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How a Rural Hospital Treated a COVID-19 Patient 120 Miles Away

Posted on Jul 2, 2020 in Expanding Access, Innovation, Memorial Hospital, Los Banos, Quality, Safety, Scroll Images, Uncategorized

When Sutter Health’s Memorial Hospital Los Banos had a critically ill patient test positive for COVID-19, there wasn’t an ICU room for her. The small community hospital’s four ICU beds are located in the same large room separated by curtains, and this patient needed to be isolated.

A private room was made available, but there was a problem: It was not equipped with the Sutter eICU telehealth system that allows 24/7 critical-care physician coverage from a central hub 120 miles north in Sacramento. But, as part of its preparations for a COVID-19 patient surge, Sutter Health had just deployed a new system that allowed its eICUs to more than double its capabilities. The patient in Los Banos was the first to be cared for using the new system.

Sutter, a national pioneer in electronic ICU (eICU), has for years ensured critically ill patients in both large cities and small towns have 24/7 access to an expert team of doctors specially trained in their care. From central hubs in Sacramento and San Francisco, these doctors monitor patients in ICUs many miles away using live interactive video and remote diagnostic tools to instantly assess critical changes in a patient’s condition and provide expert critical-care physician support and supervision for the hospitalists, specialists and nurses who provide the hands-on care.

Sutter Health has more than 300 ICU patient rooms at 18 hospitals, each one outfitted with interactive video cameras, but in a matter of a month, Sutter designed and deployed specialized units that enable the eICU’s critical-care physicians to care for upward of 1,000 coronavirus patients without having to travel from hospital to hospital and using in-demand PPE. As part of its COVID-19 surge planning, each hospital set aside other patient rooms that don’t have the eICU video technology installed, and Sutter’s eICU team created and deployed 82 iPad stands across its network to bring these specialized critical care teams to those patients, too. Including the patient in Los Banos.

“The challenge was to come up with a plan for our eICU to provide care for a surge in patients across Northern California,” said Dr. Tom Shaughnessy, medical director of Sutter Health Bay Area eICU. “We are now able to meet the need of a patient surge by giving the same comprehensive, quality care whether a patient is in one of our ICU beds or a converted room.”

With the assistance of the eICU team through the mobile units, the patient in Los Banos recovered from the novel coronavirus. Now rural hospitals throughout the Sutter network are prepared for patients who need to be isolated and still have 24/7 critical-care physician coverage, and Sutter’s larger hospitals are prepared for a future patient surge of any type that requires all-hours critical-care coverage.

“We have nurses and physicians providing some of the best bedside care in the country, and the eICU allows us to come in and provide advanced specialized support as they care for patients,” said Dr. Vanessa Walker, medical director of the Sutter Health Valley Area eICU. “This is critical in the care for those suffering from compromised lung function due to a virus such as COVID-19. Now with these additional mobile units, we are well prepared to meet a surge of patients from this current crisis or any other that may come in the future.”

Vanessa Walker, D.O., cares for a patient through the eICU system in Sacramento

Domestic Violence: Tips for Staying Safe during COVID-19

Posted on Jul 1, 2020 in Safety, Scroll Images

If you or your family are in immediate danger call 911

SACRAMENTO, Calif. –As the COVID-19 crisis continues, many people are spending more time than ever in their homes. With shelter-in-place orders, tensions and anxiety are high for everyone, and this presents a potential risk for domestic violence.

It’s not always easy to identify when you or someone close to you is in an abusive relationship, and the signs of domestic violence may be different in each relationship. Abuse can be verbal, emotional, physical or psychological.

“Just because there may not be physical abuse, does not mean that it is not abuse,” says Dean R. Sobcoviak, chief protective services officer for Sutter Health. “Verbal abuse, psychological abuse and bullying are all real abuses, and the effects can be just as, or possibly even more damaging than the visible wounds that are obvious from physical abuse.”

Signs of unhealthy, abusive relationships include:

• Physically aggressive with you

• Physically aggressive toward other people or animals

• Abusing alcohol or drugs

• Controls all the finances

• Denies there are any problems

• Isolates you from others

• Verbally abusive

• Possessive, jealous and unpredictable

Recognize these signs in yourself:

• Feel controlled and manipulated by your partner

• Are unable to make your own decisions

• Don’t feel safe in your own home

• Feel watched, even at work

• Feel humiliated, dismissed and helpless

Safety and Self-Care Strategies

If you identify as someone in an abusive relationship, reach out for help:

1. Consider creating a safety plan that includes ways to remain safe while you are in the relationship, planning to leave or after you leave.

