Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Nov. 12, 2010 Issue | Archived Issues

Protect Your Family and Your Patients with a Flu Shot

Physicians’ family members can receive free influenza vaccinations from 10 a.m. to 1 p.m. Sunday, Nov. 14, on the second floor of the Steven Spielberg Building. You must register by noon on Friday by calling (310) 423-9586. Members of the medical staff may get their free flu shot in Employee Health Services. Appointments and walk-ins are welcome.

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MEC Update

At its Nov. 1, 2010, meeting, the Medical Executive Committee revised the language in Section 11.3.2 of the Medical Staff Rules and Regulations; approved the search committee’s recommendation of Sarah Kilpatrick, M.D., as OB/Gyn department chair, and formed a nominating committee for medical staff secretary and treasurer.

MEC Morning After Report - November 2010


Meetings and Events

Run for Her
Nov. 14

Ethics Consultation: Harm or Healing 
Nov. 17

Arrhythmia Symposium at the Cedars-Sinai Heart Institute
Dec. 10

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Support Cancer Research This Sunday

You can still register to participate in the sixth annual Run for Her friendship walk this Sunday. The 5K run/walk, which supports ovarian cancer research, starts at 9 a.m. at Pan Pacific Park. 


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Attending Staff Can Obtain Access to CS-Link™

All Cedars-Sinai medical staff members can now use CS-Link™ to view clinical data in the new Electronic Health Record (EHR).

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Form Required Prior to Placing a Percutaneous Feeding Tube

Effective Monday, Nov. 15, Cedars-Sinai will require the completion of the Percutaneous Endoscopic Gastrostomy (PEG) Evaluation Form before placement of a percutaneous feeding tube – regardless of the type of tube and regardless of whether the procedure is performed in the GI lab, by Interventional Radiology or by Surgery.

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Medical Students Make Their Rounds at Annual Reception

Sixty-four medical students representing schools from around the country were introduced to what Cedars-Sinai offers its residents as part of the annual Arthur I. Johnson, M.D., Memorial Medical Student Reception.


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Epocrates Essentials to Remain at Physicians' Fingertips

Cedars-Sinai has renewed its license for the full Epocrates Essentials package for all of members of the medical staff who have Blackberrys or iPhones.

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‘Plavix Resistance’ Test Available at Cedars-Sinai

Physicians now have a test at their disposal to determine if their patients have a resistance to the popular anti-platelet drug Plavix®. Cedars-Sinai is one of the few locations offering this test in the nation.

» Read more

Support Cancer Research This Sunday

Support ovarian cancer research at Cedars-Sinai by participating in the sixth annual Run for Her 5K run and friendship walk this Sunday. The event starts at 9 a.m. at Pan Pacific Park and ends there at noon.

Registration is $40 and you can sign up before the race from 7 to 9 a.m. or earlier at two "packet pick-up" locations:

  • lululemon athletica at The Commons in Calabasas on Friday, Nov. 12, from 3 to 8 p.m.
  • lululemon athletica, 334 N. Beverly Drive, Beverly Hills, on Saturday, Nov. 13 from 10 a.m. to 3 p.m.

For registration and more information, visit www.runforher.com.

Attending Staff Can Obtain Access to CS-Link™

All Cedars-Sinai medical staff members can now use CS-Link™ to view clinical data in the new Electronic Health Record (EHR). 

With this access, physicians cannot do chart input, note input or order input. CS-Link will be running in parallel to Web/VS for medical staff to begin learning how to navigate the new EHR.

The announcement came at the Nov. 10 CS-Link Physician Advisory Committee meeting, co-chaired by Marty Hopp, M.D., and Steve Galen, M.D. Now that nursing has successfully gone live, the focus of the CS-Link Project Team is shifting from implementation to optimization of the system and expanded physician use.

The Physician Advisory Committee is charged with ensuring that Cedars-Sinai medical staff stay informed about the status of the CS-Link project and provide feedback from physicians to the Project Team.

At the committee meeting this week, members discussed details of the Inpatient Phase 2 go-live that occurred Oct. 23. Members discussed the changes in Web/VS as well as the new features in CS-Link. Now that nurses and other caregivers are documenting in CS-Link, many physicians are finding that having View (read-only) access is of considerable advantage given the detail and depth of the clinical information available.

Training is required before physicians can use CS-Link. Physicians can complete this training one of the following ways: 

  • Taking a one-hour classroom training sessions (offered daily)
  • Completing an e-learning course available on DVD
  •  Accessing the e-learning course while on the Cedars-Sinai Intranet

For more details about View training call (310) 423-2828, or go to the Medical Staff Lounge to visit the CS-Link Learning Center.

To date, 341 physicians have CS-Link.

Form Required Prior to Placing a Percutaneous Feeding Tube

Effective Monday, Nov. 15, Cedars-Sinai will require the completion of the Percutaneous Endoscopic Gastrostomy (PEG) Evaluation Form before placement of a percutaneous feeding tube – regardless of the type of tube and regardless of whether the procedure is performed in the GI lab, by Interventional Radiology or by Surgery.

Use of the form was piloted successfully in the Gastrointestinal Lab earlier this year in an effort to limit the number of inappropriate PEG placements. The form will now be required for procedures performed in Interventional Radiology and the OR.

