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Feeling Anxious Because of COVID-19?

Posted on Jun 10, 2020 in Scroll Images, Uncategorized, Wellness

SACRAMENTO, CALIF. – We are all worried about our health, safety and protecting our loved ones right now. As the COVID-19 crisis continues, it’s more important than ever to protect our mental health and build resilience.

Recognize Anxiety Overload

“Anxiety is a signal from our brain that puts us on alert, mentally and physically, to both real and perceived dangers. It’s normal to feel anxious right now. But anxiety overload can cause physical symptoms and impact wellbeing,” says Kim S. Narvaez, a licensed marriage and family therapist with Sutter Health.

“Be aware of the signs,” says Narvaez. “These may include: restlessness, aches and pains, sweating, heart pounding, stomach problems, difficulty concentrating, feeling on edge, excessive worrying, irritability, obsessions, uncontrollable behaviors and fearfulness.”

Try Mindfulness to Help Manage Anxiety

Mindfulness is a useful tool that you can practice easily by paying close attention to yourself and your surroundings.

“The goal is to be present and notice what is going on within yourself,” says Narvaez, “Listen to how you are feeling, without any distractions or the need to do anything. This allows us to process thoughts and information calmly so we can move forward in a less reactive way.”

You can practice mindfulness in several ways. Click here to learn more about relaxation, breathing and meditation techniques.

Take time to reflect and ask yourself questions such as:

• Are my thoughts out of proportion to what is actually happening?
• Am I acknowledging my feelings?
• Am I giving myself enough credit for all the things that I am doing?

You can learn more about mindfulness and stress reduction on the Sutter Health website.

Reach Out for Help

Your mental health is important to your physical health and your overall wellbeing. Notice if your anxiety is escalating. If you want more help, contact your primary care physician who can provide you with a referral to licensed, professional therapists who can help with personal problems.

Critical Blood Shortage May Impact Hospitals

Posted on Jun 9, 2020 in Affiliates, Alta Bates Summit Medical Center, Scroll Images, Uncategorized

OAKLAND, CALIF. – Hospitals across the country are facing the potential for critical blood shortages as a result of blood drive cancellations during mandatory shelter in place orders. Blood donation may also be hampered by the changes blood banks have had to make to keep donors safe.

Now Ronn Berrol, M.D., medical director of the Summit campus emergency department at Sutter’s Alta Bates Summit Medical Center, explains the impact of the blood shortage on hospitals in a recent interview with KTVU Fox 2.

Watch the video interview

For a while, the drop in blood donation wasn’t as problematic since there was a lower demand for blood as people obeyed shelter in place orders—the number of emergency surgeries and hospitalizations was reduced— and elective procedures were cancelled, says Dr. Berrol. But as people begin venturing out and hospitals resume urgent and elective surgeries, he says there is the potential for disruption or delays for blood-intensive surgical procedures such as complicated heart, cancer, gynecologic or orthopedic surgery because of the blood and blood product shortage.

The solution?

Dr. Berrol urges healthy people to contact their local blood bank to make an appointment to donate blood. He also counsels patience because, though the need for blood donation is urgent, there may be a delay of a week or two for an appointment since blood banks have had to reduce the number of appointments they can offer in order to implement safety measures like physical distancing and extra cleaning.

Contact the Red Cross or Vitalant to learn more about how you can donate blood in your community.

Clean Machines: How Disinfecting Robots are Helping the Frontlines

Posted on Jun 8, 2020 in Safety, Scroll Images, Uncategorized

It’s not a scene from science fiction. But the battle is real against germs inside hospitals and care centers. And standing alongside healthcare professionals and cleaning crews on the frontlines? Disinfecting robots.

High-tech “clean machines” are more widely used than ever in healthcare—and have been an especially welcome in the arsenal against COVID-19. Integrated health networks like Sutter Health have had them in practice for several years, setting the stage for safety for patients and staff alike.

