2022 NMC Annual Report

2022 Annual Report Introduction

ED Renovation Project

About the Project

Work is in progress on an $11 million renovation of the Emergency Department (ED). The project will revamp 9,500 square feet of space and add 2,400 new square feet of space. The addition means the ED moves from 14 treatment rooms to 20. The new design will also increase capacity and comfort for patients experiencing mental health issues, offering four dedicated rooms for those community members whereas the current ED space only has one such room. Additionally, the new space will have greater capacity to provide negative pressure to help provide greater infection control measures in the ED.

Phases of Construction

Renovation of temporary space:

September – December 2022
Shuttered inpatient unit will be used as temporary ED and must be prepared to accommodate emergency care.

Emergency Department moves:

Early 2023
Relocation of emergency services will take place on a single day in early January, in the early morning hours with overlapping shifts providing doubled staff.

Renovation of current ED:

January 2023 – September 2023
The current department will be over-hauled to provide a new layout with two parallel hallways and a centralized staff space between the halls. The new floorplan includes separate and dedicated space for patients experiencing mental health issues and brings registration and security into the secure area of the department.

What You Need to Know with the Temporary ED

The new, temporary ED entrance will be near the ambulance bays.
Registration and triage process will remain the same.
Parking will be altered only slightly and will be close to the temporary ED.
There will be a waiting room available for patients and visitors
The temporary ED is a slightly smaller footprint, but will provide better privacy and quiet than the old Emergency space.
Ambulance drop-off will be in a different location and EMS crews are aware of changes

Improvements in the New Emergency Department

Learn about the new Emergency Department and the improvements it brings to the patient care space. The new ED will be larger, offering greater privacy, safety, and quiet, a more efficient design, and a dedicated therapeutic space for treatment of mental health issues.

A Phased Approach for Exceptional Care

Moving a busy operation that is open 24 hours a day, 7 days a week requires careful planning, months of preparation and a phased approach. Hear from staff and project planners how the phases unfold and what the public needs to know about accessing care during construction.

Excitement for an Improved Space

Caption: Hear from NMC’s Director of Facilities, ED Medical Director and the ED Director and others about how exciting this project is for staff, and for the community.

Enhancing Technology and Infrastructure

Strengthening Local Care

NMC is committed to leveraging the latest technology in the care of our patients. We believe exceptional care starts with empathy, and the delivery of that care is made more efficient when our tools and techniques are industry standard and best practice.

Two examples of innovative use of technology and strong partnerships are the launch of Tele-ICU and a Tele-Neurology programs in collaboration with Dartmouth-Hitchcock Medical Center. Patients at NMC who need Intensive Care get help from both NMC’s team and the DHMC team via a monitor in the patient room that allows for two-way conversations between the local patient and care team and the experts at DHMC.

With Tele-Neurology, patients in NMC’s Emergency Department who need either routine or emergency consultations because of stroke symptoms get access to expert care without having to travel out of their community.

These programs keep high-quality care local, and are shown to result in better outcomes and less cost.

NMC has also advanced local cardiology care by adding TEE or transesophageal echocardiogram to the services we offer.

This test is done when a healthcare provider wants a closer look at a patient’s heart. A TEE uses high-frequency sound waves to examine the heart structure. TEE’s are now administered right in our clinic's building through Northwestern Cardiology.

In addition to expanded services, NMC also rolled out several advances in technology and equipment. This past year NMC up upgraded our Mindray monitoring system across the inpatient unit, in Surgical Services, and in the Emergency Department to modernize and standardize patient monitoring all across the hospital.

Another tech update was the implementation of an electronic appointment reminder system called “Well.” This communications software makes it easy to text reminders to patients about appointments and communicate quickly to specific segments of our patients – like those who are due for an annual exam or follow-up.

Upgrading our Infrastructure to Improve Patient Comfort and Access

Infusion Clinic & Sleep Lab:

Several projects this year updated our physical spaces for improved care. One project relocated the Infusion Clinic to a permanent location after several shifts in spaces. The new Infusion Center is located in dedicated hallway near the inpatient unit. The clinic shares space with our Sleep Lab for maximum efficiency. Sleep studies are performed in the rooms at night and infusions are conducted there during the day.

New Mattresses:

NMC purchased a new set of specialized mattresses for the Progressive Care Unit. The mattresses help prevent pressure injuries, which can be a significant problem for some patients. Having all beds equipped with these type of mattresses ensures that all patients immediately benefit from the resource.

New Wheelchairs:

NMC’s Auxiliary generously allocated funds from its fundraising endeavors to purchase a total of 24 new wheelchairs (both Staxi and Stryker brands) to help with patient transport at NMC for the benefit of Volunteers/Staff/Patient/Public.

Building an Oxygen Farm:

NMC’s use of oxygen for patients increased dramatically during the pandemic. The increased usage highlighted a need to create a larger “farm” of bulk storage tanks for the important medical gas. In late summer of 2021, NMC removed the old oxygen tanks which sat outside the Conference Center and added news ones in a space behind the Doctors Office Commons. Part of the project required carefully shutting down oxygen services in the hospital for a short period, and using temporary oxygen services until service could be restored. This was an intense, high-impact project that was very much behind the scenes of normal hospital operations.

Improving Quality

Patient Access Tackles LDM with Creativity, Sees Strong Success

The Patient Access team has had success in implementing Lean Daily Management (LDM) processes, leading to a big improvement in one of their Key Performance Indicators: reducing patient identification errors.

Introducing LDM to a team of about 55 employees who work varying shifts in 16 different physical locations presented a unique challenge. Michelle Cook, Patient Access System Coordinator, said the diverse makeup of the team meant that the issues facing central registration were different for those of registrars in the ED or the pre-encounter scheduling team. This made selecting the initial set of KPIs a tough process of winnowing down a long list.

One of the first KPIs the team selected focused on the process for properly identifying patients.

There was some initial hesitancy from the team in reporting data because it might mean highlighting mistakes. Michelle said it was important to reinforce the idea that the Learning Board and KPI measurements are about process improvement, and not individual people. Once that was understood, the team was on board.

Tracking their safety goal on patient identification allowed Patient Access to uncover a problem with their systems. “We discovered some miscommunication between the registration and scheduling teams regarding patient names and spell backs,” said Michelle.

They conducted a a “5 Whys” exercise to get at the heart of the issue and put an action plan together. That action plan resulted in immediate improvement, and a huge reduction in patient identification errors.

“Our board went from all red to all green almost overnight,” said Michelle. “It was really exciting to see the engagement of the team and that everyone was dedicated to this goal.”

Taking Big Steps on the High Reliability Journey

This year, NMC made great strides in our journey toward High Reliability. The organization rolled out Learning Boards in 18 departments to put a daily focus on measuring improvements in quality, safety, delivery and more.

The Learning Boards are a foundational tool that provide a visual display of the ideas that have come forward and how they are progressing through improvement effort toward resolution. Each day teams of leaders visit the boards on a Gemba walk (see related story) hearing about challenges and progress on Key Performance Indicators (KPIs) from front-line staff.

The staff engagement around identifying issues, measuring data with the KPIs and implementing solutions has been incredible. To read about two examples of KPI success, see a story about the Diagnostic Imaging Department and the Patient Access team.

The Learning Boards are a key part of High Reliability at NMC which is an ongoing focus on delivering safe and high-quality service or care even while operating in a complex and high-risk environment.

Many industries – including healthcare - have adopted High Reliability approach's including airlines and nuclear power plants where the risk of harm from error can be catastrophic.

Along with the daily Gemba walks, the Learning Boards provide a system for reviewing safety topics on a monthly basis through Executive Patient Safety Rounds. Each month, senior leaders meet with staff at the Learning Boards to ensure progress is being made and help overcome any barriers.

Organization-wide training on the principles of High Reliability re-started in person this year. More than 300 NMC staff attended trainings over the summer and early fall months, and High Reliability was added as a permanent part of the onboarding process for all new employees. A commitment to continuous learning is a key strategy of High Reliability organizations.

KPI Success Story with X-Ray Process

NMC’s Diagnostic Imaging team found an opportunity for process improvement that would help their department be more efficient and strengthen patient privacy at check-in.

For years, patients who needed a general x-ray were able to walk-in without an appointment. This presented three concerns for Diagnostic Imaging related to patient satisfaction, protected health information (PHI), and efficiency.

Because patients arriving for an x-ray didn’t have an appointment they had to state aloud the reason for their visit, and then sit in the waiting area until they could be seen. This meant patient information could be overheard and delayed the check-in process while the practice support specialist manually entered appointment info.

During the COVID-19 pandemic, DI had to begin using scheduled appointments to ensure social distancing. The team used their Learning Board to track a Key Performance Indicator goal for service delivery and worked with Information Systems to find a way to make the process of scheduling and check-in private and efficient.

Putting the process improvement took three months and a great deal of collaboration with DI, IS and the Patient Access team. The changes to this process proved to be a big win for the Diagnostic Imaging team and their patients. Since implementation, DI has noticed a reduction in patient delays, increased efficiency, greater HIPPA compliance, and improved patient satisfaction.

Health Needs Assessment Takes a More Inclusive Approach

In 2022, NMC conducted a Community Health Needs Assessment but used a different approach than in years past, with a collaborative steering team using different data collection methods and casting a wide net for information.

Conducting a Community Health Needs Assessment (CHNA) is a federally mandated process hospitals must complete every 3 years to gain a comprehensive understanding of the community’s health needs and then adopt an implementation strategy to address the identified needs.

The CHNA process shifted focus to recognize the impact of social determinants of health have on health outcomes. The newly designed assessment methods were intentionally designed to be more inclusive of historically and presently under-served and marginalized communities.

The CHNA committee used health indicators, focus groups, key informant interviews and an electronic survey to gather data widely.

77 Key Performance Indicators were reviewed.
20 key information interviews focused on attaining perspectives from communities including: migrant farm workers, single parents, individuals receiving home health services, members of our black, people of color and indigenous communities, emergency services, economic development, people with a disability, and people in recovery.
Five focus groups convened to take a deeper dive into the health needs of certain communities including Abenaki youth, seniors living in rural areas, LGBTQIA youth, military families, and people experiencing homelessness and food insecurity.
A community-wide, electronic survey explored linkages between health outcomes, built environment, community and individual demographics, social determinants, and access to health services.

Themes that emerged as important health needs including:

Affordability of care
Access to Care
Safety and Belonging
Community Gathering and Connectedness

The steering committee took the gathered data and shared it back to the community in public spaces, at events and in meetings, asking for help with prioritization. The info is displayed on posters and a “dot-mocracy” approach asks community members to take their most urgent need with a dot.

Once the themes have been prioritized, an action plan will be developed based upon a problem-driven data statement that comes directly from the data gathered from the community. Work on the action plan will likely continue with a collaborative approach as NMC takes part in the Grand Isle, Franklin Accountable Community for Health to develop lasting solutions to complex problems with affordability, access, safety and connectedness.

