News Around the State

NMSH names Allred Employee of the Quarter

Michelle Allred was recently named Employee of the Quarter for North Mississippi State Hospital (NMSH) in Tupelo. Mrs. Allred has worked at the Hospital for 8 ½ years, first as a pharmacy technician and currently as a Quality Mental Health Professional in the performance improvement division. Prior to her employment at NMSH, she worked at Mantachie Pharmacy, Weatherall’s Inc., and East Heights Pharmacy in Tupelo. 

Mrs. Allred is a 1995 graduate of Mantachie High School. She is a certified pharmacy technician and has completed the State Personnel Board’s Basic Supervisory course. In addition she is a trainer for The Mandt System® to prevent workplace and relational violence. 

In honoring Allred, NMSH Director Paul A. Callens, Ph.D., stated, “Michelle never says, ‘It’s not my job.’ She is a real team player and is always willing to lend a helping hand. We appreciate having her as part of the NMSH team.”

Employees of the Quarter are nominated and chosen by their colleagues at NMSH, an acute care behavioral health program of the Mississippi Department of Mental Health.

NMSH Names Employee of the Year

Aundra Agnew was recently named 2012 Employee of the Year for North Mississippi State Hospital (NMSH) in Tupelo. Ms. Agnew has worked at the hospital since it was opened in 1999. She has served as a mental health technician and is currently serving as the accounts payable officer. 

Ms. Agnew is a graduate of Union University with a degree in Social Work. Her previous work experience has been with North Mississippi Medical Center’s Baldwyn Nursing Center. She is the daughter of the late Jimmy D. Agnew and Doris Agnew.

In naming Ms. Agnew Employee of the Year, Hospital Director Paul A. Callens, Ph.D., had this to say, “Aundra is considered a strong asset to NMSH. She comes to work every day with an extremely positive attitude and has many times turned a bad day into a good day for others around her. She is kind, caring and always willing to help others. She has a tremendous work ethic, always staying on top of any job assigned and striving for excellence. She is the kind of employee we love to have working for us!”

Employees of the Year are elected by their fellow employees at North Mississippi State Hospital, an acute behavioral health program of the Mississippi Department of Mental Health.

NMMC Physicians Implant State's First Vagal NerveStimulator for Heart Failure

Doctors at North Mississippi Medical Center recently implanted the state's first vagal nerve stimulator as part of a clinical research study to treat heart failure through nerve stimulation in the neck.

According to cardiac electrophysiologist Karl Crossen, M.D., and neurosurgeon Louis Rosa, M.D, research demonstrates a connection between the heart and brain that could benefit heart failure patients. Last fall, 61-year-old Jack Aldridge of Mooreville and 59-year-old Annie Richardson of Tupelo became two of NMMC's first patients to benefit from that research and receive the CardioFit® implantable electrical stimulation device.

Vagal nerve stimulation therapy has been used for years to control seizures in epilepsy patients and more recently for treating drug-resistant cases of clinical depression. Drs. Crossen and Rosa are leading NMMC's participation in the INOVATE-HF clinical trial, the first time vagal nerve stimulation is being used to treat congestive heart failure.

Aldridge's heart problems began late in 2011. "I was very weak. I couldn't walk anywhere without having to sit down," he said. "I would have to sit up on the edge of the bed to breathe because I couldn't breathe lying down too well. I had a heaviness on my chest."

Tests revealed his heart had a leaky mitral valve as well as two blocked arteries. He underwent mitral valve repair and heart bypass surgery in November 2011. After surgery, he experienced complications that required a second surgery and a long recovery process. Then he was diagnosed with congestive heart failure, meaning his heart is unable to pump enough blood to sustain adequate circulation. At the time his ejection fraction, or heart's pumping ability, measured only 25 to 30 percent.

Richardson suffered her first heart attack seven years ago and a second one in May 2012. "The second heart attack was a hard one," she said. "It damaged my heart a lot." Because of the extensive damage, Richardson's heart was pumping at only 10-15 percent.

