Posts by boarmaa

CPMC’s HELP Program for Older Adults Receives Top Designation from AGS

Posted on Oct 22, 2020 in California Pacific Medical Center, Expanding Access, Scroll Images, Uncategorized

CPMC becomes fifth U.S. medical center to achieve elite ‘Center of Excellence’ status

California Pacific Medical Center (CPMC) in San Francisco is now one of only five organizations in the United States to achieve the American Geriatric Society (AGC) CoCare: HELP™ Center of Excellence designation for its Hospital Elder Life Program (HELP). CPMC was recently awarded this elite status after demonstrating the highest level of best practices in geriatric care.

“I am so proud of our dedicated team at CPMC for all their hard work in building a world-class geriatric care program,” says hospitalist and geriatrician Wendy Zachary, M.D., who directs CPMC’s Acute Care for Elderly (ACE) unit and is the HELP physician-champion. “This accreditation from the American Geriatric Society validates and strengthens our mission to provide patient-centered, advanced care for older members of our community who are particularly medically vulnerable–especially during the COVID-19 pandemic.”

Watch this video about CPMC’s ACE unit.

Targeted Interventions Lead to Better Outcomes for People Ages 70+

The AGC CoCare: HELP™ program is designed to prevent both delirium and functional decline in patients 70 years and older. CPMC’s HELP program uses an interdisciplinary team (Advanced Practice Nurses, specially-trained Elder Life Specialists, and trained volunteers) to integrate principles of geriatric care into standard nursing and medical care at all three CPMC hospital campuses in San Francisco, including the ACE unit at the Mission Bernal Campus, as well as the Van Ness Campus and Davies Campus.

Geriatric syndromes include conditions typical of aging such as delirium, incontinence, falls, pressure injuries, and functional decline. CPMC’s HELP program works to prevent these geriatric syndromes in the hospital setting by helping re-orient patients to their surroundings through conversation and social support, assisting with range-of-motion and breathing exercises, walking, offering companionship during meals, implementing a schedule, and more.

Benefits of HELP at CPMC include:

  • Helps maximize independence and physical functioning of high-risk patients (age 70+)
  • Improves overall quality of hospital care for older patients, including improvement in hospital outcomes and satisfaction with care
  • Helps decrease the length of stay for patients by an average of 1- 1.5 days
  • Helps reduce hospital readmissions
    • Van Ness Campus’ HELP program saw a decrease in readmissions by 11% in 2020 Q1, 17% in 2019, and 24% in 2018
    • Mission Bernal Campus’ HELP program prevented more than 30 readmissions in 2019
  • Helps reduce falls for older patients by as much as 50% at the Van Ness Campus and Davies Campus (2019)
  • Provides cost-effective care, with reduced overall hospital costs by as much as $2 Million across each of the three campuses in 2019

“The HELP program is making a meaningful difference in changing the course of lives for elderly patients and their loved ones, and I am truly grateful for our staff, volunteers and support from our philanthropic donors who helped make this elite recognition possible,” said Warren Browner, M.D., CEO of CPMC.

Mission Bernal Campus Hub of Geriatric Care in San Francisco

While CPMC’s HELP program is carried out across all its three campuses, its Mission Bernal Campus is home to the medical center’s comprehensive ACE unit and one of only three accredited Geriatric Emergency Departments in Northern California.

“These differentiators of specialty care for older adults and this recent acknowledgement from the AGS further highlights CPMC’s commitment to geriatric care and cements our Mission Bernal Campus as a hub of geriatric patient care in San Francisco and the broader Bay Area,” says Vernon Giang, M.D., chief medical executive of Sutter’s CPMC.

Musical B-I-N-G-O Brings Moments of Levity for One Hospitalized Elder

Posted on Oct 22, 2020 in California Pacific Medical Center, People, Quality, Scroll Images

Callie Cowart, a full-time board-certified music therapist at Sutter’s California Pacific Medical Center (CPMC) in San Francisco uses music to heal.

Cowart recently offered her therapy sessions to an older patient undergoing care at CPMC’s Mission Bernal Campus Acute Care for Elderly (ACE) unit. Cowart explains that the patient had many recurring hospitalizations over the span of four months this year.

“She and I worked together originally to use music to provide a competing stimulus to pain, which she unfortunately experienced a lot of during her time here,” said Cowart.

A B-I-N-G-O Playlist to East Anxiety & Pain

As Cowart and the patient got to know each other, the patient would look forward to sessions with “her Callie” as an energy booster and motivator.

“One morning I read in the physical therapist’s notes that prior to shelter-in-place this patient would frequent a local BINGO hall, but she’s not been able attend since the start of the pandemic. Since I knew her favorite songs, I surprised her in our next session with a customized BINGO card with each square having a different song title,” said Cowart.

