Stanford Health Care People: Fall 2018

STANFORD HEALTH CARE

A PUBLICATION FOR EMPLOYEES OF STANFORD HEALTH CARE

FALL 2018

PROTECTING QUALITY HEALTH CARE STANDOUT STORIES BLOOD ON BOARD

from the CEO Dear Colleagues, In the November 6 election, residents of Palo Alto and Livermore will vote RQ D EDOORW LQLWLDWLYH WKDW LI SDVVHG ZRXOG KDYH D VLJQLĂĽFDQW DQG QHJDWLYH impact on Stanford Health Care, SHC ValleyCare, other local providers, city government, and the patients we serve.

Called Measure F in Palo Alto and Measure U in Livermore, the ballot initiative would force SHC to cut our budget by nearly 25 percent—making it impossible to continue offering many of our patient care services and programs.

We would need to reconsider how to use the new hospital building that is slated WR RSHQ QH[W \HDU DQG HOLPLQDWH SODQV WR UHWURĂĽW FXUUHQW IDFLOLWLHV 7KH PHDVXUHV would also apply to many other local providers, including dentists, optometrists, and other small specialty practices in our communities.

For patients and their families, these measures would limit their access to care in Palo Alto and Livermore. For employees, the measures would have a drastic effect on the entire SHC community.

7KH PHDVXUHV ZRXOG DOVR IRUFH FLW\ JRYHUQPHQW WR LPSOHPHQW WKLV FRQIXVLQJ DQG ill-advised initiative, costing taxpayers millions of dollars and potentially putting other public services at risk. Hospitals are already highly regulated by federal and state governments. Adding another layer of bureaucracy is unnecessary and would GLYHUW WD[SD\HU GROODUV IURP RWKHU SUHVVLQJ FLW\ QHHGVÔOLNH üUH DQG SROLFH Given the potential consequences of Measure F in Palo Alto and Measure U in Livermore, this edition of SHC People provides helpful information about what the ballot initiative means for you and your colleagues—and what SHC is doing to defeat it.

Other articles focus on our record of patient safety and how we continue to improve. As you know, we recently announced that SHC was again ranked ninth on U.S. News & World Report’s Honor Roll of the best hospitals in the country.

7KH UDQNLQJ UHĂŚHFWV RXU RXWVWDQGLQJ SHUIRUPDQFH LQ TXDOLW\ SDWLHQW VDIHW\ DQG reputation, among others. I want to thank all of you for making this possible.

SHC leadership is committed to maintaining our world-class status as an academic medical center. We will be working hard to defeat Measure F and Measure U over the coming weeks so that we can continue to provide H[FHSWLRQDO FDUH WR DOO ZKR FRPH WKURXJK RXU GRRUV $V DOZD\V 7+$1. <28 IRU everything you do to improve the health of our patients each and every day.

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STANFORD HEALTH CARE PEOPLE is produced by the Corporate Communications Department.

Send comments to communications@stanfordhealthcare.org.

2 / STANFORD HEALTH CARE PEOPLE

PROTECTING

QUALITY

HEALTH

CARE SHC JOINS COALITION OF LOCAL HEALTH CARE PROVIDERS TO DEFEAT HEALTH CARE SPENDING INITIATIVE IN PALO ALTO AND LIVERMORE

I

N THE NOVEMBER 6 ELECTION, PALO ALTO AND LIVERMORE RESIDENTS WILL VOTE ON A BALLOT INITIATIVE THAT MISLEADINGLY CLAIMS TO CONTROL HEALTH CARE COSTS. In reality, the initiativeâ&#x20AC;&#x201D;

called Measure F in Palo Alto and Measure U in Livermoreâ&#x20AC;&#x201D; does nothing to address health care costs or limit prices charged to patients who have insurance coverage. Instead, it poses far-reaching, negative consequences for a broad range of health care providers, the Palo Alto and Livermore city governments and, ultimately, the patients and people we care about and serve.

Sponsored by the Service Employees International Union-United Healthcare Workers West (SEIU-UHW), the initiative would require providers and hospitalsâ&#x20AC;&#x201D; including SHCâ&#x20AC;&#x201D;to pay rebates to insurers without any requirement that the rebates be passed on to patients. While the

LQLWLDWLYH ZRXOG SDG WKH SURĂĽWV RI IRU SURĂĽW RXW RI VWDWH LQVXUDQFH FRPSDQLHV LW ZRXOG QRW EHQHĂĽW SDWLHQWV DQG WKH people we serve.

The initiative impacts large health systems like Stanford Health Care, Kaiser, John Muir Health and the Palo Alto Medical Foundation, as well as local dentists, optometrists and other small specialty practices in our communities. â&#x20AC;&#x153;This ballot initiative would put Palo Alto and Livermoreâ&#x20AC;&#x2122;s entire health care systems at risk,â&#x20AC;? said David Entwistle, President & CEO. â&#x20AC;&#x153;Thatâ&#x20AC;&#x2122;s why we oppose Measure F in Palo Alto and Measure U in Livermore. They would do nothing to improve health care quality, patient safety or accessibility.

In fact, they will only jeopardize access to Stanford Health Care, Palo Alto Medical Foundation, Kaiser Permanente, medical clinics and other health care providers.â&#x20AC;?

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STANFORD HEALTH CARE PEOPLE / 3

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HOW would the measures impact SHC?

effect on the entire SHC community.

It would also threaten our world-class status as an academic center that supports research and education.

â&#x20AC;&#x153;It is estimated that Measures F and U would cut SHCâ&#x20AC;&#x2122;s budget by nearly 25 percent,â&#x20AC;? said Quinn 0F.HQQD &KLHI 2SHUDWLQJ 2IĂĽFHU â&#x20AC;&#x153;If the measures were to pass, they ZRXOG UHGXFH WKH ĂĽQDQFLDO UHVRXUFHV available to take care of our patients and take care of our staff.â&#x20AC;?

Similarly, the two ballot measures would force smaller community hospitals, medical clinics, local dentists, optometrists and small specialty practices to reduce services, cut back on hours of operation or even relocate to communities not burdened by this measure. This would VLJQLĂĽFDQWO\ OLPLW DFFHVV WR SDWLHQW care for not only SHC patients but others in the area.

According to an analysis of the impact on SHC, the budget reduction would make it impossible to continue our current offering of patient care services and programs. This would force SHC to reconsider how to use the new hospital building that is slated to open next year and HOLPLQDWH WKH DELOLW\ WR UHWURĂĽW FXUUHQW facilities. As a result, SHC would only be able to offer a small subset of specialty services to patients and would be forced to eliminate other services, which would have a drastic

â&#x20AC;&#x153;Hospitals recognize that health care is costly. We are always working to bring costs down,â&#x20AC;? said McKenna. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re on a journey to help improve the effectiveness and HIĂĽFLHQF\ RI WKH FOLQLFDO VHUYLFHV ZH deliver. These initiatives only take resources out of the community and give them back to out-of-state insurance companies.â&#x20AC;?

WHY is this initiative on the ballot?

VOICES â&#x20AC;&#x153;I am concerned that this ballot initiative would limit access to important medical services for patients in our community, not only for patients coming to Stanford Health Care but all patients receiving care in Palo Alto. If passed, it would result in unsustainable budget cuts and dramatically affect Stanford Health Careâ&#x20AC;&#x2122;s ability to deliver patient care. We would have to reduce and potentially close certain services and programs, undermining our commitment to providing world-class care to the population of patients we serve.â&#x20AC;?

KNOW THE

The Service Employees International Union-United Healthcare Workers West (SEIU-UHW), which has sponsored and is promoting both Measure F and Measure U, claims they will cut health care prices. But the union has tried to use these types of measures in the past solely to gain concessions from hospitals.

