New Programs, Services & Health Facilities 2001-2012

Sutter Health Preserving and Enhancing Health Care Services Updated August 6, 2012 New Programs, Services & Health Facilities 2001-2012 To help preserve community-based health care services during challenging times for health care organizations (link if necessary), many physicians and hospitals from throughout Northern California came together to form Sutter Health. Today our network includes more than two dozen community-based, not-for-profit hospitals, relationships with approximately 5,000 physicians, and a breadth of other programs and services, including home health and hospice care, health education and medical research. Becoming part of Sutter Health has not only protected our affiliated organizations during very challenging times, it has also helped them grow and improve. Working together, Sutter Health affiliates are helping advance the quality of care in Northern California. Consider these facts: Since affiliating with Sutter Health, every one of our hospitals and physician organizations (medical foundations) has added new health care programs and services. More than 600 new programs and services have been added by our hospitals and medical foundations since 2001. The listing that follows is just a sampling. Since 2001, Sutter Health has built or replaced 13 hospitals and 21 major patient care centers throughout Northern California (see locations below) Twenty-four hour emergency services have been enhanced and expanded in Sacramento, Davis, Roseville, Modesto, Lakeport, Crescent City, Jackson, Vallejo, Castro Valley, Burlingame, Santa Rosa, Marin County, Antioch and San Mateo. Sutter Health doctors and hospitals are sharing their knowledge and expertise with one another to find better ways of treating disease and caring for patients. For example, our affiliates are helping improve early detection and treatment of breast cancer, treatment of heart attack, care of patients with congestive heart failure, and care of first-time mothers and their babies to achieve the best possible outcomes. New hospitals: Crescent City, Davis, Novato, Modesto (new seven-story patient care tower), Santa Cruz, Burlingame, Castro Valley, Oakland (new patient care tower), Santa Rosa, Jackson, Sacramento (two) and Roseville. New hospital proposed for San Francisco. New care centers: Sacramento, Lincoln, Elk Grove, Modesto, Palo Alto, Fremont, Mountain View, Redwood Shores, Burlingame, San Carlos, San Mateo, Berkeley, Santa Rosa, Tracy, Stockton, Fairfield, San Francisco, Vallejo, Woodland, Marysville and Yuba City. 1

Affiliate-Specific Listing Table of Contents (click to link directly to page) ALTA BATES SUMMIT MEDICAL CENTER... 3 CALIFORNIA PACIFIC MEDICAL CENTER (INCLUDING ST. LUKE S HOSPITAL)... 5 EDEN MEDICAL CENTER (INCLUDING SAN LEANDRO HOSPITAL CAMPUS)... 8 KAHI MOHALA, A BEHAVIORAL HEALTHCARE SYSTEM... 9 MEMORIAL HOSPITAL LOS BANOS... 10 MEMORIAL MEDICAL CENTER... 11 MENLO PARK SURGICAL HOSPITAL... 13 MILLS-PENINSULA HEALTH SERVICES... 14 NOVATO COMMUNITY HOSPITAL... 15 PALO ALTO MEDICAL FOUNDATION (INCLUDING PALO ALTO, CAMINO, MILLS AND SANTA CRUZ DIVISIONS)... 16 SAMUEL MERRITT UNIVERSITY... 18 SUTTER AMADOR HOSPITAL... 19 SUTTER AUBURN FAITH HOSPITAL... 20 SUTTER CARE AT HOME (FORMERLY SUTTER VNA & HOSPICE)... 21 SUTTER COAST HOSPITAL... 22 SUTTER DAVIS HOSPITAL... 23 SUTTER DELTA MEDICAL CENTER... 24 SUTTER EAST BAY MEDICAL FOUNDATION... 26 SUTTER GOULD MEDICAL FOUNDATION (INCLUDING GOULD MEDICAL GROUP)... 27 SUTTER LAKESIDE HOSPITAL... 28 SUTTER MATERNITY AND SURGERY CENTER... 29 SUTTER MEDICAL CENTER, SACRAMENTO (INCLUDING SUTTER CANCER CENTER, SUTTER CENTER FOR PSYCHIATRY, SUTTER GENERAL HOSPITAL, SUTTER MEMORIAL HOSPITAL)... 30 SUTTER MEDICAL CENTER OF SANTA ROSA... 32 SUTTER MEDICAL FOUNDATION (INCLUDING SUTTER MEDICAL GROUP, SUTTER NEUROSCIENCE MEDICAL GROUP AND SUTTER WEST MEDICAL GROUP)... 33 SUTTER NORTH MEDICAL FOUNDATION (INCLUDING SUTTER NORTH MEDICAL GROUP)... 34 SUTTER PACIFIC MEDICAL FOUNDATION (INCLUDES PHYSICIAN FOUNDATION AT CALIFORNIA PACIFIC MEDICAL CENTER, PHYSICIAN FOUNDATION MEDICAL ASSOCIATES, INC., MARIN HEADLANDS MEDICAL GROUP, SUTTER MEDICAL FOUNDATION NORTH BAY, SUTTER MEDICAL GROUP OF THE REDWOODS )... 35 SUTTER REGIONAL MEDICAL FOUNDATION (INCLUDING SOLANO REGIONAL MEDICAL GROUP AND SUTTER DELTA MEDICAL GROUP)... 36 SUTTER ROSEVILLE MEDICAL CENTER... 37 SUTTER SOLANO MEDICAL CENTER... 38 SUTTER TRACY COMMUNITY HOSPITAL... 40 NOTEWORTHY SYSTEM DEVELOPMENTS... 41 2

Alta Bates Summit Medical Center (Affiliated in 1996; name changed from Alta Bates Medical Center in July 2000) Implemented a new diabetes program to further enhance care and services for patients in the community battling the chronic illness. Began offering a specialized asthma education program to help patients better identify triggers to help keep them out of the hospital. Established the East Bay AIDS Clinic and developed a Downtown Youth Clinic, to support the growing population of young adults at risk for or with HIV/AIDS Began offering Intra operative Radiotherapy (IORT), an intensive radiation treatment administered during surgery to treat cancers resist eradication during surgery alone. Initiated a Palliative Care program at Alta Bates Summit Medical Center to help support patients with chronic illnesses. Because of the widespread community need for fast and effective stroke treatment, Alta Bates Summit developed a Regional Stroke Center. Our Stroke Center is dedicated to quick response, advanced treatment and comprehensive rehabilitation services that span all three medical center campuses. Began offering Bronchial thermoplasty, a new, technologically advanced procedure for severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long acting beta agonists. Brought the da Vinci Robotic Surgical System single site procedure to patients in the East Bay. Added superdimension ilogic System, a new, minimally invasive tool for accessing lung lesions, especially those located beyond the reach of traditional bronchoscopes. Launched an International Early Lung Cancer Screening program Opened a new Outpatient Imaging Center at the Providence Campus Began using a 64-Slice CT Scanner, which allows physicians to see more anatomical detail in only a fraction of the time. To enhance and advance care for surgery patients, began pre-and-post operative vein mapping for native arteriovenous fistula (AVF) maturation Enhanced liver screening for detection and characterization of malignant and benign liver lesions with MRI/EOVIST Began offering MRI enterogrpahy to produce detailed images of small intestine Began performing minimally invasive radioguided parathyroidectomyfor patients. Began offering Y90 liver embolization for patients battling liver cancer. As part of an expansion of the COMPASS Guide program, began offering multilingual Breast Cancer navigators to further support patients diagnosed with breast cancer. Added genetic counseling and testing for patients. Opened a Breast Health Clinic specializing in care for women of Korean descent. Colorectal Cancer Awareness Screening Program The Summit campus opened a Family Resource Center The Alta Bates campus opened a Family Resource Center Completed a $4.7 million renovation of the Electrophysiology Room Upgraded Echo machines to include 3D capability in the Surgery unit at Summit campus, and the non-invasive cardiology unit Alta Bates and Summit campuses. Replaced the Interventional Radiology Room at Summit campus. Opened a new Imaging Center on the Summit Campus, with state-of-the-art imaging equipment that delivers efficient exams, superior service and quick turnaround. Broke ground on the new Patient Care Pavilion in Oakland. Alta Bates Summit opened a Women s Health Center in Lafayette. Opened the Carol Ann Read Breast Health Center. This state-of-the-art center brings all diagnostic modalities to one place, which will make for the quickest turnaround in diagnosis and facilitate collaboration among the various specialties. Alta Bates Summit Medical Center began offering TomoTherapy Hi-Art Treatment. ABSMC is the first in the Bay Area to offer helical IMRT treatment for brain, breast, head & neck, lung, pelvic and prostate malignancies. The newly redesigned 12,300-square-foot emergency department opened to better serve the needs of the community. Equipped with the latest technology, private patient rooms and a separate entrance dedicated to first-responders, employees and the community will have the modern space they need. As a part of new countywide program to improve patient outcomes Alta Bates Summit Medical Center was named a cardiac receiving center in Alameda County. The Summit Campus opened new Cath Lab #5, resulting in now offering five labs to the community. Alta Bates Summit Medical Center opened its new emergency department its first makeover in more than three decades. The new emergency department is approximately 6,000-square-feet and includes large patient rooms, a nurses station, locked pharmacy station and charting rooms for physicians and paramedics. Old emergency department also remodeled; the $15.8 million department covers approximately 12,000 square feet with 22 beds and an updated entrance. 3

The Imaging Department of Alta Bates Summit Medical Center installed a Picture Archival Communications System, which will enhance patient care by improving physician access to diagnostic imaging. Alta Bates Summit Medical Center installed new equipment to enhance its medical imaging capabilities including a new secular X-ray and biplane Cardiac X-ray systems. Alta Bates Summit Medical Center and Telecare, a daily phone service that checks on elderly and home-bound community members, are collaborating with the Alameda County Senior Injury Prevention Project to sponsor a research project to demonstrate that regular exercise reduces the incidence of falls and hospitalizations related to falls. Alta Bates Summit Medical Center introduced a new intuitive surgical robotic system to support physicians and staff in performing complex procedures such as radical prostatectomy, heart valve replacement and coronary artery bypass graft (CBAG). Alta Bates Summit Comprehensive Cancer Center is the first on the West Coast to treat patients using automated respiratory gating, a computer-aided technique used in radiation therapy to automatically compensate for tumor movement due to a patient's respiratory cycle. Physicians at Alta Bates Summit Medical Center made significant advances in the use of technology to enhance and improve patient care with the da Vinci greater detail Alta Bates Summit Medical Center cardiologists began offering Intracoronary Brachytherapy, a breakthrough therapy for patients whose stented coronary artery has become narrowed by scar tissue. In an effort to strengthen and broaden the scope of HIV services in the community, Alta Bates Summit Adult Immunology Clinic and the East Bay AIDS Center merged and created one of the largest and most diverse HIV programs in California. The Summit Campus of Alta Bates Summit Medical Center opened its newest cath lab, raising the total number of cath labs at Alta Bates Summit to four. Alta Bates Summit Medical Center acquired four Acist Contrast Management Injection systems from Bracco Diagnostics for its cardiac cath labs. These injectors expedite procedures, provide for use of smaller catheters and eliminate hand fatigue from multiple hand injections. Radiation Oncology at the Summit Campus received the new Digicut automatic precision Block Cutter and advanced "Eclipse" 3D treatment planning computer from VARIAN Medical Systems which greatly improves treatment accuracy. 4

California Pacific Medical Center (including St. Luke s Hospital) (Affiliated in 1996) California Pacific Medical Center and Lucile Packard Children s Hospital at Stanford began working side-by-side at the pediatric inpatient units at CPMC s California Campus to expand access to high-quality pediatric services. Institute for Health and Healing complementary medicine services introduced at St. Luke s campus Diabetes Center patient services expanded at St. Luke s campus through introduction of new technologies. Began use of da Vinci robotics for GI, gynecologic and urologic surgeries Introduced Interoperative Radiation Therapy (IORT) as an innovative cancer treatment Performed the West Coast s first 5-way kidney swap transplantation surgeries CPMC s stroke telemedicine program expanded to eight sites Initiated single week breast cancer radiation treatment Seismically retrofitted main hospital building on St. Luke s campus Stroke telemedicine program consulting services made available to critical neurology patients at St. Luke s campus Began offering care for neurology, oncology and hepatology for patients at the St. Luke s campus. St. Luke s Health Care Center extended hours and days of operations for the Pediatric Clinic and Women s Center. A new digital mammography system became available for patients at St. Luke s campus. St. Luke s upgraded its pharmacy equipment to include medication dispensing machines that help improve medication safety for patients. Stroke telemedicine consulting services introduced for critical neurology patients at St. Luke s campus Opened chemotherapy infusion center Expanded melanoma surgery service to include all types of melanoma Opened the Kalmanovitz Child Development Center in Marin St. Luke s opened a specialty clinic, providing orthopedics for adults and pediatrics, oncology/hematology, gastroenterology, neurology, and breast surgeons. CPMC Regional Rehabilitation Center renovation and expansion completed with more acute rehabilitation beds and state-of-theart facility design and equipment. CPMC launched a stroke telemedicine program. Initiated cancer genetics program Began multidisciplinary liver cancer and melanoma clinics Opened interventional radiology lab at Davies campus Established a dedicated neonatal/pediatric transport team to expand outreach and meet community needs To provide more specialized care for the youngest of patients, CPMC opened the first Pediatric Emergency Department in San Francisco. CPMC opened the SimSurg Center the most technologically advanced surgical training center in the nation, and in certain aspects, the world. CPMC began offering EKOS Microcan-Infusion Catheter a new procedure using an ultrasound enhanced delivery catheter to help patients suffering from deep vein thrombosis avoid discomfort and pain associated with the condition. Expanded the echocardiogram lab and built a new interventional and surgical suite for the Neuroscience Institute. Opened the Frank Stein and Paul S. May Center for Low Vision Rehabilitation Opened Center for inflammatory bowel disorders. Pediatric Surgery offered at the California campus Began cancer patient navigation services Opened a Special Care Nursery on the St. Luke s campus and completed extensive renovations throughout the hospital. California Pacific Medical Center became the first medical research institution in the world to use a gene therapy to treat Hepatitis B, the second leading cause of cancer worldwide. CPMC opened a unique rehabilitation terrain park that helps patients recovering from an injury or stroke learn how to walk again. The first-of-its-kind features real world challenges such as uneven surfaces, marble floors, gravel hiking trails, even beaches and cobble stoned roads. The idea is to help patients learn how to walk in an environment that prepares them for the kinds of challenges they will face outside the hospital. California Pacific Medical Center opened the first medical center in San Francisco devoted solely to caring for the health needs of women and children. The new Women and Children s Center houses all of CPMC s pediatric and women s health services on one site and was specifically re-designed to offer pediatric patients and their families the best in health care services, new state-of-theart technology, and some added home comforts to make their stay more comfortable. The new Bayview Child Health Center opened to bring high quality, affordable health care to a community in need. The clinic will provide a wide range of services including physical exams, well-baby care, urgent care appointments, nutrition education, referrals to specialists, even weight management classes and mental health services. Charles E. Williams PET/CT Scanner installed, allowing clinicians to quickly assess a tumor s response treatment 5