2. Continue to stay in frequent contact with your support network, such as family, friends and co-workers.

3. Recognize that there are many resources available and reach out for help:

  • If you or your family are in immediate danger call 911
  • Anonymous, free and confidential support and resources:

o National Domestic Violence Hotline: 800-799-7233

o National Resource Center on Domestic Violence

o California Partnership to End Domestic Violence

  • Whether by phone, video chat or in-person, talk to your doctor about what options exist. Your doctor can provide you with a referral to a licensed, professional therapist.

Workplace Support: If you feel comfortable sharing, let your boss know. Ask if your employer offers additional services for employees in your situation. Not every employer offers additional services, but informing them may help keep you safe while on the job.

Domestic Violence Restraining Order: This is a court order that helps protect you from abuse or threats from your spouse or intimate partner. To explore the option of a domestic violence restraining order, contact your local District Attorney’s office or courts.ca.gov/selfhelpdomesticviolence.htm. Filing is free.

Therapy: Work with a counselor or therapist to build your emotional strength to leave, and to process the trauma afterward.

Asking for help can feel difficult or dangerous in situations like this, says Kim Narvaez, a licensed marriage and family therapist with Sutter Health. “A counselor or therapist will recognize the turmoil you are going through,” Narvaez says, “Just know that you are not alone, and you have the right to be safe.”

Remember your life is valuable. Get help and remove yourself from the situation as soon as safely possible.

If you feel you or your family’s life or safety are in immediate danger, call 911.

Sutter Tracy Community Hospital Named to the Fortune/IBM Watson Health™ 100 Top Hospitals List

Posted on Jun 30, 2020 in Scroll Images, Uncategorized

Annual list recognizes excellence in clinical outcomes, operational efficiency, patient experience and financial stability

TRACY Calif.—Sutter Tracy Community Hospital today was named to the Fortune/IBM Watson Health 100 Top Hospitals list. This is the second time Sutter Tracy has earned this honor, with its first recognition taking place in 2015. The annual list was unveiled on Fortune.com.

IBM Watson Health has identified the top hospitals from a rigorous evaluation of 3,134 short-term, acute care, non-federal hospitals in the U.S. The annual list recognizes excellence in clinical outcomes, patient safety, patient experience, operational efficiency and financial stability. Truven Health Analytics, now an IBM Watson Health company, first established the list to help identify best practices that may help other healthcare organizations achieve consistent, balanced and sustainable outcomes.

“We work to understand and best serve the diverse needs of our community,” said David M. Thompson, CEO of Sutter Tracy Community Hospital, who has been with the medical center for 30 years. “Patient outcomes and patient experience go hand in hand. Our teams are extremely focused on exceeding the expectations of our patients and families while delivering safe, high-quality care.”

Sutter Tracy Community Hospital is the area’s only full service, acute care hospital, and serves more than 100,000 people in the Tri-Central Valley region. The hospital is part of Sutter Health’s not-for-profit, integrated network, which serves as a more user-friendly system by helping patients achieve healthier outcomes via greater access to quality programs and services at a lower total cost.

In 2016, Truven Health AnalyticsTM, the originator of the 100 Top Hospitals list, named Sutter Health and Sutter’s Valley Area – which includes Sutter Tracy – two of the nation’s top five performers among large healthcare systems. Other recent recognitions for Sutter Tracy include an Elite Plus Honor Roll award for stroke care in 2019 by the American Stroke Association and an “LGBTQ Health Care Equality Leader” in 2019 by the Human Rights Campaign Foundation.

The Fortune/IBM Watson Health 100 Top Hospitals recognition demonstrates Sutter Tracy Community Hospital’s ongoing commitment to prioritize patient-centered care, particularly during this very challenging and unprecedented time. According to IBM Watson Health, as compared to similar hospitals, the hospitals included on the Fortune/IBM Watson Health 100 Top Hospitals list had better results on key clinical and operational performance indicators. These include survival rates, patient complications, healthcare-associated infections, 30-day mortality and 30-day hospital-wide readmission rates, length of stay, throughput in emergency rooms and ratings from patients.

