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Car Clinics: The Dual Benefit of Drive-Through Care

Posted on Mar 17, 2020 in Carousel, Expanding Access, Innovation, Palo Alto Medical Foundation, Quality, Safety, Scroll Images, Uncategorized

Power, data cables and sanitation supplies topped Raymond Fellers long list.

No, Fellers wasn’t preparing to isolate during the COVID-19 outbreak—quite the opposite—he was opening the first ever “car clinic” at the Palo Alto Medical Foundation’s San Carlos Center. One of several across the Sutter network, the car clinic is designed as an in-person option for PAMF patients with serious respiratory symptoms who have already talked to a provider by phone or video visit.

“We’re solving two problems at once,” said Dr. Rob Nordgren, M.D., MBA, MPH and area CEO of PAMF peninsula region. “By keeping potentially contagious people in their car it means that doctors can assess and treat their symptoms, while minimizing exposure to patients who need routine or urgent care inside the medical facility.”

Making use of a covered garage, a procession of patients – each in their personal car – flowed through a series of stations that comprised the clinic. Every station had a laptop connected to Sutter’s electronic health record and the basic medical equipment you’d find in a regular exam room. A portable X-ray machine was even set up outside to help diagnose lung infections.

Arnold Layung, a licensed vocational nurse who usually sterilizes instruments during surgery, brought his sanitation skills to the car clinic.

“The key here, just like in the operating room, is to have one person per job so no steps are missed,” remarked Layung as he disinfected stethoscopes and other equipment after each use. Filling the role of medical technician, Layung was paired with a physician and registered nurse to form a three-person team—each in full gowns, goggles, gloves and masks—who saw patients through their open car window or in a chair just outside their vehicle.

With a background in emergency medicine, Dr. Nathan Bornstein knows the importance of conserving hospital capacity for those with acute illness. “My job out here is to find the people who need to be escalated to a higher level of care, while also helping people manage serious symptoms so they can safely return home,” he said.

Many of the patients who came through the car clinic had existing respiratory conditions, like asthma, which make them prone to serious breathing difficulty if their lungs are put under added strain. For these patients showing symptoms of a virus, Dr. Bornstein ordered a flu test. In accordance with Centers for Disease Control and Prevention guidelines, Dr. Bornstein also collected samples for COVID-19 testing from symptomatic patients in high-risk groups, such as those with certain pre-existing conditions, epidemiologic or social risk factors.

Dr. Bornstein listened to each patient’s lungs, and if indicated, ordered X-ray or CT scans to detect infection. Finally, Dr. Bornstein reviewed current medications to determine if a dosage change or new prescription would help ease a patient’s symptoms enough to keep them out of the hospital.

Every person had their temperature, respiration rate, heart rate and oxygen saturation checked and each left with a personalized plan for what to do if their symptoms worsened.

PAMF’s San Carlos Center is one location within Sutter Health’s integrated network that supports car clinics. This service is not available in all locations, nor is it open to the general public.

Sutter encourages patients who feel ill to schedule a video visit or call their doctor to receive guidance. If one’s symptoms are mild to moderate, they are encouraged to stay home to rest, get well and prevent exposure to others.

For more information about COVID-19, please visit Sutter Health’s resources page.

‘Rockin’ It: Art Helps Cancer Patient Find Healing and Purpose

Posted on Mar 17, 2020 in Affiliates, California Pacific Medical Center, People, Wellness

SAN FRANCISCO – “Life is tough, but so are you.”

This powerful message is hand painted onto a smooth, palm-sized stone that rests at Sutter’s California Pacific Medical Center’s Van Ness Campus kindness rock garden in San Francisco.

But it won’t be there for long.

Someone who needs it will pick it up and take it with them.

That’s the idea behind the hospital’s rock garden, located on the facility’s fifth floor terrace. Here, stones with inspiring messages and colorful scenes are on constant rotation as patients, staff and visitors are encouraged to “take one, share one, leave one.”

This simple yet meaningful concept struck a chord with Cameron Yee, a nursing student who found herself at CPMC, part of the Sutter Health not-for-profit network of care, when her cancer returned.

Cameron Yee visits CPMC Van Ness Campus hospital’s Rock Kindness Garden.

Yee was diagnosed with rhabdomyosarcoma, a rare type of cancer that forms in the body’s soft tissue, at 18. She went into remission in 2016 and began feeling the cancer’s symptoms again in October 2019.

Yee was admitted to CPMC in late 2019 due to a complication from her chemotherapy and radiation. Her oncologist suggested a visit by the medical center’s expressive arts therapist, Jane Siegel.

