HealthFocus Fall 2023

The role of a PCP in managing your healthcare needs

By Dr. Danielle Giddins

A primary care provider (PCP) serves as the “quarterback” of your healthcare team to help you manage your health needs and navigate the healthcare system; they provide preventative care and manage acute and chronic illnesses, both physical and mental. They will help you determine what testing or screenings you should have based on your age, sex, past and family history. They can also provide you with personalized guidance on the steps you can take to improve or maintain your health, such as a specific diet, regular physical activity goals, getting adequate sleep and managing your stress levels. These things can have a huge impact on your overall wellness and lifespan.

A PCP will also help to coordinate the medical care you need and empower you to take control of your health. This may include any laboratory or medical testing that is needed, along with seeing specific specialists to help manage any chronic diseases. Some patients need a team approach to help them be successful in taking care of themselves. Your team may include a medical doctor, surgeon, nurse practitioner and a physician assistant. There are also non-physicians that may be of help such as a dietician, a nurse, a health coach, a therapist or counselor; your primary care provider will ensure continuity of care.

Lastly, one of the best benefits of having a PCP is better health outcomes. Working together with your provider over time to prevent illness, manage acute and chronic diseases — and to engage more care team members when needed — will lead to a healthier life. Therefore, it is important to establish care with a local provider and take control of your health and wellness.

If you are in need of a PCP, TidalHealth has providers in locations throughout Delmarva, many of whom are even available without leaving your home through telemedicine.

This year was indeed a remarkable one for our health system. We faced unprecedented challenges with unwavering dedication, commitment, and resilience.

Our vision to be the trusted leader in health and wellness, providing world-class care while building healthier communities for generations to come, remains steadfast. To achieve this vision, we have outlined three driving strategies: access, effectiveness, and engagement. These strategies are our guiding stars, illuminating our path toward excellence and the accomplishment of our vision.

As part of our strategic plan, we develop an annual operating plan that emphasizes key priorities for the fiscal year. Each year, we adjust and move the goals forward. Each entity within TidalHealth develops its own annual operating plan that aligns with the health system’s plan, and goals are cascaded to all leaders and team members. The focus this year will be:

• Primary care: Strengthening our primary care services is foundational to our mission. We aim to be the cornerstone of healthcare in our communities, providing accessible and comprehensive care to all.
• Surgical volumes in Seaford: We’re dedicated to enhancing our specialty services in this region to cater to the diverse healthcare needs of our community.
• Diversity and inclusion: Our commitment to diversity and inclusion is unwavering. We believe in a healthcare ecosystem that mirrors the rich tapestry of the communities we serve.
• Margin: Fiscal responsibility is essential to sustain and grow our mission. We will continue to work diligently to ensure the financial health of our organization.
• Quality: Quality care is at the heart of our mission. We will relentlessly pursue excellence in every aspect of our service, ensuring that our patients receive the best care possible.
• Experience and engagement: A positive patient experience and engagement with our team members are integral to our success. We will focus on creating an environment that fosters trust and satisfaction.

Our shared values and mission are the cornerstone of our organization, binding us together across all locations. It is this unity that makes TidalHealth a remarkable place to work and receive care.

Let us not forget our commitment to staying local for care. We are a complex system with a regional presence, allowing us to provide the right care in the right locations for our communities. This is a testament to our dedication to serving our neighbors, friends, and families.

As we look ahead, I am excited about the opportunities and challenges that await us. We will continue to build upon our strengths and embrace innovation to further enhance the quality of care we provide.

I want to reiterate how proud I am to lead this incredible team, and I am confident that, with your support and dedication, we will achieve even greater success in the coming year.

Fiscal year 2023 by the numbers

• 422 licensed beds
• 20,386 adult admissions
• 91,628 actual days of care
• 4.49 average length of stay (days)
• 109,168 emergency department visits
• 591,479 outpatient visits
• 6,298 outpatient observations
• 2,776 babies delivered
• 23,289 total surgical procedures
• 705,817 physician office visits
• $44,739,423 total community benefit
• 2,318 nominations to honor TidalHealth team members that include peer-to-peer Values in Action entries, manager to team Member entries, the Daisy RN Award, Sunshine CNA Award and Team Members of the Quarter.

