CHW Healthcare Blog

Lloyd Dean Among Health Care's Most Influential

We're pleased to announce that Catholic Healthcare West's president/chief executive officer, Lloyd H. Dean, has been recognized as one of the nation’s top 20 most influential people in health care by Modern Healthcare magazine. This marks the fifth consecutive year Mr. Dean has been named to the list. He is ranked 19th, up from 24th in 2010.

“I am truly honored to be recognized among so many extraordinary leaders,” said Mr. Dean. “I look forward to continuing my work with them to ensure that our nation’s health care system delivers the best quality care in the world and that it covers all in need.”

Mr. Dean went on to observe that the predominance of political leadership at the top of the list is not unexpected given the 2012 elections and the ongoing debate about the constitutionality of the health care reform law, but cautioned that change is unavoidable. “Regardless of what occurs in Washington, D.C., the health care system in the United States needs to change,” Dean said. “Every day we see the impact of our broken health system on the communities we serve. We are committed to seeing that the fundamental human right of health care is a reality for everyone.”

Mr. Dean took a leadership role in advocating for health care reform, both in his capacity as President/CEO for Catholic Healthcare West and as chairman of the Catholic Health Association of the United States in 2008. He also worked directly with Congressional leaders and the Obama Administration in supporting passage of the Patient Protection and Affordable Care Act.

Under Mr. Dean’s leadership, CHW has been preparing for the changing health care environment for many years. The organization has been an early adopter of programs that improve care and lower costs. CHW’s severe sepsis prevention program saved nearly 1,000 lives and reduced costs by more than $36 million over the course of three years. Additionally, a pilot Accountable Care Organization in Sacramento showed a 15 percent drop in readmissions and $15.5 million in cost savings.

Over the next ten years the organization will be diversifying into ambulatory settings, launching health plan capabilities, and expanding the use of electronic health records for both caregivers and patients.

Nominations for the Modern Healthcare list were submitted by readers, narrowed by the magazine’s editors, and then opened to voting. Reader selections represent 50 percent of the final outcome. Senior editors of Modern Healthcare determined the other 50 percent.

In his role as President/CEO, Mr. Dean is responsible for $12 billion in assets and the overall management, strategy and direction of CHW’s integrated health care system of 40 hospitals, 45 health clinics, 9 trauma centers, two medical practice groups, 55,000 employees, and 10,000 physicians. CHW serves a population spanning 22 million people throughout California, Arizona, and Nevada.

Remote Heart Rate Monitoring Supports Pregnant Moms

Doctors at our Sequoia Hospital in Redwood City can now remotely monitor heart rates during labor. Check out this news story:

 

Nationwide Maps Help Public Health Planning

Today we made our groundbreaking Community Need Index™ (CNI) available online at www.chwHEALTH.org/cni. This is a powerful resource for public health planning that is being used by health care and community organizations nationwide to assess community need and strategically allocate resources.

The CNI aggregates socioeconomic indicators long known to contribute to health disparity and then applies that data to hospital admissions. CHW’s research has shown that residents of communities with the highest CNI scores (zip codes shown in red on the online maps) are twice as likely to be hospitalized for manageable conditions – such as asthma, pneumonia, or congestive heart failure – as communities with the lowest CNI scores (zip codes shown in blue).

“Tens of thousands of people are admitted to our hospitals every year for conditions that, if properly treated in a primary care or community clinic setting, should not progress to the stage where hospitalization is needed,” said Dr. Robert Wiebe, chief medical officer for CHW. “Because of the barriers to health care access that many of these patients face, they often do not seek care until it is too late to treat the condition in an outpatient setting. This is more than a community health issue. It is a social justice issue.”

 Costs for treating these conditions, known as ambulatory care sensitive conditions, across CHW’s network of 40 hospitals were more than $261 million in fiscal year 2010. This represents more than 29,000 hospitalizations and more than 120,000 inpatient days. Nationwide, there were approximately 2.9 million hospitalizations for these conditions in 2010.

“CHW has done some pioneering work creating this Community Need Index to tackle the issue of ambulatory care sensitive conditions,” said John Whittington, MD, lead faculty for the Institute for Health Improvement. Dr. Whittington leads the Triple Aim Project, an international collaboration of organizations working to improve population health, enhance the patient experience of care, and reduce the per capita cost of care. “Within the framework of the Triple Aim we think this tool will be helpful for the work that many organizations are attempting in the U.S. We appreciate greatly CHW’s willingness to openly share this tool with others.”

CHW hospitals have been using the CNI to reduce and prevent hospitalizations for 17 conditions that are considered ambulatory care sensitive. Between 2008 and 2010, CHW hospitals invested $5.7 million in preventive and disease management programs for patients who had been deemed at risk for hospitalization for asthma, diabetes, or congestive heart failure. This focus resulted in 8,917 individuals participating in disease management programs and a subsequent 86 percent reduction in admissions for these patients.

“As one of the largest safety net health care providers in the nation, we have a responsibility to improve the health and well being of the communities we serve,” said Lloyd H. Dean, president/chief executive officer of CHW. “In a reformed health care environment we must also maintain our focus on reducing the cost of care while we improve the quality of life. We have identified a tremendous opportunity through this tool to target our preventive health care services where they are needed most and where they will have a significant impact on the overall health of the nation.”

