the magazine from FirstHealth of the Carolinas

Spring 2011

the magazine from FirstHealth of the Carolinas

Reid Heart CenterThe FirstHealth Cardiac & Vascular Center

firsthealth.org

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f i r s t h e a l t h C E O m e s s a g e

Charles T. FrockChief Executive OfficerFirstHealth of the Carolinas

The culture of innovationin·no·va·tion (in'-v'-sh-n) n. (LL innovatio) 1 the act or process of innovating 2 something newly introduced; new method, custom, device, etc.; change in the way of doing things

In a recent blog for the Harvard Business Review’s Health Care Innovations Insight Center, Gardiner Morse, a senior HBR editor who focuses on innovation, emerging technologies and sustainability, opined on

the need for innovation in health care:

“If ever a field needed a makeover, it’s medicine,” he said. “…There’s no shortage of clever ideas, but barriers to innovation are just as abundant.”

Despite the barriers, which include what he described as “heart-stopping price tags for technology” and a sometimes stubborn reluctance toward change, Mr. Morse proposed 10 innovations that he believes could “transform medicine.”

While some of his suggestions, innovations that concern regenerative or genetic medicine, for example, are obviously more suited for research institutions, others—medical checklists, surgical robots, online portals for patient information and evidence-based decision-making—are already common practice for FirstHealth of the Carolinas. Still others, accountable care organizations and innovative options for physician payment, are being investigated.

In fact, innovation is so much a part of the FirstHealth mentality that it is becoming ingrained as part or our culture. It might be argued that the very seeds of our organization were sewn in a climate of innovation. Few people thought that the tiny Moore County Hospital, created at the beginning of the Great Depression more than 80 years ago, would survive, much less thrive. But it did and FirstHealth of the Carolinas, its 21st century descendant, is now a comprehensive health care system that serves the mid-Carolinas with technology, programs and services that are rare—if not unique—for a community of this size.

Over the years, we have developed our culture of innovation by being open to and, when appropriate, welcoming change. Unlike large

teaching institutions, we don’t have a research and development program. So instead, we rely on instinct, good judgment, professional education and the successes—or lack thereof—of others when considering new technology, programs and services.

We are blessed with a Community Health Services department with an eye for innovation and a talent for aligning itself with innovation-supporting organizations that include The Duke Endowment, the Kate B. Reynolds Charitable Trust and the W.K. Kellogg Foundation. We also have outstanding financial support from the Foundation of FirstHealth, and we can depend on the talents of a bright and motivated staff and the advice of an involved medical community for ideas.

Several years ago, Dr. Mike Rowland, one of our general surgeons, encouraged us to investigate robotic surgery. We did, eventually investing in the da Vinci Robotic Surgical System, which has greatly enhanced the options we can offer to patients who need certain urologic and gynecologic surgeries.

More recently, physicians and staff encouraged us to include two dual-purpose (also known as hybrid) operating rooms in the new Reid Heart Center and the staff of the FirstHealth Centers for Health & Fitness introduced the Exercise is Medicine (EiM) concept to a community eager for disease prevention and wellness.

The dual-purpose ORs, which merge the high technology of a cardiac catheterization lab with the sterile environment of an operating room, give us the flexibility for complex cardiac and vascular procedures with untold opportunities for the future. The EiM program partners physicians with the fitness experts of the Centers for Health & Fitness to encourage physical activity as a regular part of daily living.

These and other innovations are highlighted in this issue of FirstHealth, and each—according to the musings of Gardiner Morse—portends the future of health care. I can assure you that more are on the way for FirstHealth of the Carolinas.

“Innovation is so much a part of the FirstHealth mentality that it is becoming ingrained as part of our culture.”

155 Memorial DriveP.O. Box 3000

Pinehurst, NC 28374

Editor, FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . Brenda BouserManaging Editor . . . . . . . . . . . . . . . . . . . . . . . . . . Jason SchneiderCreative Director . . . . . . . . . . . . . . . . . . . . . . . . . . . Jan McLeanSenior Art Director . . . . . . . . . . . . . . . . . . . . . . . . . . James DavisProduction Director . . . . . . . . . . . . . . . . . . . . . . . . . . Traci Marsh

f irsthealth.org

Contributing WriterBrenda Bouser

Contributing PhotographerDon McKenzie

Board of DirectorsFirstHealth of the Carolinas

Robert Bahner Jr., M.D. Mr. H. Edward Barnes Jr.David Bruton, M.D.Mr. James H. BulthuisMr. David L. BurnsDavid M. Cowherd, M.D. John N. Ellis, M.D. Walter S. Fasolak, D.O. Mr. Charles T. FrockMrs. Carolyn D. Helms

Mrs. Anna G. HollersMr. John M. MayDr. Susan R. PurserBruce S. Solomon, D.O.John S. Stevenson, M.D.William L. Stewart, M.D.Stephen A. Szabo, M.D.Mr. Robert E. TweedMr. David Woronoff

Corporate Officers

President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William G. MooreSenior Staff Accountant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kelly Carter

The not-for-profit FirstHealth of the Carolinas is headquartered in Pinehurst, N.C., and is composed of Moore Regional Hospital, Montgomery Memorial Hospital, Richmond Memorial Hospital (a division of Moore Regional Hospital), the Foundation of FirstHealth, FirstCarolinaCare Insurance Company, and Regional Health Services. Comments on FirstHealth of the Carolinas magazine or changes of address should be directed to bbouser@firsthealth.org or to (910) 715-4278.

FirstHealth of the Carolinas is published three times a year by Vitality Communications

407 Norwalk St.Greensboro, NC 27407

(336) 547-8970

© Copyright 2011 by Vitality Communications, an operating company of StayWell/MediMedia USA, and FirstHealth of the Carolinas, Inc. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Vitality Communications. Articles in this publication are written by professional journalists who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consulta-tion with the reader’s physician or professional adviser. All editorial rights reserved. Opinions expressed herein are not necessarily those of Vitality Communications or FirstHealth of the Carolinas.

Models are used for illustrative purposes only.

Chief Executive Officer, FirstHealth of the Carolinas . . . Mr. Charles T. Frock

Chief Operating Officer, FirstHealth of the CarolinasPresident, Moore Regional Hospital . . . . . . . . . . . . . . . . . . Mr. Stuart G. Voelpel

Chief Financial Officer, FirstHealth of the Carolinas . . . . Mrs. Lynn S. DeJaco

Chief Information Officer, FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . . . . . . . . Mr. David Dillehunt

Vice President, Human Resources,FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . . . . . . . . Mr. Daniel F. Biediger

Vice President, Finance, FirstHealth of the Carolinas . . . . Mr. Jeffrey A. Casey

Vice President, Community Services,FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Vivian Harrington

Vice President, Quality,FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Cindy McNeill-McDonald

Vice President, Patient Care Services/CNO,Moore Regional Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Linda Wallace

President, Montgomery Memorial Hospital . . . . . . . . . . . . Mrs. Kerry Hensley

President, FirstHealth Richmond Memorial Hospital . . . Mr. John J. Jackson

President, FirstCarolinaCare Insurance Company . . . . . . . Mr. Kenneth J. Lewis

President, Foundation of FirstHealth . . . . . . . . . . . . . . . . . Mrs. Kathleen Stockham

On the cover In its 15-year history, FirstHealth of the Carolinas has achieved a reputation for innovation that reached a new level with the opening of the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. This issue of FirstHealth recalls FirstHealth of the Carolinas’ first 15 years with a look at some of the highlights in technology, services and programs that have taken the organization from two hospitals in 1995 to a comprehensive multi-county health care network by the end of the first decade of the 21st century.

Mr. Alex Bowness, ChairMr. Julian King, Vice Chair

4 . . . FHC Happenings

9 . . . Calendar

10 . . New providers

26 . . Letters

26 Letters

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12 15 years of innovative

services, programs and technology

12 15 years of innovative services, programs and technology

20 A FirstHealth tradition of innovation

28 2010: A FirstHealth of the Carolinas year in review

20 A FirstHealth tradition of innovation

4 Spring 2011

FirstHealth

FirstHealth offers digital mammography in Hoke County

FirstHealth of the Carolinas now offers digital mammography through its outpatient facility in Raeford. The new Hologic Breast Imaging system at the FirstHealth Raeford Center is identical to the full-field digital system that is used at FirstHealth Moore Regional Hospital. An enhanced communications line allows images to be transmitted from Raeford to a Pinehurst reading room where they are interpreted by a board certified radiologist from Pinehurst Radiology.

“From the patient’s point of view, having a digital mammogram is very much like having a conventional screen-film mammogram,” says Emily Averbook, M.D., of Pinehurst Radiology. “Both film-based and digital mammography use compression and X-rays to create clear images of the inside of the breast. Unlike film-based mammography, however, digital mammograms produce images that appear on the technologist’s monitor in a matter of seconds. There is no waiting for film to develop, which can mean a shorter time spent in the breast imaging suite.”

firsthealth.org/hoke

firsthealth.org 5

For more information on any of these stories, call (800) 213-3284 or visit firsthealth.org

Orthopedics clinic opens in Richmond CountyFirstHealth of the Carolinas has opened an orthopedics clinic in Rockingham that is dedicated to providing

orthopedics care—from initial office visit to surgery—in Richmond County.