HOW would the measures impact Palo Alto and Livermore?

Measures F and U also add an unnecessary and expensive layer of bureaucracy to the health care payment system. Hospitals in California are already regulated by the federal government and the state, said Andy Coe, &KLHI &RPPXQLW\ 5HODWLRQV 2IĂĽFHU DW 6+& ,I WKHVH PHDVXUHV SDVV WKH cities of Palo Alto and Livermore would be forced to administer a new and complex health care reimbursement system, costing taxpayersâ&#x20AC;&#x2122; money and potentially putting other public services at risk.

Coe said the ballot initiative is part of a highly coordinated campaign designed to pressure SHC into allowing SEIU-UHW direct access to its non-unionized employees to expand its membership. â&#x20AC;&#x153;The union has used a similar strategy at a statewide level for years,â&#x20AC;? said Coe, â&#x20AC;&#x153;to gain the ability to organize workers at hospitals where they donâ&#x20AC;&#x2122;t have representation.â&#x20AC;?

WHAT is SHC doing to defeat the initiative?

SHC is part of a broader coalition of business and community leaders, hospitals and other health care providers in Palo Alto and Livermore. The coalition is being led by the California Hospital Association for its expertise in organizing and developing campaigns to defeat initiatives such as these. â&#x20AC;&#x153;It will be a major campaign to engage voters to vote no on these initiatives,â&#x20AC;? said Coe. There is also a strong RSSRVLWLRQ IURP ORFDO HOHFWHG RIĂĽFLDOV LQ 3DOR $OWR DQG /LYHUPRUH WKDW ZRXOG EH responsible for implementing and enforcing the new measures if passed.

These measures are opposed by a wide-ranging group of health care providers, FRPPXQLW\ OHDGHUV QRQSURĂĽWV KRVSLWDO VWDII DQG YROXQWHHUV SDWLHQWV DQG RWKHU concerned citizens who do not want access to quality local health care limited.

Opponents of Measure F include Palo Alto Medical Foundation, Stanford Health Care, Kaiser Permanente, Mid-Peninsula Dental Society, Hospital Council of Northern and Central California and California Hospital Association.

Through the Protect Palo Alto and Protect Livermore organizations, SHC leaders and interested employees are participating in a variety of community outreach efforts to educate voters before the November election.

employee

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â&#x20AC;&#x153;Measure F would require the City of Palo Alto to create an entirely new department to regulate the health care industry. They have no expertise in managing health care expenses for all providers in the city.

As a Palo Alto resident, it would also cause me to have to pay even higher property taxes or lose services in other vital areas.â&#x20AC;?

Teresa Bell-Stephens, BSN, RN, CNRN Department of Neurosurgery

â&#x20AC;&#x153;I would characterize Measure F in Palo Alto as strange, perplexing, unnecessary, unwarranted and XQMXVWLĂĽHG ,W VHHPV WR KDYH DULVHQ as a labor-based tactic simply designed and intended to disrupt Stanfordâ&#x20AC;&#x2122;s exceptional health care services. Why? How does that damage help the union? Iâ&#x20AC;&#x2122;ve yet to VHH RU SHUFHLYH DQ\ WUXH EHQHĂĽWV that might result from this initiative.â&#x20AC;?

HOW can employees get involved?

Stanford Health Care encourages interested employees to get involved LQ PXOWLSOH ZD\V VDLG 'DYLG ' -RQHV &KLHI +XPDQ 5HVRXUFHV 2IĂĽFHU Employees who live in Palo Alto and Livermore and wish to help can become informed on the initiative, share their knowledge with others and get out and vote, he said. They can also choose to post a campaign signâ&#x20AC;&#x201D;â&#x20AC;?Protect Palo Alto: No on Measure Fâ&#x20AC;? or â&#x20AC;&#x153;Protect Livermore: No on Measure Uâ&#x20AC;?â&#x20AC;&#x201D; on their property or in their window.

Both resident and non-resident employees alike can also publicly add their name to a list of individuals who oppose the initiative or print out materials to hand out to neighbors and friends.

All these activities are purely voluntary, emphasized Jones. SHC employees are entitled to their own views on the initiatives. No one in the SHC community should take offense, react negatively or retaliate against colleagues for supporting or opposing the ballot measure.

Chief of General Primary Care

4 / STANFORD HEALTH CARE PEOPLE

Guest Services Navigator Stanford Medicine Outpatient Center

In the November 6 election, Palo Alto and Livermore residents will vote on a ballot initiative that misleadingly claims to control health care costs. In reality, the initiativeâ&#x20AC;&#x201D; known as Measure F in Palo Alto and Measure U in Livermoreâ&#x20AC;&#x201D;does nothing to address health care costs or limit prices charged to patients who have insurance coverage.

If passed, the ballot measures would: 1. Force us to cut our budget by nearly 25 percent. )RUFH 6+& WR VLJQLĂĽFDQWO\ FXW EDFN DQG HYHQ FORVH PDQ\ services and programs, which would have a drastic effect on the entire SHC community.

For more information, or to sign up to endorse the campaign against Measures F and U, interested employees should go to protectpaloalto.org or protectlivermore.org.

â&#x20AC;&#x153;If passed, the initiative would place enormous administrative costs on the city government while rewarding the insurance companies, all at the expense of patient care and the local taxpayers. The initiative will not solve any cost problems; rather, it will take money away from many necessary clinical services. Some of our patients need specialized care programs we do not currently have or that we are trying to grow. With less funding comes fewer programs, and those patients in need of growing or developing programs may go without.â&#x20AC;?

Ann Fehring Larkin Megan Ruth Mahoney, MD

FACTS

Jared Roberts

3. Cause SHC to reconsider how to use the new hospital building WKDW LV VODWHG WR RSHQ QH[W \HDU DQG HOLPLQDWH DQ\ SODQV WR UHWURĂĽW the current SHC facilities, which would reduce patient beds and services. )RUFH 3DOR $OWRĂ&#x2013;V PHGLFDO FOLQLFV DQG GRFWRUVĂ&#x2013; RIĂĽFHV WR UHGXFH VHUYLFHV cut back on hours of operation, or even relocate to communities not EXUGHQHG E\ WKLV PHDVXUH Ă&#x201D; VLJQLĂĽFDQWO\ OLPLWLQJ DFFHVV WR SDWLHQW care not only for SHC patients but for others in the area.

5. Require the cities of Palo Alto and Livermore to implement and enforce this confusing scheme, costing taxpayers millions and potentially putting other public services at risk.

WORDS TO REMEMBER

Limit: The initiative would do nothing to limit health care costs. Any VDYLQJV ZRXOG EH UHEDWHG WR IRU SURĂĽW RXW RI VWDWH LQVXUDQFH FRPSDQLHV

Reduce: It would reduce access to care by forcing providers such as SHC, PAMF, ValleyCare, Kaiser, John Muir Health, local dentists, and optometrists to close operations and cut back services.

Burden: $ WUHPHQGRXV UHJXODWRU\ DQG PXOWLPLOOLRQ GROODU ĂĽQDQFLDO burden would be placed on the cities of Palo Alto and Livermore, leading to cuts in other city services, increased taxes or both.

