MAMMOTH HOSPITAL NEWSLETTER
Mammoth Hospital is a modern, 17-bed Critical Access Hospital, supported by full-time board certified medical staff and first rate equipment. We are proud to offer personalized care with our highly qualified nursing staff throughout our facility and 12 out-patient clinics.
As an Official Medical Provider for the U.S. Ski and Snowboard Teams, we are proud of our specialized orthopedic surgery and rehabilitation programs. At Mammoth Hospital, we are always prepared to meet the health care needs of our residents and visitors with 24-hour emergency care.
Treating Neck and Back Pain
By Blake Rossi PT, DPT, OCS, ATC
Lower back and neck pain can be very common complaints throughout our lifetimes. Pain can range from dull, annoying pain, to severe disabling pain in the lower back. Pain in the back of the neck can be acute, which comes on suddenly and intensely, or chronic, which can last for weeks, months, or even years.
A very important aspect of spine health is the ability to adequately stabilize your spine. Most patients I evaluate ask how your abdominals or core help to stabilize the spine. My analogy is a soda can. If you have an empty can without any blemishes in the walls, the can will support quite a bit of weight. This is a great way to think about how to stabilize you spine adequately. Our diaphragm (respiratory muscle) is the top of the can, pelvic floor musculature is the bottom, and your abdominals are the side walls of the can. Our abdominals wrap from the back of your spine to the front of your pelvis and work along with the deep stabilizers of our spine for a cylindrical effect around our spine. When all of these muscles are properly coordinated, (along with breathing) the spine is properly supported from all angles.
Physical therapists are trained to evaluate movement patterns of the spine, including strength and coordination, motor control and mobility, and body mechanics of the neck and back. Each and every patient is thoroughly evaluated and a specific treatment plan is designed after evaluation. The earlier you can get a referral to physical therapy to address movement, strength, flexibility and mobility, the earlier you can receive treatment.
When a physical therapist assesses how well you are stabilizing your spine, they include looking at how well you use your diaphragm, pelvic floor, and abdominals for strength, coordination and stability. Many times people with low back or neck pain are deficient in stabilizing their spine. In physical therapy, we address these deficits and offer solutions to better stabilize your spine.
If you have recently been experiencing low back pain, mid back pain, or neck pain, talk to your primary care physician or call to schedule an appointment with Mammoth Hospital’s Physical Therapy clinic and Orthopedic Institute in Bishop. Our physical therapists are extensively trained in the evaluation, treatment and management of back and neck pain and can offer treatment plans to start getting appropriate care from your first appointment. You will be evaluated by one of our orthopedic providers in conjunction with a physical therapist to address your neck and low back pain. It’s our goal to find the best solution, to be applied at the best time, for each patient.
Mammoth Orthopedic Institute Hosts Mammoth Sports Course
Mammoth Orthopedic Institute in partnership with Mammoth Hospital recently hosted its first annual course and lecture series on the practice of Orthopedics developed by orthopedic surgeons, Michael Karch, Timothy Crall, and Brian Gilmer.
Participants from all over the country included doctors, nurses, physician assistants, physical therapists, and athletic trainers. Dr. Brian Gilmer was pleased with the attendance and quality of guest presenters, and said the talks really reinforced the objective of the conference. “The spirit and purpose of this course wasn’t just to rehash the same PowerPoint presentations given by experts at various meetings, but to critically evaluate the indications, techniques, successes, and failures involved in the treatment of complex problems in which no clear evidence-based guidelines exist,” says Gilmer.
Case presentations included lessons at disaster sites from Ground Zero at the September 11th Terrorist Attacks through Hurricane Haiyan in the Philippines in 2014 by Dr. Michael Karch. Drs. Brian Gilmer and Timothy Crall moderated discussions and presented on topics from complex knee and shoulder reconstruction, to upper extremity cartilage. Guest speaker, Dr. Raffy Mirzayan, a field leader in articular cartilage reconstruction from Kaiser Permanente also provided a lecture on his specialty. “All presenters were great, and having Dr. Mirzayan share the latest techniques on cartilage replacement was fascinating,” said Sarah Lang, ATC.
