California Pacific Medical Center

CPMC’s HELP Program for Older Adults Receives Top Designation from AGS

Posted on Oct 22, 2020 in California Pacific Medical Center, Expanding Access, Scroll Images, Uncategorized

CPMC becomes fifth U.S. medical center to achieve elite ‘Center of Excellence’ status

California Pacific Medical Center (CPMC) in San Francisco is now one of only five organizations in the United States to achieve the American Geriatric Society (AGC) CoCare: HELP™ Center of Excellence designation for its Hospital Elder Life Program (HELP). CPMC was recently awarded this elite status after demonstrating the highest level of best practices in geriatric care.

“I am so proud of our dedicated team at CPMC for all their hard work in building a world-class geriatric care program,” says hospitalist and geriatrician Wendy Zachary, M.D., who directs CPMC’s Acute Care for Elderly (ACE) unit and is the HELP physician-champion. “This accreditation from the American Geriatric Society validates and strengthens our mission to provide patient-centered, advanced care for older members of our community who are particularly medically vulnerable–especially during the COVID-19 pandemic.”

Watch this video about CPMC’s ACE unit.

Targeted Interventions Lead to Better Outcomes for People Ages 70+

The AGC CoCare: HELP™ program is designed to prevent both delirium and functional decline in patients 70 years and older. CPMC’s HELP program uses an interdisciplinary team (Advanced Practice Nurses, specially-trained Elder Life Specialists, and trained volunteers) to integrate principles of geriatric care into standard nursing and medical care at all three CPMC hospital campuses in San Francisco, including the ACE unit at the Mission Bernal Campus, as well as the Van Ness Campus and Davies Campus.

Geriatric syndromes include conditions typical of aging such as delirium, incontinence, falls, pressure injuries, and functional decline. CPMC’s HELP program works to prevent these geriatric syndromes in the hospital setting by helping re-orient patients to their surroundings through conversation and social support, assisting with range-of-motion and breathing exercises, walking, offering companionship during meals, implementing a schedule, and more.

Benefits of HELP at CPMC include:

  • Helps maximize independence and physical functioning of high-risk patients (age 70+)
  • Improves overall quality of hospital care for older patients, including improvement in hospital outcomes and satisfaction with care
  • Helps decrease the length of stay for patients by an average of 1- 1.5 days
  • Helps reduce hospital readmissions
    • Van Ness Campus’ HELP program saw a decrease in readmissions by 11% in 2020 Q1, 17% in 2019, and 24% in 2018
    • Mission Bernal Campus’ HELP program prevented more than 30 readmissions in 2019
  • Helps reduce falls for older patients by as much as 50% at the Van Ness Campus and Davies Campus (2019)
  • Provides cost-effective care, with reduced overall hospital costs by as much as $2 Million across each of the three campuses in 2019

“The HELP program is making a meaningful difference in changing the course of lives for elderly patients and their loved ones, and I am truly grateful for our staff, volunteers and support from our philanthropic donors who helped make this elite recognition possible,” said Warren Browner, M.D., CEO of CPMC.

Mission Bernal Campus Hub of Geriatric Care in San Francisco

While CPMC’s HELP program is carried out across all its three campuses, its Mission Bernal Campus is home to the medical center’s comprehensive ACE unit and one of only three accredited Geriatric Emergency Departments in Northern California.

“These differentiators of specialty care for older adults and this recent acknowledgement from the AGS further highlights CPMC’s commitment to geriatric care and cements our Mission Bernal Campus as a hub of geriatric patient care in San Francisco and the broader Bay Area,” says Vernon Giang, M.D., chief medical executive of Sutter’s CPMC.

Musical B-I-N-G-O Brings Moments of Levity for One Hospitalized Elder

Posted on Oct 22, 2020 in California Pacific Medical Center, People, Quality, Scroll Images

Callie Cowart, a full-time board-certified music therapist at Sutter’s California Pacific Medical Center (CPMC) in San Francisco uses music to heal.

