Justin M. Givens, M.D., orthopedic surgeon with Norton Orthopedic Institute, is among the first five surgeons in the country — and the first in Kentucky — to perform a new groundbreaking, robotic-arm assisted reverse shoulder replacement surgery with Mako SmartRobotics. This procedure hopes to offer a higher degree of precision and accuracy compared with traditional methods.

“It’s an honor to be among the first to use this technology,” Dr. Givens said. “This new procedure allows me to give my patients a level of accuracy unlike any other. It’s a more personalized approach to each patient’s needs, which can lead to improved results and faster recovery times.”

The technology is designed to elevate the surgeon’s control and confidence by providing the surgeon with a 3D image of the patient’s unique shoulder anatomy. Dr. Givens can then study the 3D simulations before surgery and view them on a screen during the procedure. The robotic arm assists him in shaving down the patient’s glenoid (shoulder socket), creating the new surface and inserting the implant.

“I still do the approach, meaning I make the incision and move the soft tissue, nerves and veins out of the way,” Dr. Givens said. “But now, the technology helps me to know the movements I’m making are exactly the ones I want to make. This gives us precision to ensure every cut and movement is exactly what the individual patient needs.”

The robotic arm’s capabilities help provide enhanced feedback to ensure the implant is positioned within the preplanned boundaries, while aiming for improved accuracy. The goal is to allow for a more natural range of motion and better long-term outcomes for patients.

“We’ve never had this level of accuracy before in this field,” Dr. Givens said. “Now, the procedures we’ve theorized can be put into practice, and that’s why it’s so exciting to be at the forefront of innovation.”

Reverse shoulder replacement is ideal for patients with severe arthritis, rotator cuff tears or other degenerative shoulder conditions that do not respond to conservative treatments. Furthermore, shoulder arthroplasty (reconstruction or replacement) is the fastest-growing joint arthroplasty in the U.S. According to Dr. Givens, more than 90% of patients are satisfied with their replacements, but doctors are consistently striving for more accuracy and reproducibility to improve that number and help patients achieve a higher level of satisfaction in a shorter amount of time.

Dr. Givens’ orthopedic surgery practice is focused on shoulder and elbow care, including arthroscopy, fracture repair, and joint replacement and revision. In 2024, he performed more than 150 shoulder arthroplasties and anticipates performing more than 200 in 2025.

“My goal is to restore the shoulder to where it’s supposed to be and allow my patients to get back to their normal activities,” Dr. Givens said. “I want my patients to go back to living their normal lives as soon as possible, and this new technology is another tool that will allow them to do so.”

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The Leapfrog Group, an independent national watchdog organization, assigns an “A,” “B,” “C,” “D” or “F” grade to general hospitals across the country based on more than 30 national performance measures reflecting errors, accidents, injuries and infections, as well as systems that hospitals have in place to prevent harm.

“This ‘A’ ranking at our hospitals is a testament to the hard work of our dedicated providers and employees, who consistently strive to deliver safe, high-quality care to our patients,” said Russell F. Cox, president and CEO, Norton Healthcare.  “In addition, numerous others throughout the organization provide essential support and resources to our providers and caregivers.”

The Leapfrog Hospital Safety Grade is the only hospital ratings program based exclusively on hospital prevention of medical errors and harm to patients. The grading system is peer-reviewed, fully transparent and free to the public.

Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses publicly available hospital safety data to assign grades to nearly 3,000 U.S. acute-care hospitals twice per year, in the fall and spring.

To see full grade details for each of Norton Healthcare’s four Louisville adult-service hospitals and get patient tips for staying safe in the hospital, visit HospitalSafetyGrade.org and follow The Leapfrog Group on X, formerly known as Twitter, and Facebook.

The post Norton Healthcare’s four Louisville-based adult-service hospitals nationally recognized with an ‘A’ for fall 2023 Leapfrog Hospital Safety Grade appeared first on Norton Healthcare.

This kind of heart attack is called an ST-elevation myocardial infarction (my-oh-CARD’-ee-ull in-FARK’-shun), or STEMI. Often also called a widow-maker, this is the deadliest form of heart attack. That’s because it is caused from a complete blockage in the heart, and no blood is able to pass through. Restoring blood flow is all that matters, and the faster it’s done, the better the chances of recovery and preventing long-term damage to the heart muscle. In this situation, time is muscle.

