Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Feb. 17, 2012 Issue | Archived Issues

Two weeks until CS-Link launch

With the launch of CS-Link around the corner, physicians have a host of additional training options and resources available to them both before and after the March 2 go-live. Click below to learn more. 

» Read more

New hope for broken hearts

Results from a Cedars-Sinai Heart Institute clinical trial show that treating heart attack patients with an infusion of their own heart-derived cells helps damaged hearts re-grow healthy muscle.

» Read more

A novel way to curb readmissions: taking healthcare home

A novel experiment by a Cedars-Sinai healthcare team to reduce hospital readmissions has produced promising results - decreasing by half the percentage of patients who return to the medical center within 30 days of discharge.

» Read more

New research institute looks at diabetes, obesity

One of the newest research initiatives at Cedars-Sinai Medical Center is the Diabetes and Obesity Research Institute, which was established in July 2011. Its goal is to examine the prediction, prevention, treatment and cure of diabetes, obesity and associated conditions.

» Read more

Circle of Friends honorees for January

Eighty-one people were honored by the Circle of Friends program in January. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai.

» Read more

Proposals sought for $1.5M prostate cancer research grant

A request for letters of intent and proposals has been issued for the 2012 Team Science Award from the Steven Spielberg Discovery Fund in Prostate Cancer Research. Letters are due March 30.

» Read more

Your ideas needed for 2012 Great Debates topic

The Ninth Annual Dr. Leon Morgenstern Great Debates in Clinical Medicine Resident Competition will be held on Thursday, April 26, at 8 a.m. in ECC A-C.

» Read more

Workshop answers questions from expectant parents about raising a Jewish family

Every year, 7,000 babies are born at Cedars-Sinai Medical Center - many of them to Jewish parents who have questions about the role of Judaism in their new families. Now Cedars-Sinai is providing answers in a novel workshop for expectant couples seeking to navigate Judaism's ancient traditions in their modern lives.

» Read more

Two weeks until CS-Link launch

Completed training? Take the next steps toward proficiency

Workshops

Once you've completed training, attend one of nearly 30 workshops being offered. These hour-long sessions provide an in-depth review of CS-Link™ functionality of special interest to physicians.

Office hours

Practice your newly acquired CS-Link skills during office hours, which are staffed by individuals with an in-depth knowledge of CS-Link and Cedars-Sinai's specific workflows.

Workshops and office hours will be available in the Medical Staff Lounge (Room 2810) until the Resource Center (Room 2806) opens Feb. 25. For more details about workshops and/or office hours, visit www.cslinkcentral.org.

Town halls: physicians' questions/concerns addressed

Many medical staff turned out for the recent CS-Link Town Halls. Participants got answers to their questions about how CS-Link will affect their hospital practice and provided valuable feedback about CS-Link functionality and configuration,as well as insights about future training topics. Watch for details about future CS-Link events.

Web/VS after March 3

We have received inquiries from physicians about CS-Link functionality versus Web/VS. Following are a few things to know:

  • Web/VS PPLs and inpatient Team Lists will available as read only - you can see them, but cannot add or delete patients from the lists.
  • A new Team Memo function, similar to that in Web/VS today, will be available in CS-Link at go-live (March 3)
  • Web/VS PPLs and inpatient Team Lists will remain viewable until the end of May. Equivalent functionality is in CS-Link. Please attend CS-Link workshops or office hours for a more in-depth review of these topics.
  • Web/VS Outpatient Team Lists will not be affected.

Physician Resource Center opens Feb. 25

After the Physician Resource Center (Room 2806) opens on Feb. 25, stop by to hone your new CS-Link skills, ask a CS-Link expert a question, or attend one of many workshops being offered. Some of your CS-Link tools and templates can be personalized before go-live on March 3. After go-live, there will be plenty of CS-Link experts on hand in the Physician Resource Center to help you personalize all of your CS-Link tools and templates. You may want to ask them about:

  • Setting defaults on The Results Review Activity

  • Creating your My Patient Lists and setting up the column headers, as well as adding individual patients to them from the Unit System Lists and adding the relevant Provider System Lists

  • Setting up your Today's Patient Report

  • Manage your Preference List of Order

  • Creating some personal SmartPhrases and standardizing your naming convention

  • Set defaults and personalize Order Sets to expedite the selection of your most common orders

Access to CS-Link

There will be a variety of ways for you to can get convenient access to CS-Link.