“Hospitals, health systems and the dedicated clinicians and staff who work at these organizations have emerged as true heroes of the COVID-19 pandemic, and we are grateful to be able to recognize these extraordinary leaders at this time,” said Kyu Rhee, M.D., MPP, vice president and chief health officer, IBM Watson Health. “From small community hospitals to major teaching hospitals, organizations on this list demonstrate a relentless commitment to high value, patient-centered care and innovation. It is clear that the COVID-19 crisis will be a catalyst for reinvention, and we believe these top-performing hospitals are positioned to emerge stronger and smarter out of this crisis.”

For more information, visit http://www.100tophospitals.com/.

3 Reasons Not to Skip Well-Child Visits

Posted on Jun 29, 2020 in Pediatric Care, Scroll Images, Wellness

SANTA ROSA, Calif. – A lot happens within a child’s mind and body as they grow. Their personalities emerge, their moods shift, and their bodies mature. With so much rapid change, its important they get on a path to being and staying as healthy as possible, and well-child visits can help ensure this happens. While these visits may have been postponed in recent months, now is the time to check back in.

“Well-child visits help track children’s health and development, address parents’ questions or concerns, and provide recommended immunizations to prevent illness,” says Tara Scott, M.D., program director of the Sutter Santa Rosa Regional Hospital Family Medicine Residency program.

Read on for reasons why scheduling your son or daughter’s well-child visit should be high on your list and the precautions Sutter care centers are taking amid COVID-19:

Physical Development

The physical part of a well-child exam may include checking your child’s blood pressure, vision, hearing, height and weight. Are they overweight? Underweight? A doctor will help address these concerns. The doctor may also listen to your child’s lungs, feel their abdomen and check their reflexes.

It’s during this part of the exam a doctor may also ask about sleep, exercise and their social circle.

“Over the course of a child’s life from birth to 18, they may have between 15 and 20 well-child visits, with more taking place in their early years and then annually or every other year as they get older,” says Scott. “Well-child visits are more than an annual physical, however.”

Mental Health & Development

Just as important as physical growth is mental growth.

“Many mental health problems occur early in life and may disrupt a child’s developmental processes,” says Scott.

During well-child visits, doctors may ask open-ended questions that assess a child’s mental and emotional state. Questions like “What do you want to be when you grow up,” “Tell me about what you’re looking forward to this fall,” “What are your favorite subjects in school,” or “What are you and your friends doing over summer break” may reveal a lot about what’s happening inside your child or teenager’s mind.

In times like a pandemic, where a lot of change is happening very quickly, a doctor may be able to uncover early signs of mental health problems that require specialized care. They may also be able to identify common signs of anxiety or depression and put in place interventions to help alleviate your child’s symptoms.

Vaccinations

Regular well-child visits are the time when important and recommended immunizations are given.

The measles vaccine, for example, is first administered between 12 and 15 months, with the second dose given between four and six years old. Measles are actually more contagious than COVID-19. Once a community measles immunization rate drops below 90 percent vaccinated, outbreaks can happen. In 2014, California dropped below this rate and experienced a measles outbreak, and another one in 2019.

According to Dr. Scott, “Keeping up with current recommended vaccinations keeps children safe from other illnesses that may be even riskier than COVID-19.”

Now is the time to schedule well-child visits. Even if your child is feeling OK, preventive care is very important.

Our Current COVID Precautions

Sutter care centers, including doctors’ offices, have implemented specific measures to help protect patients. These steps include:

Mandatory Masking – Staff, patients and visitors must wear masks at all times.
Isolation – Those with COVID-19 symptoms are treated in separate spaces.
Cleaning – Teams are performing cleaning and disinfecting.
Screening – Everyone is screened for signs and symptoms of COVID-19 before entering care sites.
Contact-Free Check-In – Skip the front desk and check in from your mobile device at some locations through Hello Patient, a new feature on My Health Online.

How to Stay Safe with Rising Heat and COVID-19 Cases

Posted on Jun 26, 2020 in Carousel, Pediatric Care, Quality, Safety, Scroll Images, Sutter Medical Center, Sacramento

Temperatures are rising in Northern California, and so are confirmed cases of COVID-19. How do you keep safe from both? Stay home, says an emergency medicine physician with Sutter Medical Center, Sacramento.

