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To Mend a Broken Heart: Sutter Health Starts eCPR Protocol in San Mateo County

Posted on Mar 15, 2019 in Cardiac, Community Benefit, Innovation, Mills-Peninsula Health Services, Scroll Images, Uncategorized

BURLINGAME, Calif. — If you’ve ever watched a televised medical drama, you’ve probably seen a doctor yell “clear” before delivering a jolt of electricity to re-start a patient’s heart. Unfortunately the shows make it seem like the defibrillator works every time. In reality, it doesn’t. Sometimes a faulty heart rhythm won’t return to normal even after multiple shocks, and if the problem is a blocked artery, no amount of shocks will help. In these cases, a patient’s only hope is to receive CPR while they are rushed to a hospital, and once there, receive advanced life support until doctors can repair their heart.

These two life-saving steps form the basis for a new emergency response protocol, called eCPR, which has the potential to decrease deaths from sudden cardiac arrest by 30 percent. Sutter Health affiliated Mills-Peninsula Medical Center is the first hospital on the West Coast to adopt this new protocol, which was proven effective in a 2016 study by Minneapolis-St. Paul area hospitals.

 

‘Hands Free’ Device Performs CPR During Transport

Until recently, it’s been next to impossible to perform effective CPR while in transit. “Our protocol has been to perform CPR at the scene and start transport only if we can stabilize the patient,” said John Kammeyer, Fire Chief, San Mateo Central Fire. Unfortunately many patients never stabilize – and 95 percent of sudden cardiac arrest victims die before they even reach a hospital.

The widespread use of a mechanical CPR device is set to change that. The device, known as LUCAS (Lund University Cardiac Arrest System), continuously delivers the same 2-inch chest compressions that a human hand would during traditional CPR, but the machine makes the process “hands free.” This means that emergency medical technicians (EMTs) can start their drive to the hospital sooner. A LUCAS device is carried on every San Mateo Fire rig that serves the county and two of the LUCAS devices now in the field were donated by Mills-Peninsula Medical Center community benefit.

ECMO Buys Time for Treatment

Once a patient arrives at Mills-Peninsula Medical Center the second life-saving step – advanced life support – comes in. A special machine called ECMO or extracorporeal membrane oxygenation, pumps oxygenated blood through the patient’s body, allowing the heart and lungs to rest while an emergency cardiac procedure is performed.

ECMO can support patients for days to weeks while doctors treat their underlying heart condition and give the heart time to heal. “Historically ECMO has only been used in support of a planned cardiac procedure,” said Joe Walsh, M.D., an interventional cardiologist with Palo Alto Medical Foundation. “Under this new protocol we’re using ECMO on an emergency basis, but time is still of the essence.”  This expanded use of ECMO can only be accomplished if the hospital has trained supportive personnel at the ready – which Mills-Peninsula Medical Center does.

Mills-Peninsula Medical Center launched its ECMO program in 2017 and has treated approximately 25 adults per year with the technology. Dr. Walsh is director of the ECMO Program and has seen first-hand that gallant CPR efforts and rapid use of ECMO can save lives.

Spotting the Signs: Sutter Health Athletic Trainers Address Student Concussions

Posted on Mar 12, 2019 in Affiliates, Community Benefit, Novato Community Hospital, Scroll Images, Uncategorized

Novato, Calif — New research studies on concussions have shown that left untreated, they can cause serious long-term health problems—a frightening prospect for student athletes and their families. In 2014, Novato Community Hospital (NCH) and Novato Unified School District came together to help. They teamed up to improve concussion detection and injury prevention for the district’s more than 1,600 student athletes across 21 different sports. The result was the NCH Athletic Trainer Program.

Designed by the NCH Orthopedics Department and supervised by the department chief, the program takes a holistic approach to safeguard the health and safety of student athletes. Launched in 2015, it funds two full-time certified athletic trainers, one at San Marin High School and one at Novato High School, who work with students on a daily basis, attending all practice sessions and games where high-impact sports are played. “The certified athletic trainers are healthcare professionals that are educated on and experienced in the evaluation and management of athletic injuries, including concussions,” said Jennifer Lehr, director of orthopedic services at NCH.