Dr. Crossen explains that the brain helps control the function of the heart through two branches. The sympathetic branch activates the "fight or flight" response during stress, increasing heart rate and blood pressure. The parasympathetic branch has a calming effect on the heart through signals carried from the brain to the heart by the vagus nerve. Normally the two branches are in balance. In congestive heart failure, there is an imbalance.

"In heart failure as the pump function weakens, the body attempts to adapt by using the adrenaline-or sympathetic-nervous system in the same way that when someone exercises the body uses adrenaline to increase heart rate and cardiac contraction," Dr. Crossen said. "We now know that these adaptations over long periods of time are detrimental."

Like driving a car, easing up on the accelerator (sympathetic) will slow down the car a bit, but stepping on the brake (parasympathetic) will reduce the speed more quickly. Some heart failure medications help to "slow down" the sympathetic branch, but currently there are no proven treatments that help an underactive parasympathetic branch.

"Medications such as beta blockers, which block the sympathetic system, are associated with improved outcomes in heart failure. At the same time that this system is ramping up to respond to worsening heart failure, the parasympathetic system is suppressed in heart failure patients," Dr. Crossen said. "There is no medication that predictably increases the effect of the parasympathetic branch to bring better balance to the heart. Stimulating the vagus nerve in the right side of the neck can directly raise the parasympathetic effect on the heart and is the basis for this new treatment."
The goal is to decrease the workload on the heart, giving it a chance to heal. As the heart becomes more effective, patients should be better able to tolerate activity. The clinical trial will assess whether combining vagal nerve stimulation and medication is more effective than medication alone. "Because the FDA is still monitoring how well this will work, they need something to compare it to," Dr. Crossen explained. "Three out of every five patients in the trial are randomly selected to receive the vagal nerve stimulator, and then we follow all five of the patients-both those who got the implant and those who did not-to see how their outcomes compare."

Drs. Crossen and Rosa operate together in NMMC's hybrid operating room-a cross between a cardiac catheterization laboratory and a surgery suite-to implant the vagal nerve stimulator, and many patients also have an internal cardiac defibrillator implanted at the same time to shock the heart back into normal rhythm if necessary. Like a traditional pacemaker, the vagal nerve stimulator is placed under the skin of the chest and attached to the heart-but it is also connected to a nerve on the right side of the neck. The device sends electrical pulses to the nerve, which sends signals to the heart.

Right away Aldridge, who enjoys working on his own vehicles and doing yardwork, could tell a difference. "I was fighting for every breath I could get. It has helped me tremendously," he said. "Things I couldn't do before, I'm more able to do now. It has given me more strength and a better outlook on life."

Richardson agrees that the device is making a difference. "I feel pretty good," she said. "I'm glad I have it."

For four to six weeks after the procedure, patients come in weekly to have their device titrated. "We condition the patients by starting out with the electrical impulses very low and then gradually increase them," Dr. Crossen said.

NMMC is one of only 22 sites in the United States and 36 sites worldwide participating in the INOVATE clinical trial. Outside Tupelo, the closest sites are in Birmingham, Ala.; Orlando, Fla.; Atlanta, Ga.; Houston, Texas.

Heart failure is also the leading cause of hospitalization in people over 65. "Heart failure has a high mortality rate and significantly limits a patient's ability to live a normal life," Dr. Rosa said. "Our goal is to help the patient by providing increased heart function and improving quality of life."

NMHS' employee recognition program earns Rose Award

Rodger Brown, NMHS vice president for Human Resources, accepts the Rose Award for Outstanding Total Recognition Program from Michael C. Fina representatives, Chris Dandrea of Nashville, and Rich Tuck of Chicago.

North Mississippi Health Services is one of the recipients of the Fourth Annual Rose Awards presented by Michael C. Fina, a leading provider of global employee recognition programs and solutions. The awards, named in honor of company co-founder Rose Fina, celebrates best practices in employee recognition and recognizes companies who engage their employees by fostering a culture of pride, integrity and respect.