Opened dedicated Interventional Endoscopy Center Began offering head and neck melanoma surgery St. Luke s launched the HealthFirst program for children with asthma and adults in need managing diabetes. The program pairs patient with community health workers as care partners to improve health outcomes. To help detect cancer earlier so that patients can live longer and healthier lives, St. Luke s opened its new Breast Health Center. St. Luke s implemented a state-of-the-art security system to further protect the safety of newborns Physicians at California Pacific Medical Center are making major advances in the use of technology to enhance and improve patient care by using the da Vinci robot to perform heart surgery, which allows the surgeon to greater more detail California Pacific Medical Center developed the African-American Breast Health Program to help ensure African American women have access to the breast health services and treatments that may save their lives. California Pacific Medical Center began offering the Deep Inferior Epigastric Perforator flap procedure, an advanced reconstruction procedure that uses breakthrough muscle-sparing microsurgery techniques combined with advanced plastic surgery practices to rebuilt lost breast following mastectomy. For patients with early stage breast cancer, California Pacific Medical Center introduced a new form of radiation therapy called Mammosite RTS, which reduces time spent in radiation therapy from seven weeks to just five days. California Pacific Medical Center established a tele-echocardiogram service with Sutter Medical Center of Santa Rosa, enabling pediatric cardiologists in San Francisco to view procedures in real time as patients are seen in Santa Rosa. California Pacific Medical Center started a new pediatric diabetes program. California Pacific Medical Center s Radiation Oncology Department implemented a Stereotactic Radiosurgery program to treat small lesions of the brain that might not otherwise be operable. Opened the Kanbar Cardiac Center. Located within the Pacific campus, the center includes three new cardiac catheterization labs as well as technically advanced, cardiac noninvasive diagnostic equipment California Pacific Medical Center s Department of Radiology now offers three types of CT screening exams, including coronary calcium, lunch cancer and virtual colonoscopy screenings. Initiated Neurovascular/Stroke Program St. Luke s Hospital added Mammography R2 Technology with ImageChecker System computer aided detection, which acts as a second pair of eyes for physician and minimizes the possibility of false-negative readings. The latest technology is part of the $16 million in new equipment St. Luke s has added in the past year to advance patient care including an MRI, CT Scanner, mammography digitizer and nuclear medicine camera. St. Luke s established a successful collaboration with the Latina Breast Cancer Agency to promote Mujeres Cuidando Mujeres and to provide low-income, medically underserved Latinas over 40 with the opportunity to receive free clinical exams and mammograms. St. Luke s surgical suite received a $1.2 million electrical upgrade, four new surgical tables, one new surgical light and two new sterilizers. As part of Sutter Health s system-wide patient safety initiative, St. Luke s implemented offsite monitoring of ICU beds, and made significant progress toward implementation of emap, an electronic medication administration program that uses barcoding technology to ensure that the right medication is given to the right patient at the right time. California Pacific Medical Center expanded its liver transplant program by opening an outreach site in Nevada. This program has 19 outreach clinics in places such as Oakland, Sacramento and San Luis Obispo, Calif. California Pacific Medical Center's Department of Radiation Oncology installed new stereotactic radiosurgery and radiotherapy equipment for treating brain tumors. The Center for Diabetes Services at California Pacific Medical Center began offering a state-of-the-art blood glucose monitoring system that tracks blood sugar levels continually for three days. Physicians and diabetes educators use the data collected to more precisely determine the patient's insulin needs. California Pacific Medical Center's surgeons began using a "New Pyloric Sparing Whipple" technique to detect small tumors that other imaging studies may miss. California Pacific's motility program added two new diagnostic tools for patients with gastrointestinal disorders including a capsule ph test and an electrogastrogram. Both tests allow for quick diagnosis with little discomfort. St. Luke's Hospital has opened its Cardiac Cath Lab To better serve its patients, St. Luke s established a new department of orthopedics. St. Luke s converted its fifth floor Mother/Baby Unit to all private rooms. St. Luke s completely renovated the main hospital lobby and the entrance to the Monteagle medical office building. California Pacific Medical Center, in partnership with the Institute on Aging, opened the Irene Swindells Center for Adult Day Services. The center offers daytime care for adults with Alzheimer's, Parkinson's or other forms of dementia. California Pacific Medical Center's Radiation Oncology Department installed a Varian(tm) linear accelerator that offers the most advanced clinical capabilities in the industry. California Pacific Medical Center physicians offered two new procedures. The first procedure involves an implantable gastric pacemaker that stimulates the stomach to control the intractable nausea and vomiting associated with gastroparesis. The second procedure is a nerve stimulation system that prevents or interrupts electrical disturbances in the brain for persons with hard-to- 6

control epileptic seizures. California Pacific Medical Center began offering genetic risk assessment services for patients at higher risk for developing breast, ovarian, colorectal or endometrial cancer. Experts in the field of genetic medicine such as physicians and certified genetic counselors will evaluate, educate and counsel these high-risk patients. California Pacific Medical Center added new technology including multi-slice CT scanners, biplane angio/interventional suite, digital X-rays, stereotactic radiosurgery and two new MRIs. St. Luke s made $2.75 million in capital improvements to the hospital during the year. St. Luke s collaborated with the medical staff at California Pacific Specialty Services to begin construction on a new cardiac center for San Francisco s South-of-Market community. Sutter Health granted $6.4 million to construct the advanced center. St. Luke's Stonestown Imaging Center installed a new Instrumentarium Imaging mammography unit that features a compression system to make mammograms more comfortable. 7

Eden Medical Center (including San Leandro Hospital campus) (Affiliated in 1998) Rebuilding Eden Medical Center Began offering PET/CT scanning services for patients. Opened an oncology rehabilitation unit specializing in supporting cancer survivors. Physicians at Eden Medical Center began working to diagnose cancer sooner by using endobronchial ultrasound a new technology to diagnose lung cancer in its earliest stages for better treatment outcomes. Began offering minimally invasive thoracic surgery and Brachytherapy treatments Opened outpatient wound care clinic Partnered with Youth Alive, a hospital based youth violence intervention program for patients between the ages of 14 20 who have been brought to Eden s Trauma Center as the result of a violent act. Began offering next Generation PET/CT Scanner services at Eden Medical Center for optimized oncology imaging Purchased the O-arm device to improve patient safety, reduce surgical recovery times and improve surgical outcomes for spine surgery. The device provides surgeons with a navigable 3-D model of the spine and shows them a live rendering of complex spinal anatomy, allowing them to achieve a degree of accuracy with surgical instruments and implants that was previously much more difficult. Eden Medical Center took the first steps to building a new state-of-the-art hospital in Castro Valley that will better serve patients and the area communities for years to come. Implemented critical Hospitalist services at the San Leandro campus to further improve care for patients admitted to the hospital through a partnership with the Sutter East Bay Medical Foundation. Eden Medical Center began offering Balloon Sinuplasty, a new minimally invasive procedure that can help patients suffering with chronic sinusitis to return to normal activities in up to 48 hours. Eden Medical Center began offering LightSpeed VCT at its San Leandro Hospital campus. A state-of-the-art CT imaging system, LightSpeed allows doctors to perform new and enhanced procedures and get the information they need more quickly to diagnosis patients suffering from chest pains or stroke-like symptoms. Eden Medical Center established a Rapid Response Team a group of specialists available 24 hours a day to rush to the bedside of any patient at immediate risk of having an imminent heart attack. With the purchase of three new Cholestech machines, Eden Medical Center provides cholesterol screenings for up to 24 people an hour. Previously, one machine was shared among regional affiliates. Eden Medical Center overhauled its imaging services by implementing the digital radiology imaging system, PACS, which replaces traditional film-based X-rays with digital images and allows medical experts to provide faster and more enhanced care and service to patients Eden Medical Center unveiled its $8.5 million Sutter East Bay Neuroscience Center, which provides advanced medical and surgical care for the treatment of brain tumors, vascular disorders, movement disorders, and spinal and peripheral nerve problems. Eden Medical Center completed the remodeling of the Women s Health Services, an entire floor dedicated to the care of women. Changes include more private rooms and showers, as well as aesthetic changes to create a warm and caring environment. Eden Medical Center s Emergency Department was expanded to include more treatment rooms, a reception and registration area with improved patient privacy, a children s corner and larger nursing station. Eden Medical Center opened a neurointerventional suite, allowing brain trauma patients to stay in the community for neurointerventional radiology services. Eden Medical Center opened a new Imaging Center, which features diagnostic and screening mammography, stereotactic breast biopsy, nuclear medicine with PET capabilities, done densitometry, the latest MRI technology and three-dimensional ultrasound. Eden Medical Center completed the first phase of its Surgery Department expansion, adding another surgery suite. Eden Medical Center launched emap SM, a medication administration program that uses bar-code technology to better ensure safe bedside delivery of patient medications. Eden Medical Center neurosurgeons started providing spinal fusions using a less-invasive technique. Patients benefit from shorter hospital stays, less scarring, shorter recovery time and less post-operative pain. Eden Medical Center's Emergency Department expansion began and will include construction of additional evaluation rooms, support space, a registration area and waiting room that will increase patient privacy. Eden Medical Center opened a new fluoroscopy room with technology that provides faster, more vivid images with less radiation. Eden Medical Center's Nuclear Medicine Department introduced new technology to perform advanced Bone density studies, allowing early intervention and prevention of osteoporosis. Eden Medical Center s Radiology Department installed on-site stereotactic equipment to perform breast biopsy procedures. 8

Kahi Mohala, A Behavioral Healthcare System (Affiliated in 1992) Renovations to the Lokelani child and adolescent unit were completed. Kahi Mohala expanded outpatient services including a new electroconvulsive therapy suite and new televideo technology to provide mental health screenings for hospital patients. Kahi Mohala created a new Electro-Convulsive Therapy Suite. Kahi Mohala redesigned its inpatient Eating Disorder Service, which is constructed around positive behavioral supports and cognitive behavioral therapy. A physician at Kahi Mohala is one of only three physicians in the state of Hawaii providing electro convulsive therapy to patients. Kahi Mohala received a Department of Education contract to provide outpatient mental health services for the hearing impaired. Kahi Mohala opened a new pharmacy providing in-house services and an outpatient service for patients families. A new medical library provides medical texts, medically related computer software and patient education materials. Kahi Mohala entered into two agreements with the Hawaii State Department of Education to deliver psychiatric services to children in the leeward side of Oahu and to provide mental health counseling to deaf children and their families. Kahi Mohala partnered with three other not-for-profit community organizations to provide mentoring services for children of prisoners. Services will be delivered on Maui and Oahu and will include delivering therapy to traumatized children. Kahi Mohala and the Hawaii Clinical Research Center began conducting cutting-edge clinical research and education with psychoactive and other investigational medications through in-patient clinical trials with study volunteers. Kahi Mohala implemented The Star Program, an individualized system used to assist each patient with meeting treatment plan goals by increasing self-esteem, self-awareness and promoting positive behavior. 9

Memorial Hospital Los Banos (Affiliated in 1996) Memorial Hospital Los Banos implemented a Hospitalist program Installed pneumatic tube system from the Emergency Department to the Laboratory and Pharmacy. Installation of the tubing system improves the quality of patient care and provides a superior patient experience. The system transports pharmaceuticals, laboratory specimens, blood products, paperwork and sensitive medical items. Memorial Hospital Los Banos implemented Sutter Health's electronic health record system, along with Memorial Medical Center in Modesto and Sutter Tracy Community Hospital. To improve the quality and consistency and help reduce the overall cost of care for patients, initiated a program to convert inpatients from IV administered antibiotics to oral antibiotics. Expanded MRI availability with permanent placement of a mobile platform. To further improve medication safety, Memorial Hospital Los Banos completed conversion to Pyxis 4000 dispensing units. Redesigned the trauma bay. Began implementation of lab services for the Central Valley Service Area for Modesto, Los Banos and Tracy. Implemented the collaboratively built Sutter Health enterprise-wide MIDAS Quality Management application. Led local implementation of American Heart Association s START Program Completed facility upgrades to OB and Emergency Department Implemented Interdisciplinary Practice Model (IPM), a patient centric delivery process. Implemented a new room service program for patients in the OB Unit. Expanded and updated many facilities including the emergency and radiology departments and rural health clinic. Memorial Hospital Los Banos implemented the eicu, part of Sutter Health s $50 million commitment to improving quality care and patient safety. Memorial Hospital Los Banos expanded its radiology services by adding a new state of the art Helical CT scanner and PACS computer archival system. Memorial Hospital Los Banos remodeled the Med Surg Wing of the hospital. The Radiology Department at Memorial Hospital Los Banos installed a state-of-the-art Helical CT scanner and switched to digital X-rays. Memorial Hospital Los Banos opened its remodeled and expanded Rural Health Clinic, which enhances medical care in the community by offering services in orthopedics, urology, ENT, diabetes training, dietician consultation, general surgery and obstetrics. Began offering dietary consultations to patients through the Rural Health Clinic at Memorial Hospital Los Banos. Memorial Hospital Los Banos expanded and enhanced its Physical Therapy department to meet the increasing needs of the community. Memorial Hospital Los Banos developed a wound care program. Mobile MRI services were added at Memorial Hospital Los Banos. Construction began at Memorial Hospital Los Banos Rural Health Clinic to expand treatment rooms from three to five and add additional space to help nurse practitioners meet demands from an increasing volume of patients. Memorial Hospital Los Banos introduced a new support program for cancer survivors and their families called I Can Cope. 10