Total attendance for the course held at the Village Lodge was around 30 people, which helped facilitate more of an interactive exchange between participants. “The collaborative environment and sharing case studies led to great discussion and learning,” said Cory Lamblin, MD.
Due to its success, the surgeons of Mammoth Orthopedic Institute are looking forward to hosting future conferences in the upcoming years. “The opportunity to come together from many disciplines (surgeons, physician assistants, therapists, nurses, athletic trainers) was invaluable for understanding the big picture, building a better team, and caring for our patients,” said Karilyn Myers, PT.
For more information on the Mammoth Sports Course, please call (760) 924-4084.
Got Pain? Mammoth Orthopedic Institute Offers New Treatments to Residents and Guests of the Eastern Sierra
Our beautiful east side offers unlimited recreational opportunity to meet any active lifestyle. It also affords a peaceful and majestic environment to enjoy less strenuous activities like walking the dog, fishing, gardening, photography, painting, music, and family gatherings. But injury or pain from degenerative conditions can interfere with quality and enjoyment of life. The Mammoth Orthopedic Institute has the facilities, technology, knowledge, and experience to assist you in living more pain free.
“Now, more than ever, there are a variety of interventions that can be tried that can relieve suffering and improve function before resorting to surgery,” said Dr. Brian Gilmer who joined the Institute in October of 2014. “Platelet Rich Plasma injections, for example, may be used to stimulate the healing response in soft tissue. Visco supplementation is another intermediate therapy that can relieve joint pain in arthritic conditions. This, according to Gilmer, involves injecting a lubricating substance into the painful joint that is no longer producing enough of its own. “We also use Xiaflex injections to break down the thick scar tissue that can form in the hand with Dupytren’s Contracture. This allows us to restore functional range of motion without the need for surgery. We also routinely use ultrasound guidance to accurately target tendons and other structures we are injecting in the shoulder and other joints to ensure the medicine gets concentrated precisely in the painful structure. It’s great having Dr. Peter Clark as a sports trained family medicine physician on our team as well to broaden our medical expertise.”
“The Institute was formed this past year to better support the level of expertise that our orthopedic program has attained in the past few years,” said Tim Crall, one of the principle physicians in the group. “We’ve expanded our interests into conducting and publishing our research to add to the medical literature in orthopedics. Over the past few years we’ve broadened our service lines to include spine, hand, and foot and ankle care. We are actively teaching medical students, sports medicine fellows, and will soon have orthopedic residents doing rural rotations at Mammoth Hospital with us. We are working with Loma Linda University Medical School to develop a fellowship program here and plan to offer an annual symposium in orthopedics in the summer of 2017. It’s all very exciting and we’re proud to offer a very comprehensive program of high quality, minimally invasive services and first rate trauma care and a total joint replacement program to our residents and guests.”
The three principles in the group, Dr. Tim Crall, Dr. Brian Gilmer, and Dr. Mike Karch are all fellowship trained in advanced arthroscopic surgery and all are highly experienced in treating orthopedic trauma. Dr. Karch has focused his practice almost exclusively over the past few years to Total Hip and Knee Replacement. Both Crall and Gilmer are highly skilled in minimally invasive surgical techniques for shoulder, knee, and other peripheral joint and soft tissue repairs and reconstructions. Additionally, they both perform total shoulder joint replacements. “ Surgery is becoming more specialized and we respect the advantages that repetition and working consistently with a focused, high-performance team bring to reducing variability, increasing patient safety, and improving quality outcomes,” said Dr. Mike Karch.
“Many of our Total Joint Replacement patients are going home within 24 hours because of the Institute’s team approach to care. It takes the coordinated effort of a number of skilled people, including anesthesiologists with advanced skills, experienced surgical staff, physician assistants, physical therapist, nurses, information technologists, environmental services staff, and financial experts to achieve that level of care,” said Karch with a smile. “Great medical care is a team sport that is all centered on the needs of the individual patient.
