Dr. Yvonne Truong brings big smiles to Valley Health Center community clinics

YT PicMeet Dr. Yvonne Truong

Yvonne Truong was an undergraduate at UC Santa Cruz when she visited a friend in dental school and watched her fabricate dentures for an HIV patient who had lost his teeth due to malnourishment. She was hooked!

“Becoming a dentist was almost an immediate decision – I could see myself doing this. I liked to work with my hands, and I wanted to make a difference,” shared Dr. Truong. She practiced as a dental assistant for a couple of years and then graduated from the Goldman School of Dental Medicine at Boston University.

While in dental school, Dr. Truong completed an externship at the Dorchester House, a community health center in a low-income neighborhood of Boston. There she discovered a passion for working in a community clinic setting, supporting underserved populations: “I saw that I could really make a difference in people’s lives.”

Dr. Truong joined VMC in 2004, working for many years in the mobile dental clinic, providing dental services to high-need areas throughout Santa Clara County. She now staffs the dental clinics at Valley Health Centers Sunnyvale, Milpitas, and Tully.

Dr. Truong shared that her typical day “is very fast paced! I see at least 16 patients each day – doing exams and cleanings, taking dental impressions, giving oral hygiene instructions, and performing extractions, fillings, and other procedures. Every day is different because our patient population tends to have a lot of dental emergencies.” Indeed, the dental clinics serve a combination of patients with appointments and those who walk-in with urgent needs.

“The best thing about my job,” says Dr. Truong, “is seeing immediate results. If a patient comes in with pain, most of the time I can make them feel better right away.”

Take, for example, a recent patient of Dr. Truong’s. A male in his 30s, he hadn’t seen a dentist in five years after losing his job and his dental insurance. The patient traveled by bus from Palo Alto to Valley Health Center Tully to attend a walk-in clinic because he had severe tooth pain. Dr. Truong informed the patient that the tooth had decayed and that he would need a root canal and crown, but the patient didn’t have the money to pay for the procedure so he requested that the tooth be extracted instead. Dr. Truong did some research and found that the patient lived in the catchment area of VHC Sunnyvale, and that funds were available to help pay for his root canal and crown – no extraction needed! The patient was extremely grateful and has been coming back to VHC Sunnyvale for comprehensive treatment ever since.

With financial support from the El Camino Healthcare District, the dental clinic at VHC Sunnyvale expanded to offer one evening dental clinic per week so patients with daytime jobs and family responsibilities could better access care. Dr. Truong shared, “We wanted to be better able to accommodate patients who can’t miss work, those who don’t have insurance, and those who walk in with emergency needs. Without the grant funding, these patients would not have the oral health they need to lead a healthy and comfortable life.” The evening dental clinic is consistently booked at least 2-3 weeks in advance and demand far exceeds the current capacity of the clinic.

Still, Dr. Truong is inspired by the work she does, sharing, “I feel honored and privileged to be part of VMC, working here with such a dedicated groups of dentists. This is a challenging job – we have a lot of medically-compromised patients with financial limitations and language barriers. But I love coming to work every day because of how rewarding it is.”

When Yvonne Truong isn’t practicing at VMC, she is operating her own part-time private dental practice or spending time with her 4-year-old son at her home in San Jose.

El Camino Healthcare DistrictYou can learn more about El Camino Healthcare District’s investment in the health of our community in their 2014 Community Benefit Report.

Recognizing Kathy Madlem, VMC Quality Improvement Coordinator

Katherine L MadlemThe VMC Foundation congratulates superstar VMC employee Kathy Madlem for her important role in combating sepsis at Valley Medical Center. Kathy is the manager of the VMC Foundation’s Sepsis Quality Improvement Fund and we support her coordination of VMC’s Sepsis Seminars. Kathy’s excellent communication skills, positive can-do attitude, and amazing follow-through make her a true partner of the VMC Foundation. Thank you, Kathy!


Kathy shared her thoughts in a recent interview with VMC Foundation Development Officer Debbie Burdsall:

Debbie: Can you give me some background on the sepsis training for VMC staff and how you became involved?

Kathy: I have been in my current role as Quality Improvement Coordinator for about three years. I am responsible for the coordination of hospital-wide efforts to prevent sepsis through early diagnosis. Since I have led the effort, VMC has seen a 50% decrease in mortality due to sepsis through improved screening and staff education.