“Our UV robots help combat against C. diff, MRSA and multi-drug resistant organisms in the hospital,” said Brett Laurence, M.D., Sutter Medical Center, Sacramento’s chief of infection control. “The UV light rays disinfect high-touch surfaces and procedural areas to improve and ensure patient safety.”

Disinfecting robots are featured at California Pacific Medical Center, Memorial Medical Center, Mills-Peninsula Medical Center, Sutter Auburn Faith Hospital, Sutter Medical Center, Sacramento, Sutter Roseville Medical Center and Sutter Tracy Community Hospital. They have even been used inside the Rural Health Clinic in Los Banos.

Sutter Health has taken other steps to make patients feel welcome and safe upon returning to network care centers, as well. In addition to increased frequency of cleanings, Sutter has adopted universal masking for staff and patients, set up temperature check stations and moved or marked furniture to promote physical distancing in waiting rooms.

“The health and well-being of our patients, employees and clinicians is a top priority,” said Sean R. Townsend, M.D., vice president of quality and safety at California Pacific Medical Center. “We are combining the power of science with sensible approaches all in the name of safety.”

Respiratory Care Clinics: How Dedicated Exam Spaces Limit the Spread of Viruses

Posted on May 26, 2020 in Carousel, Expanding Access, Innovation, Palo Alto Medical Foundation, Quality, Safety, Scroll Images, Uncategorized

BAY AREA, Calif. – Its second nature for people to visit their doctor’s office or an urgent care center when they’re sick — or are worried they might be. In early March doctors across the Sutter Bay Medical Foundation prepared for patient demand at these locations by developing Respiratory Care Clinics (RCCs); an outdoor exam experience that keeps potentially contagious people distanced from those that aren’t, while allowing all who need in-person care to receive it.

“We always knew patients would have concerns that were serious enough to need an in-person exam, but not urgent enough for a trip to the emergency room,” said Kurt Vandevort, M.D., inter-regional medical director for the Palo Alto Foundation Medical Group, part of the Sutter Medical Network. “As community-based providers this middle level of care is our core competency, so it was incumbent on us to find a way to keep providing it, safely.”

By March 16th the Sutter Bay Medical Foundation had established fifteen RCCs in cities across the Bay Area, each seeing patients with COVID-19 concerning symptoms (or who reported a potential exposure to the coronavirus), outside of a nearby medical building that needed to stay open and clean for patients with urgent or medically necessary needs unrelated to COVID.

A month into their operation reporters from The Mercury News and San Francisco Chronicle took notice and wrote about these MASH-like clinics. Now, as Sutter Health resumes more routine patient visits, the RCCs will continue to separate patients with respiratory symptoms from those without, to reduce the risk of exposure to viruses, including the novel coronavirus. Read below to learn more about how the RCCs work and what to expect if you are directed to one.

Call First 

Sutter Health is focused on helping ensure patients have access to the right level of care to match their medical need, but we also understand that sometimes that’s hard for people to gauge. That’s why Sutter Health set up the COVID-19 Advice Line at 1-866-961-2889.

Staffed by a team of nurses from 8 a.m. – 6 p.m., seven days a week, every caller is screened for symptoms linked to coronavirus. Callers are then directed to the most appropriate level of care based on the severity of their symptoms. Patients may be directed to self-monitor at home, to see a provider by video visit or to come to an RCC location where they can receive an in-person exam.

“By linking the RCCs to a pre-screening process (by phone or after a video visit) we can ensure patients coming to RCC do need to be seen in-person, and aren’t ill enough to go straight to the emergency room,” said Dr. Vandevort, who is also the medical director of the RCCs established throughout the Palo Alto Medical Foundation footprint. “When patients arrive at the RCC we also have some information about their chief concerns, thanks to notes entered in our electronic medical record.”

