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Dedication to Duty: Blackouts and a Wildfire Won’t Stop Sutter Nurses

Posted on Nov 1, 2019 in Uncategorized

A spine injury at age 19 left Santa Rosa resident Ken Kilgore with paralysis in both his arms and legs. Bedbound and dependent on a special electric mattress that circulates air to prevent bedsores, Kilgore was nervous about the planned power shutoffs, until his bigger fear came true: an evacuation order.

Kilgore was one of approximately 150 patients routinely seen in their homes by the staff of Sutter Care at Home in Sonoma County who had to evacuate in response to the Kincade Fire. Through the uncertainty, fear and displacement, Kilgore says there was one constant: his nurse Paige Medeiros and the whole Sutter Care at Home family. “I must have gotten three calls a day from Sutter,” remembers Kilgore who is now safely back at home.

While the wildfire raged and blackouts rolled, Medeiros worked every day to make sure patients who rely on Sutter Care at Home had an in-person visit, or when that wasn’t possible, repeated phone calls to check on symptoms, give medical advice and guide patients to in-person care options as needed.

“These are people with feeding tubes, IV pumps, wound vacuums or special air mattresses like Ken’s,” Medeiros explained. “These are very frail patients that have high medical needs and are all homebound.” Working down a list, Medeiros drove to each patient’s house or the location where they’d been evacuated to, and checked if they needed supplies or nursing services, seeing to the needs of her regular patients and several patients who were normally cared for by other nurses, who had themselves been evacuated.

“It was a real team effort,” recalls Medeiros. “All of my co-workers and the whole Sutter family pitched in.”

Medeiros praised a nurse who drove from Marin to Mendocino (approximately 131 miles one way) to give a patient an in-home infusion (a special treatment that not all nurses can provide) and another who problem-solved through a four-day power outage, charging patients’ phones from her car battery and driving medical devices to the community resource center to be charged before returning them to her homebound patients.

James Conforti, chief operating officer for Sutter Health, knows that staff work tirelessly to provide quality care to patients. “Sutter’s integrated network allows us to coordinate care and contact patients. From filling prescriptions, rescheduling appointments to keeping vital chemotherapy infusions on track, we make sure our patients have continuity of care. The resilience of our staff and community never ceases to amaze me.”

But perhaps Kilgore said it best: “It’s not just a job to them—they really care about us.”

Quelling the Storms of Seizures in People with Epilepsy

Posted on Nov 1, 2019 in Affiliates, California Pacific Medical Center, Innovation, Neuroscience, Quality, Research, Scroll Images, Sutter Medical Center of Santa Rosa, Sutter Medical Center, Sacramento, Transformation, Uncategorized

SAN FRANCISCO, Calif. – An electrical “storm” in the brain causes seizures in people with epilepsy, producing symptoms that may include lapses in consciousness, twitching or jerking movements, weakened or limp muscles, spasms, blurred vision, experiencing unusual smells or tastes, and changes in sensation or emotions.

Epilepsy—a neurological disorder caused by abnormal electrical activity in the brain—impacts almost 3.4 million nationwide.1 Despite advances in epilepsy treatment, approximately one-third of adults with the illness experience recurrent seizures.2

Epileptic seizures are generally categorized into three main groups: generalized (affecting both sides of the brain), focal (seizures that start in one area of the brain), and those that could start anywhere.

The stormy weather of seizures can clear with medications called anti-epileptic drugs (AEDs). AEDs can to stop seizures from occurring, but they do not always lead to a remission or cure epilepsy. With the right AEDs, up to 70% of people with the illness may remain seizure-free, and sometimes may “outgrow” seizures or go into remission. For other people whose seizures are uncontrolled with conventional AEDs, other treatments including surgery may be an option. Surgery may involve removing part of the brain that causes the seizures.

Michael Chez, MD

“Knowing where seizures start in the brain provides us clues into what occurs during a seizure, what other conditions or symptoms may be seen, how they may affect someone and, most importantly, what treatment may be best for that seizure type,” says Michael Chez, M.D., a pediatric neurologist and epileptologist, and Sacramento regional director of pediatric epilepsy and research at the Sutter Neuroscience Institute.

“Life without seizures and improved quality of life is what specialists aim to provide epilepsy patients, through a treatment plan personalized to their particular type of epilepsy and seizures,” says Dr. Chez.

Two Sutter hospitals, California Pacific Medical Center and Sutter Medical Center, Sacramento are renowned for providing patients specialized Level 4 epilepsy care— a designation by the National Association of Epilepsy Centers—guided by leading-edge research. Sutter researchers are uncovering new clues about how epilepsy develops and how it can be treated more effectively.

Sutter examining new ways to ‘map’ and monitor brain activity

Epilepsy is usually diagnosed with magnetic resonance imaging (MRI) and electroencephalogram (EEG) testing. Those techniques are also used to regularly monitor brain activity in people with the illness. Sutter researchers are studying the use of novel neuroimaging techniques to visualize and track the brain’s electrical activity in people with epilepsy.

For patients with refractory epilepsy (in whom medications are not adequately controlling seizures), a new “high-density” EEG machine is being tested to locate precisely where a patient’s seizures originate in the brain.

“Use of these high-density or high-array EEG machines can help dramatically accelerate research and patient care by identifying the focal point of a seizure,” says Kenneth Laxer, M.D. a researcher in the Sutter Pacific Epilepsy Program at Sutter’s California Pacific Medical Center (CPMC).

With more than 40 years’ experience in epilepsy research, Dr. Laxer is renowned for studying neuroimaging techniques including magnetic resonance spectroscopy for the evaluation and management of the illness. With high-density EEGs, the patient wears a net over their head, and the brain’s electrical activity is recorded from 250-plus electrodes. The recordings are combined with the patient’s own high-resolution MRI scan to help localize the seizure focus. Surgeons use these precise images to remove the section of the brain that’s causing the seizures.

