The mission of National Healthcare Decisions Day is to inspire, educate and empower the public and providers about the importance of advance care planning. The initiative encourages patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be.

A 2003 article by the U.S. Agency for Healthcare Research and Quality entitled “Advance Care Planning: Preferences for Care at the End of Life,” found that less than 50 percent of the severely or terminally ill patients studied had an advance directive in their medical record.

The Advance Directive Sessions are free and will be held on Tuesday, April 16 from 7 to 9 a.m. and 11:30 a.m. to 1:30 p.m. at O’Connor Hospital Café A & B, 2105 Forest Ave, and from 3:30 to 5:30 p.m. in the O’Connor Hospital Medical Office Building Auditorium, 2101 Forest Ave. in San Jose. To register, call 800-220-0182. Refreshments will be served.

Learn the difference between the two conditions at O’Connor Hospital’s upcoming Living Well Class, “Headaches and Migraines,” on Tuesday, April 2, presented by Michael Stevens, M.D. Community members are invited to attend free of charge.

Dr. Stevens will provide general information on migraines, including the evolution of migraines, prevalence for the severe headache, and genetic factors that contribute to the condition. Dr. Stevens will also focus on the causes of migraines, such as common triggers and physiological, dietary and environment aspects, as well as treatment options.

Dr. Stevens is an Associate Director of the O’Connor Hospital Family Medicine Residency Program. He is a graduate of George Washington University School of Medicine. Dr. Stevens is a diplomate of the American Board of Family Medicine and is certified in the subspecialty of headache medicine by the United Council for Neurologic Subspecialties.

O’Connor Hospital’s Living Well Community Lecture Series are free of charge, but please call (800) 220-0182 for reservations or register online. Each class provides ample time for a question-and-answer period at the end of the session. “Headaches and Migraines” will take place from 6:30 to 8 p.m. in the Medical Office Building (MOB) Auditorium at O’Connor Hospital, 2101 Forest Avenue, San Jose. Refreshments will be served.

The designation signifies that O’Connor met nationally established quality care and outcomes criteria developed with input from the medical community, and also met cost measures that address consumers’ need for affordable healthcare.

“This recent recognition again underscores the quality care that sets O’Connor apart,” said James Dover, FACHE, O’Connor Hospital President & CEO. “We continue our commitment to follow best practices with all our services to provide the highest quality, cost-effective and safest patient care.”

The recognition by BCBSA is the higher of two distinctions by the insurance company. Blue Distinction Centers meet quality-focused criteria that emphasize patient safety and outcomes. Blue Distinction Centers+ meet the same criteria, as well as cost-of-care measures. BCBSA includes the Blue Cross and Blue Shield companies that collectively provide healthcare coverage for 100 million members or one in three Americans.

Quality is key, and only those facilities that first meet Blue Distinction’s nationally established, objective quality measure are considered for designation as Blue Distinction Centers+. Since 2008, the program has identified hospitals delivering quality care in bariatric surgery, cardiac care, complex and rare cancers, knee and hip replacements, spine surgery and transplants.

“The program provides consumers with tools to assist them in making better informed health care decisions based upon quality, efficiency and the patient experience,” Dover added.

O’Connor Hospital is a Joint Commission Center of Excellence in hip replacement and knee replacement.  In 2012, US News & World Report ranked 12 local hospitals in the San Jose area, and O’Connor Hospital was ranked among the top three, with high performance in Orthopedics. Recently, O’Connor Hospital also received an “A” rating for hospital safety by the Leapfrog Group.

Participants will learn about the causes of knee pain and what they can do to help improve knee function. The presentation will focus on avoiding overuse knee injuries, managing “wear and tear” arthritis (osteoarthritis) and improving leg strength.

Dr. Henehan will review different exercises that can be used to strengthen and improve the flexibility of the knees – exercises that are effective, easy to do, focus on important muscular structures and only take ten minutes to do.

Daily use of these exercises, even when the knees feel good, will help keep them healthy and strong, Dr. Henehan says. Regular physical activity is also recommended to compliment the knee care program, he added.

The “Please Your Knees” presentation is the first of three lectures by Dr. Henehan on sports-related and overuse injuries. He will present “Overuse Injuries” on Thursday, April 25, 2013 and “Save Your Shoulder” on Thursday, May 23, 2013.

