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Kaiser Permanente has been recognized as a Platinum-Level Fit-Friendly Worksite by the American Heart Association for helping employees eat better and be more active. Implement at least nine criteria outlined by the American Heart Association in the areas of physical activity, nutrition and culture. The Fit-Friendly Worksite program is a catalyst for positive change in the American workforce by helping worksites makes their employees’ health and wellness a priority. For more information about the Fit-Friendly Worksites program and how it is helping to improve the health of Americans by focusing on an activity that is convenient, free and easy, visit startwalkingnow.org. The American Heart Association is devoted to saving people from heart disease and stroke – America’s No.
In April 2014, we were pleased to be honored as the Best Hospital and Best Pharmacy in the area by readers of the Daily Republic newspaper, and Business of the Year by the Vacaville Chamber of Commerce. Vacaville is a member of the Kaiser Permanente Napa-Solano Service Area (NSA), which also includes the Vallejo Medical Center, the medical offices at Vallejo, Fairfield and Napa, and the Kaiser Foundation Rehabilitation Center — a specialty care facility helping patients recover from stroke, brain, or spinal cord injury, or other conditions that affect the ability to move, speak, or think. Vacaville is proud to be designated as Solano County’s sole Level II trauma center for serious injuries and life-saving care. At Kaiser Permanente we offer a fully integrated care delivery program where you’ll enjoy clinical autonomy, comprehensive administrative support, and the opportunity to realize your highest professional aspirations. When it comes to clinical training, interpersonal excellence and diversity, Permanente physicians stand apart. Professional Education and Development is a core component of Permanente Medicine and supports the concepts of group excellence and self-governance that have been the backbone of a strong care delivery system for over 65 years.
Serving one of Kaiser Permanente’s fastest-growing service areas, our Vacaville facility will continue to expand its services to meet our community’s growing needs.
Kaiser Permanente Northern California residency programs have been in existence since 1947. The Volunteers In Public Service (VIPS) program was founded in 2005 by now-retired Vallejo physician Richard Fleming. Situated halfway between San Francisco and Sacramento and bordered by rolling hillsides, Vacaville is a haven for anyone who enjoys a mix of metropolitan culture and small-town living. Our breathtaking surroundings, great cost-of-living, countless amenities and family-oriented lifestyle make it easy to fall in love with Vacaville.
Students, teachers and staff at Kaneohe Elementary School in Hawaii are taking a proactive approach to getting their students up and moving during recess and teaching them important life skills along the way. Staff and students of Kaneohe Elementary School cheer each other on in Playworks’ structured play curriculum. Kaneohe Elementary is one of nine schools in Hawaii participating in a recess pilot program put on by Playworks, sponsored by Kaiser Permanente Hawaii. Giving all kids an outlet to participate in physical activity creates a healthier school lifestyle and can reduce the risk of obesity.
Playworks hopes to implement this program across schools in Hawaii, furthering their goal of giving kids positive experiences that they will take back to the classroom, back to learning and back to their communities.
Kaiser Permanente Thriving Schools is a comprehensive effort to create a culture of health & wellness for students, staff and teachers in K-12 schools. A study at Kaiser Permanente in San Francisco tracked 600 gay men for over two years as they used Truvada, also known as PrEP or “pre-exposure prophylaxis,” a drug taken to prevent the contraction of HIV – and none of the study participants tested HIV-positive! The study looked at the use of Truvada in a real-world rather than a clinical setting; the participants used the drug for an average of seven months, and some of them reported having multiple partners in a short span of time, which researchers termed as a high-risk setting. Truvada has been criticized as a “party drug,” and concerns have been raised that people who use Truvada may use it in lieu of condoms, even though Truvada only prevents HIV and not other sexually transmitted infections.
However, the study shows that Truvada is, at least, an extremely effective part of HIV prevention, along with condoms and other safe sex methods. We have blogged previously (here and here) about false negative results in qualitative point-of-care (POC) hCG devices due to high concentrations of hCG?cf in urine.
However, only a few research laboratories quantify hCG?cf, so it is difficult for most clinical laboratories to determine which urine samples have high concentrations of this hCG variant.