Cowart recently offered her therapy sessions to an older patient undergoing care at CPMC’s Mission Bernal Campus Acute Care for Elderly (ACE) unit. Cowart explains that the patient had many recurring hospitalizations over the span of four months this year.

“She and I worked together originally to use music to provide a competing stimulus to pain, which she unfortunately experienced a lot of during her time here,” said Cowart.

A B-I-N-G-O Playlist to East Anxiety & Pain

As Cowart and the patient got to know each other, the patient would look forward to sessions with “her Callie” as an energy booster and motivator.

“One morning I read in the physical therapist’s notes that prior to shelter-in-place this patient would frequent a local BINGO hall, but she’s not been able attend since the start of the pandemic. Since I knew her favorite songs, I surprised her in our next session with a customized BINGO card with each square having a different song title,” said Cowart.

To give the full effect, Cowart cut out strips of paper with the matching song titles, placed them in a bag, and used the strips as her BINGO balls that the patient could pull out. Once a BINGO “ball” was drawn, the two would sing and play together.

Music Therapy at CPMC

The Music Therapy Program at CPMC offers patients and their families the opportunity to receive therapy services from a board-certified music therapist, at no cost to the family. Music therapists are seen as an integrated part of the patient’s multidisciplinary care team and work closely with doctors, nurses, child life specialists and other therapists as part of care for the patient’s whole self.

The Sound of Music on Health

According to an article published on Harvard Health, a growing body of research attests that music therapy is more than a nice perk. It can improve medical outcomes and quality of life in a variety of ways.

For example, music therapy can help people who are recovering from a stroke or traumatic brain injury that has damaged the left-brain region responsible for speech. Because singing ability originates in the right side of the brain, people can work around the injury to the left side of their brain by first singing their thoughts and then gradually dropping the melody.

Sessions that Strike the Right Chords

Cowart says that the patient was an excellent handheld shaker player and developed a sort of fan club among the ACE unit staff for her spunky personality.

“She told me time and time again that this musical intervention gave her an increased sense of social support and mood/energy boosting during her hospitalizations at ACE because visitors had not been allowed in the hospital during COVID,” shared Cowart.

“Having something and someone to look forward to in a place that can sometimes be scary or associated with negative memories and emotions can prove to be very important,” she adds.

As for the patient, thankfully she has not had to return to the ACE unit and appears to be doing well, which is music to Cowart’s ears.

Welcoming to the world one bundle of joy…make that two bundles… actually three!

Posted on Oct 2, 2020 in California Pacific Medical Center, Quality, Scroll Images, Women's Services

When Zarmina and Haris Anjum learned they would be having triplets this spring, one of the first things they did was buy an SUV.

“We planned for one, then it was twins, and then two weeks later it was three. It was wonderful and not at all expected,” said Haris. “We joked that we better hold off on having any more ultrasounds.”

Fast forward to this fall.

The Anjum’s were scheduled to deliver at a San Francisco hospital. When that facility experienced a staph outbreak, the family was transferred to nearby Sutter’s California Pacific Medical Center Van Ness campus hospital.

“We were met with such warmth,” said Haris. “It was reassuring to be cared for by such professional doctors and nurses. The facility was phenomenal, and we were relieved there were private NICU rooms.”

Healthy delivery

The Anjum triplets – Yahya, Yakub, and Yusuf – were born at 34 weeks via cesarean section.

“Delivering twins is already fun, but triplets—now that’s super fun,” said obstetrician Ruth Olweny, M.D. “We’re well equipped to handle multiple births at CPMC and having three providers on that night made Zarmina’s delivery seamless. The room setup was mostly the same, too, except that for triplets we have three isolettes on hand (a clear plastic enclosed crib that maintains a warm environment) as opposed to one or two.”

Obstetrician Izumi N. Cabrera, M.D., added, “When the family arrived at CPMC, Haris had a big box of supplies for cord blood blanking.”

Cord blood is the blood from a baby that is left in the umbilical cord and placenta after birth. This blood contains special cells called hematopoietic stem cells that can be “banked” (stored) for later use by the individual and has been used to help treat certain diseases.