Memorial Medical Center (Affiliated in 1996) Memorial Medical Center opened a hybrid OR - the only operating room-based, fully functional imaging and hybrid suite in the region. It houses the most advanced imaging systems available to provide quick and detailed information for shorter, more accurate treatment with substantially less X-ray exposure when compared to traditional devices. Memorial Medical implemented Sutter Health s electronic health record system. Memorial Medical Center s Trauma Services Department was verified as a Level II Trauma Center by the Verification Review Committee, an ad hoc committee of the Committee on Trauma (COT) of the American College of Surgeons. To empower clinicians, help advance training and education, and further improve care for premature babies, began using an innovative neonatal resuscitation simulator mannequin. Implemented the StreamLAB technology, which further improves the predictability and reliability of turnaround times for chemistry tests that physicians need when treating and diagnosing patients. Implemented the collaboratively built Sutter Health enterprise-wide MIDAS Quality Management application. As part of our long-term efforts to improve patient and employee safety, a Sutter Health network team and Memorial Medical Center, Modesto worked to develop short- and long-term solutions for patient mobilization. Specifically, Memorial Medical Center in Modesto installed 50 ceiling lifts and will be installing an additional 20-25 per year over the next several years to further improve patient mobility safety. Memorial Medical Center, Modesto opened its new state-of-the-art, seven-story patient care tower. Opening of the first five floors of the North Tower expansion, a seven-story patient care tower featuring 112 inpatient beds and 18 operating rooms. As with previous construction, the remaining two floors have been shelled in to accommodate future expansion. Added writing and art therapies to Memorial Medical Center s Complementary Therapy Program, an element of the hospital s Cancer Services that enhances the lives of cancer patients and their families as they heal or cope following a diagnosis of cancer. Memorial Medical Center s Intensive Care Unit implemented the eicu system, which uses telecommunications from bedside monitors, remote cameras, trend-recognition software and clinical decision software to enable board certified Sutter intensivists in Sacramento to assist local physicians in caring for their ICU patients at Memorial in Modesto. Memorial Medical Center initiated the SBAR (Situation - Background - Assessment - Recommendation) program to enhance the organization and communication of information between members of the hospital staff. Memorial Medical Center introduced the Rapid Assessment and Treatment Team to reduce code blue events by making critical care interventions and early, advanced assessment available in non-critical areas. Memorial Medical Center celebrated the Topping Out of its North Tower Project when the uppermost steel beam supporting the building was hoisted and secured into place, marking completion of the building s steel structure. When it opens in spring 2007, the $170 million, seven-story North Tower will include 112 acute medical inpatient beds, 18 state-of-the-art operating rooms and relocated lobby, gift shop and administrative areas. Five floors of the building will be completed, with the remaining floors shelled in to make them available for expansion as future growth requires. Memorial Medical Center initiated a new OB Online Pre-registration Program to help women scheduled to deliver at the hospital better plan for their new babies from the comfort of their own homes. Memorial Medical Center opened its Live Life Well Store in a newly relocated Health Education and Conference Center to feature products that enhance the health and well being of patients who face physical and emotional challenges during and after recovery. Memorial Medical Center joined the Stanislaus County Asthma Coalition to help fund the local Air Quality Alert Flag Program. Memorial is the first local hospital to participate in this program and began flying flags on its campus to alert the community, patients and employees of 6 daily air quality conditions. Memorial Medical Center was designated a Level II Trauma Center, making it one of only two trauma centers for Stanislaus, Alpine, Calaveras, Amador, Mariposa and Merced Counties. Memorial Medical Center broke ground on its North Tower project, which will add 112 acute medical inpatient beds and 18 new operating rooms. The $160 million project is slated for completion in early 2007. Memorial Medical Center opened a 10,000-square-foot addition to its Family Birthing Center. The $4.6 million expansion includes 11 postpartum beds and three labor/delivery rooms. It provides more private patient rooms with private showers, an expanded waiting room and a new area to view newborns. The clinical laboratory at Memorial Medical Center began performing a diagnostic test for determining heart failure as well as the Methotrexate test, which is used to treat leukemia. Memorial Medical Center's Emergency Department implemented rapid hemoglobin testing for trauma patients and others who might need transfusion. The department's Quick Registration Program helps speed this treatment process. Construction began on a new medical office building at the southeastern corner of the Memorial Medical Center campus. The building, which will provide on-site office and medical treatment space for some of Sutter Gould Medical Foundation's specialists, is a collaboration between Memorial Hospitals Association and the physician organization. Memorial Medical Center began construction of a new parking structure, which will provide nearly 900 additional spaces for patients, visitors and staff. 11

The new Phillips CT Room opened at Memorial Medical Center. The former CT scanning location was converted into a peaceful observation and recovery room for patients in the Emergency Department. Opened the Family Birthing Center, a 10,000-square-foot addition to the Labor and Delivery Department; included a new wellbaby nursery and labor and delivery rooms. Memorial Medical Center remodeled and combined its angio room and cath lab to improve the center s diagnostic abilities. 12

Menlo Park Surgical Hospital (opened 2007) Menlo Park Surgical Hospital completed renovations to further improve patient care at the facility, including adding flat-screen tv s, fold-out couches and private bathrooms. 13

Mills-Peninsula Health Services (Affiliated in 1996) Mills-Peninsula Health Services expanded its geriatric hip fracture program. Mills-Peninsula Health Services expanded its substance abuse treatment program and opened a unique residential-based rehabilitation option. Mills-Peninsula Health Services opened a $640 million, state-of[-the-art, seismically upgraded hospital to serve patients and communities across the greater Peninsula region. Mills-Peninsula Health Services introduced a unique residential-based rehabilitation option an intensive 28-day program for people with alcohol- and drug-dependencies. Mills-Peninsula was the first hospital in the Sutter Health network to launch our systemwide electronic health record. To better meet the needs of its growing community, Mills-Peninsula Health Services hired an executive chef. Chef Louie, who has cooked for U.S. Presidents, is now bringing more diversity and a healthy approach to hospital food. To help its growing Chinese community better access health care services, Mills-Peninsula Health Services has added Mandarin to many hospital and health center signs. Mills-Peninsula implemented the eicu, part of Sutter Health s $50 million commitment to improving quality care and patient safety. Mills-Peninsula rolled out a new rapid response team as part of the 100,000 Lives participation to bring critical care expertise to the med/surg beside. The goal is to intervene before a patient becomes critical. A new nurse leadership program was introduced to improve communication between caregivers and help transition to new technologies. Mills-Peninsula opened its second digital catheterization laboratory at the Peninsula Medical Center campus. Mills-Peninsula introduced minimally invasive total hip arthroplasty, a breakthrough technique that dramatically speeds patient recovery. A surgical oncologist of the Mills-Peninsula Health Services Dorothy E. Schneider Cancer Center is among a few physicians in Northern California to use intraperitonal hyperthermic chemotherapy to treat patients with cancer in the abdominal cavity. Mills-Peninsula Health Services introduced free relaxation/guided imagery training for patients preparing for surgery. Mills-Peninsula is first on the San Francisco Peninsula to offer a new form of radiation therapy to women with early stage breast cancer. High-dose radiation brachytherapy reduces the traditional regimen of therapy from seven weeks to five days and allows delivery of a higher dose of radiation directly to the area most at risk, with minimal side effects. Mills-Peninsula is the first in San Mateo County to introduce R2 technology in its Breast Center. This new computer-aided detection device functions like a spellchecker for medical images. While the radiologist reads the film, R2 digitizes the image and checks for abnormalities. This gives the radiologist a valuable second look at every mammogram. Mills-Peninsula is the first in Bay Area and the only site in Northern California to provide specialized chemotherapy treatment for certain abdominal cancers. Interperitoneal Hlyperthermic Chemoperfusion employs a hated chemotherapy agent, which is administered during surgery. Mills-Peninsula introduced ThinPrep, a new lab procedure that reduces the occurrence of false negative cervical cancer readings. Peninsula Medical Center successfully implemented the electronic medication administration program, part of Sutter Health s $50-million initiative that promises fundamental improvements in bedside medication delivery and patient safety. Mills- Peninsula is also working to implement computerized physician order entry. The Dorothy E. Schneider Cancer Center at Mills-Peninsula, became the first on the Peninsula to offer radio frequency ablation, a treatment for metastatic liver cancer. The center also is the first on the Peninsula to introduce high-dose radiation (HDR) brachytherapy for early stage breast cancer and prostate cancer. It reduces the radiation therapy treatment regimen from a customary six to seven weeks down to five days for breast cancer. Mills-Peninsula Health Services became "officially" part of the Institute for Health and Healing at California Pacific Medical Center. IH&H programs and services are being integrated into Mills-Peninsula through its Cancer Program. Mills-Peninsula Health Services introduced IMRT (Intensity-Modulated Radiation Therapy) in for patients at the Dorothy E. Schneider Cancer Center. This advanced technology allows clinicians to deliver higher doses of radiation more precisely and with fewer side effects. IMRT was initially introduced for prostate cancer patients, with plans to expand to treatment of other cancer sites. 14

Novato Community Hospital (Affiliated in 1985) Implemented smart pumps for improved intravenous medication delivery and safety Opened a new Minimally Invasive Peripheral Vascular Surgery program Launched effort to upgrade orthopedic surgery instrumentation Opened second Physical Therapy/Sports Medicine Center To better care for patients at the end of life to ensure their comfort and dignity, Novato Community Hospital implemented a palliative care program in partnership with Hospice by the Bay and Sutter Care at Home. Added critical technologies to further enhance the care and services provided to patients including a 64-slice CT scanner, radiometer ABL instrument to deliver critical lab panel results in 15 minutes and a platelet incubator to improve platelet transfusion safety. Implemented the collaboratively built Sutter Health enterprise-wide MIDAS Quality Management application. To better meet patient needs and reduce potential screening backlogs, Novato Community Hospital expanded its mammography screening hours. Novato Community Hospital implemented a state-of-the-art digital mammography system to improve care and diagnosis of breast cancer patients in the community. Opened a new minimally invasive surgical suite. Opened the Sutter Terra Linda Health Plaza with including urgent care, laboratory services, a sports medicine clinic, physical therapy and physician offices. Novato Community Hospital implemented the eicu, part of Sutter Health s muti-million-dollar commitment to improving quality care and patient safety. Installed a new, faster and less claustrophobic MRI. The new $1.2 million MRI completes a scan in about 20 minutes compared to 60 minutes in the old machine. Novato Community Hospital has a new mobile positron emission tomography (PET) scanner service, which can more accurately detect cancer, heart disease and neurological disorders in their earliest stages. Enhanced breast cancer screening mammograms by installing the ImageChecker, the first FDA-approved computer-aided detection system. Began offering extracorporeal shock wave lithotripsy, considered the most noninvasive way to treat painful kidney stones. Launched the Primary Stroke Program, a collaborative effort between Novato Community Hospital and Marin General Hospital to further improve the urgent care delivered to stroke patients arriving at the Emergency Department. 15

Palo Alto Medical Foundation (including Palo Alto, Camino, Mills and Santa Cruz Divisions) (Palo Alto Medical Foundation affiliated in 1993) Palo Alto Medical Foundation became one of the few centers in Northern California and among the first medical providers in the United States to offer bronchial thermoplasty a procedure that gives long-term relief from asthma. Began construction on be a new patient care center in San Carlos Opened a new Sleep Disorders Center in Fremont to provide East Bay patients with convenient access to the care they need to treat their sleep disorders and improve their health. PAMF s Mountain View Center is the first medical center in Northern California with a powerful new dual-source cardiac computed tomography (CT) scanner that allows cardiologists to find patients heart problems quickly and painlessly. Palo Alto Medical Foundation became the first health care organization in the world to use a new high-definition multileaf collimator (HD120 MLC). This ultra-fine device for radiosurgery allows doctors to treat brain tumors and cancer in all parts of the body with unsurpassed accuracy all with fewer side effects, greater patient comfort and improved outcomes as compared to conventional open surgery. For individuals with sleep disorders in the Santa Cruz area, PAMF now offers polysomnographic (PSG) overnight sleep studies, which are needed to diagnose disorders such as sleep apnea, narcolepsy and restless legs syndrome. PAMF launched The Pulse, a new online education center that links patients and visitors to podcasts, videos and other educational health content from PAMF s doctors and clinicians. Santa Cruz Medical Foundation, part of the Palo Alto Medical Foundation, unveiled a range of new cancer care services for patients and the community in a remodeled facility. The new facility brings together in one convenient location all of the cancer care services patients previously received through other departments and referrals to other locations. Pulmonologists in PAMF s Mountain View Center and their patients are reaping the benefits of the latest bronchoscopy technology. The inreach electromagnetic navigation bronchoscopy system allows clinicians to non-invasively biopsy small lesions in the periphery of the lung for the first time. The technology could result in earlier diagnosis of lung cancer and the better prognosis that comes with it. Working with Enigma CKM Inc. (Enigma), based in King of Prussia, Pennsylvania, Palo Alto Medical Foundation developed medical informatics technology to personalize the care of individuals with chronic health conditions. Additional health care services introduced to patients at the Aptos office of the PAMF. Construction of a second floor to the building added 11 additional patient exam rooms, a new procedure room, three new doctors offices, X-ray services and phlebotomy station. Opened a 20,000-square-foot, two-story, medical office building in Santa Cruz. The new facility improves access for patients seeking care for podiatric medicine and surgery, orthopedics and OB/GYN. PAMF s Psychiatry and Behavioral Health Dept. launched a new Alcohol and Drug Treatment program to support patients seeking treatment for substance abuse. Palo Alto Medical Foundation added a new medical concierge to help patients navigate the health care process. She assists in making appointments, transferring relevant medical records and other services. PAMF launched a new Web Site Breast Cancer Care to further support patients diagnosed with the disease. The Palo Alto Medical Foundation has opened the doors of its new 60,000-square-foot Dublin Center, offering primary and specialty care to the growing communities in the East Bay. Palo Alto Medical Foundation updated its health Web site for parents, which includes a wealth of information that will help to facilitate discussions with kids about what can sometimes be difficult topics, such as depression, bullying, and alcohol and drugs. PAMFOnline hit a milestone, signing up 50,000 patients for secure access to their electronic medical records. About one-third of the Palo Alto Division s adult patient population is using the Web-based service called PAMFOnline to view key components of their health records, request appointments and prescription renewals, access test results, and receive customized health information. The Palo Alto Division opened its expanded Fremont Center and its new three-story, 41,000 square-foot Clark Building to better serve the needs of its patients and the growing surrounding community. Construction continued on the Camino s Division s new, state-of-the-art, 250,000-square-foot medical facility in Mountain View, which will consolidate many specialty services so the medical group s 200,000 patients can better access treatment and services. The Palo Alto Division launched new educational Web site focused on asthma, weight-loss surgery and joint replacement to bring the most accurate and reliable health information to the community. Palo Alto Medical Foundation s Fremont Center is now offering full-service reconstructive and cosmetic surgery procedures and launched a new lactation consulting service. A physician in the PAMF Department of Sports Medicine preformed a reverse ball-and-socket shoulder replacement, bringing this revolutionary procedure to Bay Area Residents. Palo Alto Medical Foundation opened the new Redwood City Center providing primary care services as well as radiology and laboratory care. 16

