Alta Bates Summit Medical Center

Leading Neurologist Gives Insight on Stroke Care Innovation

Posted on May 2, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Innovation, Mills-Peninsula Health Services, Research, Scroll Images, Sutter Medical Center, Sacramento, Transformation

SAN FRANCISCO – Every second counts in detecting and treating stroke, the leading cause of serious, long-term disability in the U.S. Each year, approximately 795,000 people suffer a stroke. New research at Sutter Health is helping bring faster, life-changing care to stroke patients through a clinical trial called BEST-MSU that will test the efficacy of Sutter’s Mobile Stroke Unit (MSU).

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Real-Time Research: Using Insights to Help Healthcare Today and Tomorrow

Posted on Apr 20, 2019 in Alta Bates Summit Medical Center, California Pacific Medical Center, Innovation, Mills-Peninsula Health Services, Research, Scroll Images, Transformation

SAN FRANCISCO – New research shows that weight loss during the first 12 weeks of a year-long behavioral lifestyle program can predict which participants will achieve weight loss after completing the program. This revelation, along with several others, were shared by Sutter Health’s Center for Health Systems Research (CHSR) during the recent annual meeting of the Health Care Systems Research Network (HCSRN) in Portland.

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Collaboration Leads to Reduction in Low-Risk, First-Birth C-sections

Posted on Apr 17, 2019 in Alta Bates Summit Medical Center, Quality, Scroll Images, Women's Services

By Katarina Lannér-Cusin, M.D., administrative medical director, Women’s Services, Alta Bates Summit Medical Center

 

BERKELEY, Calif. – One of the advantages that an integrated healthcare delivery network like Sutter Health has is that its clinicians are able to improve quality by studying the experience and practice patterns of fellow clinicians. An example of this is our work to support vaginal delivery by reducing the rate of cesarean sections for low-risk, first-time births.

Katarina Lannér-Cusin, M.D., Administrative Medical Director, Women’s Services, Alta Bates Summit Medical Center

Sutter Health’s low-risk, first-birth C-section rate is among the lowest in California, with nine hospitals receiving recognition in 2017. Sutter’s average rate of 21.2 percent is lower than the state’s Healthy People 2020 target of 23.9 percent and the 2016 California Maternity Quality Care Collaborative target of 22.2 percent.
Sutter’s integrated network enables sharing of best practices and real-time data for continual process and quality improvement, which allows the network to outperform state and national averages in many quality measures and improve outcomes for the communities it serves. Sutter hospitals are leaders in California in lowering C-section rates—notably low-risk, first-birth C-section rates.

Sutter is a member of the California Maternity Quality Care Collaborative (CMQCC), a multi-stakeholder organization committed to ending preventable morbidity, mortality and racial health disparities in California. Partnering with CMQCC and the California Health Care Foundation, Sutter is leading a labor culture campaign to proactively educate first-time mothers about C-sections and encourage them to engage with their care teams to support vaginal birth and avoid C-sections for low-risk pregnancies.

There are several key drivers that have been instrumental to achieve real progress in decreasing C-section rates in the Sutter network of care.

• The first and most important driver is effective communication and teamwork—a joint commitment by the clinical team (nurses, midwife and physician) to create a great supportive environment for patients.

• The second driver is alignment on best practices for labor support, including collaborative labor management and education. Sutter adopted a checklist in labor and delivery that establishes parameters clinicians need to complete before deciding on a C-section. The teams work collaboratively using the checklist to ensure that all best practices for supporting a vaginal birth have been implemented. Additionally, labor support education has been developed for nurses, midwives and physicians.

• The third driver is maternal agency—a birth preference sheet was created to educate new mothers about choices they make that may increase their likelihood of a vaginal delivery and give them the opportunity to talk with their physician or midwife about these choices before birth.

• Finally, a large component of lowering low-risk, first-time birth C-section rates is the open sharing of physician-level rates among peers. This transparency creates the opportunity for dialogue and shared learning among clinicians. Each group is encouraged to discuss these rates internally and come up with a plan to address any issues uncovered by the data.

Sutter Health is working to ensure that every patient receives the highest quality maternity care for herself and for her baby. For more information, please visit Pregnancy and Childbirth Services.

Change of Heart: Sutter Health is Poised for New Era in Cardiology Care

Posted on Mar 29, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Carousel, Mills-Peninsula Health Services

BURLINGAME, Calif. — Change can be sudden or slow, in this case it’s both. Sutter Health has been at the forefront of a decade-long journey to offer more patients with aortic valve stenosis an alternative to open-heart surgery. With new research presented last week at one of the world’s top cardiology meetings that goal seems achievable almost overnight.

Aortic stenosis is a serious cardiac condition in which the aortic valve in the heart narrows, limiting blood flow to the body. Doctors can treat aortic stenosis by replacing the patient’s faulty valve either during open-heart surgery or through a minimally invasive procedure called TAVR (Transcatheter Aortic Valve Replacement).

David Daniels, M.D.

It is estimated that 100,000 TAVR procedures have been performed over the past decade, yet open-heart surgery remained the standard of care. “This meant that I could only offer TAVR if open-heart surgery would put my patient at an unnecessarily high risk for complications,” said interventional cardiologist David Daniels, M.D., co-director of Sutter’s Structural Heart Program in the Bay Area and a Sutter Health clinician-investigator.

Recently a major clinical trial[1] showed that a reversal may be in order; going forward TAVR may be the routine treatment or ‘gold standard’ for aortic stenosis, and open-heart surgery may be the exception.