NMHS won the Outstanding Total Recognition Program Award. The regional health care organization, based in north Mississippi and northwest Alabama, was one of 10 honorees representing a wide range of industries across several categories, including Estee Lauder, RaceTrac and PVH. The winners were selected based upon critical success factors for any employee recognition strategy, including employee participation rates, ease of participation, program reach and administration, communication and training, use of technology and data delivery.

“We feel very fortunate that we are able to partner with some of the most progressive companies across all industries,” said President Ashley Fina. “They understand how recognition improves overall business results and are true partners. We learn from them every day.”

NMHS launched its award-winning recognition program in 2010. The Web-based platform recognizes employees’ key milestones and accomplishments as well as charitable giving.

“We wanted a recognition process that focused on our Critical Success Factors,” said Rodger Brown, NMHS vice president for Human Resources. “We checked to see what other companies where doing and fine tuned this offering to meet our needs.”


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Rodger Brown, NMHS vice president for Human Resources, accepts the Rose Award for Outstanding Total Recognition Program from Michael C. Fina representatives, Chris Dandrea of Nashville, and Rich Tuck of Chicago.

NMMC implants nation's first absorbable heart stent

Cardiologists at North Mississippi Medical Center's Heart Institute recently implanted the nation's first absorbable stent as part of a research study.

Abbott Vascular received FDA approval in December to begin the ABSORB trial in the United States. Absorb, the world's first drug eluting bioresorbable vascular scaffold, is a first-of-its-kind device for treating coronary artery disease. It works by restoring blood flow to the heart similar to a metal stent, but then dissolves into the body. The result is a treated vessel that may resume more natural function and movement because it is free of a permanent metal stent.

Absorb is made of polylactide, a naturally dissolvable material that is commonly used in medical implants such as dissolving sutures. The device is referred to as a scaffold because it is a temporary structure, unlike a stent, which is a permanent implant. The scaffold supports the vessel until the artery can stay open on its own, and then dissolves naturally.

The potential long-term benefits of a scaffold that dissolves are significant. The vessel may expand and contract as needed to increase the flow of blood to the heart in response to normal activities such as exercising; treatment and diagnostic options are broadened; the need for long-term treatment with anti-clotting medications may be reduced; and future interventions would be unobstructed by a permanent implant. "This technology represents a true shift in the way that doctors will treat patients with severe obstructive coronary artery disease," said Barry Bertolet, M.D., an interventional cardiologist whose team at the NMMC Heart Institute implanted the first Absorb stent in the United States on Dec. 28. "We are excited about Absorb because it may allow blood vessels to return to a more natural state and expand long-term diagnostic and treatment options for cardiac patients."

Worldwide data seems to indicate that the Absorb scaffold performs similar to a best-in-class drug eluting stent across traditional measures such as major adverse cardiovascular events and target lesion revascularization, while providing additional benefits associated with a device that dissolves over time. As the Absorb scaffold dissolves, vascular function is potentially restored to the blood vessel, allowing more blood to flow through the vessel as the body requires.

"I give all the credit on this first case to the supporting staff at Abbott Vascular, the NMMC Institutional Review Board, NMMC's Cath Lab staff and the Cardiology Associates of North Mississippi research team for their hard work and dedication," Dr. Bertolet added. "We are all very excited about this game-changing technology and all the lives that will benefit from this research."

Heart disease is the leading cause of death for men and women around the world. Coronary artery disease, the most common type of heart disease, occurs when arteries that supply blood to the heart become narrowed or blocked, leading to chest pain or shortness of breath and increased risk of heart attack.

NMMC among first to implant triple-chamber pacemaker

North Mississippi Medical Center is one of the first eight hospitals nationwide chosen to implant the new Evia HF-T triple-chamber cardiac resynchronization therapy pacemaker. Immediately following U.S. Food and Drug Administration approval, manufacturer BIOTRONIK began delivering the new devices to meet considerable demand for improved options for patients.

The first 34 patients nationwide received devices the week of Nov. 19, with dozens more scheduled in the following weeks. The device puts out pulses to keep the heart beating regularly and on time, improving the health of patients with bradycardia and heart failure.

