Posts by zavorag

How a Rural Hospital Treated a COVID-19 Patient 120 Miles Away

Posted on Jul 2, 2020 in Expanding Access, Innovation, Memorial Hospital, Los Banos, Quality, Safety, Scroll Images, Uncategorized

When Sutter Health’s Memorial Hospital Los Banos had a critically ill patient test positive for COVID-19, there wasn’t an ICU room for her. The small community hospital’s four ICU beds are located in the same large room separated by curtains, and this patient needed to be isolated.

A private room was made available, but there was a problem: It was not equipped with the Sutter eICU telehealth system that allows 24/7 critical-care physician coverage from a central hub 120 miles north in Sacramento. But, as part of its preparations for a COVID-19 patient surge, Sutter Health had just deployed a new system that allowed its eICUs to more than double its capabilities. The patient in Los Banos was the first to be cared for using the new system.

Sutter, a national pioneer in electronic ICU (eICU), has for years ensured critically ill patients in both large cities and small towns have 24/7 access to an expert team of doctors specially trained in their care. From central hubs in Sacramento and San Francisco, these doctors monitor patients in ICUs many miles away using live interactive video and remote diagnostic tools to instantly assess critical changes in a patient’s condition and provide expert critical-care physician support and supervision for the hospitalists, specialists and nurses who provide the hands-on care.

Sutter Health has more than 300 ICU patient rooms at 18 hospitals, each one outfitted with interactive video cameras, but in a matter of a month, Sutter designed and deployed specialized units that enable the eICU’s critical-care physicians to care for upward of 1,000 coronavirus patients without having to travel from hospital to hospital and using in-demand PPE. As part of its COVID-19 surge planning, each hospital set aside other patient rooms that don’t have the eICU video technology installed, and Sutter’s eICU team created and deployed 82 iPad stands across its network to bring these specialized critical care teams to those patients, too. Including the patient in Los Banos.

“The challenge was to come up with a plan for our eICU to provide care for a surge in patients across Northern California,” said Dr. Tom Shaughnessy, medical director of Sutter Health Bay Area eICU. “We are now able to meet the need of a patient surge by giving the same comprehensive, quality care whether a patient is in one of our ICU beds or a converted room.”

With the assistance of the eICU team through the mobile units, the patient in Los Banos recovered from the novel coronavirus. Now rural hospitals throughout the Sutter network are prepared for patients who need to be isolated and still have 24/7 critical-care physician coverage, and Sutter’s larger hospitals are prepared for a future patient surge of any type that requires all-hours critical-care coverage.

“We have nurses and physicians providing some of the best bedside care in the country, and the eICU allows us to come in and provide advanced specialized support as they care for patients,” said Dr. Vanessa Walker, medical director of the Sutter Health Valley Area eICU. “This is critical in the care for those suffering from compromised lung function due to a virus such as COVID-19. Now with these additional mobile units, we are well prepared to meet a surge of patients from this current crisis or any other that may come in the future.”

Vanessa Walker, D.O., cares for a patient through the eICU system in Sacramento

How to Stay Safe with Rising Heat and COVID-19 Cases

Posted on Jun 26, 2020 in Carousel, Pediatric Care, Quality, Safety, Scroll Images, Sutter Medical Center, Sacramento

Temperatures are rising in Northern California, and so are confirmed cases of COVID-19. How do you keep safe from both? Stay home, says an emergency medicine physician with Sutter Medical Center, Sacramento.

“Our recommendation for the heat is stay inside and exercise intelligently; that’s kind of what we would say about COVID-19. They overlap,” said Arthur Jey, M.D. “Because it’s so hot, we’re not going to want to go out anyway, so it’s a good excuse to stay home with your family.”

With communities opening up and more area residents wanting to take advantage of the great outdoors and other opportunities, Dr. Jey pleads for folks to keep their masks on … or at least handy. Popular activities in the region include walking and hiking, which are great ways to get some fresh air and exercise at the same time. Won’t wearing a mask make you even hotter?

“When you’re outside, walking and hiking, and there’s no one around, you don’t need to wear the mask,” he said. “But you don’t know when you’re going to come close to someone, so keep your mask close by. I am always wearing a mask around my neck or it’s in my pocket. As soon as someone approaches, I put it on. … When there are people around, my mask is on all the time.”

During an interview with the media, Dr. Jey gave some other tips on how to avoid heat-related illnesses, from heat rashes and sunburns to heat exhaustion and heat stroke. Those most susceptible to the heat illnesses include toddlers who can’t communicate that they’re suffering, the very old, and those who have to work in the sun, including farm and construction workers.

