Posts by dugase

Wildfires, Extreme Heat, Unhealthy Air During a Pandemic

Posted on Aug 20, 2020 in Pulmonary & Lung Health, Scroll Images

An Integrated Network Continues to Serve Northern California Communities

SACRAMENTO, Calif. –Wildfires fueled by high temperatures and winds are spreading across Northern California. Firefighters are battling to stop the blazes, which have forced thousands of people out of their homes. And to top it off, smoke from the fires is causing extremely unhealthy air quality in many areas, compounding respiratory issues concerns–especially for people with COVID-19.

Sutter’s round-the-clock emergency management system is monitoring the progress of the fires and the impact the heavy smoke is having on some of our care sites. Sutter has a long-standing commitment to the health and safety of the communities we serve, especially in times of natural disasters. During these unprecedented times, our integrated network is able to quickly move and redirect resources to those most in need. And despite the many challenges we’re all facing right now, Sutter hospitals and the vast majority of our clinics are open and stand ready to care for patients.

“I want to thank the thousands of firefighters and additional emergency personnel who are responding to these blazes and patients with medical conditions triggered by them—especially the physicians, nurses and staff across Sutter’s integrated network,” said Sarah Krevans, Sutter Health’s president and CEO. “Our teams have been on the front lines caring for patients since the very beginning of the COVID-19 pandemic and now they are simultaneously helping support their communities during these fires.”

December 11, 2017 – Fire crews, using controlled burns, create a barrier in the foothills of Carpinteria, California, in the hopes of containing the Thomas fire in Southern California.

“We are deeply saddened by the devastation the firestorms are waging on our communities and we are committed to supporting wildfire victims and evacuees,” said William Isenberg, MD, Phd, Sutter Health’s chief quality and safety officer. “Sutter Health team members also live in these communities and we know many of their homes and families have been impacted by the fires, so we are activating employee resources like emergency financial assistance.”

Resources to Help You Access Care

Although some care sites may be experiencing temporary closures due to evacuation orders, air quality concerns or COVID-19, listed here, care team members at those care sites are available to determine which available options work best to help patient access care during the closures:

  • Video visits with a care provider
  • Obtaining in-person care at another Sutter facility
  • Rescheduling services once it is safe to do so

In partnership with clinicians and care sites across our network, Sutter’s Mental Health & Addiction Care team is also available to assist with your mental wellness. Even if you are not directly affected by the wildfires across Northern California, just hearing about them may trigger memories from a past event, leading to fear, anxiety or other strong emotions. If you or a loved one needs help, please contact your primary care physician or access the emergency resources found here.

A Message from Sarah Krevans on the Northern California Wildfires

Posted on Aug 19, 2020 in Integrated Network, Scroll Images

Wildfires are again burning in multiple Northern California counties. Sadly, it’s an all too familiar occurrence for many of the communities Sutter Health is privileged to serve.

Sarah Krevans, President & CEO,
Sutter Health

I want to thank the thousands of firefighters and additional emergency personnel who are responding to these blazes—especially the physicians, nurses and staff across Sutter’s integrated network. Our teams have been on the front lines caring for patients since the very beginning of the COVID-19 pandemic and now they are simultaneously helping support their communities during these fires.

We are closely monitoring the progress of the fires, as well as the resulting poor air quality, and their impact on our care sites. As always, the safety of our patients and staff is our top priority. We will work to keep our communities informed during this evolving situation.

Sutter is also committed to supporting our staff who may have been evacuated or otherwise impacted by the wildfires. We are checking in with our team members and activating employee resources like emergency financial assistance.

As we have done throughout the ongoing pandemic and in past wildfires, we will use the breadth of our integrated network to move resources around our care sites to where they are needed most to help our communities and patients in Northern California.

Caring for a Newborn in a Pandemic

Posted on Aug 17, 2020 in Pregnancy & Childbirth, Scroll Images

This article was written by Anita Mantha, M.D., pediatrician with the Palo Alto Medical Foundation for the August 2020 issue of Bay Area Parent magazine. 

Raising a newborn has never been easy. Nighttime feedings, coping with your own body’s recovery and the constant worry that comes with keeping your little bundle of joy safe are all part of being a new parent. In the midst of a pandemic, that job may be even more challenging. In the era of COVID-19, how do we keep our newborn baby safe, while enjoying the beautiful journey ahead?

If a mother is suspected or known to have COVID-19, how do doctors care for the newborn?

This is an evolving topic, as we learn more about this virus. Many hospitals are currently testing pregnant women around the time of their delivery for COVID-19. You can check with your obstetrician and the hospital team to find out if and when this test is being done if you have questions.