Different, by design 

A physical exam in a parking lot or garage is strange, but the safety that these setting offer is worth the weird-factor. “To protect patients, staff and the community we designed the RCCs to first and fore-most prevent transmission of any virus from a contagious person; that’s why most of them are outdoors and anyone who comes within six feet of the patient is in full personal protective equipment” said Dr. Vandevort. “At the same time we took great pains to try to make the experience similar to what patients are used to when they go to the doctor or urgent care.”

The outdoor RCCs all have a contact-free arrival process, allowing patients to drive-up and call a phone number to “check-in” for their appointment. At every stage of the visit the patient is distanced from others by either staying in their car or in a marked off space within an exam bay.

In addition to an initial temperature check, patients will have their lungs listened to with a stethoscope, have their blood oxygen saturation checked, have their medical history and medications reviewed, and may be tested for coronavirus or the flu if symptoms indicate they should be. Depending on medical need, patients will also receive additional tests and procedures, including imaging scans, blood draws, heart monitoring and more.

The few indoor RCCs are all in buildings, or sections of buildings, that can safely be separated from other areas where patients who don’t have respiratory symptoms are being seen. The indoor RCCs have implemented all the necessary transmission precautions to ensure that spread of a virus from patient to patient or patient to staff is prevented.

Not Just COVID Care

In addition to screening and treating respiratory complaints, the RCCs have filled another important role; addressing non-respiratory related issues reported by patients who have symptoms linked to COVID (fever, cough, shortness of breath). “Just because COVID-19 is here, that doesn’t mean that other illnesses and injuries go away,” said Dr. Vandevort. “One of the best things about the RCCs is that you are being evaluated by a physician who can treat a wide variety of minor illnesses or injuries, prescribe medications or make a dosage change to an existing medication, and otherwise address a whole host of concerns. It’s what we do every day, and in these safe settings, we can keep doing our job even for patients who may have a virus and be contagious.”

In the short time the RCCs have been up and running, doctors staffing them have made unexpectedly important diagnoses and delivered increasingly complex care. “We’ve seen and treated conditions ranging from an appendicitis, to a swallowed fish bone, to an infection requiring IV antibiotics. We’ve done a lot of good.”

Twice the Team 

It’s not easy to run two clinics (one regular and one RCC), simultaneously, just feet apart, but for the safety of our patients and providers that is what we’ve done. “We had to reassign doctors and nurses so we had coverage in both the RCC and the regular urgent care at the same time, some staff now act as a front-door attendants making sure that patients are directed to the right clinic based on their symptoms, and others are runners shuttling supplies between the two spaces.”

All this investment was made for one reason: to prevent the spread of illness. But the RCCs have had several secondary benefits too.

“We’re also helping to preserve hospital capacity by keeping patients from going to the emergency department unnecessarily.” You wouldn’t normally go to the ER for a fever, and the RCCs make sure our smart use of resources stays intact, even during a pandemic.

At the same time, the RCCs have helped refer patients to a higher level of care when that was needed. “Our job is to help stabilize people so they can safely return home, but when their symptoms are serious we help get them to the hospital.”

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.

Study Shines Light on COVID-19 Racial Disparities

Posted on May 21, 2020 in Expanding Access, Research, Scroll Images, Uncategorized

Differences in How People Access Care Contribute to Inequalities

SACRAMENTO, CALIF. – As the COVID-19 pandemic spreads throughout the U.S., evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. Here in California, African Americans are about 6% of the California population, but make up 10.3% of COVID-19 deaths where race/ethnicity is documented.

To better understand how this issue impacts patients in Sutter Health’s network, and to help develop solutions, Sutter’s Advancing Health Equity team undertook a thorough data analysis of the not-for-profit system’s COVID-19 patients. The resulting study, published today by the journal Health Affairs, revealed that African American COVID-19 patients are 2.7 times more likely to be hospitalized than their Non-Hispanic White counterparts, and they tend to arrive at Sutter healthcare facilities sicker and with more severe symptoms.

