Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF July 17, 2015 | Archived Issues

P & T Approvals, FDA Warnings About Codeine-Containing Meds, NSAIDs, Proglycem

Pharmacy Focus

See highlights of the June meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued warnings about codeine-containing medicines in children, nonsteroidal anti-inflammatory drugs and Proglycem in infants.

» 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 - July 2015 (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.

Important Changes Coming for Web/VS

Dear Colleagues,

We would like to inform you of significant upcoming changes to Web/VS. As of Monday, Aug. 3, Web/VS will be accessible only from within CS-Link™. Direct login access to Web/VS for physicians will be disabled. You will still be able to use Web/VS as an alternate viewing platform and for retrieval of clinical information recorded prior to 2007.

» Read more

Notes, 'Fat Tab' Among CS-Link Updates

Several improvements were added recently to CS-Link™, including the ability to write notes via Haiku and Canto. Please note one change in particular: All order functions now are grouped into one "fat tab" called "Manage Orders."

» Read more

Where There's Smokey, There's Fireworks

About 480 medical staff members and their families joined the crowd at the Hollywood Bowl on July 2 for a night of patriotic music, fireworks and a performance by Motown legend Smokey Robinson.

» Read more

Nominations Sought for Pioneer in Medicine Award

Deadline for Submissions Is Aug. 10

Attending physicians on the medical staff are encouraged to nominate a candidate for the 2015 Pioneer in Medicine award. This award is given to a member of the medical staff who has made clinical and research contributions recognized at Cedars-Sinai and in the national or international medical communities. The deadline for nominations is Monday, Aug. 10.

» Read more

Physicians Educate About End-of-Life Plans

Two Cedars-Sinai physicians are among those determined to bring about a significant increase in the number of Los Angeles residents who have discussed their end-of-life wishes with their loved ones, physicians and others, and written them down in an Advance Healthcare Directive. This goal brought Jonas Green, MD, MPH, and Daniel J. Stone, MD, MPH, MBA, to a recent discussion of the subject at Temple Isaiah.

» Read more

ICD-10 Sessions for Physicians Set for Aug. 17-20

ICD-10 educational sessions for physicians are scheduled for Monday-Thursday, Aug. 17-20. These CME activities will provide physicians with information on the International Classification of Diseases, 10th Revision.

» Read more

Clinical Documentation Course Continues Aug. 4

Participants Can Earn Two Continuing Medical Education Credits

Members of the medical staff can take a "Clinical Documentation Integrity Power Course for Physicians" that meets the first Tuesday of each month through Dec. 1. The Aug. 4 session takes place from from 3:30-6:30 p.m. in PEC 8. Participants need to attend just one session. Two continuing medical education credits will be available.

» Read more

Cedars-Sinai Brings Urgent Care to Culver City

Cedars-Sinai is expanding its urgent care services to Culver City with a new facility that will offer convenient and affordable medical care for adults and children seven days a week. The new Cedars-Sinai Urgent Care, at 10100 Culver Blvd., opened June 24.

» Read more

Use New Reflex Test for Ionized Calcium

Attention frequent users of calcium testing: Please order an ionized calcium reflex test, not ionized calcium directly. On June 30, the Core Lab began offering a reflex to ionized calcium when total calcium is abnormal. In the vast majority of instances, this reflex should be ordered instead of ionized calcium directly.

» Read more

CS-Link Tip: Care Everywhere Data Reconciliation

Another milestone toward "one patient, one record" went live this month. New alerts in the chart indicate there is new data from outside sources to reconcile.

» Read more

Sand 'N' Snore Set for Sept. 11

Sand 'N' Snore is just around the corner. The dinner, sleepover and breakfast starts Friday, Sept. 11, at the Jonathan Beach Club in Santa Monica.

» Read more

Circle of Friends Honorees for June

The Circle of Friends program honored 249 people in June. 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

Important Changes Coming for Web/VS

Dear Colleagues,

We would like to inform you of significant upcoming changes to Web/VS. As of Monday, Aug. 3, Web/VS will be accessible only from within CS-Link™. Direct login access to Web/VS for physicians will be disabled.

You will still be able to use Web/VS as an alternate viewing platform and for retrieval of clinical information recorded prior to 2007. After you log into CS-Link, Web/VS can be launched from either the Chart Review toolbar or the Web Activities menu.

As an additional service to you, we plan to re-enable the "subscription to results" feature of Web/VS. Furthermore, certain interactive features from Web/VS will remain and have been moved to CS-Link. For example, clinical inquiries such as Ask Radiologist and Request Films are available in Chart Review in CS-Link at the patient level. Other nonclinical features, such as Update Profile and Ask Administration, are available in Web Activities within CS-Link.