“If we pinpoint that abnormal area, we can remove a smaller portion of the abnormal brain tissue and therefore decrease the risk of serious complications from the surgery,” says Dr. Laxer. He notes that 50-70% of patients who undergo a focal resection may become seizure free. “Most of these patients remain on seizure medications, frequently at reduced dosages; however, the goal of surgery is to bring the epilepsy under control—not to stop epilepsy medication use. Patients who undergo such surgeries typically experience improved quality of life.” Stay tuned later this month for Part 2 of this series on Sutter epilepsy research, which will include information on neuromodulation and anti-epileptic medications.

Stay tuned later this month for Part 2 of this series describing epilepsy research at Sutter.

References: 1. Centers for Disease Control and Prevention. https://www.cdc.gov/epilepsy/about/fast-facts.htm 2. Epilepsy Foundation. https://www.epilepsy.com/learn/types-seizures/refractory-seizures SAN .

Preparedness Tips for Power Shutoffs

Posted on Oct 31, 2019 in Scroll Images, Uncategorized

Many Northern California communities have been impacted by PG&E’s Public Safety Power Shutoffs (PSPS) throughout the last month.

When PSPS plans are announced, we work with PG&E to identify facilities located in potential outage areas and implement preparedness protocols to minimize potential impacts. Sutter is also able to leverage the strength of our integrated network to help keep patients connected to care.

As additional shutoffs are announced, or you prepare for colder winter weather, consider these personal preparedness tips to help safely manage power outages.

  • Make sure you and your family are prepared for an outage at home, helpful information can be found at: prepareforpowerdown.com
  • Have emergency supplies, food and water.
  • Consider a backup plan for your refrigerated and frozen foods. Buy ice at the grocery store and place needed items and prescriptions in coolers.
  • Have a plan for child and pet care, should school or work places be affected, or your normal schedule change.
  • Fill up your gas tank in advance of known power outages.
  • Allow for extra travel time as traffic signals may be out, and limit travel when possible.
  • Be cautious when using open flame light/heating sources and generators, as they can be dangerous.
  • If you receive home healthcare support, ensure your provider has contact information to reach you, as well as your emergency contacts.

Find out more about the shutoffs at pge.com or call PG&E at (866) 743-6589

Five Sutter Medical Network Organizations Achieve IHA Honors

Posted on Oct 31, 2019 in Scroll Images, Uncategorized

SACRAMENTO, Calif. —Integrated Healthcare Association (IHA) has recognized four Sutter Medical Network (SMN) organizations for achieving top marks on quality and patient experience measures while effectively managing cost of care for Commercial HMO patients in 2018.

Excellence in Healthcare Award
In keeping with the national imperative to reduce healthcare costs while delivering high-quality care, IHA’s Excellence in Healthcare Award recognizes physician organizations in California making progress to that end. Sutter Medical Group, part of Sutter Medical Foundation, was one of just 28 physician organizations statewide to receive a 2019 Excellence in Healthcare Award from IHA. This award recognizes physician organizations that perform in the top 50th percentile across three domains: clinical quality, patient experience and total cost of care.

Of the nearly 200 physician organizations statewide participating in the Align. Measure. Perform. program, fewer than one in five attained an Excellence in Healthcare Award this year.

Exemplary Performance
IHA also recognizes physician organizations that demonstrated exemplary domain-specific performance. Mills-Peninsula Medical Group and Palo Alto Foundation Medical Group, both affiliated with the Sutter Palo Alto Medical Foundation, achieved high performance (top 10th percentile) in the clinical quality and patient experience domains. Two more Sutter-affiliated physician organizations, Sutter Medical Group and Gould Medical Group, achieved high performance (top 10th percentile) in the patient experience domain only.

Most Improved
IHA also recognizes eight physician organizations—one from each region— that demonstrate the greatest year-to-year improvement in clinical quality and patient experience domains. Gould Medical Group and Brown & Toland Physicians each earned the Ronald P. Bangasser Most Improved honor for making the greatest improvements in quality and patient experience from 2017-2018 among all physician organizations in the Central Valley and Bay Area regions, respectively. Brown & Toland Physicians contracts with Sutter Health affiliates to provide patient care.

SMN is part of Sutter Health’s not-for-profit network of care, which proactively implements programs across its system that continuously improve the quality and value of healthcare for patients. Integration across Sutter’s regions, clinical settings and data environments is delivering care models with some of the best clinical outcomes in the nation.

Lucky Landing: Mobile Stroke Unit Treats Traveler at SFO

Posted on Oct 28, 2019 in Expanding Access, Innovation, Mills-Peninsula Health Services, Neuroscience, Quality, Research, Scroll Images, Uncategorized

BURLINGAME, Calif. – It was a 9-1-1 response three years  in the making.

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Stroke Patient on Integrated Health Network: ‘This Is How Medicine Should Work’

Posted on Oct 25, 2019 in California Pacific Medical Center, Innovation, Neuroscience, Novato Community Hospital, Quality, Scroll Images, Uncategorized

When Patricia Mosier had a stroke, she was worried she wouldn’t be able to stay active. However, the integrated network of care from her community hospital in Novato to the more advanced neuroscience services at San Francisco’s California Pacific Medical Center got her back doing the activities that she loves. “This is how medicine should work,” she says about the continuum of care she received from Sutter’s integrated network. See her story in the following video:

For more on Sutter’s integrated network and how it leads to healthier communities, go to www.sutterhealth.org/newsroom/can-expect-integrated-network.