People

Art Out of Turmoil: Mission Care Center Converts Plywood into Community Murals

Posted on Jun 17, 2020 in People, Scroll Images

SAN FRANCISCO – Sutter Pacific Medical Foundation (SPMF) invited a dozen local artists along with employees and their family and friends to craft murals on its temporarily boarded-up windows at 899 Valencia Street Care Center, a group of family and internal medicine clinicians who see children and adults.

In response to recent racial justice protests in the Mission District, the primary care clinic, which sits at the corner of Valencia Street and 20th Street in the heart of the Mission, erected plywood boards to protect the facility and ensure it would remain open and able to provide healthcare for patients.

The clinic provides routine health care services, including preventive care, women’s health, chronic condition management, and treatment for acute illnesses for this diverse community, and has remained open during the COVID-19 pandemic.

“The project’s goal has been to create a safe space for artists to express themselves in support of recent urgent civil issues, which directly impact this community,” said SPMF Care Center Manager Andrea Contreras.

Local artists painted colorful murals on 16 large floor-to-ceiling wooden panels. Themes focused on essential workers, Black Lives Matter and health in the community. Mediums ranged from graffiti to paint to vinyl wall wraps with messages like “Essential Workers for President!” and “We are with you 899.”

“Our center understands there are many challenges in the struggle for equality and firmly believes that well-being, safety and quality-of-life must include quality health care,” said Robert Nordgren, M.D., CEO of the Sutter Bay Medical Foundation, who attended the painting.

The Mission District has a proud tradition of creating murals to reflect the current culture and changing times. As onlookers passed by the artworks in progress, many stopped to praise the bold emerging themes and to share their happiness over the new colorful—and powerful—displays.

“While these boards are temporary, we hope this gesture will be a long-lasting force for bringing the community together to heal,” said Dr. Nordgren.

PPE Donations: Like Mother, Like Daughter

Posted on Jun 17, 2020 in Affiliates, Alta Bates Summit Medical Center, People, Safety, Scroll Images

Jiaqi Yu

OAKLAND, Calif. –It’s not quite the family business, but 15 year old Jiaqi Yu has definitely learned how to make connections and obtain much-needed PPE like masks and shoe coverings by watching her mom, Minfen Ding, RN.

Minfen Ding, RN

In April, Yu’s mother facilitated donation of 13,000 masks and other PPE to Sutter’s Alta Bates Summit Medical Center in Oakland where she works as an oncology nurse. Now Yu has helped make connections and facilitate the delivery of 20,000 masks to the hospital.

“I am very proud of Jiaqi. She cares about the safety of our staff and is able to advocate for our hospital,” says Ding.

The College Preparatory School ninth grader says she was inspired to facilitate the donation of masks by watching her mom’s efforts to gather PPE to protect her colleagues.

“I believe that every medical worker on the frontlines deserves the best equipment,” says Yu. “They are all working hard to protect us, but they need protection too, and I wanted to do what I can to help them.”

Yu facilitated donation of the masks, which she secured from the Fountain Project Foundation, an East Bay non-profit working to help people with no health insurance obtain medical care.

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.

Can a Long-acting, Injectable Drug Prevent HIV Infections?

Posted on May 31, 2020 in Alta Bates Summit Medical Center, Community Benefit, Expanding Access, Innovation, People, Quality, Research, Scroll Images

Christopher Hall, M.D., knows well the uncertainty and fear sparked by an infectious disease outbreak, as well as the excitement spurred by new research to develop effective treatment and vaccines.

An infectious disease specialist and researcher at Sutter’s Alta Bates Summit Medical Center (ABSMC) in Oakland, Dr. Hall began working to combat the HIV virus in 1987 in Washington, DC. Subsequent clinical leadership work at prominent HIV/AIDS care centers earned him the “street cred” to be selected for consulting roles for sexually transmitted infection (STI) prevention training programs, and membership among a national coalition of STI experts.