However, please understand that Web/VS Personal Patient Lists no longer will be viewable, actionable or shareable as of the Aug. 3 cutover date. Alternative methods of maintaining such lists are being reviewed, so please stay tuned for further updates.

For your private office staff, direct login access to Web/VS will be disabled on July 15. A pop-up alert regarding the need to obtain CS-Link access is in effect for these users.

Thank you for your continued feedback and support as we continue to enhance the safety and security of our medical record across the Health System.

Chris Ng, MD, Chief of Staff
Rick Riggs, MD, Chief Medical Information Officer

Notes, 'Fat Tab' Among CS-Link Updates

Several improvements were added recently to CS-Link™, including the ability to write notes via Haiku and Canto.

Please note one change in particular: All order functions now are grouped into one "fat tab" called "Manage Orders." The current "Order Entry" function can be found within "Manage Orders" and will be along the right-hand column.

Also note that your ordering preference list will be accessed via the "+New" button. This change brings all ordering options onto one screen and serves to remind us to utilize the preferred "Modify" or "Discontinue" buttons for changes to existing orders, rather than using a nurse communication.

For more information about the improvements, including screen shots, see this PDF at CS-Link Central.

Inter-Facility Transfer Report — Psychotropic Meds

The Joint Commission (TJC) requires hospitals to obtain a Physician Certification Statement (PCS) when patients are transferred to skilled nursing facilities (SNFs) on psychotropic medications. In an effort to satisfy this requirement, a new documentation section has been added to the Inter-Facility Transfer Report navigator. The PCS is generated automatically and printed as part of the Inter-Facility Transfer Report for use by the receiving facility.

This improvement will:

  • Satisfy the TJC requirement to obtain a Physician Certification Statement prior to discharging patients to SNFs with psychotropic medications
  • Help in continuum of care when patients transferred to SNFs
  • Help ensure timely patient care with regard to ordering and dispensing of psychotropic medications at the receiving facility

Optimization of Clinical Swallow Evaluations

To encourage providers to use Clinical Swallow Evaluations when appropriate for patients, this feature incorporates a recommendation for a Clinical Swallow Evaluation prior to ordering a Video Swallow Study (VSS). This enhancement supports using needs assessment to drive clinical decision-making.

When physicians place an order for VSS and a patient does not have a Clinical Swallow Evaluation on file, an Alternative Alert will pop up asking if physicians would like to "Accept Alternative" recommended order or "Continue with Original Order."

This improvement will:

  • Support utilizing needs assessment to drive clinical decision-making prior to ordering a Video Swallow Study
  • Encourage providers to use Clinical Swallow Evaluations when appropriate for patients, providing clinicians with information regarding:
    • Whether the patient's dysphagia is oral or pharyngeal
    • Readiness for the radiologic study (patient must be alert and able to accept food in the mouth)
    • The oral reaction to various tastes, temperatures, and textures in the oral cavity
    • The presence of any swallowing apraxia or any abnormal oral reflexes such as a tonic bite
    • Postural and behavioral needs of the patient that must be addressed during the radiographic study

Optimal benefits from a VSS are dependent on stability of patient's medical status, behavior and cognitive level.

Clinical Overview Report

This report puts together frequently used reports in one Patient Summary report in order to make it easier to navigate and view patient data. The report is based on best practice experience at other hospitals.

This improvement will create one unified view of multiple reports, including team-based communication, patient flags and key clinical data.

Handoff/Rounding Tool

This piloting handoff tool will assist with team sign-outs and enable auto-generated rounding reports.

A new SignOut button will be added in the patient list toolbar for physicians to document a patient summary and a to-do list. This will automatically populate the SignOut report under the patient lists with the ability to print multiple patient reports per page.

This improvement will create a better handoff and rounding report for physicians.

Notes and Manage Orders — "Fat Tabs"

Notes and Manage Order buttons have changed to the "Fat Tab" format. Order Entry and Order Review no longer are available as standalone activity tabs.

The Manage Orders tab is now the primary screen for placing orders and access to Order Review. The ordering preference list is now found by clicking on "+New" button.

This improvement will:           

  • Provide visual distinction of the most commonly used physician activity tabs for inpatients
  • Assure utilization of the preferred Manage Orders activity

CHF: Patient Identification — Best Practice Advisory

In Med-Surg areas, nurses will now complete an assessment for certain patients who are at risk for congestive heart failure (CHF). If the nurse assesses that the patient potentially has CHF, and if the patient doesn't already have CHF on their problem list, physicians will see a Best Practice Advisory (BPA) that asks whether CHF should be added to the problem list.