Safety

Champs

To emphasize our focus on safety, NMC recognizes a staff member each month who is doing great work on safety.

The Gemba Walk at NMC

Staff-Led Process Improvement an Internal Investment

Northwestern Medical Center is focused on being a high reliability organization (HRO), committed to high-quality care, open communication, and self-driven improvement. HRO’s are organizations that successfully attain their missions despite massive complexity and high-risk environments.

“NMC’s relationship with the community is one based on trust. That is quantified through consistent levels of safety and quality being provided to our patients and employees,” says Jonathan Billings, NMC’s Interim Chief Executive Officer.

What is a Gemba Walk?
A Gemba Walk is a workplace walkthrough which aims to observe employees, ask about their tasks, and identify productivity gains. Gemba Walk is derived from the Japanese word “Gemba” or “Gembutsu” which means “the real place”, so it is often literally defined as the act of seeing where the actual work happens.

“Health care is a fast-paced and high-stress environment already,” says Billings. “Providing a zero-harm environment remains priority.”

Employee surveys reflected a staff desire to be involved in the long-term improvement of their department and organization. With approximately 800 employees to consider, figuring out how to engage people in that process was key.

NMC’s senior leadership team chose to implement a successfully documented, daily-initiative called a Gemba Walk. The Gemba Walk is based upon concepts of Lean Daily Management (LDM), continuous improvement through small, incremental changes in processes to improve efficiency and quality. The walk is what it sounds like - an opportunity for senior staff to walk the floor of the hospital, to better understand the care environment and its challenges.

What is meant by Lean?
Lean management is an approach to managing an organization that supports the concept of continuous improvement, a long-term approach to work that systematically seeks to achieve small, incremental changes in processes to improve efficiency and quality.

The Gemba Walk, is one of the 5 Lean guiding principles, an activity that takes management to the front lines on a daily basis.

“It’s not about who to blame, it’s about what and how to fix a problem,” Billings says. “It’s never punitive.”

Gemba Walk procedures began at NMC in 2020, with the pandemic requiring a pause. At that time six departments were participating, while 19 departments now have active Key Performance Indicator (KPI) boards visited daily during the Gemba Walk.

“The connection between leadership and staff is strengthened through the daily interactions at the board,” says Betsy O’Rourke, NMC’s Process Improvement Project Manager.

“It also allows for the frontline staff who are doing the work to be the individuals driving the change to promote patient safety and job satisfaction.”

O’Rourke has been instrumental in facilitating the KPI boards and tracking the collected data, as well as educating others through the process. O’Rourke has been at NMC for three years, serving in her current role for about six months. She underwent months of training with Mary Ann Megimose-McClay, with Next Level Partners, LLC, a firm hired by NMC to help initiate the Gemba Walk procedures.

“I am excited about the collaboration NMC is demonstrating with the KPI boards and Gemba Walks,” O’Rourke says. “This role allows me to help support and encourage that collaboration.”

At 8:15 a.m. each day, the Gemba Walk team consisting of five senior leaders and another six departmental directors, meets at their KPI board. They split into two pre-assigned groups to begin their walk, which lasts approximately one hour. Each group visits nine departments, each stop lasting four to five minutes. The amount of time it takes for the group to walk between KPI boards has also been calculated into their route.

The Gemba leadership group must stay together en-route, with no side conversations, offering full attention and respect to the staff presentation at the board.

“Every morning someone from each department will present the past 24-hours’ worth of data to leadership during the Gemba Walk,” says O’Rourke.

Departments create their own goals, tracking relevant data on their KPI board, as well as choosing which staff member will present to the leadership team.

“The Gemba Walk leadership group will discuss trends found on the pareto (chart) with the presenter and encourage additional tools to progress the department’s goals forward, while troubleshooting challenges,” says O’Rourke.

As data presentations end, one final question is always asked, “Do you have everything you need to meet today’s goals?” Whether it’s Billings, CMO Dr. John Minadeo, or another leader asking, an assurance is given that the respective needs will be addressed.

“I take part in Gemba Walks every day and when trends align within a department, I follow-up utilizing lean tools such as “5-Why” or process mapping, to identify the root cause and define action steps to move their goals forward,” says O’Rourke.

As the morning Gemba Walk closes, the leadership groups converge at their board to track their own measures of how the walk went.

“The Leadership group discusses challenges or wins found during the walk, as well as action plans for any department that may need help with meeting one of their goals,” O’Rourke says.

The Gemba Walk often provides situational awareness on topics like staffing and supply needs for next 24 hours and allows for real-time adjustments. Highly reliable leaders are taught to manage by anticipation and prediction rather than reaction, to best keep patients, families, employees, and visitors safe.

As the leadership group disperses from the KPI board, they head into a 15-minute Safety Brief meeting, held at 9:15 a.m., seven days a week. Active for about a year and a half, the Safety Brief is designed to share both recognition for use of High Reliability tools and processes, as well as any safety concerns or issues that need to be addressed by a team that includes all department leaders.

The hour of 8:15 to 9:15 a.m. is known internally as a ‘No Fly Zone,’ preventing unwarranted schedule conflicts.

“This is a process, a culture change,” says Billings. “It is a shift in how we recognize and address goals.”

Many of the KPI boards are located where patients and visitors can easily view them, keeping in line with the transparency aspect of the process.

“The great thing about Lean Daily Management and the use of KPI boards is that they promote an environment of continuous process improvement,” says O’Rourke.

“Healthcare is always evolving. LDM tools allow us to measure and evolve with it so that we are always looking at how we can better take care of our patients and ourselves,” she says.

“This is the work,” says Billings, “to help our staff improve processes and implement the changes, benefits our patients and the internal flow.”

Recognizing that those closest to the frontline are often the experts and empowering them to make decisions when a critical issue arises, results in quicker mitigation of harm. Creating the safest environment, the most efficient workspace and flow for staff, while providing quality care for patients are imperative elements of any medical facility.

“Safety and quality, along with empathy and respect,” Billings says, are NMC’s four keys to success. “My hope is that this is how we will continue to run the hospital going forward.” ---

Story: Sarah Parsons West for NMC

October 2022

Characteristics of High Reliability Organizations (HRO)

The theory of high reliability has come to healthcare from naval aviation and the nuclear power industry.

1. Preoccupation with Failure

Everyone is focused on errors and near-misses, learning from them and figuring out how to prevent them from happening again. Attention to detail is crucial. Finding and fixing problems is everyone’s responsibility and is encouraged and supported by leadership.

2. Reluctance to Simplify Interpretations

Constantly asking the “why” question and inviting others with diverse experience to express their opinions. The belief is that the more you’re immersed in something, the harder it is for you to objectively observe and question things that need questioning. Leverage new thinking to get the right answer!

3. Sensitivity to Operations (an HRO Distinguishing Characteristic)

An ongoing concern with the unexpected. Closing loopholes in processes where there is potential for patient harm, maintaining situational awareness, developing teams that speak up and paying attention to the frontline – which in hospitals is primarily nurses, patient care attendants, techs and support staff.

4. Commitment to Resilience

The concept that things will go wrong that we can’t predict; mistakes will be made, and we will get into trouble. But we will quickly identify issues and have structures in place so we can immediately respond and minimize the harm.

5. Deference to Expertise

Finding and using experts for the given problem in the given time. Recognizing that those closest to the frontline are the experts and empowering them to make decisions when a critical issue arises results in quicker mitigation of harm.

In HROs, senior leaders are conducting Gemba Walks, to reinforce safety behaviors and find and fix critical safety issues. They’re also meeting in daily operational briefs where they look back to learn from failures and look forward to predict and lessen risk or harm, to best keep patients, families, employees and visitors safe.

Data edited from: Weick, K. E., & Sutcliffe, K. M. (2001). Managing the unexpected: Assuring high performance in an age of complexity. Jossey-Bass.

Hand

Hygiene

To emphasize our focus on hand hygiene, NMC recognizes the department with the highest rate of hand hygiene compliance.

Hand Hygiene Data

The World Health Organization has identified hand hygiene as the most important measure healthcare workers can take to avoid transmission of harmful germs and prevent health care associated infections. NMC is monitoring staff compliance with hand hygiene as one of our key quality initiatives, with monthly reporting and recognition of the top teams. Attention to clean hands has improved our scores from in the 60 percent compliant range to above 80 percent.

Hospital-Acquired Infections Data

As another key quality initiative, NMC is measuring rates of hospital-acquired infections to keep these stats low as we focus on patient safety and high-quality care. Our attention to continuous improvement and High Reliability principles are helping hard-wire changes that are leading to declining rates.

Provider Spotlight

New Providers

NMC welcomed many new providers to the medical staff this year in the fields of Primary Care, Cardiology, Neurology, Audiology, Urgent Care and Emergency Medicine.

Dana Barkley, PNP

Pediatrics

Jack Bates, PA

Emergency Dept

Ann Carpenter, NP

Emergency Dept

Danielle DiGangi, PA

Orthopedics

Diane Erianne, PA

Urgent Care

Richard Horak, DO

Radiology

Kristin Kindred, DPM

Orthopedics

Joseph Lahey, MD

Emergency

Colleen Moran, MD

Pediatrics

Kristie Oliver, PA

An existing employee who will split her time between ENT and UC

Katie Shattuck, PNP

Pediatrics

Jacqueline Wilson, PA

Urgent Care/Emergency Dept

Hear From Our Providers

Dr. Kristin Kindred

Ashlea Dosanjh, Au.D.

Dr. Kahren Aydinyan

Dr. Tracy Hagerty

Dr. Nathan Mauser

Patient Care

“Another New Part”

Total Ankle Arthroplasty (TAA) First of its kind at NMC

Former St. Albans’ Mayor and retired teacher Peter DesLauriers is no stranger to physical pain. Having previously undergone both a left knee replacement and right rotator cuff repair at NMC, DesLauriers says, “I have had two strokes and two fingers on my left hand amputated. I have not been good to my body.”

Years ago, DesLauriers injured his right ankle in a biking accident, “At that age I was too foolish to take proper care of it. It never truly got better.”

Last spring, when his ankle became so debilitated by severe arthritis that he could barely walk, his wife got him an appointment with Northwestern Orthopedics.

“I was expecting to see Dr. Beattie,” DesLauriers says of his prior surgeon. Instead, he was introduced to Dr. Kristin Kindred, DPM, a Podiatrist specializing in reconstructive foot and ankle surgery.

a physiotherapist performing an ultrasound on the ankle to check for injury

“Ankle arthritis is most commonly post-traumatic but can also be due to alignment imbalances in the ankle,” says Dr. Kindred. End stage ankle arthritis can be treated with a total ankle replacement or ankle fusion, she explained to her patient.
“The ankle fusion would leave my ankle stiff with no flexibility and a bit of a limp forever. As much fun as all of that sounded, I eagerly awaited the second choice,” DesLauriers recalls.