Myocardial infarction is the medical term for a heart attack. An infarction is a blockage of blood flow to the myocardium (my-oh-CAR’-dee-um), the heart muscle. That blockage causes cells in the heart muscle to die.

A STEMI is a heart attack that causes a distinct pattern on an electrocardiogram (abbreviated either as ECG or EKG). This is a medical test that uses several sensors (usually 10) attached to your skin that can detect your heart’s electrical activity. That activity is then displayed as a wave pattern on a paper readout or a digital display. Certain patterns of heart activity mean there’s a total blockage of one of the heart’s main supply arteries.

During a heart attack, those patterns can mean the heart muscle is dying. At this point, the key goal is to reopen that artery and restore blood flow as soon as possible. This may prevent permanent damage, or at least limit the severity of the damage. If there’s too much damage to the muscle in the ventricles, your heart can’t pump enough blood to support your body. The heart muscle cannot repair itself. That’s why STEMI heart attacks are so dangerous and why restoring blood flow quickly is so critical.

Chest pain or heart attack?

Despite what you might have seen on TV or in movies, a heart attack does not always come on suddenly or include clutching one’s chest in agony. Many times, a heart attack feels like pressure, heaviness or other discomfort in the chest, neck, jaw or down the arms. Though men and women both have heart attacks, they often report different sensations in the body.

STEMI symptoms include:

• Tightness, squeezing, pain, or pressure in your chest that doesn’t go away after a few minutes, or stops and returns
• Pain or discomfort in your arms, neck, jaw, back, or stomach
• Shortness of breath
• Lightheadedness
• Nausea and vomiting
• A cold sweat

There are several conditions that can feel like a heart attack, including anxiety, gas and muscle strain. You always should err on the side of caution when it comes to chest pain, and visit a health care provider to see what the cause of your pain is.

STEMI treatment

Treatment options for STEMI will depend on several factors, including:

• Where the blockage is in your heart
• Results of tests such as ECG/EKG
• Age, general health and lifestyle factors

No matter what, treating a STEMI is time-sensitive. Faster treatment can mean better outcomes. If your blood oxygen levels are low, treatment may include supplemental oxygen. There are also several different potential treatments for heart attack, several of which may happen in sequence or at the same time.

Other treatments include:

• Percutaneous coronary (per-kew-TANE’-ee-us COR’-oh-nar-ee) intervention  (PCI) — this procedure uses a tiny balloon that inflates to clear the blockage in the artery. A stent may be used, which is a scaffold that unfolds to hold the artery open.
• Medication — several medications are usually given early on in the treatment of heart attack, including beta blockers and statins.
• Coronary artery bypass grafting (CABG) surgery — CABG (pronounced like “cabbage”) means a surgeon takes a blood vessel from somewhere else in your body and uses it to make a new blood vessel that bypasses the blockage. CABG is often called bypass surgery or open heart surgery.

STEMI heart attack care network

Norton Healthcare has worked with Louisville-area health systems, emergency medical services (EMS) providers, air transport providers and affiliates to build the area’s first regional STEMI network. Like a top-notch pit crew for a race car, everyone on the team has a specific role: From the time you first seek medical care to the time the blockage is cleared, the STEMI network has your care covered.  

Part of the network’s purpose is to equip EMS crews with EKG equipment that can detect a STEMI heart attack. When a 911 call is made and EMTs arrive to provide care, the EKG taken in the first moments is sent to the STEMI network, activating a team that begins to prepare for the arrival of a patient. In some cases, the crew can save time by skipping what may be the closest hospital and heading directly to an accredited chest pain center where staff have been trained in heart attack care.

The goal is to get blood flowing within 90 minutes or less. Norton Heart & Vascular Institute and its partners in the STEMI network — which reaches into rural parts of Kentucky and Southern Indiana — beat the goal nearly 100% of the time. In 2022, Norton Healthcare had a median time of 56 minutes.