“Our recommendation for the heat is stay inside and exercise intelligently; that’s kind of what we would say about COVID-19. They overlap,” said Arthur Jey, M.D. “Because it’s so hot, we’re not going to want to go out anyway, so it’s a good excuse to stay home with your family.”

With communities opening up and more area residents wanting to take advantage of the great outdoors and other opportunities, Dr. Jey pleads for folks to keep their masks on … or at least handy. Popular activities in the region include walking and hiking, which are great ways to get some fresh air and exercise at the same time. Won’t wearing a mask make you even hotter?

“When you’re outside, walking and hiking, and there’s no one around, you don’t need to wear the mask,” he said. “But you don’t know when you’re going to come close to someone, so keep your mask close by. I am always wearing a mask around my neck or it’s in my pocket. As soon as someone approaches, I put it on. … When there are people around, my mask is on all the time.”

During an interview with the media, Dr. Jey gave some other tips on how to avoid heat-related illnesses, from heat rashes and sunburns to heat exhaustion and heat stroke. Those most susceptible to the heat illnesses include toddlers who can’t communicate that they’re suffering, the very old, and those who have to work in the sun, including farm and construction workers.

What and How Much to Drink

If you are out in the sun, Dr. Jey says the best thing to do is drink a lot of fluids. He recommends good, ol’ plain H2O. Not ice-cold water that can cause cramps, but cooled water. He also recommends sugar-free electrolyte drinks, which are good ways to replenish those essential minerals when working out. Avoid alcoholic beverages along with sodas and sports drinks that contain sugar.

“Make sure you’re smart about what you drink,’ he said. “Alcohol is going to dehydrate you. Really heavy sugared water, like Gatorade, is going to dehydrate you. Electrolyte waters with low or no sugar, fantastic. Water, fantastic.”

He also says it’s not important to count how much fluids to take in, but rather to sip consistently and continually, not a lot at one time. “Everyone asks me how much to drink. Many medical professionals say drink eight to 10 glasses a day. But really, just try to drink well.” He said to take sips at least every half an hour while out in the sun. His counsel: “Don’t wait until you’re thirsty to take a drink.”

He also recommends that those going outside wear light, loose clothing and a hat. “I tend to wear baseball caps a lot, but they aren’t the best choice. The ones that you really want are the wide-brimmed ones, like the fishing hats, that cover the back of your neck. We’ve all been sunburned there before.”

What to Do When You’re Feeling the Heat

“There’s a whole continuum of heat-related diseases,” Dr. Jey says, and they progressively worsen as you’re exposed longer to the hot weather.

1.       Heat rashes, which is a reddening of the skin.

2.       Sunburns, which can be very painful.

3.       Heat exhaustion, when you’re still sweating, but you’re feeling a little woozy or nauseous. Your urine at that point is a darker yellow.

4.       Heat stroke.

“This is when it gets scary,” Dr. Jey says. “You stop sweating and your thinking slows down, and you feel horrible. You look like you’re having a stroke; that’s why it’s called heat stroke. I’ve seen people come in completely confused, acting like they’re almost drunk, that’s when you really get scared. The way you prevent that is that you don’t wait until you’re thirsty to start drinking water.”

He says when heat stroke is happening, the first step is to get out of the heat and let someone know you’re not feeling good. That’s why toddlers who aren’t talking yet are very susceptible to heat illness, because they can’t verbalize how they’re feeling.

Next step: “Get some water in you. Don’t chug it, don’t drink a whole gallon of it. Just sit down in the shade or some air conditioning and sip some water. And, if you don’t get better, then come see us at Sutter.”

Dr. Jey said, even during this pandemic, don’t be afraid to go to the emergency room when you are in a medical emergency, whether it’s heat stroke, a real stroke, or any other kind.

“We get concerned that you push things off too far,” he said. “Our nurses and physicians here work really hard to make sure that we keep you safe. … So if you start feeling problems with temperature, problems with the heat, or for that matter, trouble breathing, come see us. Don’t be scared. We have a separate area for those who we think might have COVID-19. Especially now when we’re starting to have another uprising of it. We’re very cautious of it. But I don’t want that to stop people from coming in when they have other illnesses.”

