Health care heroes.

Pop culture's traditional portrayal of heroic characters usually includes attention getters wearing bright colors and performing feats of greatness.

You won't find masked wonders moving at the speed of light on the following pages, but you will find feats of greatness illustrating health care's ideal- people bringing change, hope and healing to those in need. In an industry challenged by regulations and high health insurance culprits, you'll be encouraged by reading about the heroes who are rising above the issues every day in Utah's health care environments.

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Lifetime Achievement

Terry P. Clemmer, M.D.

Director of Critical Care Medicine

LDS Hospital

Dr. Terry Clemmer's story is of one who's spent his career pursuing uncharted waters and laying the groundwork for standardization of revolutionary critical care medicine.

"When I started out there was almost no critical medicine," says Clemmer. "I was in the military and a friend helped me set up a medical critical care fellowship training program- it was the first one in any branch of the military."

That was 37 years ago, and since then, Clemmer has seen the field flourish. "I saw the formation of the critical care society and when the Journal of Critical Care Medicine was first published, and all of the technology that's developed is just tremendous," he says. Clemmer has also been the author of more than 100 scientific publications, is an internationally recognized authority on critical care medicine, and has organized the treatment of sepsis, devising and implementing systems that are reducing hospital-related infections and deaths.

"My hope one day is to be able to promise patients that they won't face the complications some people get when they come to the hospital," Clemmer says. "I think (hospital) safety is really going to change."

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Tom Hanrahan

Regional Vice President

Urban North Region,

Intermountain Healthcare 

Tom Hanrahan's 33 years of service in health care includes several administrative roles at hospitals from the area north of Salt Lake City to the Idaho state line, positions on numerous boards, and affiliations with many associations, including serving as the chairman of the Utah Hospital Association from 1995-1997 and as the Utah delegate on the American Hospital Association Regional Policy Board from 2001-2004.

But he says the most meaningful thing he's done during the extent of his career is work with the Junior League of Ogden to develop the Children's Health Connection, a program that provides an array of health care services to children and their families through the voluntary efforts of area physicians, dentists, optometrists, nurses and other health care professionals. "This program has resulted in timely medical intervention and even saved the lives of children who don't have a physician," says Hanrahan. "For me, this is the essence of health care ... people helping people, thereby healing both the individual and the community."

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Hanrahan believes the health care system will never realize its potential without a full partnership with the private sector. "Health care is not an isolated dimension of the human experience," explains Hanrahan. "What we eat, where we live, where we are employed, all contribute to the health care challenge."

Scott D. Williams, M.D., M.P.H.

Chief Medical Officer

HCA MountainStar Division

Regardless of the comprehensive view Dr. Scott Williams has from working almost 23 years in every health care sector, he says the root cause associated with health care issues have to do with systems designed for the "business side" of health care, not what works best for patients.

"Financial incentives lead to treating people when they are the very sickest," says Williams. "But if we focus resources at the early end of health care problems, we'll prevent people from having more complications and improve their health now. They won't need as much treatment down the road, which saves money later on too."

Williams, formerly an executive director of the Utah Department of Health, spear-headed efforts to streamline communication and documentation of patient treatment. He is particularly focused on the dissemination of electronic health records (EHR),which he says should help remedy the fact that Americans get only half of the preventive health care services they should receive.

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"The list of prevention services is complicated, it keeps changing and physicians often don't get paid enough to spend time providing them," explains Williams. "EHR reminder systems can be updated with changes, which take the human element out of keeping track of medical science and individual patients."

Health Care Provider--Physician

Donald L. Lappe, M.D.

Chief of Cardiology

Intermountain Medical Center

Despite being a recognized national leader for implementing medical best practices to improve the care of patients with heart disease, Dr. Donald Lappe says the most critical component of successful cardiovascular health is in the patient's hands.

"There's this notion that 'I can go ahead and eat that cookie because I can take my (medication), says Lappe. "We have miraculous drugs and therapies so the consequences of an unhealthy lifestyle are being dealt with by the health care community but it does create a sense of complacency in the patient's own role in their health and well-being."