The Radiology Departments at all of PAMF s Palo Alto Division locations are now using digital X-ray machines in place of the old film systems. The departments are using a centralized, secure, electronic image and data archiving system called PACS (Picture Archiving and Communication System) to store and handle patient imaging studies. Physicians at Camino Medical Group are offering a new, minimally invasive treatment for prostrate cancer called cesium brachytherapy. Palo Alto Medical Foundation opened a new building to increase space for its cardiology, cosmetic surgery and internal medicine practices. The Fremont Center of the Palo Alto Medical Foundation was the site of a groundbreaking for a new 74,000-square-foot building, which will allow for 57 additional physicians to accommodate the rising population of the community. Palo Alto Medical Foundation s Fremont Center opened new imaging suites, which include a new MRI machine, CT machine and expanded ultrasound services. Palo Alto Medical Foundation s Department of Pathology was one of the first laboratories in Northern California to install new technology that makes it easer to screen for cervical cancer. Palo Alto Medical Foundation began using a cardiac MRI to identify coronary artery disease and other heart conditions. Through new technology, Palo Alto Medical Foundation s Department of Urology is shortening recovery time and reducing risks during surgery for patients with enlarged prostate glands. Camino Medical Group introduced Lasik eye surgery, opened a sleep center and provided traveler s medicine for international business people. Palo Alto Medical Foundation launched an urgent care program to speed services to kids. A Camino Medical Group physician began offering a minimally invasive hip replacement surgery, using a smaller anterior incision instead of a high-long incision. An ophthalmologist with Camino Medical Group now offers an innovative intraocular lens implant called Crystalens. This flexible implant eliminates cataracts as well as the need for eye glasses. Palo Alto Medical Foundation, which includes Camino Medical Group and Palo Alto Medical Clinic, implemented Advanced Access, an appointment scheduling system that allows patients to be seen on that same day or another date of their choosing, generally by their own primary care physician. PAMF s Fremont Center opened new Imaging Suites that include a new Philips MRI machine, a CT machine and expanded ultrasound services. A DEXA bone-density scanner will be added later. PAMF s Los Altos Center also began an expansion project that will nearly double the center s space and allow it to add new physicians. A new, free pharmacy consult service helps PAMF patients taking six or more medications better manage their drug regimens. The PharmCare Clinic also helps patients with limited drug coverage or income enroll in outside assistance programs or identify generic substitutes. Camino Medical Group implemented an online pharmacy module that allows doctors to initiate and refill prescriptions online. The system automatically updates the patient s pharmacy profile in their electronic medical record. Camino Medical Group rolled out a sophisticated, state of the art, voice recognition dictation program that allows physicians dictations to go directly into the patient s electronic medical record. The process speeds up the medical record dictation turnaround time and cuts long-term transcription costs. Palo Alto Medical Foundation is offering a new form of radiotherapy as a noninvasive option for treating prostate cancer. The new technique intensity modulated radiation therapy or IMRT has similar cure rates and fewer complications than the traditional surgery treatment. The Palo Alto division of the Palo Alto Medical Foundation completed its rollout of the electronic medical record (EMR), including computerized physician order entry (CPOE), e-prescribing and secure access to patient records from any location. With PAMF Online, patients also have access to their medical records and can send secure messages to their physicians. Camino Medical Group began providing in-house audiology services. Personal computers were added to the exam rooms at Camino Medical Group, allowing physicians to have each patient s health information instantly available. 17

Samuel Merritt University In direct response to the growing shortage of nurses nationwide, Samuel Merritt College opened its newest nursing facility in San Mateo. The 12,000 square-foot facility is the latest learning site that will provide vital educational opportunities to health care students living in the Bay area. The new learning center has two spacious classrooms, a 12 patient bed skills lab, ten private faculty offices, a computer lab/library, a conference room and break/lounge room. Samuel Merritt College began offering an accelerated bachelor s degree in nursing in Sacramento and San Francisco. The program, designed for students who already hold a bachelor s degree in non-nursing fields, prepares students to become registered nurses in one year. Samuel Merritt College added a family nurse practitioner education track. A new Occupational Therapy Clinic has been developed at the not-for-profit East Bay Community Recover Project (EBCRP) in Oakland to provide additional experience for occupational therapy students at Samuel Merritt College. Students help individuals enrolled in the project with skills related to meal planning, budgeting, shopping and food preparation. Samuel Merritt College and the California College of Podiatric Medicine (CCPM), the West s only podiatry school, completed their merger on July 1st. CCPM is transitioning to Samuel Merritt s campus over the summer and will be known at Samuel Merritt College as the California School of Podiatric Medicine. Samuel Merritt College began offering two new doctoral programs in podiatric medicine and physical Therapy. 18

Sutter Amador Hospital (Affiliated 1993) Opened a new acute care hospital, replacing an aging, outdated facility in Jackson. Opened a new 48,000-square-foot Outpatient Services Center with technologically advanced equipment, innovative programs and expanded services. A hands-free communications system was implemented in the new outpatient services center that allows for instant communication among employees to improve teamwork and patient service. Community members in the growing region of Jackson are now able to access care in their own neighborhood since the Sutter Amador Hospital Jackson Family Practice center was opened. Sutter Amador Hospital implemented the following computer driven medical services: o T-System a new electronic charting system for the Emergency Department o eicu Electronic intensive care unit that enables highly qualified critical care physicians and nursed to examine, diagnose and monitor ICU patients in real time from a remote location. o emap electronic system being implemented to better ensure the safe bed-side administration of medications. o Pyxis An automated pharmaceutical dispensing system that reduces medication errors by allowing an off-site o pharmacist to verify and dispense medications when the hospital s pharmacist is not on duty. PACS digital radiology imaging system that replaces traditional film-based X-rays with digital images and allows medical experts to provide faster and more enhanced care and service to patients. Sutter Amador Hospital opened a Sleep Disorders Center. Sutter Amador Hospital added Outpatient Physical Therapy as a new service line. Sutter Amador Hospital upgraded from a single slice CT scan to a 16-slice CT scan with enhanced cardiac capabilities, virtual colonoscopy and improved vascular imaging technology. Sutter Amador Hospital implemented the eicu, part of Sutter Health s $50 million commitment to improving quality care and patient safety. Sutter Amador implemented a Fast Track service in the Emergency Department. Sutter Amador Hospital recruited a new pediatrician and oncologist to the community, which was without these two specialties. Online registration is now being offered in the Family Birth Center. New technology installed includes an ambulance monitoring system, digital system in radiology and laboratory information system. Sutter Amador Hospital introduced less invasive surgery methods to retreat varicose veins and hemorrhoids. Sutter Amador Hospital developed a new scholarship program to assist local high school students seeking careers in health care. Sutter Amador Women s Services is the latest addition to Sutter Amador Hospital s community outreach program that includes two rural health centers and a pediatric center. A certified nurse midwife/nurse practitioner will provide midwifery, gynecologic outpatient services and primary care. Sutter Amador Hospital partnered with the American Cancer Society to develop a Cancer Support Group, which offers an opportunity to ask questions, meet other cancer patients and survivors, and learn about nutrition, pain management and other topics. In addition, the Man to Man Program and Support Group was developed for prostrate cancer survivors. Sutter Amador Hospital acquired a DEXA Bone Mineral Scanner, an essential tool in osteoporosis diagnosis, assessment and management. Sutter Amador Hospital is now offering chemotherapy and infusion treatments in Outpatient Services, saving cancer patients a one-hour drive out of the area to receive the treatment. Sutter Amador Hospital began a virtual nursery service allowing obstetrics patients to send photos of their newborns to family and friends via email from the hospital. Sutter Amador Hospital became the lead organization for Amador/Calaveras SAFE KIDS Chapter to fulfill the mission of the National SAFE KIDS Campaign at the local level. 19

Sutter Auburn Faith Hospital (Affiliated in June 1989; name changed in September 1995) Auburn residents now have access to state-of-the-art infusion therapy services, with the opening of Sutter Auburn Faith Hospital s UAIC Infusion Therapy Center. Thanks go generous support from the community and area businesses, Sutter Auburn Faith Hospital has opened a new Wound and Ostomy Care Center to provide patients with resources, education and individualized care to address their unique medical conditions. Sutter Auburn added ceiling lifts. Sutter Auburn Faith completed vital upgrades in several departments that provide enhanced care to the community including a new cardiac catheterization/vascular lab, an enlarged ambulatory surgery unit and emergency department and an expanded family birth center which more personalized care for mothers and their babies. Sutter Auburn Faith provided the Recreation & Respite program to the Auburn community. This enriching program provides activities for seniors with physical or memory impairments and spare time to their caregivers. Sutter Auburn Faith Hospital Foundation provided a $30,000 grant for the SAFH community benefit Lifeline program. Sutter Auburn Faith Hospital and Sutter Roseville Medical Center implemented a Community Benefit Grant program and have awarded $300,000 in one-year grants to 13 local not-for-profit organizations focused on community health improvement efforts. The Family Birth Center at Sutter Auburn Faith Hospital began offering epidural anesthesia for patients in childbirth. Sutter Auburn Faith Hospice unveiled a new healing garden, which is paved with bricks in memorial or remembrance of a loved one. Sutter Auburn Faith Hospital was connected to Sutter Health s electronic ICU monitoring technology (eicu ), which brings 24 hour life-saving technology to patients outside Sacramento. Sutter Auburn Faith Hospital purchased a Pulmonary Functions System that provides fast, easy lung testing for children and adults to help identify lung disease and lung problems, including asthma. This new equipment works with the CardioO2system, which evaluates pulmonary stress, cardiac stress and metabolic studies. Sutter Auburn Faith Hospital restructured its pediatric services to enhance pediatric care in the Auburn community. The restructure provides a designated pediatric unit and concentrated training for staff. The Diagnostic Imaging Department at Sutter Auburn Faith Hospital added bone density testing to its line of services. 20

Sutter Care At Home (formerly Sutter VNA & Hospice) To better care for patients at the end of life to ensure their comfort and dignity, Sutter VNA & Hospice partnered with Novato Community Hospital and Hospice by the Bay to implement a palliative care program at NCH. Provided hundreds of thousands of flu shots at public and private clinics. Developed and enhanced key clinical programs including Advanced Illness Management (now available in all SVNAH home care branches), Cardiac Outpatient Resources (Moore Foundation funded heart failure management program at ABSMC), wound care, and home infusion nursing. Sutter VNA & Hospice joined a collaborative effort in San Francisco to provide hospice services at a new residential care facility for the elderly. Sutter VNA & Hospice will be the preferred provider of hospice services at the facility, which includes one floor dedicated to caring for hospice patients Sutter VNA & Hospice expanded its home infusion pharmacy service line by opening Sutter Infusion & Pharmacy Services (SIPS) 2 in Emeryville. SIPS is a licensed pharmacy and sterile compounding facility that works in concert with physicians and home care nurses to make it possible for patients to receive or self-administer infusion and IV drugs at home. SIPS 1 serves the Sacramento Sierra Region and SIPS 2 will initially serve Alameda and Contra Costa Counties with plans to expand to San Francisco, Marin, San Mateo and Sonoma Counties. The hospice program at Sutter VNA & Hospice, San Francisco (formerly Visiting Nurses & Hospice) has joined a collaborative effort with the Zen Hospice Project and Age Song Assisted Living to provide hospice services in a brand new residential care facility for the elderly that includes one floor dedicated solely to hospice services and patients. Sutter VNA & Hospice began developing a specialized wound-care program focusing on standardization of clinical practices and oversight of wound/ostomy services throughout the ten counties served by Sutter VNA & Hospice. 21

Sutter Coast Hospital (Affiliated in 1986) To further improve care for hospitalized patients, Sutter Coast expanded its Hospitalist services. Began implementation of a Provider-in-Triage (PIT) Program that will reduce wait times for patients visiting the emergency room. Implemented the Trouro University 3 rd Year Medical Student Rural Health Program. Installed the PACS computer archival system in 28 provider offices. Installed a 1.5 tesla MRI. Sutter Coast Hospital successfully implemented the Sutter Health network s barcode technology for safer administration of medications at the bedside. Its system includes the pharmacy messaging interface, which allows nurses to communicate with the pharmacy department electronically. The technology will enhance the high quality of care already provided to patients. Sutter Coast Hospital implemented the eicu, part of Sutter Health s $50 million commitment to improving quality care and patient safety. Working to stabilize the availability of medical providers for its south Coast of Oregon community, Sutter Coast Hospital opened the Sutter Coast Health Center @ Brookings-Harbor. In addition to proving internal medicine, patient can also have lab tests drawn, complete the preadmission process for surgery, receive diagnostic testing or see a visiting specialist. Sutter Coast Hospital started a new hospitalist program. Sutter Coast Hospital organized a hospital-based primary care medical clinic in Brookings, OR scheduled for start-up in early 2004. Sutter Coast Hospital expanded its new teleradiology services to increase the volume of radiology interpretations at night. 22

Sutter Davis Hospital (Affiliated in 1981) Sutter Davis Hospital Foundation purchased state-of-the-art critical care equipment for the hospital's Emergency Department including a portable digital X-ray detector, which eliminates the use of X-ray film and lengthy development times. Sutter Davis Hospital launched a Joint Replacement Pre-Operative program that includes a steering team, and a joint replacement education booklet and class for patients. Installed ceiling lifts in its ICU department. Achieved national recognition for intensive efforts to encourage breastfeeding. Ranked sixth out of more than 250 hospitals throughout the state in the percentage of new mothers breastfeeding their babies exclusively upon leaving the hospital. To better serve patients, Sutter Davis and other affiliate hospitals in the Sacramento Sierra region are allowing people to go online to pre-register for surgery. The online surgery registration is part of a Sutter Health systemwide project initiated in March 2005 at California Pacific Medical Center in San Francisco. Sutter Davis Hospital and Sutter Medical Foundation opened a new outpatient imaging center with Yolo County's first digital mammography and a 64-slice CT Scanner. Sutter Davis Hospital Cardiac Rehabilitation doubled in size and added new exercise equipment and a telemetry system to monitor patients while they are exercising. The Sutter Davis Hospital Birthing Center, which opened in 1994, added an infant massage program and inpatient lactation support in August. A Meditation garden next to the cafeteria patio of the main hospital, was added to Sutter Davis Hospital, providing patients, loved-ones and employees a place to find hope, healing, and space for personal reflection. Sutter Davis Hospital s Diagnostic Imaging Department has new equipment in nuclear medicine to support cardiac studies that enable clinicians to better detect heart defects. The Diagnostic Imaging Department at Sutter Davis Hospital received a new Light Speed Ultra CT Scanner, which includes angiogram, 3D imaging and coronary artery calcification capabilities. The scanner performs eight times faster than the previous scanner, shortening diagnostic time for patients and allowing more patients to be seen throughout the day. Sutter Davis Hospital was connected to Sutter Health s electronic ICU monitoring technology (eicu ), which brings 24 hour life-saving technology to patients outside Sacramento. Sutter Davis Hospital completed $17.2 million expansion plan to remodel its medical office building, expand diagnostic imaging services and construct a second building to house 22 physician offices, a drive-up pharmacy, a blood-draw station and a cafe. The hospital remodeled four operating rooms, built larger patient and family waiting areas for the Surgical and Emergency Departments, enlarged the Laboratory Department and adedd 70 parking spaces. Sutter Davis Hospital replaced its mobile MRI unit with a new permanent GE Signa 1.5T Smartspeed MRI. The new MRI gives patients access to the technology seven days a week compared to only 2.5 days with the mobile unit. Sutter Davis Hospital s Cardiac Rehabilitation Department remodeled its gym to alleviate congestion and improve patient safety. 23