“For Peter, the choice to recommend ankle replacement was easy. He had severe ankle arthritis because of chronic ankle instability and had already limited his activity to low impact. The ankle pain was starting to affect his knee and we knew it was time to proceed with surgery,” Dr. Kindred says.

An ankle fusion is selected over replacement in patients that are younger and perform high impact activities or manual labor, Dr. Kindred adds.
“Based on that information and Dr. Kindred’s comfort and confidence in her own abilities, I made the appointment,” says DesLauriers.
With the Total Ankle Arthroplasty (TAA) scheduled for May 6, preoperative planning began utilizing Patient Specific Instrumentation (PSI). PSI is a type of computer-assisted orthopedic surgery technique aiming to perform virtual surgery based on imaging (CT or MRI).
“A CT is obtained of the patient’s ankle, and engineers and physicians use the CT to plan the optimal alignment of the ankle replacement,” Dr. Kindred explains.

“Using the CT, patient specific custom cutting guides are 3D printed. These custom guides are utilized during surgery to make the bone cuts and align the joint implant.”

TAA surgery is performed as an outpatient procedure, consisting of three weeks of non-weight bearing recovery, followed by another three weeks bearing weight in a walking boot. “Ankle replacement patients are back in a shoe around six-to-eight weeks post-op,” says Dr. Kindred.

“Since an active lifestyle is my choice and brings me joy, I am a very lucky man,”
says DesLauriers

“I used crutches for the first five weeks and after that, during the final week, I just used the walking boot. After graduating out of the boot I began physical therapy at Cobblestone,” says DesLauriers.
Since ankle replacement patients cannot withstand high impact activities, Dr. Kindred explains, the longevity of ankle implants has historically been less than hip and knee replacements. Studies have shown that the best outcomes for ankle replacements are in patients aged 60 and above.

Dr. Kindred specializes in an array of advanced techniques of the hindfoot and ankle, such as deformity correction and hindfoot arthrodesis. “I chose to work with the foot and ankle because feet are so important to function and activity. I enjoy detailed and precise surgical procedures,” she says.

“Dr. Kindred has given me a very big and important part of my life back,” says DesLauriers. “She stressed that this surgery would work because I was a good candidate, although I cannot run or jump again. However, it is well worth it because I can walk with my wife and play with my grandkids, pain-free.”

While DesLauriers credits the surgeon’s skill and ability, for Dr. Kindred the restoration of motion, function and pain reduction for her patients, is the reward.

“Giving Peter the chance to ride his bike without pain in his ankle is very gratifying,” she says.
“Since an active lifestyle is my choice and brings me joy, I am a very lucky man,” says DesLauriers, who retired in 2016 from St. Albans City School, after 42 years of teaching. He served the City of St. Albans as Mayor from 1994 to 2006, as well as Ward 5 Alderman for two terms, prior to that.

Having raised four athletic children, DesLauriers and wife Martha, who spent 43 years as a nurse at NMC, 37 served in the ER, now strive to keep up with their ten active grandchildren.

“There is very little time to rest my joints,” he says. “The ankle severely limited my activities, but I’m now close to 100-percent again.”
He reckons that an active lifestyle is like a double-edged sword, causing the wear and tear of important body parts. “With the help and expertise of local surgeons, I have been able to repair them and continue. Both Dr. Kindred and Dr. Beattie have made me younger,” DesLauriers says.
“Every time I get a new body part, I average the age of the device into my normal age and come up with my new actual age. I have been on earth for 70 years, but I am only 48 years old thanks to numerous new parts.” --

Story: Sarah Parsons West
For NMC, August 2022

NMC Adding Midwives to OB/GYN Practice

Northwestern OB/GYN will soon be adding a midwifery program to the practice. During the strategic planning process, NMC decided to make the addition to grow the practice and expand services offered to local families. It’s an exciting growth opportunity for our hospital and for the community.

NMC will hire for four full-time positions, which may be filled by five or more Certified Nurse Midwives, some of whom would work part time for greater coverage of the schedule. This growth in the practice comes at a time when we are preparing for the retirement of long-time physician Dr. Leonard Tremblay. As he formally retires, he has agreed to continue working for NMC in a part time capacity, covering one week per month both in the office and delivering babies.

Below is some information to help answer commonly-asked questions:

What training do midwives get?

Midwifery is practiced by certified Nurse-Midwives (CNMs). To become a CNM, registered nurses graduate from a master's or higher-level nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME). They must also pass the national Certified Nurse-Midwife Examination through the American Midwifery Certification Board.

What services do midwives provide?

Midwives provide a full spectrum of care that encompasses:
pregnancy, childbirth, and the postpartum period;
sexual and reproductive health;
gynecologic health;
and family planning services, including preconception care

When does the program launch at NMC?

The first CNM to join our team will start work in mid-November. November and December will be spent orienting the CNMs to our organization and to the practice. The CNMs will gradually begin to see patients through the end of the year with a tentative official “launch” set for January 2023.

Patient Feedback

I had a sleep study done last night, Weds. 09/22/2021, and must say that it was a very positive experience. The young woman that I worked with, Jessica, was extremely knowledgeable, and extremely personable.

While attaching sensors to my head and body, which took about 30 min., we had a very pleasant conversation, which made the whole process go by very quickly.

At all points during the study, she was there immediately if I needed something, and when the study was done, took me in a wheelchair down a slight hill which I would have been nervous to walk, and to my car.

She continually had a smile on her face, and we engaged in our great conversation all the way to my car. I commend you for having Jessica as an employee, and wish that there were more people out there like her.

"I have recently had 2 spinal surgeries done by Dr. Nathan Mauser at Northwestern, as well as the requisite MRI's and testing need prior to the operations, and all of the follow up appointments needed afterwards.

I have to say that I have been continually impressed by the level of professionalism I experience, the friendliness of the employees, their appreciation of the place where they work and their overall positive attitudes and happiness with their jobs.

This is very different from my experiences at UVM, where I found some very disgruntled employees, who treated the patients quite poorly.

I recently had a sleep study done at the Northwestern Sleep Center, and was again, very impressed by the friendliness of all the employees that I came in contact with, and their happiness with their jobs. I sent an email to Northwestern to inform them of how impressed I was with my sleep study experience, which they chose to use in their promotion of the sleep center. I would love to do the same thing for Northwestern itself, as the courtest, happiness and professionalism is truly impressive. If there is anything that I can do, please let me know."

Unfortunately, I have been in ER several times in last few month with family members and friends. I’m here again as I write this. Each of these times we have had Dr.Miller Pearsall as the physician. It’s important for you to know that she is absolutely amazing in all regards - knowledge, care and concern, professionalism, and sincerity. She’s approachable and non judgmental…something that has not always been the case with other ER experiences. I know how difficult it is to attract and keep physicians in Vermont and at NMC; reasons I fully understand. I hope NMC does everything it can to keep this amazing doctor. She’s a bright light in our Franklin County healthcare future.

I want to offer praise for the outstanding work of Physician's Assistant Kristen Sprague. On Monday, January 17 I needed stitches to repair a head wound (following a clumsy header into a door frame). My experience at Northwest Urgent Care was outstanding! I was lucky enough to be seen rapidly by Ms. Sprague. She quickly and effectively (with great care) took care of my stitches. I returned on Saturday, January 22 to have those stitches removed and again saw Ms. Sprague. Many thanks to Northwest Urgent Care, Ms. Sprague (and her nurse whose name I failed to catch). My scar is rapidly healing and I wanted to express my appreciation. Thanks!

"I just want to compliment a woman named Viola who gave me a Covid nose swab at 1:50 today, 06/28/2021.

She pushed me in a wheelchair to the room to do the swab, and back to my car afterwards. She was very fun to talk to, very professional and very knowledgeable. Even though the procedure was quick and absolutely painless, she made it enjoyable."

"I just arrived home after a visit to Northwestern for some Xrays on my lower back.

I worked with a gentleman named Ben, who did my Xrays.

I want to compliment him on his knowledge, his professionalism and his remarkably engaging personality. He was very helpful, and managed to make a visit to the hospital for Xrays a very pleasant experience."

I want to commend the ER staff for helping me during my ER visit 2 days ago. Dr Kovacs was pleasant and kind and he told me what I needed to know and he answered my questions, all in a cheery way. He put me at ease. And the nurses were so kind and friendly and they were patient with me and my fear of needles- I felt supported during a scary time. Thank you so much.

Spine Surgery Patient Receives Successful Results and High Quality Care at NMC

As a recent back surgery patient, Glenn Conant is happy with the success of his procedure, but also was impressed with the entire care team at NMC both in the Orthopaedics practice and all across the organization from registration to billing.
For years, Glenn was experiencing extreme lower back pain that affected his ability to walk. His condition was deteriorating as he struggled to get scheduled for back surgery. After two years without success in getting the surgery scheduled, Glenn found himself at his primary care provider’s office feeling extremely frustrated. He said that one of the staff members at Champlain Island Healthcare recommended he try scheduling an appointment with Dr. Nathan Mauser at Northwestern Medical Center, saying that her father was recently a patient of Dr. Mauser’s and spoke highly of him. Glenn’s primary care provider, , agreed and recommended that he try scheduling spinal surgery with Dr. Mauser.
Glenn called Northwestern Medical Center (NMC) and was scheduled for an appointment within a couple of days. At his first consultation with Dr. Mauser, it was decided that Glenn would undergo a procedure called a Laminectomy within the next few months. Glenn said he was fully educated on all aspects of the procedure, including what could go wrong and the risks involved. “Dr. Mauser was always very careful not to try to convince me to have the operation, by mentioning all the potential risks involved, but my confidence in him convinced me to have the surgery, and I’ve had no regrets,” Glenn said.
On January 13, 2022, Dr. Mauser performed a successful Laminectomy on several disks in Glenn’s lower back. A Laminectomy is a major spine operation that removes a portion of the vertebra called the lamina, which is part of the spinal canal. This type of surgery eases the pressure on the spinal cord or nerve roots.
Dr. Mauser also prepared Glenn for what to expect while recovering. Although his recovery has been a slow process, Glenn said he has already noticed significant improvements, his pain has been relieved, and he is regaining his ability to walk without issues.
“I recommend Dr. Mauser to anyone that I speak with regarding my experiences at NMC and am thankful that the employee at Champlain Island Healthcare, and Dr. McGettrick recommended him so highly to me,” Glenn said.
In addition to a positive surgical experience, Glenn said that NMC staff at all levels showed professionalism and engagement that he found impressive.
“What stands out to me about my experience at NMC, and what I mention to everyone that I speak with about medical care, is the positive attitudes, and the extreme professionalism of every employee that I have interacted with there – from the people who do the initial check-ins, to the people who perform different tasks, to the schedulers, to Dr. Mauser, to the finance people, and the people on the phone,” he said. “everyone that I have ever interacted with at NMC has been very professional, very engaging, very fun to work with”

Financials

Our Greatest Asset and Our Financial Journey

It is true that an organization’s greatest asset are its employees. Their abilities, knowledge, empathy, and dedication cannot be underestimated or replaced. Recruitment and retention of staff is crucial to the financial health of the organization. Like most industries, workforce challenges in healthcare have been significant since the start of the pandemic. We will continue to invest in our staff and we are truly and deeply grateful for their commitment to serve the community.