Dr. Henehan is a graduate of the Chicago College of Osteopathic Medicine and the San Jose Medical Center Family Practice Residency Program. He is a diplomate of the American Board of Family Practice and has a Certificate of Added Qualification (CAQ) in Sports Medicine through the American Board of Family Practice. As the team physician for San Jose State University athletics, Dr. Henehan brings special expertise in orthopedic and sports medicine to his work.

O’Connor Hospital’s Living Well Community Lecture Series are free of charge, but please call (800) 220-0182 for reservations or register online. Each class provides ample time for a question-and-answer period at the end of the session. Please Your Knees will take place from 6:30 to 8 p.m. in the Medical Office Building (MOB) Auditorium at O’Connor Hospital, 2101 Forest Avenue, San Jose. Refreshments will be served.

“Often the only treatment for diabetics or smokers with vascular disease was to bypass the top of the leg to the foot to salvage the limb, or to just proceed with a major amputation,” said vascular surgeon Peter Schubart, M.D., medical director of the Wound Care Clinic. “We had to make large incisions and complications such as infections often occurred.”

A patient with a non-healing wound needed the expertise of a podiatrist, vascular surgeon, general surgeon, infection control specialist and nurses to manage the patient’s care.

“The concept of a team approach with doctors and nurses working together to take care of these patients is still vitally important,” Dr. Schubart said. “The Wound Care Clinic allows physicians in private practice to collaborate about the patient’s care and have a team available for outpatient management, or when a patient is admitted to the hospital.”

Today, the O’Connor Wound Care Clinic is a Joint Commission Certified Center of Excellence for Wound Care.  “We have been a national training site for wound care,” Dr. Schubart added. “Over the years, we have done research studies and have worked with engineers to develop products that are now used throughout the country.”

The Clinic is recognized for its multidisciplinary team approach to determine why a wound is not healing and develop an individualized plan of patient care to heal the wound as quickly as possible. The core team of physicians now includes podiatrists, vascular and general surgeons, plastic surgeons, an orthopedic surgeon and an emergency physician who is refocused on wound care.  Nurses are valuable collaborators with physicians and make major contributions to patients’ care.

The number of patients seen at the Wound Care Clinic has increased from one the first day in 1993 to nearly 700 per month today with a successful healing rate of more than 90%. Additionally, the treatment options for patients have changed over the years.

“What has continued to evolve is the knowledge of the critical factors that affect tissue injury and repair and to implement this knowledge to optimize patient outcomes,” said podiatrist Bruce Lerman, who has worked at the Wound Care Clinic for the past 20 years. “This includes improving oxygenation at the wound site to stimulate and support wound healing.”

The Wound Care Clinic includes two hyperbaric oxygen therapy chambers where patients breathe 100 percent oxygen at a pressure about two and a half times the normal pressure in the atmosphere. This increases the amount of oxygen in the blood, thus delivering extra oxygen to the wounds for faster healing.

“The hyperbaric chamber is another tool that allows us to care for our patients at the clinic,” Dr. Schubart said. “There are now more advanced technologies and many options available to help the patient heal faster.”

Dr. Lerman agreed. “Accelerated wound healing technologies at O’Connor include growth factor therapy, bioengineered skin, tissue products, new mechanically functional dressing and the surgical and nonsurgical treatment of the wound site.”

“We are using advanced technology and now can heal wounds that we couldn’t heal before, with many wounds healing much faster,” Dr. Schubart added. “Our goal is to diagnose the cause of the wound, to get the wound to start healing, and to finish healing rapidly. We also educate the patient to prevent reoccurrence of his or her problem.”

The types of wounds that are treated at the Clinic include diabetic, venous, pressure or traumatic ulcers and ulcers due to arterial insufficiency. Ulcers are a sore on the skin accompanied by the disintegration of tissue.

“With the large volume of patients, we have been fortunate to be part of novel, cutting-edge research,” Dr. Lerman said. “We have learned through research and experience over the past 20 years which of these technologies work and which do not work.”

And the next frontier in wound care?

“In the next 10 years, I see the molecular mechanisms of wound care being figured out,” Dr. Schubart said. “Regenerative medicine will not only heal the wound but also make the tissue as good as the original.”