A large part of my job is to provide training to VMC staff on the prevention and management of sepsis. I coordinate VMC’s Sepsis Seminars, bringing in experts on sepsis to educate staff. I really feel like part of my job is to inspire VMC staff and keep their passion for saving lives through early sepsis detection alive and ongoing.

Debbie: How long have you been at VMC and what do you like most about working here?

Kathy: I have been at VMC for 16 years. I spent 13 years working the night shift in the MICU. I very much enjoy working with our patient population because I feel like those we serve are vulnerable. By providing education and training on the prevention and early management of sepsis, I have a stake in improving the quality of care for all of our patients. I enjoy helping our staff develop the skill set to be better care providers, thus ensuring that our patients receive the best care possible.

Debbie: How has the VMC Foundation supported you and your work?

Kathy: The VMC Foundation helped me establish a fund for the Sepsis Seminars which allowed me to focus on planning the seminar content. Payments from seminar participants are processed through the Foundation’s Sepsis Quality Improvement Fund, and the fund is used to pay vendors and speakers. The Foundation recognized how important the sepsis training is for VMC staff and has been instrumental in helping to significantly reduce the cost for VMC staff to attend the seminars by helping to sponsor the training.

Debbie: What is something people might not know about you?

Kathy: I enjoy riding horses in my spare time, and I have 2 cats and 1 dog – all rescues!

The only thing you should read today

onlyI spent a day last week with the leaders of Ventura County Medical Center.  Not surprisingly, they are just as proud of their services as we are here in Santa Clara County—and they should be; from what I learned, Ventura County Medical Center is a jewel for their community…just like VMC!

They like to talk about “The Onlys” a lot. That’s their list of things that ONLY their medical center is and does. Theirs is a long list of “onlys”, and got me thinking about trying to compile our own list.

Of course, Valley Medical Center is known as the ONLY hospital in Santa Clara County that serves anyone, regardless of ability to pay. But as the alert reader of this blog knows, we also offer “onlys” that would have you choosing us even if you had platinum private insurance and a zillion bucks in the bank.

Here, in no particular order, are some of our “onlys”:

  • VMC is the only stand-alone pediatric intensive care unit in San Jose.
  • VMC runs the only Burn Trauma Center in the Bay Area (one of only two in the state north of L.A.)
  • VMC is the only medical center in Silicon Valley that’s existed longer than 130 years.
  • VMC is home to the only sexual assault response team in the county.
  • VMC houses the only Mother’s Milk Bank in California.
  • VMC is the only top-level trauma center in San Jose. It also serves Santa Cruz, Monterey and San Benito Counties…none of which have trauma centers.
  • VMC provides the only brain/spinal cord injury rehabilitation inpatient service in the county.
  • VMC has the only Rehab Trauma Center in California.
  • VMC runs the only regenerative medicine institute in Silicon Valley.
  • VMC offers the only emergency acute psychiatric service in the county.
  • VMC is the only county hospital in the state with a genetics department.

…that last bullet I think is true – trouble is, “onlys” are hard to capture because there’s not usually some state-wide agency that keeps track of things like how many public hospitals have playgrounds on the roof (VMC does, and maybe we’re the only one).

What other “onlys” am I missing? Help me add to this list!


Women & Children’s Center at VMC receives $5.75 million towards launching campaign to raise $25 million

FIRST 5 Santa Clara County, SAP, Sharks Foundation and the Rademakers Family announce major gifts.June 24 montage

Making a historic down payment on the future of women and children’s healthcare in Silicon Valley, SAP, the Sharks Foundation, the Rademakers Family, and FIRST 5 Santa Clara County have committed $5.75 million in seed funding to create a Women and Children’s Center (WCC) at Santa Clara Valley Medical Center (SCVMC), which will be the first of its kind in San Jose.

“This Center will strengthen Santa Clara County’s historic commitment to providing quality care to women and children,” said Ken Yeager, Chair of the Santa Clara County Board of Supervisors Health and Hospital Committee. “I appreciate the generosity of these donors. Their gift lays the groundwork for this essential service as we plan for the future of VMC.”

“Caring for women and children is at the core of what we do,” said Paul Lorenz, SCVMC Chief Executive Officer, during a news conference at SCVMC today. “This is a huge first step in raising the $25 million needed to make the Center a reality in 2016.”