The findings underscore the fact that race and ethnicity still play a pivotal role in determining how and when care is accessed. Despite having health coverage, African American COVID-19 patients may not seek testing and care until it is an emergency requiring hospitalization.

Stephen Lockhart, M.D., Ph.D.

“The COVID-19 pandemic has ripped a Band-Aid off of the structural inequities that exist within our society – we must address these disparities right away because the cost of not addressing them is measured in human life,” said Stephen Lockhart, M.D., Ph.D., chief medical officer at Sutter Health. “With lives on the line, we as a state can and should do better in connecting minority patients to culturally competent care – that is why Sutter Health has committed to advancing health equity and this study is just one part of our mission and work. We have a moral obligation to do so and must work together to meet this moment and lean into the opportunity to advance health equity for generations to come.”

The study, “Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California,” was conducted using Sutter’s electronic health record (EHR) data to characterize COVID-19 tested and confirmed cases by key sociodemographic and clinical characteristics, including self-reported race and ethnicity, across the 22 Northern California counties served by Sutter’s network.

A number of factors uniquely position Sutter to offer early insights into the reasons for the disparities in health outcomes that have been noted nationally. As an integrated healthcare delivery network serving more than 3.5 million patients a year, Sutter had been studying healthcare disparities for close to three years when it became one of the first in the nation to treat patients with COVID-19. And Sutter’s integrated system-wide electronic EHR includes race/ethnicity data throughout its service area, which is one of the most diverse regions of the country.

Sutter Health also operates in an environment that is one of the closest to universal healthcare coverage of any state in the U.S., mitigating one of the known causes of healthcare disparities – unequal rates of medical coverage – and making other factors driving disparities more visible. But coverage is not the same as access, and the higher hospital admissions and mortality rates for African American COVID-19 patients in California revealed by the study illustrate that expanded healthcare coverage is not enough to resolve health disparities.

Kristen M.J. Azar

“The real value of the study lies not in the disparities it reveals but in its utility to inform our work to develop solutions that will address the equity gaps we are seeing with programs such as community outreach and engagement in at-risk neighborhoods,” said Kristen M.J. Azar, R.N., MSN/MPH, Sutter Health’s lead author for the study and research scientist within the Sutter Health Center for Health Systems Research. “This pandemic underscores the need to develop innovative solutions that are specifically tailored to address the unmet needs of those at highest risk.”

Sutter has extensive experience looking for and analyzing disparities within its own network and beyond.

The results of the COVID-19 study mirror the patterns Sutter observed in a 2017 study about African American patients with asthma and how they access care. The asthma study found 72% of patients drove up to eight miles to a hospital emergency department to access care, even though they lived within one mile of a primary care clinic. We observed they were doing so because of a lack of culturally competent care.

After reviewing the findings of the 2017 study, Sutter developed its Advancing Health Equity Adult Asthma Program. Since the program began in April 2017, nearly 600 African American patients suffering from asthma attacks have been connected to a respiratory therapist to participate in the asthma program. As a result, very few have returned to the emergency room. The asthma program serves as a model for trusted outreach, education and treatment in a public health crisis – and how they can reduce health disparities.

Provider organizations like Sutter Health are on the front lines and, while not able to address all of the complex societal factors at issue, can play a unique role in developing solutions. For example, as part of its commitment to advancing health equity, Sutter developed a novel metric, the Health Equity Index (HEI), to identify and quantify disparities in outcomes across patient groups and develop targeted interventions to enhance equity. Through the HEI, our Advancing Health Equity team is taking major steps, like those detailed here, to build on the benefits of our integrated network of care to further health equity within the Sutter system and across the country.

Our health equity work and the findings of the study released today highlight the importance of community-based outreach and access to culturally competent care within the African American community, which hold the promise of reducing disparities. Additional research is needed to understand where healthcare disparities exist, what drives them, and what targeted interventions work best to address them. Sutter remains committed to continued advancement and leadership in this field.