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Joanne's Journal - Thursday, October 5, 2017

Joanne's Journal - Thursday, October 5, 2017

Dear D-H Colleagues,

It is frightening how many natural and manmade disasters have affected our country and institution over such a short period of time. We have had hurricanes and floods in Houston, Florida and Puerto Rico, and violence in our own backyard, as well as the recent incident in Las Vegas. We as an institution want to channel our employees’ desire to help in these situations in a thoughtful way that result in real impact. Our experience in the Haiti relief effort taught us that logistics and infrastructure on the ground are critically important for aid to have its desired results. 

We have had an outpouring of genuine concern across the Dartmouth-Hitchcock (D-H) system the last few days for the welfare of those in Puerto Rico affected by Hurricane Maria. Many are asking about giving monetary support, sending medical supplies and food, or helping through other volunteer efforts. However, the issues on the ground in Puerto Rico that are impeding distribution of food, water and supplies are daunting.

Our senior leadership team has been monitoring the situation as it unfolded over this past weekend. Dr. Maria Padin, our Chief Medical Officer for DHMC, has contacts on the island and has been leading the discussion of support efforts. She has been in touch with multiple organizations and agencies to evaluate the best way for the D-H community to effectively offer our support – both in the near-term and in the long-term. Our current thinking is that we will focus more on the second phase of relief efforts since the immediate response to residents of Puerto Rico is already underway.

There are several ways we are engaging in the relief efforts:

  • Sending Supplies: We are working with contacts at some of the hospitals in Puerto Rico to ascertain their needs for medical and pharmaceutical supplies. Once we have a better understanding of what they require, we will be working through our Pharmacy and Supply Chain leadership to send supplies directly to their locations.
  • Collection of Needed Items: We are working on a way to collect needed items, such as non-perishable food, clothing and water, so that D-H staff at all of our locations can donate these items that will be directly sent to the relief organizations that are already present in Puerto Rico. We will provide more details on how to donate once the storage locations are determined.
  • Community Collaboration: We are in conversations with the Upper Valley Hurricane Maria Relief Group, as well as Dartmouth College and the Geisel School of Medicine to coordinate other relief efforts to focus on the immediate needs as well as long-term recovery endeavors.
  • Monetary Support: We are evaluating the best way for D-H and our affiliates to participate if they want to contribute monetary support that will be targeted for designated needs determined by our contacts in Puerto Rico. More details on where and how to contribute will be forthcoming. 

Every day, I see the generous spirit of D-H staff and clinicians (see the story included in this edition of the e-newsletter below) who want nothing more than to lend a helping hand or give a donation to support those most in need. For that, I want to thank you all for not only doing what you do every day for our patients, but for continuing to go above and beyond.

D-H in the World: D-H Employees Respond Following Record-Breaking Atlantic Hurricane Season

Dr. Tim Burdick, left, arrives in Key West, Florida

Dr. Tim Burdick, left, arrives in Key West, Florida.

September marked the most active month for Atlantic hurricanes ever recorded. Millions in the Caribbean continue to be without power, communications and clean water. People are in desperate need of help, and D-H employees have stepped up. While there are many D-H staff who have contributed to relief efforts, here are a few examples of our dedicated team members.

Currently, Wes Miller, Safety and Occupational Health Specialist for the southern region, is in La Fremina, Puerto Rico. Miller is putting his emergency management training to use, distributing water and food as part of a response team for the American Red Cross. His team removed many downed power lines while driving to an orphanage to deliver supplies.

Tim Burdick, MD, associate medical director of Primary Care at D-H Manchester, flew from Orlando to Key West after Hurricane Irma in a C-130 aircraft, loaded with gear and supplies. Burdick traveled as part of the National Disaster Medical System. When they arrived, the local hospital had one physician and six nurses – all who had worked for 60 hours without a break. Burdick was in Key West for over a week without power and water. His team consisted of 30 people, who set up portable hospitals and treated about 60 patients per day. Burdick said with so many in need of help, he will probably deploy to Puerto Rico in a couple of weeks.

John Hinds, operations manager of DHART, deployed to Marathon, Florida, where Fisherman’s Hospital was damaged and unusable. His team was directed to set up base behind the City Hall in a parking lot. They provided urgent and emergency care services for adult and pediatric patients. Hinds and his team spent 13 days in Marathon caring for 711 patients. The average temperature those days was around 95 to 98 degrees, with a heat index of 124 degrees. “The area was destroyed, the temperature hot, the resources scarce and the people grateful. We do it for them,” Hinds said.

In the Wake of Violence: A Message from Rev. Frank Mächt

Reverend Frank Macht, Director D-H Chaplaincy

Rev. Frank Mächt, Director of Dartmouth-Hitchcock's Chaplaincy Program.