The Women and Children’s Center at SCVMC will make use of an existing hospital building, consolidating pediatric, birthing and postnatal services into a single facility. Funded by a public-private partnership, the building will undergo significant renovation and upgrades to convert from general adult uses to specific women and children’s services.

A $4 million gift from FIRST 5 Santa Clara County will be invested in the labor and delivery department and the neonatal intensive care unit to be located on the third floor of the future WCC.

“This upgraded facility represents all the values we cherish at FIRST 5, which focus on making sure children five and younger have a better chance to lead healthy, happy, and productive lives,” said Jolene Smith, CEO of FIRST 5. “We’re excited because we’ll be able to integrate many of our programs and services throughout the WCC.”

With their $750,000 gift, SAP and the Sharks Foundation are making the single biggest donation to a non-profit since the foundation was started in 1994. As part of the SAP sponsorship agreement, SAP directs about $375,000 annually to the Sharks Foundation. The donation will sponsor the pediatric unit, located on the fifth floor of the WCC.

“The Sharks Foundation is thrilled to partner with SAP to fund the pediatric floor at the new Women’s and Children’s Center at Santa Clara Valley Medical Center,” said Jeff Cafuir, Manager of the Sharks Foundation. “We are extremely pleased to be involved with such a unique project that is going to make a significant and positive impact on the lives of so many here in Santa Clara County.”

“SAP is excited to support the development of the Women and Children’s Center as it reflects our belief that we strengthen our communities when we are making smart investments in projects aimed at improving the health outcomes for women and children,” said Jenny Dearborn, Senior Vice President at SAP.

After a tour of the WCC site at Santa Clara Valley Medical Center, John and Ann Rademakers were so impressed they decided to donate $1 million to make it a reality. “We immigrated from the Netherlands decades ago and raised our children here. We have received so much from our community that we feel this is a meaningful way to give back and support the well-being of all our children.”

VMC is partnering with Silicon Valley Creates (SVC), the region’s arts and creativity network, to bring together artists and cultural partners to completely redesign the family experience with a touch of magic that complements VMC’s premier medical services.

“We believe in the healing powers of the arts and there will be no better place to put this idea to work than at the new Women and Children’s Center,” said Connie Martinez, SVC Chief Executive Officer.

The founding sponsors of the WCC have recognized why the WCC is urgently needed as San Jose is the largest city in the United States without a free-standing children’s hospital. That deficiency has been on the minds of healthcare leaders and local advocates for decades.

They emphasized, while the initial donations are a great start, much work needs to be done to raise the remaining $20 million necessary to finish the WCC.

To learn more about the Women and Children Center at VMC Campaign, click here.

Donor Investment in Innovative Health Strategy Pays Off

Donors willing to fund “out of the box” solutions to our community’s health problems can make a big impact and help improve the way VMC provides care to its patients. With grant funding from El Camino Healthcare District, Valley Health Center Sunnyvale now has a Public Health Nurse, Joy Almquist, who visits the homes of high-risk chronic disease patients to assess environmental and home conditions that influence health behavior, and assists with the coordination of community resources. Though only in its first year, the program is already having a significant impact on people’s lives.

Joy with Patients


One of the most common patient needs is assistance with medication management. Joy works with a patient named Pamela who has a complex medication regimen that includes more than 20 prescriptions plus oxygen therapy for treatment of emphysema.

Once home from a doctor’s visit, patients like Pamela can have a hard time managing all of their medications, so Joy makes home visits to provide one-on-one help with strategies for medication compliance. Joy’s work with Pamela has also helped avoid readmission to the hospital – whenever Pamela is having a hard time breathing she communicates with Joy who determines if the issue is urgent and can quickly arrange for a clinic visit. Pamela recently shared with Joy, “I don’t know what I’d do without you. This program is very important especially for people who can’t get around. You come to my home and it makes it so much easier and more personal.”

Joy also works with Melvin, another patient referred for assistance with medication management and compliance. Joy helped Melvin establish a routine for taking medications and checking his blood sugar, which has improved his health. With Joy’s help, Melvin also keeps and attends his dental and medical appointments on time, enabling him to remain home and stay independent.