To give the full effect, Cowart cut out strips of paper with the matching song titles, placed them in a bag, and used the strips as her BINGO balls that the patient could pull out. Once a BINGO “ball” was drawn, the two would sing and play together.

Music Therapy at CPMC

The Music Therapy Program at CPMC offers patients and their families the opportunity to receive therapy services from a board-certified music therapist, at no cost to the family. Music therapists are seen as an integrated part of the patient’s multidisciplinary care team and work closely with doctors, nurses, child life specialists and other therapists as part of care for the patient’s whole self.

The Sound of Music on Health

According to an article published on Harvard Health, a growing body of research attests that music therapy is more than a nice perk. It can improve medical outcomes and quality of life in a variety of ways.

For example, music therapy can help people who are recovering from a stroke or traumatic brain injury that has damaged the left-brain region responsible for speech. Because singing ability originates in the right side of the brain, people can work around the injury to the left side of their brain by first singing their thoughts and then gradually dropping the melody.

Sessions that Strike the Right Chords

Cowart says that the patient was an excellent handheld shaker player and developed a sort of fan club among the ACE unit staff for her spunky personality.

“She told me time and time again that this musical intervention gave her an increased sense of social support and mood/energy boosting during her hospitalizations at ACE because visitors had not been allowed in the hospital during COVID,” shared Cowart.

“Having something and someone to look forward to in a place that can sometimes be scary or associated with negative memories and emotions can prove to be very important,” she adds.

As for the patient, thankfully she has not had to return to the ACE unit and appears to be doing well, which is music to Cowart’s ears.

This World Mental Health Day, Let’s Celebrate the Creativity of Our Young People

Posted on Oct 9, 2020 in Mental Health, People, Scroll Images

A message from John Boyd, Sutter’s CEO of System Mental Health & Addiction Care:

World Mental Health Day is always an opportunity to reflect on our well-being, both as individuals and as a society. After the unprecedented difficulties and upheavals of 2020, it should also serve as a challenge. We can no longer minimize or overlook the impact of individual and collective trauma, and we must work together to ensure a more supportive, empathetic and human future. Central to that project is reimagining “mental health” as “human health”—it’s fundamental to who we are, how we connect with others and how we understand the world around us. Making this shift in thinking a reality must start with a focus on young people.

As I’ve written about before, my own childhood was shaped by experiences of trauma, stigma and shame. Sadly, these same experiences are far too common among our youth, and the events of the past year have only further intensified the impact. Too often, the heaviest burden falls on our most marginalized communities, including people of color and neurodiverse students. With schools across the country facing difficult questions about whether and how to safely re-open, it’s important to center students’ developmental needs in addition to their educational needs.

It goes without saying that young people, particularly adolescents, place a great deal of value in their friendships and peer relationships. There is a deep biological and psychological basis for this—adolescents are hard-wired to seek out friendships and form social bonds. They are also learning to assert their independence, challenge authority, and test boundaries (as any teacher or parent will attest!). School and extracurricular activities provide critical outlets for these fundamental needs, and unfortunately many public health guidelines—physical distancing, avoiding large groups—are in tension with the developmental needs of our young people. But we can learn a lot about how we can solve these problems from young people themselves.

One of the most heartening aspects of the past year, despite its difficulties, has been the many stories of creativity, hope, and resilience from young people. The developmental processes I mentioned above are also great drivers of creative thinking. What may look like boredom or impatience from the outside can also be an opening for a novel, innovative idea.

We’ve seen that spirit of discovery and creativity as young people continue to raise their voices in response to ongoing police violence around the country. Others have used technology in surprising ways to stay connected with friends despite many new obstacles. Young artists are also finding ways to create through diverse media, providing a vital outlet for self-expression at a difficult time in a young person’s life. No matter what the future has in store, we can always count on young people to surprise us.

In that spirit of creativity, Sutter Health is reimagining youth mental health through human-centered design. We have a assembled a diverse team of clinical experts, social workers, designers and youth advisors to understand the lived experience of young people as they transition from childhood through adolescence and into adulthood. The interplay between the ups and downs of everyday life, developmental psychology and living with a mental health condition presents unique challenges for young people at this age. That’s why it’s so critical that we take a human health approach to reimagining the experience of young people living with mental health conditions.

We’re all facing more constraints than ever in 2020, and it’s our responsibility to keep exploring and imagining new ways to meet these challenges. We should inspire our young people to do the same—their resourcefulness and empathy gives me hope for the future. Our creativity is one of the things that makes us human. Let’s use that creativity to be healthier, too.

Welcoming to the world one bundle of joy…make that two bundles… actually three!

Posted on Oct 2, 2020 in California Pacific Medical Center, Quality, Scroll Images, Women's Services

When Zarmina and Haris Anjum learned they would be having triplets this spring, one of the first things they did was buy an SUV.