Manager, Pulmonary Service Line

STANFORD HEALTH CARE PEOPLE / 5

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RESOURCE

INITIATIVE

GUIDE KEY WEBSITES Latest updates and information on Palo Alto Measure F:

P OTENTI AL I MP AC T I F

www.ProtectPaloAlto.org

T H E BAL L OT I NI TI ATI V E P AS S ES

Three Questions with Karen Frush, MD A DISCUSSION WITH SHCâ&#x20AC;&#x2122;S NEW CHIEF QUALITY OFFICER

Latest updates and information on Livermore Measure U:

www.ProtectLivermore.org For accurate and up-to-date information about SHCâ&#x20AC;&#x2122;s record of quality patient care:

To Stanford Health Care

2

To Our Community

www.StanfordHealthCareQuality.com HOW TO GET INVOLVED Visit protectpaloalto.org and

protectlivermore.org

Forced Budget Reduction of Nearly 25%.

Force VLJQLĂĽFDQW FXWEDFNV and even close many services and programs, which would have a drastic impact on the entire SHC community.

Sign up by clicking:

â&#x20AC;&#x153;Join the Coalitionâ&#x20AC;?

This will allow you to: 1.

Sign an endorsement form to list your name and title in opposition.

2.

5HTXHVW FDPSDLJQ information and materials to share with friends and family who live in Palo Alto and Livermore.

3.

after the new hospital opens, which would reduce patient beds and services, and therefore the need for staff to support those eliminated services.

FXW EDFN RQ KRXUV RI RSHUDWLRQ or even relocate to communities not burdened by this measure.

SHC ValleyCare, Palo Alto Medical Foundation, Kaiser, physicians, dentists, optometrists, and other small specialty practices would be drastically harmed.

The true objective of this initiative is to pressure SHC into allowing the union direct access to our employees so that they can expand their membership.

Patients would suffer as providers reduced services and/or closed operations in Palo Alto and Livermore.

Nothing in the proposed ballot measure addresses health care quality, safety, or anything related to patient care. The union-sponsored initiative would

While the union claims the initiative is meant to control health care costs in our community, the reality is that if passed, the measure would not limit prices charged to most patients.

Order yard signs if you live in Palo Alto or Livermore or wish to give them to those who do.

4.

(OLPLQDWH RXU DELOLW\ WR UHWURĂĽW FXUUHQW 6+& IDFLOLWLHV

Force Palo Altoâ&#x20AC;&#x2122;s hospitals, medical clinics, DQG GRFWRUVĂ&#x2013; RIĂĽFHV WR reduce services,

6LJQLĂĽFDQWO\ limit access to patient care not only for SHC patients but for others in our community.

Receive updates from the campaign.

HAVE A QUESTION? Contact us at:

EDOORWLQLWLDWLYH#VWDQIRUGKHDOWKFDUH RUJ

PRVWO\ EHQHĂĽW LQVXUDQFH FRPSDQLHV

by compelling local providers and hospitalsâ&#x20AC;&#x201D;including SHCâ&#x20AC;&#x201D;to pay rebates to insurers without any requirement that the rebates be passed on to patients.

These actions are all part of a highly coordinated campaign by the SEIU-UHW to undermine SHCâ&#x20AC;&#x2122;s reputation overall and create mistrust among staff.

6 / STANFORD HEALTH CARE PEOPLE

The proposed initiative would put SHC and the health systems of Palo Alto and Livermore at risk. It would have VLJQLĂĽFDQW FRQVHTXHQFHV for our hospitals and the patients who rely on the care we and other area providers deliver.

continue to evolve.

We have assembled a quality team of 70 individuals who support clinical teams throughout the hospital in real-time quality improvement efforts. Our quality improvement focus includes physician improvement leaders in 20 departments, nine new quality councils, and unit-based medical directors and patient care managers who work together in dyads to lead clinical quality projects.

More than 200 staff and faculty were trained in improvement science in FY 2018 as part of 43 Clinical Effectiveness Leadership Training (CELT) and RITE (Realizing Improvement Through Team Empowerment) programs.

Karen Frush, MD, joined Stanford Health Care as its Chief Quality 2IĂĽFHU RQ -XO\ 6KH KDV ZRUNHG in patient safety and quality for the past 15 years. Most recently, VKH ZDV WKH ĂĽUVW &KLHI 3DWLHQW 6DIHW\ 2IĂĽFHU IRU 'XNH 8QLYHUVLW\ Health System.

1

What is SHCâ&#x20AC;&#x2122;s FRPPLWPHQW WR TXDOLW\"

Since the time the Institute of Medicine reports on patient safety and quality were published in 1999 (To Err is Human) and 2001 (Crossing the Quality Chasm), we have recognized that in addition to excellence in clinical and research science, we have to understand improvement science. There is a rigor and a discipline to improving our processes and our systems that we have to employ if we want to deliver the best possible care to patients and their families. Here at Stanford, I see this concept embraced. People want to be the best at getting better. They want to look at and adopt evidence-based best practices and

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Patient safety and quality metrics are imperfect but evolving and improving. Different metrics are included in various national grading systems such as U.S. News & World Report, Leapfrog, CMS and Vizient. There is little consistency in the methodology used by the multiple grading systems, and the data that is available to them from hospitals across the country is not available in real time. As a result, they use retrospective data, from one, two or three years ago, which is not a true measure of whatâ&#x20AC;&#x2122;s happening in hospitals today.

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'HVSLWH WKH ĂŚDZV LQ WKH YDULRXV LQGXVWU\ measuring systems, Stanford is doing incredibly well. Stanford Health Care was once again ranked ninth by U.S. News & World Report, which is a highly respected rating.

Another key ranking system is Vizient, which compares Stanford with 97 other academic medical centers across the country. Vizient uses data that is more recent than some of the other measurement systems. At the end of 2017, Stanford was ranked 71 out of 97 hospitals. At the HQG RI WKH ĂĽUVW WKUHH TXDUWHUV RI 6WDQIRUGĂ&#x2013;V Vizient ranking is 12! This is amazing improvement, achieved through a lot of hard work by many dedicated people and teams at SHC.

Quality Improvement Examples of current quality projects that are impacting patient care at SHC. Central Line-Associated Blood Stream Infection (CLABSI) A multidisciplinary task force developed best practices for placement of central lines, obtaining blood cultures, use of aseptic techniques, creating orders and order sets, and providing training and education.

Interventions include: ensuring supplies for CLABSI prevention are always available, revising blood culture procedures and kits, and initiating use of antimicrobial wipes during daily bathing.

Catheter-Associated Urinary Tract Infections (CAUTI) The interdisciplinary CAUTI prevention taskforce created standardized catheter utilization protocols and appropriate urine culture ordering that include nurse-led active daily management and the availability of alternative urine collection devices. New practices include physician documentation of daily necessity, Foley catheter maintenance, standard methods for obtaining cultures, aseptic techniques and orders.

Colorectal Surgical Site Infections (SSI) To reduce rates of colorectal SSIs, colorectal and general surgeons adopted evidence-based best practices and conducted a monthly coding check and review of all cases with the National Surgical Quality Improvement Program.

ECMO Careful patient selection is paramount to utilizing Extracorporeal Membrane Oxygenation (ECMO) treatment effectively. E29 ICU staff, hospital leadership and cardiac surgery developed a comprehensive ECMO policy that includes criteria for cannulation up to end of life withdrawal of care.

Merit-Based Incentive Program System (MIPS) TThe Centers for Medicare Services (CMS) implemented a quality payment incentive program that measures clinical data and rewards providers based on value and outcomes. The Ambulatory Value Oversight Committee implemented a real-time quality rounding/tracking tool, developed standardized ZRUNĂŚRZV DQG LPSURYHG SHUIRUPDQFH RQ FOLQLFDO quality measures across all outpatient clinics.