  • Rest assured there will be plenty of computers and work areas when we go-live with CS-link.

  • Additional equipment (i.e.: computers, workstations on wheels) have been added to patient care areas.

  • You will be able to conveniently access CS-Link remotely (from your home or office) via www.mycslink.com.

  • Apps that allow limited use of CS-Link are available for your iPad (Canto App) and/or iPhone and Android (Haiku App)

  • If you did not receive (or do not recall) your CS-Link user name and/or password, call ext. 3-2828 (option 3) for assistance.

Have a question? Who you can contact:

Paul Silka, MD, chief medical information officer at Paul.Silka@cshs.org or send an email to AskCSLink@cshs.org.

CS-Link Physician eNews - Feb. 6 (PDF)

CS-Link Physician eNews - Feb. 13 (PDF)

New hope for broken hearts


First-of-its-kind stem cell treatment re-grows healthy heart muscle in heart attack patients

Results from a Cedars-Sinai Heart Institute clinical trial show that treating heart attack patients with an infusion of their own heart-derived cells helps damaged hearts re-grow healthy muscle.

Patients who underwent the stem cell procedure demonstrated a significant reduction in the size of the scar left on the heart muscle by a heart attack. Patients also experienced a sizable increase in healthy heart muscle following the experimental stem cell treatments.

One year after receiving the stem cell treatment, scar size was reduced from 24 percent to 12 percent of the heart in patients treated with cells (an average drop of about 50 percent). Patients in the control group, who did not receive stem cells, did not experience a reduction in their heart attack scars.

The study appears online at www.thelancet.com and will be in a future issue of the journal's print edition.

"While the primary goal of our study was to verify safety, we also looked for evidence that the treatment might dissolve scar and regrow lost heart muscle," said Eduardo Marbán, MD, PhD, the director of the Cedars-Sinai Heart Institute who invented the procedures and technology involved in the study." This has never been accomplished before, despite a decade of cell therapy trials for patients with heart attacks. Now we have done it. The effects are substantial, and surprisingly larger in humans than they were in animal tests."

"These results signal an approaching paradigm shift in the care of heart attack patients," said Shlomo Melmed, MD, dean of the Cedars-Sinai medical faculty and the Helene A. and Philip E. Hixon Chair in Investigative Medicine." In the past, all we could do was to try to minimize heart damage by promptly opening up an occluded artery. Now, this study shows there is a regenerative therapy that may actually reverse the damage caused by a heart attack."

The clinical trial, named CADUCEUS (CArdiosphere-Derived aUtologous stem CElls to Reverse ventricUlar dySfunction), was part of a Phase I investigative study approved by the U.S. Food and Drug Administration and supported by the National Heart, Lung and Blood Institute.

As an initial part of the study, in 2009, Marbán and his team completed the world's first procedure in which a patient's own heart tissue was used to grow specialized heart stem cells. The specialized cells were then injected back into the patient's heart in an effort to repair and re-grow healthy muscle in a heart that had been injured by a heart attack.

The 25 patients - average age of 53 - who participated in this completed study experienced heart attacks that left them with damaged heart muscle. Each patient underwent extensive imaging scans so doctors could pinpoint the exact location and severity of the scars wrought by the heart attack. Patients were treated at the Cedars-Sinai Heart Institute and at Johns Hopkins Hospital in Baltimore.

Eight patients served as controls in the study, receiving conventional medical care for heart attack survivors, including prescription medicine, exercise recommendations and dietary advice.