Assessing environmental factors is something Joy is also trained to do. In her work with April, a patient with cirrhosis who is dealing with related symptoms, Joy focused on the importance of good nutrition and abstaining from alcohol. Together they discussed how April could adopt a liver-friendly diet, and Joy shared resources for alcohol counseling and treatment. Joy has actively helped April address barriers to attending her regular follow-up appointments with her primary care provider. April shared, “Joy has absolutely changed the way I think about my body and myself. I had the worst eating habits and, until I got sick, I never understood how it was all related. She makes me want to do all the right things to stay healthy and get my body and mind focused on long-term goals.”


Indeed, Joy says that her patients’ goals become her goals. She works to help patients maintain good health with her guidance and encouragement, which can make all the difference for those with complex medical conditions and challenging environmental factors. Having a dedicated Public Health Nurse working directly with VHC Sunnyvale’s primary care team means that every patient who needs individual support in a home setting can receive it, ideally improving the health of patients and reducing trips to the emergency room. Shari Hurst, VHC Sunnyvale Clinic Manager, shares, “I am confident that the collaboration between Public Health and Adult Primary Care at VHC Sunnyvale has helped patients in the North County area get access to key services that improve their health and well-being. The collaboration is an example of creative, patient-focused teamwork.”

El Camino Healthcare FoundationWith the support of El Camino Healthcare District, we hope to continue implementation of this innovative program at VHC Sunnyvale and establish a model of care that can be replicated to help patients throughout Santa Clara County. You can learn more about El Camino Healthcare District’s investment in the health of our community in their 2013 Community Benefit Report.

Citation: https://coincierge.de/bitcoin-future/


VMC Rehab Center hosts major conference

rehab groupOver 80 nurses, therapists, case managers, and physicians from all over Northern California attended Santa Clara Valley Medical Centers’ (VMC) second annual Spinal Cord Injury Symposium on May 17. VMC has cared for patients with Spinal Cord Injury for over 40 Years. Dr. James Crew, Chief of VMC’s Spinal Cord Injury Service, discusses VMC’s mission of education, “Part of our mission is to educate our colleagues about best practices in SCI care. We have been lucky enough to develop multidisciplinary expertise in SCI management from the intensive care unit to inpatient rehabilitation and on to home. Our knowledge base continues to expand, as treatment strategies evolve for those with SCI. In the 1970s, the average length of stay on inpatient rehab was 100 days after SCI in the United States, now it is about 30 days. We are all trying to accomplish more in a shorter period of time, but trying to do so safely in order to allow patients and their families a smooth transition as they return home.”

VMC was able to fulfil that mission with yet another successful conference. Our attendees, visiting  from partnering hospitals such as Community Hospital of Monterey Peninsula, Kaiser Vallejo, Kaiser Vacaville,  Natividad Medical Center and Regional Medical Center rated the conference highly. The conference grew in size from last year by 15%. Our Traumatic Spinal Cord Injury Census increased by 18% after last years conference, and we will continue to track for this year.

VMC Rehab looks forward to continuing this tradition as we grow our conference, serving our mission to put patients first by disseminating education in best practices for Spinal Cord Injury care.

The State of the County, 2014

President Wasserman with me, dressed as an ear of corn for the opening of our Farmers Market last year. I mean me dressed as corn, not him.

President Wasserman with me, dressed as an ear of corn for the opening of our Farmers Market last year. I mean me dressed as corn, not him.

One of the less-obvious parts of our work at the VMC Foundation is our collaboration with Santa Clara County’s elected officials. It’s work that I very much enjoy, and I think it makes us a more successful non-profit; when we’re best supporting our public medical center, it’s as we support the leadership of the County at its highest level.

This is why I was excited to hear the priorities of our County’s new President, Mike Wasserman. He’s served on the Board of Supervisors since 2010 and as the incoming President, gave his “State of the County Address” on January 28.  On a personal note, he’s a fellow Los Gatoan and a great guy.

