Palo Alto Medical Foundation

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.

Sutter Research: Advancing Care for Patients with Breast Cancer

Posted on Oct 21, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Expanding Access, Innovation, Memorial Medical Center, Mills-Peninsula Health Services, Palo Alto Medical Foundation, Quality, Research, Scroll Images, Sutter Medical Center, Sacramento, Transformation, Women's Services

SAN FRANCISCO, Calif. – Breast cancer research has the potential to improve cancer care for the 3.8 million American women living with the illness. Recognizing Breast Cancer Awareness Month, we’re highlighting the bold science and game-changing breast cancer research at Sutter. This work can help advance knowledge of how to detect and treat the illness.

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Stupski Foundation to Enhance Palliative Care for Alameda County Patients with $3.5 Million Grant to Sutter Health

Posted on Sep 30, 2019 in Alta Bates Summit Medical Center, Eden Medical Center, Expanding Access, Palo Alto Medical Foundation, Scroll Images

(OAKLAND, Calif) –The Stupski Foundation has awarded not-for-profit Sutter Health a $3.5 million, three-year grant to build a comprehensive Palliative and Advanced Illness Care (PAIC) program for northern Alameda County.

This significant grant will enable Sutter to build on successful palliative care programs already in place at the healthcare network’s Alameda County hospitals, Alta Bates Summit Medical Center in Oakland and Eden Medical Center in Castro Valley, while incorporating elements of both the Palo Alto Medical Foundation’s (PAMF) innovative ambulatory palliative care and support services program and Sutter’s impactful home-based Advanced Illness Management Program.

The grant will help caregivers at these Sutter organizations integrate palliative and advanced illness care services across care settings, to provide more continuous and comprehensive support for patients and families facing serious illness. This collaborative model extends services to thousands of additional people in the county who suffer from the complex challenges of serious illnesses such as cancer, dementia or advanced heart, lung or kidney disease, by providing more timely, seamless and flexible services to address their physical, social, emotional and spiritual needs. Multidisciplinary palliative care teams at Sutter include specially trained doctors, nurse practitioners, nurses, social workers, chaplains and other specialists.

“We are honored to partner with the Stupski Foundation to improve patient and family experience by enhancing serious illness care across Alameda County,” says Elizabeth Mahler, M.D., Sutter Health Vice President Clinical Integration, Office of Patient Experience. “This generous grant will help us serve thousands more patients and families with collaborative care that seeks to decrease suffering by putting the personal preferences, needs and values of patients and families front and center.”

“Sutter Health has been recognized as a national leader in serious illness care since the creation of its Advanced Illness Management (AIM) program,” Dan Tuttle, director of health at the Stupski Foundation says. “This grant supports their efforts to roll out an even more comprehensive palliative care model for people with serious illness, bringing home-based care to hundreds of patients and new inpatient and outpatient services to thousands more throughout Alameda County every year. We hope that healthcare continues to move from inside clinic walls to meet people where they need it and we see quality home-based palliative care as a critical part of that shift.”

Reaching More Patients in Need

Sutter Health Palliative and Advanced Illness Management programs serving Alameda County are running close to maximum capacity, currently serve about 3,000 patients annually. Sutter palliative care program leaders estimate that an additional 2,000 patients will benefit from improved PAIC coordination, capacity and services made possible by the Stupski Foundation grant.

This new comprehensive model of care in Alameda County will encompass four key components of serious illness care including specialty palliative care, advance care planning, family caregiver support and links to social services.

“This grant gives Sutter the opportunity to more broadly provide compassionate care to the communities we serve. It will allow us to create a path of care, comfort and support for those patients and families who are facing an advanced illness in a way that we have previously not been able to provide,” says Jeffrey Stoneberg, DO, Palliative Care Medical Director at Alta Bates Summit Medical Center.

Sutter will launch the ambulatory based PAIC program at Alta Bates Summit next year, followed by Eden starting in 2021.

A Lifetime Supply of Care: 98-Year-Old Reflects Back on Nearly a Century of Support

Posted on Aug 5, 2019 in Palo Alto Medical Foundation, Scroll Images, Uncategorized

Patient serves as living history of medical foundation’s commitment to access, high-quality care

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New research by Sutter’s Center for Health Systems Research focused on fostering physician wellness

Posted on Jul 2, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Innovation, Mills-Peninsula Health Services, Palo Alto Medical Foundation, Quality, Research, Scroll Images, Transformation

SAN FRANCISCO – How do you take care of those whose life’s work is to take care of others? “Physician, heal thyself” is an increasingly challenging objective to achieve for the more than 50% of American clinicians who report symptoms of burnout. Emotional exhaustion, depersonalization, depression and feelings of helplessness burden the care providers staffing primary and specialty clinics nationwide.

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New digital health tool aims to help patients keep better tabs on diabetes

Posted on Jun 5, 2019 in Affiliates, Alta Bates Summit Medical Center, California Pacific Medical Center, Innovation, Memorial Medical Center, Mills-Peninsula Health Services, Palo Alto Medical Foundation, Research, Scroll Images

SAN FRANCISCO (Calif.) Type 2 diabetes is not curable, but it is controllable—but as any patient or doctor will tell you, managing diabetes comes with its own set of challenges.

Given the disease’s complexity, patients and doctors need to maximize their time together. To help improve the care of people with cardiometabolic conditions such as type 2 diabetes, hypertension, and high cholesterol, investigators in Sutter’s Center for Health Systems Research (CHSR) and collaborators at AstraZeneca Pharmaceuticals developed and piloted an online tool called CM-SHARE (cardiometabolic Sutter Health Advanced Reengineered Encounter) to help primary care providers better manage patients with diabetes and other cardiometabolic conditions during their office visits.

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