What and How Much to Drink

If you are out in the sun, Dr. Jey says the best thing to do is drink a lot of fluids. He recommends good, ol’ plain H2O. Not ice-cold water that can cause cramps, but cooled water. He also recommends sugar-free electrolyte drinks, which are good ways to replenish those essential minerals when working out. Avoid alcoholic beverages along with sodas and sports drinks that contain sugar.

“Make sure you’re smart about what you drink,’ he said. “Alcohol is going to dehydrate you. Really heavy sugared water, like Gatorade, is going to dehydrate you. Electrolyte waters with low or no sugar, fantastic. Water, fantastic.”

He also says it’s not important to count how much fluids to take in, but rather to sip consistently and continually, not a lot at one time. “Everyone asks me how much to drink. Many medical professionals say drink eight to 10 glasses a day. But really, just try to drink well.” He said to take sips at least every half an hour while out in the sun. His counsel: “Don’t wait until you’re thirsty to take a drink.”

He also recommends that those going outside wear light, loose clothing and a hat. “I tend to wear baseball caps a lot, but they aren’t the best choice. The ones that you really want are the wide-brimmed ones, like the fishing hats, that cover the back of your neck. We’ve all been sunburned there before.”

What to Do When You’re Feeling the Heat

“There’s a whole continuum of heat-related diseases,” Dr. Jey says, and they progressively worsen as you’re exposed longer to the hot weather.

1.       Heat rashes, which is a reddening of the skin.

2.       Sunburns, which can be very painful.

3.       Heat exhaustion, when you’re still sweating, but you’re feeling a little woozy or nauseous. Your urine at that point is a darker yellow.

4.       Heat stroke.

“This is when it gets scary,” Dr. Jey says. “You stop sweating and your thinking slows down, and you feel horrible. You look like you’re having a stroke; that’s why it’s called heat stroke. I’ve seen people come in completely confused, acting like they’re almost drunk, that’s when you really get scared. The way you prevent that is that you don’t wait until you’re thirsty to start drinking water.”

He says when heat stroke is happening, the first step is to get out of the heat and let someone know you’re not feeling good. That’s why toddlers who aren’t talking yet are very susceptible to heat illness, because they can’t verbalize how they’re feeling.

Next step: “Get some water in you. Don’t chug it, don’t drink a whole gallon of it. Just sit down in the shade or some air conditioning and sip some water. And, if you don’t get better, then come see us at Sutter.”

Dr. Jey said, even during this pandemic, don’t be afraid to go to the emergency room when you are in a medical emergency, whether it’s heat stroke, a real stroke, or any other kind.

“We get concerned that you push things off too far,” he said. “Our nurses and physicians here work really hard to make sure that we keep you safe. … So if you start feeling problems with temperature, problems with the heat, or for that matter, trouble breathing, come see us. Don’t be scared. We have a separate area for those who we think might have COVID-19. Especially now when we’re starting to have another uprising of it. We’re very cautious of it. But I don’t want that to stop people from coming in when they have other illnesses.”

The Sacramento Bee posted one of Dr. Jey’s interviews on heat illnesses. Click here to watch it, and notice his mask is around his neck for when someone comes close!

No Need to Put Off Possible Life-Saving Mammogram Any Longer

Posted on May 19, 2020 in Carousel, Expanding Access, Quality, Safety, Scroll Images, Sutter Medical Foundation, Women's Services

ROSEVILLE, Calif. — Laurie Deuschel of Rocklin received news during the COVID-19 crisis that breast cancer runs in her family, but during the first two months of the pandemic, mammograms were considered elective scans and weren’t being performed. The first week they became available again, Deuschel got an appointment.

“I’m here to have my first mammogram, and I’m a little bit scared,” she said, but she wasn’t scared about catching the novel coronavirus while at the Sutter Imaging center in Roseville Monday, May 18.

Why? “Sutter Imaging knows the cleaning procedures and how to keep me safe,” she said.

Sutter Health is going to great lengths to protect its patients and staff in the COVID-19 era. It has created a “new normal” for its imaging centers, focused on a “safety strategy” that is incorporating guidance from the national Centers for Disease Control, California Department of Public Health and the American College of Radiology. Some of those measures include:

  • Temperature screening of all staff, doctors and patients at the door,
  • Universal masking,
  • Social distancing in waiting rooms (patients can wait in their cars if they prefer),
  • Screening patients at the time of scheduling and arrival for symptoms,
  • Deeper cleaning of equipment after every patient,
  • Regular sanitization of chairs and door handles,
  • Thorough wipe-downs of patient lockers and dressing rooms with a “Cleaned” sign placed for patients and staff to know those areas have been disinfected,
  • Regular audits or “double checks” with staff to ensure that the new procedures are being followed. 

Miyuki Murphy, M.D., the director of breast imaging for Sutter Medical Group, was interviewed for a story on the Sacramento NBC affiliate KCRA, Channel 3. Dr. Murphy explains why not delaying your mammogram is important, and the story includes video of some of the safety measures being taken at Sutter Imaging. Click here for that story on their website.

