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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.”

Employees Rate Sutter as one of the Best in Latest Forbes Poll

Posted on Aug 24, 2020 in People, Scroll Images, Uncategorized

Employees across Sutter Health hold the network in high regard, according to the latest list by Forbes. In its second annual ranking of America’s best employers by state, Sutter Health was listed as one of California’s top employers.

“Sutter Health appreciates our entire workforce and how they help enhance the health and well-being of our communities,” said Jill Ragsdale, chief people and culture officer for Sutter Health. “Our teams live our values every day. With caring and compassion, they support patients and families, as well as each other.”

Using anonymous surveys, Forbes and market research company Statista verified the best-liked organizations by employees. Determining factors included potential for development, working conditions, diversity, salary, etc. Employees were also asked to rate on a scale from 1-10 whether they would recommend working for their employer to others.

This ranking takes special significance this year. Surveys took place from Oct. 2019 – May 2020, a portion of time that included the COVID-19 pandemic hitting stateside. Healthcare providers were facing challenges not seen before in their lifetimes. In response, Sutter identified resources that helped compassionately support the needs of staff. These creative solutions include offering temporary lodging around hospitals where staff may be relocated to support, retraining for staff asked to care for patients in other parts of the network, child care options close to work, self-care and mental health support, and remote work help.

Sutter Health was recently named one of 22 healthcare systems on Forbes’ 2020 list of “America’s Best Employers for Women.” Sutter ranked on Forbes list of California employers in 2019, too.

Sutter Health is more than 60,000 people strong, thanks to our network of clinicians, employees and volunteers. Grounded in our not-for-profit mission, our team members partner to provide access to high quality, affordable care for more than 3 million Northern Californians through our network of hospitals, medical foundations, urgent and walk-in care centers, telehealth, home health and hospice services.

Caring for a Newborn in a Pandemic

Posted on Aug 17, 2020 in Carousel, Palo Alto Medical Foundation, Pediatric Care, Quality, Safety, Scroll Images, Uncategorized, Women's Services

This article was written by Anita Mantha, M.D., pediatrician with the Palo Alto Medical Foundation for the August 2020 issue of Bay Area Parent magazine. 

Raising a newborn has never been easy. Nighttime feedings, coping with your own body’s recovery and the constant worry that comes with keeping your little bundle of joy safe are all part of being a new parent. In the midst of a pandemic, that job may be even more challenging. In the era of COVID-19, how do we keep our newborn baby safe, while enjoying the beautiful journey ahead?

If a mother is suspected or known to have COVID-19, how do doctors care for the newborn?

This is an evolving topic, as we learn more about this virus. Many hospitals are currently testing pregnant women around the time of their delivery for COVID-19. You can check with your obstetrician and the hospital team to find out if and when this test is being done if you have questions.

If you do test positive, do not panic. Hospitals have policies and procedures in place to help keep you and medical staff protected. While your care team may look a bit different than you imagined – gowns, face shields, masks and gloves – they will still work hard to support you during your delivery.

Once your baby is born, your care team will likely recommend that you wear a mask and practice good hand hygiene. Your baby may also be tested. Your care team will likely discuss additional precautions around topics such as physical distancing and feeding. Please remember not to put face coverings on children less than 2 years of age.

Can I still breastfeed my baby if I have COVID-19?

The benefits of breast-feeding have been long documented. One of the benefits is that breastmilk has antibodies that help protect the body against bacteria and viruses, potentially making it all the more important to breast feed your newborn now. In limited studies, COVID-19 has not been detected in breast milk. However, we do not know for sure whether mothers with COVID-19 can spread the virus via breast milk. 

What we do know is that it’s important to practice good hand and breast hygiene while pumping. Also, consider having a caregiver in good health offer bottles of your milk. If you have tested positive for COVID-19, you and your care team can discuss when and how to nurse your baby directly. 

What are the symptoms of COVID-19 in a newborn?