While the world awaits effective, safe treatments and a potential vaccine for COVID-19, HIV research has dramatically flashed forward since the AIDS epidemic of the 1980s. Among the biggest achievements in HIV prevention came in 2012, when the U.S. Food and Drug Administration (FDA) approved a daily pill called Truvada® as a means to prevent HIV virus infection—a strategy known as HIV pre-exposure prophylaxis (PrEP) for people who are HIV-negative.

Dr. Hall hopes his latest research initiative will have a similar significant impact. He leads Sutter’s participation at ABSMC in a clinical trial testing a new long-acting, injectable drug for the prevention of HIV. Earlier this month, preliminary results of an international study of the antiviral cabotegravir as PrEP were released by the HIV Prevention Trials Network (HPTN).(1,2) The results haven’t yet been published in a peer-reviewed journal.

The international, Phase 3 study known as HPTN 083 compares the effectiveness of bimonthly cabotegravir injections with oral Truvada® as PrEP to prevent HIV infection in people aged 18 years and older.

Chris Hall, M.D. and research coordinator Trish Smallwood

“This large-scale study is the first of its kind to show a long-acting form of HIV prevention to be highly effective,” says Dr. Hall. “Without a vaccine, the more options for PrEP that we can prove are effective and safe, and make accessible to people who may benefit, the better. Different options are needed for different patients. Cabotegravir injection may be an excellent tool to include in the PrEP toolkit, especially for people who have difficulty taking a daily oral medication as PrEP.”

HPTN 083—a four-year trial that began in 2016—is led by the National Institute of Allergy and Infectious Diseases (NIAID). The study randomized approximately 4,600 men and transgender women who have sex with men and are at high risk of contracting HIV, to receive either intramuscular injections with cabotegravir every two months, daily Truvada®, or placebo.(3)

Among the 50 people who became infected with HIV during course of the study, 12 were randomized to receive cabotegravir and 38 received daily Truvada®. Results showed that one third as many people became infected on cabotegravir compared with the oral drugs.

Though the study was designed to demonstrate that cabotegravir was at least as effective as conventional Truvada®, early results suggested the superiority of the injectable medication. With the encouraging results, an independent safety committee recommended the study stop early.

Conducting the study through ABSMC’s East Bay Advanced Care (EBAC) presented a unique opportunity to enroll participants from diverse, underserved communities in San Francisco’s East Bay area.(4) A commonly reported criticism of past HIV prevention research has been that the populations studied did not reflect the populations most affected.(5,6)

“We enrolled participants from San Francisco’s East Bay with the goal to study a patient population that closely reflects people at highest risk of HIV infection,” says Dr. Hall. Two-thirds of the participants were younger than 30 years old, 12% were transgender women, and 50% were African American.

“All three demographics are among the most vulnerable and at highest risk for acquiring HIV. And although specific enrollment of Latinos/Hispanics was not originally part of the study design, people from Hispanic communities were actively recruited and enrolled, and the study is stronger with their participation.”

Though results of the HPTN 083 study may be a coup for the international HIV/AIDS community, its added value in Northern California may lie in providing a new asset for EBAC: knowledge from medical research that may benefit people seeking care at the Center.

“At East Bay Advanced Care, we’re proud to offer hands-on support, medical treatments, complementary therapies and educational services for people living with HIV/AIDS,” says Jeff Burack, M.D., an internal medicine physician at Sutter and medical director of EBAC. “Insights from studying this promising new strategy for HIV prevention may greatly expand our ability to deliver care informed by science and guided by an ethos to support health equity.”

It is not yet known when single-agent cabotegravir will be reviewed for approval by the FDA for the prevention of HIV. A Viiv Healthcare press release stated that detailed results from HPTN 083 will be presented at an upcoming scientific meeting and used for regulatory submission to the FDA.