If you do test positive, do not panic. Hospitals have policies and procedures in place to help keep you and medical staff protected. While your care team may look a bit different than you imagined – gowns, face shields, masks and gloves – they will still work hard to support you during your delivery.

Once your baby is born, your care team will likely recommend that you wear a mask and practice good hand hygiene. Your baby may also be tested. Your care team will likely discuss additional precautions around topics such as physical distancing and feeding. Please remember not to put face coverings on children less than 2 years of age.

Can I still breastfeed my baby if I have COVID-19?

The benefits of breast-feeding have been long documented. One of the benefits is that breastmilk has antibodies that help protect the body against bacteria and viruses, potentially making it all the more important to breast feed your newborn now. In limited studies, COVID-19 has not been detected in breast milk. However, we do not know for sure whether mothers with COVID-19 can spread the virus via breast milk. 

What we do know is that it’s important to practice good hand and breast hygiene while pumping. Also, consider having a caregiver in good health offer bottles of your milk. If you have tested positive for COVID-19, you and your care team can discuss when and how to nurse your baby directly. 

What are the symptoms of COVID-19 in a newborn?

Newborns can have a wide range of symptoms including fever (defined as a temperature greater than 100.4F), poor feeding, being very tired, coughing, congestion, runny nose and/or breathing difficulties. The tricky part about newborns is that these symptoms can be caused by a variety of things, so it is important to discuss any concerns with your care team. The good news is that most children (including newborns born on time) with COVID-19 are asymptomatic or have mild symptoms. Prior to going home with your newborn, consider having a thermometer at home and being comfortable taking a rectal temperature, which is the most accurate temperature reading in newborns. Having your physician’s advice line number on hand is also important in case questions arise.

Can I let family members visit the baby? How do I keep my newborn safe from COVID-19?

Aside from COVID-19, we recommend caution, especially in the first month of life, to prevent your baby from catching an infection. Your newborn has an immature immune system and is at risk for serious bacterial infections. For these reasons, a fever is considered an emergency, and you should seek care for your child right away if it happens.

Now, more than ever, try to limit visitors in the first month of life. Anyone who visits should practice careful hand hygiene, practice physical distancing and wear a mask as much as possible. Please remember, even in the midst of a pandemic, normal newborn concerns still exist: jaundice, weight checks, etc. Please keep all regularly scheduled newborn care appointments and inform your care team if you or your baby are symptomatic prior to these visits so they can determine next steps.

I know moms can go through “baby blues.” Won’t physical distancing only make this feeling of isolation worse?

With all that is going on, it is natural for new mothers to feel as if they are on an emotional roller coaster. The important thing is, even though you may need to physically distance yourself to keep your newborn safe, you do not need to emotionally distance. Make sure to connect virtually with friends and family as much as possible. Connecting with other parent friends via video or phone calls can be helpful as well. La Leche League (llli.org) also provides great support to new parents.

What can I do to help my postpartum worries?

Make sure to take time for yourself and try to maintain a bit of a routine to help feel more balanced. Try to avoid frequently checking the news or social media, as this can lead to more stress. Consider some time for meditation, spending time outdoors or anything else you find enjoyable. Postpartum blues can turn into something more serious such as postpartum depression or anxiety, so please seek help if you are feeling that your mood is making it difficult to function. There are many resources to help, so do not wait to reach out. As things are constantly changing, please check with your healthcare team for updates on the care of newborns in this challenging time. The CDC also offers helpful information here.

Sutter Hospitals Honored for High Quality Stroke and Cardiac Care

Posted on Aug 5, 2020 in Heart & Cardiac, Scroll Images

SACRAMENTO, Calif. – Twelve hospitals within Sutter’s not-for-profit network received recognition from the American Stroke Association (ASA) for providing a high level of stroke care and participating in the ASA’s Get With The Guidelines® program. Additionally, 20 hospitals in the Sutter system received recognition from the American Heart Association (AHA) for consistently applying the American College of Cardiology guidelines when treating patients with heart failure, and participating in the AHA’s Get With The Guidelines® program.

Stroke Care

Sutter hospitals including Alta Bates Summit Medical Center in Oakland, California Pacific Medical Center – Van Ness campus in San Francisco, Eden Medical Center in Castro Valley, Memorial Medical Center in Modesto, Mills-Peninsula Medical Center in Burlingame, Sutter Medical Center, Sacramento, Sutter Tracy Community Hospital, Novato Community Hospital, and Sutter Santa Rosa Regional Hospital each earned a Get With The Guidelines®-Stroke Gold-Plus Quality Achievement Award for meeting or exceeded performance-focused quality benchmarks set forth by the American Stroke Association. Memorial Hospital Los Banos and Sutter Roseville Medical Center earned the Silver-Plus Quality Achievement Award and Sutter Solano Medical Center earned Bronze. 

