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- 21st Century Medical Centers Taking Shape in Concord and Walnut Creek
- "Critical Vision" Program Underscores Commitment to Quality Patient Care
- Functional Magnetic Resonance Imaging (fMRI) Adds New Level of Precision in Treatment of Brain Tumors
- Helping Foster Youths Make a Successful Transition to Adulthood
- Free Breast Cancer Screening Services for Needy Women in Contra Costa County
21st Century Medical Centers Taking Shape in Concord and Walnut Creek
The expansions underway at the John Muir Medical Center – Walnut Creek and John Muir Medical Center – Concord will definitely make the medical facilities at both campuses larger, but even more important, both hospitals will continue to get better, with new technologies, enhanced services, improved workflow for professional staff, upgraded service delivery, and enhanced public spaces for visitors and patients alike.
At Walnut Creek, we are adding a five-story, 380,000 square-foot tower, the Thomas J. and Muriel T. Long Patient Care Tower. The addition will include 242 new beds (230 in private rooms), a 24-bed Intensive Care Unit (supporting around-the-clock, real-time audio and video monitoring of ICU patients), and a 35-bed Neonatal Intensive Care Nursery. Thirteen surgical suites (three new and 10 existing) are designed to accommodate current and future technology advances, such as intra-operative MRI and robotic surgery. And the Walnut Creek Emergency Department will be significantly bolstered, with a doubling of treatment bays (from 22 to 44), a new and more efficiently located helicopter landing pad, and four state-of-the-art trauma bays to deliver the extraordinarily high level of trauma care that has become synonymous with the John Muir Health name.
In Concord we are also expanding the Emergency Department to 32 rooms as part of a new 172,000 square foot patient care tower. In recognition of a generous gift from the K.H. Hofmann Foundation, the new five-story patient tower will be named in honor of Jean and Ken Hofmann. The tower will also house 61 new private rooms and be the home of the John Muir Cardiovascular Institute. The Institute will include four cardiac catheterization labs, 12 preop/recovery beds, four discharge stations, a twelve-bed Intensive Care Unit (also with around-the-clock, real-time audio and video monitoring of patients), and 49 advanced telemetry beds that will allow staff to closely track patient progress before and after procedures.
The new construction in both Walnut Creek and Concord are an opportunity to incorporate green building technologies, including innovative co-generation systems that simultaneously produce electricity from in-house generators and – harnessing the waste heat from that process – hot water. The resulting "combined heat and power" reduces our need to purchase electricity and natural gas, shrinking both John Muir Health's ongoing energy costs and overall carbon footprint. In addition, several initiatives related to the selection of environmentally-friendly and efficient equipment and materials are also being implemented. Importantly, we have also designed the expansions at both campuses with significant improvements to the general amenities. Hallways are wider, privacy is enhanced, windows and skylights admit natural daylight, and public spaces and landscaping provide comfortable, healing environments for patients and their families.
"Critical Vision" Program Underscores Commitment to
Quality Patient Care
In January 2008, John Muir Health launched a comprehensive program called Critical Vision designed to enhance system-wide critical care services. After just one year, the initiatives we've put in place have generated a significant improvement in both patient outcomes and the efficiency of our critical care delivery.
At the heart of the Critical Vision program is new technology that allows our Intensive Care Unit physicians and nursing staff to more effectively track the status of each patient in the ICU. The program provides centralized, 24-hours-a-day monitoring of the intensive care units at both campuses by a dedicated team of critical care nurses and pulmonary critical care physicians. Using advanced technology tools this team can consistently track patients, identify changes in vital signs, help our critical care staff make more informed decisions, intervene earlier, and prevent complications before they begin. This ICU technology infrastructure enables high-level management of patients even when attending physicians are unavailable. It has proven especially effective during night shifts between 7 p.m. and 7 a.m.
The results of the Critical Vision program are compelling and very gratifying. Compared to the program's baseline year in 2006, during 2008 the combined ICUs at John Muir Medical Center-Walnut Creek Campus and John Muir Medical Center-Concord Campus realized a 45% reduction in ICU deaths and an 18% reduction in hospital deaths. In addition, the program's aggressive monitoring and intervention has contributed to more effective critical care recovery, reducing total ICU days by 54 percent and General Care days at the two campuses by 30 percent.
Building on the success of the program, we have now deployed five mobile units linked to the Critical Vision infrastructure to areas outside of the ICU. Future plans for these mobile units include other areas such as the emergency department and labor/delivery, to provide the same level of enhanced patient care and quality of outcome wherever and whenever critical care is needed in the hospital.
"The nurses and physicians in the Critical Vision department monitor all critical care patients, identify changes in vital signs and provide early intervention so that serious complications can often be prevented. Patients receive an additional layer of care and attention, which in turn leads to better outcomes."
Aamir Faruqui, M.D.