Staffed by five board certified orthopedic surgeons from Pinehurst Surgical’s Orthopaedic and Joint Replacement Center, the Richmond Medical Group – Orthopaedics Clinic is located in the FirstHealth Richmond Medical Plaza, 809 Long Drive, Rockingham.

David Casey, M.D., is the clinic’s medical director. “We are proud to be part of a hip and knee replacement program that has been top-rated by a national quality rating organization,” he says. “We are excited as we work together to continue this same quality of care in Richmond County.”

In addition to Dr. Casey, the Pinehurst Surgical orthopedic surgeons who staff the new clinic are David Strom, M.D.; Ward “Pat” Oakley, M.D.; John R. Moore IV, M.D.; and Kurt Wohlrab, M.D. All are certified by the American Board of Orthopaedic Surgery.

David Casey, M.D.

MMH patients appreciate their hospital

In a health care environment that has become increasingly conscious of quality, providers of health care have become increasingly aware of how patients feel about the care they receive.

This is especially true of small hospitals like FirstHealth Montgomery Memorial Hospital, where patients and hospital caregivers are often relatives and friends.

Consistently high patient satisfaction scores for the past three years at Montgomery Memorial indicate that patients are very pleased with the care they receive at their local hospital. Mean (average) score trends for fiscal years 2008, 2009 and 2010 remained in the mid- to high 90s for the hospital’s inpatient, transitional and ambulatory surgery units with scores for the Emergency Department only slightly lower.

MMH President Kerry Hensley attributes the consistency of the scores to the staff. “I believe that we can attribute these scores to the quality of the staff we have,” she says. “Members of our staff stay up to date with their clinical knowledge and skills while giving compassionate care to our patients who are often their friends and neighbors.”

firsthealth.org/mmh

6 Spring 2011

FirstHealth Moore Regional Hospital has become the first hospital in the entire FirstHealth of the Carolinas service area, and one of only three in North Carolina, to offer MRI scanning with a completely open scanning system.

Open scanning is especially beneficial for patients who feel anxious or uneasy in the confined spaces of traditional closed MRI scanners or the partially open MRI systems that some hospitals now have. Unlike closed or partially open scanners, Moore Regional’s Hitachi Oasis MRI can accommodate very large, heavy patients. With a table that will lower to 18 inches off the floor, it is also more convenient for patients with limited mobility.

From a diagnostic standpoint, the greatest advantage of Oasis over the partially open MRI system it replaced is the improvement in image quality. Michael Edwards, M.D., a neuroradiologist with Pinehurst Radiology, says the clarity of the Oasis-produced images is comparable to that of the hospital’s closed MRI scanners. “Overall, we get the same quality,” he says.

Moore Regional has three MRI scanners: two closed units in the main hospital and the true open Oasis open scanner in the outpatient FirstHealth Imaging Center in Pinehurst.

firsthealth.org/mri

True open MRI scanner is unique to region

firsthealth.org/mri

firsthealth.org 7

OLYMPIC GUESTOlympic snowboarding medalist Chris Klug (second from left) participated in a deepwater jogging class taught by Kelley Kibler, of the FirstHealth Center for Health & Fitness–Pinehurst, during a visit to Pinehurst for a Foundation of FirstHealth “Promise of Hope” program. Both Klug, a bronze medalist during the 2002 Winter Olympics, and Kibler are liver transplant recipients.

HEART CENTER OPENINGPamela Sands, R.N., the nursing supervisor for Interventional Cardiology Services, talks to a tour group visiting one of the electrophysiology suites in the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. Tours of the new facility highlighted a Jan. 9 open house that attracted about 1,500 visitors to the campus of FirstHealth Moore Regional Hospital.

Visit reidheartcenter.org for more information on the Reid Heart Center at FirstHealth Moore Regional Hospital. McLEAN

HOUSE DEDICATIONFirstHealth of the Carolinas celebrated the construction of the Clara McLean House with a Nov. 30, 2010, dedication ceremony at the hospitality house’s FirstVillage construction site. Yvonne Sneed, Miss McLean’s longtime caregiver, (pictured) spoke about her friend during the dedication program.

reidheartcenter.org

8 Spring 2011

Foundation funds RMH ICU renovation

A recent remodeling project at FirstHealth Richmond Memorial Hospital is making a difference for families and patients. “The project to refurbish our Intensive Care Unit (ICU) offers a variety of enhancements that directly and indirectly improve patient care,” says ICU Clinical Director Christy Land, R.N. “Although we did not increase the actual size of the unit, we reorganized the area to take advantage of the existing space and to add special features that improve patient safety and staff efficiency.”

A $200,000 contribution from the Richmond Memorial Hospital Foundation, which included funds from the A.A. Webb Fund, assisted with the renovation. The cost of the project totaled about $350,000.

The RMH ICU includes 12 beds with updated headwalls piped for oxygen as well as extra outlets to accommodate needed equipment and a monitoring system complete with advanced touch screen technology. New computerized documentation stations not only enable providers to complete documentation immediately, but also allow physicians and other health professionals to provide education right at the bedside.

Other changes include a new nursing station, the expansion of a supply/medication room to house patient care supplies, and an on-site workstation for physicians and case managers.

Raven Currie, R.N., (seated), and Clinical Director Christy Land, R.N., work at the nursing station in the renovated Intensive Care Unit at FirstHealth Richmond Memorial Hospital.

FirstHealth Montgomery Memorial Hospital recognized three generations of a Montgomery County family known for its philanthropy during the Jan. 6 dedication of a hospital nursing unit.

The naming of the newly renovated Blair Hall pays tribute to the late Ada Allen Blair; her son, the late Joseph Reece Blair; and his children, some of whom remain civically active in the Montgomery County community. Located on the hospital’s third floor, the unit provides both traditional hospital and rehabilitation care.

Ada Allen Blair donated the land on which Montgomery Memorial Hospital was built 60 years ago as well as the land for Montgomery Community College. The nursing unit named for her family provides a full-range of services including physical and occupational therapy, extended IV antibiotic therapy, recuperative care for cardiac bypass and orthopedic surgery patients, and nursing care for patients transferred from other hospitals.

MMH recognizes family with nursing unit dedication

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March“Eating Green”Tuesday, March 225:30 p.m. FirstHealth Center for Health & Fitness-PinehurstIt is easy to eat green. Learn what it means to eat organic and discover how and when to buy organic and how to eat healthier while minimizing your impact on the environment and your wallet.

Reid Heart Center Education Series

March-June 2011Join us to learn more about the heart and vascular system – how it works, what can go wrong and all of the treatment options that are available at FirstHealth Moore Regional Hospital at the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute.

• Thursday,March31“GotHeartProblems? Come and Learn from the Experts” John F. Krahnert Jr., M.D., heart surgeon, and David Cowherd, M.D., cardiologist

• Thursday,April21“Diagnosing& Treating Heart Disease” Peter Duffy, M.D., cardiologist

• Thursday,May19.“IsYourBloodFlowingLikeItShould:AbdominalAorticAneurysmandPeripheralArteryDisease(PAD)”ClintonK.Atkinson,M.D.,andJoelBerman,M.D., vascular surgeons

• Thursday,June9“ShoppingforQuality Heart Surgery: What HospitalsMeasureandWhy”ArtEdgerton, M.D., heart surgeon

• Thursday,June30“ValveDisease–SoYouThinkYouHave a Heart Murmur?”Peter Ellman, M.D., heart surgeon

Allprogramsbeginat6p.m.andwill be held at the Reid Heart Center on the campus of FirstHealth Moore RegionalHospital(PageRoadoffHighway211andMemorialDrive).Registration is required.

April“Nutrition and Irritable Bowel

Syndrome”Thursday,April75:30 p.m. FirstHealth Center for Health &

Fitness-PinehurstMany people live with the pain anddiscomfortofIBS,yetmedicaltreatments are limited. Learn nutrition strategies to manage the symptomsofIBSfromaFirstHealthregistered dietitian.

Run for the Ribbons 5K & 1KSaturday,April9Carolina Horse Park at Five PointsThis annual community fitness event benefits the Moore Regional Hospital Foundation’sCancerCAREFund.

“The Color of Health” Monday,April115:30 p.m. FirstHealth Center for Health & Fitness-PinehurstLearn about the phytochemicals and antioxidants in fruits and vegetables that can help improve health and reduce risk for disease.

Montgomery Foundation Spring Event

Saturday,April167p.m.TheGarnerCenter211BurnettSt.TroyProceeds from the annual fundraiser for the FirstHealth Montgomery Foundation will be directed toward dental health needs in Montgomery County.

Moore Regional Hospital Pregnancy Fair

Thursday,April216to7:30p.m.,TheFairBarn,HarnessTrack,Highway 5, Pinehurst

For information on any of these events, call(800)213-3284orvisitfirsthealth.org/calendar.

10 Spring 2011

Art Edgerton, M.D. Board Certified

FirstHealth Cardiovascular & Thoracic CenterHospital Affiliation: Moore Regional HospitalTraining: M.D., Bowman Gray School of

Medicine, N.C.Internship/Residency: Wake Forest University

Baptist Medical Center, N.C.