The O’Connor Wound Care Clinic, located across from O’Connor Hospital at 125 Ciro Ave., Suite 201 in San Jose, will be holding an open house to celebrate their 20^th anniversary on Thursday, March 7 from 4 p.m. to 6 p.m. Refreshments will be served.

Allergies in the spring occur because light and dry pollen cells from trees are carried in the air. They can send the body’s immune system into overdrive and cause symptoms such as sneezing, stuffy nose and itching eyes. Hay fever, which is triggered by 11 types of trees, affects 30 to 60 million people in the United States alone. In the summer, different allergens are present, mostly grass pollens, and in the fall ragweed allergies. Mold is a year-round allergy, but more prevalent in the spring after the rainy season.

More and more people are developing allergies and O’Connor physician Dr. Theodore Chu, board certified in internal medicine and allergy and immunology, will explain why in the “Allergies Are Increasing. What Can You Do?” class on Feb. 25. His presentation will focus on what allergies are, why they are on the rise, what causes them, how to prevent and treat them and how to minimize their impact on your life.

Dr. Chu will answer questions related to how can you tell if a runny nose or asthma is due to allergies; what sorts of plants, animals and microscopic organisms are allergenic; and what are some of the treatments for allergies that non-doctors can use, among other questions.

The series continues on Thursday, March 7, with “What is an Allergy,” presented by O’Connor physician John Kellogg, a board certified internist and allergy and immunology specialist. Dr. Kellogg will discuss how allergies can cause subtle and sometimes severe reactions in the body. Learn about common triggers and the natural progression of allergies from infancy to adulthood. The class is intended for parents, teachers, health care providers or anyone interested in learning about one of the fastest growing diseases worldwide.

The third class in the series will focus on food allergies. O’Connor pediatrician Katharine Nelson’s talk, “Do You Have a Food Allergy?” on Wednesday, April 3, will focus on common food allergies, the difference between a food allergy and food intolerance, how to diagnose and treat food allergies and new research, including new methods for diagnosis and cure. Anyone who is affected by food allergies can benefit from this informational class.

O’Connor Hospital’s Living Well Community Lecture Series are free of charge, but please call (800) 220-0182 for reservations or register online . Each class provides ample time for a question-and-answer period at the end of the session. All three classes will take place from 6:30 to 8 p.m. in the Medical Office Building (MOB) Auditorium at O’Connor Hospital, 2101 Forest Avenue, San Jose. Refreshments will be served.

Five years ago, Diana Doner, RN, Director of Women’s and Children’s Services, came up with the idea of having red caps knitted for O’Connor Hospital babies, including some for premature babies, as part of National Wear Red Day. Wear Red Day began ten years ago by the American Heart Association and the National Heart, Lung and Blood Institute in support of the fight against heart disease in women ­– ­ the No. 1 killer of American women.

Doner got O’Connor employees to knit the caps. She also gives each mother a letter about following a heart-healthy lifestyle so each can be a role model for her child, while also explaining the reason for the red knit cap, Doner said.

“I have learned that most young mothers have little knowledge of their risk of heart disease, so providing this information to them is very valuable,” she said.

Initially, employee Marcia Miloslavich knitted the baby caps and got her sister, Paulette Fultz, of Tolleson, Arizona to help. Now Fultz knits 50 hats and Miloslavich knits a few for the premature babies for Wear Red Day. Fultz starts knitting the caps in the summer then ships them to her sister in late December.  She says, she has arthritis in her hands and making the hats is good exercise for her hands and fingers.

“I love making the baby hats, it is so rewarding,” Fultz said. “If we can help one mother, sister, grandmother, aunt or friend fight heart disease it is all worth it. Every time I make them, it reminds me to get a heart-healthy checkup.”

As part of National Wear Red Day, Doner will also have a “Go Red for Women” table set up outside the cafeteria for employees and visitors to learn more about women and heart disease.

“Cervical Health Awareness Month provides an opportunity to focus on women’s health and cervical health issues, including HPV (human papillomavirus) and cervical cancer,” Dr. O’Neill said.

“Class participants will learn about well woman visits, which should include a pelvic exam, what is a normal and abnormal Pap test, screening guidelines for cervical cancer and the role that HPV plays in the disease,” Dr. O’Neill said. “We will cover HPV vaccine recommendations and barriers,” she added.

