President’s Message

President’s Message

Posted on Aug 5, 2020 in President's Message | 0 comments

It’s been roughly six months since we started planning for COVID-19. We had early hints that the storm was going to come, with an early surge of cases in March. Administration and medical staff leaders came together to devise a plan on how we would handle this new threat; establishing a command center, creating surge plans and capacity to care for those affected, securing PPE, bolstering our testing capabilities, and obtaining therapeutics that may have some benefit. We weathered that initial precipitation quite well, perhaps also lucky that a massive surge did not overwhelm us in the way that it did in other states and localities.

Nationwide, we have approximately 4.5 million cases. Over 150,000 Americans have died. California now leads the country with over 493,000 cases. We have suffered over 9000 deaths. ABSMC has identified and cared for over 468 cases since the start of the pandemic, of which 20 have died. Our current census of COVID patients as of July 30 is 44 cases shared amongst the two campuses. There has been a concerning rise in the overall burden of cases in the community, and as a result, hospitalizations, in the last 2 weeks.

Those numbers above become more personal when among them are our own staff. We recently lost two employees to COVID-19. Janine Paiste-Ponder was an RN on PCU 6 and Juan Salgado was a chef in our Summit café. Both were valued members of our Summit family, and they exemplified the qualities of selflessness and caring that make our medical center so great. They will be greatly missed. I am frightened by the prospect that we will undoubtedly lose more staff members to this deadly disease.

Please know that we are doing everything we can to make this medical center safe for patients and employees. It is absolutely critical that we are consistent with messaging to our fellow doctors and nurses in regards to appropriate PPE, both within and outside the hospital. Miscommunication will only further sow mistrust and fear. Studies have shown that wearing a simple surgical mask while the patient is masked can drastically cut down on transmission. We have an opportunity to model to the community in our personal lives as well, wearing a facemask and eye coverings at all times, even while exercising or being outdoors.  We should not attend large in person gatherings, and limit nonessential travel. Only through concerted efforts inside and outside the hospital can we limit the spread of disease.

A note of positivity:

ABSMC Summit was nationally ranked as a high performing program in bypass surgery, heart failure, and COPD by US News and world report!

https://health.usnews.com/best-hospitals/area/ca/alta-bates-summit-medical-center-6930031#common-care-ratings

Please take care of yourselves and be safe.

Jeff Chen MD, MPH, FACEP
Chief of Staff, ABSMC Summit Campus

President’s Message

Posted on Jul 7, 2020 in President's Message | 0 comments

The death of George Floyd was shocking and horrifying. As the nation has reeled with massive social unrest for weeks, it is clear that there is a need for dramatic change in how black people are treated in this country. While it would be easy to assign some bad actors to systemic racism within law enforcement, we all have a duty to understand our part in the injustice.

It is imperative as health care providers that we examine and challenge our own implicit biases. This is not to say that all bias is intrinsically wrong, some of it may be informative and predictive. But bias influences how we make decisions for our patients, how we perceive their underlying medical problems, and most importantly, their outcomes.

Studies, including one within Sutter’s own population of patients, have shown that significant health disparities in both exposure and outcomes, as well as access to care, are disproportionate in communities of color. Please see link below for more information.

https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00598

Oakland is among the most ethnically diverse cities in the country; we have a duty to be both culturally sensitive and aware of the structural inequalities that have shaped the experiences of our patients.

On June 8, physicians and nurses took a knee for George Floyd to show solidarity with peaceful protests (see below).

I implore each of you to examine your own implicit biases and to do as much as you can to help balance the scales.

Jeff Chen, MD, MPH
Chief of Staff ABSMC Summit Campus

President’s Message

Posted on Jun 1, 2020 in President's Message | 0 comments

We’ve made it to June.

Unfortunately, the sense of relief that the pandemic has not surged through our hospital has been replaced by the increasing anxiety of how we successfully open up our services safely. As we’ve discovered, opening up has been a greater challenge than the lockdown posed.

I have the greatest confidence in our leadership and our staff that we can meet this challenge and safely deliver high quality care to our patients. Volumes are creeping up, though not to pre-COVID levels, our OR and procedural areas have been ramping up caseload, and we have testing capabilities in place to ensure that patients are adequately screened for the coronavirus. Things are not perfect, however, and we should not expect a return to how things used to be, as the new normal will undoubtedly be with us for at least the next year as we see a regular stream of COVID cases, and not until a vaccine/herd immunity takes effect. We should also anticipate that our work to be ever more challenging, with workflows that have become more complicated and time consuming, even for patients that would have been previously straightforward and simple.