Evelina G. Kartsimaris, M.D. Board Certified

Moore Regional Hospital Hospitalist ServiceHospital Affiliation: Moore Regional Hospital Training: M.D., Jagiellonski University School of

Medicine, PolandInternship/Residency: Bassett Healthcare, N.Y.

Mohamed A. Y. Ibrahim, M.D.Board Certified

FirstHealth Richmond Medical Group– Women’s Center

Hospital Affiliation: Richmond Memorial Hospital Training: M.D., University of Khartoum, SudanInternship/Residency: Federal Ministry of Health,

Sudan; Wad Medani Teaching Hospital, Sudan; St. Joseph’s Regional Medical Center, N.J.

Lisa B. Cowan, M.D.Sandhills Emergency PhysiciansHospital Affiliation: Moore Regional Hospital,

Richmond Memorial Hospital Training: M.D., East Carolina University, N.C.Internship/Residency: East Carolina University

School of Medicine, N.C.

John Shoffeitt, M.D.Moore Regional Hospital Hospitalist ServiceHospital Affiliation: Moore Regional Hospital Training: M.D., Eastern Virginia Medical SchoolInternship/Residency: Medical University of

South Carolina

James W. Shaffer, P.A.-CMoore Regional Hospital Hospitalist ServiceHospital Affiliation: Moore Regional Hospital Training: P.A., Methodist University, N.C.

David L. Chandler, D.O.Board Certified

Pinehurst Anesthesia AssociatesHospital Affiliation: Moore Regional HospitalTraining: D.O., Kirksville College of

Osteopathic Medicine, Mo.Internship/Residency: Walter Reed Army

Medical Center, Washington, D.C.

Scott A. Hollrah, M.D. Board Certified

Sandhills Emergency PhysiciansHospital Affiliation: Moore Regional Hospital,

Richmond Memorial Hospital, Montgomery Memorial Hospital

Training: M.D., University of KansasInternship/Residency: McGaw Medical Center,

Northwestern University, Ill.

Cardiac and Thoracic Surgery

Hospitalist

OB/GYN

Emergency Medicine

Hospitalist

Hospitalist

Anesthesiology

Emergency Medicine

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Kurt P. Wohlrab, M.D. Board Certified

Pinehurst Surgical & FirstHealth Richmond Medical Group-Orthopaedics Clinic

Hospital Affiliation: Moore Regional Hospital, Richmond Memorial Hospital

Training: M.D., Chicago Medical School, Ill.Internship/Residency: Tripler Army Medical

Center, Hawaii

Glen Toomayan, M.D.Board Certified

Pinehurst Radiology

Hospital Affiliation: Moore Regional Hospital, Montgomery Memorial Hospital

Training: M.D., Duke University, N.C.Internship/Residency: Duke Medical Center, N.C.

Daniel L. Rowland, M.D.Board Certified

Pinehurst SurgicalHospital Affiliation: Moore Regional Hospital Training: M.D., Ross University School of

Medicine, West IndiesInternship/Residency: Newark Beth Israel

Medical Center, N.J.; Lutheran General Hospital, Ill.

Paul G. Singh, M.D. Board Certified

Carolina Spine Center Hospital Affiliation: Richmond Memorial

Hospital Training: M.D., Rosalind Franklin University of

Medicine & Science, Ill. Internship/Residency: Rush University, Ill.;

Hospital of the University of Pennsylvania

Wilson McWilliams, M.D.Board Certified

Carolina Eye AssociatesHospital Affiliation: Moore Regional HospitalTraining: M.D., Medical University of South

Carolina Internship/Residency: Baylor Hospital System,

Texas; University of Virginia Medical Center

Russell B. Stokes, M.D.Board Certified

Pinehurst SurgicalHospital Affiliation: Moore Regional HospitalTraining: M.D., UCLA, Calif.Internship/Residency: University of California

Davis Medical Center

Orlinda A Martinez, P.A.-CPinehurst Hip and KneeHospital Affiliation: Moore Regional Hospital Training: P.A., Chicago Medical School, Ill.

Orthopedics

Radiology

OB/GYN

Physical Medicine & Rehabilitation

Ophthalmology

Plastic Surgery

Orthopedics

Angela Morrison, M.D.FirstHealth Richmond Medical Group–Women’s

CenterHospital Affiliation: Richmond Memorial

Hospital Training: M.D., Eastern Virginia Medical SchoolInternship/Residency: Reading Hospital &

Medical Center, Pa.

OB/GYN

For a complete listing of FirstHealth of the Carolinas providers, visit the website at firsthealth.org/physician. If you prefer a printed copy, call (800)213-3284

12 Spring 2011

1995FirstHealth of the Carolinas is formed with the merger of Moore Regional Hospital in Pinehurst and Montgomery Memorial Hospital in Troy. What began as a two-hospital organization is now a comprehensive health care system with three hospitals (with 582 beds) and a variety of health services, including the Reid Heart Center, a rehabilitation center, three sleep disorders centers, three dental clinics, family care and specialty services centers, six fitness centers, a laundry, four charitable foundations, a Hospice program, home health services and an insurance plan as well Critical Care Transport, EMS and Medical Transport services.

Moore Regional Hospital’s Clarke Neonatal Intensive Care Unit, which opened in 1977, moves to renovated space. The 16-bed Level III nursery will again move to a larger renovated space in 2004.

An Intensive Outpatient Chemical Dependency Program begins under the supervision of FirstHealth Behavioral Services.

Moore Regional Hospital is re-accredited for a new three-year term by the Joint Commission on Accreditation of Healthcare Organizations. The hospital has been continuously accredited since 1961.

The cancer program at Moore Regional Hospital earns its first accreditation from the American College of Surgeons Commission on Cancer.

The FirstHealth Center for Health & Fitness–Pinehurst, a medical fitness center, opens with 3,000 members.

In 2010, FirstHealth of the Carolinas observed its first 15 years as a comprehensive health care system serving the mid-Carolinas. This timeline highlights the organization’s progress as a health care leader in programs, services and technology during those 15 years.

Community Hospital Comprehensive Cancer Center

firsthealth.org 13

1996Sandhills Hospice merges with FirstHealth of the Carolinas. The nonprofit that provides services to patients with life-limiting illness is now known as FirstHealth Hospice

& Palliative Care. An early fundraiser that is established as the Hospice

Pottery Auction eventually becomes the Pottery Plus Auction.

With the support of the Moore Regional Hospital Auxiliary and the 1996 U.S. Women’s Open Golf Championship, FirstHealth of the Carolinas purchases a 35-foot van and begins providing mobile health services that currently include vascular, diabetes, blood pressure and cholesterol screenings.

FirstHealth unveils a community benefit program targeting at-risk populations, the community at large and other not-for-profit organizations.

The Moore Regional Hospital Rehabilitation Center, which opened in 1994, is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). A contract with the Montgomery County Board of Commissioners to provide emergency medical services sets the stage for what is now the FirstHealth Regional EMS, a program serving residents of Chatham, Montgomery and Richmond counties in North Carolina and Chesterfield County, S.C. The system also includes Medical Transport in Moore County, wheelchair vans in Montgomery and Hoke counties, and Critical Care Transport.

Assisted by funding from the Kate B. Reynolds Charitable Trust and the NC Office of Rural Health, FirstHealth breaks ground on a $3.5 million, two-story medical arts building on the Montgomery Memorial Hospital campus. The building will house physician offices and a pharmacy.

Clarke Neonatal Intensive Care Unit

FirstHealth Center for Health & Fitness-Pinehurst

Mobile Health Services

14 Spring 2011

1997FirstHealth adopts its core purpose (“to care for people”) and core values (respect for the individual, integrity, service to others, excellence).

The In Love and Service campaign (supporting a patient tower, outpatient admissions, cancer center and emergency department at Moore Regional Hospital) begins. By the time the campaign ends in September 1999, $10.4 million has been raised for these projects.

1998FirstHealth begins a unique service to dentally underserved children with the opening of the first of three FirstHealth Dental Care Centers. Programs are now located in Southern Pines, Troy and Raeford.

Ellen Willard, M.D., a medical oncologist and hematologist, becomes the first physician in North Carolina to become board certified in hospice and palliative medicine.

A FirstHealth Center for Health & Fitness opens in Troy, the first medical fitness service to be opened in the small, rural communities served by FirstHealth.

Moore Regional Hospital is approved as a member of a national cancer trials group with its designation as an affiliate of the National Cancer Institute-sponsored Gynecologic Oncology Group.

FirstHealth becomes one of 13 national learning laboratories to help improve health care quality and access with the award of a $2.5 million grant from the W.K. Kellogg Foundation. The initial program is directed toward medically underserved populations in Moore, Montgomery and Hoke counties, and is later expanded to include Richmond County.

FirstHealth introduces home health care to its family of medical services. FirstHealth Home Care initially operates as a franchise of a national chain of home health services.

Dental Care Centers Ellen Willard, M.D. FirstHealth Richmond Memorial Hospital

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1999FirstCarolinaCare is formed as a wholly owned subsidiary of FirstHealth of the Carolinas. In October 2000, it is licensed by the North Carolina Department of Insurance to offer products in 51 counties.

