By The Joint Commission, National Quality Forum (NQF) for KP Nor Cal’s Advance Alert Monitor program for predicting risk, saving lives among hospitalized patients

By Antonia Ehlers, PR and Media Relations, Kaiser Permanente Northern California

OAKLAND, Calif., April 19, 2022 – Kaiser Permanente Northern California’s life-saving Advance Alert Monitor (AAM) program – an early detection system that helps care teams predict when hospitalized patients are at risk for clinical deterioration – has been recognized by The Joint Commission and National Quality Forum (NQF).

The program has been honored with the 2021 John M. Eisenberg Award for Local Level Innovation in Patient Safety and Quality. The prestigious national award recognizes those initiatives that improve patient safety and overall quality of care.

AAM uses a predictive algorithm developed by physician researchers at the Kaiser Permanente Division of Research that scans almost 100 elements from patient health records hourly at 21 hospitals in Northern California, giving clinicians a 12-hour lead time prior to clinical deterioration, permitting early detection and intervention.

“Advance Alert Monitor is another example of how our physicians and staff maximize our extensive clinical and operational expertise, our technologically advanced systems, and our integrated care delivery model to provide exceptional care to our patients,” says Richard Isaacs, MD, FACS, who is the CEO and Executive Director of The Permanente Medical Group. “By combining the groundbreaking use of predictive analytics with clinical workflows, we’ve created a Northern California virtual center that is saving lives by helping us identify patients in medical-surgical and transitional care units who may need expedited care.”

The output of the algorithm is monitored remotely by clinical staff who virtually observe all Kaiser Permanente Northern California hospitals, and who immediately contact the patient’s local care team in the event of an alert, enabling physicians and nurses to provide critical and potentially life-saving treatment more quickly.

A recent analysis of the program by the physician researchers who developed it, published in the New England Journal of Medicine, found the system was responsible for preventing on average 520 deaths per year over a 3-and-a-half-year study period. It also showed a lower incidence of ICU admissions and shorter hospital stays.

“This award is a testament to the ongoing work of Kaiser Permanente Northern California to provide our clinical care teams cutting edge technology that enables them to predict and prevent serious complications before they happen,” said Carrie Owen Plietz, FACHE, president of Kaiser Permanente’s Northern California region. “Our staff is intervening early and swiftly, providing the appropriate medical attention to keep patients safe with improved outcomes.”

Last year, Kaiser Permanente Northern California was recognized by the International Hospital Foundation with the Autsco Excellence Award for Quality and Patient Safety for the AAM program, which is in place at all 21 Kaiser Permanente Northern California hospitals, with nurses handling more than 16,000 alerts a year.

How it works

AAM predicts the probability that hospitalized patients are likely to decline, require transfer to the intensive care unit or emergency resuscitation, and benefit from interventions. Early warnings could be helpful for patients at risk of deterioration where intervention may improve outcomes.

 

To do this, AAM analyzes electronic hospital patient data to identify those at risk of deteriorating and alerts a specialized team of Virtual Quality Nurse Consultants who determine if on-site intervention is needed. The virtual nurses contact the Rapid Response Team of nurses, which performs an assessment, and then works with the supportive-care team and the patient and/or family to develop a patient-centered treatment plan.

“Analytics tools allow us to use complex patient data to improve our care in real-time,” said Vincent Liu, MD, MS, a research scientist with the Division of Research, whose advanced analytics group developed the algorithm that underpins AAM. “They support clinicians’ practice by finding signals hidden within the electronic health record,” added Liu, whose advanced analytics group developed the algorithm with leadership from retired DOR investigator Gabriel Escobar, MD.

Nurses confirm AAM’s value

Vincent Emeziem, an ICU nurse at Kaiser Permanente Antioch Medical Center, is part of the Advance Alert Monitor team at the hospital. He said he’s seen firsthand how the program saves lives, including a recent case where a hospitalized patient was declining rapidly and because of early intervention was rushed into surgery for a life-threatening aneurism.

“This program has been very useful, and a lot of patients have benefited,” said Emeziem, a Kaiser Permanente nurse for 18 years. “These patients are getting the care they need very fast.”