The CNI aggregates five factors long known to contribute to health need – income, culture/language, education, housing status, and insurance coverage for every zip code in the United States. The interactive site also allows users to identify where community resources – hospitals, urgent care centers, shelters, farmer’s markets, etc. – are located. This feature provides a means for community groups, policy makers, and health organizations to visually compare the level of need alongside the availability of resources. 

There are currently more than 30 hospitals and health systems using the CNI for local health planning, including Parkland Health & Hospital System in Dallas, Texas. “CHW’s Community Need Index has become an important part of our community and health system planning efforts,” said Sue Pickens, director of population medicine for Parkland Health & Hospital System. “It has helped us define service areas, locations for new health centers, and targeted outreach activities. We have also shared it with our community partners to help identify communities needing interventions. It has been a valuable tool for Parkland and its community partners.”

CHW pioneered the national index in 2005 in partnership with health data provider Thomson Reuters to help health care organizations, nonprofits, and policy makers identify and address barriers to health care access in their communities. The online tool, as well as more detailed information about the methodology for the CNI, can be accessed at www.chwHEALTH.org/cni.

Chandler Regional Launches Stroke Care Program

CHW's Chandler Regional Medical Center has launched a new program for the care of stroke victims. Stroke symptoms include the abrupt onset of slurred speech or other difficulty talking, difficulty with balance, inability to lift an arm or a leg or loss of sensation in an arm or a leg. In a stroke, a small clot appears in a blood vessel, preventing blood flow to that part of the brain.

With the implementation of this new program, a patient who arrives at Chandler Regional with stroke symptoms will be seen by an ER physician within 10 minutes. A CT scan will be read within 25 minutes, and, if doctors decide clot-buster drugs are needed, the patient will get them within an hour.

Read more at the Arizona Republic.

CHW Makes $3.87 Million in Community Grant Awards

We are pleased to announce that Catholic Healthcare West has made more than $3.87 million in grant awards during our 2010 cycle to non-profit organizations in California, Arizona, and Nevada. These grants are a vital part of our commitment to the communities we serve. Just as we commit ourselves to quality, compassionate health care at our hospitals and health centers we also dedicate ourselves to fostering healthy communities. These grants are helping expand community resources and improve the overall quality of life.

Grant awards typically range from $5,000 to $50,000 and support local needs such as chronic disease management programs, shelters for the homeless and victims of domestic violence, and childhood nutrition and dental care. Since 1990, we have awarded nearly $37 million in grants to local non profit organizations.

To be selected for a CHW grant, the organization or program must meet one or more of the following criteria:

• Address the greatest health needs of the community;
• Emphasize prevention to addresses the underlying cause of health problems;
• Contribute to a seamless continuum of care;
• Build upon and mobilize existing services in the community; and
• Engage diverse community stakeholders in implementation and oversight.

Read more about these grants at the Sacramento Bee and the Ventura County Star.

You can also visit our website to learn more.

Nation's Elite Center for Neurosurgery Launches New Research Center

The Barrow Neurological Institute of Phoenix, which is part of CHW's St. Joseph's Hospital and Medical Center, is one of the nation's elite centers for neurosurgery. The Institute performs about 6,000 neurosurgical procedures each year, including 1,200 brain surgeries, and is regularly listed among the best hospitals in the nation by US. News & World Report and Becker's Hospital Review.

We're pleased to announce the development of a new research center aimed at battling the deadliest of brain cancers. Backed by a planned $8 million endowment, the Barrow Brain Tumor Research Center will create a team of surgeons and scientists to use new tools, investigate new drugs and pursue breakthroughs to prolong the lives of brain-cancer patients. The goal is ambitious since progress against brain cancer has been painfully slow. Gliomas, the term for tumors that sprout in supportive brain tissue, account for 80 percent of all malignant brain tumors. While major diseases such as breast, lung and colon cancers attract considerable funding and research, it is difficult to attract comparable funding that draws scientists into the brain-tumor field because the disease, though deadly, afflicts far fewer people.

The Barrow center will hire scientists to develop five labs that focus on different areas of brain-tumor research. Two of the labs will study the role adult stem cells play in brain-tumor development. Another will focus on developing ways to prod a person's immune system as a vaccine against brain tumors. Other labs will study epigenetics, an emerging field that studies how non-genetic factors can influence how genes change or adapt. The Barrow center's goal is to double the number of clinical trials available to patients within five years, continuing until every patient has the opportunity to participate in an investigational study.

Read more at The Arizona Republic

Cord-Blood Bank Assists with CHW's Stem Cell Research

The first pouch of precious, potentially lifesaving stem cells found its way into a cryogenic freezer in an inconspicuous research center in Gilbert last month.

Brigid Wilson, born Sept. 2 at St. Joseph's Hospital and Medical Center in Phoenix, became the first umbilical-cord-blood donor for the new Celebration Stem Cell Centre, which has its grand opening Thursday.