The Foundation of FirstHealth is established as the umbrella organization for Moore Regional Hospital Foundation, FirstHealth Hospice Foundation and FirstHealth Montgomery Foundation. The FirstHealth Richmond Memorial Hospital Foundation is added after the purchase of Richmond Memorial Hospital.

The signing of a management agreement with the Board of Trustees of Richmond Memorial Hospital brings the Rockingham facility into the FirstHealth family. The hospital is soon renamed FirstHealth Richmond Memorial, and its acquisition as a full FirstHealth entity is finalized on March 1, 2001.

Montgomery Memorial Hospital becomes the first hospital in the state to officially submit a letter of intent in the Critical Access Hospital program. A response to the 1997

Balanced Budget Act, the Critical Access designation allows small, rural hospitals to base Medicare reimbursements on actual cost rather than on predetermined diagnosis-based payment.

Community leaders from throughout the region are recruited to serve on a FirstHealth Community Health Board designed to work toward meeting the needs of the underserved, those with public assistance, those without health insurance and the working poor.

The firsthealth.org website is introduced as the cyberspace address for FirstHealth of the Carolinas.

An $8.5 million, 24,980-square-foot Outpatient Center, part of Phase I of the FirstHealth MRH 2010 Project, opens at Moore Regional Hospital. Phase I will also include a Central Energy plant; a new Emergency Department, Cancer Center and Patient Tower; parking facilities; and interior hospital renovations and refurbishments.

FirstHealth expands its cardiac diagnostic and treatment services with the operation of its first mobile

cardiac catheterization lab and the conversion of a cardiac cath lab to an electrophysiology suite.

The FirstHealth Central Laundry opens in the Sandhills Industrial Park in Aberdeen to serve the linen needs of FirstHealth and other organizations in the area.

FirstHealth’s cancer program is designated a Community Hospital Comprehensive Cancer Center by the American College of Surgeons Commission on Cancer.

The Hospice Challenge begins with the goal of raising the Hospice Foundation endowment to ensure annual support for FirstHealth Hospice operations. The three-year fundraiser increases the endowment from $2 million in 1999 to $10 million in 2002.

FirstHealth joins the Hoke County community to celebrate the opening of the 39,000-square-foot FirstHealth Raeford Center. The facility houses primary and specialty care clinics and a Center for Health & Fitness. A Dental Care Clinic is located on the same campus.

FirstHealth Montgomery Memorial Hospital Center for Health & Fitness-Raeford

16 Spring 2011

2000A Patient Tower housing the FirstHealth Community Hospital Comprehensive Cancer Center, an enlarged and renovated Emergency Department, and medical and surgical nursing units opens at Moore Regional Hospital.

The FirstHealth Dental Care Centers earn national attention as FirstHealth CEO Charles T. Frock and Sharon Nicholson Harrell, Dental Care Center director, participate in the Washington, D.C., release of the Surgeon General’s first report on dental health.

The newly introduced FirstHealth Intranet allows employees, physicians and volunteers to search for information within the corporation. During a 2002 overhaul, the Intranet is named FirstWeb.

In a banner year for patient care recognition, Moore Regional Hospital is named one of the nation’s Top 100 hospitals for cardiovascular, stroke and orthopedics care.

Ultrasound becomes Moore Regional Hospital’s first “filmless” department.

The state of North Carolina credentials FirstHealth’s school-based health center program. Services are offered through a partnership between FirstHealth and Montgomery County Schools at East Middle School in Biscoe and West Middle School in Mt. Gilead with support from the FirstHealth Montgomery Foundation.

FirstHealth opens the Center for Health & Fitness–Pembroke in Robeson County and breaks ground for the Center for Health & Fitness–Richmond in Rockingham.

2001FirstHealth receives a major grant from the American Legacy Foundation to promote tobacco-use prevention and cessation.

The FirstHealth Child Development Center receives a five-star rating from the state of North Carolina.

Cardiac surgeons at Moore Regional Hospital begin offering off-pump bypass surgeries.

The Cancer CARE Fund is established with the opening of the FirstHealth Community Hospital Comprehensive Cancer Center. A Heart CARE Fund has existed since the early 1990s, and more CARE funds are subsequently added to support children, emergency services, neurosciences, arthritis/orthopedics and behavioral health.

2002The implementation of a wireless communication network connects the entire FirstHealth organization.Richmond Memorial Hospital wins a state award for volunteerism for its participation in the Richmond County Chamber of Commerce’s School/Business Partnership.

FirstHealth Montgomery School Health Centers FirstHealth Child Development Center

firsthealth.org 17

2003The FirstHealth Center for Health & Fitness–Richmond opens on the campus of Richmond Memorial Hospital.

FirstCarolinaCare develops FirstPlan, a health benefit plan for small businesses that provides a premium subsidy for eligible employers and lower-wage workers.

The Employee Health Improvement Program (EHIP) offers financial incentives to FirstHealth employees who improve their health through diet and physical activity. Participating employees receive their first reward checks, as much as $240, in July 2004.

Hospitalist physicians begin seeing patients at Moore Regional Hospital. The program is later expanded to include Montgomery Memorial and Richmond Memorial.

High Dose Rate (HDR) Brachytherapy, a form of internal radiation therapy that precisely delivers radiation from the inside out, is added to FirstHealth’s cancer program.

2004The Chest Center of the Carolinas begins accepting patients at Moore Regional Hospital. The program consolidates board certified thoracic surgeons, pulmonologists, medical and radiation oncologists, pathologists and radiologists dedicated to the treatment of diseases of the chest.

On July 4, FirstHealth becomes the first hospital system in North Carolina to go tobacco-free when it declares its “independence from tobacco.” The FirstQuit program is introduced to support members of the greater FirstHealth community as well as FirstHealth employees in their tobacco-cessation efforts.

The Stepping Stones campaign begins with a goal of $25 million. The goal is raised to $30 million in 2007. The $34 million that is actually raised by the time of the campaign’s conclusion in 2008—through community, physician, employee and governance donations—will support the Reid Heart Center, Clara McLean (hospitality) House, Hospice House and renovations to the Emergency Department at Moore Regional Hospital.

FirstHealth takes a giant step into the electronic world with the implementation of paperless patient records.

Moore Regional Hospital and Pinehurst Radiology form a partnership called FirstImaging of the Carolinas to offer PET (positron emission tomography) imaging.

2005Ground is broken for FirstVillage, a 15-acre project that will ultimately include the Surgery Center of Pinehurst, a new Pinehurst Surgical building, the Clara McLean House and a multi-level parking deck.

FirstHealth of the Carolinas is awarded a certificate of need for a designated heart hospital on the campus of Moore Regional Hospital.

A dedication ceremony introduces an expanded and renovated Emergency Department at Richmond Memorial Hospital.

The Moore Regional Hospital Auxiliary observes its 75th anniversary with the announcement that it has fulfilled a $1 million pledge toward a construction and renovation project for the FirstHealth Child Development Center.

A Specialty Centers Division is established in the former Pinehurst Surgical building on the Moore Regional Hospital campus. The Specialty Centers Building now houses the Infectious Diseases Program, the FirstHealth Wound Care & Hyperbaric Center and the FirstHealth Back & Neck Pain Center.

The Moore Regional Hospital Foundation funds a pilot telemonitoring program through FirstHealth Home Care. The program has since been expanded several times and now provides home-monitoring technology for 120 patients.

N.C. House Speaker Pro Tempore Richard Morgan of Moore County announces the award of a $177,300 state grant to the FirstHealth Dental Care Center in Southern Pines. Most of the money will be used to add two treatment rooms and a consultation room to the facility.

Surgery Center of Pinehurst

18 Spring 2011

2006A newly renovated building housing the enlarged FirstHealth Center for Health & Fitness-Southern Pines opens on Davis Road in Southern Pines.

The FirstHealth Regional EMS System adopts the STEMI-alert protocol for heart attack response. FirstHealth takes a “generational leap” in the treatment of prostate surgery with the implementation of the da Vinci Robotic Surgical System at Moore Regional Hospital. The robotic program has since expanded to include certain gynecological procedures.

Moore Regional Hospital joins the best of the nation’s best with its selection as a Magnet Nursing Program hospital. At the time, only 216 health care organizations in 42 states had earned the recognition from the American Nurses Credentialing Center.

Richmond Memorial Hospital receives two national 2006 Compass Awards from Press Ganey and Associates for patient satisfaction.

Tug transport robots begin delivering medications from the Pharmacy to nursing units at Moore Regional Hospital.

Richmond Memorial Hospital becomes one of only a few community hospitals in the state to acquire a computer-aided detection system for reading mammograms. CAD technology is now used throughout the FirstHealth organization.

2007Specialized wound treatment is introduced with the opening of Wound Care & Hyperbaric Centers at both Moore Regional and Richmond Memorial hospitals.

FirstCarolinaCare broadens its structure, receives its license as a North Carolina insurance company and becomes FirstCarolinaCare Insurance Company Inc.

The introduction of an innovative cafeteria pricing system encourages FirstHealth employees to eat better by lowering the price of healthy foods.

A renovated and expanded FirstHealth Center for Health & Fitness–Pinehurst, with the full-service spa called firstspa, begins serving the FirstHealth community.

