Collaboration Leads to Reduction in Low-Risk, First-Birth C-sections

Posted on Apr 17, 2019 in Alta Bates Summit Medical Center, Quality, Scroll Images, Women's Services

By Katarina Lannér-Cusin, M.D., administrative medical director, Women’s Services, Alta Bates Summit Medical Center


BERKELEY, Calif. – One of the advantages that an integrated healthcare delivery network like Sutter Health has is that its clinicians are able to improve quality by studying the experience and practice patterns of fellow clinicians. An example of this is our work to support vaginal delivery by reducing the rate of cesarean sections for low-risk, first-time births.

Katarina Lannér-Cusin, M.D., Administrative Medical Director, Women’s Services, Alta Bates Summit Medical Center

Sutter Health’s low-risk, first-birth C-section rate is among the lowest in California, with nine hospitals receiving recognition in 2017. Sutter’s average rate of 21.2 percent is lower than the state’s Healthy People 2020 target of 23.9 percent and the 2016 California Maternity Quality Care Collaborative target of 22.2 percent.
Sutter’s integrated network enables sharing of best practices and real-time data for continual process and quality improvement, which allows the network to outperform state and national averages in many quality measures and improve outcomes for the communities it serves. Sutter hospitals are leaders in California in lowering C-section rates—notably low-risk, first-birth C-section rates.

Sutter is a member of the California Maternity Quality Care Collaborative (CMQCC), a multi-stakeholder organization committed to ending preventable morbidity, mortality and racial health disparities in California. Partnering with CMQCC and the California Health Care Foundation, Sutter is leading a labor culture campaign to proactively educate first-time mothers about C-sections and encourage them to engage with their care teams to support vaginal birth and avoid C-sections for low-risk pregnancies.

There are several key drivers that have been instrumental to achieve real progress in decreasing C-section rates in the Sutter network of care.

• The first and most important driver is effective communication and teamwork—a joint commitment by the clinical team (nurses, midwife and physician) to create a great supportive environment for patients.

• The second driver is alignment on best practices for labor support, including collaborative labor management and education. Sutter adopted a checklist in labor and delivery that establishes parameters clinicians need to complete before deciding on a C-section. The teams work collaboratively using the checklist to ensure that all best practices for supporting a vaginal birth have been implemented. Additionally, labor support education has been developed for nurses, midwives and physicians.

• The third driver is maternal agency—a birth preference sheet was created to educate new mothers about choices they make that may increase their likelihood of a vaginal delivery and give them the opportunity to talk with their physician or midwife about these choices before birth.

• Finally, a large component of lowering low-risk, first-time birth C-section rates is the open sharing of physician-level rates among peers. This transparency creates the opportunity for dialogue and shared learning among clinicians. Each group is encouraged to discuss these rates internally and come up with a plan to address any issues uncovered by the data.

Sutter Health is working to ensure that every patient receives the highest quality maternity care for herself and for her baby. For more information, please visit Pregnancy and Childbirth Services.

One of Nation’s Top Residency Programs is Magnet for Future Family Doctors

Posted on Apr 12, 2019 in People, Scroll Images, Sutter Medical Center of Santa Rosa

Santa Rosa Family Medicine Residency Program Selects 12 Graduates for Class of 2022

SANTA ROSA-Sutter Santa Rosa Regional Hospital (SSRRH) Family Medicine Residency Program announced its 2019 incoming class who will graduate the program in 2022.  Twelve of the nation’s top medical school graduates were selected from 747 applicants for this three-year program. The nationally recognized Santa Rosa Family Medicine Residency program is one of 450 family medicine training programs in the United States and has trained hundreds of family physicians since its inception in 1938.

The 12 graduates who will begin the training program in July came from medical schools across the country; Drexel University, University of California Irvine, Texas Tech University, University of California Davis, Michigan State, University of Washington, Western University, Geisel School of Medicine, University of Massachusetts, Wayne State University, University of Maryland, and University of Wisconsin. They each come with an impressive background of academic achievement and community service.

The residency program is a critical strategic healthcare asset in confronting the emerging physician shortage in Sonoma County. The residency has been the largest single source of family physicians to Sonoma County for over 70+ years.  Residency graduates comprise nearly half of family physicians in Sonoma County. They fill 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.

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, Kaiser Permanente, Santa Rosa Memorial Hospital and or St. Josephs Health as affiliate partners in the community.

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.

