Posts by SutterHealth

Our Commitment to LGBTQ+ Patients, Families and Employees: A Message from Sarah Krevans

Posted on Jun 15, 2020 in Access to Care, Scroll Images

Sarah Krevans, president and CEO of Sutter Health, shares the following message in light of the rule finalized on June 12 by the U.S. Department of Health and Human Services that removes protections for gender identity and sexual orientation from the nondiscrimination provision of the Affordable Care Act:

“Our commitment to our LGBTQ+ patients, families and employees is unwavering. We remain dedicated to providing compassionate, high-quality care that is free from discrimination and affirming of gender identity and sexual orientation. Removing protection for gender identity and sexual orientation from the nondiscrimination provision of the Affordable Care Act is in direct conflict with our values, and increasing barriers to healthcare during a pandemic is unconscionable. These changes will not impact the way we care for our patients, nor do they change our commitment to equitable, inclusive care for everyone we serve, including LGBTQ+ patients and families.

Additionally, I applaud today’s Supreme Court decision protecting the civil rights and legal protection of LGBTQ+ employees across the U.S. There’s no place for discrimination of any type in our country – including our worksites and in healthcare. Sutter Health is proud to operate in one of the most diverse regions in the U.S. It is our mission to respect and serve all.”

Standing by our Values in Difficult Times: A Message from Sarah Krevans to the Employees of the Sutter Health Network

Posted on Jun 3, 2020 in Health Equity Institute, Scroll Images

Last week our Advancing Health Equity Team published a study looking at disparities in treatments and outcomes in African American patients with COVID-19. The unequal burden of disease and disparate treatment is still a significant problem in our country, and Sutter Health is committed to being part of the solution. We have seen across the country, and in our own neighborhoods, the tragic impact to communities of color from the coronavirus, and then on May 25, we watched with horror and sadness the unjust death of George Floyd in Minneapolis.

Over the last several days, many peaceful protesters raised their voices to advocate for justice and equality, and we stand with them as they peacefully advocate for a just society where no one’s life is at increased risk because of racism or discrimination. We must also condemn the violence that has led to injuries and to the senseless death of a federal security officer in Oakland.

To our patients and communities, I want to affirm Sutter’s unwavering commitment to our values and our not-for-profit mission. Our integrated network strives every day to provide a safe, caring and compassionate place to work and receive exceptional care, regardless of gender, age, race, disability, ethnicity, sexual orientation or religious belief. We are committed to advancing diversity and inclusion throughout our organization and providing equitable health outcomes for all.

Study Shines Light on COVID-19 Racial Disparities

Posted on May 21, 2020 in Health Equity Institute, Scroll Images

Differences in How People Access Care Contribute to Inequalities

SACRAMENTO, CALIF. – As the COVID-19 pandemic spreads throughout the U.S., evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. Here in California, African Americans are about 6% of the California population, but make up 10.3% of COVID-19 deaths where race/ethnicity is documented.

To better understand how this issue impacts patients in Sutter Health’s network, and to help develop solutions, Sutter’s Advancing Health Equity team undertook a thorough data analysis of the not-for-profit system’s COVID-19 patients. The resulting study, published today by the journal Health Affairs, revealed that African American COVID-19 patients are 2.7 times more likely to be hospitalized than their Non-Hispanic White counterparts, and they tend to arrive at Sutter healthcare facilities sicker and with more severe symptoms.

The findings underscore the fact that race and ethnicity still play a pivotal role in determining how and when care is accessed. Despite having health coverage, African American COVID-19 patients may not seek testing and care until it is an emergency requiring hospitalization.

Stephen Lockhart, M.D., Ph.D.

“The COVID-19 pandemic has ripped a Band-Aid off of the structural inequities that exist within our society – we must address these disparities right away because the cost of not addressing them is measured in human life,” said Stephen Lockhart, M.D., Ph.D., chief medical officer at Sutter Health. “With lives on the line, we as a state can and should do better in connecting minority patients to culturally competent care – that is why Sutter Health has committed to advancing health equity and this study is just one part of our mission and work. We have a moral obligation to do so and must work together to meet this moment and lean into the opportunity to advance health equity for generations to come.”