The other 17 patients who were randomized to receive the stem cells underwent a minimally invasive biopsy, under local anesthesia. Using a catheter inserted through a vein in the patient's neck, doctors removed small pieces of heart tissue, about half the size of a raisin. The biopsied heart tissue was then taken to Marbán's specialized lab at Cedars-Sinai, using methods he invented to culture and multiply the cells.

In the third and final step, the now-multiplied heart-derived cells - approximately 12 million to 25 million - were reintroduced into the patient's coronary arteries during a second, minimally invasive catheter procedure.

Patients who received stem cell treatment experienced an average of 50 percent reduction in their heart attack scars 12 months after infusion while patients who received standard medical management did not experience shrinkage in the damaged tissue.

"This discovery challenges the conventional wisdom that, once established, scar is permanent and that, once lost, healthy heart muscle cannot be restored," said Marbán, The Mark S. Siegel Family Professor.

The process to grow cardiac-derived stem cells involved in the study was developed earlier by Marbán when he was on the faculty of Johns Hopkins University. The university has filed for a patent on that intellectual property and has licensed it to a company in which Marbán has a financial interest. No funds from that company were used to support the clinical study. All funding was derived from the National Institutes of Health and Cedars-Sinai Medical Center.

A novel way to curb readmissions: taking healthcare home

A novel experiment by a Cedars-Sinai healthcare team to reduce hospital readmissions has produced promising results - decreasing by half the percentage of patients who return to the medical center within 30 days of discharge.

Doctors, nurses, social workers and home health leaders closely coordinated follow-up care for 59 patients who were discharged last November under a plan designed by a new Readmissions Home Health Team.

Prior to discharge, nurses from the private agency Accredited Home Health met with patients and their families to plan a schedule of home visits and to answer questions about subsequent care.

Team members say that step alone helped solve a major problem: patients' frequent reluctance to open their front doors to unfamiliar caregivers.

Nurses visited most of the patients at home within 48 hours of discharge; they also made "tuck in" phone calls or visits on Fridays, and checked on patients during the weekends.

During the first two weeks of the experiment, more than half of the patients received seven or more visits or phone calls.

The stepped-up attention produced a dramatic result: Just 6.8 percent of the 59 patients were readmitted to the hospital within 30 days of being discharged, compared to a 14 percent readmission rate the previous year.

The experiment was led by Bruce Samuels, MD, a staff cardiologist with the Division of Cardiology, and Sharon Mass, PhD, director of case management. Team leaders said their strategy represents a significant step forward in ongoing efforts to address one of healthcare's biggest challenges: Keeping patients from returning unnecessarily to the hospital.

With the initial results in hand, the team is planning to expand its outreach this month to patients served by three other home health agencies. The results of those efforts will be reported in April.

New research institute looks at diabetes, obesity

One of the newest research initiatives at Cedars-Sinai Medical Center is the Diabetes and Obesity Research Institute, which was established in July 2011. Its goal is to examine the prediction, prevention, treatment and cure of diabetes, obesity and associated conditions.

The director of the institute, Richard Nathan Bergman, PhD, and associate director Marilyn Ader, PhD, as well as five additional faculty, postdoctoral fellows, students and allied personnel, moved to Cedars-Sinai from the University of Southern California.

In past years, Bergman was recognized for his group's achievements by receiving the prestigious Banting Medal from the American Diabetes Association and the TOPS Award from the Obesity Society. The group's contributions include the development of the Minimal Model Approach for assessment of metabolic status and the Disposition Index, the most powerful predictor of the onset of type 2 diabetes. Other areas of research include the mechanisms of insulin resistance, the consequences of abdominal obesity, the metabolic effects of psychotropic medications, and the use of mathematical modeling techniques to corroborate genetic loci that contribute to the risk of developing diabetes.

At Cedars-Sinai, new research initiatives have begun, including examination of the relationship between sleep patterns and diabetes, as well as mechanisms by which bariatric surgery reduces or even eliminates diabetes. The institute will play a role as a nexus for translational collaboration among the departments of Biomedical Sciences and Medicine, the S. Mark Taper Foundation Imaging Center, the Center for Hypertension at the Cedars-Sinai Heart Institute and the Department of Surgery as ongoing research relates to diabetes and obesity.