East Bay Advanced Care (EBAC): The largest HIV primary care clinic in the East Bay, EBAC delivers care and provides resources to approximately 1,400 people from diverse communities in the surrounding area.

The Center provides a comprehensive continuum of high-quality, professional treatment and support services to all clients regardless of their socioeconomic status. “Our mission is to provide essential, confidential medical and support services to all people living with HIV. The hope is to maximize quality and length of life, and to enhance personal dignity and self-empowerment in the face of HIV,” says Dr. Burack. Each year, an estimated 1.7 million people are newly diagnosed with HIV.(7) Interested in supporting research at EBAC? Donate to Alta Bates Summit Medical Center.

Targeting the HIV/AIDS virus—decades of research give new hope for “cure”: What does it take to halt a virus that has claimed the lives of approximately 32 million people?(7) HIV drugs cannot cure the disease, but they can help people with the virus stay healthy by preventing the virus from reproducing. The HIV virus completes several different steps to make copies of itself as part of the HIV lifecycle. If unimpeded, HIV integrates its viral DNA with the body’s healthy CD4 cells, essentially turning the CD4 cell into a factory that makes more HIV cells, resulting in an HIV infection. All HIV drugs work by interrupting a step in HIV’s lifecycle; this helps halt HIV replication.

Currently, six classes of HIV drugs target four steps of HIV’s lifecycle. Cabotegravir stops the HIV viral replication process at the crucial point of the virus attempting to integrate its DNA with the DNA of a healthy CD4 cell. “The approval of new classes of HIV drugs — and new drugs in the classes already available — will help provide more treatment options for people living with HIV,” says Dr. Hall.

References:

  1. Cabotegravir is manufactured by ViiV Healthcare.
  2. The HPTN 083 study that is part of the NIH-DAIDS-funded HIV Prevention Trials Network (HPTN). HTPN 083 was jointly funded by the U.S. NIAID, part of the NIH, and ViiV Healthcare, and was conducted by the HPTN. Study product was provided by ViiV Healthcare and Gilead Sciences.
  3. This particular group of study participants was selected because, in trials such as HPTN 083, demonstrating efficacy requires the population studied is at risk of acquiring HIV – otherwise, study endpoints cannot be reached in a reasonable amount of time.
  4. HPTN 083 was also offered to partners of existing patients as well as the clinic’s prevention program clients.
  5. A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. Jennifer A. Pellowski, Seth C. Kalichman, Karen A. Matthews, and Nancy Adler. Am Psychol. 2013 May-Jun; 68(4): 197–209. doi: 10.1037/a0032694.
  6. HIV/AIDS Inequality: Structural Barriers to Prevention, Treatment, and Care in Communities of Color. Why We Need A Holistic Approach to Eliminate Racial Disparities in HIV/AIDS. Russell Robinson and Aisha C. Moodie-Mills. July 27, 2012.
  7. World Health Organization data. https://www.who.int/gho/hiv/en/

Sutter Santa Rosa Regional Hospital Family Medicine Residency Program Announces Incoming Class of 2023

Posted on May 26, 2020 in Affiliates, People, Scroll Images, Sutter Santa Rosa Regional Hospital

SANTA ROSA, Calif. (May 26, 2020) – The Sutter Santa Rosa Regional Hospital (SSRRH) Family Medicine Residency Program today announced its incoming class of 2023. The 12 new residents were selected from among 850 applicants representing the nation’s top medical schools. SSRRH’s three-year program, one of 450 family medicine training programs in the United States, has trained hundreds of family physicians since its inception in 1938.

SSRRH’s Family Medicine Residency is a critical strategic asset with which to combat the emerging physician shortage in Sonoma County. The residency has been the largest single source of family physicians to Sonoma County for over 80 years. Residency graduates comprise nearly half of family physicians in Sonoma County, filling openings in private practices, community clinics, and large medical groups such as Sutter Medical Group of the Redwoods, The Permanente Medical Group, local community health centers, Sonoma County Health Services and leadership positions throughout the medical community.