 

The trainers identified concussion symptoms in 47 local student athletes in 2017, all of whom needed to see a doctor. “Without this intervention, they may have continued on the field, risking permanent injury,” said Steven Dehart, the certified athletic trainer at San Marin High School.

In addition to in-the-moment concussion assessment, the certified athletic trainers also conduct extremely detailed computer-based pre-injury concussion testing at the start of every school year to establish each student’s unique brain-health baseline. Later in the year, if a concussion occurs during practice or play, the severity of injury can be objectively measured to provide information vital to medical treatment.

Finally, the certified athletic trainers provide student athletes and school coaches with basic sports medicine training, including how to avoid common bone, joint and muscular-skeletal injuries. “We really focus on injury prevention,” Lehr said. “The ultimate goal is to enhance the student-athlete experience and establish good habits now for lifelong health and well-being.”

The Athletic Trainer Program is made possible through the support of the community. The Novato Community Hospital Foundation funds a portion of the program and donors have supported the purchase and licensing of the computer-based pre-injury concussion testing software, as well as a portion of the salaries for the certified athletic trainers. In addition, donations covered the cost of advanced software the radiologists at NCH needed to conduct susceptibility weighted imaging during an MRI, which can more precisely diagnose brain injuries. Novato Community Hospital covers the remainder of program costs through community benefit investments. The Novato Unified School District provides oversight, infrastructure and acts as the first point of contact with parents.

Tiny Twin Fighters Will Win Your Heart

Posted on Mar 8, 2019 in California Pacific Medical Center, Scroll Images, Uncategorized, Women's Services

The road ahead it twists and turns .  . . but I keep, keep on pushing through,” sings John Isaac in the soulful song titled I Get Up. This song is the perfect anthem for Mason and Logan, fraternal twins, who need the specialized care of doctors and nurses at Sutter’s California Pacific Medical Center (CPMC) Van Ness Campus. The neonatal intensive care unit, or NICU, is a special section of the hospital dedicated to babies born early or with delicate medical  needs. In the NICU babies gain weight and develop a little more every day until they are healthy enough to go home.

At Sutter we want all of our patients to be at their strongest and the spirit of these two twin fighters matches our mission and echoes these poignant lyrics: “With every step my heart it pounds, yes I’m sure I’ve had my doubts, but I must keep, keep on pushing through. Yeah I get up, and I may fall right back down – but your love lifts me back to solid ground.” Thank you, Mason and Logan, for showing us how to keep on pushing through.

 

Sutter Health Announces Stable 2018 Financial Performance

Posted on Mar 7, 2019 in Uncategorized

SACRAMENTO, Calif.–Integrated healthcare delivery system Sutter Health has announced its financial performance for 2018. Sutter Health’s combined 2018 income was $201 million, which reflects the day-to-day operations of its hospitals, physician based care centers and a variety of other healthcare services, compared to $326 million in 2017. The system’s total 2018 operating revenues of $13 billion increased slightly from 2017’s operating revenues. Sutter Health posted $(267) million in investment income and changes in net unrealized gains and losses from investments classified as trading in 2018, compared to $651 million the prior year. Income attributable to Sutter Health for 2018 was $(198) million, compared to $893 million in 2017.

Community-Based Investments to Improve Access to Healthcare

The shift in overall performance between 2017 and 2018 was due to the temporary swing in the investment market at the end of the fourth quarter, as well as the fact that Sutter Health recognized multiple years of revenue from the Hospital Fee Program1 in 2017. As an integrated network of care, Sutter Health is positioned to withstand changes such as these. This ability gives Sutter the opportunity to further expand community access to high-quality healthcare. Additionally, as a not-for-profit, Sutter continually reinvests in its communities. In 2018, Sutter Health invested $924 million in new facilities and lifesaving technology throughout Northern California—extending its total investment to nearly $10 billion during the last 10 years.

