Quality

“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.

21 Sutter Hospitals and Medical Foundations Earn Recognition as Leaders in LGBTQ Healthcare Equality

Posted on Sep 3, 2020 in Quality, Safety, Scroll Images, Uncategorized

SACRAMENTO, Calif.— Twenty-one affiliates within Sutter Health’s integrated, not-for-profit network earned recognition as an “LGBTQ Health Care Equality Leader” by the Human Rights Campaign Foundation (HRC), the educational arm of the country’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization. The designation was awarded in the 13th edition of HRC’s Healthcare Equality Index (HEI).

The HEI recognizes facilities that meet key criteria, including foundational elements of LGBTQ patient-centered care, LGBTQ patient services and support, employee benefits and policies, and LGBTQ patient and community engagement.

“We are dedicated to providing compassionate, high-quality care that is free from discrimination and affirming of gender identity and sexual orientation. We are equally committed to sustaining a supportive work environment where our employees and clinicians can reach their full potential,” said Jill Ragsdale, Sutter Health senior vice president and chief people & culture officer. “This honor is meaningful for our teams because it shows how we are living our values each day. We are proud to care for patients in one of the most diverse regions in the U.S. It is our mission to respect and serve all.”

The 21 Sutter Health affiliates earning a spot on the 2020 HEI Index include:

The 21 Sutter Health network affiliates recognized join a select group of healthcare facilities nationwide named as Leaders in LGBTQ Healthcare Equality. A record 765 healthcare facilities actively participated in the HEI 2020 survey. In addition, the HRC Foundation proactively researched key policies at more than 1,000 non-participating hospitals.

“From the previously unimaginable impact of the COVID-19 pandemic to the horrific incidents of racial violence targeting the Black community, the events of the past year have brought about so much pain and uncertainty. Yet, even during this moment of profound unrest, we are seeing more of our humanity and resilience come to life. For me, nowhere is that more true than through the tireless dedication of our health care providers and the intrepid support and administrative staff members by their sides that show up every day to ensure this life-saving work continues,” said HRC President Alphonso David. “The health care facilities participating in the HRC Foundation’s Healthcare Equality Index (HEI) are not only on the front lines of the COVID-19 pandemic, they are also making it clear from their participation in the HEI that they stand on the side of fairness and are committed to providing inclusive care to their LGBTQ patients. In addition, many have made strong statements on racial justice and equity and are engaging in efforts to address racial inequities in their institutions and their communities. We commend all of the HEI participants for their commitment to providing inclusive care for all.”

For more information about the HEI, or to download a free copy of the report, visit www.hrc.org/hei.

Video Visits by Flashlight: Telehealth Keeps the Doctor ‘In’ Even When the Power is Out

Posted on Aug 25, 2020 in Carousel, Expanding Access, Quality, Safety, Scroll Images, Transformation, Uncategorized

When the next heat wave causes power outages or the next round of wildfires prompt evacuations throughout Northern California, chances are the global COVID-19 pandemic will still be unfolding. Under any or all of these conditions, we want to remind patients how and when to seek care, even during displacement or power loss.  

First: Make Your Smart Phone Smarter with the My Health Online App.

There is no question that mobile phones have become essential to our lives, and that reality has been underscored during the current emergency. Your phone may already receive alerts, including air quality reports, evacuation announcements or planned power shutoff notices, but is your phone optimized for your personal health needs?

If you haven’t already, we encourage Sutter patients to download the My Health Online smart phone app from the Apple App Store or Google Play. The My Health Online smartphone app helps connect you with your care team – even if you lose power or are displaced – provided you have wireless or mobile internet access and a charged phone battery.

“When we created the My Health Online patient portal we knew we would need a mobile phone option, but I don’t think we realized how important it would be in the context of natural disasters,” said Albert Chan, M.D., chief of digital patient experience at Sutter Health. Within the app you can send a message to your care team, view lab and most test results, securely access health records and schedule and complete a video visit.

“While we previously saw the app as a convenience, we now know that it’s a necessity; in fact we have a dedicated support team at (866) 978-8837 to troubleshoot any issues that patients have activating the app,” said Dr. Chan.

Second: Know that Severe Weather Can Cause Symptoms to Worsen, Quickly.

The smoke from wildfires, the heat in late summer and the stress of evacuation or a power outage can compromise your immune system and put stress on your body. “People who already have heart or lung-related illness, and some who don’t, may need personalized medical care to manage through this period,” said Chan. Video visits can often help doctors determine the severity of symptoms, provide medical advice and guide someone to in-person care as needed; providing reassurance in a very uncertain time.