Through it all, we must look after ourselves. The nature of our work is incredibly draining: physically, mentally, and emotionally. Every day that our batteries drain, we need to recharge them to be effective clinicians, in order to provide the empathic care that our patients expect. Whether that’s going for a hike, a bike ride, meditating, or cooking a delicious meal, we must treat ourselves to these moments of joy to stay whole. I ask you to connect with your fellow clinicians, see how they’re doing; oftentimes a kind word and sharing a laugh is enough for us to feel that what we’re doing is worth it.

Our Wellness medical director, Jill Kacher Cobb, has compiled these useful resources for you (listed below). Please avail yourself of these opportunities and don’t be shy!

In addition, Lenny Husen has started a small book lending library called the Resilience Shelf Project: books are available in the Doctor’s lounge, peruse and take one home, donate if you have something to contribute.

Leif Hass, our Wellness committee chair, has these thoughts:

Amazingly, disasters can lead to true emotional highs as we find ourselves being our best selves and working together.  Eventually, what goes up must come down and we can come down really hard when we are physically and emotionally exhausted.  Expect to have real low moments. I know I hit lows most every day in the last week or so.  I comfort myself by saying this is part of being a normal healthy human being.

What can really help is support – or as I often say a little love.  Be Your authentic self, if you are tired and a little down, let others at work know.  We are all caregivers.  I am sure any colleague you talk to will be there with some support and reassurance.

For those of us on the giving end remember, picking up a colleague builds culture and makes you feel good in the moment.

Be on the lookout for a survey about wellbeing from the Sutter research team.

Next week you will get an email about a quick survey. The results will help people from big Sutter down to our campus best help you all out!


Mental Health Resources including MANY free counseling sessions:

1. EAP-provided for free to all physicians on the ABSMC Medical Staff including a 24/7 crisis hotline and three free counseling sessions: 1-800-477-2258
2. Free counseling sessions provided by local Bay Area Therapists who are volunteering their time to help us out during the crisis. Click here for easy sign up for sessions: https://sites.google.com/view/cpbc-proj/home

3. Peer Support at ABSMC. Free one-on-one support from an ABSMC peer. Email us at peeroutreachABSMC@gmail.com

4. Dr. Pamela Wibble has been a nationwide resource for physicians at risk for suicide. https://www.idealmedicalcare.org/contact/?inf_contact_key=d914553d5079fa4f2638ad2b21296b60680f8914173f9191b1c0223e68310bb1

5. Another source for free counseling: https://www.7cups.com/

6. Resilience Consultations 1-650-756-7787 (Northern California). This is CMA’s 24 hour Physicians’ and Dentists’ 24 hour assistance line providing completely confidential doctor-to-doctor assistance. This service is free.

7. National Crisis Lines: 1-800-273-TALK or 1-800-SUICIDE

Fun things to do:

1. The Open Culture website is a gem. They scour the web for free courses, free audiobooks, and free language lessons, along with free movies, text books, business courses, educational videos, K-12 resources, art & images, music, writing tips, etc. Scroll down to find Choir! Choir! Choir! for weekly sing alongs and a link for Dolly Parton to read you a bedtime story. Not kidding! http://www.openculture.com/

2. The California Academy of Sciences with the museum at home with live streams and science labs/STEM-friendly activities: https://calacademy.org/academy-home

3. Free opera with the NY Metropolitan Opera: https://www.metopera.org/user-information/nightly-met-opera-streams/

4. Free Cirque du Soleil shows every Friday evening: https://www.cirquedusoleil.com/cirqueconnect.

5. Free virtual museum tours at many famous museums including the British Museum in London, The Uffizi in Florence, Musée d’Orsay in Paris: https://www.travelandleisure.com/attractions/museums-galleries/museums-with-virtual-tours

Stress Reduction/Meditation:

1. Headspace is free for health care professionals: provide your NPI number: https://www.theverge.com/2020/3/16/21181773/headspace-free-health-care-provider-public-health

2. Online yoga classes at Tahoe Yoga: http://www.tahoeyoga.com/

3. Mindfulness for Anxiety and Sleep-was free, may now need to pay: https://www.udemy.com/course/heal-anxiety-sleep-easily-tara-brach/

4. 21 Best Meditation Podcasts for busy people: https://www.verywellmind.com/best-meditation-podcasts-4771686#for-busy-people

5. 12 Mindfulness Hacks: https://medium.com/the-mission/12-mindfulness-hacks-you-can-use-in-24-hours-558fe00d7dd2

6. Mindfulness hacks for those who cannot sit still: https://siyli.org/resources/mindfulness-hyperactive-hack

7. Greater Good Science in Action: practice gratitude, empathy, connection and forgiveness; find the wonder and beauty in life; many free activities: science based practices for a meaningful life: https://ggia.berkeley.edu/