The study, “Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California,” was conducted using Sutter’s electronic health record (EHR) data to characterize COVID-19 tested and confirmed cases by key sociodemographic and clinical characteristics, including self-reported race and ethnicity, across the 22 Northern California counties served by Sutter’s network.

A number of factors uniquely position Sutter to offer early insights into the reasons for the disparities in health outcomes that have been noted nationally. As an integrated healthcare delivery network serving more than 3.5 million patients a year, Sutter had been studying healthcare disparities for close to three years when it became one of the first in the nation to treat patients with COVID-19. And Sutter’s integrated system-wide electronic EHR includes race/ethnicity data throughout its service area, which is one of the most diverse regions of the country.

Sutter Health also operates in an environment that is one of the closest to universal healthcare coverage of any state in the U.S., mitigating one of the known causes of healthcare disparities – unequal rates of medical coverage – and making other factors driving disparities more visible. But coverage is not the same as access, and the higher hospital admissions and mortality rates for African American COVID-19 patients in California revealed by the study illustrate that expanded healthcare coverage is not enough to resolve health disparities.

Kristen M.J. Azar

“The real value of the study lies not in the disparities it reveals but in its utility to inform our work to develop solutions that will address the equity gaps we are seeing with programs such as community outreach and engagement in at-risk neighborhoods,” said Kristen M.J. Azar, R.N., MSN/MPH, Sutter Health’s lead author for the study and research scientist within the Sutter Health Center for Health Systems Research. “This pandemic underscores the need to develop innovative solutions that are specifically tailored to address the unmet needs of those at highest risk.”

Sutter has extensive experience looking for and analyzing disparities within its own network and beyond.

The results of the COVID-19 study mirror the patterns Sutter observed in a 2017 study about African American patients with asthma and how they access care. The asthma study found 72% of patients drove up to eight miles to a hospital emergency department to access care, even though they lived within one mile of a primary care clinic. We observed they were doing so because of a lack of culturally competent care.

After reviewing the findings of the 2017 study, Sutter developed its Advancing Health Equity Adult Asthma Program. Since the program began in April 2017, nearly 600 African American patients suffering from asthma attacks have been connected to a respiratory therapist to participate in the asthma program. As a result, very few have returned to the emergency room. The asthma program serves as a model for trusted outreach, education and treatment in a public health crisis – and how they can reduce health disparities.

Provider organizations like Sutter Health are on the front lines and, while not able to address all of the complex societal factors at issue, can play a unique role in developing solutions. For example, as part of its commitment to advancing health equity, Sutter developed a novel metric, the Health Equity Index (HEI), to identify and quantify disparities in outcomes across patient groups and develop targeted interventions to enhance equity. Through the HEI, our Advancing Health Equity team is taking major steps, like those detailed here, to build on the benefits of our integrated network of care to further health equity within the Sutter system and across the country.

Our health equity work and the findings of the study released today highlight the importance of community-based outreach and access to culturally competent care within the African American community, which hold the promise of reducing disparities. Additional research is needed to understand where healthcare disparities exist, what drives them, and what targeted interventions work best to address them. Sutter remains committed to continued advancement and leadership in this field.

To Our Healthcare Superheroes

Posted on Apr 9, 2020 in Integrated Network, Scroll Images

As millions across the nation shelter at home to help minimize the impact of the coronavirus pandemic, a group of individuals continues to step onto the front lines: our healthcare teams. Doctors, nurses, clinicians, hospital workers, pharmacists, transporters, EMTs—and everyone else who supports patient care sites—continue to treat and serve the very ill.

It’s not easy to fully express the enormous gratitude and appreciation we feel for these healthcare heroes. But recently, hundreds of Sutter employees tried, all sharing words of encouragement and thanks for their teammates on the front lines. Here is a sampling of their messages:

Words cannot adequately express our appreciation. From those who give direct patient care to all those who support patient care behind the scenes, you are all remarkable human beings. We can’t fight this fight without you. (Liz M.)

