Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Nov. 7, 2014 | Archived Issues

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 - November 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.

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TJC Tidbits: Donning and Doffing PPE

The Joint Commission is due to visit before the end of the year, and there are only a few eligible weeks remaining. We will be notified early on the Monday morning of the surveyors' arrival, so look for this notification by email. This tidbit describes the proper sequence for putting on (donning) and removing (doffing) personal protective equipment (PPE).

» Read more

Help Outpatients Skip the Wait at Drawing Stations

Did you know that Cedars-Sinai has not one, but three outpatient blood drawing stations? Most medical staff members are familiar with the Plaza Drawing Station in Room 2803 of the South Tower, where the majority of patients go for their lab work. During peak hours, you can help patients spend less time in line by directing them to one of two other locations, when appropriate.

» Read more

CS-Link Tip: Save Time With Keyboard Shortcuts

People who use the keyboard and avoid the mouse are more efficient users of CS-Link™ and save time.

» Read more

Run for Her Is Nov. 9

The 10th annual Run for Her® 5K Run and Friendship Walk will take place Sunday, Nov. 9, starting at 9 a.m. in Pan Pacific Park. Registration is available at runforher.com.
 

» Read more

Wearable Biosensors Lecture Opens Series

Brennan Spiegel, MD, MSHS, Cedars-Sinai’s new director of Health Services Research, will kick off the 2014-15 Health Services Research Lecture Series with a presentation on wearable biosensors. The lecture will take place Monday, Nov. 17, from noon-1 p.m. in Harvey Morse Auditorium.

» Read more

Night at the Aquarium Set for Feb. 7

Medical staff members and their families are invited to a Night at the Aquarium, a dinner and sleepover at the Aquarium of the Pacific in Long Beach, on Saturday, Feb. 7, starting at 7 p.m.

» Read more

Society Certifies Hypertension Center's Expertise

The Cedars-Sinai Heart Institute's Hypertension Center has been certified as a comprehensive hypertension center by the American Society of Hypertension. The Cedars-Sinai center is one of only a dozen designated comprehensive hypertension centers in the nation — and the only one in California — certified to provide advanced care for patients who have difficult-to-treat hypertension and related conditions.

» Read more

Multidisciplinary Clinics Give IBD Patients Hope

Nada Zahr-Gallagher was being treated at Cedars-Sinai for inflammatory bowel disease (IBD) when she found out she was pregnant. That put her in a position to be among the first participants in a new multidisciplinary approach to treating IBD.

» Read more

TJC Tidbits: Donning and Doffing PPE

The Joint Commission is due to visit before the end of the year, and there are only a few eligible weeks remaining. We will be notified early on the Monday morning of the surveyors' arrival, so look for this notification by email.

This tidbit describes the proper sequence for putting on (donning) and removing (doffing) personal protective equipment (PPE).

Please note that this is NOT for use with Ebola patients, but rather for standard contact precautions.

Please review the steps outlined below, and/or watch this YouTube video.

Sequence for putting on (donning) PPE:

  1. Hand hygiene
  2. Gown
  3. Mask or respirator (as necessary)
  4. Goggles or face shield (as necessary)
  5. Gloves

Sequence for removing (doffing) PPE:

  1. Gloves
  2. Goggles or face shield
  3. Gown
  4. Mask or respirator
  5. Hand hygiene

For your reference, here are links to other TJC Tidbits:

TJC Tidbits No. 3: Nurse communication orders (Oct. 24, 2014)

TJC Tidbits No. 2: Practical reminders (Oct. 10, 2014)

TJC Tidbits No. 1: Key hospital programs/initiatives (Sept. 26, 2014)

TJC Quick Reference for Medical Staff (PDF)

Help Outpatients Skip the Wait at Drawing Stations

Did you know that Cedars-Sinai has not one, but three outpatient blood drawing stations?

Most medical staff members are familiar with the Plaza Drawing Station in Room 2803 of the South Tower, where the majority of patients go for their lab work.

During peak hours, you can help patients spend less time in line by directing them to one of two other locations, when appropriate. For example, the Medical Office Towers (MOT) Blood Draw Station on the East Tower's fifth floor is more convenient for patients visiting physicians in the MOT.

  • For Routine Blood Work
    Medical Office Towers Blood Draw Station in room 530 East
  • For Pre-Procedure Blood Work
    Anesthesia Pre-Procedure Evaluation Center (APEC) in the Advanced Health Sciences Pavilion, Plaza Level, adjacent to the patient/visitor elevators

Physicians should note that APEC is open only to patients who are scheduled for procedures in the Procedure Center at the Pavilion.

