National Hospital Week celebrates the everyday heroes at hospitals; the people who through dedicated, compassionate care and constant innovation make a significant difference in the lives and health of patients. At Marin General Hospital, there are hundreds of dedicated individuals who qualify as “everyday heroes.” To celebrate Hospital Week, we’ve chosen just a few stories to tell below.
Helping a Family Navigate End of Life Care
The hospital received a letter from a patient’s daughter saying that Dr. Michael Vaughan and Dr. Anucheat Chea deserve special recognition for their extraordinary efforts to help her family after her father was brought to the Marin General Emergency Department (ED). A spry and active 87-year-old, he had suddenly developed an enormous blister on his foot, ultimately diagnosed as an E. coli infection, and also suffered severe back pain from spinal stenosis.
“The first day I met Dr. Vaughan he had to go through my dad’s medical directive with me. In addition to all the bioethics issues, Dr. Vaughan had to start preparing me for the worst,” Laurie said in a letter to Marin General Hospital (she asked that her last name not be used.) Dr. Vaughan was the hospitalist on duty when they arrived in the ED. “In this particular situation most physicians would have walked away after giving all the bad news. He did not. In fact, he stayed with me.”
Laurie marvels at how Dr. Vaughan navigated that first encounter and all the ones to come; how he never relinquished the bond of communication he established in that first meeting—even when things took a turn for the worse.
Dr. Chea, an infectious disease expert, was brought in to consult on the foot problem and began treatment. Against the odds, Laurie’s father began to improve. Then, out of the blue, he suffered a massive stroke. He was unable to speak and completely paralyzed on one side, so he could not easily participate in decisions about his care. “Dr. Vaughan just kept telling me to ask myself what Dad would want for himself in the situation. He was absolutely right. These decisions have to be about what the patient wants for himself.”
Complicated by the patient’s age and other health issues, one question was whether or not to administer tPA, a clot-busting drug that can be miraculous for some patients, but deadly if administered in the wrong situation. Dr. Vaughan ultimately chose not to use it, a difficult and complex decision.
As a series of progressively worse medical situations evolved, Dr. Vaughan kept in touch with the patient’s family physician, as well as family members. “We received 10 years of medical problems in a very short period of time,” Laurie says. “Through it all Dr. Vaughan was amazing. He never let us down. He really cares about his patients and it comes from the heart.”
Later, Laurie discussed Dr. Vaughan’s handling of various decisions with another doctor, who told her that Dr. Vaughan had avoided all the pitfalls that would have tripped up other physicians. “He did everything right, always with my dad’s best interests in mind,” she says.
She also has high praise for Dr. Chea. “He was a young doctor just starting out,” she says. “But he was very thorough. Both he and Dr. Vaughan became very involved with our family. Dr. Chea even visited my dad on his day off, and he attended the funeral on 24 hours notice. It really meant a lot to us.”
Laurie is grateful that her father was able to spend his last days at home where “we had several good days,” she says. “Even with all the technology, sometimes the body just quits,” she says philosophically. “But I cannot say enough about these kind, caring doctors. If I hadn’t had them I think I would have gone crazy.”
Unique, Dignity, Understanding and Compassion for Patients
A Mill Valley resident wrote to the hospital to commend the ICU nursing staff and team of doctors who cared for his partner Jill during a 45-day stay. She arrived at MGH with severe diverticulitis with multiple complications from a perforated colon. Her condition was critical and at times the prognosis was dim.
“The dignity, understanding and compassion demonstrated by every employee were unique, noteworthy and outstanding,” he wrote. “Your ICU nursing staff is amazing. [Their] thoughtfulness in providing additional services like palliative care and efficient case work was very helpful. Jill’s room and location and environment of your hospital were very lovely and comforting.”
After 45 days at MGH, Jill transferred to CPMC to continue her recovery and rehab. Mike wrote, “We are getting very good and competent care and treatment at CPMC but we have to admit that we immediately missed the compassion, friendliness, competency, maturity and familiarity of the professionals and our friends (especially nurses) at MGH. You do a great job with outstanding people and are a credit to the medical profession.”