NMC remains committed to improving financial sustainability. Fiscal Year 2022 (FY’22) resulted in a 4.32% operating loss. This year’s operating loss was driven by the increased cost of having contracted temporary staff providing direct patient care in our hospital. We pay a premium for contracted temporary staff, however, we could not have provided the necessary care to our community without these individuals. It was essential to supplement our workforce to continue providing safe, quality care.

We continue to carefully assess all that we do to ensure it is a match for a community hospital and meets community needs. When needed, we are engaging partners to take on services which they are better positioned than the hospital to provide due to expertise, regulation, or reimbursement. In FY’22, our pediatric practices transitioned from being hospital owned to being in private practice, now under the name of Maple Monarch Pediatrics.

Also in FY’22, our primary care practices transitioned from being hospital owned to being part of Northern Tier Center for Health (NOTCH). These transitions preserved access for the community to these essential services and allows NMC to invest in other services that the community needs. For example, NMC is partnering with Dartmouth Hitchcock on Tele-Neurology services to keep stroke care local, reducing the number of patient transfers to tertiary care facilities.

NMC also continues to invest in equipment and infrastructure and has begun modernization of the Emergency Department. The space had not been meaningfully renovated in over 30 years and the project brings much needed improvements to address issues with patient safety, privacy, workflow, and care of patients with infectious conditions. We anticipate the project to be complete by October of 2023. The organization has been saving and planning for this project for many years and are excited to see it completed after several years of pandemic related delays.

Lastly, NMC’s Fiscal Year 2023 (FY’23) budget was approved by the Green Mountain Care Board. The FY’23 budget results in a positive modest 1% operating margin and is a meaningful step in the right direction on our financial improvement journey.

NMC By The Numbers

A few stats about the care provided by NMC

Hospital Admissions

Inpatient Lab Tests

Outpatient Lab Tests

Urgent Care Visits

Diagnostic Imaging Tests

Specialty Practices Visits

Emergency Room Visits

Financial Report

Highlights & Happenings

Highlights

Investing for a Healthier Community

As a not-for-profit organization and as one of the largest employers in the region, NMC carries a responsibility (formal and informal) to help address critical issues which impact community health that go beyond the direct care NMC provides. We do so through our ‘community benefit investments’ (a term of the Internal Revenue Service – IRS) to help our community achieve a healthier future.

NMC’s vision calls on us to “partner to improve the wellness of our community.” Investing in wellness and prevention to prevent illness and chronic disease and reduce the demand for costly medical treatments is a vital part of bending the cost curve in healthcare long term and improving the quality of life. We are a significant funder for the Franklin Grand Isle Tobacco Coalition efforts, which has been instrumental in reducing the rates of tobacco use in our community. We are the major funder of the Healthy Roots Collaborative, the diversified agricultural effort in our local region which is helping fresh healthy local produce and foods into homes across our community. The return on these investments is long-term and it is real. The national Prevention Institute says, “For every dollar we spend on prevention we see a 5 to 1 return on investment in just 5 years. We simply can’t fix our economy without it.”

On top of these focal efforts relating to community benefit, NMC provides close to $100,000 a year in funding to key community partners working on priorities within the community health needs assessment, on social determinants such as housing, and on related efforts to improve the quality of life. These agencies are able to have a positive impact in areas outside NMC’s direct expertise, but which directly impact the lives of our patients and our staff. NMC is a significant funder of the United Way of Northwestern Vermont and also provides donations and support to partners including: the American Red Cross; American Heart Association; Vermont Maple Festival, Martha’s Kitchen; Tim’s House; Franklin County Home Health; Hard’Ack; the Afterglow Foundation; Spectrum Youth & Family Services, Northern Forest Canoe Trail; the Franklin County Regional Chamber of Commerce; the Howard Center; Special Olympics; Make A Wish; Northwest Family Foods of CVOEO; the Friends of Northern Lake Champlain; Fairfield Community Center, the St. Albans Rotary Club; and more. No single individual or agency can tackle the challenges of our community alone and NMC is proud to collaborate with these great partners as we work collectively towards a healthier future for all.

COVID Resource Center Provided Unprecedented Community Support

In the summer of 2021, the State of Vermont began preparing for the fall season of the COVID-19 pandemic, anticipating increased cases and a need for increased testing and vaccination.

The state offered NMC a contract to create and staff a new clinic to meet this need and in September the clinic opened in the Medical Office Building.

Demand ramped up immediately and the clinic moved to Valley Crossroads using an outdoor, drive-through model for testing with vaccinations provided inside the building.

This COVID Resource Center operated from September 2021 through June of 2022. The clinic operated six days per week, for approximately four hours each day with the hours evolving over time to meet the demand. Staff dealt with a rollercoaster of changing operational needs, including preparing to offer boosters and vaccinations children. The testing service moved indoors in the winter to protect staff and patients from the harsh weather, and the vaccination clinic relocated to the Cobblestone Health Commons building on NMC’s campus.

Throughout the unpredictable and stressful life of the clinic, the CRC team performed nearly 23,000 self-swabbed tests in this time frame and gave out nearly 1,700 take-home kits. The vaccination team provided approximately 5,000 adult COVID vaccinations and about 1,500 pediatric vaccinations. During the CRC operation, the infection prevention protocols protected staff and patients, with zero patient-to-staff infections or staff-to-staff infections.

Creemee Truck Visits NMC

NMC’ers Donate Blood to the American Red Cross

CuddleCot Donated to Family Birth Center at NMC

Family Birth Center Staff accept the generous gift of a CuddleCot donated by Scarlet’s Mission. The CuddleCot was designed to provide grieving families with time to form a bond with their baby following a stillbirth. The CuddleCot is a cooling pad placed on the baby’s mattress that cools to an ideal temperature to preserve the baby without being too cold for the parents. This allows time for families to bond with their baby and to grieve their loss. It is used in thousands of hospitals across the world, and NMC is one of seven hospitals in Vermont to offer this support for families of a stillborn.

NMC Employees celebrate Pride 2022

2022 Golf Tournament

After a two-year hiatus due to the pandemic, the Community Partners Classic returned! Golfers and volunteers enjoyed a beautiful and fun day of golf at Champlain Country Club to raise money for Northwestern Medical Center and Northwestern Counseling and Support Services (NCSS). NMC and NCSS partner in various capacities to care for the wide range of health and human service needs of the people in our community. Proceeds raised from this annual event help support both organizations and our work.

2022 Employee Awards Banquet

Each year we recognize staff who have reached years of service milestones. These honorees were recognized at our Employee Recognition Banquet held at the Abbey Pub and Restaurant and received a commemorative certificate and a gift as a token of appreciation.

Congratulations to all of our Years of Service honorees and thank you for your dedication to NMC and our community!

United Way Campaign

Thanks to our staff’s generosity, we raised just nearly $40, 778 in donations during the 2021 United Way Campaign. It was one of our biggest fundraisers yet – and it is all thanks to our NMC donors!

Funds raised through pledges, donations, and participation in fundraisers of this annual campaign help support programs in our community that benefit all of us. The United Way of Northwest Vermont is a vital partner for local nonprofits to help support their impact on health, education, and income in our community. Their work spans many key issues affecting our vision of a healthy community, including: addiction, homelessness, hunger, abuse, childcare, aging, and employment.

Harvest Moon Cruise

In September, the NMC Activities Committee sponsored a Harvest Moon Dinner. NMC Staff and Volunteers attended the Activities Committee event on the Spirit of Ethan Allen enjoyed a lovely evening!

Volunteer Recognition

NMC is incredibly appreciative of our Volunteers who support our hospital operations specifically in the MOB, Main Lobby, Surgical Services, Gift Shop, Courier, Café, Cobblestone Reception, Enosburg PT and Pet Therapy. Earlier this year, we were able to recognize with an in-person event and thank them for the special contribution they make to our community hospital.

Hospital Week BBQ

In May, NMC celebrated Hospital Week with fun activities that include a free staff BBQ. Our Restaurant and Catering team cooked amazing food and members of our Leadership Teams helped serve. It was a beautiful day to come together and celebrate one another.

NMC Employees Show Off Their Ugly Sweaters

Wearing Pink

Every year NMC has a "Wear Pink" day in recognition of October as Breast Cancer Awareness month. NMC’ers are encouraged to wear pink masks, scrubs, outfits and more to show their support of Breast Cancer Awareness.

Recognition and Milestones

Leon Berthiaume Honored with NMC’s Community Service Award

The Northwestern Medical Center (NMC) Board of Directors is pleased to announce Leon Berthiaume, as the recipient of NMC’s 2022 Community Service Award in recognition of his long and devoted service to the community.

Berthiaume’s nomination said that he inspires others to get involved, make a difference, and give back to the community. His nomination included recognition for his service as NMC’s Boar Chair during the most recent major renovations to the facility, and his tenure as a member of the St. Albans Rotary where he worked on projects like a coat collection and the now annual tractor parade. He has been a strong leader for the St. Albans Cooperative Creamery, where he has always encouraged employees to give back and is part of the Dairy Farmers of America that continues to support community engagement. Today he serves on the boards of Franklin County Industrial Development Corporation, Peoples Trust Company, and Vermont Business Roundtable.

The award was announced by Board Vice President John Casavant who thanked Berthiaume for his service on NMCs’ board and his incredible generosity with his time and support.

“I am truly honored to receive this special and meaningful recognition,” said Berthiaume. “I am thankful and proud to have served the NMC organization and the Franklin County community over the years.” He said he was appreciative of the support of both his family and his employer who made it be possible for him to be so involved.

The NMC Community Service Award was established by the NMC Board of Directors in 2013 to recognize an individual or organization residing in Franklin or Grand Isle Counties who exhibits enthusiasm, integrity, and perseverance beyond the ordinary to help fellow citizens and the community through selfless giving to improve the overall health of the community. Nominations are invited from NMC’s Board, staff, medical staff, volunteers, and Incorporators. The NMC Board makes the selection from the nominations.

The NMC Community Service Award is presented each year at a meeting of the NMC Incorporators. Recipients are presented with a crystal maple leaf commemorative award and have their name added to a plaque which hangs in the NMC Conference Center. Prior recipients of the NMC Community Services Award are: Dr. Thomas Howrigan; Marcia Perry; Helene Biggie; Dr. Frank & Judy Zsoldos; Retired Rear Admiral Warren and Barbara Hamm; Emerson Lynn; Kathleen Keenan, RN, Pam Cross, RN and Janet McCarthy, RN.

Deogracias “Deo” P. Esguerra, MD Service Award

Dr. Laura Bellstrom accepted the “Deo” P. Esguerra, MD Service Award from last year’s honoree, Dr. Lowry Sullivan.

