Cedars-Sinai Medical Center

medical staff pulse newsletter

Text size: A A A
A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Aug. 15, 2014 | Archived Issues

P and T Approvals, Tramadol Change, Warnings About Promacta and Sporanox

Pharmacy Focus

See highlights of the June 3 meeting of the Pharmacy and Therapeutics Committee. Also, tramadol is now being managed as a controlled substance, and the federal government has released a warning about Promacta and a list of contraindications for Sporanox.

» Read more


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 - August 2014 (PDF)


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue. Click here to email us your milestones and comments.

» Read more

MEC Morning After Report

See highlights of the Aug. 4 meeting of the Medical Executive Committee.

» Read more

New Alerts Implemented in CS-Link

New "passive alerts" have been turned on in CS-Link™ to serve as reminders for health maintenance and preventive care documentation. The alerts pertain only to physicians who use CS-Link in their office and who serve a primary care function, including those in Internal Medicine, Cardiology, Endocrinology and Nephrology.

» Read more

CS-Link Tip: Using the After-Visit Summary

We learned back in 2003 that patients forget up to 80 percent of what we have told them immediately after they leave our office. Almost half of what they do remember, they remember incorrectly. We should write it down.

» Read more

New Outpatient Transplant Center to Open Soon

Transplant physicians are preparing to see patients in Cedars-Sinai's new Comprehensive Transplant Center outpatient facility shortly after Labor Day. "This facility represents such a huge benefit to our transplant patients, who will now have access to all of their transplant physicians and many of their support services in one location," said Andrew S. Klein, MD, director of the Comprehensive Transplant Center.

» Read more

Risk Is Low, but Know Ebola Recommendations

There is currently a large outbreak of Ebola virus disease (EVD) in the West African countries of Guinea, Sierra Leone and Liberia. Although the risk of an Ebola outbreak in the U.S. is extremely low, healthcare providers should be aware of the clinical presentation of Ebola illness in individuals who have returned within 21 days from areas where outbreaks of Ebola have been confirmed.

» Read more

Sand 'N' Snore Set for Sept. 5

Sand 'N' Snore is just around the corner. The dinner, sleepover and breakfast starts Friday, Sept. 5, at the Jonathan Beach Club in Santa Monica.
 

» Read more

Resident Credits Teaching in Car-Crash Response

Danielle Thomas, MD, had no idea that a drive to her parents in San Diego would suddenly lead to a chance to use her training from the Cedars-Sinai Orthopaedic Surgery Residency program. But that's what happened, as she found herself leaping into action at the scene of a car crash.

» Read more

Circle of Friends Honorees for July

The Circle of Friends program honored 131 people in July. 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

MEC Morning After Report

Highlights of the Aug. 4 meeting of the Medical Executive Committee are summarized in the PDF link below.

Morning After Report - Aug. 4, 2014 (PDF)

New Alerts Implemented in CS-Link

New "passive alerts" have been turned on in CS-Link™ to serve as reminders for health maintenance and preventive care documentation.

The alerts pertain only to physicians who use CS-Link in their office and who serve a primary care function, including those in Internal Medicine, Cardiology, Endocrinology and Nephrology.

These alerts are not pop-ups, so they will be unobtrusive. Your navigator "Best Practice" tab will be highlighted in yellow when the alert is active. You can click on the tab to reveal the alert. 

The four new alerts, which help you document that a patient was counseled in certain areas, are necessary for Cedars-Sinai's Medicare Shared Savings Program accountable care organization (ACO) and to meet meaningful use criteria.

For each alert, there is a "discussed" SmartPhrase that starts with ".dis." If you use the SmartPhrase in your note, it includes a link that automatically satisfies the requirements of the ACO and meaningful use.

The phrases are:

  • Counseling a patient who smokes: .dissmoking
  • Counseling a patient with a single blood pressure elevation without a diagnosis of hypertension: .dishtn
  • Counseling a patient with a positive depression screen without the diagnosis of depression: .disdepression
  • Counseling a patient with a body mass index above 25 or below 18: .disbmi

Unlike normal SmartPhrases, these are encoded and can be used for reporting. Do not save and modify them as your own. If you have a suggestion to improve the phrase, please contact Maya Kadekodi (maya.kadekodi@csmns.org) or Lisa Masson, MD (lisa.masson@cshs.org).

