In Good Hands

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Sacramento’s becoming known in medical circles as a top-notch spot for cutting-edge care in a number of specialties. That’s something to feel good about.

You would think Sacramentans might consider moving to the Bay Area for better health care&emdash;not the other way around.
But that all depends on the kinds of services you seek.

If you have children with autism, as Laura and Rick Henderson do, Sacramento offers a goldmine in UC Davis’ M.I.N.D. Institute, a leader in autism research and treatment. M.I.N.D., which stands for Medical Investigation of Neurodevelopmental Disorders, was the reason the Hendersons moved here from the Silicon Valley five years ago.

Others have made a longer journey. When his young daughter required a complex spinal surgery that was unavailable in the Philippines, Celso Avaricio sought help in the United States, ultimately landing at Sutter Medical Center in Sacramento, where some of the most advanced neurosurgeries in the country are being performed.

We’re still not on as many best of lists as Bay Area behemoths Stanford and the UCSF Medical Center. But as these stories illustrate, we’re not exactly Mayberry, either&emdash;and you might be surprised at the kinds of accolades Sacramento medical providers are getting these days. Here’s a peek.

Keeping UC Davis in M.I.N.D.

When 60 Minutes calls, you know you’ve made it.

The UC Davis M.I.N.D. Institute made it last year.

On its Feb. 18, 2007 broadcast, CBS’ award-winning news magazine featured M.I.N.D.’s two pioneering Sallys&emdash;Drs. Ozonoff and Rogers&emdash;sharing with reporter Lesley Stahl revolutionary new ways of detecting and treating autism in children as young as 12 months of age. Local parents and their toddlers were featured, too.

This was a big deal for M.I.N.D., where some of the world’s greatest minds in science, medicine and education are working together
to unlock the mysteries of such neurodevelopmental disorders as Tourette Syndrome and Attention Deficit Hyperactivity Disorder. But autism is what started the institute and where its focus remains.

The parents told us when they founded us, ‘We want you to find a cure [for autism],’ says Robert Hendren, M.I.N.D.’s executive director and a UC Davis School of Medicine professor of child and adolescent psychiatry.

Hendren is referring to the five founding fathers of M.I.N.D.&emdash;Steve Beneto, Chuck Gardner, Rick Hayes, Rick Rollens and Lou Vismara&emdash;whose frustration over the lack of available services for their children with autism inspired them to rally for a world-class facility dedicated to improving the lives of those with neurodevelopmental disorders. In the short 10 years since then, M.I.N.D. has secured a spot in many minds as the place for autism research.

I think the Sacramento area exceeds any area I’ve heard of for their ability to deal with autism, says Laura Henderson, who with her husband, Rick, relocated here from Mountain View to find better help for their three sons with autism.

Henderson says her boys have been involved in all kinds of research studies and interventions&emdash;even a vitamin B-12 study, where I had to inject my child with B-12. 

Because M.I.N.D. is more about research than treatment&emdash;its waiting list is anywhere from six to nine months, according to Hendren, and sometimes more than a year&emdash;patients are often referred out. And, as parents like Henderson have found, some forms of treatment work better than others.

But M.I.N.D.’s greatest gift goes beyond the search for a cure, says Henderson. For children with autism and their parents, it provides a comforting sense of community in an otherwise alienating world.

It gives me and my children a place to belong, says Henderson. It gives me hope.

 

UC Davis Medical Center also is known as a good place to go for . . .

• Bariatric surgery: It’s designated a national center of excellence by the American Society for Metabolic and Bariatric Surgery
• Cancer: It’s a National Cancer Institute Center
• Ear, nose and throat problems, and kidney disease: In 2007, it ranked among the top 50 hospitals in the country for these specialties by U.S. News & World Report
• Heart care: It’s designated a Blue Distinction Center for Cardiac Care by Blue Cross
• Trauma: It’s home to the area’s only Level 1 (highest level) adult and pediatric trauma centers

The Heart of the Matter: Mercy

It seems Mercy is always tooting its horn about being the region’s best in heart care. But how does it really measure up?

Pretty well, apparently: Mercy General has been designated a Blue Distinction Center for Cardiac Care by Blue Cross (as has its sister hospital, Mercy San Juan). And in 2006, Mercy General was the only hospital in Greater Sacramento to be named one of the top 100 hospitals in the country in a Cardiovascular Benchmarks for Success report by Solucient (now Thomson), which looked at such key areas as mortality rates and procedure volume.