Medical Director, John Muir Critical Vision program
Functional Magnetic Resonance Imaging (fMRI) Adds New Level of Precision in Treatment of Brain Tumors
The John Muir Neurosciences Institute (neurosurgery, neuropsychology and neuroradiology) recently implemented a state-of-the-art imaging system that allows neurosurgeons to prepare for surgery of brain tumors with an extraordinarily high degree of precision. Functional MRI (fMRI), using the 3.0 Tesla MRI, allows physicians to visualize specific parts of the brain which are activated during specific cognitive tasks and allows for both neurosurgical planning and intra-operative navigation.
With 3T MRI and fMRI physicians are able to visualize and diagnose brain tumors and then map specific areas in the brain where a patient's speech, language, memory and/or visual centers are located. During the scanning process, the individual is awake and performing tasks – such as speaking, moving fingers and hands, or tracking moving objects with eyes – which create activity in the brain that the fMRI can detect.
These functional areas are then overlaid with the diagnostic brain-scan, providing a highly accurate map for the neurosurgeon to plan the patient's surgery, whether a traditional surgery or non-invasive stereotactic radiosurgery. Using this map, the neurosurgeon can perform the safest and most complete tumor resection and/or treatment reasonable with the information provided by the 3T MRI and fMRI while attempting to consider the issues related to their quality of life.
The 3T MRI provides a level of scanning sophistication and accuracy traditionally found only at leading university research medical centers. As one of our physicians notes, using fMRI is similar to suddenly being able to see in 3-D after a lifetime of diagnosing patients in two dimensions. This ability of our neurosurgeons, neuroradiologists and neuropsychologists now to assess not only brain anatomy and pathology, but function as well, is a huge diagnostic and therapeutic advantage for the patients of John Muir Health. It is just one more example of how we are committed to improving the health of the communities we serve.
"The fMRI procedure was very valuable before I had surgery on a brain tumor. The scan showed that the mass was directly adjacent to an area of my brain that directs speech and motor functions. Today I'm two weeks post-surgery and I feel great. I'm out walking twice a day. And as you can see, I'm in full voice – very important, since I just can't listen to the politicians on television without talking right back at them ..."
Donald Sledge, 69
Danville, CA
"As a neurosurgeon, precise anatomic mapping of brain function is critical to my goals of complete tumor removal and preservation of eloquent brain. For Mr. Sledge, his tumor placed his ability to speak at risk. With fMRI imported into the operating room, his tumor was completely resected with speech preserved."
George J. Counelis, M.D., Attending Neurosurgeon
Diablo Neurosurgical Medical Group, Inc.
John Muir Health
Helping Foster Youths Make a Successful Transition to Adulthood
John Muir Health's commitment to improving the health of its communities takes many forms, including partnerships with local organizations that share our dedication to addressing the needs of vulnerable populations: low-income residents with significant barriers to care or evidence-based disparities in health outcomes.
One particular at-risk group that we serve is foster children; in particular, older youth making the critical transition from foster care into independent adulthood. Our partner in this outreach effort is Martinez-based Foster A Dream, which delivers programs and resources to support Bay Area foster children and increase their chances for lifelong success.
With Foster A Dream, the people of John Muir Health are providing an array of academic support services and work-readiness mentoring for young adults. More than 60 youths participated in John Muir Health-sponsored career fairs in Contra Costa County. Our employees provided "soft skills" training for high school and community college students to improve resume writing, job interviewing, and basic technology skills. And we awarded a $2,500 John Muir Health "Dare to Dream" scholarship to a high school graduate who is planning to become a nurse.
In all, during 2008 51 John Muir Health employees volunteered in our Foster a Dream partnership, including five individuals who served as personal mentors for young adults exploring careers in health care, and two of our senior nursing professionals who now proudly serve on the Foster a Dream board of directors.
"Winning this 'Dare to Dream' healthcare scholarship is a big first step into the 'real world' for me. It's allowed me to get the books, laptop computer, and other tools I need for nursing school. After I get my RN, I'm on my way – toward building a career in healthcare and a successful life."
Amanda Petite
Rocklin, CA
Free Breast Cancer Screening Services for Needy Women in Contra Costa County
Each year more than 25,000 women are diagnosed with breast cancer in California. Early detection is a critical factor in successful treatment, and John Muir Health has collaborated with the Contra Costa Breast Cancer Partnership to create Every Woman Counts. The goal of the program is to reduce the number of breast cancer deaths among underserved, low-income women in our communities. Every diagnosis is a life saved or extended. In 2008, the John Muir Breast Health Center diagnosed four of 250 women screened with cancer.
The program provides education and screening/diagnostic services free of charge to women over the age of 40, who are uninsured or have medical insurance with high deductibles or co-payments, and who have household income that falls within guidelines established by the State of California. Every Woman Counts is funded by the California Department of Health Services Cancer Detection Section, and services are provided at the John Muir Breast Health Center in Concord.
John Muir Health partners with Contra Costa County Health Services, Association Hispana del cancer and Pittsburg Pre-School Coordinating Council to provide culturally appropriate free clinics so that participating women can receive all their diagnostic services at one time, in one place.