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Care Team Enables Communication Solution for Laboring Mother Who Relies on Lip Reading

Posted on Jun 16, 2020 in California Pacific Medical Center, Quality, Scroll Images, Uncategorized, Women's Services

SAN FRANCISCO – When the COVID-19 pandemic began, Sutter’s California Pacific Medical Center (CPMC) put strict infection control measures in place to keep patients and staff safe. These measures included temperature screenings, masking and visitor restrictions. But while masks are crucial for slowing the virus’ spread, they can present a communication problem for certain patients. That’s why Sutter Health purchased clear face masks for those people who would have difficulties communicating otherwise.

Karma Quick-Panwala was an expecting mom, who relies on lip reading to communicate. The clear face masks allowed her to see her labor and delivery nurses’ facial cues for reassurance and encouragement.

Technology + Teamwork

“Giving birth during COVID-19 has brought new challenges—but also many opportunities,” said Yuan-Da Fan, M.D., chairman of obstetrics and gynecology at CPMC’s Van Ness campus. “We were determined to find a solution that fit Karma’s need. We wanted communication between Karma and her care team to be as seamless as possible in order to provide the best possible care to her and her baby.”

The solution? Before her due date, Quick-Panwala worked with CPMC’s staff to put into place real-time captioning, also called Communication Access Realtime Translation (CART). CART works by a stenographer translating spoken word into text that then appears in real time on a tablet screen.

When she arrived at CPMC to deliver her baby, Quick-Panwala’s care team called a captioner via the CART service. The captioner listened to the conversations happening in the labor room over speaker phone and translated the speech into text. Nearly instantly, the text appeared on a screen at Quick-Panwala’s bedside.

Seamless Communication

“Thanks to technology, the Internet and iPads, we were able to make it happen so that I could have relatively simultaneous access to speech through all the instructions, questions and answers,” said Quick-Panwala. “From the moment we arrived, everyone [on the care team] knew they needed to put on their clear mask and change the way they communicated a little bit.”

“It’s been a good experience. [The technology] helped my labor and delivery go smoothly because I was able to see, communicate and understand what was taking place in the room. Fortunately, it was a straightforward delivery. Everyone has been absolutely wonderful,” she said.

Axel Panwala arrived happy and healthy on June 10.

“We were happy to make this delivery experience a success for Karma and her husband,” said Dr. Fan. “Our staff were able to adapt to her needs and learn a new piece of patient communication and technology in the process. It was a win for everyone.”

Asit Panwala, Quick-Panwala’s husband, said, “There can be a lot of unpredictability in labor and delivery, so this communication channel was important.”

The San Francisco Chronicle featured Quick-Panwala’s story here: How clear face masks helped a Bay Area mom who’s hard of hearing give birth.

Critical Blood Shortage May Impact Hospitals

Posted on Jun 9, 2020 in Affiliates, Alta Bates Summit Medical Center, Scroll Images, Uncategorized

OAKLAND, CALIF. – Hospitals across the country are facing the potential for critical blood shortages as a result of blood drive cancellations during mandatory shelter in place orders. Blood donation may also be hampered by the changes blood banks have had to make to keep donors safe.

Now Ronn Berrol, M.D., medical director of the Summit campus emergency department at Sutter’s Alta Bates Summit Medical Center, explains the impact of the blood shortage on hospitals in a recent interview with KTVU Fox 2.

Watch the video interview

For a while, the drop in blood donation wasn’t as problematic since there was a lower demand for blood as people obeyed shelter in place orders—the number of emergency surgeries and hospitalizations was reduced— and elective procedures were cancelled, says Dr. Berrol. But as people begin venturing out and hospitals resume urgent and elective surgeries, he says there is the potential for disruption or delays for blood-intensive surgical procedures such as complicated heart, cancer, gynecologic or orthopedic surgery because of the blood and blood product shortage.

The solution?

Dr. Berrol urges healthy people to contact their local blood bank to make an appointment to donate blood. He also counsels patience because, though the need for blood donation is urgent, there may be a delay of a week or two for an appointment since blood banks have had to reduce the number of appointments they can offer in order to implement safety measures like physical distancing and extra cleaning.