CS-Link Tip: Using the After-Visit Summary

We learned back in 2003 that patients forget up to 80 percent of what we have told them immediately after they leave our office. Almost half of what they do remember, they remember incorrectly.

We should write it down. With CS-Link™, we are providing our patients with an after-visit summary (AVS). To make the AVS meaningful, add in your specific patient instructions. This improves patient satisfaction, especially if you discuss the AVS with the patient. Providing patient instructions is now a component of meaningful use criteria.

To add instructions to the AVS, click "Patient Instructions" on the left side of your navigator and start typing.

You can schedule physician efficiency training at your office by emailing Alex Bram at alex.bram@cshs.org or Lisa Masson, MD, at lisa.masson@cshs.org.

Click here for more CS-Link training updates for physicians.

New Outpatient Transplant Center to Open Soon

Two work rooms at the new transplant facility provide meeting space for physicians.

Transplant physicians are preparing to see patients in Cedars-Sinai's new Comprehensive Transplant Center outpatient facility shortly after Labor Day.

"This facility represents such a huge benefit to our transplant patients, who will now have access to all of their transplant physicians and many of their support services in one location," said Andrew S. Klein, MD, director of the Comprehensive Transplant Center. "The building features easy access for our patients, and when they arrive at the valet area, they will take the elevator straight to the third-floor clinic area for their appointment."

The new third-floor clinical space features 22 spacious exam rooms.

Physicians and other staff members can relax and take meal breaks on an outdoor patio on the second floor of the new center.

Located on the southeast corner of Beverly Boulevard and South La Peer Drive, the 32,000-square-foot Transplant Center will house clinical and administrative services for liver, kidney, pancreas and lung transplant patients in a three-story building with a two-story subterranean parking garage. The facility features nearly 12,000 square feet of clinic space, including 22 exam rooms, a three-bay phlebotomy room and a dedicated space for infusion therapy services.

"The building was originally configured as a residential/retail space, so it features numerous design elements that will enhance the patient experience, such as an open floor plan and large windows that allow natural light to come in," says Zeke Triana, AIA, director of Facilities Planning, Design and Construction. "As soon as patients step into the third-floor waiting room, they will have a breathtaking view of the Hollywood Hills. There is also plenty of onsite parking, and patients will have the option of self-parking or using the valet. In addition, there is ample parking for staff members."

Administrative personnel already have moved into their new offices on the second floor of the building, which features an outdoor patio area. These employees include staff members from the Liver Disease and Transplant Center, the Kidney and Pancreas Transplant Center and the Lung Transplant Center. They do not include members of the Heart Transplant team, who will remain in their current offices in the Advanced Health Sciences Pavilion and the Pacific Theatres building, as well as private-practice offices on Le Doux Road.

Clinical personnel will move in pending an inspection of the new facility by the California Department of Public Health this month.

Risk Is Low, but Know Ebola Recommendations

By Rekha Murthy, MD, Medical Director, Department of Hospital Epidemiology

There is currently a large outbreak of Ebola virus disease (EVD) in the West African countries of Guinea, Sierra Leone and Liberia. Although the risk of an Ebola outbreak in the U.S. is extremely low, healthcare providers should be aware of the clinical presentation of Ebola illness in individuals who have returned within 21 days from areas where outbreaks of Ebola have been confirmed.

Early recognition is critical for infection control. Notify Hospital Epidemiology immediately at 310-423-5574 of any suspected cases of EVD.

EVD should be considered in the case of illness in a person who has both consistent symptoms and risk factors as follows:

  • Clinical criteria that include:
    • Fever of greater than 38.6 degrees Celsius (101.5 degrees Fahrenheit)
    • And additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain or unexplained hemorrhage
  • And epidemiologic risk factors within the three weeks before the onset of symptoms, such as:
    • Contact with blood or other body fluids of a patient known or suspected to have EVD
    • Residence in or travel to an area where EVD transmission is active
    • Direct handling of bats, rodents or primates from disease-endemic areas

Isolation and Testing

Pre-emptive standard, contact and droplet precautions are recommended for management of hospitalized patients with known or suspected EVD.