STANFORD HEALTH CARE PEOPLE / 7

Whatâ&#x20AC;&#x2122;s Your 6WDQG2XW 6WRU\" SHC is committed to becoming a strength-based organization where employees can use their strengths every day to impact the lives of their patients, colleagues and communities. Are you an Advisor? A Provider?

A Connector? With the recent rollout of StandOut, employees are learning what they love, what they loathe, and how to translate their strengths into peak performance. Hereâ&#x20AC;&#x2122;s what theyâ&#x20AC;&#x2122;re saying about StandOut so far.

I need. Some of these arenâ&#x20AC;&#x2122;t surprising as they can be the mundane tasks that just have to get done; however, some of them were unexpected and are things that I can help prevent in the future. I also enjoy OHDUQLQJ DERXW VSHFLĂĽF WKLQJV P\ WHDP ORYHV GRLQJ DQG ĂĽQG WKDW IRU WKH PRVW SDUW WKH WKLQJV WKH\ ORYH doing are also adding value to the organization.

THE 9

STRENGTH N

ROLES IN BRIEF

ADVISOR You are a practical, concrete thinker who is at your most powerful when reacting to and solving other peopleâ&#x20AC;&#x2122;s problems.

VIVIAN LIBERTI Manager, Design â&#x20AC;&#x201C; SHC Marketing I like being able to write out my input in weekly check-ins with my Director. It allows me to give him top-line highlights, so he knows the areas where I would like his assistance. As a manager, itâ&#x20AC;&#x2122;s been good to know my team membersâ&#x20AC;&#x2122; strengths. Their weekly summaries give me a sense of what they do and donâ&#x20AC;&#x2122;t like to do so I can help make their work more understandable and meaningful. Thatâ&#x20AC;&#x2122;s the teacher in me.

CONNECTOR You are a catalyst.

Your power lies in your craving to put two things together to make something bigger than it is now.

CREATOR You make sense of the world, pulling it apart, seeing a better FRQĂĽJXUDWLRQ DQG FUHDWLQJ LW

SHERRY SOLORIO Administrative Assistant :KHQ , FRPSOHWHG P\ ĂĽUVW ZHHNO\ 6WDQG2XW FKHFN LQ I was actually a little taken aback by the question, what do I loathe? I answered honestly, knowing that I can be fully transparent with my manager. We talked about my personal growth and my desire to learn and gain new strengths. Since that check-in, she has given me more tasks that challenge me, and more opportunities to learn and showcase my strengths.

DAWN RORIG

CHRISTOPHER WINTRODE Administrative Director, Business Operations & Strategic Initiatives and Contracts $W ĂĽUVW LW ZDV VWUDQJH WR VKDUH ZKDW , ORYHG GRLQJ during the week, and especially what I loathed!

StandOut gave me an opportunity to stop and UHĂŚHFW RQ WKH ZRUN WKDW , GR DQG WKH YDOXH ,Ă&#x2013;P contributing to the mission of our organization. It also gave me an avenue to highlight my strengths and ask for assistance with tasks that arenâ&#x20AC;&#x2122;t in my wheelhouse. Weekly check-ins ensure that I feel my voice is being heard.

MYSTI SMITH-BENTLEY Administrative Director, Service Excellence After attending training, I was really looking forward to using the tool with my team and was surprised how much I like using it myself for my own check-ins. It HQDEOHV PH WR VSHQG WLPH UHĂŚHFWLQJ DERXW WKH YDOXH of my work and my priorities for the coming week.

I like knowing that my manager checks in and really DSSUHFLDWHV ZKHQ VKH UHVSRQGV WR WKH VSHFLĂĽF WKLQJV 8 / STANFORD HEALTH CARE PEOPLE

at play, especially when I have a tough decision to make. Iâ&#x20AC;&#x2122;m able to concretely talk about this process with my colleagues or manager, and they understand because of the commonality of our language DQG WRROV 6WDQG2XW KDV FUHDWHG HIĂĽFLHQFLHV DQG connectedness that I havenâ&#x20AC;&#x2122;t seen before. Itâ&#x20AC;&#x2122;s been fun to hear colleagues react to their strengths, and have team members chime in to clarify, support or even challenge their reactions. I think itâ&#x20AC;&#x2122;s helping us get to know another layer of the people working with us.

StandOut Steps 1. Take your strengths assessment 2. Do weekly check-ins with your team leader 3. Participate in quarterly engagement pulse survey (Oct 31â&#x20AC;&#x201C;Nov 14)

EQUILIZER You are a

KATIE STEPHENS

Executive Director, HR Services

level-headed person whose power comes from keeping the world in balance, ethically and practically.

Program Manager, Nursing Excellence

StandOut check-ins have been really valuable for me to have focused conversations with each of my employees, and to understand whatâ&#x20AC;&#x2122;s top of mind for them. It has helped me get to know them better to leverage their strengths and ensure that weâ&#x20AC;&#x2122;re in alignment week to week on the right priorities. As a Teacher and a Connector, I love the connection of people, process and technology. I try to leverage my strengths to bring out the best in all three of these Upcoming Dates components in the work thatKey I do every day.

INFLUENCER You engage people directly and convince them to act. Your power is your persuasion.

PIONEER You see the world as a friendly place where, around every corner, good things will happen. Your distinctive power starts with your optimism in the face of uncertainty.

As a Stimulator and Pioneer, I look to put situations in a more positive light, and love engaging and connecting with people. Seeing my scores really helped me embrace that part of my personality.

The StandOut platform creates a process for being intentional about my work. It forces me to look back at my week and identify the activities that energized me, and those tasks that I procrastinated. When looking at the weekâ&#x20AC;&#x2122;s activities and divvying up the work, my team members and I can cater to what we each enjoy, which are usually different things.

PROVIDER You sense other peopleâ&#x20AC;&#x2122;s feelings, and you feel compelled to recognize these feelings, give them a voice and act on them.

STIMULATOR You are the host of other peopleâ&#x20AC;&#x2122;s emotions. You feel responsible for them, for turning them around, for elevating them.

TEACHER You are thrilled by the potential you see in each person. Your power comes from learning how to unleash it.

LĂ&#x201A;M PHAN Senior Talent Acquisition Consultant, Human Resources Itâ&#x20AC;&#x2122;s been so clarifying for me to see my strengths

October 31 through November 14 â&#x20AC;&#x201D; StandOut Quarterly Engagement Pulse The Engagement Pulse is open to all employees.

Its purpose is to capture a snapshot of your teamâ&#x20AC;&#x2122;s engagement experience in real time. The survey consists of eight brief questions, which will take you only two minutes to complete.

November 1 â&#x20AC;&#x201D; Annual Service Awards Banquet Awards are presented to employees who have given dedicated and exemplary service to Stanford Health Care, and those who have contributed VLJQLĂĽFDQWO\ WR WKH LQVWLWXWLRQĂ&#x2013;V PLVVLRQ DQG YDOXHV 6HUYLFH \HDUV KRQRUHG DUH LQ PXOWLSOHV RI ĂĽYH Each attendee celebrating a milestone year will get an appropriate Service Year pin. This year we have an Awardee group of 1,272.

One referral can change everything.

7KH IXWXUH RI PHGLFLQH LV KDSSHQLQJ at SHC. When you bring new talent to our team, you have the power to make Stanford Health Care even stronger.

6WDUW ĂŚH[LQJ WKDW SRZHU DQG UHIHU D friend (or 10 friends) today. For every referral hired, youâ&#x20AC;&#x2122;re eligible to receive XS WR 7KDWĂ&#x2013;V D ELJ QXPEHU %XW the impact your referral can make is much larger. Letâ&#x20AC;&#x2122;s put the Power of One to work for our team, our patients, and our world.