Contact the Red Cross or Vitalant to learn more about how you can donate blood in your community.

The Unseen Risk of Parkinson’s Disease

Posted on Jun 5, 2020 in California Pacific Medical Center, Expanding Access, Innovation, Quality, Research, Scroll Images

Older patients with Parkinson’s disease also often suffer from a very high risk of falls, and may experience disabling fractures. Research has not shown whether drug treatments for the prevention of osteoporosis (such as zoledronic acid) could also prevent fractures for them. Researchers at Sutter’s San Francisco Coordinating Center (SFCC) designed the “Trial of Parkinson’s and Zoledronic Acid” (TOPAZ) study to answer that question.

Steve Cummings, MD
Steve Cummings, MD

“There are few treatments for Parkinson’s disease itself, but TOPAZ could show how a simple treatment given at home could prevent one of the most important causes of disability and death in these patients,” said Steve Cummings, M.D., director of SFCC and a lead investigator of TOPAZ.

Dr. Cummings noted that TOPAZ is the first study of its kind nationwide. The study aims to enroll 3,500 patients with Parkinson’s disease who are 65 years or older. As part of the study, neurologists who specialize in Parkinson’s disease may conduct a video interview with the patient to confirm the diagnosis.

A study nurse will check patients to confirm that treatment with zoledronic acid would be safe, and once confirmed, will then give zoledronic acid or placebo intravenously. Patients will be contacted every four months for at least two years about whether they have had a fracture.

SFCC leads the effort with a nationwide research team including neurologists and bone disease experts from UC San Francisco (UCSF), the Parkinson’s Foundation and Duke University.

“Fractures can result in a loss of independence, so it’s important to find ways to prevent them, particularly in this group of patients,” said Parkinson’s disease expert Caroline Tanner, M.D., Ph.D., professor of neurology at UCSF and a lead investigator of TOPAZ. “We hope this study will provide us with some answers.”

“Patients with Parkinson’s disease have difficulty traveling to clinics for care. Our goal is to test if we can bring the evaluation and treatment to their home making it easier for them to reduce their risk of disabling fractures,” added Kenneth W. Lyles, M.D., senior fellow in the Center for the Study of Aging and Human Development at Duke University, TOPAZ lead investigator at Duke, and world expert on zoledronic acid.

The five-year, $30 million study is sponsored by the National Institute on Aging, part of the U.S. National Institute of Health.

Nearly 800,000 Americans age 65 or older have Parkinson’s disease—a brain illness that causes slow loss of control of movements, walking and balance, increased risk of falling and decreased cognitive functions. There is no cure for Parkinson’s disease, but TOPAZ could show that one treatment could prevent a disabling consequence of the illness.

For patients:
For more information on TOPAZ and to enroll in the study, call 1-800-4PD-INFO (1-800-473-4636). You may be referred to UCSF to arrange a telemedicine neurology assessment at home to confirm that the study is right for you.

For Parkinson’s disease specialists:
Call 1-800-4PD-INFO (1-800-473-4636) for more information on enrolling patients directly into the trial.

CPMC’s Hamila Kownacki Recognized as One of San Francisco Business Times’ Most Influential Women in Bay Area Business

Posted on Jun 4, 2020 in Affiliates, California Pacific Medical Center, People

SAN FRANCISCO – Hamila Kownacki, RN, MSHA, and chief operating officer at Sutter’s California Pacific Medical Center (CPMC), has been recognized by the San Francisco Business Times as one of 2020’s Most Influential Women in Bay Area Business. The publication’s annual list celebrates women business leaders in finance, health care, law, real estate, technology and more. Honorees are both passionate leaders in their organizations, as well as their communities.

Hamila Kownacki is the Chief Operating Officer at Sutter’s California Pacific Medical Center (CPMC) in San Francisco.

As COO of CPMC, part of the Sutter Health not-for-profit integrated network of care, Kownacki oversees all operational direction and outpatient services for the medical center’s three campuses in San Francisco: Van Ness, Mission Bernal and Davies.