Sutter’s Adult Congenital Heart Disease Program First in Area to Receive National Accreditation

Posted on Apr 12, 2019 in Cardiac, Innovation, Scroll Images, Sutter Medical Center, Sacramento, Sutter Medical Foundation, Uncategorized

The Sutter Medical Center, Sacramento Adult Congenital Heart Disease team includes ACHD Medical Director Pei-Hsiu Huang, M.D., right, and ACHD Clinic Coordinator Zilda Crist, left. They are shown with Chelsea Byrnes, who was born with a rare condition and was told she could never have children. She now has given birth twice at Sutter Medical Center, thanks to the advanced care of the ACHD team.

SACRAMENTO, Calif. – In recognition of its expertise in serving adults with congenital heart disease (CHD), Sutter Medical Center, Sacramento earned accreditation from the Adult Congenital Heart Association (ACHA), a nationwide organization focused on connecting patients, family members and healthcare providers to form a community of support and a network of experts with knowledge of CHD.

Individuals with CHD, the most common birth defect diagnosed in one in 100 births, are living longer. There are 1.4 million adults in the U.S. living with one of many different types of congenital heart defects, ranging among simple, moderate and complex.

“We find that patients born with a heart defect who have graduated from the care of a pediatric cardiologist frequently do not continue their care with a cardiologist with specific expertise in treating adults with congenital heart disease, and sometimes do not have a cardiologist at all,” said Pei-Hsiu Huang, M.D., medical director of the Adult Congenital Heart Disease Program and Cardiac Catheterization Laboratory at Sutter Medical Center, Sacramento. “As Sacramento’s first and only adult congenital heart disease program, we are excited to be recognized by the ACHA for providing ACHD patients, many of whom may not otherwise be seeing a cardiologist regularly, the best and most appropriate care.”

Pediatric Heart Surgeon Teimour Nasirov, M.D., left, is a member of the Sutter Medical Center, Sacramento ACHD team. In 2018, Dr. Nasirov repaired RJ Laffins’ atrial septal defect, which went undetected for 55 years. Laffins, right, is now winning cycling races thanks to his increased energy after the surgery.

The ACHA accreditation program aims to improve the quality of care ACHD patients receive by introducing standards for the infrastructure and the type of care ACHD programs provide. The Sutter Medical Center, Sacramento Adult Congenital Heart Disease Program received accreditation by meeting ACHA’s criteria, which includes medical services and personnel requirements, and going through a rigorous accreditation process, both of which were developed over a number of years through a collaboration with doctors, physician assistants, nurse practitioners, nurses, and ACHD patients.

“There are now more adults than children in the U.S. with CHD,” said Mark Roeder, President and CEO of ACHA. “Accreditation will elevate the standard of care and have a positive impact on the futures of those living with this disease. Coordination of care is key, and this accreditation program will make care more streamlined for ACHD patients, improving their quality of life.”

There are now 27 ACHA ACHD Accredited programs throughout the United States. The only other programs in California outside the greater Sacramento area that have been accredited are at UCLA and Stanford.

The Sutter Heart & Vascular Institute at Sutter Medical Center, Sacramento provides comprehensive cardiovascular care throughout a patient’s life. Specialized multisciplinary teams combine the resources and clinical expertise including high-risk obstetrics services and pediatric cardiovascular program, the comprehensive adult cardiovascular program including the Adult Congenital Heart Disease Program. Pediatric and adult heart disease specialists include board certified cardiologists, cardiovascular surgeons, cardiac anesthesiologists, obstetricians, physician assistants and nurse practitioners, nurses, registered dietitians, financial coordinators, pharmacists and genetic counselors.

About the Adult Congenital Heart Association

The Adult Congenital Heart Association (ACHA) is a national not-for-profit organization dedicated to improving the quality of life and extending the lives of adults with congenital heart disease (CHD). ACHA serves and supports the more than one million adults with CHD, their families and the medical community—working with them to address the unmet needs of the long-term survivors of congenital heart defects through education, outreach, advocacy, and promotion of ACHD research. For more information about ACHA, contact 888-921-ACHA or visit


The ACHA ACHD Accreditation Program was partially funded by Actelion Pharmaceuticals U.S., Inc. ACHA and Actelion Pharmaceuticals have partnered together since 2007 to support the CHD community.