Self Care/Exercise:

1. Care tips for emergency responders from the CDC: https://emergency.cdc.gov/coping/responders.asp 

2. Peloton exercise app: offers many exercises and a virtual exercise community: https://www.onepeloton.com/app

3. A list of free online exercise offerings: https://www.fastcompany.com/90481514/these-free-online-exercise-offers-will-help-keep-you-fit-and-sane-during-the-coronavirus-pandemic

4. Nike is offering free exercise courses online: https://news.nike.com/news/nike-digital-health-activity-resources

Education:

1. Take one of 450 free online Ivy League courses: my high schooler is doing this and is having a blast! https://www.freecodecamp.org/news/ivy-league-free-online-courses-a0d7ae675869/

Kids:

1. Scholastic learn at home website for K-12 students: https://classroommagazines.scholastic.com/support/learnathome.htm

2. Kids Activities blog: a compilation of fun things to do at home with kids: https://kidsactivitiesblog.com/

3. Podcasts for kids: https://www.wired.com/story/best-podcasts-for-kids/

4. Mindfulness hacks to calm an anxious child: https://lemonlimeadventures.com/7-simple-mindfulness-hacks-calm-anxious-child/

5. List of educational online resources for kids and parents: https://smartsocial.com/online-activities/

A guide for difficult conversations with patients and families:

1. Vital Talk: a COVID-19 physician communication playbook for difficult conversations: https://www.vitaltalk.org/guides/covid-19-communication-skills/

Jeff Chen, MD, MPH
Chief of Staff ABSMC Summit Campus

President’s Message

Posted on May 1, 2020 in President's Message | 0 comments

It looks like the curve has flattened in the Bay Area. Our worst fears that our emergency departments and ICU’s were going to be swamped, thankfully, did not come to pass.

So what now?

As we begin the process of trying to figure out how to open up again, as a state, as well as a hospital, we are left facing new challenges. It is clear that our hospital volumes have diminished substantially during the last few months, but it is equally unclear whether or how we can regain the volume loss. The effects of this pandemic and the associated economic toll are just beginning. Many of our outpatient based practices have seen a significant decline in visits, and only some larger practices have instituted telehealth capabilities. Some of us have had to make difficult decisions to furlough non-essential staff.

As much as we as healthcare providers have worried about how we can safely provide care to our patients, both COVID and non-COVID, our patients have felt that same concern.

This story in the SF chronicle, which features interviews from Dr. Junaid Khan and Dr. Ronn Berrol, summarizes the fears of our patients accessing our medical systems and hospitals.

https://www.sfchronicle.com/bayarea/article/A-shelter-in-place-side-effect-Bay-Area-people-15219842.php#photo-19328615

We are carefully planning how we can address the non-COVID health care needs of our patients, as established disease processes are agnostic to this new kid on the block. It is vital that we do this, not only to adequately safeguard our community, but to maintain financial viability of the hospital. For this, we are asking for your help. Please circulate the below information to your patients and to your staff.

How We’re Managing Non-COVID-19 Care

At Sutter, your health is our main priority. We understand you might have concerns about going to an emergency room or to see your doctor if you don’t have COVID-19 (coronavirus) symptoms. That’s why we want to let you know that if you need any type of care, we’re here for you.

If you have a medical problem, please contact your doctor.
We may be able to schedule a video visit, or you may need to come in to be seen by your provider. If you visit a care center, be reassured that we’re actively isolating anyone with COVID-19 symptoms. All patients are screened before entering the building. It’s important not to delay seeking treatment when you need it.

Our emergency and urgent care facilities are open and ready to provide care.
We’ve taken several steps to make sure you’re safe when you come to our doctors’ offices, emergency departments and urgent care facilities:

  1. Mandatory Masking – All patients and visitors must be masked while in any of our care sites, with specific exceptions.
  2. Isolation – Anyone with COVID-19 symptoms is isolated from waiting areas, patient rooms, entrances and any space that the general population uses.
  3. Cleaning – Our teams are performing extra cleaning and disinfecting in all spaces.
  4. Employee Screening – We’ve instituted mandatory employee temperature screenings before each shift.

You can find out more about the steps we’ve taken to prepare for COVID-19 and answers to frequently asked questions on our website.

If you or someone you know is experiencing an emergency such as a heart attack or stroke, it’s essential to seek care immediately by calling 911 or going to the nearest emergency room.

Thank you for trusting us with your care, and for the support and gratitude you’ve shared for our clinicians on the front lines. Together, we’re #SutterStrong.