Newborns can have a wide range of symptoms including fever (defined as a temperature greater than 100.4F), poor feeding, being very tired, coughing, congestion, runny nose and/or breathing difficulties. The tricky part about newborns is that these symptoms can be caused by a variety of things, so it is important to discuss any concerns with your care team. The good news is that most children (including newborns born on time) with COVID-19 are asymptomatic or have mild symptoms. Prior to going home with your newborn, consider having a thermometer at home and being comfortable taking a rectal temperature, which is the most accurate temperature reading in newborns. Having your physician’s advice line number on hand is also important in case questions arise.

Can I let family members visit the baby? How do I keep my newborn safe from COVID-19?

Aside from COVID-19, we recommend caution, especially in the first month of life, to prevent your baby from catching an infection. Your newborn has an immature immune system and is at risk for serious bacterial infections. For these reasons, a fever is considered an emergency, and you should seek care for your child right away if it happens.

Now, more than ever, try to limit visitors in the first month of life. Anyone who visits should practice careful hand hygiene, practice physical distancing and wear a mask as much as possible. Please remember, even in the midst of a pandemic, normal newborn concerns still exist: jaundice, weight checks, etc. Please keep all regularly scheduled newborn care appointments and inform your care team if you or your baby are symptomatic prior to these visits so they can determine next steps.

I know moms can go through “baby blues.” Won’t physical distancing only make this feeling of isolation worse?

With all that is going on, it is natural for new mothers to feel as if they are on an emotional roller coaster. The important thing is, even though you may need to physically distance yourself to keep your newborn safe, you do not need to emotionally distance. Make sure to connect virtually with friends and family as much as possible. Connecting with other parent friends via video or phone calls can be helpful as well. La Leche League (llli.org) also provides great support to new parents.

What can I do to help my postpartum worries?

Make sure to take time for yourself and try to maintain a bit of a routine to help feel more balanced. Try to avoid frequently checking the news or social media, as this can lead to more stress. Consider some time for meditation, spending time outdoors or anything else you find enjoyable. Postpartum blues can turn into something more serious such as postpartum depression or anxiety, so please seek help if you are feeling that your mood is making it difficult to function. There are many resources to help, so do not wait to reach out. As things are constantly changing, please check with your healthcare team for updates on the care of newborns in this challenging time. The CDC also offers helpful information here.

Sutter Hospitals Honored for High Quality Stroke and Cardiac Care

Posted on Aug 5, 2020 in Carousel, Quality, Scroll Images, Uncategorized

SACRAMENTO, Calif. – Twelve hospitals within Sutter’s not-for-profit network received recognition from the American Stroke Association (ASA) for providing a high level of stroke care and participating in the ASA’s Get With The Guidelines® program. Additionally, 20 hospitals in the Sutter system received recognition from the American Heart Association (AHA) for consistently applying the American College of Cardiology guidelines when treating patients with heart failure, and participating in the AHA’s Get With The Guidelines® program.

Stroke Care

Sutter hospitals including Alta Bates Summit Medical Center in Oakland, California Pacific Medical Center – Van Ness campus in San Francisco, Eden Medical Center in Castro Valley, Memorial Medical Center in Modesto, Mills-Peninsula Medical Center in Burlingame, Sutter Medical Center, Sacramento, Sutter Tracy Community Hospital, Novato Community Hospital, and Sutter Santa Rosa Regional Hospital each earned a Get With The Guidelines®-Stroke Gold-Plus Quality Achievement Award for meeting or exceeded performance-focused quality benchmarks set forth by the American Stroke Association. Memorial Hospital Los Banos and Sutter Roseville Medical Center earned the Silver-Plus Quality Achievement Award and Sutter Solano Medical Center earned Bronze. 

“The care teams in our Brain & Mind service line work closely together, using evidence-based clinical practices, so patients receive high-quality care and exceptional service,” said Bill Isenberg, M.D., chief quality and safety officer for Sutter Health. “Our goal of continuous improvement in the neurosciences helps drive and strengthen our integrated health care network.”

