Hospital Surgery Ratings

Last week I paid for access to Consumer Reports magazine to get washer/dryer ratings.  While I was at it, I looked to see what else was available.  In the September 2013 magazine, hospitals around the US are rated in terms of “avoiding adverse events in Medicare patients during their hospital stay for surgery.  Specifically, the Ratings are based on the percentage of a hospital’s surgery patients who died in the hospital or stayed longer than expected for their procedure.”

“The analysis looked at Medicare claims data from 2009 through 2011 for patients undergoing 27 categories of common scheduled surgeries.  For each hospital, the results for all procedures are combined into an overall surgery Rating. …[Some] hospitals themselves use this approach to monitor quality.”

The ratings are 5 levels from “Better” to “Worse.”

In Northern and Central California, these hospitals received a “Better” overall surgery rating:  (in alphabetical order)
Enloe Medical Center, Chico
French Hospital, San Luis Obispo
Fresno Heart and Surgical Hospital
Fresno Surgical Hospital
Mercy Medical Center Redding
Oroville Hospital
Sacramento Medical Center
Sequoia Hospital, Redwood City
Shasta Regional Medical Center, Redding
St. Helena Hospital Napa Valley, St. Helena
Sutter Lakeside Hospital, Lakeport
Sutter Surgical Hospital – North Valley, Yuba City
Washington Hospital, Fremont

These hospitals received the next rating lower than “Better”:
Alta Bates Summit Medical Center, Berkeley
Alta Bates Summit Medical Center – Summit Campus, Oakland
Bakersfield Heart Hospital, Bakersfield
Clovis Community Medical Center, Clovis
El Camino Hospital, Mountain View
Mercy General Hospital, Sacramento
Mercy Hospitals of Bakersfield, Bakersfield
Methodist Hospital of Sacramento
Sierra Nevada Memorial Hospital, Grass Valley
St. Elizabeth Community Hospital, Red Bluff
St. Joseph Hospital, Eureka
St. Joseph’s Medical Center, Stockton
Stanislaus Surgical Hospital, Modesto
Sutter Amador Hospital, Jackson
Sutter Auburn Faith Hospital, Auburn
Sutter Davis Hospital, Davis
Sutter Medical Center, Sacramento

See for:

  • an article on “How Safe is Your Hospital”  (available at no charge)
  • “Your Safer-Surgery Survival Guide”  (available at no charge)
  • rankings for 2463 hospitals in the US.  Ratings are for 5 procedures including replacement of the hip or knee and angioplasty.  And there are scores for safety, bloodstream infections, avoiding readmissions, drug information, and adverse events.  (there is a fee to see the info)


“How Do I Manage My Parents’ Money When They Can’t?”

This post will be of particular interest to adult children caregivers.

This one sentence is a good summary of this blog post:  “The hardest part of managing a parent’s money is figuring out how to make it last.”

This blog post is by Paul Solman, a journalist who covers business and economic news on the PBS NewsHour.  He and his sister gained control over their father’s finances.  He writes about managing his parent’s money when the parent can’t. Wonderfully, the father must’ve had a large nest-egg because his budget was $135K per year.

Similarly, after my brother and I took over our father’s finances, we wanted safe investment vehicles.  We also kept a good chunk of money in cash in case of disaster.  Disaster did strike after Dad had a heart attack, developed pneumonia, and was put on a ventilator.  He lived several months in a care facility that could handle those with vents.  Incredibly, it cost $1K *per day* to live in that care facility.  When he died, we had about $10K left in cash.  A little too close for comfort…

Here’s a link to Paul Solman’s blog post:

How Do I Manage My Parents’ Money When They Can’t?
PBS NewsHour
By Paul Solman
August 2013

This second link includes Paul Solman’s asset allocation plus, more importantly, his step-by-step advise on how to find a financial advisor:


PSP Association International Medical Workshop- Notes

The PSP Association is based in the UK.  It focuses on PSP and CBD throughout Europea.  They have a blog section on their website.  I occasionally find items there of interest.

In this recent blog post, Tim Rittman, a clinical research fellow in neurology, offered some notes after attending The PSP Association’s International Medical Workshop in July 2013.  You can find a link to the blog post here:

And the full text is copied below.


From Tim Rittman
Posted to the PSP Association’s Blog

On the 25th of July around 40 doctors and scientists from the UK and around the world met at Queen Square in London. I went along with Sian Alexander – Academic neurology trainee, researcher on clever cellular stuff and an accomplished baker of cakes (catch her on twitter @siankalexander). This meeting was a poignant echo of the diseases under discussion, coming 50 years after the first description of ‘Richardson’s syndrome’, or Progressive Supranuclear Palsy (PSP) as we know it today. The meeting covered cutting edge research in PSP and its cousin Corticobasal Degeneration (CBD). Below are some thoughts from me and Sian on the day.

At the end of the day I was left encouraged, but with a touch of disappointment. There was a hint of disappointment that two big trials in PSP had failed to show any impact on the disease. However, this is not a field where people shrug their shoulders and sit back. There was a palpable sense of optimism. The two trials had shown that it can be done. Yes, the first bites at the cherry have failed, but doing it all again is not so daunting, partly thanks to a newly formed national network of centres in the UK studying PSP and CBD. The PSP Association should take credit for raising the profile of the disease, not only amongst the general public but also for cajoling, arm twisting and, more importantly, funding researchers to take on the challenge. I overheard an American visitor who was astonished how much money the PSP Association had managed to put together to fund research and care, far outstripping their American counterparts per head of population.