Cervical cancer was once one of the most common causes of cancer death for American women, but with the increased use of the Pap test for early detection, cervical cancer deaths have fallen more than 70 percent. Each year, about 12,000 women are diagnosed with cervical cancer in the U.S., and about 4,000 women die from the disease, according to the American Cancer Society.

“Cervical cancer is preventable and treatable, and the HPV vaccination and Pap screening tests are important parts of cervical cancer prevention,” Dr. O’Neill said.

Cervical cancer usually does not have symptoms until it is quite advanced. It occurs when cells in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina, slowly become abnormal. Screening tests, such as the Pap test, can help find early signs of the disease so that problems can be treated early, before they turn into cancer.

The majority of the cases of cervical cancer are caused by a strain of the HPV virus, a sexually transmitted virus that is responsible not only for cervical cancer but also for genital warts. The HPV vaccine, which protects against HPV infection and HPV-related diseases, offers the greatest health benefits to individuals, both boys and girls, who receive all three doses of the vaccine before having any type of sexual activity.

Dr. O’Neill received her medical degree from Creighton University. She is board certified in obstetrics and gynecology and is a fellow of the American Congress of Obstetricians and Gynecologists. She grew up in the San Jose area, where she has been practicing Ob/Gyn since 1990. She travels extensively, volunteering her medical expertise in developing countries around the world.

Kay Thanawala, CNM, graduated from Columbia University in 2007. She has a B.A in psychology and a master’s degree in nurse-midwifery. She has worked with a diverse population of women, from recent Mexican and African immigrants in the Bronx to Amish families in Lancaster, Pennsylvania.

Dr. O’Neill and Thanawala will speak and answer your questions as part of the O’Connor Hospital Living Well Community Lecture Series. All classes are free of charge, but please call (800) 220-0182 for reservations or register online . Woman to Woman: Understanding Your Annual Exam will take place on Wednesday, January 30, 6:30 to 8 p.m., in the Medical Office Building (MOB) Auditorium at O’Connor Hospital, 2101 Forest Avenue, San Jose. Refreshments will be served.

The DCHS Medical Foundation is expanding its footprint along the California coast. The DCHS Medical Foundation, a statewide medical foundation established by Daughters of Charity Health System and headquartered in San Jose, CA, was formed in April 2012.

The Family Medicine Associates of San Jose (FMASJ), consisting of 12 physicians, joined the DCHS Medical Foundation on December 28, 2012. The board-certified family physicians at FMASJ have provided medical care to South Bay residents since 1977. The group also serves as the teaching faculty for the O’Connor Hospital Family Medicine Residency program, which is affiliated with Stanford University.

“We are excited to be part of DCHS Medical Foundation,” says Robert Norman, MD, FMASJ president and director of the residency program. “This partnership strengthens our ability to offer a medical home to our patients while providing fully integrated continuity of care.” More than 10,000 patients receive a full spectrum of medical services at their San Jose location.

The FMASJ practice includes preventive health visits for all ages; acute care; management of chronic diseases; minor surgical procedures; maternity care, coordination of subspecialist care, and more. Areas of expertise include women’s health and obstetrics, newborn and pediatric care, sports medicine, and treatment of headaches, depression, HIV/AIDS and geriatrics.

Also partnering with the DCHS Medical Foundation are George Smith, MD, of Active Medical Group of Northern California in Daly City, and W. Brian Joyce, MD, of Morgan Hill Medical Associates in Morgan Hill. Dr. Smith is board certified in internal medicine and pain medicine. Dr. Joyce is also board certified in internal medicine.

In Southern California, All Care Medical Group and Allied Healthcare Providers Medical Group, both located in Huntington Park, are also now affiliated with the DCHS Medical Foundation. All Care is a multi-specialty medical group initiated in 1948 consisting of approximately 25 physicians, employees and independent contractors representing specialties including internal medicine, dermatology, urology, general surgery, orthopedics, pediatrics and more. Allied Healthcare Providers Medical Group is the Independent Physician Association (IPA) of All Care and was started in 1984.

Craig Kaner, currently CEO of All Care Medical Group and Allied Healthcare Providers Medical Group, has also taken on the role of the DCHS Medical Foundation’s Chief Operating Officer for Southern California. Kaner has served as administrator for All Care and Allied Healthcare Providers since 1982. Kaner is a seasoned executive with experience in operations, financial management, human resources, team building, and business development. He received his MPA in Health Services Administration from the University of Southern California.