Dr. Miyuki Murphy on KCRA about the safety of mammograms at Sutter Imaging.

Program Designed to Attract Docs to Rural Areas Receives Accreditation

Posted on May 15, 2020 in Community Benefit, Expanding Access, Scroll Images, Sutter Amador Hospital, Sutter Medical Center, Sacramento, Uncategorized

The Sutter Rural Residency Program received a U.S. grant last year and this week was accredited and is ready to screen applicants. Leaders involved in the program include, from left, Dineen Greer, M.D., program director of the Sutter Family Medicine Residency Program; Sutter Amador Hospital CEO Tom Dickson; HRSA regional administrator Capt. John Moroney, M.D; Jackson Mayor Robert Stimpson; Sutter Valley Area Chief Medical Officer Ash Gokli, M.D.; former Sutter Amador CEO Anne Platt; and Robert Hartmann, M.D., longtime Amador County internal medicine physician and an instructor in the Rural Residency Program.

JACKSON, Calif. – Sutter Amador Hospital’s Rural Residency Program this week received accreditation from ACGME (Accreditation Council for Graduate Medical Education), the organization responsible for accrediting all graduate medical training programs for physicians in the United States. This Sutter Health program is designed to bring more primary-care physicians to rural regions, which have been hampered throughout the country by a shortage of family doctors.

The ACGME accreditation allows the Sutter Health Rural Residency Program to begin screening and selecting residency applicants. Those selected – two each year for six total in the program – will complete core inpatient training in Sacramento during the first year, with their next two years on the campus of Sutter Amador Hospital and in community medical offices.

The goal of the Sutter Health program is to develop a sustainable, accredited rural training track in Amador County and to ultimately expand the area’s rural primary-care workforce. In Amador County, there is a high need for primary-care physicians (PCPs) in the area as the ratio of the population to one PCP is 1,760-to-1; the ratio throughout the state of California is 1,280-to-1, according to the County Health Rankings and Roadmaps website.

“This is welcome news for Amador County, as it will provide an influx of bright, young physicians into our community to care for our families and should give us a steady supply of primary-care physicians for years to come,” said longtime Amador County internal medicine physician Robert Hartmann, M.D., who will be one of the instructors in the Rural Residency Program. “This is a major collaborative accomplishment between Sutter Amador Hospital, Sutter Medical Group physicians and the Sutter Family Medicine Residency Program.”

The Rural Residency Program was made possible through a grant from the U.S. Health Resources and Services Administration (HRSA), which allows not-for-profit Sutter Health to expand its successful Sacramento-based physician residency program to Amador County as part of the federal agency’s efforts to provide better access to quality medical care in rural areas.

Since its inception in 1995, the Sutter Family Medicine Residency Program has graduated 139 physicians, all of whom passed their Board Certification assessments on the first effort. Currently there are 21 residents in the program, and the Amador County program will expand the program to 27 residents.

“We are working to strengthen the physician pipeline throughout our integrated network so our patients receive the same high-quality care no matter where they live,” said Dineen Greer, M.D., program director of the Family Medicine Residency Program. “We have combined a strong, dedicated core faculty, community preceptors, innovative curriculum and access to Sutter hospitals so that our residents develop the skills needed to be outstanding family physicians and leaders in their communities.”

The accreditation was welcome news for the state legislators who serve the Gold Country. State Sen. Andreas Borgeas said: “The physician shortage continues to be a prevalent issue in Amador County and many rural areas of California. I offer my sincere congratulations and gratitude to Sutter Health on the program’s latest achievement, and for its targeted effort to bring much-needed family practice physicians to our community. This is a significant step to help expand access to quality care for our communities in the beautiful, remote areas of our state.”

State Assemblyman Frank Bigelow echoed Sen. Borgeas’ sentiment. “Sutter Health has long supported hospitals in more rural regions of California and they understand how family doctor shortages can have a negative impact on a community’s health,” Bigelow said. “I am so pleased they are pursuing this program and continuing their investment in bringing needed primary care physicians to Amador communities.”

Drs. Greer and Hartmann expect the program to be successful in filling the need for well-trained, community-minded primary-care physicians in Amador County and the greater Mother Lode region.

“The medical students applying for this residency opportunity will enter the program with a strong desire to serve in rural communities,” said Dr. Hartmann, “so their career focus will be the health and well-being of families in our towns and smaller cities. This is great for the future of health care in our community.”

For more on the Sutter Family Medicine Residency Program, go to www.suttermd.com/education/residency/family-medicine

Sutter Roseville Moves Up Opening of ER-ICU Expansion to Prepare for COVID-19 Patient Surge

Posted on Apr 27, 2020 in Expanding Access, Innovation, Quality, Safety, Scroll Images, Sutter Roseville Medical Center, Transformation

Sutter Roseville Medical Center expansion
Sutter Roseville Medical Center is opening its expansion a month early to prepare for a potential surge in COVID-19 patients.