There was a special note of commendation for Dr. Alfrey and the MGH medical team. “Shortly after arriving at CPMC, Jill’s health took a markedly impressive turn for the better thanks to the treatment initiated by, and prescribed and directed by Dr. Alfrey’s/the MGH medical team during the previous seven weeks. It was life saving and is leading to recovery. . . It is a miracle for which we are very grateful.”
Pain-free After More Than a Year
Eva Czubak, Novato, can’t say enough about her doctor, James
Yu, MD, director of robotic surgery and urologic oncology at Marin General
“He has a wonderful bedside manner – made me feel very cared
for,” says Eva. He kept checking on me while I was in the hospital, even gave
me his cell phone number in case I had questions. To me, that’s unusual for a
What Eva is most pleased about, however, is what Dr.Yu was able to do to relieve her of the pain she had been suffering with for over a year because of a kidney stone treatment that scarred and blocked her ureter. She needed stents, which had to be replaced frequently, so that the kidney could drain.
“I had gone to several doctors, and nothing was working. “I’m usually pretty chipper, but I was getting really depressed about wondering if I would have to just live with the pain and discomfort.”
When she saw Dr. Yu, he gave her three options: remove the kidney altogether; surgically remove the blockage and reimplant a new ureter made from tissue from her colon; or use robotic surgery to reimplant the ureter using a combined psoas hitch and Boari ﬂap procedure, a rare and complex procedure rarely performed outside major academic centers.
Dr. Yu recommended robotic surgery since it doesn’t require a large incision, results in less scarring and avoids a long hospital stay.
Eva chose the robotic surgery and says she is very happy with the results.
“I stayed in the hospital one night, and the next day I was ready to go home. I only have five tiny scars, and recovery was easy. I’m back to work and most important, I’m pain-free!”
Dr. Yu was quick to point out the role his colleagues played. “Successful procedures like this are possible due to an exceptional team of physicians, hospital staff and nurses,” he says, referring to Eva’s surgery. "I simply cannot do what I do without the help of other people and our team."
A Team Effort
That’s a common theme among patients and caregivers, born out by the hospital’s exceptional ratings and awards. In 2014 alone, it received the Chest Pain Center Accreditation from the Society of Chest Pain Centers, “Get With The Guidelines-Stroke Gold Plus Quality Achievement Award from the American Heart/Stroke Association, and recertification for its stroke program from the Joint Commission.
But the biggest news was the hospital’s receipt of the Healthgrades Distinguished Hospital Award- Clinical Excellence for 2014. Given out to only 260 hospitals nationwide (the top 5%), the award signifies that MGH “exhibits comprehensive high-quality care across multiple clinical specialties.”
As Lee Domanico, MGH CEO put it, “Every member of the MGH team deserves recognition for this accomplishment, which could only be achieved through hard work, dedication and commitment to excellence by each person who works with us.”
The award was based on Healthgrades’ analysis of three years of Medicare Provider Analysis and Review (MedPAR) data to produce a detailed report on mortality and complication rates in America’s hospitals. That included approximately 40 million Medicare-patient records for nearly 4,500 short-term acute care hospitals nationwide, assessing hospital performance for 31 common conditions and procedures.
Healthgrades states, “The 260 Distinguished Hospital Award for Clinical Excellence recipients stand out among the rest for overall clinical excellence across a broad spectrum of care.”
Among the areas specifically cited by Healthgrades, MGH was designated as one of America’s Best 100 Hospitals for Cardiac Care and Coronary Intervention, and received top 5% and/or five star ratings for overall cardiac services, cardiology services, coronary interventional procedures, valve surgery, coronary interventional procedures and treatment of heart attacks. The hospital also got the top rating for total knee replacement (4 years in a row); treatment of stroke; treatment of pneumonia; carotid surgery; gastrointestinal care, overall GI services, small intestine surgeries, treatment of pancreatitis and gallbladder removal surgery; critical care and treatment of sepsis; and gynecologic surgery.
“It is impossible to get these across-the-board high marks unless you have superior people in every department,” says Mr. Domanico.
As Hospital Week reminds us, Marin residents can take pride that the hospital built through their generosity is one they can rely on to deliver exceptional care, every day.