The volume part is huge for patients, as it means they’re in the hands of unusually experienced cardiac teams, says Doris Frazier, RN, vice president for cardiovascular services at Mercy General. Volume is one of the things that makes our cardiac program extremely strong, says Frazier.

She is referring specifically to coronary bypass surgeries, in which blood is rerouted or bypassed around clogged arteries, which Mercy General performs to the tune of more than 1,000 hearts a year.

That’s a lot of hearts, and not all of them are Mercy patients: In the Sacramento region, Kaiser Permanente patients in need of heart surgery are routinely sent to Mercy. (Kaiser’s Sacramento hospitals do not offer coronary bypass surgery.)

Mercy also stays on the cutting edge by offering the latest minimally invasive techniques, which for many patients takes the fear out of heart surgery&emdash;and shortens the scar that traditionally comes with it. When Rose Stinson needed surgery for a leaky mitral valve earlier this year, she immediately imagined the worst. As soon as I heard ‘open heart surgery,’ I started visualizing it and getting apprehensive, says Stinson, 65. But with the minimally invasive technique requiring small incisions instead of a slash through the sternum, she was relieved. I was still a little nervous, but after I went on the Internet and saw that Mercy was in the top 10 percent in the country for heart care, I felt more confident, says Stinson, whose Kaiser cardiologist referred her to Mercy for the surgery.

And should you have a heart attack, Mercy General’s record suggests it’s a good place to do so. Their door to balloon time&emdash;that critical interval of time between a heart attack victim’s arrival at the emergency room door and the inflation of the angioplasty balloon that opens the heart’s artery&emdash;was clocked at an average of 72 minutes in 2007, well below the 90-minute gold standard set by the American College of Cardiology.

Catholic Healthcare West/Mercy hospitals also are known as good places to go for . . .

• Bariatric surgery: Mercy San Juan’s bariatric program is designated a national center of excellence by the American Society for Metabolic and Bariatric Surgery
• Hyperlipidemia and heart failure: Mercy General is certified by The Joint Commission, a nonprofit that accredits 15,000 health care organizations, for these specialties
• Stroke: Mercy General, Mercy San Juan and Woodland Memorial Hospital are certified Primary Stroke Centers by The Joint Commission

Heads Above In Neuroscience and Neurosurgery: Sutter

To most locals, Sutter Memorial is known as the region’s baby hospital, touted for both its top-notch neonatal intensive care unit and sheer volume of births&emdash;more than 300,000 since the East Sacramento hospital opened in 1937. That’s more than three-quarters of the city’s population, notes Sutter spokesperson Gary Zavoral.

But this past year, Sutter Medical Center made U.S. News & World Report’s list of the top 50 hospitals in the country for another of its specialties: neurology and neuroscience. Thanks to its Sutter Neuroscience Institute, next to Sutter General Hospital in midtown, Sutter also was named one of only two Neuroscience Centers of Excellence in California for 2006–07, the other being John Muir Medical Center in Walnut Creek.

What this means, in laymen’s terms: Sutter is earning a national and even international reputation as a place to go for brain surgery, spinal surgery and other neurological issues, such as epilepsy, Alzheimer’s disease and sleep problems. (They have an entire center devoted to getting a good night’s rest.)

Our patients come not only from out of state, but in some cases from around the world&emdash;Europe, the Philippines, confirms Sam Ciricillo, M.D., medical director of the Sutter Neuroscience Institute and a hotshot surgeon himself (one of his specialties is the Gamma Knife, a super high-tech, minimally invasive tool for brain surgery).

By staying ahead of the curve with the newest techniques and most advanced technologies, Sutter’s team often is able to help those who can’t find help elsewhere. For Khayla Uy&emdash;born with a rare congenital disability in which her vertebrae were fused together, preventing her spine, joints and bones from developing normally&emdash;it was a long road from the Philippines to Sacramento. But after undergoing complex spinal surgery and six months of healing, Uy, now 9 years old, is attending regular school at Orchard Elementary in Rio Linda and has gained newfound confidence and independence despite being wheelchair-bound, according to her father, Celso Avaricio.

She’s able to sit up straight in her wheelchair now, which makes her more confident because she can move around in it better, he says. Uy still struggles with speech and hearing problems due to a cleft palate and hearing loss. But she’s mentally capable, and she is bright and enthusiastic, says Avaricio, who found Sutter (and pediatric spine surgeon George Picetti, M.D.) through a support group.