In the meantime, Lappe, who is also the director of Intermountain's Cardiovascular Clinical Program and an adjunct associate professor with the University of Utah School of Medicine, is on top of things at his end, developing protocols that ensure the appropriate prescription of discharge medications and compliance with postdischarge treatment programs. One estimate says the protocols may save as many as 450 lives every year. He also champions education programs for heart failure patients and young people. "We've got to get our next generation eating right and exercising right," says Lappe.

Joan Balcombe, M.D.

Chief of Emergency Medicine, Assistant Trauma Medical Director Ogden Regional Medical Center When you listen to Joan Balcombe talk about her work, it's clear her love for working in the emergency room is all about her love for working with people.

"Most of us who work in the emergency room are adrenaline junkies-there's something wonderful about saving a life," says Balcombe. "But you have an opportunity to help in so many ways that goes beyond the excitement it's about caring for the person with an injury no matter how minor it is; people like the elderly who are just as pleased with someone who is willing to listen to them as they are for how their injury is treated."

Balcombe doesn't mind that many patients visit the emergency room for nonemergencies. "We're a safety net of care and the house of emergency medicine takes pride in being there for all comers 24 hours a day, 7 days a week, 365 days a year," she says.

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Beyond emergency medicine, Balcombe serves as chairman of the credentials committee and is heavily involved with the quality improvement processes at Ogden Regional. However, her discussion about that quickly diverts back to the relationships she's built with her staff. "What I do couldn't be done without the EMT's, the paramedics, the nurses and support staff," she says. "Recognition really belongs to my team and those heroes I am so privileged to work with every day."

Scott Albert Leckman, M.D.

General Surgeon 

St. Mark's Hospital 

Despite the numerous roles Dr. Scott Leckman fulfills to improve the quality and safety of patient care at St. Mark's Hospital, he says, "I'm just a general surgeon."

Looking at Leckman's extensive volunteer efforts though, it's hard to see him that way. "My month on the USNS Mercy was glorious," he says about his experience providing medical relief for survivors of the 2004 tsunami in Northern Sumatra, Indonesia. "There was no concern about whether the patients had insurance. There was just Americans, Navy personnel and civilians working together to get the best outcomes for our Indonesian patients."

Leckman says, however, that most of the good things that have happened in his life have come from his involvement with RESULTS, a grassroots citizens lobby group dedicated to ending hunger, of which he serves on the board of directors. "It has taken me to Bangladesh, India, Pakistan, El Salvador and Capitol Hill," he says. "In 1998, I was able to have the experience of running for the U.S. Senate and losing in a landslide."

While he may have lost his bid for the Senate, Leckman is winning his campaign to help low-income, uninsured individuals get elective health care. Since assisting in initiating the Health Access Project seven years ago, more than 600 physicians and nine hospitals are affiliated with the project and nearly $2 million in donated health care has been provide to qualified individuals at no cost.

Health Care Provider--Non-Physician

Carolyn Bauer

Operating Room Nurse

LDS Hospital

When Carolyn Bauer stepped off the plane in Gaza on her first Operation Smile mission 15 years ago, she saw more soldiers with guns than smiles. "When we first arrived, the Israeli soldiers were not going to let us cross into Gaza," says Bauer. "The coordinators were finally able to convince them of what we were doing and they allowed us to cross." When Bauer's team reached the hospital, she says children were already waiting for them, even though screenings didn't start until the next day. "The numbers were overwhelming and of course, we wanted to help them all."

Bauer has served six missions since then to several countries including the Philippines, Africa and Columbia in addition to her 21 years in the O.K. at LDS hospital. While she says the missions have provided experiences she couldn't have had any place else, working at the hospital is what gives her the most professional satisfaction.

"[Nursing] has allowed me to work in many different fields of nursing but the O.R. has been the most fulfilling and fun," says Bauer. "I cannot think of any better way to spend my days helping my patients and interacting with other professional people."

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Arlene M. Samen

Founder and Executive Director

One H.E.A.R.T.

You could say that One H.E.A.R.T., a non-profit organization dedicated to health, education and research in Tibet, was born out of a chance meeting.