For more information about ACHA, or to schedule an interview with Mark Roeder, please contact Terri Schaefer at 215-849-1260 or

For Volunteers, Rewards Come in Helping Patients –And Getting Smiles Back

Posted on Apr 11, 2019 in Palo Alto Medical Foundation, Scroll Images

Kelly Robutz, volunteer coordinator at PAMF’s Mountain View Center, shares a moment with volunteers Donald Holthaus and Noreen Ryker.

MOUNTAIN VIEW, Calif. — How would you like the most important task in your job to be providing that special touch that makes patients feel comfortable when they visit the doctor? To welcome them, smile at them, perhaps engage them in conversation, help with a wheelchair, give directions or arrange for a taxi?

Those are some of the high touch tasks performed by almost 150 volunteers who spend time at Palo Alto Medical Foundation (PAMF) offices in Mountain View, Palo Alto, Los Gatos, San Carlos and Sunnyvale. National Volunteer Week, observed April 7-13 this year, is a good time to highlight the impact of volunteer service and the power of volunteers to brighten a patient’s day, share their compassion and help build stronger communities.

Donald Holthaus and Noreen Ryker, two longtime volunteers, say it’s one of the best jobs in the world.

“I am so very happy that I am a volunteer,’’ said Holthaus, a retired engineer who has helped out at PAMF’s Sunnyvale Center since 2012. “I meet a lot of wonderful people here – -they are just like old friends.”

Noreen Ryker, who retired from banking, has been a volunteer at the Mountain View Center for twelve years.

“If patients want to talk, then you talk a bit,” Ryker said of her role at the front desk. “If they don’t, you smile and sometimes they look downcast, but then they smile back. It makes it all worthwhile.’’

Ryker, Holthaus and members of their families are patients at PAMF, and they say volunteering is one way they show their appreciation for the skilled care they have received over the years.

“For the most part, the volunteers are the first face a patients sees,’’ said Adrineh Poulatian, PAMF’s director of patient experience. “They set the tone and bring that positivity and passion and empathy – that is part of their DNA.’’

In addition to welcoming patients, volunteers serve on the Patient Advisory Council, which is made up of patient advisors who review information, communication materials and participate in improvement work for clinical programs to make sure a patient’s perspective is represented.

Students volunteer during the summer, usually helping at the Urgent Care Centers in Los Gatos and Mountain View.

Several volunteers bring dogs to visit with patients at the Cancer Center in Sunnyvale, arranged through a partnership with the Peninsula Humane Society.

“Our volunteers are a wonderful resource,” said David Quincy, M.D., Area CEO, Sutter Bay Medical Foundation, South Bay. “Our patients are always telling us they appreciate help from volunteers, and that they make a difference in a patient’s visit. The volunteers add even more to our patient-centered approach.”

Poulatian, Kelly Robutz and Anamarie Rodriguez, coordinators for the volunteer program, said they are impressed by how committed the volunteers are to making sure the patient has a good experience.

Some of the volunteers have retired from a career working for PAMF. And some of the students who have volunteered at PAMF have gone on to study medicine and pursue careers as physicians.

Last year, volunteers clocked 23,000 hours working at PAMF clinics.

Volunteers often go above and beyond their commitment. Holthaus volunteers two days a week starting at 8 a.m. But he often gets to the Sunnyvale Center earlier so he can help patients who are going to the lab that opens at 7 a.m.

And then there are “Madeleine Mornings” – the times when he brings madeleine cookies to the receptionists.

And there are more sobering times.  Holthaus recalled a woman who came out of a doctor’s office crying due to a difficult diagnosis for a family member.

“All you can do is give them a hug,” he said, adding that the woman calmed down.

“It can be hard, but I love it,’’ he said of his experiences as a volunteer.

For more information about volunteering at Sutter Health, please visit Volunteering at Sutter Health.






Dr. Steve Lockhart Honored for Skill and Service

Posted on Apr 11, 2019 in People, Quality, Scroll Images, Uncategorized

Sutter’s Chief Medical Officer Stephen H. Lockhart, M.D., Ph.D., has received a Distinguished Alumni Award from National Medical Fellowships (NMF). The award honors Dr. Lockhart for his commitment to improve healthcare and his passion for humanitarian work.

“Your leadership at Sutter Health, along with your wide-ranging experience as a healthcare administrator, academic achievements and remarkable philanthropic work, particularly your inspiring efforts in Haiti, make you a true role model and someone our young scholars should emulate as professionals,” wrote Esther R. Dyer, M.D., NMF president & CEO, in a letter to Dr. Lockhart.