“Bottom line, if you experience new or worsening symptoms we encourage you to schedule a same-day video visit with your doctor or another provider in the Sutter network – don’t ignore your body’s signals.”

You can also use the “symptom checker” that is integrated into Sutter Health’s website and My Health Online patient portal. Originally launched in February 2019, the self-led symptom checker is a kind of online survey that helps patients decide whether to engage in self-care or to seek care, if they need an in-person appointment or a video visit, and if they need to be seen now or soon.

As always, call 911 or go directly to the nearest hospital emergency department if you are experiencing chest pain or having difficulty breathing.   

Third: Don’t Let an Evacuation Erode Your Health.

“Often, when people are ordered to evaluate they are in such a great rush that they leave medications, medical equipment, or medical instructions behind,” said Chan. “We recommend preparing a ‘go bag’ for each member of the family with medications and any needed medical supplies, just in case.”

But if you have to evacuate without medications, remember an often- overlooked value of video visits is their role in enabling physicians to authorize new prescriptions or call in short-term refills of existing medications to pharmacies near a patient’s temporary relocation spot. “We will do everything in our power to assist with your medication or medical device needs, so please remember to reach out as soon as you are somewhere safe.”

Wildfires, Extreme Heat, Unhealthy Air During a Pandemic

Posted on Aug 20, 2020 in Carousel, People, Quality, Safety, Scroll Images

An Integrated Network Continues to Serve Northern California Communities

SACRAMENTO, Calif. –Wildfires fueled by high temperatures and winds are spreading across Northern California. Firefighters are battling to stop the blazes, which have forced thousands of people out of their homes. And to top it off, smoke from the fires is causing extremely unhealthy air quality in many areas, compounding respiratory issues concerns–especially for people with COVID-19.

Sutter’s round-the-clock emergency management system is monitoring the progress of the fires and the impact the heavy smoke is having on some of our care sites. Sutter has a long-standing commitment to the health and safety of the communities we serve, especially in times of natural disasters. During these unprecedented times, our integrated network is able to quickly move and redirect resources to those most in need. And despite the many challenges we’re all facing right now, Sutter hospitals and the vast majority of our clinics are open and stand ready to care for patients.

“I want to thank the thousands of firefighters and additional emergency personnel who are responding to these blazes and patients with medical conditions triggered by them—especially the physicians, nurses and staff across Sutter’s integrated network,” said Sarah Krevans, Sutter Health’s president and CEO. “Our teams have been on the front lines caring for patients since the very beginning of the COVID-19 pandemic and now they are simultaneously helping support their communities during these fires.”

December 11, 2017 – Fire crews, using controlled burns, create a barrier in the foothills of Carpinteria, California, in the hopes of containing the Thomas fire in Southern California.

“We are deeply saddened by the devastation the firestorms are waging on our communities and we are committed to supporting wildfire victims and evacuees,” said William Isenberg, MD, Phd, Sutter Health’s chief quality and safety officer. “Sutter Health team members also live in these communities and we know many of their homes and families have been impacted by the fires, so we are activating employee resources like emergency financial assistance.”

Resources to Help You Access Care

Although some care sites may be experiencing temporary closures due to evacuation orders, air quality concerns or COVID-19, listed here, care team members at those care sites are available to determine which available options work best to help patient access care during the closures:

  • Video visits with a care provider
  • Obtaining in-person care at another Sutter facility
  • Rescheduling services once it is safe to do so

In partnership with clinicians and care sites across our network, Sutter’s Mental Health & Addiction Care team is also available to assist with your mental wellness. Even if you are not directly affected by the wildfires across Northern California, just hearing about them may trigger memories from a past event, leading to fear, anxiety or other strong emotions. If you or a loved one needs help, please contact your primary care physician or access the emergency resources found here.

A Message from Sarah Krevans on the Northern California Wildfires

Posted on Aug 19, 2020 in Carousel, People, Quality, Safety, Scroll Images

Wildfires are again burning in multiple Northern California counties. Sadly, it’s an all too familiar occurrence for many of the communities Sutter Health is privileged to serve.