Each of the honored hospitals are designated by The Joint Commission as Primary Stroke Centers and serve as a resource available to patients needing stroke-related services.

Our goal of continuous improvement in the neurosciences helps drive and strengthen our integrated health care network.

Eleven of the Sutter hospitals honored also earned a place in the Stroke Honor Roll —with Sutter Tracy Community Hospital and Sutter Santa Rosa Regional Hospital each receiving Elite Plus Honor Roll status. To qualify for this recognition, these hospitals met quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat acute ischemic stroke.

Furthermore, this year marks the debut of two new Stroke Honor Rolls, and Sutter hospitals earned a place on each. Sutter Medical Center, Sacramento is among only 11 hospitals in California to be listed on the Advanced Therapy Honor Roll which recognizes participating hospitals that met timeliness targets for the removal of blood clots from the brain under image guidance. This procedure, known as endovascular thrombectomy, is not performed at all hospitals. Additionally, eight Sutter hospitals earned a place on the new Type 2 Diabetes Honor Roll, which promotes evidence-based care for patients with this condition.

Cardiology Care

The 2020 Get With The Guidelines® awards also recognizes hospitals that maintain high standards in the treatment of heart failure. Overall, 20 Sutter hospitals demonstrated their commitment to providing the most appropriate cardiac care by following nationally recognized, research-based guidelines to treat heart failure and participating in the Get With The Guidelines® program.

Sutter’s Alta Bates Summit Medical Center (Oakland and Berkeley campuses), California Pacific Medical Center (Davies, Mission Bernal, and Van Ness campuses), Memorial Medical Center, Mills-Peninsula Medical Center, Memorial Hospital Los Banos, Sutter Auburn Faith Hospital, Sutter Coast Hospital in Crescent City, Sutter Davis Hospital, Sutter Delta Medical Center in Antioch, Sutter Lakeside Hospital in Lakeport, Sutter Roseville Medical Center, Sutter Solano Medical Center in Vallejo, Sutter Medical Center, Sacramento, Novato Community Hospital, and Sutter Santa Rosa Regional Hospital each earned a Get With The Guidelines®- Gold Quality Achievement Award for high quality heart failure care. Sutter Tracy Community Hospital earned Silver and Eden Medical Center earned the Bronze Quality Achievement Award for high quality heart failure care. 

Sutter’s Mills-Peninsula Medical Center also earned recognition for the evidence based care of coronary artery disease, and for meeting or exceeding care recommendations for patients presenting with an ST-elevation myocardial infarction (STEMI) – a specific kind of heart attack that can be caused by coronary artery disease.

“The American Heart Association and American Stroke Association are pleased to recognize these Sutter hospitals for their commitment to stroke and cardiac care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines® quality improvement initiative can often see fewer readmissions and lower mortality rates.”

Sutter Health proactively implements programs across its integrated network that continuously improve the quality and value of healthcare for patients. Its integration across regions, clinical settings and data environments is delivering care models with some of the best clinical outcomes in the nation. From heart transplants to valve replacements to cardiac ablations, Sutter’s Cardiovascular Health service line practitioners use innovative procedures and treatments to care for patients with a wide variety of specialized heart and vascular needs.

Virtual ‘Topping Out’ Ceremony Caps Sutter Santa Rosa Expansion Milestone

Posted on Jul 30, 2020 in Expanding Access, Scroll Images, Sutter Santa Rosa Regional Hospital

SANTA ROSA, Calif. – With a few clicks of a mouse, the community logged on to witness the “topping out” of Sutter Santa Rosa Regional Hospital’s new three-story expansion. The medical facility reached its latest construction milestone on July 30 and marked the occasion with a virtual gathering, where viewers watched as the final structural steel beam was secured into place. Hospital staff; elected officials, including Congressman Mike Thompson and Susan Gorin, chair of the Sonoma County Board of Supervisors; HerreroBOLDT crewmembers; and the public, all tuned in.