Thank you to all the brave men and women on the front lines giving it your all every day to care for our patients! We know the sacrifices you are making, putting your own lives on the line to provide world-class care to every patient. There are not enough words to tell you how much we appreciate each and every one of you! We are all in this TOGETHER! (Michelle M.)

To our courageous, selfless teams on the frontlines—the doctors and nurses, lab techs, housekeeping crews, nutritional services employees, pharmacy employees, security staff and so many more—thank you for all you do. (Anita C.)

An Open Letter from M.D.s

Posted on Mar 21, 2020 in Scroll Images, Wellness & Integrative Health

By: Warren Browner, M.D., MPH and Stephen Lockhart, M.D., PhD

As physicians, we want you to know why we are so concerned about the novel coronavirus/COVID-19.

Some of you may have heard that it’s a minor inconvenience, like a bad cold. So far, that’s true for the majority (but not nearly all!) of people who are young and healthy. However, that’s only a very small part of the story. Here’s the rest:

• Up to one in five of those infected with the coronavirus will get pneumonia and have to be treated in a hospital, often for a few weeks.
• So far in the U.S., more young and middle-aged people have needed hospitalization than in China.
• In those who are infected and over age 70, especially those with underlying health problems, up to one in 15 to 20 will die.

Coronavirus needs people like all of us to multiply and spread. So what matters is not just whether you get sick, but also whether you pass the virus to other people. None of us—except maybe those who have recovered from COVID-19—are immune to it. All of us are potential carriers who can be infected without knowing it.

Right now, on average, every infected person passes coronavirus to two or three other people, who in turn infect two to three others. After only 10 cycles, a single original person can infect 20,000 people in only four or six weeks. Much of Northern California will be infected in no time if we don’t act now.

If we can reduce social contacts by one-third, the number of people who will need to be hospitalized will drop 20-fold. If we do even better, and can reduce social contacts by two-thirds, the pandemic will end. This helps buy time for clinical teams and other scientists to determine what treatments work. We will give hospitals more time to prepare—and keep the healthcare system from being overwhelmed.

How do we do this? By staying away from other people, which means anyone outside your immediate household, including friends and relatives. That means avoiding:

• Birthday parties
• Sleepovers
• Play-dates or meet-ups
• Public places (like playgrounds) where virus particles can linger
• Air travel or sitting too close to someone on public transit

Other important notes to keep your home virus-free:

• Leave only if absolutely necessary and head straight back as soon as your errand is done.
• Exercise out of the house alone or with just members of your household.
• If you buy groceries or cook meal for neighbors who cannot get out, call to let them know you are coming by, and leave your delivery outside their front door.
• If you do go out, wash your hands with soap and water thoroughly for at least 20 seconds as soon as you can, preferably before you touch any surfaces in your home.
• Make sure that people—like kids—who can’t or don’t follow these instructions are kept away from those who are especially vulnerable, like their grandparents or someone with a chronic disease.
• Think about possible exposures. A card or tennis game with friends may sound like fun, but the virus travels on the cards or the tennis balls. Play only with those in your immediate household.

A virus-free home is only as strong as its weakest link, so please stick to the approach, as difficult as it may seem. Following these guidelines can help the nurses, doctors, first responders, pharmacists and grocery store employees continue doing their jobs to support you.

If you do need us, our teams are equipped to provide you with high-quality care while protecting the safety of our care providers. Our staff are well trained to address infectious respiratory illnesses, including coronavirus. If you are sick, and don’t require emergency care, call your doctor before coming in. Do a video visit. Know that if you need care, we’re here for you.

Stay safe. Stay six feet away.

Dr. Browner, an internist, is the CEO of Sutter’s California Pacific Medical Center. He has a master’s degree in public health in epidemiology and is an adjunct professor of epidemiology and biostatistics at UCSF. Dr. Lockhart, Sutter Health’s chief medical officer, has a PhD in biostatistics and is a trained anesthesiologist.