CS-Link Tip: Save Time With Keyboard Shortcuts

People who use the keyboard and avoid the mouse are more efficient users of CS-Link™ and save time.

There are many keyboard shortcuts. Some are easy to find — just click the "?" at the bottom of the navigator.

You can learn more of them by visiting CS-Link Central or by scheduling a training session with Lisa Masson, MD, (lisa.masson@cshs.org) or Alex Bram (alex.bram@cshs.org).

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

Run for Her Is Nov. 9

The 10th annual Run for Her® 5K Run and Friendship Walk will take place Sunday, Nov. 9, starting at 9 a.m. in Pan Pacific Park.

Registration is available at runforher.com. Cedars-Sinai employees can use the discount code CSMC14 to get $10 off the $35 registration fee.

Supporters anywhere can participate by joining Run for Her's Sleepwalkers Around the World program.

Click the PDF link below for a map of the route and street closures associated with Run for Her.

Run for Her Route, Street Closures - Nov. 9 (PDF)

Click the image below to see a video from last year's Run for Her.

Wearable Biosensors Lecture Opens Series

Brennan Spiegel, MD, MSHS

Brennan Spiegel, MD, MSHS, Cedars-Sinai’s new director of Health Services Research, will kick off the 2014-15 Health Services Research (HSR) Lecture Series with a presentation on wearable biosensors.

The lecture will take place Monday, Nov. 17, from noon-1 p.m. in Harvey Morse Auditorium. All are welcome.

The lecture series will address the potential of HSR to impact the triple aim of improving population health, healthcare and costs. It will feature both Cedars-Sinai and prominent outside speakers.

Lectures will occur monthly through Jan. 13 and approximately every two weeks thereafter. Specific topics will include everything from mobile health and social media to biometrics and cost-effectiveness analysis.

A major goal of the series is to spark interest across diverse groups and to identify opportunities for collaborations.

Night at the Aquarium Set for Feb. 7

Medical staff members and their families are invited to a Night at the Aquarium, a dinner and sleepover at the Aquarium of the Pacific in Long Beach, on Saturday, Feb. 7, starting at 7 p.m.

Eat dinner in the shadow of a life-size blue whale replica, experience aquatic exhibits and interactive entertainment, and watch aquarium staff feed the seals and sea lions their breakfast.

Pack sleeping bags, blankets, pillows and air mattresses (no tents). Dinner, exhibits and entertainment are included, as is a continental breakfast Sunday morning.

Cost is $60 per adult and $45 per child age 3-11. The cost for those who don't spend the night is $50 per adult and $25 per child age 3-11. Parking is $8 per car.

Contact Cheryl Verne in the office of Marjorie Santore Besson at 310-423-2681 or cheryl.verne@cshs.org to reserve tickets.

Society Certifies Hypertension Center's Expertise

The Cedars-Sinai Heart Institute's Hypertension Center has been certified as a comprehensive hypertension center by the American Society of Hypertension, the largest organization of clinical hypertension specialists and hypertension researchers in the U.S. The Cedars-Sinai center is one of only a dozen designated comprehensive hypertension centers in the nation — and the only one in California — certified to provide advanced care for patients who have difficult-to-treat hypertension and related conditions.

"The vast majority of patients with hypertension can control their high blood pressure with standard medications and lifestyle changes," said Ronald Victor, MD, director of the center, associate director of the Cedars-Sinai Heart Institute and the Burns and Allen Chair in Cardiology Research. "But we earned this new designation because we have the multidisciplinary expertise to help doctors with the 20 percent of patients who have particularly difficult hypertension."

Patients with hard-to-control high blood pressure often require the help of endocrinologists, interventional radiologists, laproscopic surgeons, cardiologists and other experts who can get to the root cause of each patient's condition.

"We have a multidisciplinary team in place in the Cedars-Sinai Hypertension Center that can determine the cause of the hypertension," Victor said. "We have become a referral center for patients with hormonal causes of hypertension."

Hypertension often is called a "silent killer," because patients usually don't experience symptoms. But when blood pressure is high, it forces the heart to work harder and can lead to injured blood vessels. It also can lead to kidney and eye damage, as well as life-threatening conditions such as heart disease and stroke. Factors like smoking, being overweight and having a sedentary lifestyle can lead to hypertension. Alcohol and salt consumption, stress, genetics and kidney disease also can contribute to the condition.

According to the Centers for Disease Control and Prevention, nearly one in three U.S. adults has high blood pressure, and the condition contributes to nearly 1,000 deaths a day.