Hospital CEO Dan Peterson kicked off the program and acknowledged the unusual online ceremony made necessary by the pandemic. “This is no traditional ‘topping out.’ We’re using technology to keep everyone safe, and we’re making history with one of the country’s first virtual topping out celebrations.”

Watch the full program below.

Healthcare, Always in Demand

The healthcare industry continues to be one of the largest and fastest growing in the U.S. The country’s aging Baby Boomer population, plus the addition of the COVID-19 crisis, has only made healthcare more taxed and in demand than ever.

“Today healthcare is on all our minds as we face the continued threat of coronavirus pandemic. This facility will expand our ability to deliver quality care no matter the crisis we face—a pandemic, wildfires or earthquakes,” said Congressman Thompson. “I can’t wait to celebrate, hopefully in person, when we cut the ribbon to open the space.”

Supervisor Gorin added, “Sutter has been a vital partner to Sonoma County for almost three decades, and this expansion is the embodiment of its continued commitment to the community. This hospital will provide high-quality care to residents in a state-of-the-art, seismically safe and environmentally conscious setting.”

Expansion Will Add Hospital Bed Capacity

Sutter Health has invested $158 million to expand the hospital to increase capacity, adding 40 all-private patient rooms, 13 outpatient care unit beds, an 11-bed post-acute care unit bay, and 21 emergency department bays. The first phase of the three-story tower will add 67,000 square feet of space and is scheduled for completion in spring 2022. It will be followed by a phase II renovation to expand the hospital’s emergency department and support services in fall 2022.

“Today’s ceremony is a celebration of a momentous achievement for our hospital that will help us serve our patients and our community for generations to come. Everyone at Sutter Santa Rosa knows the hard work it’s taken to reach this milestone, and I want to offer a heartfelt ‘thank you’ to our team, which has continually served this community with integrity and compassion,” said Peterson.

Out with The Shovels and in with The Sharpies

Ahead of the event, hospital staff, physicians and construction crewmembers were invited to sign their names on the final beam. Former hospital CEO, Mike Purvis, was even on hand to add his name to history.

“It warms my heart to know that this beam was personally signed by our hospital’s doctors, nurses, staff and construction crew—all important players in our hospital’s future,” said Peterson. “Once the beam is bolted into place, it will signify that we’re ready for the next chapter in our 2022 hospital expansion.”

Construction in the Time of COVID

From first learning of the pandemic, the HerreroBOLDT team made worker safety its number one priority, ensuring proper social distancing and masking.

“Our biggest accomplishment thus far has been that we have not had a single case of COVID-19 spread on our project,” said Tom Guardino, HerreroBOLDT project superintendent. “Our entire team has been committed to early proactive behaviors.”

Crunching the Numbers of Hauling Dirt & Erecting Steel

• During the preparation of the project site, crews hauled off 3,300 yards of dirt—enough to fill 1.5 Olympic-size swimming pools.

• During the foundations phase, teams poured 1,987 yards of concrete. It was delivered in 223 concrete trucks and represents 8 million 47 thousand pounds of concrete.

• Roughly 196 thousand pounds of reinforcing was used to strengthen the building’s foundations. If stretched out in a continuous line, it would span more than 7 miles.

• The expansion consists of 441 tons of structural steel, weighing about 882,000 pounds. To put that into perspective, an average blue whale weighs about 110 tons. That means the building’s steel weighs about four blue whales.

“We are excited about the opportunity to build such an important project in the North Bay. A lot of our construction works are from this area. We’ve enjoyed a long and successful history with Sutter, and we are proud to be part of a project that will give back to the community for years to come,” Guardino said.

About Sutter Santa Rosa Regional Hospital

Sutter Santa Rosa Regional Hospital, part of Sutter Health’s not-for-profit integrated network of care, is an 84-bed acute care hospital that offers an extensive array of inpatient and outpatient services. The facility opened in 2014 and 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.

Seven Months of Coronavirus. Here’s What We’ve Learned Treating COVID Patients.