As a result of the form's use and due to the diligence of physicians, nurses and the GI Lab's staff, all PEGs placed in the month of September were deemed to be appropriate, said Andrew Ippoliti, M.D., director of Administration and Clinical Affairs, Division of Digestive Diseases. This determination was based on criteria set forth in the PEG Evaluation Form.

Along with an overall decrease in PEGs requested, a retrospective analysis showed that inpatient mortality for patients with PEGs placed in the GI Lab dropped 64 percent since use of the form was required for procedures performed there, Dr. Ippoliti added.

The form may be found at the nurses’ stations or downloaded and printed from the Cedars-Sinai Intranet site. Find the form by typing “PEG” into the Intranet homepage’s search box.

Medical Students Make Their Rounds at Annual Reception

Sixty-four medical students representing schools from around the country were introduced to what Cedars-Sinai offers its residents as part of the annual Arthur I. Johnson, M.D., Memorial Medical Student Reception.

The students took a tour of the medical center and learned about the array of training opportunities available here.

More than 40 medical staff members and current residents attended the October event in Harvey Morse Auditorium.

The event was planned by Mark Noah, M.D., medical director of Graduate and Continuing Medical Education and director of both the Office of Student Affairs and the Internal Medicine Residency Training Program, and Sheila Kar, M.D., clinical chief of cardiology and member of the Cedars-Sinai Board of Directors. Thomas M. Priselac, Cedars-Sinai’s president and CEO, and other members of senior management also attended the event.

A panel of resident physicians answered questions about medical training and included Christine Lennon, M.D., PGY 4 from Anesthesiology, Henry Horton, M.D., a second-year Internal Medicine resident, Christina Saad, M.D., a first-year OB/Gyn resident; Kristopher Kersch, M.D., PGY 4 in Pathology, and Karen Zaghiyan, M.D., a Surgery resident.

Six other residents from the departments of Medicine and Pathology and Laboratory Medicine served as tour guides for the students prior to the event.

The annual reception was named after Dr. Johnson, a member of the medical staff for more than three decades who passed away in 2007. Dr. Johnson was the first physician in the history of Cedars-Sinai to hold all elected offices of the medical staff during his career, including two terms as Chief of Staff in 1998 and 1999. A board-certified specialist in Obstetrics and Gynecology, he served as Clinical Chief of Obstetrics and Gynecology from 1995 to 1996.

Dr. Johnson's son and daughter-in-law, Anthony and Yvonne Johnson, also attended this year’s reception.

 

 

The annual event allows potential residents to connect with Cedars-Sinai medical staff members and residents.

 

 

 

 

Dr. Kar, right, speaks with one of the students attending the reception.

 

 

 

 

More than 100 people attended this year’s Arthur I. Johnson, M.D., Memorial Medical Student Reception.

Epocrates Essentials to Remain at Physicians' Fingertips

Cedars-Sinai has renewed its license for the full Epocrates Essentials package for all of members of the medical staff who have Blackberrys or iPhones.

Epocrates Essentials includes drug monographs, drug interaction checkers and calculators, pill pictures, herbal medicines, disease monographs, infectious disease treatment guides, and information about diagnostic and laboratory tests. 

To obtain a license code and installation instructions, send an e-mail to the Web/VS clinical support team at mdsupport@cshs.org. Please include your full name and physician ID number. If you received a license code for Epocrates from us last year, you will need to request a renewal from mdsupport@cshs.org, and register the new license code to continue to use the product in 2011.

Epocrates is developing a version of their product for the Verizon DROID product line, but are not yet in a position to announce a date for availability, said Ray Duncan, M.D., Chief Technical Officer.

‘Plavix Resistance’ Test Available at Cedars-Sinai

Physicians now have a test at their disposal to determine if their patients have a resistance to the popular anti-platelet drug Plavix®. Cedars-Sinai is one of the few locations offering this test in the nation.

Plavix (clopidogrel) requires activation in the body by an enzyme called CYP2C19. Genetic variations in the enzyme may limit or completely cancel the drug's efficacy.

These inherited genetic variants are frequent, occurring in 55 percent of Asians, 49 percent of African Americans, and 30 percent of Caucasians. The "Plavix Resistance" test identifies whether a patient has this genetic variant, which affects the drug's metabolism.

This test can be ordered in CS-Link™ or through Cedars-Sinai's Department of Pathology and Laboratory Medicine and only requires a 5 mL EDTA purple top tube of blood. The report is available within 10 days.

The "Plavix Resistance" test is the most recent addition to the department’s growing menu of companion diagnostics to promote personalized therapy by helping physicians choose the appropriate drug and dose for patients, said Jean R. Lopategui, M.D., director of Molecular Pathology and Cytogenetics. The department also offers testing for warfarin and irinotecan sensitivity.

In March 2010, the U.S. Food and Drug Administration updated the Plavix package insert with its Black Box warning about poor metabolizers of Plavix and the existence of tests that can identify the genetic differences in patients' CYP2C19 metabolic function. Identification of genetic variations prior to initiation of Plavix therapy may avoid adverse drug reactions such as bleeding and clotting, thus maximizing drug efficacy.

Plavix is primarily indicated for unstable angina, acute coronary syndrome (NSTEMI/STEMI) and post PCI/stent placement.

If you would like more information, please contact Dr. Lopategui at (310) 423-7847 or jean.lopategui@cshs.org.