Garage A accident and repair

One of the biggest stories of 2023 on our Salisbury campus had nothing to do with patient care, but had a huge impact on every team member. In January a driver, at a very high rate of speed, slammed into an outside wall of our staff parking garage, collapsing a section of the structure in the process.

The estimate was for the garage to be out of commission for the entire year, but with some determined and dedicated work, the garage reopened at the end of July with the damaged section completely rebuilt and some new safety and speed measures put into place to slow down traffic and make the garage safer for drivers and pedestrians.

Trauma bill signed

Legislation to address Maryland trauma centers’ long-range funding challenges, including TidalHealth, was signed into law this year by Governor Wes Moore in Annapolis. Signaling the importance of the legislation’s passage, TidalHealth leaders joined bill sponsors Senator Mary Beth Carozza (R-District 38) and Delegate Tom Hutchinson (R-District 37B) at the bill signing ceremony.

Trauma centers often require significant resources to operate effectively as they specialize in swiftly treating life-threatening conditions and promptly providing resuscitative care.

In 2003, the Maryland General Assembly created the Maryland Trauma Physician Services Fund to aid Maryland’s trauma system. In the 20 years that have passed, there has been no comprehensive review of this fund despite the industry growing and evolving. Many trauma centers in Maryland are experiencing funding challenges.

Dr. Trudy Hall appointed to trauma funding commission

Trudy Hall, MD, TidalHealth’s Senior Vice President of Medical Affairs & Chief Medical Officer, was named this summer to the newly formed Commission to Study Trauma Center Funding. Her appointment was made official by Laura Herrera Scott, MD, MPH, Secretary of the Maryland Department of Health.

Senate Bill 493 and House Bill 675, signed into law by Governor Wes Moore in May of this year, established the commission to examine the adequacy of trauma funding across the state for operating, capital, and workforce costs.

This commission to study trauma funding, which features a representative from each of the designated Level I, II, III and pediatric trauma centers in Maryland, is tasked with the goal of finding a permanent funding reimbursement solution.

YDI ownership

Your Doc’s In (YDI), the leader in urgent and immediate care on the Eastern Shore of Maryland, and TidalHealth announced a new collaboration with TidalHealth purchasing a 50 percent share of the Your Doc’s In franchise. Peninsula Health Ventures, an existing company of TidalHealth, is providing administrative oversight for the 50/50 partnership.

As part of the agreement, the urgent care practices will continue to operate under the Your Doc’s In brand, and Walter Gianelle, MD, will remain as the corporation’s CEO and Medical Director. The outstanding and existing team of Your Doc’s In providers and support staff will still handle the day-to-day care.

Additionally, in 2023, Dr. Sarah Arnett was named President of YDI and Steve Tracy was named President of Peninsula Health Ventures.

Giddins named Chief Wellness Officer

Danielle Giddins, MD, was appointed to the position of Chief Wellness Officer for the health system this fiscal year. In her new role, Dr. Giddins assumed the lead for the promotion and support of the overall health and well-being of all TidalHealth team members, including its medical staff and healthcare professionals.

The Chief Wellness Officer is responsible for evaluating the current culture, identifying workplace opportunities and programs and designing an organization-wide strategy to increase the personal and professional health and wellness of team members. A key goal is to help reduce burnout and increase professional fulfillment of healthcare providers.

Angela Brittingham named Chief Nursing Executive

Angela (Angie) Brittingham, MSN, RN, CEN, CPEN, NEA-BC, CPHQ, was named the health system’s Chief Nursing Executive (CNE) in March. Brittingham was selected after the completion of a national search.