Sutter Delta Medical Center (Affiliated in 1990; name changed in 1996) Opened an outpatient wound care clinic Began offering hyperbaric oxygen therapy to patients in the community Sutter Delta opened an advanced, multimillion-dollar Cardiovascular Interventional Laboratory to perform invasive diagnostic cardiac procedures, inpatient emergent and urgent cardiovascular interventional procedures, and invasive diagnostic and interventional endovascular procedures. Opened a pain management lab to enhance care and services for patients suffering with pain. Sutter Delta opened an outpatient care unit specially equipped with telemetry monitoring services that cater to patients with transfusion and infusion service needs. Opened ED Express Care in the emergency department to care for patients with conditions that require urgent care. Began offering digital mammography and stereotactic biopsy services to patients in the Antioch community. Began using a 64-Slice CT Scanner, which allows physicians to see more anatomical detail in only a fraction of the time. Sutter Delta Medical Center patients now have access to the Carol Slatten Memorial Rehab Garden an outdoor facility designed to help rehabilitate patients using real-world activities such as gardening, golfing and crossing the street. Sutter Delta Medical Center expanded its comprehensive rehabilitation services to include pelvic floor therapy and kinesio taping. To better support patients diagnosed with cancer, Sutter Delta began offering an oncology resource/nurse navigator specialist services. Began offering anterior hip procedure, a state-of-the-art approach that helps to minimize scarring and trauma to muscles during surgery and reduce recovery time. Sutter Delta Medical Center began using HALO ablation technology, which uses heat to eliminate diseased tissue known as Barrett s esophagus. By targeting only Barrett s tissue, this minimally invasive procedure leaves healthy tissue undamaged. Sutter Delta began practicing Image Gently CT imaging for pediatric patients, so parents can rest assured that our staff is using the lowest radiation dose possible to obtain diagnostic images. Opened a multidisciplinary sports medicine program to care for active youth and adults throughout the continuum of life, with special emphasis on prevention and joint protection. Expanded urology services to include no-scalpel vasectomies, treatment for incontinence, urodynamics and prostate brachytherapy Expanded podiatry services to include; bunionectomy and fasciotomy. Sutter Delta Medical Center Intensive Care Unit implemented the eicu system, which uses telecommunications from bedside monitors, remote cameras, trend-recognition software and clinical decision software to enable board certified Sutter intensivists in Sacramento to assist local physicians in caring for their ICU patients. Established a teleconnection to the state-of-the-art Sutter East Bay Neuroscience Center to bring advanced neuroscience services to patients in Contra Costa County Collaborated with the St. Vincent De Paul Society to found the Rotocare Clinic in Pittsburg and worked with the City of Oakley to establish a new clinic operated by La Clinica de la Raza. As a part of a multimillion-dollar investment, began renovations at the Cardiovascular Intervention Laboratory. Sutter Delta Medical Center began offering the Bay Area s most advanced cardiovascular imaging system. To help doctors identify breast cancer earlier and treat it more effectively, Sutter Delta Medical Center began offering digital mammography, stereotactic breast biopsy tools and a breast magnetic resonance imaging (MRI). The Every Woman Counts, program was launched at Sutter Delta Medical Center. It provides cancer detection and treatment for low income, uninsured women age 40 and over. The Save a Life Sister program also continues to offer free mammography and, now, further diagnostic services for younger women. These two programs combined served 127 women in 2007. Sutter Delta Medical Center opened a special care nursery facility and pediatrics center for the community as a part of its fouryear plan that includes a Women's Health Center. Sutter Delta Medical Center became among the first affiliates in the Sutter Health network to implement the Physician Remote Access system, which allows doctors to instantly view X-rays from their secure Sutter Health computer, significantly reducing the amount of time patients have to wait for diagnosis and treatment. As part of efforts to respond to the growing needs of the community, Sutter Delta Medical Center opened a new surgical care unit. Sutter Delta Medical Center opened its new Urgent Care Clinic in Antioch. The Women s and Children s Center at Sutter Delta Medical Center was expanded. Sutter Delta Medical Center invested $250,000 for a digital operating suite to make surgeries more efficient. Sutter Delta Medical Center opened a new cardiac electrophysiology program, the first in the East Bay Area, which offers new hope for people with abnormal heartbeats. Sutter Delta Medical Center successfully implemented bar-code technology to ensure safer delivery of medications at our patients bedsides. This Electronic Medication Administration Program known as emap SM is part of Sutter Health s $50 million investment in advanced patient-safety technologies that support caregivers in performing complex procedures. 24

Completed a 50,000-square-foot, $23 million expansion project at Sutter Delta Medical Center; project doubled the capacity of the hospital's Family Birth Center and Emergency Departments, and includes a new level II nursery. Sutter Delta Medical Center expanded rehabilitation services. 25

Sutter East Bay Medical Foundation (Created in October 2005). Opened urgent care services for patients needing immediate care that isn t an emergency Extended hours and services in Albany Opened centers to expand access to services for patients in Antioch, Brentwood, Castro Valley and Dublin Opened a multi-specialty medical office building in Orinda Expanded access to specialty health services including anesthesiology, endocrinology, orthopedics, otolaryngology, palliative Care, urogynecology and urology Began offering laboratory and radiology services for patients across the East Bay Sutter East Bay Medical Foundation welcomed five new primary care providers and specialists to the network to further care for patients in the communities it serves. Sutter East Bay Medical Foundation began implementing Sutter Health s Electronic Health Record software, which helps to provide more consistent and coordinated care for patients. Extensive renovations began at Sutter East Bay Medical Foundation s 12 Camino Encinas, Orinda medical office building. Once complete, the new state-of-the-art facility will serve as the home for OB/GYN, Imaging and radiology services. 26

Sutter Gould Medical Foundation (including Gould Medical Group) (Affiliated in 1993, changed name in 1999) Acquired Stockton Endoscopy Center to bring additional services to patients in the Central Valley. Helped implement a Hospitalist program to further advance and enhance to quality of care provided to patients at Sutter Tracy Community Hospital. Opened the Stockton Surgery Center in Stockton. Acquired Stockton orthopedic group to bring additional orthopedic services to the community. Helped implement a Hospitalist program to further advance and enhance to quality of care provided to patients in Stockton. Sutter Gould s new, state-of-the-art, high-tech, 70,000-square-foot, three-story medical office building, Stockton Medical Plaza I, in Stockton, opened to the community. The Sutter Gould Medical Foundation Care Center at Stockton Medical Plaza II opened in Stockton. Sutter Gould Medical Foundation constructed a new care center to provide improved access to quality health care services at 600 Coffee Road, Modesto. Patients in Los Banos now have more options when seeking health care as Sutter Gould Medical Foundation opened a new care center in the rural community. Expanded services in more than a than a dozen health care specialties by welcoming 30 additional physicians to the area. Sutter Gould Medical Foundation began offering mysutteronline a new, online health management tool that helps patients stay up-to-date on their medical histories, schedule and cancel doctor s appointments, get lab results and even more. Opened Briggsmore Specialty Center, an outpatient surgery center in Modesto. Helped implement a Hospitalist program to further advance and enhance to quality of care provided to patients at Memorial Medical Center and Doctor s Medical Center. Sutter Gould Medical Foundation introduced throughout its clinics the Picture Archiving and Communication System (PACS), which is a filmless method of communicating and storing digital images. It allows one or more physicians to view secure images from any location via a Web browser. Sutter Gould Medical Foundation installed a new $1.7 million CT Scanner, as well as two new mammography machines. Helped initiate a Hospitalist program to further advance and enhance to quality of care provided to patients at Memorial Medical Center in Modesto. Sutter Gould Medical Center added a new GE Prestige II Digital Remote Fluoroscopy and Radiography unit. 27

Sutter Lakeside Hospital (Affiliated in 1992, name changed in 1992) Stroke Telemedicine Program made available to critical neurology patients Deployed the new Mobile Health Unit, which helped bring basic health services directly to rural Lake County residents. Digital mammography, a picture archiving and communication system and a 16-detector spiral CT scanner are just some of the advanced imaging equipment that became available to patients at Sutter Lakeside Hospital. Sutter Lakeside Hospital (SLH) was designated as a Level IV trauma center. The designation, as well as new state-of-the-art medical equipment, means the Sutter Health affiliate can provide a higher level of trauma care to the local community. SLH is located in Lakeport, which is almost two hours from the closest other trauma center. To further enhance access to quality health care in the community, Sutter Lakeside Hospital launched the Healthy Seniors are Contagious Senior Center program, which provides vital health care services to Lake County s five senior centers and provides meaningful programs to improve health among the community s elderly. Sutter Lakeside Hospital completed more than $10 million remodel to upgrade it Imaging Department and bring improved patient care technologies to the community. The project includes a new in hours MRI suite. Sutter Lakeside Hospital opened an acute inpatient dialysis service allowing patients of Lake and Mendocino Counties to receive care closer to home. Sutter Lakeside Hospital started an Orthopedic Center for Excellence, which employs a multidisciplinary approach for patients undergoing total joint replacement. Sutter Lakeside Hospital launched emap SM, a medication administration program that uses bar-code technology to better ensure safe bedside delivery of patient medications. Sutter Lakeside Hospital built a new patient intake center, which will improve patient access to outpatient services at the hospital. The Clinical Laboratory at Sutter Lakeside Hospital become the first lab in Lake and Mendocino Counties to use a new automated coagulation analyzer, which provides more consistent results and is sufficiently sensitive to rule out deep vein thrombosis. The Emergency Department at Sutter Lakeside Hospital opened a new diagnostic X-ray room. Sutter Lakeside Hospital opened Wellness Center and developed and LVN/RN Bridge Program to help staff development. Sutter Lakeside Hospital opened a new 28,153-square-foot wing including an expanded Emergency Department, a decontamination room, surgery area, urgent care center and Family Medicine Clinic, which combines pediatrics and women's care. 28

Sutter Maternity and Surgery Center of Santa Cruz To support a healthy food program that is both ecologically sound and socially responsible, Sutter Maternity & Surgery Center is participating in Santa Cruz County s Food Scrap Compost program. The program seeks to naturally eliminate food waster rather than disposing it in local landfills. Sutter Santa Cruz successfully implemented the Sutter Health network s barcode technology for safer administration of medications at the bedside Santa Cruz Medical Foundation began its phased-in implementation of Sutter Health s electronic health record (EHR) system becoming among the first Sutter Health affiliates to install a new collaborative version of the EHR into its daily operations. Physicians began using a new, state-of-the-art MRI machine, enhancing care provided to patients in the community. The Medical Foundation Radiology Department completed the first phase of it Picture Archival and Communications System implementation. Sutter Maternity & Surgery Center introduced emap, a computerized barcode medication administration system to ensure the safe delivery of mediations for hospitalized patients. Sutter Santa Cruz is participating in the Community Chronic Care Network to track and provide health service to 18,000 Santa Cruz County residents with diabetes. Urologists from the Santa Cruz Medical Foundation began using green light laser surgery for training the prostate and urinary tract. A Santa Cruz Medical Clinic physician was the first in Santa Cruz County to perform a nerve-sparing, laparoscopic radical prostatectomy, a new treatment for prostate cancer. A physician at Sutter Maternity & Surgery Center of Santa Cruz performed the first laparoscopic nephrectomy, a relatively new procedure to the field of urology. Santa Cruz Medical Clinic opened an Anticoagulation Clinic where registered nurses, under the direction of cardiologists, care for patients who need their blood tested and Coumadin regulated. A finger stick blood test gives immediate PTT results and the nurse is then able to recommend Coumadin changes according to protocol. 29

Sutter Medical Center, Sacramento (including Sutter Cancer Center, Sutter Center for Psychiatry, Sutter General Hospital, Sutter Memorial Hospital) Sutter Cancer Center, Sacramento enhanced its Gamma Knife program with an upgraded unit. Only one of two such instruments in Northern California, the Gamma Knife allows surgeons to treat previously inoperable brain tumors, vascular malformations and functional disorders. More than 700 patients have been treated with the life-saving Gamma Knife technology since its introduction in 1998. A new combined PET/CT Scanner was installed at Sutter Medical Center, Sacramento. Gregory Graves, M.D., board certified oncologist and thoracic surgeon, and Scott Foster, M.D., interventional radiologist, are the first in the Sacramento Sierra Region to offer radio frequency ablation for the treatment of liver, lung and kidney cancer. Patients from as far away as Alaska have traveled to the Sutter Cancer Center, Sacramento to receive this treatment. Sutter Cancer Center began offering a support group for children who are dealing with cancer or other life threatening illnesses in their families. The program was made possible through a grant from Johnson & Johnson and the Society for the Arts in Healthcare. Sutter Cancer Center, Sacramento began the largest-ever prostate cancer clinical trial. The trial, known as SELECT, enrolls men to study whether either selenium or vitamin E can protect against prostate cancer. Sutter Center for Psychiatry completed a renovation project, which includes adding a new outpatient building, additional inpatient beds and improved treatment space for better patient and employee use. An innovative new treatment may give patients who suffer with chronic depression more control of their lives. Called Vagus Nerve Stimulation (VNS), the interventional treatment is designed for patients who have treatment-resistant depression (TRD). The Sutter Center for Psychiatry is the only Sacramento area mental health facility that offers this procedure for the treatment of depression. Sutter Center for Psychiatry, in partnership with Summit Psychotherapy and Associates, is offering an inpatient program to help adults diagnosed with anorexia or bulimia nervosa. It's the only program of its kind in Northern California. As part of our safety culture, a Sutter Health network team and Sutter General Hospital worked to develop short- and long-term solutions for patient mobilization. Specifically, Sutter General plans on bringing ceiling lifts into its ICU department. Sutter Medical Center, Sacramento is partnering with the Salvation Army and several other community groups to launch the Interim Care Program, which provides a clean and safe place for homeless patients to recuperate after being released from the hospital. (2005) The Sutter Gamma Knife Radiosurgery Center was the first in the world to install the Leksell Gamma Knife 1.2 software upgrade for treating child and adult brain disorders. The Epilepsy Program at Sutter Neuroscience Institute expanded to include seven beds, 5 adult and two pediatric, making it the largest long-term epilepsy monitoring unit in the Western United States. Sutter Medical Center, Sacramento s Neuroscience Institute is opening a second Sutter Sleep Disorders Center in Roseville to serve Pacer County and the surrounding area. Sutter General Hospital of Sutter Medical Center, Sacramento became the first Sutter hospital and the first hospital on the West Coast to implement advanced patient safety technology developed by Baltimore-based VISICU, Inc. Sutter's eicu combines early warning software, advanced video and electronic monitoring, and off-site critical care specialists to bring additional expertise to the care provided to ICU patients. Sutter will implement this technology systemwide in the coming years. Sutter Neuroscience Institute neurosurgeons Michael Edwards, M.D. and Edie Zusman, M.D. performed the first GliaSite procedure at Sutter General Hospital. A balloon-catheter is used to treat brain cancer and lessen the side effects of radiation therapy. Sutter Medical Center, Sacramento is the now using a radioactive drug called Yt90 SIR-Spheres to kill cancerous cells in nonresectable liver tumors. A new approach to controlling tremor is now being offered at Sutter General Hospital. Surgeons at the Sutter Neuroscience Institute recently began working with deep brain stimulation to stop uncontrollable shaking in patients with Essential Tremor. A 23-bed telemetry unit was opened at Sutter General Hospital to better meet specialized needs of patients. Construction began for Sutter Medical Center, Sacramento's state-of-the-art Anderson Lucchetti Women's and Children's Center. The 242-bed Anderson Lucchetti Women's and Children's Center will be an eight-story, 395,241-square-foot building located across L Street from the Ose Adams Medical Pavilion (currently known as Sutter General Hospital) and to the east of the existing Sutter Cancer Center and Old Tavern. It will replace Sutter Memorial Hospital, located at 5151 F St., the other acute-care facility under the SMCS umbrella. Sutter's Infusion Services expanded from its current space at Sutter Cancer Center to a new infusion center at the Fort Sutter Medical Building for cancer patients receiving chemotherapy. Sutter Medical Center, Sacramento enhanced patient service and conveniences with the construction of a new parking structure in Midtown Sacramento on 28th and N streets. The Sutter Community Garage, part of the SMCS' expansion of its medical campus in Midtown, will provide 324,000 square feet of garage space for hospital and public use. Opened a new 210,000-square-foot Sutter Medical Foundation Building, housing 39 doctors' offices, 93 exam rooms, 35 procedure rooms, six outpatient operating rooms and 13 outpatient imaging rooms, along with endoscopy and interventional 30