If a patient has an order for a loop diuretic, an ejection fraction less than 40 percent, a BNP greater than 300 or documented shortness of breath, Med-Surg nurses will be required to complete a CHF assessment on the patient. Nurses will indicate that a patient potentially has CHF based on the criteria in a sidebar report.

If a Med-Surg nurse indicates that a patient potentially has CHF, physicians will see a BPA that asks whether it is appropriate to add CHF to the patient's problem list. If the patient has CHF, the physician should add it to the problem list by opening the Problem List activity from the BPA.

This improvement will:

  • Help identify patients with CHF so that nursing, pharmacy and nutrition staff can be notified to provide appropriate patient education
  • Help track patients with CHF, so that physicians can better manage care for these patients

VTE Prophylaxis Best Practice Advisory

If an adult patient has been admitted for more than 24 hours and if VTE prophylaxis has not yet been addressed, physicians will see a Best Practice Advisory (BPA) that prompts them to address prophylaxis.

A new BPA will display for physicians if they have not addressed VTE prophylaxis for an adult patient who has been admitted for 24 hours. VTE prophylaxis is considered "addressed" only with one or more of the following orders:

  • Mechanical prophylaxis
  • Pharmacological prophylaxis
  • Contraindication for both mechanical and pharmacological prophylaxis
  • Low risk for VTE; no prophylaxis needed

These orders can all be found in the VTE order set suggested by the BPA, and in the IP General Admission Order Set.

This improvement will help prevent VTE in at-risk patients.

Care Everywhere — Data Reconciliation

If there is outside data to reconcile, you will now see the hyperlinks within the Care Everywhere summary report in the following sections:

  • Allergies
  • Problem List
  • Medications

A second way to access the activity is to click the hyperlink that appears within the Allergy, Meds and Problem List activities.

These will appear only if there is data to reconcile in these activities.

The link display button has listed "Reconcile with Patient's Chart." Once the link has been selected, click Add or Discard to add the allergy, problem or medication to the Cedars-Sinai chart. Click Discard if you don't want to bring it in. These actions have no impact on the source organization.

When you choose to add a medication, there is the option to edit additional details about the med. The source organization automatically pulls into the Comments field. If we already have the medication in our system, it will ask if you want to discontinue the duplicate med.

For more information on this improvement, view this PDF at CS-Link Central.

Haiku/Canto Notes Entry

You will now see hyperlinks to document the following notes within Haiku/Canto Care:

  • Consult — Initial
  • Discharge Summaries
  • H&P
  • Operative Report
  • Post-Op (Brief Op Note)
  • Procedures
  • Progress Note — Doctor
  • Progress Notes (this is available in the ambulatory encounter context)

Click on the Note link to display and select a Note Type. Once identified, enter and sign the note.

Order Entry — Manage Orders

Inpatient physicians no longer have access to Order Entry activity. Physicians have to use Manage Orders activity to enter or place orders.

Diabetic Supplies Order-Set Enhancement

Names have been updated to familiar terms for supplies and medications under sections Meters/Test Strips/Lancets, Test Strips Only and Insulin Pens & Needles.

Meters/Test Strips/Lancets

  • Change from FreeStyle UniStik Lancet to FreeStyle Lancet
  • Change from FreeStyle Test Strip to FreeStyle Lite Test Strip

Test Strips Only

  • Change from FreeStyle Test Strip to FreeStyle Lite Test Strip

Insulin Pens & Needles

Additional options: BD AutoShield-DUO Safety Pen Needles 30G x 5mm

Miscellaneous (new section)

  • Glucose tablets
  • Glucagon Emergency Kit
  • Home Sharps Container

DME Order Enhancement

The DME order now has a new question option for specifying Hospital Bed. This new question has dropdown options of: Bed Cradle (18"-27"), Full Bed Rails, Full-Electric Hospital Bed, G-1 Alternating Pressure Pad and Pump, G-2 Low Air Loss Mattress, Half Bed Rails, Over Bed Table, Semi Electric Hospital Bed, and Trapeze.

This improvement will make it easier to order hospital beds for discharge.

Related story:

CS-Link Tip: Care Everywhere Data Reconciliation

Where There's Smokey, There's Fireworks

A photo from this year's Independence Day event at the Hollywood Bowl. More photos are below.

About 480 medical staff members and their families joined the crowd at the Hollywood Bowl on July 2 for a night of patriotic music, fireworks and a performance by Motown legend Smokey Robinson.

The Hollywood Bowl Orchestra also performed during the annual Independence Day celebration.