SEND TO A FRIEND

I want to thank you all for your resilience. The medicine that we practice now is drastically different than three months ago, and it is incumbent upon us to determine how, as a medical staff, we can envision the shape and direction of healthcare going forward at ABSMC. I am continually impressed with the level of engagement and volunteerism that our medical staff has demonstrated during this crisis.

We rely on our hospital administrative partners: Ursi Boynton, CME, Denise Navelier, CNE, Patty Pilgrim, CFO, to channel that vision, and I want to thank them for the incredible work that they have done to get our hospital ready, to train staff, to procure critical PPE. We welcome David Clark, our new CEO, who has done an amazing job in the last year as our interim CEO, as he helps to lead ABSMC in the challenging times ahead.

President’s Message

Posted on Apr 2, 2020 in President's Message, Uncategorized | 0 comments

Dear Colleagues,

We are at the forefront of a monumental challenge in the fight against COVID-19. This global pandemic has ripped apart the norms by which we practice medicine, threatens to sicken us as we care for those affected, and will undoubtedly alter forever the nature of our social fabric.

It is with that understanding that I feel ever more committed to my community – my neighbors, my colleagues, and my patients. Every day I go to work, I reassure myself that my training and experience have prepared me for this. Our senior administrative leaders have been working tirelessly with our physicians to plan and execute a strategy for dealing with the pandemic. We are expanding our clinical footprint, re-purposing existing spaces, flexing staff to meet the demands.

Is it enough?

Reading and watching the news is profoundly sobering. New York has a growth and death curve for the disease that surpasses the tragedy occurring in Italy and Spain. Is California only a week or two behind? Did the shelter in place order enacted by our counties and our state do enough to “flatten the curve” locally?  There are more questions than answers.

Let me acknowledge all the fears and anxieties that you face, because I have them too. I worry about getting sick, and exposing my family to disease. I worry about my colleagues who are older and with medical conditions that put them at greater risk. These are my friends. My greatest comfort and expectation is knowing that in these extraordinary times, we physicians will act extraordinarily.  Already I have received pledges of support from physicians in the community, physicians returning to bolster the ranks, and offers from other specialties to fill in wherever they are needed.

 We must also be mindful to care for ourselves in all of this. Get some sleep. Go for a run. Read your kid a story. Catch up on Game of Thrones. Get in touch with friends through FaceTime. In such difficult times, it is often the little things that will get us by.

If those little things are not enough, our EAP for physicians is going live on April 1. This is a resource that can help you with free counseling, referrals for pet care/child care etc.

Call 800-477-2258 or email eap@sutterhealth.org

You can also reach out to peer support @ peeroutreachabsmc@gmail.com

Attached is also a list of resources from the Palo Alto Medical Foundation, some of them dealing specifically with coronavirus.

President’s Message

Posted on Mar 3, 2020 in President's Message | 0 comments

Hello!

My name is Jeff Chen, your new chief of staff. I am an emergency physician by training and have been working at ABSMC for the past 14 years. I am excited to represent all of your concerns over the next two years.

Before going further, I would like to recognize Dr. Jill Kacher Cobb for her incredible leadership, energy, and vision these past two years, and for the remarkable efforts she has made to further physician wellness and engage with our hospital administration to work towards our common goals.

My journey into medicine started of course as a patient. As a young man, I had embarked upon many perilous activities that invariably landed me in the emergency department for treatment. I was always thankful for the care that I received and felt the innate vulnerability that one feels when ill or suffering. It is this intrinsic human-ness that lends to our ability to care for others, that we have been or certainly most will be in that place. As patients, we have implicit trust in our doctors, and yet that faith that the care will be safe, personal, and accessible is not one that is easily achieved.

We practice in difficult times. Our patients expect and deserve the best that we can give. We are constantly asked to do more with less time. Distractions abound. Innovations in technology encourage more time in front of a screen instead of a face. Market forces, legislative mandates, and the changing demographics of our community threaten to curb our ability to practice.

At the heart of it all, the connections we make with our patients, those moments in which we remember that we too are patients, is what makes our care truly special.

Tip of the month:
Practicing safe medicine requires that we be cognizant of the possibility of error. Before critical tasks, whether procedurally based or cognitive:

Stop
Think
Act
Review

Congratulations to the ABSMC Mitral Valve program, which earned the Society of Thoracic Surgery 3 star (out of 3 stars) rating for 2016-2019, of which only 4 out of 133 programs in the state received 3 stars! This was due to the combined efforts of our excellent thoracic surgeons, cardiologists, anesthesiologists, and ancillary staff. Kudos!

Jeff Chen MD, MPH, FACEP
Chief of Staff, ABSMC Summit Campus