Testing for EVD must be coordinated with Hospital Epidemiology and the Cedars-Sinai lab through local public health agencies.

Malaria diagnostics should be a part of initial testing, as malaria is a common cause of febrile illness in persons who have traveled to the affected countries.

Additional information, including updates, frequently asked questions and current advisories, is available on the website of the U.S. Centers for Disease Control and Prevention and on the Hospital Epidemiology Intranet site.

Sand 'N' Snore Set for Sept. 5

Sand 'N' Snore is just around the corner.

The dinner, sleepover and breakfast starts Friday, Sept. 5, at the Jonathan Beach Club in Santa Monica. Those who don't want to sleep on the sand are welcome to enjoy dinner and the evening with colleagues and their families. There's a limit of one tent per physician.

Tickets for the whole event are $60 per adult and $45 for each child under age 12. Tickets for Friday's dinner only are $50 per adult and $25 for each child younger than 12.

To reserve a place, call Cheryl Verne, in the office of Marjorie Santore Besson, at 310-423-2681.

A photo from the 2013 Sand 'N' Snore

To see coverage of the 2013 event, click here.

Resident Credits Teaching in Car-Crash Response

When Danielle Thomas, MD, saw a car roll over on the freeway, she ran to help the driver, and her training took over.

Danielle Thomas, MD, had no idea that a drive to her parents in San Diego would suddenly lead to a chance to use her training from the Cedars-Sinai Orthopaedic Surgery Residency program. But that's what happened, as she found herself leaping into action at the scene of a car crash.

Thomas was able to act instantaneously to aid an injured driver before other help arrived. She credited the teaching of Guy Paiement, MD, director of the Orthopaedic Surgery Residency, and Donald A. Wiss, MD, director of the Orthopaedic Trauma Program, as well as the skills she picked up during trauma rotations. 

"Even though we're specialists and know a very narrow area of the body, we are doctors first — trained to respond in an emergency, trained to respond in trauma," said Thomas, who recently completed her first year in the program, which included trauma and orthopedic rotations.

In the middle of a May afternoon, Thomas was driving south on the 5 Freeway near Camp Pendleton when she saw a car traveling the opposite direction lose control. The vehicle rolled several times before hitting the center divider and landing upside down.

Still wearing scrubs, Thomas stopped her car, hopped the divider and ran to the crash scene to help. Then her training took over. Thomas started by checking the "ABCs" of the injured driver: airway, breathing and circulation.

"I gave her chest compressions in cycles and checked for a pulse," she said. "When she regained a pulse, I stopped. By then, other people had arrived on the scene."

Paiement said he was not surprised by Thomas' immediate reaction. He described Thomas as knowledgeable, mature and down to earth, and said she had the ideal combination of aptitude and attitude.  "I wouldn't be surprised if she reaches a leadership position in national or international orthopedic societies," he said.

Paiement said physicians in training should, like Thomas, strive to be good doctors first and good specialists second.

"It's really hard, when you're young and enthusiastic about the field that you have chosen, to take a step back and look at the whole picture and the whole patient, but we're really trying to teach the residents to look at the big picture," he said.

Circle of Friends Honorees for July

The Circle of Friends program honored 131 people in July.

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.