FirstHealth of the Carolinas and Pinehurst Medical Clinic partner to consolidate outpatient cancer services at the FirstHealth Outpatient Cancer Center. The facility houses the outpatient chemotherapy services of Moore Regional Hospital and the offices and clinics of the oncology/hematology physicians of Pinehurst Medical.

Da Vinci Robotic Surgical System Tug Transport Robot FirstHealth Outpatient Cancer Center

firsthealth.org 19

2008Moore Regional Hospital acquires a Stealth Station Treatment Guidance System. The GPS technology allows neurosurgeons to navigate throughout the body while using 3D images as their guide.

A $155,000 grant from the North Carolina Office of Rural Health and Community Care allows Richmond Memorial Hospital to purchase and install a state-of-the-art information management system that replaces paper charts in the hospital’s Emergency Department with an electronic charting program.

Clinical Trials, a program that was initiated at Moore Regional Hospital in 1995, becomes a formalized FirstHealth department.

2009The stroke care program at Moore Regional Hospital earns The Joint Commission’s Gold Seal of Approval and is named a Joint Commission-certified Stroke Center.

FirstComm begins providing services. The centralized EMS operation dispatches 911 emergency calls for FirstHealth EMS-Chesterfield as well as inter-facility and non-emergency transports for the entire FirstHealth Regional EMS. It also handles calls from the RACE (Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments) hotline and FirstHealth Response, a personal emergency response service.

FirstHealth begins an effort to increase health care services to Hoke County by applying for a certificate of need to build an eight-bed community hospital near Raeford. After Cape Fear Valley Medical Center appeals FHC’s approved CON application, a long application and appeals process ensues. A ruling from the state of North Carolina is expected during 2011.

2010With the introduction of Exercise is Medicine, area physicians begin referring patients to the FirstHealth Centers for Health & Fitness for a program that encourages physicians to consider physical activity as a patient vital sign just as they would blood pressure and weight.

The opening of the FirstHealth Transfer Center streamlines the inter-facility transfer of patients to FirstHealth hospitals.

The Employee Health Improvement Program (EHIP) surpasses the $1 million mark in paid benefits to participating FirstHealth employees.

An open house introduces the expanded and renovated FirstHealth Center for Health & Fitness-Troy.

Ground is broken for FirstHealth Hospice & Palliative Care construction, and the Clara McLean House is dedicated.

With funding assistance from the FirstHealth Richmond Memorial Hospital Foundation, Richmond Memorial Hospital completes a renovation of its Intensive Care Unit.

In partnership with Pinehurst Surgical, FirstHealth opens an orthopedics clinic in Rockingham that is dedicated to providing orthopedics care—from initial office visit to surgery—in Richmond County.

Construction nears completion on the Reid Heart Center: The FirstHealth Cardiac & Vascular Institute. The facility that consolidates cardiac and vascular services opens in January 2011.

(A review of FIrstHealth during 2010 can be found beginning on page 28.)

Proposed Hoke Community Hospital Reid Heart Center: The FirstHealth Cardiac & Vascular Institute

20 Spring 2011

AFirstHeAltH trAdition oF innovAtion

firsthealth.org 21

If it takes dressing up like a vegetable or a piece of fruit to convincechildrenaboutthevalueofhealthyeating,GinaSmith and Christina Turbeville are happy to do it.

Smith, the family nurse practitioner, and Turbeville, the nutrition educator, of the FirstHealth Montgomery School Health Centers in Montgomery County, are committed to helping children stay healthy in a part of North Carolina with an unusually high incidence of obesity and weight-related diabetes. The program’s innovative obesity prevention initiative, conducted in partnership with Montgomery County school staff andschoolnurses,recentlyreceiveda$10,000TIEs(technology,innovation,evaluation)awardfromtheBlueCrossandBlueShield of North Carolina Foundation.

The FirstHealth Montgomery School Health Centers, located inMt.GileadandBiscoe,provideon-sitemedical,mentalhealth and nutritional care that is open to any child in the Montgomery County School System. Thousands of children are assisted every year.

In Moore County, a FirstHealth partnership with Moore County Schools and the North Carolina Department of Health and Human Services provides school-based nurses to 22 schools. The program has received both state and national recognition as a best-practice standard by contributing to the well-being and lifelong achievement of more than 12,000 school-aged children each year.In2006,theMooreCountySchoolNurseProgrambecame

the first in the nation to receive Magnet Nursing designation.“Wehavesavedthousandsofdollarsinunnecessary

emergency department visits through our innovative programs,” saysProgramManagerPhyllisMagnuson,R.N.“Wewerealsothe first school nurse program in the state to use an electronic medical record-keeping program that was designed just for us.”

Innovation is a tradition for FirstHealth of the Carolinas. From tobacco-cessation programs to student health, from healthy eating incentives to patient-centered care, FirstHealth has been a leader in innovative health care throughout its more than 80-year history.There are many examples of this FirstHealth standard of innovation—far too many to share them all. Here are a few.

StudentHealth

Family nurse practitioner Regina Smith (right) and nutrition educator Christina Turbeville, of the FirstHealth Montgomery School Health Centers, talk to a group of Montgomery County third-graders about nutrition. The HEAP (Healthy Eating Active Play) program they developed with the assistance of a registered dietitian received a Silver Star Award for Health Care from the N.C. Fruits & Veggies Nutrition Coalition.

Quit-tobacco programmingWhen FirstHealth of the Carolinas declared its independence

fromtobaccoonJuly4,2004,itbecamethefirsthospitalsystemin the state to become tobacco-free. It has since become a model for quit-tobacco services and programming.

From the beginning of this organization-wide quit-tobacco initiative, FirstHealth leaders acknowledged that giving up tobaccoisalwaysaverydifficultthingtodo.Asaresult,theavailability of Community Health Services quit-tobacco classes and support groups was increased throughout the FirstHealth service area.

Participation in the FirstQuit classes involves only a nominal fee, and there is no charge to participate in a quit-tobacco support group. More recently, an inpatient tobacco-cessation program has started at both Moore Regional and Richmond Memorial hospitals. The program is designed to reach tobacco-users during their brief interim of tobacco-free hospitalization and to direct them to the long-term assistance of FirstHealth’s outpatient FirstQuit program in an effort to help them break their tobacco habit.

In addition, all three FirstHealth hospitals provide free nicotine replacement gum to adult visitors to help them deal with their tobacco cravings while they are visiting. firsthealth.org/healthyliving

Patient-centered careThe concept of patient-centered care is not unique,

but FirstHealth of the Carolinas, its providers and staff have taken this patient commitment to a new level—by combining medical excellence with the small-town touch.

Cardiothoracic surgeon John F. Krahnert Jr. describes this unofficial FirstHealth philosophy as“big-citymedicineinacommunityhospital.”FirstHealth made the practice official by adopting the simplepledge“tocareforpeople”asitscorepurpose.

Time and time again, this patient-centered effort has been nationallyrecognized.In2006,forexample,FirstHealthMooreRegional Hospital and several off-site nursing programs received the Magnet designation for excellence in nursing care from the AmericanNursesCredentialingCenter.Threeyearslater,thehospitalearnedTheJointCommission’sGoldSealofApprovaland was named a Joint Commission-certified Stroke Center for excellence in stroke care.

The new Reid Heart Center, on the campus of Moore Regional Hospital, stands as a testament to medical excellence based on patient-centeredcare.“Wedocomplexmitralrepairs,aorticrootsurgery, arterial revascularization, minimally invasive radial artery harvest, high-risk cases, and we’ve been doing it for 20 years with excellentresults,”Dr.Krahnertsays.“Wealsodoitinapersonaland compassionate way not seen in bigger programs, so we provide the best of both worlds.”

W hen health care reform was still a twinkle in the eyes—or a scowl on the faces—of members of the U.S. Congress, FirstHealth of

the Carolinas had already begun to adopt its own reform measures. Some of them are identical to those found in the national reform legislation that was adopted last year.FirstCarolinaCare(FCC),FirstHealth’snonprofithealth

plan subsidiary, has been developing ways to help reduce the number of uninsured in its service area since it was formed in 2000. The FCC measures date from 2003 with the development of FirstPlan, a health benefit plan for small businesses that provides a premium subsidy for eligible employers and lower-wage workers. The program has been nationally recognized for making health care coverage more accessible.In2006,inamovepreviouslyunheardofinthehealth

insurance industry, FCC returned to its clients a portion of the premiums they had paid for group health coverage during the previous year. The decision was based on FirstHealth’s mission as a not-for-profit organization as well as on FCC’s stronger-than-expected financial results for 2005.FirstCarolinaCarewasagainaninnovatorin2007when

it extended coverage for members’ children through age 26.Atthetime,mostofthestate’sinsurancecompaniesoffereddependentcoverageonlyuptoage19.

This FirstCarolinaCare tradition of innovation extends to a hands-on approach that includes free health screenings for members as well as nursing staff follow-up that helps members control their health costs while improving the status of their health. firstcarolinacare.com

Health care reformIn 2008, FirstCarolinaCare (represented by President Ken Lewis) received a Power of Prevention Award from the North Carolina Health & Wellness Trust Fund. Presented in the Innovator category, the award recognized FirstCarolinaCare’s efforts to reduce the growth in the number of uninsured in its service area while promoting preventive health care to its members.