radiology services. There are four floors plus two parking levels in the basement, which also houses the Energy Center for the entire SMCS campus. The Sutter Heart Institute implanted Sacramento s first left ventricular assist device (LVAD), improving a heart patient s quality of life while he awaits a heart transplant. An LVAD, used as a bridge to transplant, is a battery-operated device that helps maintain the pumping ability of a heart that can't effectively work on its own. Previously, Sacramento cardiologists were sending their patients to the Bay Area for LVADs, and those patients were then undergoing heart transplants there, too. To better serve patients, Sutter Medical Center, Sacramento and other affiliate hospitals in the Sacramento Sierra region are allowing patients to go online to pre-register for surgery. The online surgery registration is part of a Sutter Health systemwide project initiated in March 2005 at California Pacific Medical Center in San Francisco. The Sutter Joint Replacement Center introduced the first computer-assisted total hip replacement in Sacramento using the CI System a new advancement in orthopedics that provides physicians with a three-dimensional view of the hip joint and other detailed data that provides patients with better functioning and a longer lasting hip. In the comfort of waiting rooms, family members of patients at Sutter Medical Center, Sacramento can get up-to-the minute information about their loved one s status during surgery and heart catheterization procedures with the new Navicare Family Vue Screen tool. The Sutter Center for Health Professions implemented a physician learning center that features a classroom equipped with video conference and telemedicine technologies where physicians can view surgical procedures, presentations and other clinical information. Nursing and Surgical staff has the flexibility to view and request open shifts over the Internet or the SMCS Intranet and Information Centers using BidShift. Wherever Internet access and SMCS Intranet is available, staff will now be able to see available shifts across all units and easily request shifts they are qualified to work. Sutter Medical Center, Sacramento implemented a Picture Archival Communications System in its Cardiology Department, allowing diagnostic images to be captured and stored in digital format and transferred over computer networks for immediate or future viewing. Sutter Medical Center, Sacramento opened a healing garden where visitors can rest and reflect away from the fast-paced hospital environment in front of the Sutter Memorial Hospital campus. Cardiologists at Sutter Heart Institute in Sacramento will now use the new FDA-approved FilterWire protection device during coronary bypass graft stenting procedures. The Sutter Heart Institute was the sole study site in the region for this device that acts as a sieve or strainer to help "catch" embolic debris during coronary stenting procedures to help patients avoid heart attacks. Sutter Heart Institute opened an outpatient congestive heart failure clinic at Sutter Memorial Hospital. The clinic, the first of its kind within Sutter Sacramento Sierra Region, assists physicians with managing, educating and following-up with patients who have experienced heart failure. The specialized, multi-disciplinary clinic consists of a cardiologist, physician assistant, nurse coordinators, transplant support representatives, social workers, dieticians, financial coordinators and chaplaincy. Sutter Memorial Hospital opened a state-of-the-art electrophysiology lab last month to offer adult and pediatric studies, mapping, ablations and device implants. The new lab also has bi-plane imaging capability and 3-D mapping to identify and treat specific sources of arrhythmias. Children's Center at Sutter Medical Center, Sacramento announced the reopening of its pediatric cardiac program. Children will receive care from board-certified pediatric specialists as well as cardiologists, anesthesiologists, critical care physicians, neonatologists, surgeons and nurses. Sutter Medical Center, Sacramento established a one-of-a-kind clinic for patients with congenital heart disease. Staffed by a team of adult and pediatric cardiologists as well as other specialists, it will be part of Sutter Medical Center's Transplant and Outpatient Heart Specialty Clinics. The Children s Center at Sutter Medical Center, Sacramento launched the Pediatric Healthy Lifestyles Program. Children and their families attend a six-week behavioral management program, which includes food and nutrition activities with a pediatric dietician, exercise/play activities with an exercise specialist and emotional support with a pediatric clinical social worker Sutter Memorial Hospital began performing a new cardiac procedure on children, which repairs a hole between the upper chambers of the heart without resorting to surgery. A new Interventional Observational Unit was opened at Sutter Memorial Hospital. Sutter Medical Center, Sacramento celebrated the grand opening of its Lactation Station at Sutter Memorial Hospital. The Lactation Station carries lactation-related products, breastfeeding aids, breast pumps, custom-fitted nursing bras, baby slings, breastfeeding pillows and more. Sutter Medical Center, Sacramento has been approved as a cystic fibrosis center (located at Sutter Memorial Hospital) by the national Cystic Fibrosis Foundation, making it the first community-based, non-teaching hospital to gain such recognition in the last five years. 31

Sutter Medical Center of Santa Rosa (Affiliated in 1996; name changed 1997) Broke ground on a $284 million state-of-the-art hospital. Set to open 2014, the hospital will provide a full range of services including intensive care, emergency services, obstetrics, nursery care and level III neonatal intensive care. Submitted a business plan for new 70 bed hospital and Joint Venture Physician s Medical Center along with plans to pursue a joint venture Physicians Medical Center on the same campus. Thanks to the purchase of additional, state-of-the-art screening equipment, even more women in the local community were able to receive ultrasound, mammography and bone densitometry scans in the Women s Health Resource Center. Sutter Medical Center of Santa Rosa began offering the community The Women s Heart Advantage Program at its Women s Health Resource Center (WHRC). This unique cardiac health-screening and education program is specifically designed for women and is offered to all women scheduling their screening mammogram or dexascan. Sutter Medical Center of Santa Rosa partnered with Sonoma State University s School of Nursing to develop one of three Direct Entry Master s of Science in Nursing programs in California. The Breast Center opened in the Sutter Medical Center of Santa Rosa s Women s Health Resource Center. A division of Sutter Medical Center of Santa Rosa, the Center will offer services from screening to diagnosis through treatment. Sutter Medical Center of Santa Rosa opened the WCC House to provide on-site lodging for the out-of-town families of hospitalized infants and children. Sutter Medical Center of Santa Rosa started an electrophysiology service to treat irregular heartbeats. Surgeons at Sutter Medical Center of Santa Rosa began performing endoscope vein harvesting, used to remove the leg vein for use in coronary bypass surgery. The procedure reduces scarring the potential for infection. Sutter Medical Center of Santa Rosa is now using ultrasound-guided peripherally inserted central catheters, which is expected to increase the success rate of line placements. The Nuclear Medicine Department at Sutter Medical Center of Santa Rosa added a new dual-head gamma camera. Sutter Medical Center of Santa Rosa s ICU implemented continuous renal replacement therapy, which Physicians at Sutter Medical Center of Santa Rosa performed their first procedure using the hospital s new minimally invasive therapy to treat heart disease. Brachytherapy allows doctors to deliver low-dose beta radiation into the coronary artery to prevent recurring blockages. Sutter Medical Center of Santa Rosa is one of two testing sites in the country for the Immersion AccuTouch Endovascular (Virtual Cath Lab) Simulator, which allows cardiologists to perform virtual angioplasty using several patient scenarios. The system measures subtle movements made by the physician during an interventional procedure and provides valuable feedback. It serves as a training tool and a means to practice new techniques. Sutter Medical Center of Santa Rosa instituted a PICC (peripherally inserted central catheter) line program. The program will make PICC line insertions available 5 days a week at both hospitals. Sutter Medical Center of Santa Rosa recently relocated and expanded its outpatient services and medical surgical units. Outpatient services are now easier to access, feature more spacious rooms and can accommodate more patients. The med surg unit features a new nurse station and double the bed capacity. Sutter Medical Center of Santa Rosa is now offering laparoscopic (Roux-en-Y gastric bypass) weight-loss surgery to patients suffering the medical effects of severe obesity. The Sutter Medical Center of Santa Rosa Residency Training Program has initiated a Doula Project for its family practice residency physicians. Doulas are certified birth advocates who provide non-medical physical, emotional and informational support to women during childbirth. High-risk mothers-to-be are the project's target population. Sutter Medical Center of Santa Rosa completed an diagnostic imaging upgrade project, including an MRI suite featuring a stateof-the-art MRI unit. Sutter Medical Center of Santa Rosa renovated its Medical/Surgical and Outpatient Surgery Departments, increasing the number of beds in each. 32

Sutter Medical Foundation (including Sutter Medical Group, Sutter Neuroscience Medical Group and Sutter West Medical Group) Sutter Medical Foundation opened two new medical office buildings Greenback Oaks Care Center and Greenback Oaks Lab and Imaging. Opened first of multiple in-store medical clinics in partnership with Rite Aid Drug stores; staffed by high quality nurse practitioners trained and experienced in diagnosing ailments and prescribing medicine. Sutter Davis Hospital and Sutter Medical Foundation opened a new outpatient imaging center with Yolo County's first digital mammography and a 64-slice CT Scanner. The Hospitalist program was expanded to all SHSSR hospitals. Hospitalist physicians are experts in inpatient services who specialize in the treatment and coordination of hospital care for medical admission until discharge. The hospitalists are dedicated to providing quality care in a compassionate, personal, and efficient manner. Because they are in the hospital all day, then can assist with a smooth and speedy recovery by following up on tests and adjusting the patient treatment plan throughout the day as needed. In order to meet the needs of growing populations, Sutter Medical Foundation opened two new medical office buildings in Elk Grove and Davis. Sutter Medical Group opened a new medical office in Natomas in order to meet the needs of this growing population. In addition to physician offices, the new building features a laboratory for added patient convenience. Sutter West Medical Group s Diabetes Care Program has expanded service to the growing Laguna area in southern Sacramento County. Opened medical office buildings in Davis and Elk Grove to help improve patient access to a wide range of medical services. Sutter Medical Group physicians and staff stared the Diabetes Care Program to partner with patients to achieve excellence in diabetes management. Sutter Medical Group in Sacramento announced the opening of Sutter Downtown Integrative Health Care, a program that combines complementary and conventional medicine to reach the best outcomes for patients. 33

Sutter North Medical Foundation (including Sutter North Medical Group) (Affiliated in 1993) Opened the new Sutter Surgical Hospital North Valley, a new specialty hospital that provides inpatient and outpatient surgery services to area residents. Sutter North implemented a groundbreaking technology for patients of the Cardiology Dept. Medtronic s Carelink remote monitoring program allows patients in rural communities to send information from their pacemakers directly to physicians through wireless technology. Sutter North Medical Foundation developed a new Childhood Obesity Task Force. The team of health experts, representatives from area school districts, county health departments and other groups that serve children will work together to develop a longterm, comprehensive approach to help children adopt healthy behaviors. Physicians at Sutter North Medical Foundation began using the 3D Echo imaging tool to help them examine patients hearts. Sutter North Medical Foundation brought the latest in diagnostic imaging to the community with the 64-slice computed tomography (CT) scanner, which provides physicians with even clearer and sharper images of patients bones, blood vessels and organs. A Gastroenterologist at Sutter North Medical Foundation began performing a new outpatient procedure to treat acid reflux that may provide lasting relief without hospitalization or the long-term use of medications. Sutter North Medical Foundation s OB/GYN Department moved into a remodeled and expanded area. Sutter North Medical Foundation opened a 60,000-square-foot medical office building and ambulatory surgery center. Sutter North Medical Foundation added two ultrasound systems and is providing patients access to the PRODIGY bone densitometer. The Diagnostic and Outpatient Center at Sutter North Medical Foundation now offers pediatric echocardiograms, allowing patients to stay in their community for the service rather than travel to Sacramento. Transcranial Doppler procedures were added to the services offered by Sutter North Medical Foundation's Cardiology Department. Sutter North Medical Foundation partnered with the Yuba-Sutter Family YMCA to provide first-time parents with survival skills necessary to transition from life as a couple to life as a family. The no-cost "Becoming Parents" program is designed to ensure new parents have the necessary tools to meet the normal challenges, stresses and changes parenthood produces. Sutter North Medical Foundation s Hospice Program completed the licensing process and began providing services to the communities of Yuba and Sutter Counties. 34

Sutter Pacific Medical Foundation (Includes Physician Foundation at California Pacific Medical Center, Physician Foundation Medical Associates, Inc., Marin Headlands Medical Group, Sutter Medical Foundation North Bay, Sutter Medical Group of the Redwoods ) As part of its commitment to embracing innovative technologies that enable caregivers to provide superior patient care, Sutter Medical Foundation North Bay implemented the Sutter-wide Electronic Health Record, which helps doctors provide patients with a more convenient and consistent health care experience. Sutter Medical Foundation North Bay expanded the care it provides to women in the communities it serves by adding the Women s Health Resource and Breast Care Center. Sutter Medical Foundation North Bay opened a new vascular clinic called Sutter Vein Solutions. Sutter Medical Foundation - North Bay physicians were the first in their area to implement Allscrips TouchWorks, RX+, an ambulatory medication management and prescription communication tool featuring drug interaction and allergy checking and plan-specific formularies. Addressing a lack of endocrinologists and specialized diabetes care in the Santa Rosa area, Sutter Medical Foundation North Bay started a Diabetic Clinic to improve the overall care of diabetics in the community. Provided a multitude of health care educational services free of charge to our members and patients through the Northern California Center for Well-Being, a non-profit community resource center. Proactively contacted patients to come in for screenings such as pap smears, mammograms and retinal exams. In addition, began contacting allergy and asthma patients prompting them to review health status with the goal of improving physician care and follow up. 35