The construction of California Pacific Medical Center, which meets 2030 seismic regulations, is now complete in San Francisco. The second of two new and innovative hospitals, the CPMC Van Ness Campus located in the city center, opened on March 2. The CPMC Mission Bernal Campus, located at Valencia and Cesar Chavez, opened Aug. 25, 2018. Sutter Health also facilitated expanded access to clinics through construction projects in multiple communities, including Alameda, Contra Costa, Lake, Placer, Sacramento, San Mateo, Santa Clara and Sonoma counties.

Sutter Health continues to innovate safe, high-quality care delivery outside of hospital and clinic walls to meet community needs for flexibility and efficiency—all with an eye toward also helping reduce healthcare costs. Sutter’s support runs across the healthcare spectrum—from where people access their care to how they manage their care. Video visits and walk-in care centers helped create more options for patients to access primary care in 2018. More than 1 million appointments were scheduled online by patients last year, offering greater ease and convenience. Sutter Health also invested $54 million in research and development in 2018, supporting efforts addressing a range of health concerns including stroke, breast cancer, Alzheimer’s disease and dementia, recovery after liver and kidney transplant, and diabetes.

“Patients and families count on us to deliver high-quality care, and we are committed to serving them and all those who call Northern California home,” said Sutter Health President and CEO Sarah Krevans. “Thanks to our integrated network, we continue to make care more accessible and more equitable. We focused efforts on better connecting patients to the right care service, at the right time and in the right place. We also maintained our commitment to care for the underserved. We’re proud to play a strong role in making our overall communities healthier.”

Care for the Underserved

Sutter Health’s total investment in community benefit in 2018 was $734 million, which is an increase from $612 million in 2017. This amount includes traditional charity care and unreimbursed costs of providing care to Medi-Cal patients, as well as investments in health education and public benefit programs such as community clinics and prenatal care for those with low income. Overall, since the implementation of the Affordable Care Act, greater numbers of previously uninsured people now have healthcare coverage through the Medi-Cal program.

The payments for patients who are covered by Medi-Cal do not cover the full costs of providing care. In 2018, Sutter Health invested $435 million more than the state paid to care for Medi-Cal patients. Medi-Cal accounted for nearly 19 percent of Sutter Health’s gross patient service revenues in 2018.

See more about how Sutter Health reinvests into the community by visiting sutterpartners.org.

Sutter Health – 2018 Financial Results, Continued

Sutter Health 2018 Financial Results

Dollars in millions

2018

2017

Operating Revenues

$12,697

$12,444

Operating Expenses

12,496

12,118

Income from Operations

201

326

Investment Income

187

336

Change in net unrealized gains and losses from investments classified as trading

(454)

315

Loss on extinguishment of debt

(54)

(19)

(Loss) Income

(120)

958

Less income attributable to noncontrolling interests

(78)

(65)

(Loss) Income attributable to Sutter Health

(198)

893

Capital Investment

$924

$924

1The Hospital Fee Program imposes a “quality assurance fee” on certain general acute care hospitals in California. Each of these hospital’s Hospital Fee Program’s proceeds are used to earn federal matching funds for Medi-Cal, and to increase Medi-Cal payments, helping offset the costs for expanding services to the most vulnerable population. Sutter Health’s shift in overall performance between Fiscal Years Ended December 31, 2017 and 2018 is, in part, due to Sutter Health’s recognition of multiple years of revenue from the Hospital Fee Program in Fiscal Year Ended December 31, 2017. For Fiscal Year Ended December 31, 2017, Sutter Health recognized $432 million from the Hospital Fee Program compared to $272 million for Fiscal Year Ended December 31, 2018.

ADA compliant versions of the audit available upon request.

New Sutter CPMC Van Ness Campus Hospital Opens its Doors in the Heart of San Francisco

Posted on Mar 2, 2019 in California Pacific Medical Center, Scroll Images, Uncategorized

15 years in the making: new hospital merges advanced technology, safety, efficiency and personal touches – such as private rooms – to support the highest quality care

 

SAN FRANCISCO – San Francisco residents now have a modern new hospital at their doorstep as Sutter opened the doors to its new California Pacific Medical Center (CPMC) Van Ness Campus hospital at 7 a.m. today.