According to Ernie Wallerstein, President and CEO of DCHS Medical Foundation, all of the new members fit into their vision of facilities who provide person-centered care. “We are seeking physician partners who provide quality care and share our values and deep-rooted commitment to serving the diverse communities where the Daughters of Charity sponsor hospitals.” offers Wallerstein. “We have found those values and level of commitment in the physicians comprising our newest affiliations.”

Benefits to physicians joining the foundation are far-reaching, according to Wallerstein. “As a new and exciting venture, the DCHS Medical Foundation offers physicians an opportunity to create the organization from the ground up. They have a voice in how we will accomplish our shared goals of achieving optimal patient outcomes while achieving cost-savings and true integration.”

“We are pleased to be moving forward in our relationship with Ascension Health,” said Robert Issai, President and Chief Executive Officer, Daughters of Charity Health System. “This affiliation agreement will create significant opportunities for us to work with Ascension Health and benefit from their strategic expertise in many areas.”

DCHS is sponsored by the Daughters of Charity of St. Vincent de Paul, Province of the West. Four other Provinces of the Daughters of Charity, together with what is now the Congregation of St. Joseph, were the original Sponsors of Ascension Health when the health system was formed in 1999. The Sisters of St. Joseph of Carondelet and Alexian Brothers also now participate in Sponsorship of Ascension Health Alliance.

“Daughters of Charity Health System and Ascension Health have a common commitment to serve all with special attention to those who are poor and vulnerable,” said Robert J. Henkel, FACHE, President and Chief Executive Officer, Ascension Health and Executive Vice President, Ascension Health Alliance. “This agreement will strengthen Catholic healthcare through our shared Mission.”

A Joint Advisory Committee will be formed consisting of representatives from both organizations. According to Issai, this committee will provide a platform for ongoing dialogue and strategic planning to enhance delivery of quality inpatient and outpatient care throughout California. “An affiliation agreement provides the necessary structure for DCHS to form collaborative relationships to create more efficient person-centered care for the people in our California communities,” he added.

Specific terms of the affiliation agreement are confidential.

About Ascension Health Alliance:
Ascension Health Alliance (www.ascensionhealthalliance.org) is the nation’s largest Catholic and nonprofit health system. Ascension Health Alliance is transforming healthcare by providing the highest quality care to all with special attention to those who are poor and vulnerable. Last year Ascension Health Alliance, through its subsidiary Ascension Health, provided more than $1.3 billion in care of persons living in poverty and community benefit programs. Its Mission-focused Health Ministries employ more than 122,000 associates serving in more than 1,400 locations in 21 states and the District of Columbia. Other Ascension Health Alliance subsidiaries focus on a wide range of service areas, including treasury management services, venture capital investing, global mission support and medical engineering services.

About Daughters of Charity Health System:
Daughters of Charity Health System (DCHS) is a regional health system spanning the California coast from the San Francisco Bay Area to Los Angeles. Its hospitals include: Seton Medical Center, Daly City; Seton Coastside, MossBeach; O’Connor Hospital, San Jose; Saint Louise Regional Hospital, Gilroy; St. Vincent Medical Center, Los Angeles; and St. Francis Medical Center, Lynwood. DCHS was formed in response to the healthcare needs of the people of California. Every day, more than 8,000 associates and physicians serve patients and their loved ones, providing quality, compassionate care – body, mind and spirit. For more information on DCHS, please visit http://www.dochs.org/.

“Get Pumped: Strategies for Nursing Mothers Returning to Work or School,” provides breastfeeding mothers with the skills and confidence they may need during the transition back to work, Kathleen Helsing, MPH, LEC, prenatal and lactation educator and one of the instructors for the class, said.

“We’re frequently asked by our new mothers about how to transition back to work while breastfeeding,” Helsing said. “Returning to work or school can be a stressful time for new mothers and this class can help them with the skills and confidence they may need to be successful.”

“New mothers have lots of questions and worries about returning to work or school while continuing to breastfeed – some will not start breastfeeding because of that,” lactation consultant and class instructor Susan McLaughlin, R.N., MPH, IBCLC, said.