“The care teams in our Brain & Mind service line work closely together, using evidence-based clinical practices, so patients receive high-quality care and exceptional service,” said Bill Isenberg, M.D., chief quality and safety officer for Sutter Health. “Our goal of continuous improvement in the neurosciences helps drive and strengthen our integrated health care network.”

Each of the honored hospitals are designated by The Joint Commission as Primary Stroke Centers and serve as a resource available to patients needing stroke-related services.

Our goal of continuous improvement in the neurosciences helps drive and strengthen our integrated health care network.

Eleven of the Sutter hospitals honored also earned a place in the Stroke Honor Roll —with Sutter Tracy Community Hospital and Sutter Santa Rosa Regional Hospital each receiving Elite Plus Honor Roll status. To qualify for this recognition, these hospitals met quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat acute ischemic stroke.

Furthermore, this year marks the debut of two new Stroke Honor Rolls, and Sutter hospitals earned a place on each. Sutter Medical Center, Sacramento is among only 11 hospitals in California to be listed on the Advanced Therapy Honor Roll which recognizes participating hospitals that met timeliness targets for the removal of blood clots from the brain under image guidance. This procedure, known as endovascular thrombectomy, is not performed at all hospitals. Additionally, eight Sutter hospitals earned a place on the new Type 2 Diabetes Honor Roll, which promotes evidence-based care for patients with this condition.

Cardiology Care

The 2020 Get With The Guidelines® awards also recognizes hospitals that maintain high standards in the treatment of heart failure. Overall, 20 Sutter hospitals demonstrated their commitment to providing the most appropriate cardiac care by following nationally recognized, research-based guidelines to treat heart failure and participating in the Get With The Guidelines® program.

Sutter’s Alta Bates Summit Medical Center (Oakland and Berkeley campuses), California Pacific Medical Center (Davies, Mission Bernal, and Van Ness campuses), Memorial Medical Center, Mills-Peninsula Medical Center, Memorial Hospital Los Banos, Sutter Auburn Faith Hospital, Sutter Coast Hospital in Crescent City, Sutter Davis Hospital, Sutter Delta Medical Center in Antioch, Sutter Lakeside Hospital in Lakeport, Sutter Roseville Medical Center, Sutter Solano Medical Center in Vallejo, Sutter Medical Center, Sacramento, Novato Community Hospital, and Sutter Santa Rosa Regional Hospital each earned a Get With The Guidelines®- Gold Quality Achievement Award for high quality heart failure care. Sutter Tracy Community Hospital earned Silver and Eden Medical Center earned the Bronze Quality Achievement Award for high quality heart failure care. 

Sutter’s Mills-Peninsula Medical Center also earned recognition for the evidence based care of coronary artery disease, and for meeting or exceeding care recommendations for patients presenting with an ST-elevation myocardial infarction (STEMI) – a specific kind of heart attack that can be caused by coronary artery disease.

“The American Heart Association and American Stroke Association are pleased to recognize these Sutter hospitals for their commitment to stroke and cardiac care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines® quality improvement initiative can often see fewer readmissions and lower mortality rates.”

Sutter Health proactively implements programs across its integrated network that continuously improve the quality and value of healthcare for patients. Its integration across regions, clinical settings and data environments is delivering care models with some of the best clinical outcomes in the nation. From heart transplants to valve replacements to cardiac ablations, Sutter’s Cardiovascular Health service line practitioners use innovative procedures and treatments to care for patients with a wide variety of specialized heart and vascular needs.

Respiratory Care Clinics: How Dedicated Exam Spaces Limit the Spread of Viruses

Posted on May 26, 2020 in Access to Care, Scroll Images

BAY AREA, Calif. – Its second nature for people to visit their doctor’s office or an urgent care center when they’re sick — or are worried they might be. In early March doctors across the Sutter Bay Medical Foundation prepared for patient demand at these locations by developing Respiratory Care Clinics (RCCs); an outdoor exam experience that keeps potentially contagious people distanced from those that aren’t, while allowing all who need in-person care to receive it.

“We always knew patients would have concerns that were serious enough to need an in-person exam, but not urgent enough for a trip to the emergency room,” said Kurt Vandevort, M.D., inter-regional medical director for the Palo Alto Foundation Medical Group, part of the Sutter Medical Network. “As community-based providers this middle level of care is what we do best, so it was incumbent on us to find a way to keep providing it, safely.”