Sutter Regional Medical Foundation (including Solano Regional Medical Group and Sutter Delta Medical Group) (Created July 2003) Sutter Regional Medical Foundation s Vacaville care center upgraded to digital mammography, offering another advanced tool in screening for breast cancer. To provide better service and access for patients, Sutter Regional Medical Foundation made a series of enhancements to its call center, which handles more than 20,000 calls per month. New enhancements include expanded hours, wait time status and language options. Sutter Regional Medical Foundation opened a new modern and convenient after-hours clinic for patients with minor illnesses or injuries, or patients who are unable to access their primary care physicians. The new clinic, located at 2700 Low Court in Fairfield, will primarily serve patients in south-county; the Vacaville after-hours will continue to serve north-county residents. Community residents in Fairfield have easier access to local health care services now that a 3-story, 69,000-square-foot care center has opened its doors. The new care center is the perfect compliment to the Sutter Fairfield Medical Campus that houses physician specialty offices, the advanced Diagnostic Imaging Center, the state-of-the-art Ambulatory Surgery Center and an afterhours clinic. Broke ground on a 69,000 square-foot medical office building in Fairfield at 2400 Low Court. The new medical offices will include primary and specialty care physicians from the Solano Regional Medical Group. Installed the latest high-definition colonoscopes at the Ambulatory Surgery Center in Fairfield. SRMF is the first health care provider in Solano County to provide patients with access to this advanced technology. Introduced state-of-the-art digital mammography and MRI breast cancer early detection screening techniques to Solano County. Opened new medical offices in Fairfield at 2450 Martin Road. The renovated space provides greatly enhanced access to SRMF clinicians for residents of Fairfield and Vacaville. Opened new medical offices in Vallejo at 100 Hospital Drive. The new offices provide a one-stop approach to health care primary care, ENT, general surgery, diagnostic imaging, and laboratory services all under one roof. Sutter Regional Medical Foundation announced a $42.5 million expansion plan to improve community access to high-quality medial care in Solano County by expanding physician office locations. 36

Sutter Roseville Medical Center (Affiliated in 1993; name changed in 1995) Built the new Sutter Roseville Medical Center to replace an aging and outdated facility. Sutter Roseville Medical Center opened a neo-natal intensive care unit (NICU). The 16-bed, 13,000-square-foot unit features many family-friendly components and amenities, including four private rooms that are roomy enough to even allow the mother to stay overnight. These are the only private rooms in a NICU in the Sacramento region. Sutter Roseville Medical Center, which is undergoing construction transformation as part of its 10-year master site plan, expanded the Family Birth Center and this month opened a renovated wing that features 24 private post-partum rooms for new mothers who have given birth. Sutter Roseville Medical Center opened the Acute Rehabilitation Center. The 106,000-square-foot in-patient acute rehabilitation center help patients who have been disabled by illness or injuries achieve their maximum functional independence. Common patient types include those with stroke, brain injury, multiple trauma, amputation, spinal cord injury, orthopedic conditions, and degenerative neurological disorders, such as Parkinson s disease or Multiple Sclerosis. Sutter Roseville Medical Center opened its Patient Care Tower. The unit serves patients from the surrounding 23 county area, providing 24-hour, seven-day-a-week attentive care and active monitoring for the chronically ill. In 2006, the medical center expanded the Emergency Department from 19 beds to 34 beds; opened a Wound Care Center to provide treatment for chronic wounds; and opened a second cardiac catheterization lab and installed new angiography equipment in both catheterization labs. To better serve patients, Sutter Roseville Medical Center and other affiliate hospitals in the Sacramento Sierra region are allowing people to go online to pre-register for surgery. The online surgery registration is part of a Sutter Health systemwide project initiated in March 2005 at California Pacific Medical Center in San Francisco. Sutter Roseville Medical Center s Wound Care Center was enhanced to help prevent recurrence of wounds. SRMC partnered with SureWest to provide free wireless Internet access to patients and visitors in the hospital. SRMC opened a Lactation Station to assist new mothers with all breastfeeding needs. Sutter Roseville Medical Center and Sutter Auburn Faith Hospital implemented a Community Benefit Grant program and have awarded $300,000 in one-year grants to 13 local not-for-profit organizations focused on community health improvement efforts. Sutter Roseville Medical Center expanded its Trauma-Neuro Intensive Care Union from 8 beds to 16 beds. Sutter Roseville Medical Center s intensive care units are now benefiting from Sutter s eicu system. Patients at Sutter Roseville Medical Center now have access to a state-of-the-art PET/CT scanner, the latest diagnostic technology in the nation. Sutter Roseville Medical Center successfully implemented bar-code technology to ensure safer delivery of medications at our patients bedsides. This Electronic Medication Administration Program known as emap SM is part of Sutter Health s $50 million investment in advanced patient-safety technologies that support caregivers in performing complex procedures. Sutter Roseville Medical Center teamed up with Northern California PET Imaging Center to provide positive emission tomography to patients through a $1.6 million mobile scanner unit. Images show organ structure, allowing the physician to detect abnormalities at an earlier stage. Sutter Roseville Medical Center is now offering laparoscopic surgery for patients undergoing a kidney removal. The new procedure, which involves a tiny incision, offers an alternative to traditional surgery with a large incision. Sutter Roseville Medical Center has relocated and expanded the hospital's Antepartum Testing Center, which features five private rooms for patient treatment. Now, the Family Birth Center will be able to fulfill future plans for a 16-bed neonatal intensive care unit and a second operating room. Sutter Roseville Medical Center invested nearly $2 million in flat-screen computer monitors to be used at patient bedsides in its surgery and intensive care units. Sutter Roseville Medical Center installed a new GE CT Lightspeed Plus, a multi-detection scanner that is four times faster than the model it is replacing. 37

Sutter Solano Medical Center (Affiliated in 1984; name changed in 1985) As part of the Sacramento Sierra Region, SSMC implemented the SurgiCount Safety-Sponge System to all hospitals as a Sutter Health initiative. Sutter Solano implemented this new technology for the main Operating Room and for OB/Labor and Delivery. SSCC now has a Nurse Navigator coordinating the Cancer Navigation program at Sutter Solano Cancer Center. She works closely with referring physicians and radiologists to provide early detection and treatment for cancer patients. Purchased three orthopedic care console carts with the orthopedic grant. These carts that go into the surgery rooms, housing electronic equipment for orthopedic surgeries. Sutter Solano Medical Center partnered with Faith and Action to provide rides to the underserved populations for any medically related, non-urgent appointments. Implemented a new electronic documentation system (T-System) in the Emergency Department. SSMC and other community partners implemented an Interim Care Program (ICP) in Solano County. The ICP provides temporary housing for homeless patients ready to be discharged from the hospital. It also provides a clean and safe place to heal for up to six weeks and comprehensive wrap-around services like substance abuse treatment, permanent housing and medical care. Sutter Solano Medical Center now offers the latest breast biopsy technology with our new state-of-the-art Stereotactic Breast Biopsy System. Requiring only a tiny incision, this simple outpatient procedure minimizes discomfort and allows patients to immediately resume most normal activities. Purchased and installed a new Senographe Essential full-field digital mammography system from GE Healthcare. This powerful new tool is the latest advancement in GE s Senographe family of products. It features the industry s largest field of view detector, allowing for precision imaging of diverse body types. Purchased and installed C-ARM table for special procedure cases. This includes procedures for vascular line placements, angiography, IVC filter placements, and renal stents. The table is also utilized for thoracentesis, paracentesis, and ultrasound guided biopsies. Purchased and installed Stryker Video Tower, Small Fragment Locking Plate Set, and Bone Mill with the orthopedic grant. The Video Tower Video tower enable s SSMC to facilitate more or surgeries; Locking plate set allows the ability to create a fixedangle construct while utilizing familiar plating techniques; Bone mill is used for grinding harvested bone from the hip into uniform sizes. Patient Positioning System purchased with the orthopedic grant is used on cases with long bone fractures. Sutter Solano expanded the orthopedic program to offer some of the latest treatment options available, such as: General orthopedics Sports medicine Foot and ankle reconstruction Joint-replacement surgery Hand and microvascular surgery Spine surgery To help ease overcrowding in the emergency room of Sutter Solano Medical Center, SSMC and La Clinica Raza opened a new North Vallejo clinic. The center provides both urgent and primary care for the community s low-income, uninsured and underinsured populations. Genetic counseling offered at SSCC. The program, led by board-certified Genetic Counselor Maude Blundell, M.S., CGC, includes genetic counseling, testing, risk assessment and screening recommendations. Identification of individuals at high risk of cancer can allow for intensified screening and preventive treatments to reduce the risk of cancer. SSMC implemented red socks; this best practice is an effort to reduce the risk of patient falls. Patients who are identified as high risk will wear these sock during their hospital stay. Launched the Joint Replacement Class, comprised of a team of specialty-trained orthopedic staff, to provide all patients undergoing joint replacement surgeries with comprehensive and integrated care from diagnosis through rehabilitation. Oncology patients at Sutter Solano Cancer Center now have access to the most advanced and accurate radiation therapy system available Intensity Modulated Radiation Therapy (IMRT). The new system offers patients customized cancer treatment resulting in quicker, more accurate care for several types of cancers such as breast, prostate, head, neck and lung. Sutter Solano Cancer Center has unveiled its latest weapon against cancer it s called respiratory gating, and it monitors patients breathing patterns so that tumor motion can be accounted for during radiation treatments. This precision treatment greatly improves quality of care and patient outcomes. Sutter Solano Medical Center has expanded and upgraded its current system used to monitor heart patients. This wireless technology, called telemetry, increases patient mobility and offers more flexibility in the appropriate placement of patients throughout the hospital. A new magnetic resonance imaging (MRI) system at Sutter Solano Medical Center enables physicians to improve the diagnosis of a wide range of conditions, including vascular disease; stroke; abdominal and brain disorders; musculoskeletal conditions of the knee, shoulder, and other joints; and liver, pelvic, kidney and pancreatic disorders. 38

Sutter Solano Medical Center installed a 16-slice computed tomography (CT) scanner. The new CT scanner incorporates breakthrough innovations that deliver speed with sub-millimeter resolution, and effective dose optimization to push clinical applications to new levels. Sutter Solano Medical Center implemented a FasTRAC service in the Emergency Department (ED) to care for patients with nonlife-threatening emergencies. When a triage nurse determines that a patient has a non-emergency condition, he/she will bypass the ED and visit the on-site FasTRAC service. Implemented the electronic ICU to provide an extra layer of patient safety in the ICU. The system uses early warning software and remote video monitoring to connect and provide off-site intensivists and critical care nurses with the data needed to proactively care for ICU patients. Expanded and upgraded the wireless telemetry system to provide the capability of monitoring 27 beds. In 2007, the system will be linked to with Sutter Memorial Hospital in Sacramento where certified monitor technicians will remotely monitor patients around-the-clock. Opened a new, state-of-the-art Endoscopy suite to provide increased space and accessibility for patients and physicians. Remodeled the ED to include four additional treatment rooms, an expanded triage area, and a new radiology room. Renovated the ultrasound suite in the Hospital and added a laboratory draw station in the Cancer Center. Started an OB Hospitalist Program to provide consistent perinatal care to patients from La Clinica Vallejo as well as those that present to the ED for obstetrical and gynecological needs. Upgraded the Imaging Department s MRI camera to provide increased test capability and expanded MRI operations to five days per week. Sutter Solano Medical Center opened the doors to a new $24.5 million Cancer Center and medical office building in Vallejo. The Cancer Center offers a wide range of cancer treatments and support services including chemotherapy, radiation therapy, massage therapy, community education/health screenings and a resource center and library. The medical office building houses primary and specialty physicians. Sutter Solano Medical Center completed a $9 million remodel of its Imaging Services. The 18 project includes state-of-the-art X- ray equipment, a permanent CT unit and an electronic image storing system as sell as remodeled waiting rooms. Sutter Solano Medical Center Radiology Department installed PACS (Picture Archiving and Communications Systems), a filmless process that streamlines clinical diagnosis and treatment, allowing radiologists to share digital images and diagnoses instantly. Sutter Solano Medical Center is the first Sutter Health affiliate and the first hospital in California to begin using bar-code technology and comprehensive expert databases to help prevent errors in medication delivery. Only about 1.5 percent of U.S. hospitals currently use this technology, which is part of Sutter Health's $50 million patient-safety investment to help improve quality of care in all of our hospitals. Sutter Solano Medical Center's Surgical Services Department has opened its fourth operating suite in response to increased volume and requests from new surgeons utilizing the medical center. Imaging Services at Sutter Solano Medical Center installed a new mammography unit to enhance image quality and increase the center's capabilities. Sutter Solano Medical Center purchased and installed two state-of-the-art surgical microscopes for reconstructive and plastic surgeries, neurosurgery, ENT/ophthalmology services and spine procedures. Sutter Solano Medical Center began a post-discharge education and telemanagement program aimed at patients with congestive heart failure. 39

Sutter Tracy Community Hospital (Affiliated 1993; name changed in 1996) Sutter Tracy Community Hospital implemented a Hospitalist program to further advance and enhance to quality of care provided to patients. Sutter Tracy Community Hospital implemented Sutter Health's electronic health record system, along with Memorial Medical Center in Modesto and Memorial Hospital Los Banos. Added a new MRI machine to the Imaging Center. Implemented the collaboratively built Sutter Health enterprise-wide MIDAS Quality Management application. Sutter Tracy Community Hospital began offering a new 64-slice scanner. It uses advanced digital technology to give doctors an even faster and 3D look at the body s internal organs, blood vessels and bones. The health resource center at Sutter Tracy Community Hospital has expanded its services to provide short-term counseling for community members and other clients. Sutter Tracy Community Hospital opened a new vestibular rehabilitation program to help patients manage dizziness and balance problems resulting from inner-ear disorders. Sutter Tracy Community Hospital partnered with local schools to help families in need in its community. The PLAY program Playful Learning Adventures for Young Children provides a range of health and social services such as Mommy & Me support groups, literacy enriched play groups, parenting classes and more. Sutter Tracy Community Hospital Intensive Care Unit implemented the eicu system, which uses telecommunications from bedside monitors, remote cameras, trend-recognition software and clinical decision software to enable board certified Sutter intensivists in Sacramento to assist local physicians in caring for their ICU patients. Sutter Tracy Community Hospital remodeled patient rooms, the Obstetrics Department, physician lounge and Café to enhance patient comfort and the staff environment. Sutter Tracy Community Hospital opened its new health resource center, Health Connections. Located inside the hospital, it provides area residents access to health education, social services and family support services. Completed construction on a 10,000-square-foot surgical center and began construction on a new cardiac catheterization lab. Implemented bar-code technology to ensure safer delivery of medications at our patients' bedsides. The Electronic Medication Administration Program is part of Sutter Health's $50 million investment in advanced patient-safety technologies that support caregivers in performing complex procedures. Sutter Tracy Community Hospital became the first hospital in Sutter Health s Central Valley Region to utilize PACS (Picture Archival Communications System), which eliminates the use and storage of film X-rays and lets multiple users view the same images at the same time from different locations. Sutter Tracy Community Hospital opened the Altamont Medical Plaza, including the new Sutter Tracy Imaging Center and open MRI suite. Work continued on a $23 million plan to expand Sutter Tracy Community Hospital s emergency and OB departments and construction of a 9,000-square-foot surgical center. Opened the new Medical Office Building for primary care and specialty services including internal medicine, cardiology, obstetrics/gynecology and an open MRI. The Women's Health Center will be housed in the same location. A Sutter Tracy Community Hospital spinal specialist became the only surgeon in the Central Valley to perform endoscopic decompression. This less-invasive procedure requires a shorter hospital stay, allows for quicker recovery time and is less traumatic to ligaments and muscles. Sutter Tracy Community Hospital worked with San Joaquin County Mental Health Services to bring two new child psychiatrists to Tracy, alleviating the need for children needing mental health services to travel outside the Tracy area. Sutter Tracy Community Hospital began offering brachytherapy for the treatment of prostate cancer. The Radiology Department at Sutter Tracy Community Hospital introduced bone densitometry as a new outpatient service and is currently expanding and updating the waiting room. Remodeled the Diagnostic Imaging Department. Began renovation of the pathology area of the laboratory. An orthopedic surgeon specializing in spinal disorders performed the hospital's first kyphoplasty, a procedure that "cements" a fractured spine to improve stability. Physicians at Sutter Tracy Community Hospital performed the first sentinel node procedure that helps determine if cancer has spread to the lymph nodes. 40