Learn more here.

Cirino named Employee of the Month for October at NMMC

Daniel Cirino, lead medical technologist in the Pathology Department, was named North Mississippi Medical Center’s Employee of the Month for October.

Cirino joined NMMC in 2009. He is a Hattiesburg native and a graduate of Oak Grove High School. Cirino earned a bachelor’s degree in biochemistry from the University of Mississippi in Oxford. He also completed the medical technology program at NMMC.

“What I love most about my job is the privilege to be a part of a first-rate team working for a shared mission,” said Cirino.

Coworkers praised Cirino for his generosity and his kindness. They also noted that he can always be counted to lend a helping hand.

“Daniel is courteous, friendly to everyone,” a coworker wrote in his nomination. “He is a true gentleman. He is a person who has your back. You can trust him to always do the right thing. He does not criticize nor complain. He does not say ‘that’s not my job.’”

“Daniel is a very dedicated and conscientious employee who always makes sure his work is completed correctly and in a timely manner,” another coworker wrote. “He is more than willing to take on new endeavors. It doesn’t matter what you ask him to do, he never says no.”

Cirino and his wife, Casey, attend The Orchard in Tupelo.

Jackson named Employee of the Quarter at NMSH

Fannie Jackson, Active Treatment Technician for North Mississippi State Hospital, was recently named Employee of the Quarter. Jackson has worked for the hospital since it opened 13 years ago and has nearly 25 years of service with the State of Mississippi.

She is a graduate of Bruce High School and attended both Itawamba Community College and Rust College. Her past work experience includes home health, dietary and volunteer services work with Head Start and medical assistant work at the Lee County Health Department.

Jackson is an active member of People Community Baptist Church and is an Avon Representative. NMSH Director Paul A. Callens, Ph.D., praised Jackson as, “the kind of employee who truly cares about our patients and serves as an excellent role model for our staff. We are pleased to honor her as Employee of the Quarter.”

NMMC first in state to offer newly approved heart surgery device

North Mississippi Medical Center's Heart Institute leads the state and nation again with another first.

On Nov. 27, NMMC became the first hospital in Mississippi to perform a transapical transcatheter aortic valve replacement (TA-TAVR). In this procedure, the valve is inserted through an incision between the patient's ribs and through the bottom end of the heart called the apex.

Open heart surgery is usually done to repair or replace severely damaged heart valves, but unfortunately, not everyone is a surgical candidate. In February, NMMC became the first hospital in Mississippi to offer transfemoral TAVR, a promising new alternative for high-risk patients for whom heart surgery was not an option. TAVR has been touted as a huge breakthrough for high-risk patients who suffer from aortic stenosis, meaning that their aortic valve-the door between the left ventricle and the heart's main artery-is too narrow to open all the way. Left untreated, a person's heart could get larger until it has trouble pumping. Fluid could build up in the lungs, and the heart could begin to fail. The heartbeat could become erratic, and the person could suffer a heart attack and die.

In the original transfemoral method, the valve was delivered through an incision in the leg. The new transapical method was approved by the U.S. Food and Drug Administration in late October for high-risk patients who don't have suitable access through their leg artery. In these situations, the valve is delivered through an incision in the chest. NMMC cardiothoracic surgeons were among the first physicians in the nation trained in this method in early November.

"Aortic stenosis is similar to having a kink in a water hose," explained Barry Bertolet, M.D., a cardiologist on the NMMC Heart Institute medical staff. "We have to relieve that kink to keep the water-or in this case, the blood-flowing."

TAVR, which is manufactured by Edwards Lifesciences, allows a team of doctors to replace a diseased valve without open heart surgery and without stopping the heart. TAVR is done by a cardiologist and cardiothoracic surgeon together in NMMC's hybrid operating room, which is a cross between a cardiac catheterization laboratory and a surgery suite.