By March 16th the Sutter Bay Medical Foundation had established fifteen RCCs in cities across the Bay Area, each seeing patients with COVID-19 concerning symptoms (or who reported a potential exposure to the coronavirus), outside of a nearby medical building that needed to stay open and clean for patients with urgent or medically necessary needs unrelated to COVID.

A month into their operation reporters from The Mercury News and San Francisco Chronicle took notice and wrote about these MASH-like clinics. Now, as Sutter Health resumes more routine patient visits, the RCCs will continue to separate patients with respiratory symptoms from those without, to reduce the risk of exposure to viruses, including the novel coronavirus. Read below to learn more about how the RCCs work and what to expect if you are directed to one.

Call First 

Sutter Health is focused on helping ensure patients have access to the right level of care to match their medical need, but we also understand that sometimes that’s hard for people to gauge. That’s why Sutter Health set up the COVID-19 Advice Line at 1-866-961-2889.

Staffed by a team of nurses from 8 a.m. – 6 p.m., seven days a week, every caller is screened for symptoms linked to coronavirus. Callers are then directed to the most appropriate level of care based on the severity of their symptoms. Patients may be directed to self-monitor at home, to see a provider by video visit or to come to an RCC location where they can receive an in-person exam.

“By linking the RCCs to a pre-screening process (by phone or after a video visit) we can ensure patients coming to RCC do need to be seen in-person, and aren’t ill enough to go straight to the emergency room,” said Dr. Vandevort, who is also the medical director of the RCCs established throughout the Palo Alto Medical Foundation footprint. “When patients arrive at the RCC we also have some information about their chief concerns, thanks to notes entered in our electronic medical record.”

Different, by design 

A physical exam in a parking lot or garage is strange, but the safety that these setting offer is worth the weird-factor. “To protect patients, staff and the community we designed the RCCs to first and fore-most prevent transmission of any virus from a contagious person; that’s why most of them are outdoors and anyone who comes within six feet of the patient is in full personal protective equipment” said Dr. Vandevort. “At the same time we took great pains to try to make the experience similar to what patients are used to when they go to the doctor or urgent care.”

The outdoor RCCs all have a contact-free arrival process, allowing patients to drive-up and call a phone number to “check-in” for their appointment. At every stage of the visit the patient is distanced from others by either staying in their car or in a marked off space within an exam bay.

In addition to an initial temperature check, patients will have their lungs listened to with a stethoscope, have their blood oxygen saturation checked, have their medical history and medications reviewed, and may be tested for coronavirus or the flu if symptoms indicate they should be. Depending on medical need, patients will also receive additional tests and procedures, including imaging scans, blood draws, heart monitoring and more.

The few indoor RCCs are all in buildings, or sections of buildings, that can safely be separated from other areas where patients who don’t have respiratory symptoms are being seen. The indoor RCCs have implemented all the necessary transmission precautions to ensure that spread of a virus from patient to patient or patient to staff is prevented.

Not Just COVID Care

In addition to screening and treating respiratory complaints, the RCCs have filled another important role; addressing non-respiratory related issues reported by patients who have symptoms linked to COVID (fever, cough, shortness of breath). “Just because COVID-19 is here, that doesn’t mean that other illnesses and injuries go away,” said Dr. Vandevort. “One of the best things about the RCCs is that you are being evaluated by a physician who can treat a wide variety of minor illnesses or injuries, prescribe medications or make a dosage change to an existing medication, and otherwise address a whole host of concerns. It’s what we do every day, and in these safe settings, we can keep doing our job even for patients who may have a virus and be contagious.”

In the short time the RCCs have been up and running, doctors staffing them have made unexpectedly important diagnoses and delivered increasingly complex care. “We’ve seen and treated conditions ranging from an appendicitis, to a swallowed fish bone, to an infection requiring IV antibiotics. We’ve done a lot of good.”

Twice the Team 

It’s not easy to run two clinics (one regular and one RCC), simultaneously, just feet apart, but for the safety of our patients and providers that is what we’ve done. “We had to reassign doctors and nurses so we had coverage in both the RCC and the regular urgent care at the same time, some staff now act as a front-door attendants making sure that patients are directed to the right clinic based on their symptoms, and others are runners shuttling supplies between the two spaces.”

All this investment was made for one reason: to prevent the spread of illness. But the RCCs have had several secondary benefits too.

“We’re also helping to preserve hospital capacity by keeping patients from going to the emergency department unnecessarily.” You wouldn’t normally go to the ER for a fever, and the RCCs make sure our smart use of resources stays intact, even during a pandemic.

At the same time, the RCCs have helped refer patients to a higher level of care when that was needed. “Our job is to help stabilize people so they can safely return home, but when their symptoms are serious we help get them to the hospital.”