Norton Healthcare partners with other providers and emergency personnel who encounter STEMI patients to conduct drills and improve processes. This partnership was instrumental in the American Heart Association awarding its Mission Lifeline: Trailblazer designation to Norton Healthcare, thus recognizing the pioneering work done to create network of care to treat STEMI hear attacks.

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Medical imaging and blood tests soon uncovered the grim reality: Jonathan had a tumor on his brain stem. The diagnosis was rare — he was experiencing primary central nervous system lymphoma, an uncommon form of brain cancer.

“He always said that his job attacked him,” said Allie Parrish, Jonathan’s wife and a neurodiagnostic technologist at Norton Children’s Hospital. “He went from being in surgery with his colleagues to being a patient being taken care of by his friends.”

Jonathan faced many health challenges following his cancer diagnosis, including a bout of pneumonia and cytomegalovirus that required hospitalization in July.

Throughout the years, the Parrishes had been deeply involved in their Southern Indiana church community, along with their two young children. Unfortunately, Jonathan’s health crisis kept him from attending Sunday services.

“He made it clear to me and to others how much he missed church, just the act of worshipping as a collective group,” Allie said. “I think maybe Jonathan knew he wasn’t going to get better, and he just really wanted to worship with the church.”

Bringing the ‘church’ to the hospital

Jonathan’s health was deteriorating, and time was running out to fulfill this heartfelt wish to worship with his church family.

This poignant request caught the attention of Kristin Pickerell, chief nursing officer at  Norton Brownsboro Hospital.

“When we heard that Jonathan really missed his church family, and his wife knew it was one of his final wishes, we needed to make it happen,” Kristin said.

Staff at the hospital grappled with the intricate challenge of fulfilling the Parrish family’s wish, while concerns about Jonathan’s delicate respiratory health and compromised immune system further complicated matters.

Originally, the team discussed turning a conference room into a choir room, having a virtual performance and allowing members to visit Jonathan two at a time. When technical challenges arose, the team assessed whether the hospital’s small chapel would accommodate 20 choir members and a livestreamed service.

Ultimately, recognizing her husband’s fragile condition, Allie proposed an alternative approach: an outdoor service at the hospital, with Jonathan viewing from a window.

Her plan was approved, and immediately the space was cleared, cleaned and prepped. The hospital’s food and nutrition department supplied water for attendees, and security measures were put in place to streamline visitor flow.

“This was something that every team member at Brownsboro worked really hard to pull off,” Kristin said.

A final wish fulfilled
Around 6:15 p.m. that Sunday evening in late July, Jonathan was accompanied by Allie and an intensive care unit (ICU) nurse and moved to a pedway with windows overlooking the service in the hospital’s third-floor courtyard.

“The night exemplified what we do and why we do it,” said Autumn Chapman, ICU nurse manager. “This request was fulfilled because of the efforts and dedication of multiple departments and staff members.”

On what would be one of his final days, Jonathan was able to reconnect with his church community before he passed away.

“It was an incredible blessing,” Allie said. “We were able to sing and smile and cry, and Jonathan laughed for the last time. I can only remember it as being a joy.”

During the two-hour outdoor service, church members sang, offered prayers and shared stories of how Jonathan had profoundly impacted their lives. All the while, Jonathan and his nurses took it all in from their vantage point behind the glass.

“We always talk about being a Norton family, and through all of this, and despite the sadness, we were treated like family,” Allie said. “I know [Jonathan] was so grateful to Ryan Stettenbenz [manager, neurodiagnostics, Norton Brownsboro Hospital] and the entire team. That hospital and that floor was where he worked, and he considered it another home. To have this happen at his ‘home,’ we are beyond blessed.”

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Norton Audubon Hospital, Norton Brownsboro Hospital, and Norton Hospital all are recognized for ACC Chest Pain Center with Primary PCI accreditation; Norton Women’s & Children’s Hospital is recognized as an ACC Chest Pain Center. Norton Healthcare has the most facilities across the city of Louisville with the ability treat a life-threatening heart attack.