After the cardiologist places a catheter (or tube) into an artery of the patient's leg or chest, a balloon catheter is placed across the narrowed aortic valve and stretched open so the cardiothoracic surgeon can place the new heart valve. When the balloon is inflated, it pushes the new valve into position and the diseased valve to the side. The balloon catheter is then removed, and the new valve starts working immediately.

"Open surgery is still the treatment of choice for valve replacement," said cardiothoracic surgeon David Talton, M.D, "but for high-risk patients-those who are older or have other serious health issues-TAVR is an excellent option to extend life."

Studies have shown that for the first three years after a procedure, the outcome is the same between patients who had open surgery and patients who had TAVR.

NMHS Receives 2012 Malcolm Baldrige National Quality Award

North Mississippi Health Services was named today as one of four U.S. organizations to receive the 2012 Malcolm Baldrige National Quality Award, the nation’s highest Presidential honor for performance excellence through innovation, improvement and visionary leadership.

In addition to NMHS in the health care category, Acting U.S. Commerce Secretary Rebecca Blank named three other recipients. They are Lockheed Martin Missiles and Fire Control, Grand Prairie, Texas (manufacturing); MESA Products, Inc., Tulsa, Okla. (small business); and City of Irving, Irvin, Texas (nonprofit).

This year marks the 25th anniversary of the award and the Baldrige Performance Excellence Program (BPEP) that supports it. North Mississippi Medical Center, NMHS’ flagship hospital, won the Baldrige Award in 2006. NMMC and NMHS hold the distinction of being the only Baldrige recipients in Mississippi. NMMC shared 2006 honors with Mesa, the 2012 small business recipient.

“The four organizations recognized today with the 2012 Baldrige Award are leaders in the truest sense of the word and role models that others in the health care, nonprofit and business sectors worldwide will strive to emulate,” said Acting Secretary Blank. “They have set the bar high for innovative practices, dynamic management, financial performance, outstanding employee and customer satisfaction, and most of all, for their unwavering commitment to excellence and proven results.”

“We are honored to receive the Baldrige Award as it recognizes ‘role model’ performance and demonstrates a long-term commitment to focusing on the right things,” said John Heer, NMHS president and chief executive officer.

After submitting its application in May, NMHS hosted a site visit by a team of Baldrige examiners in early October. The team visited multiple locations throughout the health care system and interviewed approximately 600 people. They made stops throughout north Mississippi in Tupelo, Pontotoc, Baldwyn, Iuka, Columbus, Eupora, West Point and Hamilton, Ala.

“We had a fantastic site visit,” said Karen Koch, administrator of organizational performance. “The Baldrige examiners were able to understand how fully engaged and caring that our staff and physicians are with our patients and their family members.”

To date, more than 1,500 U.S. organizations have applied for the Baldrige Award and there are Baldrige-based award programs in nearly all 50 states. Internationally, the program has served as a model for nearly 100 quality programs. A December 2011 study by Albert N. Link and John T. Scott measuring the Baldrige Program's value to U.S. organizations conservatively estimated a benefit-to-cost ratio of 820 to 1, while a 2011 report by Thomson Reuters found that health care organizations that have won or been in the final review process for a Baldrige Award outperform other hospitals in all but one metric the company uses to determine its “100 Top Hospitals” in the nation (and were six times more likely to be among the top 100).

Bobby Martin of Ripley, chairman of the NMHS Board of Directors, said, “In addition to being a great honor, this is a great learning opportunity for NMHS. The Baldrige process points out where we are strong and helps identify areas where we can improve our health care organization.”

The 2012 Baldrige Award recipients were selected from a field of 39 applicants. All of the applicants were evaluated rigorously by an independent board of examiners in seven areas defined by the Baldrige Criteria for Performance Excellence: leadership; strategic planning; customer focus; measurement, analysis and knowledge management; workforce focus; operations focus; and results. The evaluation process for each of the recipients included about 1,000 hours of review and an on-site visit by a team of examiners to clarify questions and verify information in the applications.

The 2012 Baldrige Award recipients are expected to be presented with their awards at an April 2013 ceremony in Baltimore, Md.