Hereâ&#x20AC;&#x2122;s how it works â&#x20AC;&#x201D; itâ&#x20AC;&#x2122;s simple: Look up current openings that are eligible for referral awards, and then refer your friends, former colleagues or contacts to those positions. Remember, youâ&#x20AC;&#x2122;re our most important contact when it comes WR ĂĽQGLQJ WKDW RQH JUHDW FDQGLGDWH :H QHHG \RXU KHOS ZLWK ĂĽQGLQJ SHRSOH whose unique talents and personalities set them apart. People like you.

For more details, visit stanfordreferrals.com.

November 5â&#x20AC;&#x201C;16 â&#x20AC;&#x201D; Open Enrollment <RX FDQ XSGDWH DQG UHYLHZ \RXU EHQHĂĽWV IRU 2019 plan year. Two ways to update: Navigate to healthysteps4u.org/ to view and change your EHQHĂĽWV RQOLQH FDOO WKH %HQHĂĽWV 6HUYLFH &HQWHU at 855.278.7157.

1RYHPEHU Ă&#x201D; %HQHĂĽWV )DLU 7KH %HQHĂĽWV )DLU ZLOO WDNH SODFH LQ WKH 6+& Main Hospital Atrium from 7:30 a.m. to 3:30 p.m.

HR representatives and vendors will be on site WR DQVZHU DOO \RXU EHQHĂĽWV TXHVWLRQV November 5â&#x20AC;&#x201C;December 3 â&#x20AC;&#x201D; Annual Toy Drive* November 19â&#x20AC;&#x201C;January 1 â&#x20AC;&#x201D; Annual Food Drive* * Please contact jgunderson@stanfordhealthcare.org if you would like to donate.

STANFORD HEALTH CARE PEOPLE / 9

Ashley Ward Title: Administrative Coordinator Years working for SHC: 12 Why sheâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

David Byrd Title: Patient Access Representative Years working for SHC: 2 Why heâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s one of the best decisions I could have made. I never really knew how much the front desk had an impact on patient care. All these folks come in here DQG ZH FRQVLGHU WKHP IDPLO\ 7KH\Ă&#x2013;UH D IULHQG WKH\Ă&#x2013;UH D EURWKHU RU VLVWHU <RX JHW KHUH RQ WKLV FDPSXV LWĂ&#x2013;V a different type of atmosphere. For patients to come RXW DQG OHW XV NQRZ KH\ ZH DUH GRLQJ D JRRG MRE LW makes me want to work that much harder.â&#x20AC;?

Monica Thompson Title: Lead Clinic Clerical Coordinator Years working for SHC: 3 Why sheâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

â&#x20AC;&#x153;When you say you work for Stanford, it comes with pride. Working at Stanford is a great place to grow. I came in as patient coordinator and Iâ&#x20AC;&#x2122;m now lead of my department. When youâ&#x20AC;&#x2122;re stimulated in a workplace and it makes you want to do better, it makes you want to perform better. When youâ&#x20AC;&#x2122;re encouraged and validated for your performance, it makes you want to go above and beyond.â&#x20AC;?

Eric Bernier Title: Comprehensive Stroke Center Program Manager Years working for SHC: 4.5 Why heâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

â&#x20AC;&#x153;Every day I wake up and I canâ&#x20AC;&#x2122;t wait to get to work.

Itâ&#x20AC;&#x2122;s incredibly exciting to be on the front line. Our doctors are doing the research that is changing the guidelines on how we take care of stroke patients. I like to think we start taking care of patients before they even get here. Iâ&#x20AC;&#x2122;m extremely grateful to be a part of a program thatâ&#x20AC;&#x2122;s able to offer these innovative technologies that are able to save patientsâ&#x20AC;&#x2122; lives and prevent disability. Iâ&#x20AC;&#x2122;m grateful every day.â&#x20AC;?

â&#x20AC;&#x153;I love to work here. I love to get up and come to Stanford every day and make the small difference that I make. At Stanford you have the notoriety of everything that we do, weâ&#x20AC;&#x2122;re a great institution and you get to see how we help people and how we get to change lives. Iâ&#x20AC;&#x2122;ve always wanted to work in health care because Iâ&#x20AC;&#x2122;ve always wanted to help people. I work with amazing people that have a passion for what they love to do and itâ&#x20AC;&#x2122;s seen because they put HYHU\WKLQJ WKH\ KDYH LQWR WKHLU MRE DQG LW PDNHV PH then want to put everything into it.â&#x20AC;?

#ProudToWorkForStanfordHealthCare From a 38-year food service worker to a member of the housekeeping department whoâ&#x20AC;&#x2122;s worked at SHC for less than a year, our team members are #ProudToWorkForStanfordHealthCare. Over the past few months, a social media campaign using the Proud hashtag has highlighted SHC employees who share a passion for their job, Stanford Health Care and our patients. The response from the community has been heartfelt and inspiring, and weâ&#x20AC;&#x2122;d like to share it here.

Follow SHCâ&#x20AC;&#x2122;s Twitter, Facebook and Instagram pages and share why you, too, are #ProudToWorkForStanfordHealthCare.

Chris Atkinson Title: Food Service Worker Years working for SHC: Close to 10 Why heâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

Ă&#x2DC;, ZRUNHG LQ ĂĽQH GLQLQJ IRU \HDUV 0\ ODVW MRE ZDV in Hawaii at the Four Seasons Hotel. When the UHFHVVLRQ KLW LQ , KDG D UHDOO\ KDUG WLPH ĂĽQGLQJ D MRE , DFWXDOO\ FDPH WR WKH KRVSLWDO DV D WHPSRUDU\ HPSOR\HH $IWHU VL[ PRQWKV , UHDOO\ HQMR\HG ZKDW weâ&#x20AC;&#x2122;re doing here. I learned that I was very much part of what everybody here does and thatâ&#x20AC;&#x2122;s helping people get better. Iâ&#x20AC;&#x2122;m a piece of what everyone here does. And when we get to see someone leave happy and healthy with their family, that is really exciting for me.â&#x20AC;?

Gretchen Eadson Curtis Dance Title: Dietary Food Service Worker Years working for SHC: 38 Why heâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

â&#x20AC;&#x153;I cook breakfast for everyone that works here in the hospital and for everyone outside of the hospital that comes to visit.

I take pride in what I do so when I come in in the morning and start cooking I try to give my cooking the very best that I FDQ JLYH LW 7KLV KRVSLWDO KDV EHFRPH P\ family. It makes me feel better because the people that come in here I get to see them every day. And for as long as Iâ&#x20AC;&#x2122;ve been working here, for 38 years, that becomes part of family. I get to know everybody that comes in that cafeteria. And for the most part, everybody that comes in that cafeteria, when they walk by that grill, they say, â&#x20AC;&#x153;Hi Curtis. How you this morning?â&#x20AC;? $QG LW MXVW PDNHV PH IHHO VR JRRG Ă&#x2122;

Title: Environment Service Worker Years working for SHC: 11 months Why sheâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

â&#x20AC;&#x153;I work in the housekeeping department. I make sure patients are comfortable in their rooms. It makes me feel great. I learn all kinds of different things. I interact with the different patients and I hear various background and I learn something new every day. It makes me feel great inside knowing that they are in a clean environment and that they are comfortable.

Every day I come here, I learn something new. Itâ&#x20AC;&#x2122;s very exciting. I was excited when I got hired ed and Iâ&#x20AC;&#x2122;m still excited knowing that I work for a great eat hospital such as Stanford.â&#x20AC;?