There are many unanswered questions about hCG?cf, including: How high do hCG?cf concentrations get during pregnancy? After our study was published, we were frequently asked whether these devices actually performed poorly in clinical practice or if the results we observed only occurred in a controlled laboratory environment. Based on the description in the MAUDE report, we subdivided the false negatives by potential cause. The fact that false negative pregnancy test results occur relatively frequently in clinical practice was an important finding because it highlighted the limitations of currently available devices and emphasized that this problem is not limited to one or two devices. To decrease the occurrence of false negative pregnancy test results, contributions from multiple different groups will be required. In the past, we have blogged about false negative urine qualitative hCG tests in both point-of-care (POC) hospital devices and over-the-counter (OTC) devices due to the presence of high concentrations of hCGbcf. It is our understanding that the FDA is requiring device manufacturers to address this problem in any new devices going through the FDA approval process. Recently, we were made aware of two manufacturers that had apparently modified their qualitative pregnancy devices: The Cen-Med Elite Plus One-Step Pregnancy Test (a hospital POC device) and the First Response Early Result OTC device (an over-the-counter device). The original studies were performed by adding increasing concentrations of purified hCG?cf to a urine sample obtained from a pregnant woman. In a recent publication, we describe a screening method that can be easily used to examine the effect of hCG?cf and have used this method to test eleven POC hospital urine hCG devices.


Each device is tested with the two solutions and the intensity of the test bands are compared. The paper also demonstrated that devices that gave the strongest signal with hCG?cf alone were those that were least likely to show a false negative effect. The screening method can be used by device users and manufacturers to evaluate hCG devices for inhibition by hCG?cf. A false negative pregnancy test means that the test tells the patient they are not pregnant when they really are.
3) A very rare cause of false negative results occurs when very, very, high concentrations of hCG are present. One of the things that I find interesting about hCG is that there is more to it than meets the eye. All of these forms of hCG (and probably others that we don't even know about) are produced during pregnancy and can be detected in the blood and urine of pregnant women (hCG?cf is only in the urine). Their lack of regular physical activity raises their risk for a host of medical problems, such as obesity, high blood pressure and diabetes.
We are recognized as one of America’s leading health care providers and not-for-profit health plans.
A proud provider of high-quality healthcare for the Northern Solano area since 1996, Kaiser Permanente Vacaville has a well-earned reputation for providing exceptional care. With one of the largest helipad landing areas in Northern California, Vacaville is capable of receiving both county and military helicopters bringing in the area’s most severe emergency cases.
Over the past decade, Kaiser Permanente has implemented programs both to prevent stroke and improve outcomes for patients who already have suffered one. Every member of our cross-specialty practice benefits from the opportunity to enhance their skills in an innovative, collegial environment where providing exceptional patient care is our foremost priority. In Northern California, our physicians hail from top medical schools, residency programs and fellowships, with 22% receiving their training at Harvard University, Stanford University, or the University of California at San Francisco.
Our medical group has a culture that is dedicated to life-long learning in the art and science of medicine, and in the management of a high quality care delivery.
Physicians who join us will play a key role in implementing systems, services, and technology that can keep pace with Vacaville’s progress. Our goal is to train the finest quality physicians in the setting of the nation’s largest and most highly regarded integrated health care system. Each member of our close-knit community enjoys the recreational and personal advantages that come with a moderate climate. The program aims to not only increase physical activity through structured recess games, but also teach kids how to cooperate with each other and work together as a team. The program also empowers kids to work together and learn productive conflict-resolution strategies should problems arise. And, unfortunately, this turned out to be the case – 30 percent of the participants contracted a different STI within a year, 50 percent contracted an STI within two years, and while 56 percent of participants said that their use of condoms remained unchanged, 41 percent said that they used condoms less. False negative pregnancy tests can result in undesirable outcomes (including loss of pregnancy) if inappropriate treatment is given. Rather, the fact that the vast majority of pregnancy test devices performed poorly in our study and were reported to generate false negative results in clinical practice indicates that this is a much larger problem.
First, the FDA should insist that device manufacturers market devices that generate positive results in all pregnant women, including those with high urine concentrations of hCG?cf. It is our hope that a coordinated effort from the FDA, manufacturers, clinicians and laboratorians will eliminate that risk. However, it is up to manufacturers if they want to voluntarily change their existing devices. High concentrations of hCG?cf saturate either one or both of the antibodies used in the test. If Solution B shows a lighter test band than solution A, then the device is susceptible to false negatives with hCG?cf.
We hope that the results of this study will help healthcare providers make informed decisions about which hCG devices to select, especially in medical centers that are unable to perform rapid, quantitative measurements of hCG in serum. The pregnancy hormone, hCG, is not produced until implantation occurs and it takes several days for the hCG concentrations to get high enough in blood and then urine to give a positive signal. If a woman drinks a lot of fluids, the concentration of hCG in the urine will be more dilute. As pregnancy progresses, there are actually different variant forms of hCG that begin to appear in the urine.
Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. It has been repeatedly recognized on the Leapfrog Top Hospitals list for outstanding success in such areas as the use of electronic health records to reduce medication and other errors, positive outcomes on high-risk surgical procedures, low mortality rates, and appropriate physician staffing. Such efforts resulted in a significant reduction in deaths from stroke among Kaiser Permanente members in Northern California.
Because physicians who join Kaiser Permanente are attracted to our collaborative practice environment, they excel at communicating with patients and colleagues. From online self-study options, to small group sessions, to Grand Rounds presentations by nationally recognized experts, learning opportunities are offered in a variety of modalities to suit different schedules and learning preferences. Our graduates are highly sought after and many become leaders in our own or other health care organizations.


Fleming was convinced that if he could build a network of worthwhile volunteer opportunities, physicians would come.
Warm summers and mild winters offer ample, year-round opportunities to get out and enjoy a scenic city that’s adored by many, especially those who call it home.
Having structured activities during recess gives all children the opportunity to participate with their classmates. This takes the activity benefits beyond the physical elements, teaching problem-solving skills and cooperation. Are high hCG?cf concentrations associated with certain clinical symptoms or pathological conditions?
In a recent study evaluating the performance of devices used in a hospital setting, 9 of 11 devices were found to be susceptible to false negative results when used to test urine solutions containing hCG?cf concentrations observed in normal pregnancy. 91 different POC hCG devices were described from 14 manufacturers, including 10 of the 11 devices evaluated in our initial screening study. Second, clinicians at large hospitals should request that pregnancy testing be performed on serum using a quantitative assay, especially in patients with abdominal pain, vaginal bleeding or other symptoms that strongly suggest the patient might be pregnant.
Hence we have urged manufacturers to modify their devices to eliminate false negatives due to hCGbcf.
However the modified devices gave faint or clear positive signals in the presence of the same hCG concentrations (see figure).
This hCG variant effect prevents the development of a positive signal and generates a negative result despite the presence of intact hCG in the urine sample being tested.
A standardized method, using defined concentrations of hCG, is needed to evaluate the performance of currently available devices.
Most devices give positive results around the day of a woman's expected period, but this can vary widely.
For this reason many doctors recommend that testing be performed on the first urine of the morning because this tends to be the most concentrated (because you probably have not drank anything all night long). We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases.
And although we recruit hundreds of new physicians for positions throughout Northern California each year, we never compromise our standards. The ability to estimate the amount of hCG?cf in urine will allow many more laboratories to study the concentrations of this interesting hCG variant. We also found 142 reports that were likely due to hCGbcf hook effect and ten (or 7%) of those were associated with adverse events, including delayed prenatal care, delayed treatment of ectopic pregnancy, performance of inappropriate imaging studies and even surgery leading to loss of pregnancy. By contrast, the Genzyme OSOM and Cen-Med Elite Plus hCG devices were the most susceptible to false negative results due to hCG?cf (OSOM shown below). This is rare because women don't normally produce enough hCG to saturate both antibodies. 3 weeks after the expected period) concentrations of hCG beta core fragment are higher than all other forms of hCG. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers.
The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke.
The VIPs model makes it easy for clinicians to volunteer to help the underserved in local communities. In addition to the reports documented on the FDA website, it is virtually certain that many more false negative results have occurred and have gone unreported to the FDA. Lastly, laboratorians should work to decrease the time required to generate test results in order to make quantitative testing more appealing to clinicians.
The hook effect should be of concern in a hospital setting, but most women should not be concerned about a hook effect with their urine. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. To learn more or join us, call 1-800-AHA-USA1 or any of our offices around the country, or visit heart.org.
The program handles all the details, including finding service placements, arranging malpractice coverage, setting up schedules, orienting volunteers to the agencies, and periodically evaluating placements to make sure they are working well. At institutions where urine point-of-care testing must be performed, laboratorians should evaluate all available options and select the device that provides an optimal combination of sensitivity and lack of susceptibility to interference caused by elevated concentrations of hCG?cf. Unfortunately, the concentration of hCG beta core fragment can saturate one of the antibodies used in the assay in certain pregnancy kits, and the other antibody doesn't recognize the beta core fragment.
Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. The VIPS model has become so successful that it has won numerous awards and has sometimes had a lengthy waiting list… of physicians asking to participate. Similar to the hook effect, the variant hook effect can be confirmed if testing shows a positive result after diluting the sample.



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