Here are a couple of highlights from his speech, and how they relate to the work of the VMC Foundation:

  • Combating homelessness. “Wealthy” Silicon Valley, sadly, continues to face this complex problem. President Wasserman has been an advocate for years of finding solutions, and made mention of the fact that it’s not just a matter of compassion; it’s also a taxpayer issue. “A chronically homeless person costs society $60,000 a year [in medical, law enforcement and related costs] while the solution [providing them a place to live] costs half that.” This is a bold political statement, yet we know it’s true. The VMC Foundation is helping by funding programs that reduce re-admission rates to VMC’s busy Emergency Department through social service and referrals. Hand in hand, homeless advocates like HomeFirst and Destination Home and Valley Medical Center are making it more possible to house the homeless and build lives.
  • Traffic Safe Communities. President Wasserman chairs the newly-formed Traffic Safe Communities Network in Santa Clara County, and I’m proud to be a new member. Working with valley leaders from many sectors—and led by our Public Health Department—we are working to reduce traffic injuries and fatalities while providing safer pedestrian/bike access to schools and work.
  • The Center for Leadership and Transformation. This is an initiative across county departments to examine ways the county provides services and improve upon them. Yes, all of them! Employee-led and executive-sponsored, the VMC Foundation is involved in Valley Medical Center’s efforts as we promote the CLT and collect/share best practices.

President Wasserman in known for having a “head for numbers and a heart for people”, and I feel strongly that his State of the County Address reflected that. I’m also confident that 2014 will be a year of moving forward for our county, the 16,000 people employed by it, and the two million people living in it.

Here’s the full text of President Wasserman’s address.

The crucial “Patient Safety Movement”

patient safety

Wait – patient safety needs to be a “movement”? Isn’t that just what hospitals DO?

Sure, yes, but consider that in 1990 studies showed that 90,000 Americans died in hospitals yearly due to medical errors. Twenty-plus years later, we recognize the number is more than TWICE that.

I know. Yikes.

Errors in hospitals are now the third leading cause of death in the United States, so a growing group of medical and tech leaders are pledging to solve this huge problem. Last weekend I attended the second annual Patient Safety Movement Summit, led by Joe Kiani of Massimo (a medical device company that helps find heart defects in newborns before they go home from the hospital). Joe is a charismatic leader with a BHAG: Zero preventable patient deaths by 2020.

“I suppose you expect me to tell you this goal is impossible,” said Mark Chassin, MD, CEO of The Joint Commission (the nation’s top hospital certifying agency). “But I won’t. It starts with a commitment to that goal, which we must do.”

Dr. Chassin also said this: “This is not rocket science. It’s much harder than that. Rocket science is simply getting machines to do what you want 99.99% of the time. Eliminating preventable patient deaths is getting PEOPLE to do what you want 99.99% of the time.”

What kinds of mistakes are we talking about? Lots, including: Giving the wrong medication or the wrong dose, post-operative respiratory depression, pressure sores, blood stream infections, leaving things inside a patient when you sew them up, falls, ventilator-associated pneumonia…and on and on.

How is Valley Medical Center doing? Proudly, very well…but we’re not perfect. One example: VMC cares for large numbers of patients who need a ventilator to breathe…and a while back we went 30 months without a ventilator-associated pneumonia case. That’s extraordinary.

But then we had one. And to that patient, and that family, it’s a big deal no matter our past track record. Any error is, and there’s so much we can do and must do. Medical devices and tech can help, but as Thomas Zeltner, MD of the World Health Organization told us, it’s truly about three things: Culture, culture, culture.

Less fear of transparency and ranking of hospitals, more accountability, more (if you can believe it) hand-washing, greater commitment to this cause—that and more is needed. We’ve got good company and help: Bill Clinton, Barbara Boxer, top hospitals and medical device manufacturers…they were all there with us pledging to work together and to share best practices.  I’m now believing we can do this as a nation.

So what about the VMC Foundation? How can we help? We’ll do what we’ve always done: Work to raise money and support the work of our nurses, doctors and everyone at VMC for whom patient safety runs in their veins. We’ll celebrate our victories and laud the innovators and milestones. Thankfully we have lots of those here at YOUR public hospital….but we need your help. If you want to know how your contribution could translate to improving safety at Valley Medical Center, call me.

A big thanks to Joe Kiani for launching this movement. A bigger thanks to the hundreds, thousands who will help grow it.

“There’s a lot of baloney in that sandwich…”

Chris Wilder headshotWhat are we accomplishing? How do we know we’re using our donor’s dollars in the best ways? How do we measure our successes? Are we really solving problems?