Franklyn Dickenson Title: Housekeeping Assistant Why heâ&#x20AC;&#x2122;s #ProudToWorkForStanfordHealthCare:

Ă&#x2DC;, HQMR\ ZKDW ,Ă&#x2013;P GRLQJ &RPLQJ LQ KHUH every morning, it makes me feel good knowing that I can make somebody feel good at the end of the day. Itâ&#x20AC;&#x2122;s very important, what I do. When I go into the room and I connect with [a patient] by introducing myself to them, at the end of the day when Iâ&#x20AC;&#x2122;m ready to leave, they have a smile on their face and that makes me happy. And it makes PH IHHO JRRG DOVR 7KHUH DUH VR PDQ\ opportunities inside this organization where you can move from one level to WKH QH[W <RX FDQ GR VR PDQ\ WKLQJV 7KH VN\Ă&#x2013;V WKH OLPLW Ă&#x2122;

STANFORD HEALTH CARE PEOPLE / 11

THE

NEW Stanford Hospital

Private Patient Rooms Promote Healing and Enhance Care

DESIGNED FOR HEALING

Large windows with sweeping views. In-room sleeping areas for families.

Bathrooms with sliding doors. The private rooms in the new Stanford Hospital have been designed to improve patient safety, promote healing and enhance the patient and family experience.

1(: 67$1)25' +263,7$/ COUNTDOWN TO CONSTRUCTION COMPLETION

â&#x20AC;&#x153;Most new hospitals are being built with single rooms because of the desire to provide privacy for patients and families, to ensure uninterrupted sleep, to provide a site for consultations with the patient and for fostering a supportive â&#x20AC;&#x2DC;home away from homeâ&#x20AC;&#x2122; feeling,â&#x20AC;? said Norm Rizk, MD, chief PHGLFDO RIĂĽFHU IRU 6WDQIRUG +HDOWK &DUH Ă&#x2DC;3URYLGLQJ single rooms reinforces Stanfordâ&#x20AC;&#x2122;s desire to be a leader in innovative patient care and to meet our patientsâ&#x20AC;&#x2122; needs for a reassuring environment.â&#x20AC;?

Fall 2018 Emergency Department Complete Promenade Connecting LPCH and SHC Finished 368 Patient Rooms Completed

Winter 2019 ORs Complete /DUJH 0HGLFDO (TXLSPHQW Installed Furniture Installation Begins

Spring 2019 Art Installation Begins &HUWLĂĽFDWH RI 2FFXSDQF\

Improved Patient Safety George Tingwald, MD, AIA, director of medical planning for Stanford Health Care, said the hospital industry has moved toward making all patient rooms private for a variety of reasons. For instance, viruses and bacteria pass more easily between patients sharing the same room despite consistent and thorough hand-washing and cleaning practices. â&#x20AC;&#x153;It is well-studied that private hospital rooms reduce the spread of hospital-acquired infection rates,â&#x20AC;? he said.

In adult hospitals, where a high percentage of patients are over the age of 65, negotiating the bathroom door is a primary source of falls. The new Stanford Hospital has larger bathrooms that are accessed through sliding doors that will be left open at night to reduce the incidence of falls.

Family at the Bedside One of the cornerstones of the private room design is the ability for the patient to have family members stay in the hospital room at night. Every patient room, including those in the intensive care unit, has ample space for the care team, the patient and the family. Having a family member room with a patient can also help improve patient care, said Tingwald. Family members know the patient best, and can quickly spot changes in a patientâ&#x20AC;&#x2122;s health or mental status. They also absorb important knowledge about caring for the patient, which helps improve care at home after discharge. â&#x20AC;&#x153;We are encouraging patientsâ&#x20AC;&#x2122; families to spend the maximum amount of time possible with their family member, which means staying overnight and being with the patient at all times,â&#x20AC;? said Tingwald.

,PSURYHG (IĂĽFLHQF\ 3ULYDWH URRPV DUH DOVR D PRUH HIĂĽFLHQW XVH RI space. With shared rooms, nurses must spend a portion of each shift managing the transfer of patients within the hospital to create compatible roommate situations or to reduce the risk of infection. As a result, about 20 percent of beds

Summer 2019 Dress Rehearsals 0RFN /LFHQVLQJ

Fall 2019 Facility Licensed 2SHQ +RXVH DQG 5LEERQ Cutting First Patient

12 / STANFORD HEALTH CARE PEOPLE

LIKE ALL OF THE PATIENT ROOMS IN THE NEW STANFORD HOSPITAL, THE ISOLATED ICU PATIENT ROOMS HAVE BEEN DESIGNED TO IMPROVE PATIENT SAFETY, PROMOTE HEALING AND ENHANCE THE PATIENT AND FAMILY EXPERIENCE.

in shared rooms go unoccupied. With all private rooms, Stanford will be able to operate at nearly 100 percent capacity. â&#x20AC;&#x153;We want to be able to offer care to as many patients as possible who need our services,â&#x20AC;? said Ann Weinacker, MD, senior vice chair of medicine for clinical operations at Stanford Health Care.

Promote Faster Healing In designing the new hospital, Stanford used evidence-based principles to improve safety and promote healing. For example, research has shown that patients who have a view of

INTERIOR DESIGN Housed within the cantilevered towers of the new Stanford Hospital are spaces designed for KHDOLQJ 7KH KRVSLWDOĂ&#x2013;V LQWHULRUV UHĂŚHFW DQ XQGHUO\LQJ philosophy of integrating modern medicine with features that address the diverse needs of patients and visitors, as well as physicians, nurses and staff. â&#x20AC;&#x153;In health care environments, interior space, furniture and art are often the most visible and tangible elements for patients and their families,â&#x20AC;? said Grace Hsu, Director of Design Management, Stanford Health Care. â&#x20AC;&#x153;Every detail of the facility has been meticulously planned to create an environment that promotes healing while reducing stress on patients, families and visitors.â&#x20AC;?

The new Stanford Hospitalâ&#x20AC;&#x2122;s neutral interiors UHĂŚHFW WKH EXLOGLQJĂ&#x2013;V XQLTXH DUFKLWHFWXUDO characteristics by highlighting its modular plan and access to natural light. Consistency was key to promoting a safe environment that maximizes standard work, said Hsu. â&#x20AC;&#x153;Everything is where it should be to make it easy for care professionals to do their best work.â&#x20AC;?

Safety and Comfort Safety is foundational to the interior design of the new hospital, said Hsu. Ergonomic evaluations helped determine ideal room layouts and furnishing selections. Materials used throughout the hospital are non-porous, non-toxic, easy to clean and durable. Grab bars, seat heights and armrests were selected to comfortably accommodate patients and visitors of various sizes. Discussions with clinical and facilities staff,

a garden or a tree outside their window, rather than a view of a brick wall, require less pain medication and are discharged sooner. Natural light also lets patients keep track of day and night, a factor in normalizing sleep/wake cycles. â&#x20AC;&#x153;The power of design in the new Stanford Hospital is stunning,â&#x20AC;? said Tingwald, who is doubly trained as a physician and an architect. â&#x20AC;&#x153;These rooms have 7.5-by-13.5-foot windows.

They are the largest views to nature that I have ever seen in a hospital.â&#x20AC;?

Private rooms are also quieter, another factor in achieving better sleep. â&#x20AC;&#x153;Allowing people to

patient advocates and senior leadership guided furniture selections that adhered to patient and staff safety, infection control and maintenance standards. The design team strived to achieve smooth and safe transitions for patients and PHGLFDO HTXLSPHQW ZKHQ VHOHFWLQJ ĂŚRRULQJ DQG paint surfaces.

