California Pacific Medical Center

Solutions for Sleeplessness: A New Study Tests Behavioral Therapy and Medications

Posted on May 6, 2020 in California Pacific Medical Center, Expanding Access, Innovation, Quality, Research

More than 20 million Americans suffer from chronic insomnia. This sleep disorder can cause emotional distress, impaired functioning and reduced quality of life. It can even contribute to an increased risk for other health problems such as depression and high blood pressure.

Researchers at Sutter Health’s San Francisco Coordinating Center (SFCC) are collaborating with investigators at the University of Pittsburgh and other leading institutions nationwide to help improve insomnia treatment. Their collective focus begins with attempts to better support people suffering from the disorder in remote communities since access to sleep clinics may be limited.

The newly launched COZI (Comparative Effectiveness of Zolpidem and Cognitive Behavioral Therapy for Insomnia in Rural Adults) study will assess the effectiveness of web-based cognitive behavioral therapy for insomnia (CBT-I) compared with a common prescription sleep medication (zolpidem) or the combination. COZI is the largest, multicenter, randomized clinical trial of its kind to be conducted in rural primary care practices.

The study uses a self-guided online approach to CBT for insomnia developed by collaborators at the University of Virginia. COZI will enroll 1,200 people ages 18 to 80 with chronic insomnia in rural primary care practices affiliated with eight U.S. academic medical centers. Treatment effects will be evaluated at nine weeks, and at six and 12 months.

Katie Stone, Ph.D.
Katie Stone, Ph.D.

“Both zolpidem and CBT-I have been proven effective in treating chronic insomnia. However, COZI is the first randomized trial to comprehensively explore how these therapies compare in providing sustained sleep improvements, as well as their potential side effects and impact on other health outcomes,” says Katie Stone, Ph.D., senior scientist at SFCC and lead investigator of COZI for Sutter.

“People in rural areas with insomnia may have difficultly traveling to sleep clinics for care. Our goal is to test an approach that delivers insomnia treatment in their homes, making it easier for them to use an innovative, convenient approach to manage their sleep disorder,” said Daniel Buysse, M.D., Professor of Psychiatry and Clinical and Translational Science at the University of Pittsburgh School of Medicine, and co-lead investigator of COZI.

“We anticipate this new approach to delivering insomnia treatment will help lead to sustained improvements in how providers care for adults in rural communities with this common sleep disorder,” said Dr. Stone.

“This project was selected for PCORI funding for its scientific merit and commitment to engaging patients and healthcare providers in a major study conducted in real-world settings. COZI may help answer an important question about chronic insomnia and fill a crucial evidence gap,” said PCORI Executive Director Nakela Cook, M.D., MPH.”

The four-year, $5.7 million study is sponsored by the Patient-Centered Outcomes Research Institute (PCORI).1

Contact Katie Stone, Ph.D. for more information about the COZI study.

A Dose of Technology to Aid Sleep Therapy:

Many clinical studies test whether a treatment works under ideal conditions in specialized research centers, but health care is rarely delivered in such idealized situations and settings. Pragmatic clinical studies such as COZI test a treatment’s effectiveness in “real-world” practice situations such as outpatient settings, and also can include a wider range of study participants—making their findings more applicable to a broader patient population.

While CBT-I is well-established as an effective strategy for treating insomnia,2,3 it is usually delivered in person by behavioral health specialists. CBT-I broadens access to insomnia treatment and provides sleep disorder education, monitoring and individualized behavioral recommendations to improve sleep. In rural communities, use of CBT-I may be even more important because these types of sleep therapies can be limited in remote areas.

Citations:

  1. PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.
  2. Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioral and pharmacological therapies for late‐life insomnia: a randomized controlled trial. JAMA. 1999;281(11):991‐9. PubMed PMID: 10086433.
  3. Ritterband LM, Thorndike FP, Ingersoll KS, Lord HR, Gonder‐Frederick L, Frederick C, Quigg MS, Cohn WF, Morin CM. Effect of a Web‐Based Cognitive Behavior Therapy for Insomnia Intervention With 1‐Year Follow‐up: A Randomized Clinical Trial. JAMA Psychiatry. 2017;74(1):68‐75. Epub 2016/12/03.