NMF honors individuals who have made a lasting impact on healthcare and in the communities they serve. NMF is a nonprofit organization that provides scholarships and support for underrepresented minority students pursuing a career in medicine or the health professions.

NMF is the only national association solely dedicated to providing scholarships and support to students across all minority groups underrepresented in healthcare. NMF scholars come from low-income, minority, immigrant, urban and rural communities and demonstrate financial need.

NMF improves access to quality healthcare in medically underserved communities by increasing diversity the healthcare workforce. Learn more at



Bike ‘Rodeo’ Promotes Safety, Boosts Kids’ Confidence

Posted on Apr 11, 2019 in Eden Medical Center, Scroll Images, Uncategorized

CASTRO VALLEY, Calif. – Forty-five buckaroos from Stanton Elementary School in Castro Valley are riding a little taller—and more safely—in the saddle thanks to staff from Sutter’s Eden Medical Center who devoted a recent Saturday afternoon to teaching kids bike safety at a special Bike Rodeo.

“The highlight of the day was seeing the children who started out a little nervous and hesitant to ride gain the confidence to zip around like they’ve been riding forever—and knowing they had learned the skills to feel safe to ride,” said trauma injury prevention specialist Pam Stoker, who coordinated the event for Eden.

The Bike Rodeo began with experts from Bike East Bay teaching kids and parents how to check their bikes for functional safety, such as testing brakes and checking tire pressure. Then the children passed through several stations where they learned how to fit and wear their bicycle helmets appropriately, practiced riding drills that taught them how to ride their bikes safely in various ways (single file vs. side by side, turning, riding with one hand on their hip—all based on each child’s individual skill and comfort level) and learned hand signals and traffic rules, including how to handle intersections and crosswalks.

The Alameda County Transportation Commission’s BikeMobile provided no-cost repairs for the families who attended. In total, 36 bikes with problems varying from minor to more substantial received needed repairs. The Bike Rodeo is the start of a new partnership between Eden, Stanton Elementary PTA, BikeMobile and Bike East Bay collaborating to reduce bicycle-related injuries to kids.

Said parent Rebecca Stanek, “It was wonderful to see Stanton Elementary School students and other community members gain newfound skills and confidence on their bikes. And thanks to the BikeMobile, many families’ bicycles are in better shape than they were at this time last week. Many thanks to Eden Medical Center for hosting such a wonderful event for the school community!”

Memorial Hospital Los Banos Awarded Advanced Certification for Primary Stroke Centers

Posted on Apr 11, 2019 in Quality, Scroll Images

LOS BANOS, Calif.—Memorial Hospital Los Banos has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Centers. The Gold Seal of Approval® and the Heart-Check mark represent symbols of quality from their respective organizations.

“This is a very meaningful milestone for our community and our clinical care teams,” said Tushar Patel, M.D., medical director for stroke at Memorial Hospital Los Banos. “Our community can have confidence and peace of mind in knowing that exceptional stroke care is available here, thanks to the time and hard work invested by our staff.”

Memorial Hospital Los Banos, which is a part of Sutter Health’s not-for-profit, integrated network, underwent a rigorous onsite review last March. Joint Commission experts evaluated compliance with stroke-related standards and requirements, including program management, the delivery of clinical care and performance improvement.

“Memorial Hospital Los Banos has thoroughly demonstrated the greatest level of commitment to the care of stroke patients through its Advanced Certification for Primary Stroke Centers,” said Patrick Phelan, executive director, Hospital Business Development, The Joint Commission. “We commend their teams for becoming a leader in stroke care, potentially providing a higher standard of service for stroke patients in its community.”

“We congratulate Memorial Hospital Los Banos for achieving this designation,” said Nancy Brown, chief executive officer, the American Heart Association/American Stroke Association. “By adhering to this very specific set of treatment guidelines Memorial Hospital Los Banos has clearly made it a priority to deliver high quality care to all patients affected by stroke.”

Established in 2003, Advanced Certification for Primary Stroke Centers is awarded for a two-year period to Joint Commission-accredited acute care hospitals. The certification was derived from the Brain Attack Coalition’s “Recommendations for the Establishment of Primary Stroke Centers” (JAMA, 2000) and the “Revised and Updated Recommendations for the Establishment of Primary Stroke Centers” (Stroke, 2011).

Stroke is the number four cause of death and a leading cause of adult disability in the United States, according to the American Heart Association/American Stroke Association. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year. Memorial Hospital Los Banos’ certification comes just in time for May, which is National Stroke Awareness Month.