The success of the Advance Alert Monitor program is attributed to the integration of care, collaboration between the clinical care teams, and the early intervention provided to patients, said Dr. Vanessa Martinez, DNP, MHA, RN, director of Virtual Nursing Care at Kaiser Permanente Northern California. “This advance technology and the expertise of our clinical care teams is allowing us to help those patients who are at most risk for severe complications and provide the necessary treatment to improve patient outcomes,” she said.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve almost 12.5 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. http://about.kaiserpermanente.org

This year’s theme is “Connecting the Dots: Opportunity for Recovery.”

How aware are you?

If you are not aware of what one “drink” means it could be any of the following: 12 oz. of beer, 8 oz. of malt liquor, 5 oz. of table wine, 5 oz. of 80 proof liquor or 1.5 ounces of distilled spirits

By AlcoholAwareness.org

While you may not know, April is Alcohol Awareness Month, a good time to reflect on our drinking patterns and the role that alcohol plays in our lives.

This is a tradition that started as a way to increase awareness about a disease many Americans suffer from. The idea is to spread information locally, statewide, and overall nationwide. Alcohol has touched almost all of our lives in one way or another. The general goal of this month is to create some sort of catalyst for change and awareness.

According to the National Institute on Alcohol Abuse and Alcoholism, “Most adults in the United States who drink alcohol drink moderately and without complications. At the same time, alcohol-related problems are among the most significant public health issues in the country. Alcohol use disorder (AUD) affects about 15 million adults in the United States, and an estimated 88,000 people die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the nation.”

In 2018, the World Health Organization reported that alcohol contributed to more than 200 diseases and injury-related health conditions, ranging from liver diseases, road injuries, and violence, to cancers, cardiovascular diseases, suicides, tuberculosis, and HIV/AIDS. The National Institutes of Health (NIH) offers additional facts and statistics about alcohol misuse in the United States.

Connecting the Dots: Opportunity for Recovery

This year’s theme is “Connecting the Dots: Opportunity for Recovery.” This year’s efforts are being directed towards young individuals. These are the people that can be easily influenced by alcohol and drugs if not informed. As a parent the best thing you can do for your child is interfere. While you may want to let your kids grow and learn on their own, it is your job to actively educate them. A whopping 50% of children are less likely to use drugs and alcohol that have conversations with their parents about the risks, than those who do not.

Whether we drink, or have been surrounded by those who do drink, alcohol is a huge part of the lives of Americans.  At a time in our lives when we are being molded, the use of substances can change our lives forever. The use of alcohol at a young age opens the possibility of developing substance abuse issues later in life. As a parent every effort to help your children “connect the dots” will make a world of difference.

A huge part of Alcohol Awareness Month is Alcohol-Free Weekend which takes the first weekend in April. The aim of this weekend is to go 72 hours without drinking a single drop of alcohol. This may seem like a small task to some, but to others it could be almost impossible. That is the reason this weekend is so important. If it allows even one person to come to realization that they can’t go even 72 hours without alcohol, maybe that will inspire them to get some help.

The origins of Alcohol Awareness Month

Alcohol awareness month was started in 1987 by the National Council on Alcoholism and Drug Dependence (NCADD). It was started as a way to get the word out and possibly draw attention to those who suffer from alcohol use disorder. Most of us associate this disease as alcoholism.

The National Council on Alcoholism and Drug Dependence, originally called the National Committee for Education on Alcoholism, was founded by Marty Mann in 1944.

Once an alcoholic herself, she knew that there were many others going through the same struggles she had to, without anyone there to help. There was a stigmatism surrounding alcoholism. It wasn’t looked at as a disease like it is today. She wanted to reach out and share her experiences with others to help aid in their recovery.

The three creeds of the National Council on Alcoholism and Drug Dependence are:

1. Alcoholism is a disease, and the alcoholic is a sick person;
2. The alcoholic can be helped, and is worth helping;
3. Alcoholism is a public health problem, and therefore a public responsibility.

Mann traveled the country educating individuals on the effects of alcohol. She needed people to understand the consequences drinking had on the body. Though she died before alcohol awareness month was created, she was the inspiration for it.