Collaboration Connects Asian American COVID-19 Patients with Healthcare

Posted on May 1, 2020 in Affiliates, California Pacific Medical Center, Community Benefit, Scroll Images, Uncategorized

SAN FRANCISCO — California Governor Gavin Newsom has made it clear in recent weeks that the State must greatly increase COVID-19 testing in order to re-open. Testing provides critical information to public health and government officials to help slow the spread of COVID-19.

In order to achieve the governor’s goal of 60,000 tests performed per day, providers like North East Medical Services (NEMS), one of the largest community health centers in the Bay Area, are offering drive-through testing. Drive-through testing greatly increases the number of people who can be tested.

NEMS currently serves 70,000 patients in San Francisco, many of whom are low-income, best-served in a language other than English, and are from immigrant families.

Partnership Connects COVID-19-Positive Patients to Care

Thanks to a decades-long relationship between NEMS and California Pacific Medical Center (CPMC), part of Sutter Health’s integrated network of care, San Francisco-based NEMS patients who test positive—and who need immediate medical care—receive a referral to CPMC. Together, these organizations provide care for 32,000 Medi-Cal patients; NEMS provides primary and specialty care, while CPMC serves as the in-network hospital for NEMS’ patients.

According to NEMS President & CEO, Eddie Chan, “NEMS is very fortunate to have CPMC as our partner in providing world-class medical care to the majority of our patients in San Francisco.”

Eighty percent of NEMS’ patients prefer to be served in a language other than English, and NEMS offers linguistically-competent and culturally-sensitive health care services in many languages and dialects. NEMS drive-through testing is limited to current patients, but anyone who wishes to get tested can call NEMS to register as a patient without coming into the clinic.

CPMC is one of the largest not-for-profit medical centers in California with three hospital campuses in San Francisco, including Davies, Mission Bernal and Van Ness. The medical center supports a system of care for patients across the City when they need emergency and hospital services.

In San Francisco, Sutter affiliates take patients in partnership with many providers and clinic groups. By partnering with NEMS, Sutter Pacific Medical Foundation and Brown & Toland Physicians, CPMC is helping ensure that shared patients have access to COVID-19 testing and a comprehensive set of services should they become symptomatic.

Paying it Forward: Sutter Teams with Vitalant to Offer COVID-19 Survivor-Donated Blood Plasma to Patients

Posted on Apr 27, 2020 in Alta Bates Summit Medical Center, California Pacific Medical Center, Community Benefit, Expanding Access, Innovation, Quality, Research, Scroll Images, Transformation

Convalescent plasma, rich in protective antibodies, is the liquid component of blood.

With experts predicting that a vaccine for COVID-19 is at least a year away, Sutter and Vitalant are collaborating to offer investigational treatment with convalescent plasma—blood plasma collected from people who have recovered from COVID-19—to hospitalized patients with severe cases of the disease under requirements recently outlined by the U.S. Food and Drug Administration (FDA).

Convalescent plasma, rich in protective antibodies, is the liquid component of blood. Not-for-profit Sutter Health is the first non-academic hospital system in California to participate in this research, launching expanded access program testing the use of convalescent plasma at its affiliates California Pacific Medical Center (CPMC), Sutter Medical Center Sacramento and Alta Bates Summit Medical Center, with other Sutter sites beginning the clinical trial in the coming weeks.

“By collaborating with community partners like Vitalant, we’re bringing an opportunity for the latest cutting-edge research to our patients,” says Sean Townsend, M.D., an intensive care medicine specialist in CPMC’s Division of Pulmonary and Critical Care. “Convalescent plasma is a potentially promising treatment for COVID-19 that we will test in clinical trials across the Sutter integrated network of care. We hope to build a supply of convalescent plasma that will add to our arsenal of emerging treatments to fight the virus.”

Vitalant physician colleague, Chris Gresens, M.D., adds, “We hope this therapy will serve as a type of ‘stop-gap vaccine substitute’ by providing severely affected patients just enough of an ‘immune boost’ to help them to recover more fully and quickly.”

The plasma donor must test negative for COVID-19 and be otherwise healthy. Convalescent plasma from one donor may be used to treat as many as four hospitalized patients with the illness who consent to participate in a clinical trial of the treatment.

Convalescent plasma has been studied for the treatment of numerous illnesses, most recently for infectious diseases such as Ebola, SARS, MERS and H1N1.

