Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Oct. 14, 2011 Issue | Archived Issues

Lunch on Us

Annual Medical Staff Meeting is Oct. 24

Chief of Staff Scott Karlan, MD, will discuss the climate of change at the medical center and President and CEO Thomas M. Priselac will speak at the lunch meeting, which runs from 11:30 a.m. to 1:30 p.m. on Monday, Oct. 24, in Harvey Morse Auditorium.

The 2011 Pioneer in Medicine Award will be presented along with the Chief of Staff Award.

Annual Meeting of the Medical Staff (PDF)


P&T Committee Approvals Released

Pharmacy Focus

Click the PDF below to review the Pharmacy and Therapeutics Committee's September approvals.

P&T Decisions September 2011 (PDF)


Meetings and Events


Grand Rounds

Click here to view upcoming Grand Rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - October 2011 (PDF)

Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

President's Perspective: Doing the Right Thing, in the Right Settings, with the Right Resources

Thomas M. Priselac
President and CEO

As our nation moves toward a medical system that requires greater accountability across all care settings, Cedars-Sinai is engaged in a system-wide initiative that will enable us to stay ahead of the curve and continue to be a national role model in a rapidly changing healthcare environment.

Hundreds of you are actively involved in the comprehensive, multi-year Cedars-Sinai Medicine initiative. Many clinical and operational changes have already been implemented, and there will be more - all designed to ensure that each of us consistently does the right thing for our patients, in the right settings, with the right resources.

We're developing best practices for a wide range of diseases and conditions to optimize outcomes and value for our patients. This involves conducting extensive research on nationwide best practices and performance measures - and placing almost everything we do in the clinical arena under a microscope to determine the most efficient way to provide the best care. We're examining every step of the healthcare delivery process, from prevention and ambulatory care to pre-admission, hospitalization and post-acute treatment.

This work is being done under the leadership of Glenn Braunstein, MD, Vice President for Clinical Innovation, by 20 multispecialty and multidisciplinary teams. They are exploring ways to take action before health problems become more difficult and expensive to solve, to improve coordination of care and ensure seamless transitions between levels of care, and to avoid unnecessary hospital admissions and patient days.

Our clinical best practice teams reflect the pluralistic structure of our medical staff - a key strength in our push toward integration of all members of the healthcare team. Each team is co-led by a faculty member and a private attending physician, and members include faculty, private and Cedars-Sinai Medical Group physicians, as well as nurses, pharmacists, physical therapists, occupational therapists, respiratory therapists, case managers and social workers, among others. A total of more than 300 individuals are now working on these teams, and this number will continue to grow as we expand the scope of the initiative to include more clinical conditions.

The teams are focusing on high-volume, typically short-stay surgical procedures such as hip and knee replacements and non-malignant gynecologic surgeries, as well as common medical conditions that lead to hospitalization, such as pneumonia and atrial fibrillation. Top priorities also include heart failure, chronic obstructive pulmonary disease, diabetes, sepsis, stroke, back pain, and the care of the frail patient, among other conditions. We're also examining how to provide the most appropriate and compassionate end-of-life care.

Thanks to our Cedars-Sinai Medicine team members' hard work and innovative thinking, we've already begun getting results. For example:

  • Quality improvements and shorter hospital stays often go hand in hand, and this is what we're seeing in a number of areas where we've implemented best practices. We measure length of stay (LOS) by an index comparing actual days to the expected hospital stay for various conditions. Ideally, the LOS index will be 1 (indicating that actual days in the hospital match the expected number) - or less. Our LOS index has been declining for a number of conditions. For example, it is now below 1 for non-malignant gynecologic surgery and for total joint replacement. This reflects a recent 10 percent drop in the LOS index for each condition.
  • We launched "Code Sepsis" on September 19 to test new best practices for rapid response to sepsis, the leading preventable cause of death in hospitals nationwide. Under our new protocol, when sepsis is suspected, blood cultures will be drawn immediately and antibiotics administered within an hour of recognizing the condition.
  • A new protocol in the Emergency Department has reduced hospital admissions for atrial fibrillation. We formalized our processes for assessing patients with A Fib symptoms so we can more effectively identify those who have a complex cardiac problem and need to be hospitalized vs. those at low or intermediate risk who can be placed on observation status.
  • The number of births induced before 39 weeks without a specific medical reason has been as high as 10 to 15 percent at Cedars-Sinai, while the best-performing hospitals have a rate of 6 percent or less. Working cooperatively with our obstetricians, we've reduced non-medically indicated early deliveries to less than 4 percent.

Another crucial part of Cedars-Sinai Medicine is an educational process that involves sharing information with our medical staff from a software program called Crimson, which is used by leading academic medical centers around the country as a tool to help physicians evaluate their own clinical efficiency and effectiveness. Since we introduced this system in August, our MD advisors have been meeting one-on-one with physicians to show them their patient severity-adjusted inpatient clinical performance in comparison to their Cedars-Sinai colleagues on a variety of parameters.

Having access to this information will lead to valuable insights about how changes in practice can make a difference in quality and cost. Like so many other aspects of Cedars-Sinai Medicine, review of Crimson data by our physicians will be an ongoing process.

The Cedars-Sinai Medicine initiative calls for a level of introspection and transformation that isn't easy for individuals or organizations. Based on our long track record of adapting and succeeding during times of change, I have confidence in our ability to meet today's challenges in ways that will be emulated by other healthcare institutions nationwide.

Thanks for doing your part to improve quality, efficiency and effectiveness. You can learn more about Cedars-Sinai Medicine through periodic updates in Pulse, and I'll continue to discuss our priorities and progress in future President's Perspective messages as well.

Together, we will continuously build on the strengths that have made Cedars-Sinai a leading nonprofit academic medical center, giving patients from our community and other parts of the nation and the world a growing number of reasons to count on us for the healthcare they need.

Click here to read past President's Perspective columns on Cedars-Sinai's Intranet.