“We planned for one, then it was twins, and then two weeks later it was three. It was wonderful and not at all expected,” said Haris. “We joked that we better hold off on having any more ultrasounds.”

Fast forward to this fall.

The Anjum’s were scheduled to deliver at a San Francisco hospital. When that facility experienced a staph outbreak, the family was transferred to nearby Sutter’s California Pacific Medical Center Van Ness campus hospital.

“We were met with such warmth,” said Haris. “It was reassuring to be cared for by such professional doctors and nurses. The facility was phenomenal, and we were relieved there were private NICU rooms.”

Healthy delivery

The Anjum triplets – Yahya, Yakub, and Yusuf – were born at 34 weeks via cesarean section.

“Delivering twins is already fun, but triplets—now that’s super fun,” said obstetrician Ruth Olweny, M.D. “We’re well equipped to handle multiple births at CPMC and having three providers on that night made Zarmina’s delivery seamless. The room setup was mostly the same, too, except that for triplets we have three isolettes on hand (a clear plastic enclosed crib that maintains a warm environment) as opposed to one or two.”

Obstetrician Izumi N. Cabrera, M.D., added, “When the family arrived at CPMC, Haris had a big box of supplies for cord blood blanking.”

Cord blood is the blood from a baby that is left in the umbilical cord and placenta after birth. This blood contains special cells called hematopoietic stem cells that can be “banked” (stored) for later use by the individual and has been used to help treat certain diseases.

“Cord blood collection requires another step during delivery. When you consider that we were doing it for three babies, that means there’s even greater focus from the team. I was pleased we were able to capture the needed material from all three babies’ cords. We were basically a functioning assembly line as each baby was delivered,” said Dr. Cabrera.

Three facts about triplets

They’re rare. In 2018, the Centers for Disease Controls (CDC) and Prevention reported 3,400 triplet births, while there were more than 123,000 twin births. The CDC reported 3,791,712 total births in the U.S. in 2018.

They’re early birds. According to March of Dimes, the majority of triplets are born premature. Most triplets are born between 32-34 weeks of gestation and caesarean section delivery is common.

There’s often a family history of multiple births. The American College of Obstetricians and Gynecologist says that twins are the most common type of multiple births. Heredity on the mother’s side ups a couple’s odds of conceiving fraternal twins.

Settling in at Home

Born in early September, the Anjum triplets are getting stronger and gaining weight by the day.

“All three are wireless now,” chuckles Haris, referring to each baby no longer needing a feeding tube and now breathing room air.

As for what’s next, Zarmina and Haris are taking it one day at a time.

Haris says, “I have the honor of being their chauffeur and continuing to support my wife in her recovery. We’re looking forward to settling in at home and introducing our four-year-old son to his baby brothers. But first I have to conquer these car seats!”

Sutter’s Electronic ICU Helps Hospitals Handle Influx of Coronavirus Patients

Posted on Sep 9, 2020 in Innovation, Scroll Images

COVID-19 is bringing new relevance to Sutter’s longstanding electronic intensive care units (eICUs) and to telemedicine. The integrated healthcare network’s two eICUs, one in San Francisco and one in Sacramento, enable it to provide hospitalized critical care patients, including COVID-19 patients, in both rural and urban hospitals with the safest, most advanced medical care—as well as expanding the system’s critical care bed surge capacity during the pandemic.

Tom Shaughnessy, M.D. and medical director of Sutter’s Bay Area eICU, says the program’s goal hasn’t changed much since its earliest days: “Making sure the sickest patients across the system’s geographically diverse footprint get access to specially trained nurses and doctors 24-hours a day,” he says.

Sutter’s innovative eICU program began in 2004 and the first of its kind on the West Coast.

Expanding Critical Care during a Pandemic

eICUs allow critical care doctors and nurses to check in on patients remotely using cameras, microphones, alarms and other monitoring tools. This approach not only helps protect on-site physicians, critical care nurses and other professional staff at the patient’s bedside, it also conserves precious personal protective equipment (PPE) and helps provide backup to caregivers who may be stretched thin at both rural and urban ICUs. Electronic ICUs have also helped increase critical care bed capacity in the event of a COVID-19 patient surge.

Read more on CNET.com about how Sutter’s eICU is helping the integrated network handle the influx of patients during the pandemic.

“If you choose to live in a rural community, it doesn’t mean your health should suffer because you don’t have access to the resources that you need,” says Vanessa Walker, D.O., a pulmonary critical care physician and director of the eICU for the Valley area of Sutter Health.

“Sutter’s eICU program has been especially beneficial to nursing staff at our smaller hospitals. [In this pandemic], they’ve had to take a crash course on managing incredibly complicated patients. Our eICU nurses have been there to help, whether it was for a second signature for medications to prevent further exposure or as a practical guide on how to place a patient in a prone position. The teamwork between the eICU and the bedside has been phenomenal,” she says.