How you can help:

  • Under the new U.S. FDA guidelines, eligible blood donors who have had a documented diagnosis of COVID-19, and remain asymptomatic for at least 14 days post-recovery, may donate their plasma.
  • Sutter patients and health care workers who previously tested positive for COVID-19 can book an appointment for free donor screening at Sutter walk-in clinics: make a video appointment through My Health Online or call Sutter’s COVID-19 Advice Line (866) 961-2889 for more information.
  • Vitalant will only accept donors who meet all FDA-required general donor eligibility criteria in addition to the COVID-19 convalescent plasma qualifications.
  • Non-Sutter affiliated potential donors may apply to donate plasma at a Vitalant site by completing the form at Vitalant.org/covidfree. Donors cannot walk in for this procedure; they will be contacted by Vitalant to schedule an appointment.

Scott Kidd Gets a Second Chance

Posted on Apr 27, 2020 in Affiliates, California Pacific Medical Center, People, Scroll Images

If ever there was a time to believe in miracles, this may be it.

It started late last year in Folsom, Calif., when the Oakland Athletics West Coast scouting supervisor, Scott Kidd, finally scheduled a visit with his doctor after being unable to shake a persistent flu for two weeks. With the December holidays fast approaching, his wife, Gina, and their three children had become increasingly worried. Although Scott was otherwise healthy and in excellent shape, something wasn’t right. And during that medical appointment, the news Scott’s doctor shared wasn’t good.

As it had been for several days already, Scott’s heart rate was very erratic – from 167 beats per minute down to 101 and back up to 140. Fearful that he may have a stroke at any moment, Scott was rushed to the emergency department in Folsom where his condition deteriorated rapidly. Scott then went into cardiac arrest and was immediately moved to the ICU (intensive care unit).

It was starting to look like the situation wasn’t going to improve. Scott was placed on ECMO (extracorporeal electro corporeal membrane oxygenation) support and, after 12 days in a medically induced coma, he was airlifted to California Pacific Medical Center’s Van Ness Campus, part of Sutter’s not-for-profit integrated network of care, in San Francisco. The news from his care team – led by cardiologist Dr. Michael Pham and surgeon Dr. Brett Sheridan – was urgent: Scott needed a new heart and a new kidney as soon as possible.

Knowing that it could take months or even years to find a suitable donor(s), the Kidds were preparing for a long wait. Less than a week later, however – and on Scott’s 46th birthday – both a suitable heart and a kidney were found.

Scott’s life-saving transplant surgery was a success and he’s on the road to a full recovery. Through it all, holding her emotions in check while also managing the family duties back home, was Gina. After finally having a chance to look back on the whirlwind of emotion her family has endured, Gina explained how she could not have felt safer – or been more proud – of her Sutter Health/CPMC medical team.

“When we first arrived to CPMC’s Van Ness Campus location, I felt like we were in the ‘Beverly Hills’ of hospitals,” she said. “From the superb cleanliness to the team’s professionalism, we felt like we’d gone from the minor leagues to the big leagues. That was very comforting.”

Gina said her husband’s care team delivered world-class service that helped ease her anxiety. “Dr. Pham and Dr. Sheridan made every worry I had practically disappear,” she said. “Even though I was scared, they were always there for him and for me. They were so quietly confident about my husband’s path to recovery, which made me feel good. I don’t know how I’ll ever be able to thank them.”

Although David Forst, the Athletics general manager, knew inside his heart that Scott would recover, the entire situation was difficult to comprehend.

“It was a miracle,” he said. “I hate using the word ‘miracle’ because it undersells the science and medical work. To go from a coma to having a heart and kidney show up practically out of nowhere, and now his incredible on-track recovery – it’s just amazing.”

More than 50 years ago, CPMC conducted its first transplant operation—a kidney transplant. Since then, the CPMC care teams have performed more than 9,000 organ transplants, including more than 6,200 kidney, 2,000 liver, 400 pancreas, and 500 heart transplants. The new Van Ness campus hospital features custom-designed transplant operating rooms helping to optimize collaboration. For more information, please visit CPMC’s Transplant Services.