Dr. Laura Bellstrom, longtime pediatrician, was honored with the Deogracias “Deo” P. Esguerra, MD Service Award at NMC’s Medical Staff Appreciation event held earlier this month.

The award was created in 2011 to honor a provider with a “passion for excellence and dedication to the patients of our community.” Its namesake, Dr. Esguerra, was known as a caring, passionate and inspirational physician who loved both the science and art of medicine.

“What I am most passionate about and has been most rewarding is making connections with patients and their families over time and through many events in their lives and at times becoming an extension to the families of patients for whom I have cared. It is a true honor to be invited into the lives of patients at the time of their births, follow them through infancy, the toddler and early childhood years, into adolescence and adulthood and take part in the good and the bad times and help navigate all of this” Dr. Bellstrom says.

Dr. Bellstrom joins a list of “Deo Award” honors that that includes Dr. Fred Holmes, Dr. Frank Zsoldos, Dr. Mike Corrigan, Dr. Chip Chiappinelli, Dr. Robert Zelazo, Dr. Stephen Payne, Dr. Toby Sadkin, Dr. John Minadeo, Dr. Robert Beattie, and Dr. Lowery Sullivan.

This year’s Medical Staff Appreciation event was held remotely with the exception of award presentations. During the meeting, new providers were recognized, and physicians and advance practice providers who achieved milestones in length of service were also honored.

Three additional physicians were recognized for their leadership during the presentation. Dr. Chip Chiappinelli earned the Distinguished Achievement Award, Dr. Stewart Manchester earned the Clinical and Cultural Excellence Award, Sarah DeSilvey, FNP earned the Leadership Award.

2022 Run/Walk for Jim

This 2022 Run/Walk for Jim raised a whopping $11,273.54 in support of the Jim Bashaw Cancer and Catastrophic Illness Fund. The St. Albans Recreation Department helped make the run possible this year, a new partnership with the Run for Jim organizing committee. The Rec Department helped with registration, timing services and logistical support on the day of the event.

2022 Board Officers

Jake Holzscheiter

President

John Casavant

Vice President

Dawn Bugbee

Treasurer

Barb Toof

Secretary

2022 Board Members

Jake Holzscheiter

John Casavant

Dawn Bugbee

Barb Toof

Nick Hadden

Karyn Rocheleau

Corey Parent

Dr. Lowrey Sullivan

Erin Creley

Coleen Kohaut

Matthew Habedank

2022 Medical Executive Committee

Lowrey Sullivan, MD, President of the Medical Staff

Donny Khela, MD, Vice President

Anna Royer, MD, Secretary

Katie Montagne, MD, Immediate Past President

Louis Dandurand, MD, Chief of Emergency Service

Heather Shenk MD, Chief of Inpatient Service

Kahren Aydinyan, DO, Chief of Surgical Service

Haitham Nsour, MD, Chief of Outpatient Medicine Service

Colleen Moran, MD, Chief of Pediatric

Alexandra Hoppe, PA, Member at Large

2022 Senior Leadership Team

Stephanie Breault, Chief Financial Officer

Ryan Hamel, Chief People Officer

John Minadeo, MD, Chief Medical Quality Officer

Jonathan Billings, Interim Chief Executive Officer, Chief Operating Officer

Dawn Kregel DNP, MSN-HCM, RN, CCRN, Chief Nurse Executive

Board of Incorporators

The NMC Incorporators is a group of up to 128 local residents from throughout northwestern Vermont who serve as a formal connection between the hospital and the community we serve. The Incorporators meet twice a year with primary functions being electing the Board of Directors, approving the corporate bylaws, and acting as ambassadors and advocates.

Janis Appel
Judy Ashley
Lorne Babb, M.D.
Mary Bates
Reginald Beliveau
Leon and Anne Berthiaume
Robert Bessette
George Bilodeau
Steven Broer, Psy,D
Gregory Brophey, M.D.
Jacqueline Brosseau-Cyr
Lawrence Bruce
Dawn Bugbee
John Casavant
Jane Catton
Sandra Chagnon
Paul Clark
Donald Collins
Vaughn Comeau
Phillip Condon
Coleen Condon-Kohaut
Michael Corrigan, M.D.
Erin Creley
Karl Cunningham
David and Erica Debellis
Dustin Degree
Christopher Dermody
Lynn Desautels
Richard Dickinson, DMD
Grace Dickinson-Branon, D.M.D
Catherine Dimitruk
Hibbard Doe

David Ducham
Jeffrey Eaton
John Edwards
Nancy Fiske
Elaina Fontes
Bradley Gabree
Andrea Gagner
Steven Gagner
Thomas Gallagher
Elizabeth Gamache
Peter Garceau
Valdemar and Bridget Garibay
Clement Gervais
Uwe Goehlert M.D.
Nilda Gonnella-French
Leon Graves
Monica Greene
William Greenwood
Molly Grismore
Matthew Habedank
Nicholas Hadden, Esq.
Joe Halko
Christina Hamel
John and Lisa Hango
Rett Heald
Hector Hill
Jacob Holzscheiter
Jacqui Hood
Bridget Howrigan Rivet
Hayden Janes
Paula Kane
Celeste Kane-Stebbins

Kathleen Keenan
Ned Kirsch
Dana Kittell
Molly Lambert
Kathy Lavoie
Michelle Lawrence
Chelsey Lawyer
Jeffrey Levesque
Betsy Liley
Sally Lindberg
Danielle Lindley-Mitchell
Deborah Loughlin
Adam Luneau
David Mahoney
James Manahan
Kevin Manahan
JoAnn Manahan
Mike McCarthy
Michael R. McCarthy
Janet and Michael McCarthy
Ralph McNall
John Minadeo, M.D.
Sheri Moore
Dr. Joseph and Judy Nasca
William Nihan
William O'Connor
Corey Parent
Pamela Parsons
Steve Payne, M.D.
Peter Perley
Albert and Marcia Perry
Keith and Sylvia Ploof

Susie Posner Jones
Kristin Prior
William Roberts
Donna Roby
Karyn Rocheleau
Chip Sawyer
Kevin and Karen Scheffler
Marietta Scholten, M.D.
John Schreindorfer
Sherry Scott
Kristina Senna
Albert and Sally Severy
Heather Skilling, V.M.D.
Tami St. Marie
Stephen Stata
Molly Stata Comeau
Kathy Tabor
Patrick Talcott
Barb Toof
Thomas Traber
Paula Tremblay
Edward J. Tyler, III
Lynn Vallee
Howard Van Benthuysen
Daniel Vanslette
Albin Voegele
James Walsh
Homer Wetherby
Penny Wright
Dr. Frank and Judy Zsoldos

2022 Leadership List

Adam Thompson
Manager of Facilities

Alisha Sawyer
Supervisor, Medical Staff Office

Amanda Wilson
Manager, Care Management

Anna Gabaree
Director of FBC and RT

Anneke Merritt
Director, Quality & Safety and Infection Control

Bobbie Bilado
Clinical Operations Supervisor

Bridget Thompson
Supervisor, Diagnostic Imaging

Carrie Consentino
Manager, Food Service

Charles Lewis
Manager, Environmental Services

Chelsey Lawyer
Manager, Materials Management

Chris Giroux
Director, Informatics and Data Integration

Christina Beck
Laboratory Supervisor

Christopher Niles, MD
Medical Director, Urgent Care

Corey Rivers
Med-Surge Nurse Manager

Courtney Leduc
Director of Clinical Practices

Danielle Boudro
Director of Progressive Care Unit

David Blin
Director of Lab Services

Deirdre Young
Director, Surgical Services

Denise Smith
Director of Population Health Programs and Strategy

Dennis Boucher
Director, IT Operations

Devin Bachelder
Manager, Decision Support & Budget Analysis

Donna Fitzgerald
EVS Supervisor

Emily Allen
Critical Care Nurse Manager

Erica Finnegan
Director, Diagnostic Imaging

George Gattullo
Director, Facilities

Gregory Brophey, MD
Executive Medical Director, Physician Services

Haitham Nsour, MD
Medical Director, Pulmonology

Heather Shenk, MD
Medical Director, Hospitalists

Jake Ashline
Supervisor, Informatics

Jennifer Howrigan
Director, Finance/Controller

Jerri Bushey
Supervisor, Clinical Administration

Jessica Aboelezz
Director of Pharmacy

Jill Torrey
Director of Business Operations

JoAnn Manahan
Director, Emergency Department

Joel Banazek
Manager, Patient Access

Karen Staniels
Director of Business Operations

Kate Laddison
Director of Communications

Kate Merchant
Director of Patient Care Services

Katherine Winchester
Manager, Volunteer Services

Kelly Campbell
Director of Professional and Organizational Development

Kristy Cushing
Director, Rehab Services

Louis Dandurand, MD
Medical Director, Emergency Department

Megan Smith
Manager, Patient Financial Services, and Health Information Management

Rachael Shepardson-Rudden
Emergency Services Nurse Manager

Thomas Suppan, MD
Medical Director, Laboratory

New Groups for Feedback and Communication

NMC established two leadership groups this past year to provide more opportunities for staff and medical staff to share input and feedback with the Senior Leadership Team. The Provider Leadership Group and Employee Leadership Group meet monthly with informal agendas driven by the staff.

Membership of the PLG includes:

Dr. Kahren Aydinyan
Dr. Crhis Bartels
Dr Cengiz Esenler
Dr. Matias Gnass
Dr. Tracy Hagerty
Dr. Thomas Harrison
Nolan Hurley, PA
Dr. Michael Kennedy
Dr. Audry Von Lepel
Lynn McMorrow, DNP
Dr. Joe Nasca
Dr. Paul Newton
Dr. Terri Nielsen
Kristie Oliver, PA
Dr. Steve Sobel
Dr. Lowrey Sullivan
Dr. Leonard Tremblay
Dr. Tracy Tyson
Dr. Christopher Vogt
Dr. Christopher Williams

Membership of the ELG includes:

Kevin King, RN
Jessica Scanlon
Kelly Connolly
Ruth Kane
Hunter Bean
Jessica Frost
Emiley Ledoux
Jonathan Newhard
Adham Kelley
Dawn Miller, LPN
Dan Shedrick
Scott Livingston
Kayla Demeritt
Elizabeth Johnson
Robyn LaRose

Gifts from Our Community: Annual Donors

Individuals

Ronald Anstey
Shari Bashaw
Courtright Beard
Laura Bellstrom
Jonathan & Marilyn Billings
David Blin
Damian Bolduc
Steve Bourgeois
Michael Bouvier
Dan Bovat
Adam Branon
Gregory Brophey MD
Susan Bruce
Caryn Burleson
Jane Catton
Edna Chagnon
John Chesarek
Eric Ciemniewski
Tom Conley
Kelly Connolly
Peggy Coon
Richard Cowperthwait
Eric Daudelin