22 Spring 2011

firsthealth.org 23

TelehealthFirstHealth Home Care Services began

its in-home telehealth venture with a pilot program funded by the Foundation of FirstHealth. The pilot was so successful and immediately worked so well that the agency soon purchased 20 monitors and four digital cameras to add telehealth monitoring to its wound care program.In2007,a$250,000Duke

Endowment grant allowed FirstHealth to expandtheprogramto70monitorsand,in2009,theprogramgrewagainwitha$750,000TelehealthNetworkGrantfrom the U.S. Department of Health and Human Services—one of only four awarded to agencies throughout the U.S.

FirstHealth Home Care now monitors 120 patients via telehealth with plans to have up to 200 by the conclusion of the three-year HHS grant.

Telehealth monitors are provided to eligible Home Care patients at no additional charge. The state-of-the-art technology sends patient data—blood pressure, temperature, blood sugar, pulse, weight and blood pressure—over a common telephone line to a central monitoring station where a registered nurse reviews it and determines if there is a need for additional care.

In addition to giving patients and their caregivers a heightened sense of security, this in-home patient monitoring program has been shown to reduce hospitalizations and emergency room visits. firsthealth.org/homecare

F or many years, FirstHealth of the Carolinas has partnered with municipal planners and school and community leaders in an effort to keep people healthy and fit in a variety of innovative

ways. They include:n Helping to develop comprehensive bicycle and pedestrian plans for local

communities n Working with the Village of Pinehurst to develop a greenway walking trailandinitiatinga“WalkingSchoolBus”thatencourageschildrenatPinehurst Elementary School to walk to school

n Partnering with Cooperative Extension and the Town of Southern Pines to start a community garden that gives Southern Pines residents a way to grow their own fresh fruits and vegetables

n Offering an on-site, spring-to-fall Farmers Market at Moore Regional Hospital that is open to the community as well as to FirstHealth employees,andworkingwithlocalFarmersMarketstoacceptSNAP(SupplementalNutritionAssistanceProgram)benefits

nBecomingamajorsponsoroftheSandhillsRaceSeries,anorganizationthat encourages participation in area races while recognizing performance and providing support to the groups coordinating race events

nProvidinghealthylivingclassestolow-incomepopulations(TheHappyKitchen program teaches participants how to prepare healthy meals and howtosavemoneywhenshoppingforgroceries.PLAY–PeopleLivingActiveYear-Round–teachesparticipantshowtoincreasephysicalactivityintheireverydaylives.)In programs directed toward working adults, FirstHealth collaborated with

community partners to develop MooreFit and HokeFit, fitness initiatives that encourage employers in the respective communities of Moore County and Hoke County to get their workers to adopt physical activity and healthy eating as part of their lifestyle. Programs have included countywide fitness challenges that encourage participants to work more healthy foods into their diet or incorporate more walking into their day.Lastfall,aMooreFitUniversityofferedclassesinnutrition/eating,physical

activity and overall wellness. Participants who completed one class from each participation category received a FitCertificate and became eligible for prizes.

The March 2010 kickoff of the HokeFit worksite wellness competition took place at the Hoke County Recreation Complex.

Fitness programming

24 Spring 2011

Cafeteria pricing incentivesA2007studyconductedbythe

University of Washington found that low-calorie, nutrient-rich foods—mainly fruits and vegetables—are calorie for calorie more expensive than sweets and snack foods. This may help explain why the poorest Americansareusuallyamongtheheaviest.

Now consider the cost of cafeteria meals at FirstHealth Moore Regional Hospital, where just the opposite is the case. In the Moore Regional cafeteria, where healthy eating has become a standard, a FirstHealth employeepays$2.95forapoundof leafy greens and trimmings at the saladbar.Beforetheintroductionof a cafeteria pricing plan designed to encourage FirstHealth workers to eat healthy foods, that same pound of salad-bar salad would have cost $4.64.

The same pricing incentive is true for healthy entrees, vegetables and fruit.Atthesametime,less-healthyfoods—hamburgers, cheeseburgers and French fries—now cost more than they used to.

The changes in cafeteria pricing, which began with the start of FirstHealth’s2008fiscalyear,arepartof FirstFit, a program that encourages FirstHealth employees to improve their health while serving as models for the people they care for. While there are also exercise and physical activity components to FirstFit, the healthy eating aspect that includes the changes in cafeteria pricing is far and away the most ambitious.

The cafeteria pricing initiative began as something of a noble experiment, but it has since become a successful way of life around FirstHealth, confirming what had long been suspected: that given the financial incentive to do so, people will choose healthy foods over junk.

In May 2000, FirstHealth CEO Charles T. Frock and Sharon Nicholson Harrell, DDS, MPH, director of the

FirstHealth Dental Care Centers, traveled to Washington, D.C., to take part in the releaseoftheU.S.SurgeonGeneral’sfirst-ever report on oral health.

What they heard was all too familiar to them: that dental disease was contributing to numerous critical health problems in theAmericanpopulation—especiallyamong low-income children and the elderly. They were also able to share what FirstHealth of the Carolinas was already doing about the problem.

Two years before, in1998,schoolhealth nurses in the FirstHealth service area had approached the organization about a concern that they considered to be the number one unmet need among local low-income children. Children, especially the uninsured and those on Medicaid, were not getting the dental care they needed, the nurses said. They had mouths that were filled with cavities, and some were coming to school in so much pain that they

couldn’t concentrate on their work.There were several reasons for this lack

of dental care, but the most common involved the low reimbursement rates for Medicaid services and the reputation Medicaid patients had for high no-show rates in the few private dental practices that would accept them.

FirstHealth responded to the problem in October1998withtheopeningofthefirstof three FirstHealth Dental Care Centers.

In the 12-plus years since the opening of the first program in Southern Pines, the Dental Care Centers have treated nearly 22,000 children.

The service, which provides routine dental care, disease prevention, early detection and intervention in clinics in Raeford and Troy as well as Southern Pines, targets underserved children up to age18.

“About70percentofthechildrenwesaw during our first year of operation had either never seen a dentist or hadn’t seen a dentist within the last year,” Dr. Harrell says. “Nowweaverage1,000patientvisitsamonth across all three centers, and accept 100 new patients per month.”

Sharon Nicholson Harrell, DDS, MPH, (seated) is director of the FirstHealth Dental Care Centers in Southern Pines, Raeford and Troy. Since the program opened in 1998, the Dental Care Centers have provided dental care to almost 22,000 underserved children.

Surgeon General David Satcher (left) and FirstHealth CEO Charles T. Frock are shown following a 2000 news conference on the state of American oral health.

Dental Care Centers

firsthealth.org 25

B arbara McInnis loved physical activity. The supervisorofMooreRegionalHospital’sBloodBank,shewasatriathletewhomaintaineda

walking regimen until just a few weeks before cancer claimed her life.AfterMcInnisdied,herhusbandestablishedanendowment

for a wellness program—offered through the FirstHealth Center for Health & Fitness-Southern Pines—that would encourage other cancer patients to stay physically active. The FirstHealth Cancer Wellness Program supports individuals who are living with cancer through exercise and education while teaching them how to improve their quality of life.

For patients undergoing treatment or survivors striving to rebuild strength and stamina, the Cancer Wellness Program provides individualized exercise routines designed to increase energy and stamina levels.AccordingtoCinnamonLeBlanc,manageroftheSouthern

Pines Center for Health & Fitness, participants in the Cancer

Wellness Program learn how to use the facility’s equipment and take part in low-impact group exercise classes, including Pilates and yoga. “Wewantpeopletomakeuseofwhatevertheycanto

makethemfeelgood,”LeBlancsays.“Theprogramisveryuser-friendly.”ModeledafterapilotthatoriginatedinSantaBarbara,Calif.,

FirstHealth’s Cancer Wellness Program includes pre- and post-testing, as well as education, and classes that meet three times a week for seven weeks. Participants are introduced to helpful community resources, such as the Health Sciences Library at Moore Regional Hospital, and can seek assistance on matters of nutrition from a Center for Health & Fitness dietitian.

Participation in the program has been shown to relieve stress and fatigue—both results of cancer diagnosis and treatment.“FirstHealth’smissionistocareforpeople,andwecarefor

thewholeperson,”LeBlancsays.

A s medical fitness centers, the FirstHealth Centers for Health & Fitness are more than gyms.

The programs are medically based and physician-supervised. Their personal trainers have college degrees in the fitness field as well as national fitness certifications. The Pinehurst facility has a registered dietitian on staff.“I’malwaysavailableformedicalinput

about viable exercise benefits,” says the program’s medical director, Darrell Simpkins,M.D.“Everybodythere,physical therapists, exercise therapists, if they’ve got somebody with a medical problem and need to ask about exercise, I’m available to talk to them and many times to talk to patients. Whatever the problem, everybody has me as a contact. It adds to our credibility just tremendously.”In 2010, the Center for Health

& Fitness-Pinehurst expanded its commitment to medical fitness by startinganExerciseisMedicine(EiM)

program.LaunchedbytheAmericanCollege of Sports Medicine and the AmericanMedicalAssociation,EiMencourages health care providers to make exercise a part of their regular patient treatment plans by regarding physical activity as a vital sign—just as they would weight, temperature and blood pressure.AfterbeingreferredtotheEiMprogram

by a primary care provider, participants meet with an exercise technologist for a fitness assessment, goal development andexerciseprescription.Afreetwo-week pass to the Center for Health & Fitness allows them to experience new forms of exercise and work with fitness professionals who communicate information about their participation and progress to the referring physician.There are no charges for the visit

with the exercise technologist or for the individualized exercise plan, which can be followed in the location of the participant’s choosing.