“One of the amazing things about the specialty of Family Medicine is that we continue to adapt our training in order to provide the services that are needed by the particular community and the time in which we serve. After the last three years filled with fires and a SARS-CoV2 pandemic, it is becoming increasingly clear that we need to train doctors who are flexible and can adapt to, and even lead, in disaster,” says Tara Scott, M.D., program director of the residency.

“The Sutter Family Medicine Residency has fortified its position as a key part of the disaster response in the community and we have recruited an amazing class of soon-to-be Family Physicians from all over the country who are attracted to our brand of community-based training and service, says Dr. Scott. “We are thrilled to welcome these 12 amazing young physicians to the county. We know from experience that many will stay here in our community and provide Primary Care for the residents of Sonoma County for years to come.”

The eleven women and one man who will begin the training program in June came from medical schools across the country including: College of Osteopathic Medicine of the Pacific at Western University of Health Science; Frank H. Netter School of Medicine – Quinnipiac University; Edward Via College of Osteopathic Medicine of the Carolinas; George Washington University School of Medicine and Health Sciences; University of California, Davis; University of Kansas School of Medicine; University of Minnesota Medical School; University of Texas Southwestern Medical School; Virginia Commonwealth University School of Medicine; Warren Alpert Medical School – Brown University. They each come with an impressive background of academic achievement and community service.

(Click here for details about each resident.)

The new residents will graduate the program in 2023; they will begin on June 15, 2020.

The Santa Rosa Family Medicine Residency is under the sponsorship of Sutter Santa Rosa Regional Hospital (SSRRH). To provide a broader base of support for the residency and optimize learning experiences for residents, SSRRH engaged Santa Rosa Community Health Centers and Kaiser Permanente in 2006 and continues its affiliations with partners in the community today.

About the Sutter Health Family Medicine Residency Program

With the initiation of formal training in general practice dating back to 1938, Sutter Santa Rosa Regional Hospital (and formerly Sutter Medical Center of Santa Rosa) has an established tradition of excellent training of family physicians with the strong support of community physicians and specialists. In 1969, the program became affiliated with what has since become the Department of Family and Community Medicine at the University of California, San Francisco (UCSF).

About Sutter Santa Rosa Regional Hospital

Sutter Santa Rosa Regional Hospital, part of the not-for-profit, integrated Sutter Health network, has a long, proud history of providing high quality care in Sonoma County and beyond. Because of an unwavering focus on health and healing the hospital is consistently ranked as one of the top hospitals in the region.

Shining Light on Mental Health: Research at Sutter Helps Reimagine the Future of Mental Health for At-risk Youth

Posted on May 26, 2020 in Affiliates, Community Benefit, Expanding Access, Innovation, People, Quality, Research, Scroll Images, Transformation

Annie was stuck. Diagnosed with severe depression in her teens, she experienced days where mental illness slowed and dimmed her inner and outer worlds. “I couldn’t move or talk. The most I could do was twitch my fingers. And everything was like I was full of tar.”

Now 23 years old and taking courses in college, treatment and support to manage her depression have helped to open a path for Annie toward freedom and independence.(1)

Annie’s story may be familiar to many. Recognizing Mental Health Awareness Month, consider these statistics:(2)

  • 1 in 6 U.S. youths aged 6-17 experience a mental health disorder each year
  • 50% of chronic mental illnesses begin by age 14, and 75% by age 24
  • Suicide is the second-leading cause of death among people aged 10-34
  • 1 in 100,000 children aged 10 to 14 succumb to suicide each year
  • Depression affects 20-25% of Americans aged 18+ each year

As the novel coronavirus pandemic ushers in uncertainty that may evoke anxiety, depression or other mental health concerns for today’s youth, what would a new vision for their mental health look like? Sutter researchers and their collaborators across Sutter’s integrated network may offer a new path forward.