Donald Davison
James Dickmann
Annette Dragoon
Katie Driver
Faith DuBois
Kimberly Duffel
Judy Dunn
Tom Dwinell
Amber Felisko
Jesse Fleming
John Foran
Valdemar and Bridget Garibay
Gary Gilmond
Todd and Angelic Gingras
Chris Giroux
Leon Graves
Joe Halko
John and Lisa Hango
Peter Hofstetter
Carol Jones
Shaun King
David Knightes
Erin LaRocque

Deeanna Lefluer
Sally Lindberg
John Livingston
Elaine Magnan
Nellie Maley
Joann Manahan
Marianne and Steve Marshall
Linda Martell
Peter Martin
Janet and Michael McCarthy
Jackie McNall
Rene Meilleur
Amanda Mobbs
Tina Mueller
Paul Newton
John Newton
Keirsten Nulph
Adam Parent
Miller Pearsall MD
Clifford Peebles
Dean Pelkey
Dan Petherbridge
Jamie Pinkham

Randall Pratt
Greg Rainville
Dennis Sanders MD
Frank Short
David Simcoe MD
Jon and Michelle Spaulding
Heather Streeter
Adam Thompson
Daniel Thompson
Barb Toof
Edward J. Tyler, III
Howard Van Benthuysen
Matthew Walker
Chandra and Andrew Walsh
Katie Walsh
Lisa Anne Weaver
Caitlin White
Mary Woodhouse MD
H. Taylor Yates MD
Christopher Young
Robert Zelazo MD
Frank and Judy Zsoldos MD

Businesses & Organizations

A.M. Peisch Company
A.N. Deringer, Inc.
Allegiance Benefit Plan Management
Cross Consulting Engineers PC
Dickinson & Branon Dental Care
E4H - Environments for Health
Grady's Golden Goodness Fund
Handy Toyota / Handy Chevrolet
Hannaford's Bags 4 My Cause

Heald Funeral Home
Jeff's Maine Seafood
Kinney Drugs Foundation
Kissane Associates
MediCopy Services
Open Approach
Peoples Trust Company
Ruggiano Engineering
Run for Jim Event

Sticks & Stuff
Suncrest Health Care Communities
Tenth Crow Creative
The Bottomless Toy Chest
The Richards Group
The Tyler Place
Union Bank
Vermont Precision Tools, Inc.

In Memory Of

In Memory of Adrianna Lee Bohannon

Dr. Thomas Suppan and the NMC Lab Team

In Memory of Betty Wright

Alice Levick

Gregory Wright

Marilyn Jacobs

Sandra Williams

In Memory of Clement Austin
Judy and Terry Jones

In Recognition of Dan Marlow
Julie Richards

In Memory of Doris Boardman
Sherry Scott

In Memory of Greg Richard
Darlene McNally

In Memory of Mike Bouthillette
Ginette Warner
Karen Bouthillette

In Memory of Patrick Lavely

Joan Robtoy

In Memory of Robert Clark

Patrick Arkinson

In Memory of Shirley Mae Butler

Amy Biggie-Ward

In Memory of Tim Connolly

Ann Moore

David Cobb

Thomas and Cheryl Martinez

Language Assistance

patientrelations@nmcinc.org

1-800-340-5877

Click for language assistance

patientrelations@nmcinc.org

1-800-340-5877

ENGLISH

Northwestern Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Northwestern Medical Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Attention: You have the right to an interpreter at no cost to you.

Northwestern Medical Center:

Provides free aids and services to people with disabilities to communicate effectively with us, such as:

Qualified sign language interpreters
Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provides free language services to people whose primary language is not English, such as:

Qualified interpreters
Information written in other languages

If you need these services, contact Amanda Wilson, Manager of NMC’s Care Management Department at 802-524-1001.

If you believe that Northwestern Medical Center has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with NMC’s Compliance Officer: Alisha Sawyer, 133 Fairfield Street, St. Albans, VT, 0578, nmccompliance@alertline.com or 1-800-340-5877. If you need help filing a grievance, Alisha Sawyer is available to help you. If you would like to submit a complaint to NMC about these services or any other services, contact our Patient Relations Department by email at patientrelations@nmcinc.org.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Español (Spanish)

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.

Northwestern Medical Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Northwestern Medical Center no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color, nacionalidad, edad, discapacidad o sexo.

Northwestern Medical Center :

Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes:
- Intérpretes de lenguaje de señas capacitados.
- Información escrita en otros formatos (letra grande, audio, formatos electrónicos accesibles, otros formatos).
Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el inglés, como los siguientes:
- Intérpretes capacitados.
- Información escrita en otros idiomas.

Si necesita recibir estos servicios, comuníquese con Jamie Pinkham.

Si considera que Northwestern Medical Center no le proporcionó estos servicios o lo discriminó de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Puede presentar el reclamo en persona o por correo postal, fax o correo electrónico. Si necesita ayuda para hacerlo, réclamation Jamie Pinkham – Manager of Care Management está a su disposición para brindársela. También puede presentar un reclamo de derechos civiles ante la Office for Civil Rights (Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

繁體中文(Chinese)

注意：如果您使用繁體中文，您可以免費獲得語言援助服務

Northwestern Medical Center 遵守適用的聯邦民權法律規定、不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。NMC 不因種族、膚色、民族血統、年齡、殘障或性別而排斥任何人或以不同的方式對待他們。

NMC:

向殘障人士免費提供各種援助和服務、以幫助他們與我們進行有效溝通、如：
- 合格的手語翻譯員
- 以其他格式提供的書面資訊（大號字體、音訊、無障礙電子格式、其他格式）
向母語非英語的人員免費提供各種語言服務，如：
- 合格的翻譯員
- 以其他語言書寫的資訊

如果您需要此類服務，請聯絡 Jamie Pinkham.

如果您認為 Northwestern Medical Center 未能提供此類服務或者因種族、膚色、民族血統、年齡、殘障或性別而透過其他方式歧視您，您可以向 Jamie Pinkham – Manager of Care Management 提交投訴，郵寄地址為133 Fairfield Street, St.Albans, VT, 05401，電話號碼為 802-524-5911、TTY（聽障專線）號碼為 800-253-0191，傳真為，電子信箱為 jpinkham@nmcinc.org。您可以親自提交投訴，或者以郵寄、傳真或電郵的方式提交投訴。如果您在提交投訴方面需要幫助，Jamie Pinkham – Manager of Care Management 可以幫助您。您還可以向 U.S. Department of Health and Human Services（美國衛生及公共服務部）的 Office for Civil Rights（民權辦公室）提交民權投訴，透過 Office for Civil Rights Complaint Portal 以電子方式投訴：https://ocrportal.hhs.gov/ocr/portal/lobby.jsf，或者透過郵寄或電話的方式投訴：

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019、800-537-7697 (TDD)（聾人用電信設備）

Tiếng Việt (Vietnamese)

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-877-696-6775.

Northwestern Medical Center tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. NMC không loại trừ mọi người hoặc đối xử với họ khác biệt vì chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.

NMC:

Cung cấp dịch vụ hỗ trợ miễn phí cho những người khuyết tật để giao tiếp với chúng tôi có hiệu quả, như:
- Thông dịch viên ngôn ngữ ký hiệu đủ năng lực
- Thông tin bằng văn bản ở các định dạng khác (chữ in lớn, âm thanh, định dạng điện tử có thể tiếp cận, các định dạng khác)
Cung cấp miễn phí các dịch vụ ngôn ngữ cho những người có ngôn ngữ chính không phải là tiếng Anh, như:
- Thông dịch viên đủ năng lực
- Thông tin được trình bày bằng ngôn ngữ khác

Nếu bạn cần những dịch vụ này, hãy liên hệ Jamie Pinkham.

Nếu bạn tin rằng Northwestern Medical Center không cung cấp những dịch vụ này hoặc phân biệt đối xử theo cách khác dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính, bạn có thể nộp đơn khiếu nại với: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Bạn có thể trực tiếp nộp đơn khiếu nại hoặc gửi qua đường bưu điện, chuyển fax, hoặc email. Nếu bạn cần trợ giúp nộp đơn khiếu nại, Jamie Pinkham – Manager of Care Management, sẵn sàng giúp bạn. Bạn cũng có thể nộp đơn khiếu nại về dân quyền lên U.S. Department of Health and Human Services (Bộ Y Tế và Dịch Vụ Nhân Sinh Hoa Kỳ), Office for Civil Rights (Văn Phòng Dân Quyền) bằng hình thức điện tử qua Office for Civil Rights Complaint Portal, có trên trang https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, hoặc qua đường bưu điện hoặc bằng điện thoại tại:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

한국어 (Korean)

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

Northwestern Medical Center 관련 연방 공민권법을 준수하며 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 차별하지 않습니다. NMC은(는) 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 누군가를 배제하거나 다른 방식으로 대우하지 않습니다.

NMC:

장애인들이 저희와 효과적으로 의사소통할 수 있도록 다음과 같은 무료 지원과 서비스를 제공합니다.
- 자격있는 수화 통역자
- 다른 형식의 서면 정보(큰 활자, 음성, 사용 가능한 전자 형식, 기타 형식)
주로 사용하는 언어가 영어가 아닌 이들에게는 다음과 같은 무료 언어 서비스를 제공합니다.
- 자격있는 통역자
- 다른 언어로 작성된 서면 정보

이러한 서비스가 필요하면 Jamie Pinkham에게 문의하십시오. 노스 웨스턴 메디컬 센터가 인종, 피부색, 출신 국가, 연령, 장애 또는 성별에 따라 이러한 서비스를 제공하지 못하거나 차별을 당했다고 생각되는 경우 Jamie Pinkham – 케어 매니지먼트 매니저 , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. 직접 또는 우편, 팩스 또는 이메일로 신고 할 수 있습니다. 불만 사항을 제기하는 데 도움이 필요하면 Jamie Pinkham – 케어 매니지먼트 매니저가 귀하를 도와 드릴 것입니다. 귀하는 미국 보건 복지부 민권 사무소에 민권 침해 신고서 (https://ocrportal.hhs.gov/ocr/portal/lobby)를 통해 전자 민원을 제출할 수 있습니다. .jsf 또는 우편 또는 전화로.

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Tagalog

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.

Northwestern Medical Center sa mga naaangkop na Pampederal na batas sa karapatang sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian. Ang NMC ay hindi nagtatangi ng mga tao o hindi nagpapakita ng ibang pakikitungo dahil sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.

Ang NMC ay:

Nagbibigay ng mga libreng tulong at serbisyo sa mga taong may kapansanan upang mahusay silang makipag-ugnayan sa amin, gaya ng:
- Mga kwalipikadong interpreter ng sign language
- Nakasulat na impormasyon sa iba pang mga format (malaking print, audio, mga naa-access na electronic na format, iba pang mga format)
Nagbibigay ng mga libreng serbisyo sa wika sa mga taong hindi Ingles ang pangunahing wika, gaya ng:
- Mga kwalipikadong interpreter
- Impormasyong nakasulat sa iba pang mga wika

Kung kailangan mo ng mga serbisyong ito, makipag-ugnayan sa Jamie Pinkham.