“It’samazinghowourfitnesscenterhas changed over the last six months,” Dr.Simpkinssays.“We’vealwaysbeenout of the box, but most centers have peopleintheir30sand40sexercisingandpeakduringthehoursof4to8p.m.Ourcenter has never been that way. It’s busy alldaylong.ButsinceweinitiatedExerciseis Medicine, it’s amazing to see the numbersofpeopleintheir70sand80s.”AccordingtoJohnCaliri,directorofthe

FirstHealth Centers for Health & Center, the overall medical fitness program builds on the EiM initiative by giving participating physicians the tools to make appropriate referrals to FirstHealth’s trained exercise professionals.“Participationintheprogramincludes

communication back to the physician so he can assist patients in effectively using exercise as a prevention or treatment method for attaining or maintaining health,” Calin says. firsthealth.org/eim

Cancer Wellness Program

Medical Fitness Centers and Exercise is Medicine

26 Spring 2011

Gloria Johnson, R.N., Elaine Gunter, R.N., (seated), and Colleen Gordon, R.N., work on the 4 Medical nursing unit at FirstHealth Moore Regional Hospital.

Wonderful, extraordinary care

My sincerest thanks for the wonderful, extraordinary care I was given by the most competent nursing staff at FirstHealth Moore Regional Hospital. To Colleen Gordon, Tori Rogers, Elaine Gunter, Gloria Johnson (4th Floor Medical) and all of you who were so kind in making a difficult hospital stay as pleasant as conceivably possible, best wishes and thanks.

J. Marshall FriedmanNewport, N.H.

“… like I was the only patient in the hospital”

No one likes going to a hospital for surgery, but FirstHealth makes the experience about as good as it’s going to get.

From the pre-registration at the Outpatient Center, to the volunteer taking me out to the car in a wheelchair a few days later, everything was done to make me feel like I was the only patient in the hospital. Unless you personally experience it, it’s difficult to comprehend the incredible care for the patient exhibited by everyone at Moore Regional. Not only the professional staff of doctors and nurses, but the folks who deliver the food, clean the room, change the bed and the volunteers who stop by to make sure you have everything you need to be comfortable.

A special thank you to the nurses and staff on First Floor Surgical: Karin Bethea, N.A.; Arlene Campbell, N.A.; Teresa Campbell, R.N.; Terri Kennedy, R.N.; Tameka Lloyd, R.N.; Elaine Spencer, N.A.; William Thomas, R.N.; Annie Thomas, N.A.; Christy Treadaway, N.A.; Ellen Wallace, R.N.; Mary White, N.A.; and Nakesha Williams, R.N. Absolutely superb patient care from the entire team.

Thank you also to the people who care enough to hire the best, train them in the Core Purpose and Values of FirstHealth and then provide an environment that makes them want to stay here. This community is blessed to have you all here.

Joel ShribergPinehurst

firsthealth.org/surgery

“First choice in hospital care”

I want to extend a warm thank you to the nurses and staff who serve room 3308 at FirstHealth Moore Regional Hospital. All were warm and caring to my husband during his recent bout with pneumonia.

Moore Regional is our first choice in hospital care.

Kimberly BrownRaeford

“Far and above the usual”

I was an inpatient at FirstHealth Moore Regional Hospital from March 24 through April 1, 2010. I have been an inpatient in your hospital many times and, as a rule, I have received great service and care. On this admission, the care and attention was far and above the usual.

I should start by mentioning (Hospitalist Service) Drs. Matthew Brady Holler and Suzanne Wilson. They attended me every day and were always aware of my status and always willing to listen to my feelings or concerns. I felt very secure in their care.

All the staff was great, but some went that extra mile. Donna Johnson, Jo Ann Thomas and Bobbie Pate (Inpatient Oncology) were wonderful nurses. There was never a time when my needs were not met with care and professionalism. All the CNAs were so nice and kind. Sheila Jones, Melissa Murphy (Inpatient Oncology) and another lady—I apologize for not getting all the names, but they couldn’t have been any nicer. Daniel Korfmann in Physical Therapy was so kind. Inga and Shawn in Dietary treated me like family. If you have trouble with your food or selections, they are helpful and patient.

Thank you for maintaining a wonderful health institution where our citizens can go and receive the care that is equal to any hospital in any major city in America.

Lynette C. NortonRaeford

Praise from Hoke County

For more information on these or any of the services provided by FirstHealth of the Carolinas, please call (800) 213-3284.

Compliments for MMHMy grandmother, Pauline Marley, was seen in the

Emergency Department at FirstHealth Montgomery Memorial Hospital, and she can’t say enough about our facility. She said she was treated well by everyone she came in contact with. The names mentioned were Tennille Blake, Kellie Tedder, Nancy Garner, Stephanie Kornegay and Dr. Jonathan Brower, all from the ED. She also said she was treated very well in the X-ray department by Chris Sheffield and Kristi Fox.

She said this was the cleanest hospital she had ever been in. I told her that we have wonderful housekeepers as well as Tommie Marshall, who keeps our floors “sparkling.” She was very impressed by the people here as well as the appearance of our hospital.

Compliments like this only reinforce the sense of pride I have for working here at FirstHealth Montgomery Memorial Hospital.

Pam S. Duncan, RT-R (CT)Director of ImagingFirstHealth Montgomery HospitalTroy

MontgomeryMemorialHospitalemployees(seated)StephanieKornegay,R.N.,EmergencyDepartment;andChrisSheffield,Imaging);and(standing)JonathanBrower,M.D.,EmergencyDepartment;TennilleBlake,PatientRegistration; and Tommie Marshall, Environmental Services.

firsthealth.org 27

28 Spring 2011

In a year characterized by unprecedented accomplishment, three areas of achievement stand out for FirstHealth of the Carolinas during 2010:

• ExpansionprojectsthatincludedconstructionoftheReidHeartCenter:FirstHealthCardiac&Vascular Institute, the dedication of the Clara McLean (hospitality) House and groundbreaking fortheFirstHealthHospice&PalliativeCarecampus

• IncreasedmedicalandcivicsupporttothemedicallyunderservedHokeCountycommunity

• HeightenedeffortsbyboththeCentersforHealth&FitnessandCommunityHealthServicesto prevent illness and disease by promoting physical activity among the residents of the FirstHealth service area

A FirstHeAltH oF tHe CArolinAs yeAr in review

firsthealth.org 29

new Constructionreid Heart Center: the firstHealth Cardiac & Vascular instituteConstruction quickly progressed on the two-year Reid Heart Center project during 2010. The culmination of nearly 30 years of high-quality, cutting-edge cardiovascular care, the Reid Heart Center opened in January 2011.

Hospice CampusGround was broken in spring 2010 for the new FirstHealth Hospice & Palliative Care campus. Located just off Highway 15-501 in Pinehurst, the campus will feature an 11-bed Hospice House for inpatient care, a Grief Resource & Counseling Center, an Administration Building and a chapel.

Clara mcLean HouseThe Clara McLean House, which will provide temporary housing and a variety of hospitality and information services for FirstHealth patients and their families, was dedicated Nov. 30, 2010, on the campus of FirstHealth Moore Regional Hospital. The program is expected to open in fall 2011.

Community initiativesHoke County Certificate of need activitiesIn June 2009, FirstHealth of the Carolinas filed a certificate of need application with the state of North Carolina to build a hospital in Hoke County. Soon afterward, the Cape Fear Valley Health System filed an application for a hospital in western Cumberland County. Both CONs received state approval and were then appealed by both applying parties. During the same time, the state changed the Hoke County alignment for health care services to place Hoke in both the Moore and Cumberland County planning districts. Following that action, both FirstHealth and Cape Fear Valley filed CON applications in early 2010 to build hospitals in Hoke County.

Again, both CONs were approved and subsequently appealed. Word on all of the appeals, both 2009 and 2010, is expected during 2011.

Diabetes Health fairMore than 250 people attended an inaugural Diabetes Health Fair, which introduced FirstHealth’s diabetes services to people living with the disease and their families. Held in October 2010, the event included free health screenings, cooking demonstrations and exhibitions. Various health care professionals were also on hand to answer questions about medications, supplements and other diabetes-related topics.

2010 A

Fir

st

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HokeCountyPlayground

Among many Hoke County activities, the FirstHealth Foundation supported the community with a $10,000 sponsorship for parkplaygroundequipmentinRaeford.FirstHealthwasalsoaGoldSponsorofthearea’sannualTurkeyFestival.Theadditionof a family care provider at the FirstHealth FamilyCareCenter-RaefordandgrowthinFirstHealth’s on-site outpatient rehabilitation program further strengthened the organization’sservicestothearea.