Siegel introduced Yee to painting rocks as a form of mindfulness, self-care and an outlet to distract her from pain. It was the perfect non-medicinal prescription for Yee’s creative mind.

A “You’ve Got This” kindness rock was the first she took from CPMC’s garden.

“This rock kept me grounded and hopeful. It was one of the things that gave me strength and motivation to keep on going. I am forever grateful for the person who painted this rock,” said Yee.

Yee has taken to painting rocks like Monet took to painting watercolors. She was hooked—and more importantly, uplifted.

Yee paints concentric hearts onto a heart-shaped stone.

“Cameron is our rock star of rock art,” laughs Jane Siegel. “Art therapy is an outlet that offers true health benefits and stress relief for patients and staff alike. It’s deeply rewarding as well as healing.”

Now, months later, Yee has started an effort called ‘Rock Kindness’ to help populate CPMC’s rock garden and grow the rock kindness community at large.

Each month, Yee drops off a new series of rocks. Some of her themes have included “You’ve got this” and “Nobody fights alone.”

She has also started an Instagram page, @rock.kindness, where followers can learn about journey and see her latest designs and motivational messages.

At 21, Yee’s in her final semester of nursing school at Dominican University of California and shadowing a nursing preceptor at CPMC.

“I hope to become a pediatric nurse or specialize in something where you can see more chronic patients,” she says.

Yee keeps her “You’ve Got This” rock on her nightstand, where it serves as a reminder of a moment when the exact message she needed, was delivered to her at the exact right time.

Yee knows that no matter what curve ball life throws her way, SHE’S GOT THIS!

An Endgame for Epilepsy

Posted on Mar 13, 2020 in California Pacific Medical Center, Innovation, Neuroscience, People, Quality

One man’s struggle with seizures is silenced thanks to a medical device implanted on his brain.

Reno, Nev. — Andy Fiannaca, a college student at the time, first discovered he had epilepsy when he woke up in an ambulance. His head was gouged and bleeding—the result of falling during an intense epileptic seizure. Even with no family history of epilepsy, Fiannaca would soon learn that is exactly what he had.

For years, severe daily seizures affected his quality of life, limiting his activities. He experienced speech problems, such as difficulty finding and forming words, and would often lose the ability to comprehend what people around him were saying, known as aphasia. Everything became a foreign language.

Andy Fiannaca displays his post-surgery scar from where his RNS device was implanted.
Andy Fiannaca’s surgery scar is on full display where his RNS device was implanted.

Fiannaca also suffered from the “Alice in Wonderland” syndrome. During episodes, his visual perception would become drastically distorted. He was either an ant looking up at giants, or a giant looking down at ants. Driving a car was out of the question, and continuing his studies at the University of Nevada, Reno became increasingly difficult.

To control his seizures, Fiannaca tried six different medications and then a surgery in which a series of shallow cuts were made in his brain tissue. The goal was to remove the part of the brain where his seizures originated. Unfortunately, his Reno surgeons found the source was too close to his speech center. His symptoms improved after the surgery, but within two years they returned.

Clearly, Fiannaca required more advanced help. But since he lives in Sparks, Nevada (outside Reno), where this level of advanced neurology is not available, his care team finally referred him to California Pacific Medical Center (CPMC) in San Francisco, part of the Sutter Health not-for-profit network of care.

At CPMC, neurologists David King-Stephens, MD and Peter Weber, MD, recommended the RNS System, an implanted device designed to continuously monitor brain activity, detect abnormal patterns and intervene to stop seizures before clinical symptoms appear. It is the first and only medical device that can monitor and respond to brain activity. This treatment, Fiannaca says, ultimately changed the course of his life.

The Fiannaca Family
The Fiannaca Family.

Since Fiannaca had the RNS device implanted six years ago, his seizures have radically reduced. He hasn’t had a grand mal seizure in two years, and he’s finally able to drive a car again. His wife Sara has been by his side through it all. The couple worried for a long time that epilepsy would prevent them from starting a family, but with his condition now under control, Fiannaca and Sara welcomed their first child 18 months ago.

Epilepsy is a widespread condition characterized by recurrent seizures that often causes a severe impact on a person’s quality of life. It affects as many as one in 26 adults in the U.S., and in 50 percent of epilepsy cases, the cause is unknown.

Epilepsy Awareness Day is March 26, 2020.