Ciricillo, who came to Sutter from UCSF Medical Center, says he’s been actively recruiting recognized leaders and building a multidisciplinary team so Sacramentans no longer need to go to the Bay Area for the best in neurological care. If you look at the really good programs, like Case Western Reserve or the Mayo Clinic, they all apply a multidisciplinary approach to whatever they’re known for. That’s what we’ve been working to do.

Sutter Medical Center also is known as a good place to go for . . .

• Anti-coagulation, asthma, care coordination and heart failure: Sutter Medical Center was certified for these specialties by The Joint Commission
• Bariatric surgery: Sutter Roseville is designated a national center of excellence by the American Society of Metabolic and Bariatric Surgery
• Heart care: In 2006, Sutter General was named one of the nation’s best for clinical excellence in cardiac care by VHA Inc., a nationwide network of not-for-profit health care organizations

Prevention: The Name of the Game for Kaiser Permanente

Kaiser talks a lot about prevention. But do they walk the walk?

It seems so. The HMO giant won a national award in 2006 for its ALL (Aspirin-Lisinopril-Lovastatin) Initiative, a program that is estimated to have prevented some 3,400 heart attacks and strokes among its Northern California members between 2004 and 2006, according to Richard Harr, M.D., a Roseville-based internist and chief of Kaiser Permanente’s North Valley Chronic Conditions Management program.

Many individuals can lower their risk of cardiovascular disease by relatively simple interventions, says Harr. The ALL Initiative targets patients with coronary artery disease, diabetes and other conditions that put them at high risk for heart attacks and strokes.
Cardiovascular disease is the nation’s No. 1 killer, notes Harr, and Kaiser aims to help its members lower their risk by encouraging healthful lifestyle changes, prescribing preventive medications and keeping a check on blood pressure, LDL cholesterol and blood sugar levels. It seems to be working: Kaiser Permanente’s Northern California members are estimated to have a 30 percent lower risk of dying from heart disease than the general public.

Also on Kaiser’s hit list for chronic-conditions management: asthma. About 94 percent of its California members with asthma are receiving appropriate medications, according to Commercial Healthcare Effectiveness Data and Information Set performance measures for 2006. The result? Fewer emergency room visits for both adults and children who suffer with the condition&emdash;a big plus here in the Central Valley, where asthma prevalence rates run high.

Kaiser Permanente also is known as a good place to go for . . .

• Heart care, mental health care and sexually transmitted infections: In 2007, the California Office of the Patient Advocate’s Healthcare Quality Report Card rated Kaiser Northern California excellent in these specialties
• Multicultural health care: In 2007, Kaiser Permanente received a Recognizing Innovation in Multicultural Health Care award from the National Committee for Quality Assurance
• Stroke: Kaiser Sacramento (Morse Avenue), South Sacramento and Roseville are designated Primary Stroke Centers by The Joint Commission

Consumer Beware
Comparing health care quality is tricky business Healthgrades.com gave Mercy General five stars for maternity care in 2007–08 and gave UC Davis Med Center only one. Meanwhile, calhospitalcompare.org gave Kaiser Permanente South Sacramento a superior rating for surgical infection prevention in 2008, while ranking the same facility below average for overall patient experience.

What’s a consumer to make of all this? If you ask Bill Sandberg, executive director of the Sierra Sacramento Valley Medical Society, healthgrades.com is full of errors&emdash;I would never trust it. Meanwhile, Pat Sullivan of the Office of Statewide Health Planning and Development says calhospitalcompare.org is a reputable source of public information and also recommends his own department’s
website, oshpd.ca.gov, which provides data and quality ratings for California hospitals.

Whatever the source, defining greatness in health care is tricky business, says Rob Schott, M.D., a cardiologist and vice president of medical affairs at Sutter Medical Center.

Is there any sure-fire way to compare quality?

Simple measures, such as looking at mortality rates for surgery, are helpful, says Schott. But risk adjusting is complex, he says, making quality assessments hard to nail down. Assessing quality in health care is a work in progress for institutions, and for individual providers it’s embryonic.

The take-away message: Health care report cards are just tools, some more reliable than others. In the end, only you can decide whether your health care provider is meeting your needs, so be your own judge.

Sacramento’s a Good Place for Diagnostic Imaging, Too

The Big Four&emdash;UC Davis, Mercy, Sutter, Kaiser Permanente&emdash;are not the only local health care providers to win national awards. In 2007, Radiological Associates of Sacramento, noted for its long history of excellence and innovation, was named the Top Leadership Team in Healthcare for medical group practices by HealthLeaders Media. RAS has pioneered a long string of firsts, starting with the Sacramento region’s first X-ray machine when the company was founded in 1917.