"Controlling hypertension is one of the highest goals of our Heart Institute," said Eduardo Marbán, MD, PhD, director of the Cedars-Sinai Heart Institute. "We have extensive experience in treating the most difficult cases with the most sophisticated treatments, ranging from the newest medications to surgical interventions."

African-Americans suffer disproportionately from hypertension. "Hypertension is one of the biggest health problems affecting the African-American community today," Victor said.

Victor was the first to subject increasingly popular barbershop-based health programs to scientific scrutiny with randomized, controlled testing. His study, published in 2011 in the Archives of Internal Medicine, showed that if barbers offered blood pressure checks during men's haircuts and encouraged hypertensive patrons to follow up with physicians, hundreds of lives could be saved annually.

With a new grant from the National Heart, Lung and Blood Institute, Victor is about to start a randomized, controlled clinical trial that will include 500 African-American male patrons of 20 Los Angeles-area barbershops. All participants will have uncontrolled hypertension and be longtime customers of the participating barbershops.

The goal of the new trial is to test the effectiveness of barbershop-centered hypertension programs and whether expanding such programs is feasible and cost-effective. The Cedars-Sinai-led research study will be conducted in partnership with several California medical centers.

Multidisciplinary Clinics Give IBD Patients Hope

Nada Zahr-Gallagher, with daughter Lillie, was "a perfect candidate" to join a new Cedars-Sinai program for pregnant women with inflammatory bowel disease, said Gil Melmed, MD, MS.

Nada Zahr-Gallagher had been battling digestive illness since she was a teenager, but when she was 29, caring for a husband recovering from illness and with two young children, she became very ill. Doctors discovered a blockage in her intestines, and she was diagnosed with Crohn's disease, a form of inflammatory bowel disease (IBD).

"For six months I could barely walk. I felt really helpless," Zahr-Gallagher said. "I tried nearly every medication prescribed for the disease at that time, but nothing helped. I was at my worst when I finally came to Cedars-Sinai."

Zahr-Gallager was referred to Gil Melmed, MD, MS, director of clinical trials for the Inflammatory Bowel Disease Center.

Melmed (right) "was like a compassionate detective who was really on my side," Zahr-Gallager said.

"The first time I met with Dr. Melmed, he handed me a box of tissues and I cried for two hours," Zahr-Gallager said. "He asked me a lot of questions, not just about my health, but about my life. He was like a compassionate detective who was really on my side."

"IBD is a chronic illness, not a terminal illness, and it impacts a patient's quality of life for a long time. The treatment decisions we make have to look at the whole person and how they live," Melmed said.

Within weeks of seeing Melmed, as she was about to begin a clinical trial, Zahr-Gallagher discovered she was pregnant. She had to postpone plans to be part of the drug study, but pregnancy put her in the position to be one of the first participants in a new multidisciplinary approach to treating IBD.

"She was a perfect candidate for our new program called Pregnancy and Fertility in IBD," Melmed said. "She had complex IBD, had been on complex therapies over the course of her disease and she had a whole pregnancy ahead of her. We wanted to be proactive about managing her care."

Zahr-Gallagher had "tag-team" care during her pregnancy. To treat and support her, Melmed joined with maternal-fetal health expert Sarah Kilpatrick, MD, PhD, chair of the Department of Obstetrics and Gynecology at Cedar-Sinai.

"I was getting expert care for my Crohn's disease and my high-risk pregnancy at the same time," the 36-year-old mother of three said. "I wanted a healthy baby, and I was so reassured by both Dr. Melmed and Dr. Kilpatrick."

"For the very first time in a long time, I feel that I am in a good place, the right place," Zahr-Gallagher said.

The goal of the IBD multidisciplinary clinics is to provide highly coordinated care for patients with chronic illness who often are on immunosuppressive treatments.

"Patients with additional medical issues sometimes receive conflicting messages from doctors in other specialties. We wanted to address that problem," Melmed said. "The level of coordination and expertise offered by a synchronized, multidisciplinary, 'one-stop shopping' approach leads to very high patient satisfaction."

Cedars-Sinai offers four multidisciplinary IBD programs, providing treatment options for IBD care that are unique in the U.S., according to Melmed. In addition to the pregnancy/fertility program, there are coordinated care programs in nutrition, mental health and ileoanal anastomosis, or J-pouch, surgery, which is a treatment option for some patients with ulcerative colitis.

One year ago, Zahr-Gallager delivered a healthy baby girl, Lillie. She also has started a recently approved treatment for IBD at Cedars-Sinai.

"For the very first time in a long time, I feel that I am in a good place, the right place," Zahr-Gallagher said. "From the paperwork to the people who greet you to the people who treat you, I feel well cared for."