Most recently, Kownacki led the opening of two modern hospitals where high quality, technology, safety, efficiency, and personal touches are the norm. CPMC’s Van Ness facility, which opened in March 2019, offers advanced patient technology, cancer care, cardiac care, orthopedics and women’s and children’s services. CPMC’s Mission Bernal location, which opened in August 2018, is a neighborhood-based medical center that focuses on emergency, elder care, maternity and orthopedics services.

Kownacki was also chosen for the prestigious Carol Emmott Fellowship, class of 2020. As one of 21 fellows selected nationwide, she is granted the opportunity to build on her leadership capacities in order to help accelerate the advancement of women in executive roles in health care, where currently they are significantly underrepresented.

Kownacki is a board member for San Francisco’s Meals on Wheels and she serves as chairperson of the Donor Network West, an organization dedicated to saving lives through organ and tissue donation for transplantation in Northern California and Nevada. She earned her bachelor’s degree at CSU Northridge, and her master’s degree in health services administration at St. Mary’s in Moraga.

Senior Well-Being: How to Maintain Mental and Physical Health While Sheltering in Place

Posted on Jun 1, 2020 in Affiliates, Eden Medical Center, Scroll Images, Wellness

CASTRO VALLEY, Calif. – As shelter in place restrictions are gradually eased this summer, people are still being advised by public health officials to stay home as much as possible and to maintain physical distancing. While some restrictions are loosening, the virus is still circulating in the community and it remains dangerous—especially for older people. Sheltering in place can help keep you safe, but for some it can have a downside too, leading to feelings of isolation, loneliness or even depression.

During the pandemic many older adults have found new ways to stay connected through technology, others may not have access to the internet at home or may not feel comfortable with video calls or social media platforms that could help keep them connected to friends and family.

What can be done? Recognizing feelings of isolation, loneliness or depression is the first step in alleviating them. Taking some simple actions can help make sheltering in place more tolerable.

James Chessing, Psy.D., a clinical psychologist at Sutter’s Eden Medical Center in Castro Valley, says, “Sheltering in place is certainly a major challenge, but still only a challenge, one of many that a senior has dealt with in his or her life. Framing it that way calls to mind the coping skills that were used to surmount past challenges, as well as the memory of having succeeded in dealing with other tough situations. While the current situation may certainly be different, the skills or coping devices used in the past may be applicable now. Remembering that feeling of success may give hope.”

Dr. Chessing’s tips to help older people stay socially connected while maintaining physical distance include:
• set up regular phone call check-in times with loved ones
• become pen-pals with a friend or relative
• take advantage of the pleasant summer weather and set up outdoor seating (spaced the minimum six feet apart) to enjoy face-to-face conversations
• get some training or coaching on how to set up a video visit or talk via FaceTime—try asking a your adult child or a tech-savvy teenage grandchild

Just as human connection impacts mental health, so too does physical health. It’s important to your mental health to maintain your physical well-being. One strategy to keep your physical health strong is to maintain a regular schedule, says Pamela Stoker, an injury prevention specialist with Eden Medical Center’s Trauma department.

“Maintaining a regular daily schedule can provide comfort, familiarity, and health benefits. We recommend creating a daily schedule with regular mealtimes, regular bedtime and wake-up, and regular exercise. Irregular meals and sleep can have a negative impact on your hormone levels and medication responses. An irregular schedule can also cause your blood sugar to fluctuate, which can lead you to make unhealthy food choices—like reaching for cookies when you’re tired. And changes in sleep patterns, like staying up late one night and going to bed early the next, can affect metal sharpness, lower your energy level, and impact your emotional well-being.”

“The good news is that regular exercise helps keep your body strong, protects you from falls, and improves your mood,” says Stoker.

Adding to the feelings of depression and loneliness can be the feeling of lack of control, says Dr. Chessing. Even before the pandemic, some older people may have struggled to maintain independence while accepting the help of family and friends. Well-meaning family and friends may try to be helpful by delivering groceries or handling other errands in order to keep you safe from the virus, but this help may cause feelings of discomfort. You may not want to rely on others too much and you may feel your independence is slowly being stripped away. It is important to discuss these feelings with loved ones; remind them of your strengths, while acknowledging your own limitations. As Dr. Chessing reminds us “having open communication will allow you to explore the facts and weigh the risks in order to make informed decisions about behaviors.”