The class will focus on:

• Understanding your rights to breastfeed at work
• Establishing a breastfeeding routine
• Pumping, handling and storing your milk
• Maintaining your milk supply
• Getting your baby to take the bottle after months of breastfeeding
• Breast pump or other equipment needed (vendors will have pumps available for demonstration.)

The new class will be offered every other month on Mondays, January 28, March 25 and May 20 from 9:30 to 10:30 a.m. in the Medical Office Building (MOB) Auditorium at O’Connor Hospital, 2101 Forest Avenue, San Jose. Cost is $20 per class. Infants are welcome.

Call 1-800-220-0812 for reservations or register online.

The hospital quality “scorecard” is based on 2011 data collected from the Leapfrog survey and other publicly reported data. Nationally, grade “A” hospitals include the Mayo Clinic in Rochester, Minn., Cleveland Clinic in Cleveland,  New York Presbyterian Hospital in New York, and Brigham and Women’s Hospital in Boston.

The areas where O’Connor fully met the Leapfrog standards were in “Steps to Avoid Harm” and “Managing Serious Errors,” and has made substantial progress in “Reducing ICU Infections.” The Hospital Safety Score was first launched in June 2012 and now identifies “D” and “F” rated hospitals.

“There are many things for patients to consider when choosing a hospital and patient safety should be at the top of the list,” said James F. Dover, FACHE, O’Connor Hospital President and CEO. “I am proud to see that we are not only meeting the gold standards for safety by a nationally recognized group, but also showing progress in other patient safety areas.”

In California, 92 out of 246 hospitals, or 37.4%, received an “A” rating. Other local hospitals with an “A” rating are: Kaiser Permanente Santa Clara Medical Center; Stanford Hospital and Clinics and Kaiser Foundation Hospital, San Jose. Receiving “C” ratings were: El Camino Hospital, Good Samaritan Hospital of San Jose and Regional Medical Center of San Jose. A “D” rating went to Santa Clara Valley Medical Center. 

The Hospital Safety Score ratings are based on 26 evidence-based, national measures of hospital safety. Criteria included breathing failure after surgery, wounds splitting after surgery, stage 3 and 4 pressure ulcers and central-line associated infections. The study also looked at the hospitals teamwork and skill building, their nursing workforce and their physician staffing in the ED, among other aspects.

The Leapfrog report is just the latest in similar recognitions for O’Connor as one of the area’s top hospitals. In July, U.S. News & World Report ranked 12 local hospitals in the San Jose area, and O’Connor was ranked among the top three Best Hospitals with high performance in Orthopedics. In August, Consumer Reports gave O’Connor the highest safety rank among the San Jose hospitals who participated in the study.

“Thinning of the bones happens to both men and women as we age,” offers Dr. Henehan, who serves as director of the San Jose-O’Connor Hospital/Stanford Affiliated Sports Medicine Fellowship. “Participants will learn how exercise can help build strong bones when we are younger and slow bone loss as we age.”  Specific recommendations on type, frequency and duration of exercises for fracture prevention will also be discussed.

According to the Agency for Healthcare Research & Quality, a division of the U.S. Department of Health and Human Services, risk of osteoporosis can be reduced with lifestyle changes and sometimes medication. If osteoporosis already exists, treatment may involve both. A nutritious diet rich in calcium foods, weight-bearing/muscle building exercise and home-safety proofing for prevention of falls are the three mainstays in keeping osteoporosis in check. If medication is necessary, the following should be included: vitamin D, calcium and bisphosphonates, a class of drugs used to help prevent loss of bone mass. Smoking cessation is mandatory.

Dr. Henehan is a graduate of the Chicago College of Osteopathic Medicine and the San Jose Medical Center Family Practice Residency Program. He is a diplomate of the American Board of Family Practice and has a Certificate of Added Qualification (CAQ) in Sports Medicine through the American Board of Family Practice. As the team physician for San Jose State University athletics, Dr. Henehan brings special expertise in orthopedic and sports medicine to his work.

Dr. Henehan will speak and answer your questions as part of the O’Connor Hospital Living Well Community Lecture Series. All classes are free of charge, but please call (800) 220-0182 for reservations or register online . Osteoporosis: Exercises and Fracture Prevention will take place from 6:30 to 7:30 p.m. in the Medical Office Building (MOB) Auditorium at O’Connor Hospital, 2101 Forest Avenue, San Jose. Refreshments will be served.