To take a more in-depth view, we’ll break the sessions down and give you a feel for the main headlines from each. The range of talks and work show-cased impressed me. Although a few themes recurred throughout the day, each talk was unique and the cast was stellar in terms of reputation and quality.

The first session covered ‘basic science’, although as my brother continually reminds me there is nothing basic about it. The day kicked off with two household names from the world of dementia research. Michel Goedert takes an interest in how proteins build up in the brain, and particularly the tau protein that causes problems in PSP and CBD. He is firmly of the opinion that tau is responsible for the disease rather than being a by-stander, showing compelling evidence that tau protein travels from cell to cell through the brain causing mischief. John Hardy followed with an update on the genetics of the tau protein. He also talked about Genome Wide Association studies in PSP, trawling genetic information from people with the disease to look for clues that might push someone a few percent towards or away from getting the disease. The results so far point to 3 processes where damage occurs: integrity of nerve connections (synapses), the electrical insulation of nerves (myelin sheath)  and brain cells’ response to damage (the so-called ‘stress’ response). An intriguing talk from Steve Gentleman discussed dementia pugilistica, something that hit the news in the past week in rugby players. Although the link between head injury and PSP/CBD is far from certain and dementia pugilistica is quite different from either disease, there are similarities in how the brain appears under the microscope. This line of research promises to throw up some intriguing clues in the future.

Human disease biology came before lunch covering lumbar puncture, new brain imaging techniques and brain pathology. At the moment these tests remain very much in the research arena and for the moment do not add much to the diagnosis, but are starting to show promise in tracking the changes of disease over time. A promising new tool on the near horizon is a dye injected in the blood stream that clings to tau protein in the brain making it visible with a PET brain scanner. The usefulness of this sort of scan will need to be tested, but it sounds like we are getting close to something usable.

The most eagerly anticipated session came just after lunch, discussing therapeutics. I’ve previously written about Davunetide, and unfortunately both Tideglusib and Sodium Valproate disappointed in their results. Although, as one Alzheimer’s researcher pointed out, at least they didn’t make people worse as many of the recently tried drugs have for that disease. David Burn took us through a post-mortem of these trials. Reassuringly, the researchers involved in these studies were keen to share their data with him and are due to publish their results soon. This will help greatly in working out what went wrong and planning future studies. Hugh Nutall from the drug company Eli Lily had the trickiest talk of the day, trying to predict where PSP/CBD therapies will be in 5 years’ time. He talked about a number of promising compounds in development, many attacking the tau protein but in a different manner to previous efforts. It remains to be seen which will make it through to full blown clinical trials.

A particular step forward in clinical trials design has been the PSP rating scale, developed by the legendary Larry Golbe who was at the meeting. It is being widely used, enabling better assessments of how individuals with PSP respond to trial medicines.

The final session started with talks covering some good old-fashioned clinical questions of diagnosis and syndromes. The Queen Square Neurology department have been at the fore-front of sub-classifying PSP, CBD and similar diseases. It was a particular pleasure to have John Rohrer talk,  a neurologist and researcher in frontotemporal dementia – another disease where the tau protein builds up in brain cells. Even though us doctors might make a diagnosis of one or the other disease in the comfort of our clinic rooms, real life teaches us that under the bonnet there may be something very different going on. This is a challenge that will become increasingly important to solve if the treatments we develop only address a single disease process. In addition, picking up the earliest signs of PSP or CBD is extremely difficult, and other than spreading information about these diseases among GPs and neurologists, perhaps that is one challenge that no one came up with a good answer for.

To conclude the day, Larry Golbe led a discussion about funding priorities in PSP, who funds what research, and whether the research priorities are the right ones. The mission statement of the PSPA “Working for a World Free of PSP” was undisputed, but there was lots of ground for discussion about the best way to go about doing this. It was a thought-provoking way to end an enjoyable and educational day.

UK CBDer blogs about his journey

Dave Howarth describes himself as follows:

I’m just your average 56 year old guy who was expecting to work until I could afford not to, enjoy my life and time with family and friends and then CBD came a knocking and things changed somewhat.

In a couple of recent posts to The PSP Association website, he has written about his CBD journey.  (The PSP Association is a UK-based organization focused on PSP and CBD education, support, and research.)

In a two-part post, he describes his CBD symptoms. It seems his first symptoms were left hand numbness and alien limb syndrome in 2007 and 2009.

Here are links to the two blog posts:

The Journey So Far
Dave Howarth
Posted to The PSP Association blog

Part 1:

Part 2:

Happy reading,


Put Local Emergency Phone # in Your Cell Phone

Though this is of general interest, caregivers especially should take note!

I attended a CPR and first aid class today given by my local Red Cross chapter.  One suggestion I picked up from the class is that all of us should put our city’s local emergency phone number in our cell phones so it’s handy in case of emergency.  It’s always best to call 911 from a land line but if you only have access to your cell phone, calling 911 is not recommended because it’s not really an emergency number if called from a cell phone.  To reach an emergency number on your cell phone, it’s best to call the local emergency phone number.  I live in Menlo Park, so I will program the Menlo Park emergency phone number into my cell phone.  If I’m physically in Palo Alto and call the Menlo Park phone number, my cell phone call can be easily re-routed to the Palo Alto emergency number.

You can find a list here of local emergency phone numbers for cities or communities in the Bay Area:

(That list has some strange alphabetization going on….)

If you live outside the Bay Area, you can look up your city’s local emergency phone number in your phone book.  (I think some people still use those things!)