Posted on Jul 24, 2020 in California Pacific Medical Center, Scroll Images, Uncategorized

SAN FRANCISCO – The novel coronavirus has been with us since January 2020—and California is still in a continuation of the first wave. As the pandemic drags on, the medical community has acted as a sponge, absorbing knowledge of how the infection is best treated from each new case.

Vernon Giang, M.D., chief medical executive of California Pacific Medical Center (CPMC), part of the Sutter Health not-for-profit integrated network of care, shares four learnings CPMC clinicians have discovered since they began treating some of the nation’s first COVID-19 cases in March.

Constantly Refining the Approach to Treatment

COVID-19 symptoms differ based on the severity of disease. Fever, cough, and shortness of breath are more commonly reported among those who are hospitalized with COVID-19 than among those with milder cases of the disease.

“Early on, the thinking was to put patients with compromised lung function on a ventilator,” said Giang. “We’re managing patients much better now with high-flow oxygen. This is an incredible advance to keep patients surviving COVID-19 without bearing the risks of intubation.”

Additionally, Giang says, “Treatment of COVID patients has become more focused over the last few months because we’ve learned what drugs are effective against the disease.”

For instance, clinicians have learned that hydroxychloroquine or chloroquine isn’t effective against COVID-19. Rather, the anti-viral drug remdesivir is producing much stronger outcomes.

Increased & Faster Testing Means Early I.D. of Positive Patients

CPMC, like all hospitals in the Sutter network, test hospitalized patients for COVID-19, including those preparing for an upcoming surgical procedure.

“Testing is a very important part of controlling the spread of COVID-19. If we can get increased rapid testing down and make it widespread, we can help decrease the community spread of this virus. Testing in a hospital setting is important, too, as it enables staff to separate positive patients away from others, thus reducing exposure,” says Giang.

Sutter hospitals have also adopted cohorting, or grouping together, COVID positive patients on the same floor, which reduces the risk of spread and the need for additional PPE.

Clinical Progression Timeline

Giang shares that there is a strong correlation between patient infection rates and large public gatherings.

“We’re on a four- to six-week cycle,” he said. “People in early June were asking, ‘Why isn’t the death rate and hospitalizations rising?’ but we’ve learned it’s because the infection cycle takes time.”

An example of this timeline is when the country began opening over Memorial Day (May 22-25, 2020).
Giang explains that it took a couple of weeks after the holiday (COVID’s 2 to 14-day incubation period) for individuals to contract the virus and, in some cases, get sick enough that their symptoms required medical attention. In week’s three and four (or more), around mid-to-late June, we began seeing people hospitalized and pass away from the virus in increased numbers because the virus had taken its toll on their bodies.

Additionally, he confirms that patients with chronic diseases or conditions such as diabetes, heart disease and cancer, have a much greater chance of succumbing to COVID-19 because their bodies are already at a physical disadvantage, making it harder to fight off the disease.

Masking Works

According to Giang, we’ve learned there are significant portions of the population, particularly young people, who are asymptomatic or show no COVID-19 symptoms.

“What we’re seeing now is a surge in cases across the U.S. There are a number of reasons for this increase, including folks who are tired of being cooped up and returning to daily activities as if COVID didn’t exists. Some of it is from the fallout of people thinking they’re invincible and like it can’t happen to them.”

He continues, “We know that diligent masking works to help to slow the virus’ spread.”

Since March 2020, all Sutter hospitals, as well as Sutter outpatient and Walk-In Care facilities, have enacted 24-7 masking for all employees and patients. The Sutter network has also restricted visitors in these facilities.

“We’ve been able to effectively keep on top of community spread [within CPMC],” he said. “Now that we’re seeing a patient surge, we need to continue to be prudent about masking and how we connect and carry on about our everyday lives. Social Distancing and cleaning your hands frequently are also important. Things are opening up, but that doesn’t mean this virus is over.”

The Learning Never Stops

CPMC physicians, like those in teams across Sutter network, are constantly refining their approach to care in treating COVID-19 patients.

“A lot of people we’re seeing are recuperating. We’re learning everyday about how to be more effective with our treatment and we’re sending people home.”