Early Interventions to Support Youth with Mental Illness
“Suicide cuts short the lives of individuals and leaves the survivors struggling with their grief and efforts to understand,” says Kristen Azar, RN, MSN/MPH, a researcher at Sutter’s Center for Health Systems Research (CHSR). “Healthcare providers can play a significant role in preventing suicide through risk screening and supportive follow-up care.”

Azar helps lead a new study at Sutter on depression and suicide risk.(3) She and CHSR colleague Ellis Dillon, Ph.D., are measuring the effects of a suicide screening tool called the Columbia Suicide Severity Rating Scale (C-SSRS) that was implemented in 2019 across Sutter’s hospitals. The screening tool was selected for its potential to enable earlier identification of people at increased risk of suicide, including people with depression.

The new study will determine if standardized use of C-SSRS across Sutter’s hospital emergency departments, inpatient settings and behavioral health acute care facilities can improve early detection of suicide risk in youth and adults, and help guide follow-up care. C-SSRS is the most evidence-based tool of its kind for early detection of depression and suicide risk.

Azar and Dr. Dillon’s project also seeks to measure suicide screening practices across Sutter ambulatory clinics and hospitals, and hopes to advance the efforts of Sutter’s Anna Kiger, DNP, DSc, MBA, RN, NEA-BC, and Ernell de Vera, RN, MBA, who implemented screening utilizing C-SSRS in the inpatient setting.

“Screening all inpatients by C-SSRS will help us detect at-risk patients early, for early and personalized treatment and support. Further, screening by C-SSRS will facilitate easier reporting and analysis of electronic health record (EHR) data on patient outcomes, strengthening our ability to care for patients with severe depression and those at high risk of suicide,” says Dr. Dillon.

Over the next 18 months the research team will examine the impact of screening patients for major depression and suicide risk using C-SSRS.

“Using this screening tool, we can study how different approaches to screening impact the detection, follow-up care and clinical outcomes of individuals with severe depression or who may be at high risk of suicide,” says Tam Nguyen, Ph.D., director of Ambulatory Care, Mental Health Services & Addiction Care at Sutter, and clinical advisor of the suicide risk screening study.

A New Vision for Youth Mental Health
Beyond screening, helping youth like Annie develop resilience to manage their mental health in their everyday lives may also help reduce suicide risk and decrease the incidence of severe depression among Sutter’s patient population.

Dr. Dillon helps lead a strategy to do so: She and CHSR co-director Alice Pressman, Ph.D., MS, partnered with Sutter Mental Health Services and experts in Sutter’s Design & Innovation team to launch and measure the impact of the project, Youth Mental Health Reimagined.

Supported by a $1 million gift from the Bichofberger family and matching funds from a Sutter Match Grant,(4) “the project embodies our collective vision to meet a clear need for at-risk youth and create a new narrative that eliminates stigma. When we eliminate stigma, we break down the barriers between mental and physical health, and start to remove a huge barrier in access to care,” says John Boyd, Sutter CEO, Mental Health Services & Addiction Care. “Mental health is human health, and we owe it to today’s youth to shape care that’s more engaging and connected to the way they live their lives.”

“We launched Youth Mental Health Reimagined as a response to the growing need for easily accessible and more robust, non-clinical mental health support for teenagers and young adults with depression, as well as their caregivers,” says Dr. Pressman.

Youth Mental Health Reimagined supports patients by providing tools and tips (e.g., a mood tracker, mindfulness exercises, as well as tips for better sleep, nutrition and physical activity) and connections with live docents. Collectively, the approach—dubbed “Scout”, and delivered virtually with people-powered support—provides resources to youth with depression who are receiving primary care or who are transitioning out of acute care settings.

The project will be implemented across inpatient and outpatient behavioral health programs at Sutter’s Mills-Peninsula Medical Center (MPMC) and in some primary care settings at Sutter’s Palo Alto Medical Foundation (PAMF).