Kung naniniwala ka na Northwestern Medical Center ay nabigo upang magbigay ng mga serbisyo o discriminated sa ibang paraan sa batayan ng lahi, kulay, bansang pinagmulan, edad, kapansanan, o kasarian, maaari kang magsampa ng karaingan sa: Jamie Pinkham – Manager of Management Care , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Maaari kang magsampa ng karaingan sa tao o sa pamamagitan ng koreo, fax, o email. Kung kailangan mo ng tulong sa pag-file ng reklamo, Jamie Pinkham – Manager of Care Management ay magagamit upang makatulong sa iyo. Maaari mo ring magsampa ng civil complaint karapatan sa US Department of Health and Human Services, Office for Civil Rights, sa elektronikong paraan sa pamamagitan ng Office for Civil Rights Complaint Portal, na makukuha sa https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, o sa pamamagitan ng koreo o telepono sa:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Русский (Russian)

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.

Northwestern Medical Center соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола. NMC не исключает людей и не относится к ним по-разному из-за расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола.

NMC:

Для эффективного взаимодействия предоставляет безвозмездную помощь и оказывает услуги людям с ограниченными возможностями, а именно:
- услуги квалифицированных сурдопереводчиков;
- письменную информацию в других форматах (крупный шрифт, аудио формат, доступные электронные форматы, прочие форматы).
Предоставляет бесплатные услуги перевода людям, для которых английский не является основным языком, а именно:
- услуги квалифицированных переводчиков;
- письменную информацию на других языках.

Если вам нужны эти услуги, обратитесь к Саре Джемли.

Если вы считаете, что Северо-западный медицинский центр не смог предоставить эти услуги или подвергся другой дискриминации по признаку расы, цвета кожи, национального происхождения, возраста, инвалидности или пола, вы можете подать жалобу в отношении: Сары Джемли – , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Вы можете подать жалобу лично или по почте, факсу или электронной почте. Если вам нужна помощь в подаче жалобы, Сара Джемли (Jamie Pinkham) – менеджер по уходу за пациентами поможет вам. Вы также можете подать жалобу о нарушении гражданских прав в Департамент здравоохранения и социальных служб США, Управление по гражданским правам, в электронном виде через портал для подачи жалоб в отношении гражданских прав, доступный по адресу https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, или по почте или по телефону:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

العربية (Arabic)

تنبيه: إذا كنت تتحدث الإسبانية ، فلديك خدمات مساعدة لغوية مجانية.

يتوافق مركز Northwestern Medical Center مع قوانين الحقوق المدنية الفيدرالية المعمول بها ولا يميز على أساس العرق أو اللون أو الجنسية أو العمر أو الإعاقة أو الجنس. لا يستبعد مركز نورث وسترن الطبي الناس أو يعاملهم بشكل مختلف بسبب العرق أو اللون أو الجنسية أو العمر أو الإعاقة أو النس.

المركز الطبي الشمالي الغربي:

يوفر المساعدة والخدمات المجانية للأشخاص ذوي الإعاقة للتواصل معنا بشكل فعال ، مثل ما يلي:
- تدريب مترجمي لغة الإشارة.
- المعلومات المكتوبة بتنسيقات أخرى (طباعة كبيرة ، صوت ، تنسيقات إلكترونية يمكن الوصول إليها ، تنسيقات أخرى).
يوفر خدمات لغة مجانية للأشخاص الذين ليست لغتهم الأم هي الإنجليزية ، مثل ما يلي:
- المترجمين الفوريين المدربين.
- معلومات مكتوبة بلغات أخرى.

إذا كنت بحاجة إلى تلقي هذه الخدمات ، فاتصل بـ Jamie Pinkham.

إذا كنت تعتقد أن Northwestern Medical Center لم يقدم هذه الخدمات أو تميز ضدك بأي طريقة أخرى على أساس العرق أو اللون أو الجنسية أو العمر أو الإعاقة أو الجنس ، فيمكنك تقديم شكوى إلى الشخص التالي: Jamie Pinkham -Manager of Care Management, 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191 ، jpinkham@nmcinc.org. يمكنك تقديم المطالبة شخصيا أو عن طريق البريد أو الفاكس أو البريد الإلكتروني. إذا كنت بحاجة إلى مساعدة للقيام بذلك ، فستطلب من جان سودر – مدير إدارة الرعاية – تحت تصرفك تقديم ذلك. يمكنك أيضًا تقديم مطالبة بالحقوق المدنية لدى مكتب الحقوق المدنية التابع لوزارة الصحة والخدمات الإنسانية الأمريكية. U.S. إلكترونيًا عبر بوابة شكاوى مكتب الحقوق المدنية ، وهي متاحة على الموقع https://ocrportal.hhs.gov/ocr/portal/lobby.jsf ، أو بالبريد على العنوان التالي أو عبر الهاتف على الأرقام المدرجة أدناه:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Kreyòl Ayisyen (Haitian Creole)

ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou.

Northwestern Medical Center konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. NMC pa ekskli moun oswa trete yo nan fason ki diferan akoz ras, koulè, peyi orijin, laj, enfimite oswa sèks yo.

NMC:

Bay èd ak sèvis gratis pou moun ki andikape pou yo kominike avèk nou nan fason ki efikas, tankou:
- Enèprèt langaj siy ki kalifye
- Enfòmasyon ekri nan lòt fòma (gwo lèt, odyo, fòma elektwonik ki aksesib, lòt fòma)
Bay sèvis lang gratis a moun lang prensipal yo pa Anglè, tankou:
- Enèprèt kalifye
- Enfòmasyon ki ekri nan lòt lang

Si ou bezwen sèvis sa yo, kontakte Jamie Pinkham.

Si ou kwè ke Northwestern Medical Center te echwe pou pou bay sèvis sa yo oswa fè diskriminasyon nan yon lòt fason sou baz ras, koulè, orijin nasyonal, laj, andikap, oswa sèks, ou ka depoze yon plent ak: Jamie Pinkham – Manadjè nan Jesyon Swen , 133 Fairfield Street, St Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Ou ka depoze yon plent an pèsòn oswa pa lapòs, faks, oswa voye yon imèl. Si w bezwen èd ranpli yon plent, Jamie Pinkham – Manadjè nan Jesyon Swen se disponib nan ede ou. Ou kapab tou pote yon plent dwa sivil ak US Department of Sante ak Sèvis Imen, Biwo pou Dwa Sivil, elektwonikman nan Biwo pou Dwa Sivil Plent Portal, ki disponib nan https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, oswa pa lapòs oswa telefòn nan:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Français (French)

ATTENTION: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement.

Northwestern Medical Center respecte les lois fédérales en vigueur relatives aux droits civiques et ne pratique aucune discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou un handicap. NMC n’exclut et ne traite aucune personne différemment en raison de sa race, sa couleur de peau, son origine nationale, son âge, son sexe ou son handicap.

NMC:

Fournit gratuitement des aides et services aux personnes handicapées afin de permettre une communication efficace avec nous, par exemple:
- Interprètes qualifiés en langue des signes
- Informations écrites dans d’autres formats (gros caractères, audio, formats électroniques accessibles, autres formats)
Fournit gratuitement des services linguistiques aux personnes dont la langue principale n’est pas l’anglais, par exemple:
- Interprètes qualifiés
- Informations écrites dans d’autres langues

Si vous avez besoin de ces services, contactez Jamie Pinkham.

Si vous pensez que NMC n’a pas fourni ces services ou a fait preuve d’une autre forme de discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou le handicap, vous pouvez déposer une réclamation auprès de : Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Vous pouvez déposer une réclamation en personne ou par courrier, télécopie ou e-mail. Si vous avez besoin d’aide pour déposer une réclamation Jamie Pinkham – Manager of Care Management se tient à votre disposition pour vous y aider. Vous pouvez également déposer une réclamation concernant vos droits civiques auprès de l’U.S. Department of Health and Human Services (Département de la Santé et des Services Sociaux des États-Unis), Office for Civil Rights (Bureau des Droits Civiques), par voie électronique via l’Office for Civil Rights Complaint Portal, disponible à l’adresse https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, par courrier ou par téléphone à :

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Polski (Polish)

UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej.

Northwestern Medical Center postępuje zgodnie z obowiązującymi federalnymi prawami obywatelskimi i nie dopuszcza się dyskryminacji ze względu na rasę, kolor skóry, pochodzenie, wiek, niepełnosprawność bądź płeć. NMC nie wyklucza żadnych osób i nie stosuje różnego traktowania ze względu na rasę, kolor skóry, pochodzenie, wiek, niepełnosprawność bądź płeć.

NMC:

Zapewnia bezpłatną pomoc i usługi osobom niepełnosprawnym w celu umożliwienia skutecznej komunikacji, na przykład:
- Wykwalifikowanych tłumaczy języka migowego
- Informacje na piśmie w różnych formatach (duży druk, audio, dostępne formaty elektroniczne, inne formaty)
Zapewnia bezpłatne usługi językowe dla osób, dla których angielski nie jest pierwszym językiem, na przykład:
- Wykwalifikowanych tłumaczy
- Informacje na piśmie w innych językach

Jeśli potrzebujesz tych usług, skontaktuj się z Jamie Pinkham.

Jeśli uważasz, że Northwestern Medical Center nie świadczy tych usług lub dyskryminuje w inny sposób ze względu na rasę, kolor skóry, pochodzenie krajowe, wiek, niepełnosprawność lub płeć, możesz złożyć skargę: Jamie Pinkham – menedżer ds. Opieki , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Możesz złożyć skargę osobiście lub pocztą, faksem lub pocztą elektroniczną. Jeśli potrzebujesz pomocy zgłaszającej skargę, możesz pomóc Jamie Pinkham- menedżer ds. Zarządzania. Możesz także złożyć skargę o naruszenie praw obywatelskich z amerykańskim Departamentem Zdrowia i Opieki Społecznej, Biurem Praw Obywatelskich, drogą elektroniczną za pośrednictwem Biura ds. Skarg dotyczących naruszeń praw obywatelskich dostępnej pod adresem https://ocrportal.hhs.gov/ocr/portal/lobby .jsf lub pocztą lub telefonicznie pod adresem:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Português (Portuguese)

Northwestern Medical Center cumpre as leis de direitos civis federais aplicáveis e não exerce discriminação com base na raça, cor, nacionalidade, idade, deficiência ou sexo. NMC não exclui ou trata de forma diferente devido à raça, cor, nacionalidade, idade, deficiência ou sexo.

NMC:

Faculta ajuda e serviços gratuitos a pessoas com dificuldades de comunicar de forma eficaz connosco, tais como:
- Intérpretes de língua gestual qualificados
- Informação escrita noutros formatos (impressão maior, áudio, formatos electrónicos acessíveis, outros formatos)
Faculta serviços linguísticas grátis a pessoas cuja língua principal não é inglês, tais como:
- Intérpretes qualificados
- Informação escrita noutros idiomas

Se você precisar desses serviços, entre em contato com Jamie Pinkham.