Located in the heart of San Jose, O’Connor Hospital is an acute care, not-for-profit, Catholic community hospital that has served Santa Clara County longer than any other hospital in the region. Key services at O’Connor include cardiology, oncology, mother-baby care, orthopedic services, vascular care, wound care and emergency services. O’Connor Hospital sponsors the Pediatric Center for Life, Parish Nursing programs, and the Stanford-affiliated Family Medicine Residency Program. O’Connor is a Joint Commission designated Primary Stroke Center and the hospital is fully accredited by The Joint Commission, the California Department of Public Health and the Center for Medicare and Medicaid Services.

“This approval by CCS recognizes the excellent care we provide to the most fragile infants,” said James F. Dover, FACHE, O’Connor Hospital President and CEO. “This designation as a Level III Community NICU allows us to take care of these premature infants rather than transfer them to another hospital, allowing for continuity of care and peace of mind for the parents and family.”

“We are able to routinely care for high-risk mothers and premature infants as small as 27 weeks gestation and earlier gestations on a case-by-case basis,” said Diana Doner, RN, Director of Women’s and Children’s Services at O’Connor Hospital. “We have a multidisciplinary team in place to provide the best care for both premature and sick infants.”

Previously, O’Connor Hospital was CCS-approved as a Level III Intermediate NICU. To receive the higher-level status, O’Connor Hospital needed to be approved as a Pediatric Community Hospital as well. CCS conducted a site review of both the NICU and pediatrics units in order to grant community approval status. CCS levels for NICUs are intermediate, community and regional.

Some requirements for CCS Level III Community NICU full status include: the capability to provide a full range of intensive, intermediate and continuing care for severely ill neonates and infants; CCS-paneled physicians with experience in NICU and pediatrics and advanced education, training or experience; onsite medical social workers, clinical registered dietitians, and physical and occupational therapists; participation in the California newborn hearing screening program; and coordination of a discharge plan between the NICU multidisciplinary team, CCS, other agencies and the infant’s parents or caretaker.

“As a Level III Community NICU, we will provide regular patient updates and conduct weekly conference calls with CCS. For pediatric patients, clinical information also will be provided to CCS,” Doner added.

CCS provides additional resources for premature babies up to age 21, with CCS-eligible chronic medical conditions, such as cystic fibrosis, cerebral palsy, muscular dystrophy and spina bifida.

The new intra-arterial revascularization treatment program will approximately double the time available to safely and effectively administer brain protecting tPA (tissue plasminogen activator), notes neurologist Raul Guisado, M.D., stroke center medical director at O’Connor. Imaging and specialized tools will allow the team to place tPA or mechanically remove blockages at the site of the clot.

Shannon Crawford, M.D.

To launch the program, Shannon Crawford, M.D., has come to O’Connor from subspecialty training in neuro-interventional radiology at UC Davis Medical Center. He is joined in the new program by colleague Anup Singh, M.D., and by the rest of O’Connor’s nationally certified Stroke Center team, says Guisado, and Karen de la Cuesta, FNP-C, Stroke Program Coordinator.

The new program employs sophisticated imaging techniques to insert the tPA directly at site of the clot, rather than infusing the chemical into the bloodstream, a technique that while effective, has a shorter window of opportunity to circulate through the body and bust up the clot, says Guisado.

“But perhaps more importantly, in situations where it makes sense, we will be able to thread tiny wires equipped with miniaturized tools — catheters — to mechanically remove the clot from the blocked vessel,” he adds. “We will have both mechanical and chemical solutions flexibly available as needed.”

Anup Singh, M.D.

The tPA given to patients is a concentrated and synthetically manufactured chemical similar to the natural clot busting chemicals present in normal blood. Patients must have their stroke identified within three hours of the brain blockage for traditional tPA to be used because otherwise dangerous bleeding can occur. But that safety window expands up to six hours, says Guisado, if tPA is placed directly at the site of the blockage.

“This is a crucial time difference,” says de la Cuesta, “because some patients suffer a stroke while sleeping, and so the number of hours from onset is often uncertain. Our intra-arterial revascularization program will allow our imaging specialists more flexibility. Moreover, some patients with a variety of medical conditions might respond better to the more directed infusion of tPA and our ability to target the blockage directly.”