“Cord blood collection requires another step during delivery. When you consider that we were doing it for three babies, that means there’s even greater focus from the team. I was pleased we were able to capture the needed material from all three babies’ cords. We were basically a functioning assembly line as each baby was delivered,” said Dr. Cabrera.

Three facts about triplets

They’re rare. In 2018, the Centers for Disease Controls (CDC) and Prevention reported 3,400 triplet births, while there were more than 123,000 twin births. The CDC reported 3,791,712 total births in the U.S. in 2018.

They’re early birds. According to March of Dimes, the majority of triplets are born premature. Most triplets are born between 32-34 weeks of gestation and caesarean section delivery is common.

There’s often a family history of multiple births. The American College of Obstetricians and Gynecologist says that twins are the most common type of multiple births. Heredity on the mother’s side ups a couple’s odds of conceiving fraternal twins.

Settling in at Home

Born in early September, the Anjum triplets are getting stronger and gaining weight by the day.

“All three are wireless now,” chuckles Haris, referring to each baby no longer needing a feeding tube and now breathing room air.

As for what’s next, Zarmina and Haris are taking it one day at a time.

Haris says, “I have the honor of being their chauffeur and continuing to support my wife in her recovery. We’re looking forward to settling in at home and introducing our four-year-old son to his baby brothers. But first I have to conquer these car seats!”

Colon Cancer Up Among Younger Age Groups; Screening Key to Early Detection

Posted on Sep 4, 2020 in California Pacific Medical Center, Scroll Images, Wellness

Actor Chadwick Boseman’s death from colon cancer at age 43 came as a shock. Following his passing, Boseman’s family shared that he was diagnosed with stage 3 colon cancer four years earlier. Many headlines captured the public’s collective sentiment—Colon cancer? But he was so young!

Michael Abel, M.D., chair of surgery at Sutter’s California Pacific Medical Center (CPMC) and colorectal surgeon, says of the news, “When you look at a 39-year-old male in his prime who is coming in with GI symptoms and not feeling well, colon cancer would not be at the top of the list. That needs to change.”

The American Cancer Society (ACS) says the rate at which younger people are diagnosed with colorectal cancer is rising. Data shows the disease’s case rates have been increasing since the mid-1980s in adults ages 20-39 years and since the mid-1990s in adults ages 40-54 years. On the upside, data shows case rates among individuals 65 and older are decreasing.

“While the medical community doesn’t know why these rates are climbing in younger populations, physicians are now paying closer attention to this cancer,” says Dr. Abel.

Colorectal Cancer Facts

According to the American Cancer Society:

• Colorectal cancer is the third most commonly diagnosed cancer and the second most common cause of cancer death in both men and women in the U.S.

• About one in 23 men and one in 25 women will develop colon or rectal cancer at some point during their lifetime.

• It is estimated that there will be 104,610 new cases of colon cancer and 43,340 new cases of rectal cancer in the U.S. this year.

• The rate of being diagnosed with colorectal cancer is higher among the Black community than among any other population group in the U.S.

For more information about colorectal cancer, visit here.

New Thinking on Screenings

In 2018, the American Cancer Society lowered the recommended screening age for people with average colorectal cancer risk, i.e. no family history, to age 45. “More aggressive screening is the best thing we can do to help prevent colorectal cancer and helps allow those who are diagnosed with cancer to have better outcomes,” says Dr. Abel.

For individuals with a family history of the disease, meaning a first degree relative or parent was diagnosed, a physician will likely recommend getting screened as early as age 40.

Black Community at Increased Risk of Developing Colon Cancer

Black people are more likely to develop colorectal cancer at a younger age and to be at a more advanced stage when diagnosed. According to the National Cancer Institute, even when African Americans are diagnosed with early stage disease, they have significantly worse survival rates.

“Earlier and more aggressive screening in this group can help bridge this gap,” says Dr. Abel.

Primary Care Doctors Paying More Attention

A patient’s primary care doctor is typically his or her first line of defense in knowing if symptoms warrant further examination.