Sarah Krevans, President & CEO,
Sutter Health

I want to thank the thousands of firefighters and additional emergency personnel who are responding to these blazes—especially the physicians, nurses and staff across Sutter’s integrated network. Our teams have been on the front lines caring for patients since the very beginning of the COVID-19 pandemic and now they are simultaneously helping support their communities during these fires.

We are closely monitoring the progress of the fires, as well as the resulting poor air quality, and their impact on our care sites. As always, the safety of our patients and staff is our top priority. We will work to keep our communities informed during this evolving situation.

Sutter is also committed to supporting our staff who may have been evacuated or otherwise impacted by the wildfires. We are checking in with our team members and activating employee resources like emergency financial assistance.

As we have done throughout the ongoing pandemic and in past wildfires, we will use the breadth of our integrated network to move resources around our care sites to where they are needed most to help our communities and patients in Northern California.

An Immune Boost Toward COVID-19 Vaccines

Posted on Aug 18, 2020 in Affiliates, Innovation, Quality, Research, Scroll Images

Microscopy image of the novel coronavirus, COVID-19

As the COVID-19 pandemic continues to persist worldwide, few features of the human body have figured as prominently on center stage as the immune system.

How does the immune system respond to viruses?
One function of the human immune system is to inhibit viruses, and prevent them from causing illness. The body has two types of immune response to accomplish this function: innate immunity, which starts within hours of an infection, and adaptive immunity, which develops over days and weeks.

A virus causes an illness by infecting cells in the body and taking control of their genetic material. The virus then instructs these infected cells to reproduce the virus’s genetic code and replicate more viral “soldiers” that fight against our immune system.

The body’s adaptive immune response consists of two types of white blood cells—called T and B cells—that can detect “signals” specific to the virus and assemble a targeted response to it.

T cells identify and kill cells infected by a virus. B cells make antibodies—a kind of protein that blocks viral material from entering our cells and prevents the virus from reproducing.

In case the body may need to fight the same virus again, the body stores T and B cells that helped eliminate the original infection. These “memory cells” help provide us with long-term immunity. How long is long-term? Antibodies produced in response to a common, seasonal virus last for approximately one year. But the antibodies generated in response to a measles infection, for example, can provide lifelong protection.

Antibodies, a critical component of the human immune system

The human immune system and vaccines
Vaccines provide immunity, or protection against a disease without causing the illness. They are made using killed or weakened versions—called antigens—of the disease-causing virus. For some vaccines, genetic engineering is used to make the antigens included in the vaccine.

If you’re administered a vaccine to prevent viral infection, your immune system responds to the vaccine in the same way it would if exposed to the actual virus, by: recognizing the proteins and other components of the vaccine as foreign; making antibodies to “attack” the vaccine, as if it were the actual virus, and; remembering the foreign invader and how to destroy it. This response means if you are exposed to the disease-causing virus again, your immune system can intervene before you get sick.

The science on COVID-19 vaccines
Worldwide, scientists are studying more than 165 vaccines against COVID-19. Thirty are being tested in clinical trials in humans, and three of those are in Phase 3 studies.(1) Vaccines typically require years of research and testing before reaching the marketplace or clinic, but scientists are attempting to develop a safe and effective COVID-19 vaccine by next year if not sooner.

Each of the COVID-19 vaccines being tested use a different method to “attack” the virus and engage the immune system to fight infection. But to date, there are a few common approaches being studied in clinical trials:(1, 2)

1. Genetic vaccines use one or more of the COVID-19 virus’s genes to provoke an immune response, using genetic material called messenger RNA (mRNA) or DNA to produce viral proteins in the body.
2. Repurposed vaccines rely on vaccines already being used to protect humans against other diseases (e.g., tuberculosis) that may also be effective in protecting against COVID-19.
3. Viral vector vaccines use a virus to deliver COVID-19 genes into cells and provoke an immune response. These vaccines typically use viruses that infect animals such as chimpanzees or monkeys to act as the “carrier” that prompts an immune response against COVID-19 in humans.
4. Whole-virus vaccines use a weakened or inactivated version of COVID-19 to spark an immune response.
5. Protein-based vaccines use a COVID-19 protein or its pieces to invoke an immune response against the virus.

Sutter Health anticipates studying a COVID-19 vaccine being tested in humans through a Phase 3 clinical trial. Stay tuned for more news next month! Curious about other research at Sutter? Learn more.

References:

  1. World Health Organization. Accessed Aug. 11, 2020.
  2. The race for coronavirus vaccines: a graphical guide. Nature news feature, April 2020.