In her new role, Brittingham leads the professional practice of nursing across the health system, including at the Salisbury hospital, at the 99-bed TidalHealth Nanticoke hospital in Seaford, Del and at Chesapeake Cove Assisted Living and at Alice B. Tawes Nursing and Rehabilitation, both located in Crisfield, Md.

Sheets named Corporate Compliance Officer

At its annual meeting in October 2022, the TidalHealth Board of Trustees affirmed the transition of the Corporate Compliance Officer role from Timothy Feist, MBA, CHC, Vice President of Ambulatory Services, to Debra Sheets, DNP, RN, CPHQ, NEA-BC, CHC, Vice President of Organizational Effectiveness.

The transition is part of TidalHealth’s ongoing work in aligning services and functions across the health system. Dr. Sheets has been with TidalHealth since 2008 and supports the areas of regulatory compliance, patient safety/risk management and performance improvement for the health system.

Weisman VP of Information Technology

Mark Weisman, MD, MBA, was promoted to Vice President of Information Technology/CMIO & CIO late in 2022.

Dr. Weisman, who joined TidalHealth in 2018 as its Chief Medical Information Officer (CMIO), has also been servings as the health system’s Chief Information Officer (CIO) at the Senior Director level since 2021.

Dr. Weisman, an internal medicine specialist, has extensive experience in advancing clinical and technological opportunities to improve quality of care, cost effectiveness and to reduce waste and unnecessary workload. He has had numerous leadership roles in clinical management, strategy and development, analytics, and informatics.

Gary named CFO

Dr. Steve Leonard, President/CEO of TidalHealth, announced the promotion of Stephanie Gary, CPA, MBA, FACHE, Vice President of Finance, to Vice President of Finance/Chief Financial Officer (CFO) for the health system in 2023.

Gary’s promotion followed the retirement of Bruce Ritchie, Senior Vice President of Finance/CFO, January 13 after 29 years in a financial leadership role at the health system; 18 of those as its Vice President.

Gary becomes only the third CFO in TidalHealth’s history, following Ritchie — who had been its CFO for the past 15 years — and Donald Durham, who was first to hold the title, until his retirement in 2007.

CNA Program graduates

The first group of seven students in TidalHealth’s new Certified Nursing Assistant (CNA) and Geriatric Nursing Assistant (GNA) program officially graduated last year.

All students were hired as full-time team members at TidalHealth, allowing them to earn an income while learning a skilled trade through the hybrid program.

The TidalHealth Nursing Assistant Program is a six-week educational plan, including 40 hours of clinical experience, where students are introduced to employment opportunities in the healthcare field. This educational plan incorporates knowledge and skills in medical terminology, communications, anatomy and physiology in disease processes and related procedures.

The program provides TidalHealth with a self-directed pipeline of CNA and GNA students and the ability to customize the experience relevant to their daily work environments. That results in better care for residents and patients.

Richard A. Henson Research Institute

Held its inaugural Research Symposium on June 16, 2023 for members of the medical staff, nursing staff, senior leadership, and the community. Ten internal medical residents and nine researchers supported by the Research Institute presented their research to symposium attendees.

Gopal Kowdley, MD/PhD and Robert Joyner, PhD, RRT, RRT-ACCS, FAARC have teamed up to develop a systematic literature review process and made it available to residents, medical students, university students and others.

The importance of conducting systematic reviews is two-fold: the participants gain valuable knowledge on how to investigate published literature and in the process become subject matter experts on a selected topic, and its provides the necessary background to support progressive studies that will have a direct impact on patients.

Cancer Care

The Salisbury Radiation Oncology department went live with new motion management software from Varian called “Identify.” The software uses a multi-camera tracking system to monitor patient motion during radiation therapy and assists in complex treatments like Deep Inspiration Breath Hold, or DIBH. DIBH is a technique used to reduce the amount of radiation that reaches the heart while patients are receiving treatment for breast cancer.

Our Breast Program earned NAPBC recertification in April 2023. NAPBC accredited programs follow a model for organizing and managing a breast program that facilitates multidisciplinary, integrated, and comprehensive breast disease and breast cancer services.