“Providers should consider other potential causes of a symptom like rectal bleeding, beyond assuming its hemorrhoids, as an important step in diagnosing what could be a more concerning issue. The physician can then refer the patient to a specialist who will perform a more thorough screening or schedule a colonoscopy,” says Dr. Abel.

“Colorectal cancer can be preventable, and if detected early, curable,” he says.

For ways to reduce your colon cancer risk, visit here.

CPMC’s Colorectal Cancer Center of Excellence Program

In 2019, Sutter’s CPMC was recognized by the National Accreditation Program for Rectal Cancer (NAPRC) as a leading Center of Excellence. To earn this three-year accreditation, CPMC met 19 standards, including the establishment of a rectal cancer multidisciplinary team, which includes clinical representatives from surgery, pathology, radiology, radiation oncology and medical oncology.

Read more about CPMC’s accreditation here.

For more information, schedule an appointment with your primary care provider. To find a Sutter primary care physician, click here.

“Tell me your life story, I’m listening, I see you.”

Posted on Sep 3, 2020 in California Pacific Medical Center, Community Benefit, Expanding Access, Health Equity, Innovation, Mental Health, People, Quality, Research, Scroll Images, Sutter Medical Center of Santa Rosa, Sutter Medical Center, Sacramento

Faculty and residents in Sutter’s Family Medicine Residency Program

We are a mosaic of our experiences, lifestyle, social and family connections, education, successes and struggles. Apply those factors to our health, and a complex formula arises that clinicians commonly call the patient experience.

Learning the skills to assess these factors and deliver compassionate care to patients is what Sutter’s family medicine resident physicians aim to enhance. The newly enhanced Human Behavior & Mental Health curriculum is helping lead the way.

“We encourage faculty and residents to think about context, systems and dynamics within population health to address social determinants of health,” says Samantha Kettle, Psy.D., a faculty member in Sutter’s Family Medicine Residency Program.

She and colleague, Andy Brothers, M.D., a family medicine physician in Sacramento and faculty member in the residency program, are bringing health equity to the patient experience and training family medicine residents in Sacramento and Davis.

Family medicine faculty and residents at Sutter Medical Center, Sacramento

Seven residents each year learn to screen patients for social determinants of health (such as financial challenges, environmental and physical conditions, transportation needs, access to care and social factors) that may impact patients’ risk of depression and anxiety, substance use disorder and suicide.

This year’s residents may train in addiction medicine, psychotherapy, chronic pain, spirituality in medicine, well-being and the field of medicine that supports those who are incarcerated.

And in a community as diverse as the Sacramento Valley Area, statistics suggest these factors may significantly impact the health of its residents:
• 15.9% of California adults have a mental health challenge(1)
• Nearly 2 million Californians live with a serious mental challenge
• Substance misuse impacts 8.8% of Californians
• The prevalence of mental health challenges varies by economic status and by race/ethnicity: adults living 200% below the federal poverty level are 150% more likely to experience mental health challenges; 20% of Native Americans and Latinos are likely to have mental health struggles, followed by Blacks (19%), Whites (14%) and Asians (10%).

“Taking care of our local population’s health is a moral imperative,” says Dr. Kettle. “Many residents have entered our program to continue their quest in helping people in underserved communities.”

For instance, third-year Sutter family medicine resident Mehwish Farooqi, M.D., is studying ways to screen for post-partum depression using an approach developed through the ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns) program.

“Women are most vulnerable to mental health concerns during the post-partum period: as many as one in seven women experience PPD. ROSE is a group educational intervention to help prevent the diagnosis, delivered during pregnancy. It has been found to reduce PPD in community prenatal settings serving low-income pregnant women,” says Dr. Farooqi.

“Sutter has clearly demonstrated a commitment to health equity and social justice that has propelled our residency program toward a future vision of health care in which all patients are cared for as individuals with unique life stories, struggles and successes,” says Dr. Brothers.