The Institute partners with four subspecialists from the Torrey Pines Orthopedic Group in San Diego to round out their comprehensive, team approach to care. Dr. Richard Brown is a highly renowned hand surgeon, Dr. Richard Thunder is fellowship trained in spine surgery, David Hackley, M.D. is the chief of orthopedic trauma at Scripps La Jolla, and Dr. David Dalstrom is fellowship trained in foot and ankle injuries. Each is well known in their field, highly skilled, and passionate about supporting Mammoth Hospital’s philosophy of Patients First!
Check out the Mammoth Orthopedic Institute (MOI) physicians and staff online at www.mammothhospital.com or call (760) 924-4084 for more information or to schedule an appointment at any of their convenient locations in Mammoth, Bishop, or Lone Pine.
Striving for the Best: Quality Update
The Quality Department, along with hospital and medical staff throughout Mammoth Hospital and Clinics work hard to ensure that our patients and their families experience high quality clinical care and are highly satisfied with the way we provide our services. We measure clinical outcomes, compliance with evidence-based best practice clinical guidelines, patient satisfaction, and internal efficiency to ensure we are providing quality care and are constantly striving to improve.
CMS 5 Star Rating
Centers for Medicare & Medicaid Services (CMS) has awarded Mammoth Hospital a 5 Star Rating (out of 5 stars) for patient satisfaction. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) star ratings summarize patient experience, which is an important aspect of hospital quality. To be awarded 5 stars, the hospital has received in the last year at least 100 completed patient satisfaction HCAHPS surveys, scored highly in 11 different categories of patient satisfaction, and is compared to other similar hospitals. Only 155 out of 3,542 eligible hospitals received a 5-Star rating (Mammoth Hospital was one of three hospitals in California to receive a 5-Star rating). These patient satisfaction categories include measures such as pain management, nurse and physician communication, cleanliness and quietness of hospital rooms, quality of meals, and discharge communication. To view these measures and more, please go to the Hospital Compare website at www.medicare.gov/hospitalcompare.
Emergency Department Press Ganey Awards: Guardian of Excellence, Pinnacle of Excellence
This fall the Emergency Department was awarded two major awards in patient satisfaction. They received the Guardian of Excellence in Patient Experiences for reaching the 95th percentile for each reporting period for the award year. Additionally, the Pinnacle of Excellence in Patient Experience award was granted to the Emergency Department for maintaining consistently high levels of excellence across multiple years – only 3 organizations in the country receive this award each year. These awards are the result hard work by the entire Emergency Department team, as well as other departments including Radiology, Laboratory, and Admitting. Our other nursing units are also achieving high patient satisfaction scores, including the inpatient units reaching the 99th percentile and the Ambulatory Surgery department reaching the 94th percentile.
Mammoth Hospital offers a wide range of surgical services. Our clinical care of our surgical patients is aligned with evidence-based best-practices for surgical care, including antibiotic administration and prevention of blood clots, and is generally better than state and national averages. Currently our surgical site infection rate is 0.5% for all types of surgical cases. Relative to state and national rates, this is a very low rate. We do also occasionally treat infections caused by surgeries performed outside of Mammoth Hospital.
Patient and Family Centered Care
Mammoth Hospital and Clinics have started a program that involves the patient (and family) perspective of their experience throughout our healthcare services. By involving the perspectives and experiences of our patients and their families, we hope to improve the delivery of medical care, improve the patient experience through our services, and to reduce cost to both our patients and our healthcare system. Patient and Family Centered Care is realized in the form of a Patient and Family Advisory Council. Starting in January 2016, this council will meet regularly to discuss the patient and family experiences, opportunities for improvement, and the actual improvements themselves. The patients and their families will be the driving factors behind essential improvements that are made in the way we provide care.
Mammoth Hospital and Clinics are constantly striving to ensure you receive the best care and have the best experience with our services.