Showing Their Love and Strength: Sutter’s Frontline Workers Raise Voices to a Familiar San Francisco Song (video)

Posted on Apr 25, 2020 in Affiliates, California Pacific Medical Center, People, Scroll Images

SAN FRANCISCO – Front-line staff and physicians at Sutter’s California Pacific Medical Center (CPMC) Van Ness campus hospital in San Francisco joined in unison—along with thousands of others across the region—to sing the city’s unofficial anthem “I Left My Heart in San Francisco” by Tony Bennett.

Earlier in the week, the legendary Bennett, age 93, put out a public call on his Twitter feed for the citizens of San Francisco to raise their voices together on April 25 at noon.

Tony Bennett tweet

The sing-along is really a three-in-one: an ode in support of the City’s front-line workers, a musical tribute to residents for helping to ‘bend the curve,’ and a ballad to remind the public to stay the course of social distancing.

In a San Francisco Chronicle article, San Francisco Mayor London Breed said, “By taking a moment to join together in song to celebrate our front-line health workers and everyone working to make a difference during this pandemic, we can recognize how connected we are to one another, not just here in San Francisco, but all over the world.”

Check out Sutter’s front-line staff sing-along below.

CPMC is part of the Sutter Health not-for-profit integrated network of care in Northern California.

Volunteers “HELP” Elderly Patients Through Virtual Visits During COVID-19

Posted on Apr 22, 2020 in Affiliates, California Pacific Medical Center, People, Scroll Images

SAN FRANCISCO – National Volunteer Week (April 19-25) is an opportunity to recognize the impact of volunteer service and the power of volunteers to tackle society’s greatest challenges, to build stronger communities and be a force that transforms the world.

California Pacific Medical Center (CPMC), part of Sutter Health’s not-for-profit integrated network of care, has more than 850 volunteers that help provide companionship and emotional support to patients and their families in the emergency department and elsewhere, guiding people around facilities, explaining procedures, helping patients eat, playing music, performing clerical duties and so much more.

To help reduce the risk of coronavirus transmission, CPMC volunteers are currently sheltering in place but that hasn’t stopped them from participating in the hospital’s Hospital Elder Life Program (HELP). This unique program allows volunteers to engage elderly patients to help prevent episodes of delirium and increase their functional independence.

Instead of meeting patients at the bedside, CPMC volunteers are conducting phone and virtual visits to help keep their patients mobile and alert, with the goal of them getting well faster and going home sooner.

“When we knew our HELP volunteers couldn’t continue to visit our patients at the hospital, we immediately looked at digital alternatives and whether our volunteers could still make a meaningful connection through a virtual visit,” said Clara Rubin-Smith McKie, CPMC Volunteer Coordinator/Elder Life Specialist. “The answer was yes, and we’re excited that our volunteers have committed themselves to engaging patients remotely.”

HELP Volunteers are now using their mobile phones and tablets to communicate with patients. They engage and stimulate patients through activities such as guiding them through range of motion and breathing exercises to reduce stress and encouraging them to walk.

“The HELP program at CPMC has helped reduce falls for older patients by 22 percent and readmission by 25 percent,” says Wendy Zachary, M.D., CPMC hospitalist and HELP physician-champion. “It’s vital during the COVID-19 pandemic that we continue to help support these fragile patients and I applaud our volunteers for their dedication during this difficult time.”

Wendy Zachary, M.D., CPMC hospitalist and HELP physician-champion.

Patients Appreciate the Conversations

Melissa Ann Im, a HELP Volunteer had a lovely conversation last week and passed along the following comment from a patient:

“I’m not a great fan of the human race… but the people who work at the hospitals are the kindest people on the planet… working all their days to alleviating pain and saving lives. They do it because it is what they want to do. They are the most caring and professional people… I am in awe.”

“I appreciate you volunteers so much. You don’t have to do this, but you do… if you could see me right now, I have a big smile on my face.”

Building relationships are the key. HELP volunteers are taught about using a healing touch to establish a trusting relationship with the patient. Amidst the current stress of the pandemic, for many volunteers, it’s the highlight of their week.

“I’m so grateful to our volunteers for continuing to do this great work during this extremely challenging time,” says Frances Huang, CPMC Volunteer Coordinator/Elder Life Specialist. “The significant improvement in the level of care our patients receive from the HELP program is immense and I’m glad that our volunteers continue to bring smiles to so many faces.”