The new institute is designed to become a major force in leading-edge research to confront and mitigate one of the most problematic diseases in the U.S., with Cedars-Sinai well-positioned to play this leading role in the Western region.

Circle of Friends honorees for January

Eighty-one people were honored by the Circle of Friends program in January.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  •  David E. Aftergood, MD
  • Beth Y. Karlan, MD
  •  Farin Amersi, MD
  • Brenda Kearney, RN
  •  Betsy Applebaum
  • Robert Klapper, MD
  •  Peyman Banooni, MD
  • Jon A. Kobashigawa, MD
  •  Jane L. Bawayan, RN  
  • Walter Lemankiewicz, RN
  •  Daniel S. Berman, MD
  • Roger L. Lerner, MD
  •  Keith Black, MD
  • Andrew Li, MD
  •  Nathaniel D. Bravo
  • John C. Liu, MD
  •  Marshia G. Caceres, MSW, LCSW, ACM
  • Simon Lo, MD
  •  Ilana Cass, MD
  • Ali Mahtabifard, MD
  •  Kirk Y. Chang, MD
  • Raj Makkar, MD
  •  George Chaux, MD
  • Bryan M. May, RN
  •  Rebekah J. Child, RN, MSN, CEN
  • Robinetta R. McCants
  •  Ray M. Chu, MD
  • Pazetta Z. McCray
  •  Jason S. Cohen, MD
  • Robert McKenna, Jr., MD
  •  Steven D. Colquhoun, MD
  • Dorothy Melvin
  •  Bella Davis
  • Peggy B. Miles, MD
  •  Cherion Drakes
  • Alain Mita, MD
  •  J. Kevin Drury, MD
  • Charles N. Moon, MD
  •  Michael C. Estes, MD
  • Jaime Moriguchi, MD
  •  Jeremy A. Falk, MD
  • Rajan M. Patel, MD
  •  James S. Fishkin, MD
  • Brad Penenberg, MD
  •  Bethany Flakes, RN
  • Reva Pincusoff
  •  Joyce N. Fox, MD
  • Edwin Posadas, MD
  •  Kirk Gabrielsen, RN
  • David A. Pougatsch, DPM
  •  Douglas Galen, DDS
  • David L. Rhode, RN
  •  David Garcia. RN
  • Natalie L. Robinson, RN
  •  Sara Ghandehari, MD
  • Jenna Rush, RN
  •  Jeanie C. Ghosh, RN
  • Howard M. Sandler, MD, MS
  •  Crystal F. Gonzalez, RN
  • Wouter I. Schievink, MD
  •  Martin N. Gordon, MD
  • Allan W. Silberman, MD, PhD
  •  Richard E. Gould, MD
  • Brittany M. Smith
  •  Jennifer Hajj, RN
  • Carey B. Strom, MD
  •  David S. Hallegua, MD
  • Hannah T. Tualla, RN, MSN,   NP-C
  •  Emmylou Harris, RN
  • Tina L. Tyner, RN
  •  Solange Hildreth
  • Nancy Vargas
  •  William Hohl, MD
  • Eric Vasiliauskas, MD
  •  Ifeoma S. Izuchukwu, MD
  •  Robert A. Vescio, MD
  •  J. Patrick Johnson, MD
  • Aileen L. Vicencio, RN
  •  David Y. Josephson, MD
  • Sr. Rabbi Jason L. Weiner

 

  • Edward Wolin, MD

Proposals sought for $1.5M prostate cancer research grant

A request for letters of intent and proposals has been issued for the 2012 Team Science Award from the Steven Spielberg Discovery Fund in Prostate Cancer Research. Letters are due March 30.

