BY JEREMY PEPPAS

George Newbern

St. Vincent might be a big city hospital, but its intensivist program feels more like a small-town hospital, and that's by design.

"I'd agree with that," Dr. Clifton Johnson, the assistant director of the intensivist program, said. "It is the same team of people treating patients, and we spend all our time working in the ICU."

The ICU at St. Vincent consists of 20 beds, taking up just a tiny fraction of the 615-bed facility, but the unit occupies a sunny corner of the hospital. Almost all of the beds have large windows that face west to the traffic on University and north to Markham.

The intensivist team is large and draws from all areas of the hospital. On one weekday morning, 11 people gathered at 9 a.m. as they prepared to make rounds. The group was led by Johnson, the assistant director, and he was joined by staff from the pharmacy, social work, respiratory therapy and several nurses — some walked with the group; others came and went from the unit's two desks. It's the same nurses, the same physicians, and the same group of therapists each morning. The familiarity they have with each other and their patients is obvious. Every hospital has its regulars and the staff knows the familiar faces. One patient, who was admitted during the night, "didn't stay in this room the last time he was here," said one staff member, pointing to a room four doors down. "He was here, what, three months ago, and he was down the hall in this room."

"That's the advantage," intensivist program coordinator Lesa Zarin, RN, said. "We know the histories, the families, we know these patients." The program, when it was started in February 2005, had some specific goals: to decrease ventilator-associated pneumonia, to increase stress ulcer prophylaxis, to increase DVT prophylaxis and to decrease central line associated bloodstream infection.

The unit's ultimate goal of decreasing the length of stay for the patients in the ICU and also lowering their mortality rate appears to be working.

"We are seeing better and better results," Johnson said. "That's what we have been working toward, and we are starting to see things like length of stay go down." The team will also initiate referrals to palliative care and hospice, if the patient needs it. The morning rounds even include an RN from Arkansas Hospice to advise the team. Zarin said that average daily census in the ICU was 18, or right at 90 percent of capacity. "It's nice," Johnson said. "We are always here. I don't have a clinic that I run back and forth to. My job is here and in the hospital. It's a real advantage for the patients."



In Other News

Dr. Gordon Newbern made his television debut on Halloween. "Well, of sorts," Newbern said, with a laugh. Newbern, an orthopedic surgeon with Arkansas Specialty Care Centers, performed a hip replacement live on closed-circuit television for about 150 people who had gathered to watch in the auditorium on the St. Vincent campus. The event was free to public. Among the crowd were prospective patients and students from the radiology program at St. Vincent and the physician assistant school at Harding University in Searcy. This was Newbern's first time to do a surgery live. "It was interesting," Newbern said. "It wasn't like when Lowry [Barnes, another orthopedic surgeon] had done the knees. The hip is a little more difficult to work around. It doesn't lend itself to working in front of the camera, as I'm sure you saw."

It is true that Newbern didn't get much face time in front of the camera, unlike his actor brother, George Newbern, who starred in "Father of the Bride" with Steve Martin. The surgeon's face was covered in what he called a "space hood" to keep the operating room sterile and free of debris. "I'm glad that people were able to come and see this," Newbern said. "I thought it was really good that the hospital does this." And people who didn't come out to see the surgery for fear of seeing blood would have been sadly mistaken. The procedure was less gory than almost anything on the Discovery Channel or an average episode of "Nip/Tuck."



December 2006