The new hospital was built with acoustics that both protect patient privacy and reduce noise between spaces. Patients can also control the lighting and temperature-moderating window shades from their bedside. Interior and exterior spaces include relaxation and work areas for families, caregivers and YLVLWRUV (DV\ WR PRYH IXUQLVKLQJV DOORZ IRU ĂŚH[LEOH layouts to accommodate family visits and care team interactions.

Inspired Art 6LQFH WKH ĂĽUVW GHVLJQ FRQFHSW DUW KDV EHHQ DQ integral element of the new Stanford Hospital, said Hsu. Stanford is continuing the inspiring legacy that began in the 1980s by a core group of local community volunteers who understood the COMFORTABLE, WELCOMING WAITING AREAS, SUCH AS THIS SURGICAL WAITING LOUNGE, PROVIDE ACCESS TO NATURAL LIGHT AND A SOOTHING DESIGN PALETTE.

have the rest that they want, allowing people to have the privacy they want, really improves their well-being,â&#x20AC;? said Weinacker. â&#x20AC;&#x153;And we all know that emotional well-being contributes greatly to physical well-being.â&#x20AC;?

When the new Stanford Hospital opens in 2019, and remodeling of the existing hospital is complete, Stanford Hospital will have 600 private rooms. â&#x20AC;&#x153;The goal of offering private rooms has been part of the plan for many years,â&#x20AC;? said Tingwald. â&#x20AC;&#x153;We are well on our way.â&#x20AC;?

THE WELLNESS ROTUNDA FEATURES ARCHITECTURALLY INTEGRATED ARTWORKS, OFFERING PLACES FOR PATIENTS AND THEIR FAMILIES TO REST AND REFLECT.

importance of art as part of the healing process and well-being for families and staff. Building on the 600-plus pieces of art in the current collection, the new Stanford Hospital will feature 300 new ZRUNV RI DUW LQFOXGLQJ VHYHUDO VLWH VSHFLĂĽF commissions. â&#x20AC;&#x153;The interiorâ&#x20AC;&#x2122;s nature-inspired neutral palette will be punctuated by pieces of art that uplift, encourage and complement a calm and peaceful environment,â&#x20AC;? said Hsu. Each piece of artwork has been purposefully considered for its content, access and physical attributes. â&#x20AC;&#x153;The artwork needs to serve the diverse populations that experience our facilities,â&#x20AC;? she said. â&#x20AC;&#x153;We want to create a welcoming and hopeful environment that UHĂŚHFWV WKH 6WDQIRUG VWDQGDUG RI H[FHOOHQFH DQG commitment to care.â&#x20AC;?

7KH ĂĽUVW LQVWDOODWLRQ RI RXWGRRU DUW EHJDQ last year, with two architecturally integrated commissions to follow later this year. Installation of interior artwork will begin in the spring, after furniture installation that begins this winter.

STANFORD HEALTH CARE PEOPLE / 13

â&#x20AC;&#x153;Bay Valley employees showed the same love and care to those less fortunate in their community as they do to their patients every single day.â&#x20AC;?

Family Medicine Doctor Spends Year in Peruvian $PD]RQ -XQJOH Hospital Pit viper bites, open (compound) fractures and emergency surgery illuminated only by headlamp were not part of Andrew Schechtmanâ&#x20AC;&#x2122;s daily routine in his practice with Family Medicine Associates in San Jose. But working in a remote 20-bed hospital in the Peruvian jungle, he had to learn quickly.

Supervising a small group of young Peruvian physicians and visiting medical students and residents, Schechtman had to do the best he could with limited resources and intermittent electricity.

The nearest subspecialist and referral hospital was six hours downriver and the river was too treacherous to travel at night. Many of the patients traveled days in small canoes to get to the hospital and were not willing to go to the city hospital, even when the doctors recommended it. â&#x20AC;&#x153;It was an amazing opportunity for the young trainees,â&#x20AC;? said Schechtman, who divides his time between seeing patients at the Stanford UHA primary care practice in San Jose and teaching family medicine residents at Oâ&#x20AC;&#x2122;Connor Hospital. â&#x20AC;&#x153;It pushed them out of their comfort ]RQHV DQG EXLOW WKHLU FRQĂĽGHQFH Ă&#x2122; KH said. â&#x20AC;&#x153;All of the visiting residents and I got good at treating machete injuries.â&#x20AC;?

Malaria, diarrheal diseases and severe respiratory infections were treated every day in the clinic.

Early in his medical career, Schechtman worked with Doctors Without Borders in war zones and 14 / STANFORD HEALTH CARE PEOPLE

ANDREW SCHECHTMAN, MD, SPENT A YEAR IN THE PERU WITH HIS FAMILY SUPERVISING A SMALL GROUP OF YOUNG PERUVIAN PHYSICIANS.

responding to natural disasters. When he and his wife were looking for an immersive experience abroad, they sought a place that would also be safe for their two children, ages 10 and 11.

3HUX ZDV D SHUIHFW ĂĽW KH VDLG Ă&#x2DC;7KH medicine was challenging and very rewarding. The whole family had the opportunity to live in another culture.â&#x20AC;?

Good Works From fun runs to backpack drives to feeding the hungry, University HealthCare Alliance (UHA) employees are giving back to their communities in meaningful ways.

Support for Community Health In May, a group of UHA and SHC employees and physicians teamed up to SDUWLFLSDWH LQ WKH +RSH :DON WR EHQHĂĽW the Cancer Support Community. The team of 20-plus walkers raised over $1,800.

Stanford Health Care held its annual Community Skin Cancer screening at ValleyCare Hospital, where volunteers from Stanford Health Care, Stanford

Health Care â&#x20AC;&#x201C; ValleyCare and UHA helped get 114 patients screened. â&#x20AC;&#x153;It was a successful event as the SK\VLFLDQV LGHQWLĂĽHG RQH PHODQRPD one squamous cell carcinoma and ĂĽYH EDVDO FHOO FDUFLQRPDV DV ZHOO as multiple suspicious pigmented lesions requiring biopsy,â&#x20AC;? said Jyotika Rattia, Administrator for UHAâ&#x20AC;&#x2122;s TriValley Region. In all, 23 patients made follow-up appointments. â&#x20AC;&#x153;Many in the community expressed how grateful they were and how much they learned about skin cancer screening and prevention. It was a truly wonderful BAY VALLEY EMPLOYEES COOKED AND SERVED MEALS TO THE HUNGRY AND HOMELESS.

way to give back to the community.â&#x20AC;?

Cardiovascular Consultants Medical Group (CCMG) hosted a Paint Night, raising $405 to support Angels for Hearts, an organization that provides holiday gifts to pediatric patients, especially those in heart units, who spend Christmas in the hospital.

WITH...

Support for the Needy

A Discussion with Stanford Health Care â&#x20AC;&#x201C; ValleyCare President about Measure U

Employees from Bay Valley Medical Group cooked and served over 300 meals for the hungry and homeless. â&#x20AC;&#x153;Bay Valley employees showed the same love and care to those less fortunate in their community as they do to their patients every single day,â&#x20AC;? said Pat Espicha, Nurse Practitioner.

The Alameda Family Physicians medical staff raised money for the Midway Shelter for Women and Children by participating in a Fourth of July 5K.

Support for Local Youth Los Olivos Womenâ&#x20AC;&#x2122;s Medical Group collected over 2,100 kid-friendly food items for children during the summer months when school breakfast and lunch programs end. They also participated in a backpack and school supplies drive for the second year in a row. The staff, physician assistants and doctors at CCMG in Oakland donated EDFNSDFNV DQG VXSSOLHV IRU ĂĽUVW WKURXJK 12th graders living at the Davis Street Homeless shelter. Collaborative Primary Care and Kwok Pediatrics and Internal Medicine joined forces to gather backpacks for children in their local communities.