Orthopedics and Neurosciences

American Heart Association and American Stroke Association “Get With the Guildlines” Gold Plus Quality Achievement Award was presented to both TidalHealth Nanticoke and TidalHealth Peninsula Regional.

The bariatric program at TidalHealth Peninsula Regional was reaccredited by the American Society for Metabolic and Bariatric Surgery with zero deficiencies.

Ceribell (Rapid EEG stroke diagnostic tool) in place at both hospitals (Salisbury and Seaford) experienced a 21% growth over anticipated patient encounters.

Cardiac and Vascular Services

The first Electrophysiology procedure — an ablation case — was performed by Dr. Scott Kaufman at TidalHealth Nanticoke on July 27, 2023.

The Convergent procedure, a hybrid approach featuring electrophysiology and surgery for the treatment of atrial fibrillation, was performed in July.

The Joint Commission disease specific recertification survey for the Treatment of AMI (heart attack) was conducted in 2023 and awarded later that year.

Behavioral Health

August 1, 2023, marked the one-year anniversary of the TidalHealth Crisis Center, a year of rewards and accomplishments.

During the first year, we treated 1,288 patients and observed a 3.2% decrease in psychiatrist admission by meeting directly with patients within the community. During this time, the Crisis Center engaged other crisis services to coordinate care in the community in order to assist patents with wrap around or continuing and complete care.

The Crisis Center is open Monday through Sunday from 8 am to 8 pm and helps any individual with their personal mental health crisis. No appointments needed and all insurances are accepted.

Surgical Services

Implemented O-arm and stealth navigation for Neurosurgery (enhanced imaging and navigation for brain tumors).

Increased surgical volume to 4,311 cases in FY23.

Infection Prevention

Navigated the end of the COVID-19 public health emergency and helped guide the health system into a new normal.

Reduction of Hospital Onset Clostridoides difficile infections at both TidalHealth hospitals.

Maintaining CAUTI and CLABSI under predicted rates while transitioning into a teaching facility.

98% of staff at both hospitals were vaccinated for influenza.

Emergency Services

TidalHealth Peninsula Regional

• A base station redesignation survey that was used as an example throughout the state.
• Consistent EMS off-loading times about the 90th percentile.
• Decrease in the rate of patients who leave without treatment from last year with many throughput improvement initiatives.

TidalHealth Nanticoke

• Decrease in the rate of patients who leave without treatment from previous year with throughput improvement initiatives.
• Continued recognition as Level 3 trauma center for the state of Delaware.

TidalHealth McCready Pavilion

• Continued commitment to patients in Somerset County.
• Stabilization improvements for critical patients and trauma victims.

Women’s and Children’s Services

Implemented OB and Neonatal drills for TidalHealth Women's and Children's to foster team reliability for the early recognition of warning signs in maternal and neonatal complications.

In efforts to reduce maternal morbidity and mortality, we have begun using a new device, Jada, at both hospitals to provide control and treatment of abnormal postpartum uterine bleeding or hemorrhage through a conservative naturalistic approach. Maternal hemorrhage has accounted for 19% of maternal deaths worldwide in the United States and is the fourth leading cause of maternal mortality.

TidalHealth Foundation

The Foundation completed a three year Strategic Plan Sessions to deploy in FY24. Included in this process was health system leadership, foundation board members, foundation staff, volunteers, physicians and community members.

Established a Vision Statement: To ignite a ripple effect of positive change, where compassionate giving and innovative healthcare converge to empower individuals, families, and communities to create a legacy in the communities we serve.

Significant gift from Barbara and Chick Allen that brought Electrophysiology services to TidalHealth Nanticoke.

Established strategic alignment with the system leaders to become a long-term goal-based revenue stream to support Health System.

Transferred $4.6 million from the Foundation to TidalHealth System.

Foundation received $2.7 million in contributions from donors to various service lines.

Held four fundraising events in Maryland and Delaware for Graduate Medical Education.