CCC

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CCC
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Clinical Care Center (CCC)

• Vicki Baker, MD
• Director
• Department of Obstetrics/gynecology
• Laura Davisson, MD
• Co-Director
• Department of Internal Medicine
• MaryAnn Long, MD
• Co-Director
• Department of Family Medicine

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WVU COEWHInterdisciplinary Set Up
Well Women, Primary Care, Obstetrics Gynecology
Obstetrics Gynecology
Internal Medicine
Family Medicine
Primary and Specialty Care Patients
Primary Care Patients
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CCC

• Located fourth floor Physician Office Center
• Provides multidisciplinary care for women
• Handicapped access
• Resource material
• Social work support

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CCC Specialty care

• Womens stroke clinic- Dr. Claudette Brooks
  (Neurology)
• Betty Puskar Breast Care Center Radiology
  (mammography and densitometry)
• Urogynecology Dr. Stan Zaslau (Urology)
• Gynecologic oncology Dr. Vicki Baker

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Marketing

• Billboard
• Television commercials
• Upcoming feature on the CCC in the Sunday local
  newspaper (Dominion Post)
• Numerous newspaper ads

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Educational integration

• Pharmacy student rotation
• Medical student Womens Health rotation
• Internal medicine resident Womens Health
  rotation
• Family medicine resident gynecology rotation

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Educational integration

• Online didactic curriculum via SOLE portal
• Family medicine noon conference, Women's Cancer
  Screening (Dr. Long)
• Upcoming Internal medicine noon conference,
  Preventive Healthcare in Women (Dr. Davisson)

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Outreach integration

• ACS Think Pink Brunch, COEWH and Breast Cancer
• Parents Place, Preventive Healthcare for Women
• Healthline radio show on WAJR, Women's Health
  issues
• Doctors On Call television program, Womens
  Health
• Upcoming Doctors On Call, Women and Heart
  Disease, April 2006

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CCC Future

• Possible expansion under discussion with WVUHS
• Cheat Lake
• Eastern Panhandle
• Clarksburg
• Charleston

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CoEWH Future

• Expansion of all components to
• WVU HSC Charleston campus
• WVU HSC Eastern panhandle campus

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Clinic Integration
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Clinic Working Group

• Claudette Brooks, Neurology
• Anne Cather, Student Services, Professional
  Development
• Karen Clark, Student Health
• Elizabeth Cohen, OB-GYN
• Pam Courtney, OB-GYN
• Ann Dacey, WVCOEWH
• Laura Davisson, Internal Medicine
• Rebecca Dewitt, Neurology
• Teresa Dunsworth, Clin Pharmacy
• Elizabeth Durant, SON
• Tracy Hose, Patient Services

• Bridgette James, Patient Registration
• Julia James, OB-GYN
• Nan Leslie, SON
• Mary Ann Long, Family Practice
• Betty Parsons, WVCOEWH
• Julie Peasak
• Michel Vernon, Ph.D. OB-GYN
• Susan Wiltrout, Clinical Services
• Stanley Zaslau, M.D. Urology

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Stroke and WomenWVU CoEWH Womens Stroke Clinic

• Claudette E. Brooks, MD
• Asst Professor, Neurology
• Director, Stroke Clinic CoEWH
• Director, Neurovascular Laboratory
• WVUH Stroke Center/WVU School of Medicine

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Stroke and Women

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Stroke and Women

• Every 45 seconds in the US someone has a stroke
• 46,000 more women than men have a stroke every
  year in the US
• Stroke is the 3rd leading cause of death in the
  United States
• Over 700,000 strokes occur yearly in the US
  (250,000 recurrent, 500,000 new)

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WVUH Stroke Center

• Established in 2000
• JCAHO certified Primary Stroke Center
• Stroke Clinics established in 2002
• Associated with CoEWH in 2005

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Stroke Is

• Preventable
• Treatable

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Stroke and Women

• AHA survey found that 4 out of 5 women do not
  know that cardiovascular disease is the leading
  cause of death in women
• 1/3 of PCPs (primary care providers) do not
  recognize this
• Kills twice as many women than breast cancer
  yearly

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Stroke and Women 2

• 1/3 of strokes occur in those under 65 (100,000
  young and middle aged women in 2001)
• Women are more likely to have serious disability
• 16 of those hospitalized will die (6 of men)

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Stroke and Women 3

• On average, takes 49 longer for women to be
  treated for stroke in the emergency
  department/hospital
• Stroke risk doubles every decade after the age of
  55
• Women are 43 of all strokes, 61 of stroke
  deaths
• More women die of SAH than men across all age
  groups (Ayala, Croft, Greenlund, etal Stroke 2002)

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Women and Stroke in WV All, Ages 35, 1991-1998
97-106 107-111 112-115 117-121 122-139 Age
adjusted avg annual deaths/100K
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United States, Women Ages 35 Stroke Death
Rates, 1991-1998
58-110 111-120 121-129 130-141 142-226 NoData Age-
Adjusted avg annual Deathsper 100K
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Status of Women In WV

• Report published in November 2002 by the
  Institute for Womens Policy Research
• Cardiovascular Disease mortality in WV ranked
  49th
• 190.2/100,000 while the US avg was 161.7/100,000
  (190.1 vs. 159.8 Caucasian women, 218.3 vs. 195.3
  for AA women)

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Women and Stroke

• Face longer delays than men prior to being
  evaluated in the ED (Menon, Pandey, and
  Morgenstern, 1998)
• Differences in presenting symptoms may be the
  cause for delay in dx
• Adverse outcomes may be attributable to delayed
  dx and referral for tx in acute phase

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Womens Issues

• Pregnancy
• Menopause
• Hormones (OCPs and HRT) Womens Health
  Initiative
• Migraines - increase risk 3-6x (smoking, OCPs
  and migraines can increase risk up to 34x)

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Womens Issues 2

• Longer lifespan
• Often alone/widowed (lack of support system) NH
  more likely
• More caretakers of stroke survivors are women

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What do we want to accomplish?

• Increase the education and awareness of stroke
  and its risk factors in women
• Empower women with this knowledge to better take
  care of themselves and their families
• Integrate and improve our services to women by
  acknowledging the differences in their needs

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How?

• Treatment
• Education patient centered
• Research
• Support services
• Nutrition
• Social and Family Issues

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Shifting of the Paradigm

• Key is prevention
• Treating a stroke is treating a failed chance at
  prevention
• Treating a second stroke means you may have
  failed again

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