In uncertain and distressing times such as these, you or someone you love may find that it’s not enough just to stay connected with others and maintain a regular schedule—you may find professional help is needed. In the extreme, feelings of depression, loneliness, and lack of control can lead to destructive behaviors like excessive drinking, violence or self-harm. That’s why Dr. Chessing recommends staying in close contact with your doctor and reaching out for help if you feel overwhelmed.

The hardest part may be asking for help, but help is available without judgement.

Call your doctor or call:
Friendship Line California 24/7, toll free: 888-670-1360. Crisis intervention hotline and a warm line for non-emergency emotional support for Californians over 60. The phone line is staffed with specialists to provide emotional support, grief support, active suicide intervention, information and referrals.
Crisis Support Services of Alameda County, 24/7, toll free, 1-800-260-0094. Additionally, Crisis Support Services of Alameda County has expended service to include friendly visits by phone for home-bound seniors.

Antibody Testing of Healthcare Workers May Show Spread of COVID-19

Posted on Jun 1, 2020 in California Pacific Medical Center, Innovation, Quality, Research, Safety, Scroll Images

antibody tests

A new study launching at Sutter’s California Pacific Medical Center (CPMC) will use antibody tests to identify front-line doctors who have developed antibodies against the virus. Antibody tests (also called “serology tests” because they use blood samples) are used to determine if someone is producing antibodies to defend against the virus.

“A powerful way to help limit the spread of COVID-19 is to facilitate early and accurate diagnoses of viral infections and appropriate quarantine for those infected,” says Greg Tranah, Ph.D., scientific director of CPMC’s Research Institute, director of Sutter’s Center for Precision Medicine Research, and lead researcher of the new physician serology study at CPMC.

Current methods diagnose COVID-19 are valid, but can have limitations when it comes to tracking disease patterns. Serology tests show some promise in this area, for use in certain circumstances.

“Serology tests may help identify people who have been exposed to the virus even weeks after an initial infection, including people who did not show symptoms. Other studies of COVID-19 ‘seropositivity’ can reveal the extent of viral exposure, as well as the timing of first exposure and increasing rates of exposure,” says Dr. Tranah.

The new serology study aims to enroll intensivists, emergency department doctors, infectious disease specialists, anesthesiologists, hospitalists, surgeons and internal medicine residents at CPMC.

Beginning May 18, blood samples will be collected from study participants every eight weeks through 2020. The samples will be tested for the presence of antibodies produced in response to prior COVID-19 exposure. Study participants will be asked to answer a brief questionnaire to determine if they have experienced symptoms of COVID-19.

“We’re using a two-step serology test that can process multiple samples concurrently with high reliability, sensitivity and specificity,”(1) says Jose Montoya, M.D., an infectious disease specialist working at Sutter’s Palo Alto Medical Foundation who is collaborating with Dr. Tranah on the study.

Serology tests with high sensitivity and specificity are less likely to have false-positive or false-negative results and a more meaningful predictive value.

Results of the blood tests will be stored in a database, and rates of seropositivity will be compared across medical specialties bi-monthly. “Longitudinal serology testing will allow us to track rates of seropositivity among different physician specialty groups and study the duration and intensity of immune response to COVID-19,” says Dr. Tranah.

There is no current evidence that people who have detectable antibodies are immune to re-infection from COVID-19 or what the timeframe of immunity is, if any. Until more evidence is available, antibody tests should not be used to make decisions related to social distancing or the use of personal protective equipment.

“Understanding the surge of infection rate and spread is an important part of preparedness. Epidemiological studies of emerging COVID-19 infections can help determine the burden of disease, develop better estimates of morbidity and mortality, and help complement the results of PCR tests,” says Dr. Tranah.

Learn more about COVID-19 tests by following our Educational Series on this topic.

Reference:

  1. Nirmidas Biotech Rapid Test for COVID-19 IgM/IgG.