The fund, established by a gift to the Samuel Oschin Comprehensive Cancer Institute, aims to support and encourage interdisciplinary collaboration and stimulate new therapeutic ideas in prostate cancer research and clinical care. The award is intended to bring together experts from multiple disciplines to create a personalized oncology approach to prostate cancer integrating molecular pathology, laboratory-based research, imaging (where appropriate), experimental therapeutics and genetics.

Priority will be given to proposals that bridge existing or planned SOCCI Developmental Programs; demonstrate promise of strengthening an expected P-30 grant; and lead to additional peer-reviewed funding. The team selected will be awarded a grant of $1.5 million spread over a period of three years. In order to qualify, a PI must hold an MD or PhD and SOCCI membership.

A letter of intent is required prior to full proposal submission. It should be sent electronically or hard copy to Steven Piantadosi, MD, PhD, director of the Samuel Oschin Comprehensive Cancer Institute.

2012 Team Science Award (PDF)

Your ideas needed for 2012 Great Debates topic

The Ninth Annual Dr. Leon Morgenstern Great Debates in Clinical Medicine Resident Competition will be held on Thursday, April 26, at 8 a.m. in ECC A-C.

The debate committee is currently soliciting suggestions for this year's topic. Please submit your suggestions to Leo Gordon, MD, at Leo.Gordon@cshs.org.

Click here to read about last year's debate. The topic was "Industry and Medicine: Essential Partners or Unholy Alliance."

Workshop answers questions from expectant parents about raising a Jewish family

Every year, 7,000 babies are born at Cedars-Sinai Medical Center - many of them to Jewish parents who have questions about the role of Judaism in their new families.

Why, some may ask, do Jews circumcise baby boys? Are parents required to name children after long-gone family members? What exactly is a Simchat Bat ceremony for a baby girl?

Now Cedars-Sinai is providing answers in a novel workshop for expectant couples seeking to navigate Judaism's ancient traditions in their modern lives.

The March 14 session in the medical center's chapel, one of the first of its kind, is open to all Jewish couples preparing to deliver at Cedars-Sinai, including those who are unaffiliated with Jewish institutions or who are in interfaith relationships.

The one-time workshop - to be repeated in subsequent months for additional parents - is a pilot effort that could eventually be expanded to families from other religious and cultural traditions.

"We're providing the ideas and resources and information on how to raise a Jewish child," said Cedars-Sinai Senior Rabbi Jason Weiner. "We hope to convey the beauty and to inspire, giving parents the knowledge and capability to make decisions they may not have thought about until this point in their lives."

About 1,400 Jewish babies are born at Cedars-Sinai annually, accounting for roughly 20 percent of births at the medical center. Architects of the Jewish Expectant Parent Workshop said they want to give interested parents guidance as they begin to think about the kinds of Jewish homes they might create.

During the three-hour workshop, couples will explore customs for welcoming boys and girls, along with family rituals and routines that help reinforce Jewish identity. Parents-to-be also will discuss naming traditions - some time-honored, others contemporary - and the likely changes that will occur in their family lives with the addition of newborns.

Weiner said the makeup of the workshop team itself is designed to reflect the diversity of Jewish life in Los Angeles. He is an Orthodox rabbi, while his co-teacher, rabbinic student Ilana Mills, is studying at one of Reform Judaism's flagship seminaries, Hebrew Union College-Jewish Institute of Religion in Los Angeles. Both have children born at Cedars-Sinai.

Jewish educators and communal leaders say the inaugural session - with room for 12 couples - comes at an important moment for expectant parents who may have limited connection to their culture or tradition. Many do not belong to synagogues, or live far from immediate family who might otherwise support Jewish values.

"We want anyone who is bringing a Jewish child into the world to face questions with confidence," said Jonathan Schreiber, the medical center's director of community engagement who initiated the idea for the workshop. "There's more to parenthood than just the physical act of child rearing."

Expectant parents can learn more about the workshop online at www.cedars-sinai.edu. Information also is available by calling the Prenatal Education Office, (310) 423-5168, or the Spiritual Care Office, (310) 423-5550.