As director of Dartmouth-Hitchcock’s (D-H’s) Chaplaincy Program, Rev. Frank Mächt has been spending time, providing comfort and ministering to D-H staff on a daily basis for the last six years. In the wake of the incident that took place on September 12 at D-H, his role – and that of our chaplaincy staff – have been an essential part of the collective healing process for the organization. We invited Rev. Mächt to offer some reflections in the wake of this tragedy.

When patients are entrusted into our care, it is our top priority to keep them safe. ‘First, do no harm’ is a guiding principle that is instilled in physicians and health care workers of various disciplines from the very beginning of our training. Every day, we work hard to create a safe environment so that healing can take place.

Read the full story here.

Patient Experience Moment: A Life-Saving Transfer of Care

John Gemery, MD, Mark Franklin, MD, and Arifa Toor, MD

Photo - From left: John Gemery, MD, Mark Franklin, MD, and Arifa Toor, MD.

Over the Labor Day weekend, while on call at St. Joseph Hospital in Nashua, Dartmouth-Hitchcock (D-H) Gastroenterologist and Medical Director of D-H Nashua Timothy D. Scherer, MD, experienced first-hand the “benefits of being part of a system,” when one of his critically-ill patients was transferred to Dartmouth-Hitchcock Medical Center (DHMC).

“Had he stayed in Nashua, he would have died. There’s no question; St. Joseph’s does not have the tertiary services,” Scherer says of his 66-year-old patient who was suffering from a gastric variceal bleed. “Most of the issues we can deal with here in Nashua. But this time we needed help, and we got great help because of the ease of use of the Transfer Center [at DHMC] and good communication with my colleagues. It was a good exercise in working as a system, with interdisciplinary care and collegiality, all in the effort of taking care of a patient. It was great, and I was very proud to be part of D-H.”

Scherer, Intensivist Mark Franklin, MD, who was the attending on call in DHMC’s Intensive Care Unit (ICU), Gastroenterologist Arifa Toor, MD, and Interventional Radiologist John Gemery, MD, talked with D-H Today about that day.

Read the full story here.

Facebook Live Session with Dr. Joanne Conroy on Oct. 19

As the new CEO and President of Dartmouth-Hitchcock (D-H), Dr. Joanne Conroy has been meeting employees at all D-H sites, including affiliates, as well as meeting with community members around the state. For those who have not had a chance to meet her yet, you will have an opportunity through Facebook Live on Thursday, October 19, from 12 noon to 1 pm. Dr. Conroy will talk about her first two months at D-H, what her observations have been so far and what she hopes for the future for D-H staff, patients and for the health care of our region and beyond.

For those who want to tune in, just go to the D-H Facebook page at the above time. You will need to have a personal Facebook profile in order to comment on or share the video, but can view the D-H Facebook page even if you are not logged in. If you already "like" the D-H page and are logged in to your Facebook account, you are likely to see a notification pop up to let you know that we are live. Questions can be submitted in advance to

Team Up, Take Action: Partnering for Health Equity


Camara P. Jones, MD, MPH, PhD

Dartmouth-Hitchcock is partnering with the Vermont and New Hampshire Public Health Associations to present a thorough and thoughtful day-long conference to explore the many factors that either enable or interfere with addressing conditions leading to health inequity. The Team Up, Take Action Health Equity Conference/Schumann Lecture will be held on November 15, 8:30 am to 5:30 pm, at the Hanover Inn, Hanover, NH.

Presenters and breakout sessions will delve into identifying key levers such as policy, system and environmental changes, types of partnerships and relationships and other elements needed to be successful in advancing health equity. By targeting our work to produce the greatest health benefits for disadvantaged groups, ultimately, all our communities benefit.

Health equity means that everyone has the chance to be as healthy as possible. Health equity means reducing and eliminating disparities in health and its determinants that adversely affect excluded or marginalized groups. Health equity is inextricably linked with opportunity. It requires addressing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care. Health equity is fundamental to building a vibrant society because of its practical, economic and civic implications and impact on individuals living a good life.

Conference break-out sessions will pertain to:

  • Organizational capacity and infrastructure to advance health equity
  • Collecting and using data to advance health equity
  • Growing strategic community partners to advance health equity
  • Health Equity in practice

Keynote Speakers:

Opening Speaker: Dr. James Weinstein, former CEO and President of Dartmouth-Hitchcock
Dr. Weinstein chaired the Committee on Community-Based Solutions to Promote Health Equity in the United States for the National Academy of Sciences that produced the report Communities in Action: Pathways to Health Equity published January 2017.

Schumann Lecturer (4:00-5:30 PM): Camara P. Jones, MD, MPH, PhD, family physician, epidemiologist, and former President of the American Public Health Association. Her work focuses on the impacts of racism on the health and well-being of the nation. She seeks to broaden the national health debate to include not only universal access to high- quality health care, but also attention to the social determinants of health (including poverty) and the social determinants of equity (including racism).

For more information and to register for this conference.