Alcohol Use Disorder

To understand why there is an alcohol awareness month, you must first understand the disease itself. A lot of us have heard of the term alcoholism and assume that this is the only form of alcohol abuse that occurs. Many are not aware that alcohol abuse can come in several different forms. The true term for alcohol abuse is Alcohol Use Disorder. This can still include alcoholism but is not limited to only that.

Alcohol Use Disorder is an affliction that can be observed if you use alcohol to the point where it becomes an issue. If you cannot control your urges and continue to use it even though it causes problems, you could be suffering from this. You may also start to notice withdrawal symptoms if you stop drinking and an increase in your tolerance.

Binge drinking is another type of Alcohol Use Disorder. This is the consumption of excessive alcohol in a short period of time. For women this means consuming 4 drinks within 2 hours, for men, 5 drinks. This can have long term and short term effects on your health. This is not an obvious form of alcohol abuse, mostly because it can occur as little as once a week. However, this is the most common form of Alcohol Use Disorder.

The NIH defines a standard drink as having about 14 grams of pure alcohol. If you are not aware of what one “drink” means it could be any of the following:

• 12 oz. of beer, which is usually about 5% alcohol
• 8 oz. of malt liquor, which is about 7% alcohol
• 5 oz. of table wine, which is typically about 12% alcohol
• 5 oz. of 80 proof liquor, which is about 40-50% alcohol
• 1.5 ounces of distilled spirits, which is about 40% alcohol

What is moderate drinking?

The Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to two drinks or less in a day for men or one drink or less in a day for women, on days when alcohol is consumed. The Guidelines also do not recommend that individuals who do not drink alcohol start drinking for any reason and that if adults of legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more.

What signs to look for

There are many different signs to look for when determining if someone suffers from alcohol use disorder. Some are very apparent while others require you to take notice. If you are experiencing hangovers often accompanied by nausea, shakiness, sweating, and trouble sleeping; these are short term symptoms. Many people try to fight off these symptoms by drinking more. While these may seem like minor consequences, if this becomes a pattern that is sign there may be a problem. If you try to stop drinking and are unable to because you constantly crave alcohol this is a clear sign it is time to ask for help.

Drinking can cause a lot of conflict in your life aside from your health. If you start missing out on daily activities like work or outside interests due to hangovers than your life is being affected by drinking. Keep an eye out for family and friends. They may not consciously realize what they are doing. When drinking creates problems with friends or family it is a clear sign that you may have an addiction. Ask yourself how is my drinking affecting myself and those I care about?

Organizations Fighting Alcohol Use Disorder

Taking that first step toward recovery may seem daunting. Though we have already mentioned the National Council on Alcoholism and Drug Dependence, many organizations and groups have been developed and funded to help aid in the recovery of alcohol use disorder:

Alcoholics Anonymous- The first and most common would be AA or Alcoholics Anonymous. The reason this group has gained so much popularity is because it is run by a community of recovering alcoholics. They too have been where you are now and will understand better than anyone what you need to her. They have free meetings in almost every city or town around the country. Their 12 step process will give you an optimistic, driven path to follow on the road to recovery.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)- This is an organization that publishes material to help you stay informed. They stay up to date with alcohol and treatment research so that you always have a place to find the answers. If you have questions about the effects of alcohol and other consequences this is the organization to reach out to. Rethinking Drinking is a resource that can help you assess your drinking habits and provide valuable, research-based information to help you cut back or stop drinking if needed. It is available online as an interactive tool at https://www.rethinkingdrinking.niaaa.nih.gov and as a brochure that can be downloaded at https://pubs.niaaa.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf.

National Institute on Drug Abuse (NIDA)- If you have questions about the science behind alcohol abuse, this is the organization to check out. They release data that shows the long term and short-term effects of alcohol use. They also may help lead you to a correct diagnosis; if you are unsure of how severe the problem is that you or someone you care about is struggling with.

Al-Anon and Alateen- There are a lot of resources available to those on the path to recovery. However, they are not the only ones that need help. If you know someone struggling with this disease you may not know how to help them or deal with the stress that accompanies supporting someone through this tough time. This is group you can reach out to in person or over the phone when things seem to be getting too hard. They will show you how to be both encouraging and understanding.