One H.E.A.R.T. founder Arlene M. Samen was volunteering with an organization (Interplast) that operates on children with cleft lips and palates in India when she says a meeting with her spiritual teacher changed her life. The prominent Buddist religious leader who fled to India after China took political sovereignty over Tibet learned of Samen's 25 years of experience working with high-risk births in the U.S. and abroad and encouraged her to use her skills towards reducing maternal and newborn deaths in Tibet. "We were talking about children with birth defects and what Interplast could do to help them, then the turned to me and said, 'You must go to Tibet and help the poor women and children.' I felt deeply moved in a way I had never experienced before," says Samen.

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Since its start 10 years ago, One H.E.A.R.T. has grown to 100 volunteers who've created a program infrastructure with a demonstrated track record of saving the lives of Tibetan children and their mothers.

Jack Fried

Director of Respiratory & Neurodiagnostic Services

St. Mark's Hospital

Jack Fried developed his interest in respiratory therapy and illnesses from treating servicemen in Vietnam dying from blast injuries to their lungs.

"We learned to deal with bullet wounds and vascular injuries during the Korean War," explains Fried. "There had to be a way to save these men in Vietnam."

Since earning his education in cardiopulmonary technology, respiratory therapy and health management, Fried has directed respiratory services at hospitals in Florida, Louisiana, New York and Utah for the past 33 years.

In the nine years Jack Fried has initiated plans for achieving St. Mark's goals for its Respiratory and Neurodiagnostic Department, he's also represented the interests of the respiratory care profession in state and local issues, and served in an advisory capacity in Washington D.C. where he discusses health-related issues with senators and representatives in Congress.

Administrative Excellence

Margaret Pearce

Chief Nursing Officer

University Health Care

University Health Care CNO Margaret Pearce is not one to get caught up in titles or roles. "Here at the U, it does not matter what your role is, we are all here for the patient and we work closely together to make patient care outstanding," she says.

Pearce's colleagues' say she could also be considered "chief patient advocate" since when decisions need to be made, she's asking her staff, "how does it help our patients?" This question led to her championing staff and patients' ideas during the designing process of a new hospital wing with small units where patients are in the direct line of sight from the nursing station and where nurses have easy access to all of the resources they need to care for patients.

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"As a team, we look at it this way: we look out for the needs of everyone we come in contact with--staff, patients and families," explains Pearce. "When you do this, the balance comes automatically."

David D. Clark 

Regional Vice President and CEO 

Urban South Region,

Intermountain Healthcare

David Clark deeply understands the physician culture from growing up as the son of a neurosurgeon who gave him insight into what's important to physicians. "Health care is a team sport," says Clark. "By listening, striving to build consensus among physicians, and always focusing on making decisions that are in the best interest of our patients, I know our community will always be better off."

Considered by colleagues "a master at relationship building", Clark has helped the three hospitals under his jurisdiction (Utah Valley Regional Medical Center, Orem Community Hospital and American Fork Hospital) build a national reputation for quality patient care, receiving Magnet designation by the American Nurses Credentialing Center. The honor recognizes the hospitals as being in the top 4 percent nationwide for patient care.

"I have always tried to be clear in setting expectations, and I strive to be fair and consistent in my leadership style," says Clark. "Our culture values open communications, being inclusive and fostering healthy team work."

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Sunny Vance-Lauritzen

Director Rehabilitation Center,

University Health Care,

University Hospitals & Clinics

It almost seems too coincidental that someone with a name like "Sunny" could be known for promoting the positive mantra "We'll find a way", but Sunny Vance-Lauritzen's co-workers say it's a real part of her everyday language in the University's Rehabilitation Center.

"I approach the challenges that come about as opportunities and I do this with great persistence," says Vance-Lauritzen. "If it's the right thing to do for patients, staff and the organization then we will find a way to make it happen."

Standing by her mantra during her 33 years in hospital-based health care, Vance-Lauritzen led her team to transform a 28-bed inpatient acute rehabilitation unit into a regionally and internationally recognized rehabilitation center and service line. It's the only organization in the Intermountain Region to have CARF (Commission on Accreditation of Rehabilitation Facilities) specialty program accreditation in Comprehensive Inpatient Rehabilitation. But her co-workers say she's never ceased to make staff reward and recognition efforts a priority, a role she started with at the University Hospital Rehabilitation Center 15 years ago.