 

The facility represents a milestone community investment in the health of San Francisco. The state-of-the-art facility, featuring 11 floors and 274 acute-care beds, houses inpatient services with an emphasis on maternity care, pediatrics, transplant, emergency and cardiac care, among other primary care services. Every detail of the new hospital is geared toward creating an inclusive, healing environment, where high quality, technology, safety, efficiency and personal touches continue to be the norm.

“For more than 150 years, it has been our privilege to serve every person who calls San Francisco home,” said Warren Browner, M.D., CEO of CPMC. “The opening of Sutter’s CPMC Van Ness Campus provides a new and conveniently located hospital for people living throughout the city and beyond.”

By weekend’s end, more than 200 patients will be transported by ambulance from CPMC’s Pacific and California campuses to the new hospital at 1101 Van Ness Ave. during two days of carefully-choreographed moves. By noon, a patient had already received a transplant at the new hospital and patients were being treated in the Emergency Department.

Centrally located along a major arterial thoroughfare

Formerly the site of the Cathedral Hill Hotel, CPMC Van Ness Campus hospital occupies an entire city block between Geary and Post streets along San Francisco’s bustling Van Ness corridor. Across the street from the hospital, a 9-story, 476,000 square-foot medical office building will provide outpatient services, emphasizing the benefit of Sutter Health’s integrated network and its dedication to easily accessible care. The two buildings are connected via an underground tunnel. The medical office building is slated to open in spring 2019.

By the numbers

The 274-bed Sutter CPMC Van Ness Campus hospital consists of close to one million square feet of acute care, diagnostic, clinical treatment and administrative space, which includes:

• 60 medical/surgical beds
• 36 intensive care unit beds
• 64 labor/delivery and postpartum beds
• 35 neonatal intensive care unit beds
• 6 antepartum beds
• 25 pediatric beds
• 8 pediatric intensive care unit beds
• 16 operating rooms, including three dedicated to obstetrics
• 30 post-anesthesia care unit beds
• 38 exam/treatment rooms in the 24-hour emergency department, which consists of: 31 adult treatment bays and 7 exam/treatment rooms that are dedicated to pediatrics
• All 274 patient rooms are private and feature exterior city or garden views, with an abundance of natural light
• 5 living roof gardens, including a public outdoor terrace

The hospital design incorporates a theme of natural materials and touchable artwork, and is focused on the well-being of patients, families and the surrounding community. Public spaces, including the main lobby and the Chuck Williams Café, are accessible via the main entrance on Van Ness Ave. The ambulance/patient drop-off area is located off-street under a covered alcove to minimize the impact to traffic. Parking for 435 vehicles is available beneath the building.

“Our new Sutter CPMC Van Ness Campus hospital will continue to deliver the kind of coordinated, patient-centered quality care that San Francisco expects and deserves from a Sutter facility – with safety, security and inclusive care being paramount with each visit,” said Vernon Giang, M.D., chief medical executive at CPMC.

Shaking things up: CPMC Van Ness Campus hospital makes history with advanced seismic technology

Not only is CPMC Van Ness Campus hospital built to meet or exceed California’s stringent seismic laws, but the structure is the first in North America to incorporate innovative viscous wall dampers. Already used extensively in Japan, viscous wall dampers are designed to absorb strong movement during an earthquake, which helps to reduce overall stress on the building itself. This will help the hospital to remain fully operational, with patient care being relatively uninterrupted even after a strong seismic event. The Van Ness Campus hospital incorporates 119 viscous wall dampers.

“In the event of a major disaster, CPMC Van Ness Campus is built to be self-sustaining for at least four days,” said Jim Benney, R.N., senior project manager for the hospital. “We’re prepared to continue regular operations with the support of three emergency generators, food and water.”

Healthy environments foster healthy people

Designed to achieve LEED Silver certification, the hospital was constructed and operates in an environmentally conscious way. Water-saving features include using captured rainwater for the hospital’s five rooftop gardens and high-efficiency, low-flow plumbing fixtures, which will save more than 3 million gallons of water per year.