It is the Valley's first cord-blood bank and the only one in Arizona to offer free public donation services. Donated cord blood can be processed for adult stem cells and put onto a national transplant registry.

The Wilson family, including Brigid's parents Dave and Deidre, of Phoenix, were excited to advance what they believe is a promising field of science.

Cord-blood stem cells, drawn from a newborn's umbilical cord, have the potential to treat serious diseases such as cerebral palsy, Parkinson's disease, Alzheimer's disease, multiple sclerosis and strokes.

"This is an area of science and medicine that has shown good potential," said Deidre, 35,a general practice physician. "I think people can do great good with something that's so simple and doesn't involve harm to anyone."

As the new blood bank's first donor family, the Wilsons said they hope to encourage more families to consider cord-blood banking or donation.

"Cord blood normally just goes to waste, so there's all that potential out there that families could be giving to a scientific effort," Deidre said.

Unlike embryonic stem cells, cord-blood research has not stirred controversy and is supported by conservative political groups including the Family Research Council.

For the Wilsons, who are Catholic, it's an important difference.

"We felt that embryonic stem cells are derived from the destruction of human embryos, whereas adult stem cells can come from all the different body tissues as well as the cord blood," Deidre said.

Dr. Nabil Dib, head of the Cardiovascular Research Center at Mercy Gilbert Medical Center, has been using adult stem cells in clinical trials for people with heart failure and last year began treating heart-attack victims.

During treatment, doctors transplant the stem cells into a patient's heart via a catheter, without surgery. About a dozen stem cells are applied into and around the damaged heart tissue. The stem cells can then develop into heart cells and repair damaged tissue.

Dib is now also working with the Celebration Stem Cell Centre as medical director.

(Read more at The Arizona Republic)

Partnering with Shamans to Provide Culturally Competent Care

While the Affordable Care Act is challenging us to provide higher quality care at a lower cost -- for the most part by standardizing the processes and procedures that are known to deliver the best outcomes -- we must also continue to put that work in the cultural context of our patients. CHW's work with Hmong refugees in Merced, California has become a national model for how health care providers can partner with the community to provide great care.

Take a look at today's Bakersfield Express, which gives a glimpse into how the Hmong community in Merced is working with Western doctors:

Most Hmong had not experienced Western medicine until they came to the United States. Surgery and medical technologies were foreign to them. Many feared and distrusted American doctors. Instead, they relied on traditional medicine, which sometimes frustrated the mainstream medical community. American physicians were concerned about some of the shamans’ methods, such as mixing water and saliva to use on patients. Dr. John Paik-Tesch of Mercy Medical Center in Merced has worked with the Hmong community for two decades.

“Generally, with the Western point of view, we’re somewhat skeptical of shamanism, how it affects medical illnesses, per se, but at the same time there’s a recognition of the fact that it’s part of their cultural belief systems,” he says. “And I think shamans support them from more of a spiritual, emotional point of view, which can be very beneficial for the well-being of the patient.”

The 1997 book “The Spirit Catches You and You Fall Down” by Anne Fadiman documents the clash between Western and Hmong medicine. It tells the story of an epileptic Hmong girl in Merced and conflicting beliefs about her treatment. Over the years, education has increased trust between U.S. doctors and Hmong shamans.

Last year, Mercy Medical Center created a formal policy, making it easier for shamans to perform ceremonies inside the hospital. It’s the first of its kind in the nation.

 

Hybrid Endovascular Suite is First of Its Kind

CHW's Saint Mary's Regional Medical Center has opened a new hybrid endovascular suite for treating cardiac and vascular patients. The endovascular suite is the first of its kind in the region and streamlines cardiovascular imaging, vascular procedures, and surgical services into one room.

The suite also allows physicians to switch minimally invasive operations into open surgical procedures should the need arise without having to transport the patient to a different area, said Dr. John Hansen, medical director of Saint Mary's Vascular Institute. In a typical setting, patients with a serious vascular condition such as an aortic aneurysm would undergo imaging in one area, then catheterization and other diagnostic tests in another. If surgery is necessary, the patient would be transferred to a separate operating room, compromising critical minutes and increasing the time under anesthesia. "The new hybrid vascular operating room will allow for multiple combined procedures to be performed simultaneously in one setting, reducing risk and improving outcomes for our patients," Hansen said.

(via The Reno Gazette-Journal)

New Cancer and Neuroscience Center Opening in Woodland

CHW's Woodland Healthcare is slated to open a new Cancer and Neuroscience Center in late October. The hospital is asking members of the community to pitch in for some of the finishing touches.

Colleen Brock, of the Woodland Healthcare Foundation, said that fundraising efforts hope to collect nearly $200,000, which will be used to purchase equipment, furnishing and other services that will be located throughout the new center.

The total cost of the renovations, which will convert the old OB/GYN building into modern facility, is estimated to cost about $2 million, the majority of which is being paid for by Catholic Healthcare West.

Brock said that the renovations began sometime in the early summer months and are expected to be complete toward the end of this month. Once finished, the new facility will feature several outdoor patios and healing gardens to be enjoyed by the center's patients.

(via The Daily Democrat)