Live Oak Health and Housing Campus Moves Closer to Reality

Posted on Mar 6, 2020 in Carousel, Community Benefit, Expanding Access, Scroll Images, Sutter Maternity and Surgery Center, Santa Cruz, Uncategorized, Wellness

Courtesy of Santa Cruz Community Health and Dientes Community Dental Care.

SANTA CRUZ, Calif. — Santa Cruz Community Health (SCCH) and Dientes Community Dental Care (Dientes), today announced a $1 million dollar investment from Sutter Health to support the construction and operation of a 19,000-square-foot medical clinic to be run by SCCH and 11,000-square-foot dental clinic to be run by Dientes on the future site of a health and housing campus that will benefit the Live Oak community.

Rendering of the Santa Cruz Community Health medical clinic.

An Investment in Infrastructure

The future site of the health and housing campus is the ideal location for much-needed services. Supervisor John Leopold notes, “Five years ago there were no medical offices in Live Oak. A community of our size needs good access to medical and dental services and housing that is affordable to all families. This new development will help everyone in the community from small children to families to seniors.” The campus – the first of its kind in Santa Cruz County – will integrate the strengths and services of its three owners:

  • SCCH has been serving the medical and mental health needs of underserved Santa Cruz County residents since 1980, with a special focus on families.
  • Dientes has an over 25-year track record of providing affordable, high-quality and comprehensive dental care through three existing clinics and an outreach program.
  • MidPen Housing, already owns and manages 13 affordable housing communities in Santa Cruz County, providing residents with supportive services.

“Planning for this project started in 2017, and I’m so pleased we are starting to secure large contributions that will make construction possible,” said Dientes CEO Laura Marcus. “Sutter Health has a proven track record of improving the health in this region, so it was no surprise that the not-for-profit system that includes Palo Alto Medical Foundation stepped up to help. This is truly a remarkable demonstration of how we can collaborate for the overall good of our community.”

Sutter Health has committed $1 million dollars, over five years, to the construction and operation of both clinics on the campus. SCCH will receive $160,000 and Dientes will receive $40,000 each year through 2023.

“As a not-for-profit health network, Sutter focuses on improving the health of those inside and outside the walls of our hospitals and care centers,” said Stephen Gray, chief administrative officer for Sutter Maternity & Surgery Center of Santa Cruz and operations executive of Palo Alto Medical Foundation Santa Cruz. “We know that when people have access to preventive screening and routine healthcare, their health improves. This investment builds on Sutter’s commitment to improve the health of the entire community we serve.”

Rendering of the Dientes Community Dental Care dental clinic.

Capital Campaign is Ongoing

“Projects like this one can transform communities. This initiative will bring affordable healthcare and housing to the heart of Live Oak – providing a lifeline to families, adults and seniors,” said SCCH CEO Leslie Conner. “We hope the early funding we’ve secured will be a catalyst for more donations in the coming weeks and months.”

The integrated, state-of-the-art health and housing campus will address a triple-goal of increasing access to healthcare, growing affordable housing, and creating economic opportunity. The project will provide health services to 10,000 patients annually and affordable housing for 57 households. In addition, it will create more than 60 new jobs.

Dientes and Santa Cruz Community Health will break ground on their clinic in 2020 and open in 2021. MidPen will break ground on the housing component in 2021 and open in 2022.

Renderings, photos and more information about the project is available here

Alta Bates Summit Medical Center Cardiac Program Earns Highest Possible Rating for Mitral Valve Surgery from Society of Thoracic Surgeons

Posted on Mar 4, 2020 in Affiliates, Alta Bates Summit Medical Center, Quality, Scroll Images

OAKLAND, Calif.Alta Bates Summit Medical Center earned a distinguished three-star rating, the highest possible, from The Society of Thoracic Surgeons (STS) for excellence in mitral valve replacement and repair (MVRR) surgery. Of the approximately 130 participating hospitals in California, Alta Bates Summit, part of the Sutter Health not-for-profit network of care, is one of only four hospitals in the state to earn this three-star rating for MVRR surgery.

Mitral valve replacement and mitral valve repair surgeries are performed to treat diseases of the mitral valve — the valve located between the left heart chambers.

Junaid Khan, MD
Junaid Khan, MD

“The three-star rating is widely regarded as the gold standard by which cardiac surgery programs are evaluated and it’s the highest honor achievable,” says Junaid Khan, MD, director of Cardiovascular Services for Alta Bates Summit. “We take great pride in the high-quality care we provide that has resulted in long-term positive results. This recognition validates our comprehensive heart program’s excellence.”

The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs across the United States and Canada. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database participant.