 These are not just good questions for any public benefit corporation (like the VMC Foundation) to ask; they are the questions that Charity Navigator will now be asking of nonprofits around the world in a move they call CN3.0. Paul Brest, former CEO of the William and Flora Hewlett Foundation, calls it “the most important work being done in the nonprofit sector.” High praise, indeed.

But Charity Navigator’s new direction – to capture the results and outcomes of a charity’s work – is also drawing fire. Many agencies wonder how to measure outcomes when their mission is to serve immediate, day-to-day needs. Are you “solving problems” if you feed a hungry family, knowing they will be hungry again tomorrow? How do you capture satisfaction of a client when that client is a 5-year-old child on an operating table in a war zone?

In a fantastic NPR story this morning, Charity Navigator CEO Ken Berger said this about some nonprofits’ concern over their new rating system: “There’s a lot of baloney in that sandwich.”

That’s a great line. I’m totally going to use that.

Worth noting is that the for-profit sector has no similar accountability expectation. Companies like General Motors or General Foods are measured by shareholder value and little else. Whether a video game maker is improving children’s health, or the degree to which Starbucks is strengthening gender equality overseas take a back seat to “are they making money?”

Seriously though, I wonder the degree to which Ken Berger began re-thinking this rating question after he (and millions of us) watched Dan Pallotta’s TED talk called “The Way we Think About Charity is Dead Wrong”. If you haven’t seen it, please do. Like, right now. I’ll wait.

There. Pretty compelling, right? So it makes me wonder about the VMC Foundation. What problems are we actually solving? How do we meaningfully measure our results?

This would be easy if we did just two or three things…but we do more. The VMC Foundation:

  • Boosts medical center morale by throwing parties and running softball leagues
  • Manages complex grant agreements to provide everything from newborn care technology to reduction in readmission rates for patients with chronic conditions
  • Advertises the world-class care available in our spinal cord and brain injury rehab center
  • Gives away thousands of new bikes every year to kids who otherwise may never have one
  • Outfits VMC’s clinics with beautiful artwork, creating healing environments
  • Participates in hospital committees, interview panels, and conducts staff appreciations
  • Runs financials for the hospital gift shop, launched a farmers’ market, runs medical conferences…

…I really could go on and on. We’re proud of all this, but how would we begin to evaluate our overall effectiveness and whether we’re “solving problems?” We probably shouldn’t take credit for work done by VMC’s doctors and nurses, even if we brought in a big grant that pays for what they do. If our medical center’s patient satisfaction scores go up, what role did we play? What if they go down; are we then to blame?

But we also cannot just evaluate ourselves on how much money we raise or the number of programs we run. Are we moving the needle on people choosing to get care at VMC? Are we keeping staff proud of their work and reducing turnover or absenteeism? What about our overall work to improve public health (evaluating what doesn’t happen is always a challenge; how many people didn’t get the flu because they got a flu shot because they responded to our campaign)? What, in short, can we take credit for?

Just because these questions are hard doesn’t mean we shouldn’t ask them. I think Charity Navigator is on to something very important…even if I don’t know how to respond to it yet.

If you do, or have ideas, please share them. This is normally the kind of thing reserved for a 2-day board retreat, but I have a feeling that crowd-sourcing ideas here might be useful. Let’s see if I’m right.

El Camino Healthcare District awards $1.4 million grant

El Camino Hospital DistrictContinuing a partnership that began in 2008, the El Camino Healthcare District has awarded a $1.4 million grant to the VMC Foundation to fund low-income health services provided to North County residents at the VMC-operated Valley Health Center Sunnyvale.

The $1,400,000 grant includes $1,061,000 for integrated primary care services and $339,000 for the dental clinic.

The recent expansion of the dental clinic to include evening hours was entirely due to the District’s support. This allows the clinic to better meet the extremely high demand for adult dental services. Both daytime and evening clinic hours will continue due to this additional grant funding.

An exciting new aspect of the grant is the inclusion of public health activities as part of the integrated primary care model. Funding from El Camino Healthcare District will enable the clinic to add a public health nurse to work with the primary care team, specifically to focus on community level health factors for high-risk chronic disease patients. The public health nurse will conduct home visits to assess environmental and home conditions that influence health behavior (specifically identification of community health barriers) and assist in coordination of community resources.

For more background on this partnership, check out the video below.