While these are only a few of the groups that you can reach out to, there are many more ready and willing to help. Check your area to find groups that are specific to your local and may be able to help.

What resources can you use?

Once you are ready to address the problem, seeking out treatment is a good next step. Since this is already a hard step to take; you do not want to have to worry about how costly it can be too. Private rehab centers can be very expensive. But they are not the only choice. There are a lot of options that don’t put a drain on your finances.

Two less expensive avenues you can take are government funded treatment and non-profit treatment. While the two rely on very different funding support, both can help assist you in a less costly matter.  If you are not ready to take that extreme of a step, there are countless helplines that you can call. Just having the opportunity to talk to someone anonymously can make a difference.

Impact of Alcohol Awareness Month

What can on month do for the lives of so many alcoholics? The important of awareness is more critical now than ever. A 2014 study from the CDC revealed that excessive alcohol consumption was responsible for the death of almost 1 in 10 U.S. adults between the ages of 20 and 64. This means that approximately 88,000 lives are a lost to excessive alcohol use every year. What this accounts for is roughly 2.5 million years of potential life lost every year. These are a result of a combination of long term and short-term effects.

This is why it is so important to raise awareness on a local, state, and national scale. There are about 20 million individuals and their family members who are living in recovery. This proves that anything is possible.

Spread the word

While a month is not enough time to educate and help everyone recover, it at least gets the public talking. Do what you can in your community. Create pamphlets, or newsletters and distribute them around your neighborhood town. Host an event and invite everyone around the community to learn and spread alcohol awareness. Host a fundraiser to donate money to a local non-profit treatment facility.

The most important thing we can do as a society is to recognize that there is a problem. With that realization only then can we move forward. There are many people still in the dark about this disease. There are those who struggle with the disease or some who may know, but not recognize someone who is suffering. Maybe this month is an opportunity for us to fix that.

Allen D. Payton contributed to this report.

 

By Antonia Ehlers, PR and Media Relations, Kaiser Permanente Northern California

Colorectal cancer is the second leading cause of cancer deaths in the United States among men and women combined. With March being Colorectal Cancer Awareness Month, it’s a good time to remind those in your life about the importance of regular screening.

Following recently updated federal guidelines, Kaiser Permanente Northern California is now recommending screening to adults ages 45 to 49. Previously, the recommended screening age was 50 for adults who are at average risk for colorectal cancer.

“These new guidelines are important because younger people are getting colon cancer more often,” said Theodore Levin, MD, a gastroenterologist at the Kaiser Permanente Walnut Creek Medical Center. “Today, we have more options. A patient can have a colonoscopy or the at-home fecal immunochemical test.”

According to Levin, the increase in cases in younger patients has been linked to obesity, antibiotic use, and sweetened sodas and sports drinks.

Kaiser Permanente is expanding its easy to use, at-home colorectal cancer screening program to members age 45 and older following a nationwide increase in deaths of people under age 50. The fecal immunochemical test (FIT) for colon and rectal cancer is mailed annually to members’ homes, free of charge. 

Colorectal cancer symptoms include rectal bleeding, abdominal pain, a change in bowel habits and unexplained weight loss. The FIT test checks for hidden blood in a patient’s stool, which could be a sign of cancer or benign colorectal polyps.

If a test is positive, a colonoscopy is ordered to examine the inner lining of the colon and rectum for signs of cancerous or pre-cancerous growths.

According to Jeffrey Fox, MD, chair of Gastroenterology for The Permanente Medical Group in Northern California, Kaiser Permanente’s home screening test has lowered colorectal cancer deaths by 50 percent among its members during the past two decades.

“We estimate that our members have a 30 percent less risk of death from colorectal cancer than non-members in part because of this testing program,” he said.

Dr. Fox also noted that in addition to reducing deaths through use of the test among all members, Kaiser Permanente Northern California also has drastically reduced the rate of colorectal cancer among Black members. Targeted testing outreach over the last 10 years has brought the rate down from 54.2 per 100,000 to 21 per 100,000, which now is the same rate as white members.