Advancing Social Determinants of Health through Graduate Medical Education at Sutter:
Other family medicine programs across Sutter’s integrated network incorporate health equity into ambulatory training for residents. The family medicine faculty at California Pacific Medical Center include a social worker who teaches residents to address concerns like financial and food insecurity, as well as social isolation. Residents learn how to care for people with depression and anxiety, and lecture series are offered on topics like addiction medicine and chronic pain/narcotic management.

Sutter Santa Rosa Regional Hospital’s Family Medicine Residency Program incorporates social justice through a Community Engagement and a Diversity Action Work Group—a committee comprised of faculty and residents who help tackle issues around inequity and structural racism.

“We are committed to strengthening a relationship between the residency program and the diverse communities we serve, guided with cultural mindfulness and compassion in our pursuit of overall wellness for all,” says Tara Scott, M.D., Program Director of the Family Medicine Residency Program in Santa Rosa.

Learn more about Sutter’s Family Medicine Residency Program.
• Find out how Sutter is advancing health equity.

Reference:

  1. California Department of Health Care Services.

Stay on Top of Your Heart Health During COVID-19, Part II

Posted on Aug 27, 2020 in California Pacific Medical Center, Scroll Images, Uncategorized, Wellness

In another post, we provided information on how to read your blood pressure and what medical conditions may result from having prolonged high blood pressure. In this article, we offer tips from Michael X. Pham, M.D., M.P.H., chief of cardiology with Sutter’s California Pacific Medical Center in San Francisco on how to reduce—or maintain—your blood pressure.

Better Diet, Better Heart Health

To lower one’s risk of high blood pressure, Dr. Pham encourages people to limit their sodium and eat a heart-healthy diet. Canned foods, condiments, deli meats, salad dressings and sauces are some of the biggest sodium culprits. Instead, make meals using garlic, lemon juice, herbs, spices or seasonings with no salt added. Do not add salt to prepackaged or frozen meals, as they are already loaded with sodium.

What goes on our plates at mealtime also offers insight into how healthfully we’re eating. “Mentally divide your plate into four quadrants. Two quarters (or half) should be fruits and veggies. One quarter should be proteins (lean fish, chicken or beans), and the remaining quarter should be a whole grain or starchy vegetable (brown rice, sweet potato),” says Dr. Pham.

Dr. Pham says that staying hydrated with water is good. People should avoid sugary drinks and alcohol as much as possible.

Get Those Steps In

Exercise is also key in maintaining a healthy heart. For this reason, it’s important to walk outside every day—but check air quality levels first.

Dr. Pham recommends a goal of 7,000-10,000 steps daily. “If you can’t get in a big walk all at once, break it into shorter walks throughout the day.” With increased community spread of COVID-19, he recommends walking early in the morning or early in the evening when there are fewer people out, and, if possible, be conscious of physical distancing and wear a mask. For those who cannot go outside, take frequent standing breaks and do laps around your house or yard.”

Your Heart & COVID-19

According to the Centers for Disease Control and Prevention, people with moderate to severe hypertension may be at increased risk of COVID-19 complications.

“Hypertension makes it harder to fight off infections. Regular check-ups allow your provider to help manage your condition and provide a proactive plan if your blood pressure gets worse,” says Dr. Pham.

Know your numbers. An at-home blood pressure monitor, available at your local drugstore or online, can track your blood pressure readings in between checkups. Dr. Pham suggests bringing your at-home monitor to your next in-person appointment to help ensure its readings are accurate and reliable.

Award-Winning Cardiac Care

In August 2020, ten hospitals across Sutter’s not-for-profit integrated network of care received recognition by the American Stroke Association for providing a high level of stroke care as part of the 2019 Get With The Guidelines® awards.

Additionally, 20 hospitals in the Sutter system received recognition from the American Heart Association for consistently applying the American College of Cardiology guidelines when treating patients with heart failure. Read more about these recognitions here.

Options For Care

The heart is one of your body’s most essential organs. Don’t take it—or caring for it—for granted.

Sutter Health is committed to your health and safety. If you need care or to make an appointment today, Sutter’s care teams are ready to serve you in person or by video visit.

For more on Sutter’s heart disease prevention programs, visit here.