"We need to show (the rehabilitation center staff) we really appreciate what they give to all of us as a Rehab family," she says.

Volunteer

Barbara Clements

St. Mark's Hospital

Though Barbara Clements could've easily remained on the receiving side of the health care system after suffering a traumatic brain injury in an auto accident, she chose to provide care to others. Clements has donated more than 2,300 hours to St. Mark's Hospital, providing "retail therapy" in the gift shop.

"Everyone who comes into the gift shop are hoping that they will find something there," Clements says. "Sometimes they need something but don't know what it is. Some people come into the gift shop needing to find a way to momentarily distract themselves while they wait for questions to be answered which are disturbing. ... Others just need to share their story of frustration with another human being. Being there for them and helping them as a volunteer is something I consider to be an honor and a privilege because it allows me to be part of the healing process."

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A nationally recognized artist, Clements is an avid painter who continues to color the world around her with compassion.

Ruth Ann Smith

Fourth Street Clinic

Every Friday morning, Ruth Ann Smith starts her day at the Fourth Street Clinic in Salt Lake City by meeting with homeless patients suffering from cardiology complaints. Friday afternoons are spent calling colleagues to request pro bono tests, labs and surgeries. "[My interest here] is a bit selfish because I enjoy practicing medicine, so I'm glad the homeless clinic is available for me to keep up my skills and do what I enjoy doing," Smith says. "It's very challenging, which means it's interesting. I love to get to know the patients and know what challenges they're dealing with."

Smith spent 25 years as a University of Utah outpatient physician, where colleagues say she was known for incorporating a patient's personality and lifestyle into a plan of care. In the words of one of her colleagues, "Homeless patients can have trouble remembering histories, events and when they took their medications. They can miss appointments due to child care issues or transportation. Ruth Ann had the patience, understanding, persistence and gentle touch that breaks down these barriers and builds trust. She is doing the very hard, everyday work of helping the sickest patients with the least amount of resources."

Susan Daynes & Colonel

University Health Care

Sometimes the best visitors arrive on four legs. As members of Intermountain Therapy Animals, Susan and Colonel being comfort to patients in the Rehabilitation Center, Burn Trauma ICU and Huntsman Cancer Hospital. Patients will incorporate the skills they are working toward in therapy into games and tasks with Colonel, such as playing tug-of-war, brushing his coat or throwing a ball.

Susan and Colonel's volunteer contribution began when Susan's own son was involved in an accident that left him a quadriplegic. After witnessing the difference a service dog made in the life of her son, who was in high school at the time, Susan decided she wanted to provide the same experiences for other patients. She raised Colonel from a puppy and they've been serving ever since.

"We've had so many wonderful, gratifying experiences," Daynes says. "Colonel just knows what people need." Colonel's demonstrated his unique "people skills" with many patients including a girl involved in a drowning accident who remained completely unresponsive until Colonel jumped up on her bed and burped, causing her to laugh. And with a child suffering a neurological disorder who proclaimed she wanted to be a pet therapist after spending hours playing with Colonel in rehab. Regardless of age or condition, Colonel proves he's everyone's best friend.

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Community Outreach

Live Program

Tamara Lewis, M.D. & Pauline Williams

Primary Children's Medical Center,

Intermountain Healthcare

With childhood obesity a nagging concern on many parents' minds, health care professionals Tamara Lewis and Pauline Williams have set out to make eating healthy and staying active cool for kids. Studies show that one in four Utah children is overweight, with nearly one in 10 being obese. Lack of activity and unhealthy eating habits are blamed for creating the trend.

Enter Lewis and Williams. In 2007, the ladies began directing LiVe, a public education campaign to encourage healthy eating and activity levels among kids, originally concieved by Bruce Jensen, vice president of communications for Intermountain Healthcare. Using television, radio, print and outdoor public service announcements, the campaign provides easy and fun suggestions for a healthier lifestyle while an interactive Website (intermountainlive.org) allows kids and parents to download posters and brochures. The program also includes ViVe, a Spanish-language version.

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Aimed at kids ages 11 to 15, LiVe has staged a high-energy school assembly program that shows adolescents how to make healthy choices. The assembly was shown at 75 junior high schools across the state in 2008 with plans to increase that number in upcoming years to reach more than 30,000 Utah students.