Alta Bates Summit also earned a three-star rating from the Society of Thoracic Surgeons (STS) in 2019 for patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures—the most commonly performed open-heart surgery.

Mitul Kadakia, MD

“Alta Bates Summit provides exceptional care for our valvular heart disease patients under the leadership of Dr. Russell Stanten and Dr. Khan,” says Mitul Kadakia, MD, FACC director, Structural Heart and Valve Disease, Alta Bates Summit. “It is a privilege to be a part of a cardiac program which results in these kind of incredible outcomes for our patients. The 3-Star STS rating for CABG and Mitral surgery is great asset for our patients.”

Russell Stanten, MD

Dr. Khan praised the hospital’s physicians, staff members and departments who were instrumental in making this award possible.

“None of these amazing results would have been possible without our entire team including the expertise of our surgeons, cardiologists, anesthesiologists, nurses, physical and occupational therapists, case management and rehabilitation services,” adds Dr. Khan.

Michael W. Tsang, MD

Michael W. Tsang, M.D. , FACC, director of the Echocardiography Laboratory at Alta Bates Summit says, “While earning a 3 star rating in the recent public report is a great achievement for the medical center and cardiac surgery program, it is the constant and consistent feedback from my patients about their own wonderful and positive surgical experiences that make Alta Bates Summit one of the best mitral valve surgery programs in the state. Under Dr. Khan’s leadership, I have seen steady and significant strides made in our ability to deliver high quality care and to improve patient satisfaction.”

Alta Bates Summit’s three-star rating also drew praise from cardiovascular leaders at other East Bay hospitals.

“The three star rating for CABG and Mitral valve surgery by the nationally recognized Society of Thoracic Surgeons is well earned,” said Marina Tirlesskaya, MD, FACC, Chief of Cardiology, Alameda Health System. “Dr. Khan and his team have been providing outstanding care for our patients with consistently excellent results and unmatched compassion for our community and underserved patient population, supporting our mission at Alameda Health System of caring, healing, teaching and serving all.”

“As a community hospital with no onsite cardiac surgery program, our patients are fortunate to have the ABSMC cardiac surgical team provide superlative, prompt and outstanding care to our patients requiring emergent/urgent bypass surgery and mitral valve repair at Alta Bates Summit,” said Aditya Jain, MD, FACC, Director, Cardiac Catheterization Laboratory, St. Rose Hospital. “Their patient centric team approach has enhanced patient survival and improved overall well-being in the postoperative period.

How Do You Celebrate a Leap Year Birthday? Frogs and Chocolate Cake!

Posted on Feb 28, 2020 in Affiliates, Alta Bates Summit Medical Center, Scroll Images

Tiny Preemie Twins Born on Different Days Celebrate Fourth Birthday with Medical Team that Saved Them

Berkeley, Calif. –Twins Miles and Walter Erickson, born at 26 weeks and weighing barely two pounds each, arrived 11 minutes apart on different days — Feb. 28 and 29 (Leap Day), 2016. At a special leapfrog-themed birthday party and reunion, the twins and their family today celebrated their first Leap Day and fourth birthday with the Neonatal Intensive Care Unit (NICU) medical team who cared for them at Sutter’s Alta Bates Summit Medical Center.

Miles, Summer, Bruce, Ryan and Walter Erickson

Parents Summer and Ryan Erickson say they are forever grateful for the care their boys received from the Alta Bates Summit NICU doctors, nurses and staff for the first 69 days of their lives. When the tiny twins were born, the Oakland residents feared they might not survive.

Four years ago, Summer Erickson checked into Alta Bates Summit 14 weeks before her due date expecting to spend the rest of her pregnancy on precautionary bedrest. Instead, she went into preterm labor. After the birth, the Labor and Delivery staff immediately whisked the tiny preemies to the Level III NICU, where Miles and Walter spent the next 69 days.

“You go through every emotion you can imagine,” remembers Summer Erikson, “Not only were the babies fighting little warriors, but the nurses, doctors and staff worked around the clock to fight for their health and survival.”

When the Ericksons finally got the green light to bring Miles and Walter home, they took advantage of Alta Bates Summit’s NICU Post-Discharge Program, a series of classes designed for parents of preemies. This philanthropically funded program provides education and a compassionate support network during the critical transition period from NICU to home, and often for years afterward. The classes taught the Ericksons how to monitor their sons’ diet and watch for irregular breathing. But most of all, it gave them confidence for the task ahead. Miles and Walter, each 5 pounds at the time of discharge, were ready to go home.

Walter and Miles Erickson, age 4

Happy fourth birthday, Miles and Walter!