four robotic arms, allowing them more precision of movement and range of motion. We are able to draw outstanding physicians to our area by offering technological advancements like the da Vinci—all thanks to our donors.” ER IF G ‘EV Y