Sutter Health not only participated in the recently completed trial, but under a continued access protocol, three Sutter Health hospitals are able to continue offering TAVR to a broader group of patients—even while the U.S. Food and Drug Administration examines the trial’s data.

The three Bay Area hospitals participating in the continued access protocol are: Mills-Peninsula Medical Center (Burlingame), California Pacific Medical Center (San Francisco), and Alta Bates Summit Medical Center (Oakland).

“I want to stress that TAVR is not a new procedure. I’ve successfully treated over 950 patients with this technique,” remarked Dr. Daniels. “The new part of this is that we can now offer TAVR, which is done through a small incision in the groin, to even more patients than before—giving them an option that is often safer, and often has a faster recovery time, than open-heart surgery.”

A typical hospital stay for open-heart surgery is a week to 10 days. TAVR patients often go home within 24 hours and are back to their usual activities within a few days instead of six weeks or longer for open-heart surgery patients.

Remarkable Clinical Trial Results 

Sutter Health’s cardiovascular teams have been involved with TAVR since its inception and have continued to pioneer the procedure as the artificial valves themselves have evolved. Over the years, several Sutter Health hospitals have participated in studies that confirmed the safety and efficacy of TAVR in patients who have intermediate or high risk of complication from open-heart surgery.

However, the most recent trial, called the PARTNER 3 trial, specifically looked at patients for whom open-heart surgery carries a relatively low risk of complications.[2]

Sutter Health affiliated combined sites Mills-Peninsula Medical Center (MPMC) and Alta Bates Summit Medical Center (ABSMC) were major contributors to the PARTNER 3 trial and the second largest enrollment site in the state (trailing Cedars-Sinai in Los Angeles). The Bay Area hospitals achieved a zero percent complication rate (one year post procedure) among low risk patients who received TAVR as part of the trial. Sutter Medical Center Sacramento also participated in the PARTNER 3 trial.

“The PARTNER 3 results are remarkable. There was a statistically significant 60 percent reduction in risk of death and stroke in TAVR compared to surgery, and this was carried out to one year,” Dr. Daniels remarked.

The study looked at rehospitalization associated with death, stroke or heart failure, and found that these negative results were 50 percent lower (half as likely) when the patient had TAVR instead of open-heart surgery. Beyond these results, there were significantly lower rates of renal failure, life threatening hemorrhage and reduced length of hospital stay among the patients in the TAVR group compared to the open-heart surgery patients.

The Future is Here

“Presently we are in the gap between the end of the PARTNER 3 trial and a decision by the FDA that might officially extend approval of TAVR to the low risk patient group,” explained Dr. Daniels. Today, the artificial valves used in the TAVR procedure are FDA-approved only for patients who are considered too old or frail to have open-heart surgery.

“We are proud to continue to offer the TAVR procedure to low risk patients as part of our participation in the valve manufacturer’s continued access protocol.” Three Sutter Health hospitals: Mills-Peninsula Medical Center, California Pacific Medical Center and Alta Bates Summit Medical Center — are the only facilities in Northern California currently participating in the continued access protocol.

“Common sense told us that even patients with a low risk of complications from open-heart surgery may benefit significantly from treatment with TAVR instead,” Dr. Daniels said. “Results from the PARTNER 3 trial indicate that, for many patients, this has proven to be true. We are pleased to be able to offer TAVR to all patient risk groups.”

These groundbreaking clinical results are an example of how Sutter Health is leading the transformation of healthcare. If you are suffering from severe aortic valve stenosis talk to your cardiologist to see if valve replacement with TAVR is right for you.

[1] Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019 Mar 17. doi: 10.1056/NEJMoa1814052. [Epub ahead of print]

[2] The PARTNER 3 trial was sponsored by the makers of the Sapien artificial valve, Edwards Lifesciences of Irvine, Calif. Dr. Daniels is a consultant for Edwards Lifesciences.

Research at Sutter Health Shows New Treatment Approach Improves Survival, Reduces Metastasis in High-Risk Prostate Cancer

Posted on Mar 20, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Innovation, Mills-Peninsula Health Services, Palo Alto Medical Foundation, Research, Scroll Images, Sutter Auburn Faith Hospital, Sutter Medical Foundation

SAN FRANCISCO – Prostate cancer impacts one in every nine men in the U.S. Although death rates from the disease have declined over the last two decades, over 25,000 men die from prostate cancer annually.

Docetaxel, a chemotherapy drug commonly used to treat other types of cancer, has improved overall survival with limited toxicity in men whose prostate cancers have metastasized and who are no longer sensitive to androgen suppression therapy (i.e., patients are hormone resistant).

Researchers at Sutter Health and other leading centers across the U.S. and Canada hypothesized that adding docetaxel to standard therapy could potentially improve overall survival and other clinical outcomes in men with localized, high-risk prostate cancer.

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Sutter Health a Leading Site Enrolling Patients to the PARTNER 3 Trial for Treatment of Aortic Value Stenosis

Posted on Feb 28, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Cardiac, Eden Medical Center, Innovation, Mills-Peninsula Health Services, Novato Community Hospital, Palo Alto Medical Foundation, Research, Scroll Images, Sutter Davis Hospital, Sutter Gould Medical Foundation, Sutter Medical Center, Sacramento, Sutter Medical Foundation, Transformation

SAN FRANCISCO – Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure done without open-heart surgery to replace a narrowed aortic valve. The procedure is one of several research breakthroughs and interventional cardiology advances being pioneered at Sutter Health through the research of David Daniels, MD, an interventional cardiologist at Mills-Peninsula Medical Center and California Pacific Medical Center who directs Sutter’s Structural Heart Program, and collaborators across Sutter.

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