ROSEVILLE, Calif. – Sutter Roseville Medical Center on Tuesday, April 28, is opening its expansion of emergency and critical care services a month early as part of its preparations for a potential surge of COVID-19 patients. Originally slated to open May 27, the 98,400-square-foot expansion doubles the Emergency Department and nearly doubles the number of critical-care beds, adding 58 more private rooms that can safely care for patients during a possible surge.

Sutter Roseville began the $178 million construction project in 2017 to meet the growing community’s demand for emergency services, critical-care rooms and interventional cardiac and neuro procedures. It is connected seamlessly to the existing Emergency Department on the first floor and surgical and critical care services on the second.

“When our team met in late February to discuss surge preparations for COVID-19, it was apparent that we needed to move up the opening of this expansion to ensure we had the highest level of care available for the expanding needs of our community and region,” said Sutter Roseville CEO Brian Alexander. “Our staff, construction partners, and state and local agencies all banded together and worked diligently to open this expansion 30 days early, but to the same high safety and quality standards.”

As a Level II trauma center serving a seven-county region, Sutter Roseville provides a higher level of care in emergency situations and is regularly preparing for public health crises. The expansion was designed with elements that will assist in those emergencies, including two emerging infectious disease isolation rooms and options to convert the Emergency Department’s expansive lobby into a treatment area in case of a large-scale disaster or patient surge.

Expanded emergency department looby

“When our care teams helped design this expansion, they took into account numerous possible health-crisis scenarios,” Alexander said. “Because of their foresight and planning, Sutter Roseville is prepared to care for patients during this pandemic and other public-health emergencies.”

The new expansion helps Sutter Roseville stay on the forefront of exceptional, innovative care. Its features include:

  • 34 additional emergency beds in private treatment rooms, increasing the total number of emergency beds to 68;
  • Seven emergency triage areas that are equipped to provide treatment to patients;
  • 24 additional ICU rooms, each equipped with the latest eICU telemonitoring capabilities that allow specialized physicians to assist in the care of the patients from a remote hub. Added to the 32 existing critical-care beds in the hospital, there will be 56 ICU rooms available for the sickest patients if a surge were to occur;
  • Two interventional labs providing the latest technology for cardiac catheterization procedures. A third interventional lab is currently being built with additional capabilities for neuro and radiological procedures.
New intensive care unit room

“California is being challenged in new ways during the COVID-19 public health crisis, and we are rising to that challenge in ways large and small across the state,” said California State Sen. Jim Nielsen, R-Tehama. “Here in Northern California, one of the organizations stepping up to meet the challenge is the Sutter Health network, providing new levels of emergency and critical care at Sutter Roseville Medical Center that are so urgently needed across the region.”

The expansion provides a critical need in the community beyond the current global pandemic crisis. The Sutter Roseville Emergency Department expanded in 2005 to treat up to 60,000 patients a year, but last year saw more than 84,000 patients. The additional ICU rooms and interventional labs are also necessary additions as South Placer County is seeing more elderly patients requiring a higher-level of care.

Emergency department isolation room

“Strong infrastructure is one of the hallmarks of a strong community, and our capacity for protecting and promoting public health is central to that,” said State Assemblyman Kevin Kiley, R-Rocklin. “Sutter Roseville Medical Center’s continued investment in our public health infrastructure helps drive our ability to prevent disease, heal after injury or illness, and respond to both chronic health challenges and acute ones like COVID-19. My thanks to Sutter Health for stepping up to help when and where they are needed.”

This is the latest in a series of expansions Sutter Roseville Medical Center has experienced in the past two decades, transforming it from a community hospital into a regional, tertiary medical campus. The other expansions include:

  • A newly constructed Patient Care Tower with 90 new beds.
  • Expansion of the Family Birth Center to accommodate a community need as young families moved into South Placer County.
  • The addition of a Level III NICU with 16 licensed beds to provide advanced life-saving care to critically ill newborns.
  • The construction and expansion of Sutter Rehabilitation Institute, the region’s only facility dedicated exclusively to acute rehabilitation services.
  • The Sutter Cancer Center, Roseville, a facility dedicated to and designed by those with cancer.
  • Three medical office buildings that house Sutter Roseville physicians, along with two parking garages for staff and patients.

“As a healthcare provider, as an employer and as a supporter of this community, Sutter Roseville Medical Center has already been a strong force for good here and across Placer County and the region,” said Roseville Mayor John Allard. “Expanding its top-notch emergency service and critical care – especially now – builds on a decades-long commitment to serving the people of Roseville and beyond.”