Most patients, notes de la Cuesta, will continue to receive conventional tPA immediately after anischemic (blood clot induced) stroke is identified because of the technique’s long proven record.

“Regardless of the treatment selected, the most important criteria for a successful stroke program such as ours is accurate identification and response as part of our hospital’s overall program of safety and high quality patient care,” says George Block, OCH’s chief medical officer.

De la Cuesta notes that identification is crucial. While 80 percent of the 700,000 strokes that occur each year in the United States are ischemic and respond well to tPA, about 20 percent of strokes result from a burst blood vessel. For these hemorrhagic strokes, a different treatment strategy is required, she says.

Block, Guisado and de la Cuesta, a nurse practitioner working on a specialized certification in stroke management, proudly note that OCH has received the American Heart Association/American Stroke Association Get with the Guidelines — Stroke Plus Performance Achievement Award for the two most recent consecutive years. The Joint Commission, the nation’s primary hospital accreditation organization, recognizes OCH as a Certified Stroke Center.

“The bottom line for us is that day after day for the past two years, we have consistently been able to initiate tPA within 60 minutes of a stroke patient’s arrival,” de la Cuesta says. “The mantra of stroke professionals around the world is ‘time is brain.’”

To highlight the rapid damage caused by an ischemic or clot-caused stroke, Jeffrey L. Saver, M.D. of UCLA Medical Center’s Stroke Center reported in the January 2006 issue of the AHA’s journal, Stroke, that 1.9 million neurons, 14 billion synapses, and 7.5 miles of myelinated brain fibers are destroyed each minute after an untreated stroke. Moreover, the untreated ischemic brain ages the equivalent of 3.6 years for every hour the stroke-attacked brain goes untreated when compared with the slow but continuous neuron loss everyone experiences as they age.

“Because literally each minute counts, it’s important for anyone who suspects he or she has suffered a stroke to have someone drive them or request an ambulance to take them to the nearest certified stroke center, if one is available, as it is throughout urban Santa Clara County,” says Block. “As for our center, the data that we and our peer hospitals share document our door to needle time and consistency is unsurpassed in our region. This reliability is the result of coordination that starts at the Emergency Department door,” notes Block.

“We put a lot of emphasis on training for our medical and our nursing staff, and one of the first things our triage nurses look for when a patient arrives is any evidence of stroke,” says Meenesh A. Bhimani, M.D., medical director of OCH’s Emergency Department.

Nevertheless, patients and family members can help the hospital team by learning to recognize and point out to medical personnel the most common symptoms of stroke they are experiencing or observe:

• Sudden numbness, tingling, weakness, or loss of movement in face, arm, or leg, especially on only one side of the body;
• Sudden vision changes;
• Sudden trouble speaking;
• Sudden confusion or trouble understanding simple statements;
• Sudden problems with walking or balance;
• A sudden, severe headache that is different from past headaches.

De la Cuesta says the hospital has taken a number of carefully thought out steps to ensure speed and accuracy of stroke identification and treatment.

“For example, radiologists now call a neurologist directly rather than first call the Emergency Department to report that they’ve found brain blockage that will require treatment. This saves about 15 minutes every time we need to start tPA,” de la Cuesta says.

“Strokes require a multidisciplinary approach among several care teams, so streamlined communication, including minimizing the number of calls or messages among caregivers, is crucial,” adds Bhimani.

Underlying speed, however, is safety, and O’Connor was cited in the August issue of Consumer Reports with the highest overall safety rank among the San Jose area hospitals that participated in the study.  “This honors our commitment and offers us and our peer institutions an opportunity to continue work on this most basic of patient care issues,” Block says.

In addition to tPA, including enhanced neuro-IR, O’Connor offers follow-up services for stroke patients, including two National Institutes of Health clinical trials. One of these is studying a promising protective treatment using albumin protein for persons who suffer from serious strokes, while another trial is seeking to learn if providing antiplatelet medicines for persons who suffer mild strokes are protected against a more serious stroke in the future.

“The common element of successful stroke programs is close coordination and the hard and effective work of strong champions of the program. We have that here at O’Connor with Dr. Guisado, Karen de la Cuesta, and the entire team,” says Block.