  • Cheryl L. Abrazado, RN
  • Kenneth Adashek, MD
  • Michael J. Alexander, MD
  • Daniel C. Allison, MD
  • Paula J. Anastasia Davis, RN, MN, AOCN
  • Jennifer T. Anger, MD, MPH
  • Carey Ann Aprahamian, RN
  • M. William Audeh, MD
  • Meredith L. Axtell
  • Michael S. Berlin, MD
  • Andrew M. Braun, RN
  • Earl W. Brien, MD
  • Eileen G. Brown, OCN, RN
  • Matthew H. Bui, MD
  • Charles Cary
  • Jonalyn B. Casiano, RN
  • Ilana Cass, MD
  • Cheryl G. Charles, MD
  • Melvin D. Chavarria
  • Donnabel L. Cheng
  • Aaron Chiang, MD
  • Michelle Chung, MSN, RN
  • Hart C. Cohen, MD
  • Myles J. Cohen, MD
  • Robert T. Coles, MD
  • Martin Cooper, MD
  • Stephen T. Copen, MD
  • Stephen R. Corday, MD
  • Alice C. Cruz, MD
  • Robert W. Decker, MD
  • Margaret R. Farrell, BSN, RN
  • Randy Feldman, MD
  • Charles A. Forscher, MD
  • Stuart Friedman, MD
  • Tina M. Furseth, RN
  • Marielle H. Garalza, RN
  • Joel M. Geiderman, MD
  • Jay Goldberg, MD
  • Antoine Hage, MD
  • Behrooz Hakimian, MD
  • Michele A. Hamilton, MD
  • John G. Harold, MD
  • Heather Henry, BSN, RN-BC, CCRN
  • Emmanuel E. Hernandez
  • David M. Hoffman, MD
  • Jethro L. Hu, MD
  • Gabriel E. Hunt Jr., MD
  • Bjorn C. Inductivo, RN
  • J. Patrick Johnson, MD
  • Stephanie M. Kagimoto
  • Saibal Kar, MD
  • Sousan Karimi, MD
  • Beth Y. Karlan, MD
  • David Kawashiri, MD
  • Paul H. Kim, RCP
  • Asher Kimchi, MD
  • Karen Klos, BSN, RN
  • Jon A. Kobashigawa, MD
  • Michael A. Kropf, MD
  • Gary E. Leach, MD
  • Wesley Leichty
  • Dora Lendvai, RN
  • Ronald S. Leuchter, MD
  • Karen N. Levine
  • Michael M. Levine, MD
  • Meldon C. Levy, MD
  • Andrew J. Li, MD
  • Charlene T. Lichtash, MD
  • Yuliya Linhares, MD
  • Alex Lopez
  • Phyllis S. Lopez
  • Ian H. Mahorn
  • Rajendra Makkar, MD
  • Dwight L. Makoff, MD
  • Ana R. Martinez
  • Gloria Martir
  • Behnam David Massaband, DPM
  • Lisa Masson, MD
  • Philomena McAndrew, MD
  • Mary Katharine McCormick, RN
  • Robert J. McKenna Jr., MD
  • Chandrakala Medrano, RN
  • Richard J. Metz, MD
  • Steven A. Miles, MD
  • Lori Ann Mountain, RN
  • Rebecca Naor, PA-C
  • Ronald B. Natale, MD
  • Sharon G. Nicer, RN
  • Nicholas N. Nissen, MD
  • Sara Oliva, BSN, RN, OCN
  • Resa Oshiro, MD
  • Adrian G. Ostrzega, MD
  • Jignesh K. Patel, MD, PhD
  • Brad Penenberg, MD
  • Brian Perri, DO
  • Surasak Phuphanich, MD
  • Alexandre Rasouli, MD
  • Bobbie J. Rimel, MD
  • Fred P. Rosenfelt, MD
  • Moussa Saleh, MD
  • Howard M. Sandler, MD, MS
  • Gregory P. Sarna, MD
  • Jennifer Scanlan, RN, BN, OCN
  • Kevin Scher, MD
  • Wouter I. Schievink, MD
  • Oswaldo M. Serpas
  • Michael M. Shehata, MD
  • Larisa B. Shekhtman, RN
  • John L. Sherman, MD
  • Robert J. Siegel, MD
  • Allan W. Silberman, MD, PhD
  • Enrique Slodownik, MD
  • Jason Snibbe, MD
  • Karyn Morse Solky, MD
  • Jasminka Stegic, MS, ANP-BC, CCRN
  • Theodore N. Stein, MD
  • Lillian Szydlo, MD
  • Victor F. Tapson, MD
  • Pauline A. Taylor
  • Margot S. Throne, MSN, RN, NE-BC, CNOR
  • Paul A. Tournay, RN
  • Alfredo Trento, MD
  • Richard Tuli, MD, PhD
  • Eric Vasiliauskas, MD
  • Aracelia Velgara
  • Robert A. Vescio, MD
  • Dany Victorio
  • Abraham U. Waks, MD
  • Xunzhang Wang, MD
  • Shelley Yee, MD
  • Bettye Zeigler, RN