Merrill Gappmayer Family Medicine Clinic

Utah Valley Regional Medical Center, Intermountain Heathcare

Creating a new model of care for sexual violence victims, caring administrators worked with residents and faculty to develop the Merrill Gappmayer Family Medicine Clinic in 1997. While victims formerly had to wait several hours in an emergency department before receiving care, the Gappmayer clinic provides care in a private setting 24-hours a day, 365 days a year.

As the only residency program in the state to provide this type of care to victims of sexual assault violence, residents and faculty physicians recognize that victims often experience high levels of trauma, and match treatments and care accordingly. Specially trained medical assistants perform forensic medical examinations and work closely with a victim's advocate, law enforcement and prosecutors to ensure medical evidence is documented and preserved to make perpetrators accountable.

Above all, the program's mantra is compassionate care. Residents continue to spread this philosophy and their skills throughout rural hospitals and in other areas across the country when they complete their residencies.

Robert Clark, M.D.

Mountain View Hospital,

MountainStar Healthcare

Though Dr. Robert Clark's office is in Payson, his influence is felt throughout the world with numerous health initiatives, programs and outreach efforts. Since 1990, Clark has assisted with the Neonatal Resuscitation Program, a low-tech and highly effective program used by doctors and midwives on babies who can't breathe at birth. Instituted throughout the U.S., the program spread to China, Vietnam, Russia and Indonesia, beginning with Clark's work in obtaining a Thrasher grant in 1991.

Dr. Clark says he continues to practice family medicine because it allows him to provide care for entire families over a long period of time, from delivering babies to providing care as a patient grows to adulthood.

"Whether at home or abroad, the health needs of people always exceed the resources available for their care," Clark says. "At home, I have been privileged to follow many of my patients from their birth through childhood, adolescent, adulthood, marriage and the birth of their children. Overseas, I have been privileged to help establish systems that allow large numbers of newborns to have a healthy start on life, and hopefully attain the same goals."

Corporate Achievement

CHG Healthcare

At CHG Healthcare, wellness is just part of the workday.

"With us, everything starts with our core value of our company, which is putting people first. We're always looking for more initiatives, products and services to help our employees and give them the kind of programs they want and deserve," says CHG Healthcare CEO Michael Weinholz. The company frequently surveys employees to discover what wellness programs they would like at work, which has resulted in offerings such as an on-site fitness center. CHG also provides yoga classes and massage therapy to de-stress during a busy workday and fresh fruit is always available for a healthy snack. This year, more than 400 CHG Healthcare employees participated in the annual Rock Your Body program, which focuse on body composition, and collectively lost 471 percentage points of body fat.

"We believe that having happy, motivated people is important to the success of our business, and providing wellness programs for them is a key part of that," Weinholz says. From a practical standpoint, such initiatives also keep medical costs down and attendance and productivity levels higher, Weinholz says.

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1-800 Contacts

For a company that is dedicated to keeping customers' eyes healthy, 1-800 Contacts has the whole body's wellness in focus. In addition to the company's 5,000-square-foot wellness facility, (featuring an aerobics room, cardio machines, free weights and a Wii console), personal trainers are onsite to plan individualized workout programs for employees. Wellness team members also administer several weight management programs, including Weight Watchers.

1-800 Contacts submits a large contingent of runners to the Salt Lake Marathon each year and as the holidays roll around, the company kicks it up a notch with the Holiday Weight Challenge. Last year, participants collectively lost 284 pounds over eight weeks.

When employees actually do sit down for a break, they enjoy an onsite restaurant offering eight to 10 healthy entrees a day, such as lemon chicken or fresh sea bass with white wine sauce, and many meal costs are subsidized more than 90 percent. "I've been here almost four years and I can count on two hands the number of times I've gone off property for lunch. It's as good as any restaurant in town," says Max Neeves, vice president of human resources.

Ultradent Products, Inc.

Ultradent's "bombastic" health program provides 18 get-healthy events a year, including a 5k run or walk marathon, a Maintain Don't Gain program and monthly health and fitness seminars. Employees who participate in six events annually are entered in a drawing for prizes such as $1,500 cash and dinner at Flemings Steakhouse.