“This accreditation is based on national standards ensuring patients receive specific treatment in a timely manner, a task that takes teamwork across multiple areas of the hospital — including the emergency department, radiology, cardiac catheterization, laboratory and many more,” said Joseph A. Lash, M.D., cardiologist and medical director of Norton Heart & Vascular Institute and Rounsavall Family Foundation endowed chair. “Achieving this accreditation is a testament to the entire team both within the Norton Heart & Vascular Institute, but also at each of the hospitals.”

According to the Centers for Disease Control and Prevention (CDC), more than 730,000 Americans experience a heart attack each year. The most common symptom of a heart attack is chest pain or discomfort. However, women are more likely to have atypical symptoms. Other heart attack symptoms include, but are not limited to, tingling or discomfort in one or both arms, back, shoulder, neck or jaw, shortness of breath, cold sweats, unusual tiredness, heartburn-like feeling, nausea or vomiting, sudden dizziness, and fainting.

Hospitals that have earned ACC Chest Pain Center with Primary PCI Accreditation have proven exceptional competency in treating patients with heart attack symptoms and have primary PCI available 24/7 every day of the year. Percutaneous coronary intervention (PCI) is also known as coronary angioplasty. It is a nonsurgical procedure that opens narrowed or blocked coronary arteries with a balloon to relieve symptoms of heart disease or reduce heart damage during or after a heart attack.

As required to meet the criteria of the accreditation designation, these hospitals comply with standard Chest Pain Center protocols.  These facilities also maintain a “no diversion policy” for out-of-hospital cardiac arrest patients.

Hospitals receiving Chest Pain Center with Primary PCI and Resuscitation Accreditation from the ACC must take part in a multifacetedclinical process that involves: completing a gap analysis, examining variances of care, developing an action plan, a rigorous on-site review and monitoring for sustained success. Improved methods and strategies of caring for patients include streamlining processes, implementing guidelines and standards, and adopting best practices in the care of patients experiencing the signs and symptoms of a heart attack. Facilities that achieve accreditation meet or exceed an array of stringent criteria and have organized a team of doctors, nurses, clinicians and other administrative staff that earnestly supports the efforts leading to better patient education and improved patient outcomes.

Norton Heart & Vascular Institute is the area’s leading provider of cardiovascular care, from general cardiology to subspecialty care that includes vascular surgery, thoracic surgery, cardiac surgery, electrophysiology, advanced heart failure, structural cardiology and interventional cardiology.

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This is the seventh consecutive period (fall 2019, spring 2020, fall 2020, spring 2021, fall 2021, spring 2022 and fall 2022) that the four hospitals have received an “A” grade.

The Leapfrog Group, an independent national watchdog organization, assigns an “A,” “B,” “C,” “D” or “F” grade to general hospitals across the country based on more than 30 national performance measures reflecting errors, accidents, injuries and infections, as well as systems that hospitals have in place to prevent harm.

“By working together and keeping the safety of our patients — and each other — at the center of all they do, Norton Healthcare’s employees consistently do the hard work that is necessary to receive ‘A’ Leapfrog Hospital Safety Grades,” said Russell F. Cox, president and CEO, Norton Healthcare. “Our talented and dedicated providers and caregivers consistently deliver safe, high-quality care to our patients. In addition, numerous team members throughout the organization provide essential support and resources critical in today’s complex health care environment. Seven consecutive ‘A’ grades is no small feat, and I am honored to lead this exceptional team.”

The Leapfrog Hospital Safety Grade is the only hospital ratings program based exclusively on hospital prevention of medical errors and harm to patients. The grading system is peer-reviewed, fully transparent and free to the public.

Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses publicly available hospital safety data to assign grades to more than 2,700 U.S. acute-care hospitals twice per year, in the fall and spring.

To see full grade details for each of Norton Healthcare’s four Louisville adult-service hospitals and get patient tips for staying safe in the hospital, visit HospitalSafetyGrade.org and follow The Leapfrog Group on Twitter and Facebook.

The post String of seven: Norton Healthcare’s four Louisville-based adult-service hospitals once again nationally recognized with an ‘A’ for fall 2022 in Leapfrog Hospital Safety Grade appeared first on Norton Healthcare.