CPMC Van Ness Campus uses 14 percent less power than the average U.S. hospital in part because 80 percent of patient rooms receive direct natural sunlight. LED bulbs generate more light at lower temperatures, creating less heat in areas like procedural and operating rooms. Additionally, our sophisticated filtration system allows the hospital to deliver 100 percent clean and fresh air.

A truly integrated healthcare network

The hospital serves as the hub for all consolidated inpatient facilities and outpatient services. When fully complete, the campus will knit together hospital and emergency services, affiliated medical offices and specialty outpatient services.

“Thanks to being part of the Sutter Health integrated network, this new Van Ness Campus hospital was built with the most technologically advanced, patient-focused design details in mind,” said Dr. Browner. “This hospital is the jewel of the CPMC system.”

Bells and whistles that help accelerate care

CPMC Van Ness Campus uses the latest innovative technologies designed to reduce infection and increase efficiency. For instance:

• AeroScout Hand Hygiene Monitoring technology leverages the hospital’s Wi-Fi infrastructure to automatically identify (via badges) when caregivers sanitize their hands.
• The smart pneumatic tube system works like an underground freeway interchange to deliver medications, samples and supplies throughout the hospital swiftly, safely and securely. Badge-enabled containers keep contents secure, track information and reduce staff time spent transporting samples, supplies and medications between the laboratory, blood bank and pharmacy.

Building a modern hospital beckons a bold design vision and collaborative execution

Imagined as the urban hospital of the future by SmithGroupJJR, the final $2.1 billion project achieves economic, environmental and social sustainability. The building exemplifies Sutter’s goal of connecting health and the community. Led by general contractor HerreroBOLDT, the Van Ness Campus broke ground in 2013 and opened earlier than similar hospital construction projects. This fast-tracked delivery was attributed to the team’s implementation of the Integrated Project Delivery process, which utilizes a cohesive design and construction approach that keeps costs down and predicts construction challenges ahead of time.

Connecting Health to Patients and the Community

Sutter’s CPMC campuses support more than 80 non-profit organizations whose work is deeply rooted in the community. The team collaborated with CityBuild Academy, Mission Hiring Hall, City College of San Francisco, San Francisco State University and numerous other community-based hiring partners to optimize the construction process. Since 2013, the project injected 1,500 new construction jobs and more than $70 million in wages into San Francisco’s economy.

Nurturing patients extends beyond physical care. Patients of the new hospital can enjoy 755 unique and carefully chosen art pieces in a variety of different styles and mediums. Beautiful original paintings, vibrant photographs, art works created of wood, clay and metal bring color and beauty to the hospital’s walls and create a warm, inviting environment.

U.S. Army Reservist Thanks Sutter Colleagues for their Support

Posted on Jan 24, 2019 in Scroll Images, Uncategorized

Ernesto Brizuela, R.N., BSN, PHN

SACRAMENTO, Calif.–Sutter Alhambra Surgery Center (SASC) Director of Nursing Ernesto Brizuela,R.N., BSN, PHN returned in December from a nine-month assignment as a medical surgical nurse with the U.S. Army Reserves in Honduras. While gone, he missed major milestones with his wife and four children: birthdays, the 4th of July, Thanksgiving.

One thing that made being deployed far from home a little easier was knowing that his SASC colleagues were fully behind him. The SASC team worked together to cover his duties while he was away, and Administrator Andrew Kim called him every two weeks to check in on him.

“Those phone calls really helped keep me connected to home, to my family at Sutter Alhambra,” Brizuela said.

The SASC team also contributed to a special care package full of his favorite treats from home—including beef jerky, cookies and coffee creamers.

“Opening that care package felt like Christmas,” Brizuela said. “I saw that everyone had contributed something from their heart. It was really meaningful.”

To thank Kim and his co-workers, Brizuela nominated them for the Employer Support of the Guard and Reserves’ (ESGR) Above & Beyond Award, which recognizes employers that provide their National Guard and Reservist service member employees additional, non-mandated benefits.

“Ernesto is an integral member of our team, and we’re all very proud to support him,” Kim says. “His commitment to his country, his family, and our Sutter Alhambra team is incredibly admirable.”

ESGR presented the award to the SASC team on Jan. 17.