The company's Peach program gives employees $50 off their monthly medical premium for working toward or meeting a national health standard. Combine that with an onsite fitness facility and employees can enjoy meeting their fitness goals.

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"Certainly this outreach increases the happiness, the loyalty and the passion of the employee to be engaged with our company," says Dr. Dan Fischer, CEO of Ultradent. "But at the end of the day, you have to have some fun, too."

Ultradent's health goals extend to the community, the United States, and to over 100 countries in Europe, Asia and South America. Spearheaded by Fischer, Ultradent's mission is to find a cure for caries (mouth decay) using minimally invasive dentistry. The company is also the exclusive provider of sealants for the Sealants for Smiles program and is an underwriter for the National Children's Health Foundation.

Innovation:

Dwayne R.

Westenskow, Ph.D.,

Joseph A. Orr, Ph.D.,

Derek J. Sakata, M.D.

Anecare QED-100

University Health Care

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Like so many innovations, the idea behind the QED-100 began when a team of professionals thought, "There must be a better way."

The Anecare QED-100, invented by Dwayne R. Westenskow, Joseph A. Orr and Derek J. Sakata, accelerates patients out of the fog often felt after being anesthetized during surgery. Patients breathe into a small, plastic device, which actively reverses inhaled anesthesia after surgery. Using the QED-100, patients can recover faster while also decreasing post-operative side effects that often accompany general anesthesia, such as breathing problems and extreme grogginess.

From initial conception in 2003 to receiving FDA approval in 2005, the process hasn't stopped flowing for this team of faculty and business members. And though the process of taking an invention to market is a grueling haul, Sakata says it's entirely worth it. "The most exciting part is when you actually see it work ... when you see patients quickly and seamlessly emerge in the operating room and when they later verbalize that they feel amazingly awake. It's really fascinating to think, 'Wow, we are making more improvements in our anesthetic technique.'"

Robert Ball, M.D. & Michael Belfort, M.D.

MountainStar Maternal Fetal Medicine,

HCA MountainStar Division Any mother expecting twins feels an ever-expanding joy. However, the bliss can be interrupted by Twin-to-twin Transfusion Syndrome (TTTS), which affects 10 percent to 15 percent of identical twin fetuses. In TTTS, the babies share a single placenta and are both connected to nourishing veins. If left untreated, 80 percent to 90 percent of twins with TTTS do not survive.

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Dr. Robert Ball and Dr. Michael Belfort are providing a solution to TTTS for Utah mothers. As the only physicians in the Intermountain West to perform in-utero surgeries that save both babies with TTTS, the team performs a fetoscopy, a procedure that separates the veins and allows each baby to receive nourishment.

"With every case, it's a tremendous crisis and it's something the parents never expected. It is a life and death situation for the babies and you walk that journey with them," says Ball.

The pair did their first procedure in April of 2007 and performed about 15 cases in the year following. "There is something incredibly rewarding in seeing children grow up and participate so effortlessly in life that was so nearly denied them," Belfort says.

Bruce Reid, M.D.

Co-director, Artificial Heart Program,

Intermountain Medical Center,

Intermountain Healthcare

As the co-director of the Artificial Heart Program, it's safe to say that Dr. Bruce Reid brings a lot of heart to his job.

Recognizing that heart transplantation, though very successful, is only offered to a small fraction of those with congestive heart failure, Reid oversaw the Intermountain Medical Center's participation in the clinical trial of the HeartMate II Left Ventricular Assist System (LVAS), a tiny mechanical device used as a temporary bridge for patients who need a heart transplant, but are stuck on long waiting lists. The device is surgically implanted alongside a patient's heart and takes over the pumping of the left ventricle, pumping up to 10 liters of blood per minute. The HeartMate II LVAS is a therapeutic option meant to sustain patients while they wait for health transplants.

Under Reid's leadership, the program has performed 225 successful implantations of the device in recent years, but to Reid, the people mean much more than the numbers.

"The most meaningful aspect of my job is the satisfaction of being a small part of a wonderful team of health care professionals who are dedicated to the treatment of patients with heart disease," Reid says. "It is an honor to be able to care for those in need."

Photography by Brandon Flint