Scott Gregerson President, Stanford Health Care â&#x20AC;&#x201C; ValleyCare

1

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Measure U claims to limit health care SULFHV WR ĂĽ[HG FLW\ JRYHUQPHQW UHJXODWHG costs. Instead, according to doctors, nurses, the Livermore City Council, public health experts and many others, the initiative would only reduce health care quality and access.

2

Would patients see a reduction in charges for WKHLU FDUH"

No, this measure does nothing to bring down the cost of health care. It makes things worse by restricting funding for health care programs DQG VHUYLFHV DQG SURYLGLQJ UHEDWHV WR IRU SURĂĽW out-of-state insurance companies without any UHTXLUHPHQW WKDW SDWLHQWV EHQHĂĽW

3

If Measure U were to pass, how would it impact health care for /LYHUPRUH UHVLGHQWV"

Livermore is home to some of Californiaâ&#x20AC;&#x2122;s leading health care institutions, including Stanford Health Care â&#x20AC;&#x201C; ValleyCare, Kaiser Permanente, John Muir Health and many other local providers. According WR WKH &LW\ RI /LYHUPRUHĂ&#x2013;V ĂĽQDQFLDO LPSDFW UHSRUW approximately 211 local providers would be impacted. Home health agencies, hospice, urgent care services, dentists, optometrists and other

small specialty practices would be forced to make GLIĂĽFXOW ĂĽQDQFLDO GHFLVLRQV ZKLFK FRXOG LQFOXGH cuts to medical programs, services and personnel.

4

What would the ĂĽQDQFLDO LPSDFWV EH WR 9DOOH\&DUH"

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How can employees KHOS RU JHW LQYROYHG"

ValleyCare is proud to deliver quality, reliable health care to the Livermore community. This proposed measure would have devastating consequences. We are focused on affordability, but no hospital can operate at a loss. This measure does not address the underlying costs RI KHDOWK FDUH 7KH ĂĽQDQFLDO LPSDFWV DUH OLNHO\ to force many providers, including ValleyCare, to reduce services, close or relocate. The sustainability of ValleyCareâ&#x20AC;&#x2122;s skilled nursing unit, ambulatory surgery center, urgent care, radiology, physical therapy, cardiac and pulmonary rehabilitation and laboratory in Livermore would be threatened. Access to care in Livermore would be endangered.

There are many ways employees can get involved. Publicly oppose Measure U, volunteer to participate in precinct walks, place yard signs opposing Measure U. Please visit protectlivermore.org for more information.

STANFORD HEALTH CARE PEOPLE / 15

OUR OUR PATIENTS PATIENTS NOW NOW

Blood on Board Stanford Life Flight Adds New Resuscitative Capability Marty Herman chose the middle of the day to return his sonâ&#x20AC;&#x2122;s Harley-Davidson motorcycle to KLV KRPH DFURVV WRZQ ,WĂ&#x2013;V ZKHQ WUDIĂĽF LV OLJKWHVW on Highway 1 in Santa Cruz. But just blocks from home, Marty was struck by a motorist who failed to see him crossing an intersection. His right leg was crushed between his bike and the oncoming car. It was nearly severed and gushing blood from an arterial bleed.

Drawing on safety training heâ&#x20AC;&#x2122;d learned as a heavy equipment operator, Marty grabbed his thigh and coached nearby bystanders to pinch his leg and apply a tourniquet using just a T-shirt. â&#x20AC;&#x153;I remember telling them, as tight as you can, as tight as you can,â&#x20AC;? said the 60-year-old former Granite Rock foreman. Marty was taken by ambulance to a nearby helipad, where he was met by Stanfordâ&#x20AC;&#x2122;s Life Flight team. During the PLQXWH ĂŚLJKW WR 6WDQIRUG /LIH )OLJKW QXUVHV LIFE FLIGHT PROGRAM MANAGER MICHAEL BAULCH, RN (LEFT), AND FLIGHT NURSE RANDY HOUGH (RIGHT)

transfused Marty with two units of O negative blood. When he arrived at Stanfordâ&#x20AC;&#x2122;s Emergency Department, he was transfused with two more units of blood. â&#x20AC;&#x153;That blood saved my life,â&#x20AC;? said Marty, who spent eight days at Stanford Hospital after two operationsâ&#x20AC;&#x201D;one to remove his right leg, which was too severely damaged to function, and one to repair his left leg, which was also crushed.

On April 16, Life Flight became the only air medical program in California to carry blood SURGXFWV RQ HYHU\ ĂŚLJKW 7KDW QHZ FDSDELOLW\ PD\ have been the difference in Martyâ&#x20AC;&#x2122;s recovery, and possibly his life, said Michael Baulch, RN, Program Manager, Stanford Life Flight. Stanford created its program using tested protocols developed by medical units in the military. Studies showed that survival rates were much better for soldiers injured in battle who received blood transfusions in the ĂĽHOG VDLG %DXOFK Ă&#x2DC;:H UHDOL]HG WKHUHĂ&#x2013;V VRPHWKLQJ better we could be doing for our trauma patients.â&#x20AC;?

Stanford Life Flight now carries two units of O negative blood, the universal donor, and one unit of plasma. Every morning, the Life Flight crew swaps out its supply of blood with Transfusion Services to ensure that the blood aboard the helicopter is viable, and that unused blood can be used for inpatients. Flight nurses use a small device that ĂĽWV RYHU WKH WXELQJ WR ZDUP WKH EORRG DV LW LV being rapidly transfused. â&#x20AC;&#x153;Bleeding and hemorrhagic shock are a frequent cause of death before reaching the trauma center,â&#x20AC;? said David A. Spain, MD, Medical Director for Trauma at Stanford. â&#x20AC;&#x153;Being able to administer blood in the helicopter will extend trauma care to patients before they reach our emergency room. This is a major advance for our Life Flight program and effectively extends our trauma care to the entire Bay Area.â&#x20AC;?

MARTY HERMAN AND HIS WIFE, KAREN, ARE THANKFUL THAT STANFORDâ&#x20AC;&#x2122;S LIFE FLIGHT TEAM WAS ABLE TO TRANSFUSE MARTY WHILE IN FLIGHT TO STANFORD HOSPITAL.

In the past, patients who experienced severely low blood pressure due to loss of EORRG ZHUH WUHDWHG ZLWK ,9 ĂŚXLGV :KLOH ĂŚXLG resuscitation can stabilize a patient, being able to resuscitate with oxygen-carrying blood is a better option, said Baulch. â&#x20AC;&#x153;Blood is such a necessary part of any transport or trauma service,â&#x20AC;? said Flight Nurse Emily Otto, RN, a former Navy nurse who served in Afghanistan. Otto cared for Marty ZLWK IHOORZ ĂŚLJKW QXUVH 5DQG\ +RXJK 51 Ă&#x2DC;,I ZH hadnâ&#x20AC;&#x2122;t been able to give him blood products, his outcomes would have been much worse. His blood pressure was so low for so long that he may have gone into organ failure. Being able to give blood in a timely, effective manner is just truly life changing, especially for this patient.â&#x20AC;?

Since launching the program, the Life Flight WHDP KDV DGPLQLVWHUHG LQ ĂŚLJKW WUDQVIXVLRQV WR three trauma patients, all of whom survived. â&#x20AC;&#x153;When I think about the possibilities of what could have happened, it brings tears to my eyes,â&#x20AC;? he said. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;m still able to hug my wife, see my kids and enjoy my new grandson. Everything was in my favor that day. I am just so lucky to be alive.â&#x20AC;?