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“run for the ribbons”More than 600 walkers and runners took part in the first-ever “Run for the Ribbons” 5K and Family Fun 1K at the Stoneybrook Steeplechase on April 3, 2010, at the Carolina Horse Park in Hoke County. The event was a new fundraiser for the Cancer CARE Fund of the Moore Regional Hospital Foundation.

HokefitIn an effort to create health-conscious workplaces in Hoke County, the Hoke County First-In-Health 2020 Vision Task Force implemented a corporate walking challenge titled “HokeFit—Ready, Set, Walk!”

moorefitDuring the third year of the workplace wellness challenge called MooreFit, FirstHealth expanded its mission to improve the health of the Moore County workforce. During 2010, MooreFit went back to school with lessons on healthy living and, in an endeavor called MooreFit University, offered various classes in the disciplines of nutrition and eating, physical activity and overall wellness.

Happy kitchen & PLayGrant money from the Kate B. Reynolds Charitable Trust supports The Happy Kitchen and PLAY (People Living Active Year-round) programs offered by FirstHealth Community Health Services. Both programs are free and are designed to promote healthy living in low-income/disparate populations.

“Born to run”During a January 2010 visit to FirstHealth of the Carolinas in celebration of the 15th anniversary of the Center for Health & Fitness-Pinehurst, nationally known author and running enthusiast Christopher McDougall discussed his running philosophy and his best-selling book, “Born to Run,” at a Moore Regional Hospital Foundation Promise of Hope lecture.

QualitymmH Patient satisfaction scoresConsistently high patient satisfaction scores at FirstHealth Montgomery Memorial Hospital indicate that patients are very pleased with the care they receive at their local hospital. For the 2010 fiscal year that ended in September, mean scores for inpatient (96.36), swing bed (99) and outpatient (99.7) exceeded the hospital’s 2010 goal of 95.

integrated Health CareIn late 2010, the FirstHealth of the Carolinas Board of Directors endorsed recommendations from its Integrated Health System (IHS) Steering Committee that included a commitment to develop an IHS with the core principles

of a physician-led, professionally managed and community-governed organization.

transfer Center openingWith the opening of the FirstHealth Transfer Center, trained paramedics formed the core of an effort to streamline inter-facility patient transfers by coordinating patient movement throughout the organization. State-of-the-art tracking and bed management software provides real-time metrics on patient census, patient requests, bed availability and housekeeping turn-time as well as pending and confirmed discharges.

Hoops for KidsMembers of the “White

Coats” team, comprised of physicians and FirstHealth employees, celebrated a win overthe“RoundballBrainiacs”fromMooreCountySchoolsduringthesixthannual“HoopsforKids”fundraiser.The event, which was held March4,2010,atPinecrestHighSchool,raisedmorethan$7,000fortheBoysandGirlsClubsoftheSandhills.

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magnet applicationThe nursing staff of FirstHealth Moore Regional Hospital and several off-site nursing programs submitted their application for renewal of the Magnet nursing excellence designation. The current application also includes the nursing staff of FirstHealth Richmond Memorial Hospital.

Joint Commission surveysAll three FirstHealth hospitals celebrated successful Joint Commission surveys during 2010.

employee satisfaction surveyWith the assistance of an unusual mascot, FirstHealth of the Carolinas concluded a 2010 Employee Opinion Survey during May. The Charlotte-headquartered Morehead and Associates conducted the comprehensive systemwide point-in-time survey with coordination by FirstHealth Human Resources.

FirstHealth employees serving as survey “ambassadors” helped communicate the survey process and philosophy, and the “HUHU” (Help Us Help yoU) mascot gave the internal communications plan a playful look that captured employee interest.

In comparison to Morehead’s National Healthcare Average, the areas in which FirstHealth scored higher included: • Workforce commitment (a 4.24 or 76th percentile) • Patient safety and quality items • Provision of necessary tools and resources • Career development opportunities Some of the areas that scored below the Morehead National

Healthcare Average included: • Satisfaction with benefits • Employee involvement in decision-making • The use of patient satisfaction results to

influence quality initiatives Afterward, managers met with their individual

units/departments to review their specific results and to develop action plans while administration took on broader issues such as satisfaction with benefits.

Just CultureThe Just Culture concept of system safety that was introduced throughout the organization during 2010 endorses “open, fair and just”

cultures to encourage open communication and an accountability system that supports safe behavioral choices from the FirstHealth staff.

strategic Planning ConsultantsAn outside consulting group, The Beckham Company, worked with FirstHealth to develop driving strategies and supporting tactics for a major organizational strategic plan.

service expansionBraC ParticipationAs a steady stream of military personnel from the U.S. Army Forces Command (FORSCOM) continued its move from Atlanta to the counties surrounding Fort Bragg, FirstHealth of the Carolinas actively set out to engage this new population in its health services. The core FirstHealth service area counties of Moore, Richmond, Hoke, Montgomery and Lee expect to see an influx of military and defense contractor personnel over the next several years. Moore County alone is projected to welcome more than 4,000 new residents from the Base Realignment and Closure (BRAC), and hospital and health care service has been noted as a primary interest for families relocating to the area.

richmond orthopedics ProgramIn fall 2010, FirstHealth of the Carolinas opened an orthopedics clinic in Rockingham that is dedicated to providing care—from initial office visit to surgery—in Richmond County. Staffed by five board certified orthopedic surgeons from Pinehurst Surgical, the Richmond Medical Group—Orthopaedics Clinic is located in the FirstHealth Richmond Medical Plaza at 809 Long Drive, Rockingham.

exercise is medicineA new initiative for the FirstHealth Center for Health & Fitness-Pinehurst encourages physicians to treat physical activity as a vital sign in an effort to get patients to incorporate exercise into their lifestyle. After discussing physical activity needs with their patients, participating doctors refer them to the Center for Health & Fitness-Pinehurst for a professional—and free—exercise assessment and

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32 Spring 2011

treatment plan developed by a trained exercise technologist. A referral gives the patient access to a no-cost physical fitness assessment, goal-setting and a physical activity program that is suited to their specific needs.

Program participation includes communication back to the referring physician so he/she can assist patients in effectively using exercise as a prevention or treatment method for attaining or maintaining health.

Cardiac Care-netBased on a successful program that has served cancer care at FirstHealth Moore Regional Hospital for several years, Cardiac CARE-Net matches trained volunteers with new patients. Most of its volunteers have personal experience with cardiac issues, either as a patient or caregiver, so they understand the anxieties and concerns associated with the disease.

PtsD ProgrammingA therapy program conducted by FirstHealth Behavioral Services and led by a FirstHealth psychiatrist with battlefield experience was formed to assist men who suffer from combat-related Post-Traumatic Stress Disorder (PTSD). The psychiatrist, Fernando Cobos, M.D., joined the U.S. Army Medical Reserves shortly after the terrorist attacks of Sept. 11, 2001, and has been deployed to Iraq three times since.

true open mriMoore Regional Hospital becomes the first hospital in the entire FirstHealth of the Carolinas service area to offer MRI scanning with a completely open scanning system. Located in FirstHealth Outpatient Imaging at 30 Memorial Drive, Pinehurst, the Hitachi Oasis scanning system has a 1.2 Tesla magnet that provides exceptionally high-quality images. Unlike closed or partially open scanners, it can accommodate very large patients (up to 660 pounds) while offering comfort and convenience for patients with limited mobility or claustrophobia.

CommunicationmedCenter DisplaysNashville-based MedCenter Display assisted FirstHealth with the installation of five flat-screen patient and visitor education monitors in several facilities. Both FirstHealth Moore Regional and Richmond Memorial hospitals have cafeteria and emergency department monitors, and monitors were also installed at the Center for Health & Fitness-Pinehurst and the Reid Heart Center. Each monitor provides announcements as well as information on upcoming events and classes.

Additional screens are planned for FirstHealth Montgomery Memorial Hospital during 2011.

“Period of PurPLe Crying”Both FirstHealth Moore Regional and FirstHealth Richmond Memorial hospitals joined a group of North Carolina health care organizations in a shaken baby prevention program called “The Period of PURPLE Crying.” Maternity nurses share the program’s message with the parents of babies born in their hospitals, and each infant born during the "Week of the Young Child" received a purple cap as a reminder of the special abuse-prevention program.

Pink Gloves for Breast Cancer awarenessPatient care personnel at all three FirstHealth of the Carolinas hospitals now wear pink exam gloves in an effort to raise breast cancer awareness. The Generation Pink Exam Gloves are provided by Medline Industries, which donates a dollar to the National Breast Cancer Foundation for each case of gloves purchased.

Personnel at the FirstHealth Outpatient Cancer Center and the FirstHealth Specialty Centers in Pinehurst also participate in the pink gloves program.

New WebsiteA redesigned FirstHealth website replaced a 4-year-

old site that had become cluttered and difficult to navigate with a new, more patient-friendly format featuring service line landing pages and an A-to-Z servicelisting.Theredesignfollowedanin-depthanalysis of the old site and the appointment of a web teamthatincludedpersonnelfromInformationSystemsandCorporateCommunications.

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