The Leapfrog Group is an independent national watchdog organization committed to health care quality and safety. The Leapfrog Hospital Safety Grade assigns an “A,” “B,” “C,” “D” or “F” grade to all general hospitals across the country and is updated every six months. It is the only hospital ratings program based exclusively on hospitals’ prevention of medical errors and other harm to patients in their care.

“The hard work of our dedicated providers and employees, who consistently strive to deliver safe, high-quality care to our patients, is the reason each of our adult-service hospitals continue to get this ‘A’ ranking,” said Russell F. Cox, president and CEO, Norton Healthcare. “The past two years have been a challenge for everyone working in health care. I am incredibly proud of our team, who continues to keep the safety of our patients — and each other — at the center of all they do.”

“An ‘A’ safety grade is a tremendous achievement, of which this community should be extremely proud,” said Leah Binder, president and CEO, The Leapfrog Group. “I thank the leadership and workforce of Norton Healthcare for its commitment to prioritizing patients and their safety, especially during these trying times.”

Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses up to 27 measures of publicly available hospital safety data to assign grades to more than 2,700 U.S. acute-care hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.

To see full grade details for each of Norton Healthcare’s four adult-service hospitals and get patient tips for staying safe in the hospital, visit HospitalSafetyGrade.org and follow The Leapfrog Group on Twitter and Facebook.

The post Norton Healthcare’s four adult-service hospitals once again nationally recognized with an ‘A’ for the fall 2021 Leapfrog Hospital Safety Grade appeared first on Norton Healthcare.

Duke, 89, was in his yard splitting wood the week before his stroke. He’d had triple-bypass surgery nearly 30 years ago but otherwise showed no signs of any major health issues. On March 30, Duke sat down in his living room to do a puzzle. He fell to the ground.

“I don’t remember anything that happened,” Duke said.

Fortunately, Duke’s wife called a neighbor who rushed over. The neighbor found Duke on the ground. He was unresponsive, and one side of his face was sagging. An emergency medical services team quickly arrived at the scene to transport him to Norton Brownsboro Hospital.

“There’s another hospital that’s closer to his [Duke’s] home,” said Karen Nichter, Duke’s daughter. “But the EMT recommended going to Norton Brownsboro Hospital because it’s a designated Comprehensive Stroke Center. And I’m glad they did.”

Duke was fading fast when he arrived at Norton Brownsboro Hospital. He immediately came under the care of Mahan Ghiassi, M.D., neurosurgeon with Norton Neuroscience Institute.

“Duke had very little brain activity on one side,” Dr. Ghiassi said. “We needed to get blood flow quickly or the brain would die out.

Dr. Ghiassi performed a mechanical thrombectomy, a minimally-invasive procedure using specialized equipment to remove a clot from a patient’s artery. He went through the artery in Duke’s leg. Within about 20 minutes, blood flow was restored to Duke’s brain.

“Once he woke up, he was pretty much back to being dad,” Karen said. “He’s passed all the walking and strength and cognitive tests and only needed a little physical therapy. He was barely in the hospital for two days.”

Nephew experiences same type of stroke

Even though Duke was home, he needed care while he continued to recover. Paul, 61, stayed with Duke one afternoon in early April. What Paul didn’t know then was that he was about to experience a stroke just days later.

“I was at home talking to some friends who came by the house,” Paul said. “Apparently I was slurring my words.”

After the friends left, Paul went to his garage to work. The friends suspected something was up and went back to tell Paul’s wife, Linda. They then walked into the garage to find Paul on the floor. He was conscious but couldn’t move the left side of his body. Knowing what Duke had gone through weeks before, they knew immediately that Paul was having a stroke.

Like Duke, Paul was transported to Norton Brownsboro Hospital. There waiting for him was Dr. Ghiassi. The scans revealed Paul had a clot in the same artery as Duke, but on the opposite side of the brain. Paul was losing blood flow every second.

“You see patients who refer family members, but they are for elective procedures, not emergency procedures. I’ve never had family members present with acute strokes, especially not within a couple of weeks of each other,” Dr. Ghiassi said.

Dr. Ghiassi performed a mechanical thrombectomy on Paul, but unlike with Duke, he went through the artery in Paul’s wrist. Brain function returned almost immediately.