The Sacramento Bee posted one of Dr. Jey’s interviews on heat illnesses. Click here to watch it, and notice his mask is around his neck for when someone comes close!

How to Support Children and Teens during COVID-19

Posted on Jun 23, 2020 in Pediatric Care, Scroll Images, Uncategorized, Wellness

SACRAMENTO, Calif. – Every young person’s response to a traumatic event like a pandemic is unique and varied, but one thing is certain—it’s stressful. For many children and teens, stress commonly takes shape in the form of resistance, grief or even loss. These are intense emotions for developing minds, so it’s critical they don’t go unchecked.

“As parents, we set the stage for how our kids learn to navigate experiences,” says Anna Morgado, a licensed marriage and family therapist at Sutter Health. “They model behaviors based on what they see, so it’s important we provide support and create channels for safe and open dialogue.”

Morgado continues, “One of the hallmarks of a crisis is that people may feel stuck and like it will go on forever. Talking about ‘when this is all over, we will do…’ provides comfort and a sense of control.”

Here are ways to talk with your kids about COVID-19:

Information provided by Sutter’s Children’s Bereavement Art Group.

• Talking to children about COVID-19 is similar to talking to children about grief. Parents and caregivers should use concrete, simple and developmentally appropriate language to explain concepts.
• Follow your child’s lead. Allow them to ask questions and see where the conversation goes. When talking to teens, you might say, “Are your friends talking about coronavirus? What are they saying?” For younger children, you might say, “Have you heard grownups talking about a new sickness that’s been going around? What have you heard?”
• Talk openly and honestly to children about what’s happening.
• Mention the symptoms of the virus are similar to a flu (cough, fever, shortness of breath). Most people who get the virus have mild symptoms.
• Explain that the virus isn’t very common in children.
• Let them know if someone feels very ill, they can go to the hospital.
• Empower your child by letting them know they can help by practicing good hand washing, not touching their face and sneezing into their elbow.
• Let them know this time of quarantine and social distancing will pass—it’s temporary.
• Explain social distancing as, “We need to stay at least six feet away from people in public and wear masks so that we protect ourselves and others.”
• Tell them that a pandemic can be explained as, “People all over the world are sick with this virus.”

Possible behavior changes from your child

It’s okay that things aren’t normal right now. However, we need to be vigilant when our kid’s behavior is off. Here are changes to look for:

• Excessive crying or irritation in younger children.
• Returning to behaviors they have outgrown (e.g., toileting accidents or bed wetting).
• Excessive worry or sadness.
• Unhealthy eating or sleeping habits.
• Irritability and “acting out” behaviors in teens.
• Poor academic performance or avoiding schoolwork during the school year.
• Difficulty with attention and concentration.
• Avoidance of activities enjoyed in the past.
• Unexplained headaches or body pain.
• Use of alcohol, tobacco or other drugs.

How to support your child

Supporting your child doesn’t have to be a huge lift. Here are activities that will go a long way in bringing normalcy and consistency to their day:

Provide structure and a daily routine. Work together to establish a daily plan that includes mealtimes, bedtime, work time, playtime, creative time and exercise. Set small goals every day. Do your best to attend to your child and your own body, brain and emotions.
Share your feelings while also providing reassurance. Let your child know caregivers are there to keep them safe. Helpful statements include: “There are lots of amazing grown-ups, such as doctors and nurses, working hard to keep us healthy” and “We’ll get through this together.”
Model good self-care. Take breaks, get plenty of sleep, exercise, eat well and stay connected to your friends and family members.
Encourage expression. Let your children express themselves through art, writing, talking things out and physical activity.
Use touch. Take advantage of extra time during the quarantine for cuddles, hugs and play. Physical closeness and care go a long way in helping children feel safe and loved.

Reaching out for help

“These are extraordinary times, so if your child’s in a temporary funk for a day or two that isn’t overly concerning. However, if this prolonged state doesn’t budge, then it may be time to enlist a third party,” says Morgado.

Whether by phone, video chat or in-person, talk to your primary care provider about options. “It’s important to meet children where they are. Our therapists are incredibly skilled at helping kids understand, build resiliency skills and move forward,” says Morgado.

The National Parent Helpline is at 1-855-4A-Parent (1-855-427-2736).

The Sacramento Regional Family Justice Center’s 24-hour Parent Support Line is 1-888-281-3000.