Noteworthy System Developments Sutter Health joined a select group of organizations nationally to launch Care Everywhere, a new technology that enables medical teams from separate organizations to share a patient's medical records at the time he or she receives care. Through this technology, Sutter Health is now linked with UC Davis Health System, Stanford, and Santa Cruz County Health Services to share vital patient information. Sutter Health's Advanced Illness Management (AIM) program received national recognition for its approach to better meeting patients' end-of-life care wishes, improving quality of life and easing the cost burden on patients, their families and the overall health care system. Patients gained mobile access to their My Health Online account via the My Chart app, offered for the iphone, ipad and ipod Touch. For smartphone users, we introduced the itriage mobile app to help consumers look up their symptoms and health conditions, and locate our nearby services and physicians. Sutter Health accelerated the pace of our electronic health record (EHR) implementation within our affiliated hospitals. We will invest hundreds of millions of dollars to make this important technology tool available to our caregivers enhancing patient safety and quality care. The Sutter Health network of doctors, hospitals and other health care service providers was named California s top-ranking health system in health care quality according to the respected Lewin Group, an independent health care policy and research firm. Cohen Cormier Home Care & Care Management, a non-medical home care and professional care management agency, became part of Sutter VNA & Hospice allowing Sutter Health to offer a broader scope of care to elderly patients. Sutter Health launched the Sutter Medical Network a network of more than 3,000 physicians committed to providing patients with more convenient access to consistently high-quality health care services. 2008, Emmy Award for Sutter Health s Your Health television show National Academy of Television Arts and Sciences Sutter Health launched MyLifeStages a new Web portal and membership program designed especially for women. The site connects patients and potential patients with our network s foundations and hospitals systemwide. Sutter Health opened its first system-wide shared clinical service, the Shared Laboratory, which is located in Livermore, California. It allows affiliates to reduce their dependence on outside commercial laboratories and to enhance their productivity by providing a central source for non-urgent testing. Sutter Health s eicu system and sepsis program received an award for the most innovative approach to health care delivery from the Adaptive Business Leaders organization. Sutter Health became one of the first health systems in California to make critical quality data available to everyone online by creating a special section on the Sutter Health Web site that openly shares information regarding how the network stands up to key measures of quality in comparison to state and national standards. Sutter Health implemented recommendations of an internal Blue Ribbon Team to help ensure every patient s care is the absolute best, and achieved remarkable improvements in quality measures including a 112 percent increase in the number of measures that rank as high as those of the nation s top performers. Sutter Health launched Sutter Express Care medical clinics in the greater Sacramento area to provide another option for consumers seeking convenient and affordable solutions for their immediate health care needs. The network further expanded eicu patient-safety system to complete, on-time, the implementation of this life-saving technology and bring the total number of beds being monitored to 359 across our network of hospitals. Sutter Health brought to five the total number of medical foundations using an electronic health record to further improve clinical outcomes, enhance patient safety and reduce the cost of high-quality care. Five medical groups and independent practice associations affiliated with Sutter Health earned a best practice nod from PacifiCare Health System. Groups that perform in the top 90 th percentile on any of the measures exemplifying clinical and service quality and affordability earn best practice status. Camino Medical Group, Palo Alto Medical Foundation, Sutter Independent Physicians, Sutter Medical Group and Sutter West Medical Group each earned the designation. Four Sutter Health hospitals received a leadership award for their extraordinary level of clinical excellence in cardiac care. The recognition was based on nationally recognized quality measures and awarded by VHA Inc., a national health care provider alliance of more than 2,400 not-for-profit health care organizations. The four affiliates were among only nine VHA member hospitals across California to receive the organization s 2006 Leadership Award for excellence in cardiac care for Acute Myocardial Infarction (AMI), which is more commonly referred to as a heart attack. They were: Eden Medical Center in Castro Valley Novato Community Hospital Sutter Auburn Faith Hospital Sutter General Hospital, part of Sutter Medical Center, Sacramento Seven Sutter Health affiliates were among just 22 hospitals statewide recognized for outstanding commitment to health care quality and patient safety by The Leapfrog Group, a consortium of some of the nation s largest employers that are challenging 41

health care providers to make significant leaps in these areas. The Excellence in Patient Safety & Health Care Quality Award, was based on results from the prominent Leapfrog Group Hospital Quality and Safety Survey and given to: Alta Bates Summit Medical Center - Alta Bates Campus in Berkeley Mills-Peninsula Health Services in Burlingame Sutter Auburn Faith Hospital Sutter General Hospital, part of Sutter Medical Center, Sacramento Sutter Lakeside Hospital in Lakeport Sutter Memorial Hospital, also part of Sutter Medical Center, Sacramento Sutter Roseville Medical Center Sutter Health was selected, for the fourth year in a row, as a top workplace for information technology professionals by IDG's Computerworld magazine. Of the top 100, Sutter Health ranked 42nd across the entire IT industry. Sutter Health placed fourth in health care nationally and is the best place to work in the western U.S. for health care. Sutter-affiliated California Pacific Medical Center in San Francisco and the Sutter Memorial Hospital campus of Sutter Medical Center, Sacramento were named as among the top 50 acute care hospitals in the United States by the Leapfrog Group. This is the first time the prominent health care leadership organization has developed such a list. More than 1,200 hospitals nationwide were surveyed. For the fourth year in a row, Sutter Health ranked among the nation s most integrated health care networks. Sutter Health ranked 8 th among the Top 100 integrated networks identified by Verispan, a Chicago-based research firm. Sutter Health launched a new Web site for parents seeking health information specific to kids at www.kids.sutterhealth.org. Sutter Health contributed $200,000 to the American Red Cross in support of relief efforts in the regions affected by the tsunami. Sutter Health contributed another $53 million to the Sutter Health Retirement Plan to fully fund its employee pension obligations in 2004. Sutter Health launched its new advanced eicu patient-safety system in the San Francisco Bay Area. The remote ICU is currently monitoring patients at CPMC, St. Luke s and Novato Community Hospital. Sutter Health Information Technology received the 2005 HDI Team Excellence Award for Internal Support from HDI, the world s largest membership association for IT service and support professionals and the premier certification body for the industry. U.S. Health and Human Services Secretary Mike O. Leavitt visited Sutter Health and PAMF as his first stop on a nationwide tour to promote the pivotal role IT can play in transforming the nation s health care system. Sutter Health has made a commitment to deploy an electronic health record (EHR) system networkwide by the end of 2006. Sutter Health debuted a series of new, locally produced health and medical television programs that will ari in tow major media markets in Northern California. The half hour programs, called Your Health, air monthly and feature the latest health news and inspiring real-life stories from around Sutter Health. Sutter Health s babies Web site, devoted entirely to pregnancy ad birth is now available in Spanish and can be reached at www.embarazo.sutterhealth.org. VHA awarded Sutter Health its national Leadership Award in the category for community health for demonstrating that collaboration and commitment to bring positive results. Sutter Health s Sacramento Sierra Region and the Los Rios Community College District celebrated the grand opening of Sutter Center for Health Professionals, part of a $15 million dollar commitment Sutter made to local educational programs that help add hundreds of registered nurses and other health professionals to the job market. Sutter Health launched a special Web site for cancer services www.cancer.sutterhealth.org. The site, created for cancer patients and their families as well as referring doctors, includes a physician search, database of cancer-related clinical trials, locations of major cancer services, links to each affiliate Web site, patient education videos, detailed information on common cancers and selected articles. Sutter Health launched the Women s Heart Advantage, a multi-year outreach and educational program to help women in the north state understand their significant risk of heart attack, identify warning signs and live heart-healthy lives. Sutter Health expanded the advanced eicu patient-safety technology to another center that will support critically ill patients and caregivers in the greater San Francisco Bay Area. Sutter Health s hospitals and physicians achieved great success through systemwide clinical initiatives relating to cardiac care, breast cancer and first time pregnancy and delivery. Successes included the roll-out of a new AMI initiative, improved out-patient prescribing rates for ACE inhibitors and Beta-blockers for CHF patients, achieving early diagnosis of breast cancer through high mammography rates and catching it at its earliest stages, plus far exceeding our goals for needle biopsies rates. Significant improvements were also achieved in reducing induction rates and episiotomies for women with their first pregnancies. Through a focus on working together to improve outcomes for patients, the hospitals and physician organizations within Sutter Health have achieved significant improvements in operations, cost-control and integration, according to a study published by Modern Healthcare. Verispan, a Chicago-based independent research firm that has graded health care networks over the past six years, ranked Sutter Health 12th among the nation's "top integrated health care networks." Sutter Health has created a $4 million fund for a competitive scholarship program available to the children and grandchildren of employees within its network. In 2003, 273 scholarships were awarded, totaling nearly a half a million dollars. 42

In a multi-page special report, BusinessWeek recently named Sutter Health one of the nation s Web Smart 50, highlighting our network s commitment to patient safety and our investment in the advanced eicu system. Sutter Health and such impressive company as IBM, Mattel, Eli Lilly, Sony, UPS, BMW, Wells Fargo and Nike were recognized for transforming operations, customer service or collaboration through cutting-edge, Web-based applications. BusinessWeek has 5.2 million readers. For the fourth year in a row, Information Week has recognized Sutter Health on its Top 500 list for most innovative use of information technology in business strategies, investments and administrative practices. The list includes organizations from all industries. Ranked at 272 last year, Sutter Health moved up to 53 rd in 2003. Hospitals and Health Networks magazine recognized Sutter Health as one of the nation s 100 Most Wired Health Systems in 2003. This is the third time Sutter Health has been awarded this distinction which recognizes technically savvy medical providers that use Internet technologies to improve patient safety, clinical quality, customer service, business processes, employee communications and disaster readiness. Recognized for its work with physicians and nurses to improve quality and implement clinical practice guidelines, the Continuum Case Management Department of the Sutter Sacramento Sierra Region has been identified as the inaugural winner of the Franklin Award of Distinction by the American Case Management Association and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). "The Joint Commission applauds Sutter Health for its achievements in case management services," said Maureen Potter, JCAHO executive director of disease-specific care certification. "The approaches and collaboration of Sutter Health demonstrate what is possible in patient care." For its efforts to reduce waste, eliminate mercury and prevent pollution across its not-for-profit network of community-based hospitals and physician organizations, Sutter Health has received the 2003 Champion for Change Award from the Hospitals for a Healthy Environment (H2E) program. Hospitals across our network have successfully removed from use 56 percent of traditional medical products that contain mercury. Nine Sutter affiliates received H2E Making Mercury Free and/or Partner Recognition Awards, including Alta Bates Summit Medical Center, Mills-Peninsula Health Services, Sutter Auburn Faith Hospital, Sutter Davis Hospital, Sutter Lakeside Hospital, Sutter Medical Center, Sacramento, Sutter Medical Center of Santa Rosa, Sutter Roseville Medical Center and Sutter Warrack Hospital. Sutter Health completed an affiliation with Solano Regional Medical Group, Solano County s largest multispecialty physician organization. The medical group, which has 69 physicians, will work with Sutter Health through a new medical foundation Sutter Regional Medical Foundation serving communities primarily in Solano and Napa Counties. IDG's Computerworld selected Sutter Health as a top workplace for information technology professionals. The honor is part of the weekly newspaper's 10th annual Best Places to Work in IT survey, which ranks the top 100 work environments for technology professionals using the categories of benefits, diversity, career development, training and retention. Computerworld surveyed more than 11,500 IT workers for this year's national list. Through a focus on working together to improve outcomes for patients, the hospitals and physician organizations within the notfor-profit Sutter Health network have achieved significant improvements in operations, cost-control and integration, according to a study published by Modern Healthcare. Verispan, a Chicago-based independent research firm that has graded health care networks over the past six years, ranked Sutter Health 12th among the nation's "top integrated health care networks." In 2002, Sutter ranked 73rd. Verispan rated 472 regional systems in categories designed to measure success, including financial stability, integration, technology and hospital utilization. Sutter Health announced a $50 million investment in new advanced technology to enhance patient safety. Sutter Health affiliates will be the first on the West Coast to use telemedicine technology from VISICU, Inc. early warning software with advanced video and electronic monitoring to connect off-site critical care specialists to ICU patients. The Sacramento Sierra Region is set to go live with Sutter Health's first "eicu" by January 2003 with full system implementation targeted for December 2005. Sutter Health hospitals will introduce bar-code technology to help ensure the right dose of the right medicine is given to the right patient at the right time. It alerts the clinician to possible allergies, and look-alike/sound-alike or high-risk drugs. Six facilities: Peninsula Medical Center; Sutter Delta Medical Center; Sutter Medical Center, Sacramento; Sutter Roseville Medical Center; Sutter Solano Medical Center and Sutter Tracy Community Hospital, will pilot the technology by January 2003, and all Sutter affiliated hospitals should be online by December 2005. For the second consecutive year, Hospital and Health Networks magazine named Sutter Health one of the nation s Most Wired Health Systems. The survey and benchmarking study measures the nation s hospitals and health care systems on their use of Internet technologies to connect with patients, physicians and nurses, payers, health plans and employees. Alta Bates Summit Medical Center, California Pacific Medical Center, Marin General Hospital and Novato Community Hospital were honored by the American Hospital Association with the prestigious Nova Award for their participation in Operation Access, a public/private partnership that provides surgical services and specialist care to people who couldn t otherwise afford it. AHA s Nova Award recognizes outstanding community programs. 43