“There are advantages of treating a stroke radially [though the arm], as it’s less invasive and allows for quicker recovery time,” Dr. Ghiassi said. “Due to Duke’s age, we needed to go in through the leg, but both procedures are very effective.”

After two days, Paul left the hospital. He and Duke continue to deal with minor effects from their strokes, but for the most part they’re back to life as usual.

“I feel incredibly fortunate,” Paul said.

What caused their strokes?

According to Dr. Ghiassi, genetics likely played a role in both Paul’s and Duke’s strokes, as well as a family history of heart issues. However, he also attributed the timing of both as likely the product of bad luck.

“The positive is that because of Duke’s stroke, the family knew what to do when Paul had his stroke,” Dr. Ghiassi said. “That quick action very well could have saved his life.”

Paul and Duke also credit Dr. Ghiassi and the team at Norton Brownsboro Hospital.

“If you’re having a stroke, get to Norton Brownsboro,” Duke said.[templatera id=”89477″]

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The hospital received the designation from DNV Healthcare USA Inc., a world-leading certification body committed to the development and continual improvement of health care quality and patient safety in health care organizations.

“With stroke care, you must have the best team and resources, but also the ability to act organizationally with extreme efficiency because of the time-critical nature of these events,” said David A. Sun, M.D., Ph.D., neurosurgeon and executive medical director, Norton Neuroscience Institute. “This certification from DNV validates all the effort we have put into the stroke program and to ensuring the health and safety of our patients.”

The DNV Comprehensive Stroke Center certification is based on standards set forth by the Brain Attack Coalition and American Stroke Association. It affirms that the hospital addresses the full spectrum of stroke care — diagnosis, treatment, rehabilitation and education — and establishes clear metrics to evaluate outcomes.

“Achieving certification shows commitment to excellence,” said Patrick Horine, president, DNV Healthcare USA Inc. “And it helps demonstrate to your community that you are performing at the highest level.”

Norton Neuroscience Institute is a comprehensive stroke care network. Norton Brownsboro Hospital obtained its first Comprehensive Stroke Center designation from another accrediting organization in 2015. Additionally, Norton Audubon Hospital and Norton Hospital are designated Primary Stroke Centers, and Norton Women’s & Children’s Hospital is an Acute Stroke Ready Hospital. The designations mean the facilities have achieved aggressive benchmarks to deliver improved outcomes for stroke patients.

In addition, the American Heart Association Get With the Guidelines – Stroke program has recognized all four of Norton Healthcare’s adult-service hospitals for exceeding national averages in getting stroke patients in the door and administering lifesaving treatment to restore blood flow to the brain. An emergency stroke team at each facility stands ready around the clock to combat stroke emergencies.

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The Leapfrog Group is an independent national watchdog organization committed to health care quality and safety. The Leapfrog Hospital Safety Grade assigns an “A,” “B,” “C,” “D” or “F” grade to all general hospitals across the country and is updated every six months. It is the only hospital ratings program based exclusively on hospitals’ prevention of medical errors and other harm to patients in their care.

“The hard work of our dedicated providers and employees, who consistently strive to deliver safe, high-quality care to our patients, is the reason each of our adult-service hospitals continue to get this ‘A’ ranking,” said Russell F. Cox, president and CEO, Norton Healthcare. “The past year has been a challenge for everyone in health care, but our team continues to put the safety of our patients – and each other – first when our community needs us the most.”

“An ‘A’ safety grade is an elite designation that your community should be proud of,” said Leah Binder, president and CEO of The Leapfrog Group. “The past year has been extraordinarily difficult for hospitals, but Norton Healthcare shows us it is possible to keep a laser focus on patients and their safety, no matter what it takes.”

Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses up to 27 measures of publicly available hospital safety data to assign grades to more than 2,700 U.S. acute-care hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.

To see full grade details for each of Norton Healthcare’s four adult-service hospitals and access patient tips for staying safe in the hospital, visit HospitalSafetyGrade.org and follow The Leapfrog Group on Twitter and Facebook.

*Pediatric hospitals are not rated by The Leapfrog Group.

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