“We used human-centered design to create ‘Scout’ as a means to help youth build resilience in real-world settings,” says Chris Waugh, Sutter Vice President and Chief Innovation Officer. “We’re thrilled to offer Sutter patients and their caregivers these resources that leverage research, creative and engaging design, and the top-quality care made possible by Sutter’s integrated network. It’s our way to help make mental health care more engaging and patient-focused, and bring support to people in their everyday lives.”

Although some existing youth mental health programs include a behavioral component and technology-based resources, Youth Mental Health Reimagined is one of the first of its kind in the U.S. to include caregivers in a holistic approach to care.

“Family and other caregivers are an essential part of the treatment and recovery process for young people with severe depression or other mental illness. They can help youth develop coping skills and healthy relationships that build resilience, and help keep them safe during periods of crisis. Youth Mental Health Reimagined gives caregivers a new opportunity to support the youth by helping them navigate ‘Scout’-delivered resources,” says Linda Strassia, Manager of Behavioral Health Clinical Services, whose team at MPMC will recruit youth to pilot test Youth Mental Health Reimagined.

Approximately 300 Sutter patients aged 13-26 years with moderate-to-severe depression and related anxiety will be enrolled to the study through December 2020, with additional patients enrolled in 2021. Two caregivers per study participant will also receive guidance on supporting patients.

Participants will be asked to complete periodic surveys to help the study researchers assess the impact of ‘Scout’ resources on patient outcomes (changes in youth quality of life, social support, physical, and mental health) and on caregiver outcomes (changes in knowledge and behaviors towards providing care and support for youth with depression).

Youth like Annie have the opportunity to experience new outcomes made possible by such mental health support. In her words, “at some point, you have to figure out what tools you have for the situation. So that’s the thing. I think it’s really important for people to have that support structure in their everyday life.”

How Sutter research translates ideas into solutions for mental wellness:

Beyond the projects described above, health systems researchers at Sutter have led other studies to help address potential gaps in caring for people with mental illnesses.(5,6)

Adolescent behavioral health:
Completed in 2018 and funded entirely by community donors, this five-year project evaluated the PAMF Adolescent Behavioral Health program. The study measured changes in primary care provider attitudes toward adolescent behavioral health, uptake of navigation services for adolescents, and uptake and outcomes of care management provided by a nurse practitioner and a cognitive-based therapy intervention called COPE (Creating Opportunities for Personal Empowerment).

Serious mental illness and emergency department utilization:
Azar recently completed research suggesting that subtypes of severe mental illness may predict patterns of emergency department use. The results of Azar’s research were published last year in Population Health Management.

This study showed that patients diagnosed with serious mental illness seek care at multiple emergency departments within a geographic region (versus any one hospital’s emergency department). These frequent utilizers of the emergency department constitute a small percentage of the population but account for disproportionally high healthcare utilization and costs.

“The findings highlight the importance of cross-institutional collaboration between health systems. This includes approaches to share data and analytics, as well as to deliver care that addresses the needs of patients with serious mental illness who frequently visit the emergency department,” says Azar.

References:

1. Annie’s real name was not used in this story, though her story is real.
2. National Alliance on Mental Illness and National Institute of Mental Health.
3. The research study “Suicidality: Examining screening, detection and follow-up care within a large multispecialty healthcare system” is funded by Janssen.
4. The gift from the Bichofberger family will support the Mental Health Reimagined pilot—Sutter Health’s pioneering system-wide engagement to transform the way people in our communities understand and talk about mental health.
5. Yang, Yan, et al. “Primary care provider utilization and satisfaction with a health system navigation program for adolescents with behavioral health needs.” Translational Behavioral Medicine 9.3 (2019): 549-559.
6. Erlich, Kimberly J., et al. “Outcomes of a brief cognitive skills-based intervention (COPE) for adolescents in the primary care setting.” Journal of Pediatric Health Care 33.4 (2019): 415-424.