Se você acredita que o Northwestern Medical Center não forneceu esses serviços ou discriminado de outra maneira com base em raça, cor, origem nacional, idade, deficiência ou sexo, você pode registrar uma queixa com: Jamie Pinkham- Gerente de Cuidado , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Você pode registrar uma queixa em pessoa ou por correio, fax ou e-mail. Se você precisar de ajuda para apresentar uma queixa, Jamie Pinkham- Gerente de Gerenciamento de Cuidados está disponível para ajudá-lo. Você também pode registrar uma queixa de direitos civis com o Departamento de Saúde e Serviços Humanos dos EUA, Office for Civil Rights, por meio eletrônico através do Office for Civil Rights Complaint Portal, disponível em https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, ou pelo correio ou telefone em:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Italiano (Italian)

ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti.

U.S. Department of Health and Human Services (HHS, Dipartimento statunitense per la salute e i servizi umani) è conforme a tutte le leggi federali vigenti in materia di diritti civili e non pone in essere discriminazioni sulla base di razza, colore, origine nazionale, età, disabilità o sesso. HHS non esclude le persone o le tratta diversamente a causa di razza, colore, origine nazionale, età, disabilità o sesso.

HHS:

Offre sostegni e servizi gratuiti alle persone affette da disabilità per comunicare con noi in modo efficace, quali:
- Interpreti qualificati nella lingua dei segni
- Informazioni scritte in altri formati (stampe a grandi caratteri, audio, formati elettronici accessibili, altri formati)
Offre servizi linguistici gratuiti alle persone la cui lingua primaria non è l’inglese, quali:
- Interpreti qualificati
- Informazioni scritte in altre lingue

In caso si necessiti di tali servizi, contattare Jamie Pinkham.

In caso si ritenga che Northwestern Medical Center non abbia offerto tali servizi o abbia posto in essere discriminazioni in altri modi sulla base di razza, colore, origine nazionale, età, disabilità o sesso, è possibile presentare una vertenza a Jamie Pinkham- Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. È possibile presentare una vertenza di persona o a mezzo posta, fax oppure e-mail. In caso si necessiti di aiuto per la presentazione della vertenza, Jamie Pinkham – Manager of Care Management è disponibile a fornire assistenza. È altresì possibile presentare un reclamo per i diritti civili allo U.S. Department of Health and Human Services (Dipartimento statunitense per la salute e i servizi umani), Office for Civil Rights (Ufficio per i diritti civili), elettronicamente mediante il Office for Civil Rights Complaint Portal, disponibile all’indirizzo https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, oppure a mezzo posta o telefono all’attenzione di:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Deutsch (German)

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.

Northwestern Medical Center erfüllt geltenden bundesstaatliche Menschenrechtsgesetze und lehnt jegliche Diskriminierung aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab. lehnt den Ausschluss oder die unterschiedliche Behandlung von Menschen aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab.

NMC:

Bietet kostenlose Hilfe und Dienstleistungen für Menschen mit Behinderung zur effektiven Kommunikation, wie z. B.:
- Qualifizierte Gebärdensprachen-Dolmetscher
- Schriftliche Informationen in anderen Formaten (große Ausdrucke, Audio, zugängliche elektronische Formate, sonstige Formate)
Bietet kostenlose Sprachdienste für Menschen, deren Hauptsprache nicht Englisch ist, wie z. B.:
- Qualifizierte Dolmetscher
- Schriftliche Informationen in anderen Sprachen

Sprachen Sollten Sie diese Dienstleistungen benötigen, so wenden Sie sich an Jamie Pinkham.

Sollten Sie der Ansicht sein, dass Northwestern Medical Center es versäumte, diese Dienstleistungen anzubieten, oder auf sonstige Weise aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht diskriminierte, so können Sie eine Beschwerde einreichen bei: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Sie können eine Beschwerde persönlich oder per Post, Fax oder E-Mail einreichen. Sollten Sie Hilfe beim Einreichen einer Beschwerde benötigen, so steht Ihnen Jamie Pinkham – Manager of Care Management gerne zur Verfügung. Sie können ebenfalls eine Menschenrechtsbeschwerde einreichen bei: Department of Health and Human Services (U.S.-Gesundheitsministerium), Office for Civil Rights (Amt für Bürgerrechte), elektronisch über das Office for Civil Rights Complaint Portal, zugänglich über https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, oder per Post oder telefonisch an:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

日本語(Japanese)

注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。

Northwestern Medical Center は適用される連邦公民権法を遵守し、人種、肌の色、出身国、年齢、障害、または性別に基づく差別をいたしません。HHS は人種、肌の色、出身国、年齢、障害、または性別を理由として人を排除したり、異なる扱いをいたしません。

NMC:

効果的にコミュニケーションを図るため、障害のある人に以下の支援やサポートを無料で提供いたします。
- 資格ある手話通訳者
- その他形式の文字情報（大きな活字、音声信号、手軽な電子形式、その他）
英語を母語としない人へ以下の言語サービスを無料で提供いたします。
- 資格ある通訳者
- 英語以外の言語で書かれた情報

これらのサービスが必要な場合は、Jamie Pinkham にお問い合わせください。

ノースウェスタン医療センターが人種、色、国籍、年齢、身体障害、または性別に基づいてこれらのサービスの提供に失敗したり、別の方法で差別を犯したと思われる場合は、次のような苦情を申し立てることができます：Jamie Pinkham- 、133 Fairfield Street、St. Albans、VT、05401、802-524-5911、800-253-0191、jpinkham@nmcinc.org。あなたは苦情を直接、郵便、ファックス、または電子メールで提出することができます。あなたが苦情を申し立てるのを助ける必要がある場合は、Jamie Pinkham – Care Managementのマネージャーがあなたを助けるために利用可能です。また、米国保健福祉省、民間人権局に民事訴状を提出することもできます（https://ocrportal.hhs.gov/ocr/portal/lobbyにある公民権告訴局向けに電子的に申し立ててください）。 .jsf、またはメールまたは電話で：

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

فارسی (Farsi)

توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با .1-877-696-6775 تماس بگیرید

Northwestern Medical Center از قوانین حقوق مدنی فدرال مربوطه تبعیت می کند و هیچگونه تبعیضی بر اساس نژاد، رنگ پوست، اصلیت ملیتی، سن، ناتوانی یا جنسیت افراد قایل نمی شود.

NMC بر اساس نژاد، رنگ پوست، اصلیت ملیتی، سن، ناتوانی یا جنسیت افراد ایشان را از خدمات محروم نمی کند و با آنها برخورد متفاوتی ندارد.

:NMC

برای افرادی که ناتوانی دارند، برای برقرار کردن ارتباط موثر، کمک هایی بطور رایگان فراهم می کند، مانند:
- مترجمین واجد شرایط زبان اشاره
- اطلاعات نوشتاری به فرمت های دیگر (چاپ با حروف درشت، صوتی، فرمت های الکترونیک قابل دسترسی ساده، و فرمت های دیگر)
برای افرادی که زبان اولیه شان انگلیسی نیست خدمات زبانی رایگان ارایه می کند، مانند:
- مترجمین شفاهی واجد شرایط
- اطلاعات نوشتاری به زبانهای دیگر

اگر شما نیاز به این خدمات، با سارا تماس Pinkham.

اگر فکر می کنید که مرکز پزشکی نورث وسترن موفق به ارائه این خدمات و یا تبعیض در راه دیگری بر اساس نژاد، رنگ پوست، ملیت، سن، معلولیت و یا رابطه جنسی، شما می توانید یک شکایت با فایل: سارا Pinkham- مدیر مدیریت خدمات ، 133 فیرفیلد خیابان، سنت آلبانز، VT، 05401، 802-524-5911، 800-253-0191، jpinkham@nmcinc.org. شما می توانید یک شکایت در شخص و یا از طریق پست، فکس و یا ایمیل کنید. اگر شما نیاز به کمک پر کردن شکایت، سارا Pinkham- مدیر مدیریت مراقبت های موجود به شما کمک کند. شما همچنین می توانید شکایت حقوق مدنی با وزارت بهداشت و خدمات انسانی، دفتر حقوق مدنی در https://ocrportal.hhs.gov/ocr/portal/lobby فایل، به صورت الکترونیکی از طریق دفتر برای شکایت حقوق مدنی پورتال، در دسترس .jsf، یا از طریق پست و یا تلفن در:

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

Oroomiffa/Cushite

XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama.

Northwestern Medical Center seera hawwaasummaa Feederaalaan kan wal simu ta’ee sanyii, bifa, dhiigaan, uumriidhaan, yookiin koorniyaadhaan kan wal hin loognee dha. Northwestern Medical Center namoota yookiin sanyii sanyiidhaan, bifaan, dhiigaan, umriidhaan, hir’ina qaamaan yookiin koorniyaadhaan adda hin baasu.

Northwestern Medical Center :

•Namootni hir’ina garaagaraa qaban bifa gaarii ta’een nu waliin haasa’uu akka danda’aniif deeggarsa fi tajaajila tolaa kennaafii, kanneen akka:

○ Namoota afaan mallattoo haalaan hiikkuu danda’an

○ Odeeffannoo barreeffamaa foormaatii adda ta’een (barreeffama guddaadhaan, sagaleedhaan, foormaatii eleektirooniksii argamuu danda’uun, foormaatii biroo)

•Namoota afaan dhalootaa isaanii afaan Ingiliffaa hin taaneef tajaajila afaanii tolaa dhiheessuufi, kanneen akkaL:

○ Warra dandeettii afaan hiikuu gahaa ta’e qaban

○ Odeeffannoo afaanota birootiin barraahe

Tajaajila kana yoo barbaadde, Jamie Pinkham qunnamaa Kana yoo itti amante Northwestern Medical Center tajajila kana kennuudhaaf hin dandeenye yookiin tajaajila kana kennuu hin dandeenye yookiin sanyiidhaan ,bifaan, dhiigaan, umriidhaan, hiri’ina qaamaan, ykn koorniyaadhaanii fi kanneen birootiin looguu, komii keessan kanneen armaan gadiitiin dhiheessuu ni dandeessu: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Komii namaan, yookiin poostaadhaan, faaksiidhaan, yookiin e-mail dhaan dhiheessuu ni dandeessa. Komii guutuudhaaf gargaarsa yoo barbaadde Jamie Pinkham – Manager of Care Management si gargarudhaaf qophii dha. Komiiwwan mirga namoomaa U.S. Department of Health and Human Services (Kutaa Fayyaa fi Tajaajila Namoomaa U.S), Office for Civil Rights (Waajjira Mirga Hawwaasummaa) eleektirooniksiidhaan the Office for Civil Rights Complaint Portal, kunis kan argamu https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, ykn poostaadhaan yookiin bilbilaan :

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

1-800-868-1019, 800-537-7697 (TDD) Foormiin komiidhaa kan argamu http://www.hhs.gov/ocr/office/file/index.html irratti dha.