Nominations Sought for Pioneer in Medicine Award

Deadline for Submissions Is Aug. 10

Attending physicians on the medical staff are encouraged to nominate a candidate for the 2015 Pioneer in Medicine award. This award is given to a member of the medical staff who has made clinical and research contributions recognized at Cedars-Sinai and in the national or international medical communities.

The deadline for nominations is Monday, Aug. 10.

The criteria for candidates for the Pioneer in Medicine award are:

  • The candidate shall have made a major contribution to the medical center.
  • The candidate shall be or have been involved in research.
  • The candidate shall have been published in national or international peer-reviewed journals.
  • The candidate shall be a teacher and positive role model.
  • The candidate shall be an innovator or have changed the medical world around him or her.
  • The candidate shall have made clinical contributions recognized nationally.
  • The candidate shall have been a physician at the medical center during a major part of his or her career.

A committee of the medical staff will select the honoree, and the award will be presented at the annual meeting of the medical staff on Oct. 19.

To nominate a candidate for the Pioneer in Medicine award, please send a letter to Peggy Miles, MD, vice chief of staff, with the nominee's qualifications, key contributions and major accomplishments. Include a copy of the nominee's curriculum vitae.

Send nominations and letters of support to peggy.miles@cshs.org, or submit printed documents to:

Peggy Miles, MD
Vice Chief of Staff
Cedars-Sinai
8700 Beverly Blvd., Suite 2211
Los Angeles, CA 90048

Previously in Medical Staff Pulse:

Major League Medical Scientist Named 'Pioneer' (Oct. 24, 2014)

Physicians Educate About End-of-Life Plans

Cedars-Sinai physicians Jonas Green, MD, MPH, (left) and Daniel J. Stone, MD, MPH, MBA, engaged in some role-playing about end-of-life discussions.

Nearly everyone who dies in the small town of La Crosse, Wisconsin, has an advance directive or similar documentation of their end-of-life wishes. In fact, some 96 percent of La Crosse residents have put their wishes in writing, compared to about 30 percent nationally.

While acknowledging that it's far more difficult to break down the cultural taboo against discussing death in a city of 10 million, Jonas Green, MD, MPH, and Daniel J. Stone, MD, MPH, MBA, are determined to bring about a significant increase in the number of Los Angeles residents who have discussed their end-of-life wishes with their loved ones, physicians and others, and written them down in an Advance Healthcare Directive.

The goal of engaging the community in Cedars-Sinai's effort to make advance care planning a standard part of healthcare brought the two physicians to Temple Isaiah on June 2. After Senior Rabbi Zoë Klein introduced them to about 30 congregants from her synagogue and from nearby Temple Emanuel, Green and Stone led a two-hour discussion on advance care planning and end-of-life conversations.

"This is one area where retrospect doesn't do any good. We have to plan ahead to make sure we and our family members do not go through unnecessary suffering at the end of life," said Stone, medical director of the Cedars-Sinai Medical Group.

"In La Crosse, Wisconsin, they talk about death very openly," said Green, associate medical director for Clinical Effectiveness at the Cedars-Sinai Medical Network. "But in L.A., most of us don't know what our friends, neighbors or even our loved ones are thinking about the end of life. It's not an easy conversation to start — even for physicians. Our purpose today is to make it easier for you to have this conversation with those closest to you, and to give you some tools to help others do the same."

Green and Stone are partnering with Rabbi Laura Geller, senior rabbi of Temple Emanuel (who was joined at the event by Rabbi Jonathan Aaron of Temple Emanuel), and Klein to help train their congregants to serve as lay educators who can assist others in communicating their end-of-life wishes through conversations and advance directives. The two physicians are in the early stages of collaborating with L.A. religious organizations of various faiths to educate the public about advance care planning.

On June 2, they added a bit of drama to their presentation by sitting across from each other and engaging in some role-playing to show how a conversation about the end of life might go. Green initiated the simulated conversation with Stone, who showed the reticence that is so common by saying, "I should tell you up front that this conversation is really my wife's idea. How about having a beer and watching the Dodger game with me instead?"

The audience laughed, and Green kept the conversation on course, saying, "I will make this as comfortable as possible for you, and I'm glad we're having this conversation, because 90 percent of the time, people at the end of life haven't documented their wishes so their family members will know what they want."

Green used Cedars-Sinai's Advance Healthcare Directive booklet as a guide throughout the conversation, and encouraged the audience to do the same.

Andrea Baum is among audience members who left the event with a resolve to start discussing end-of-life issues and completing advance directives with loved ones. The Beverly Hills resident said she has never talked with her 89-year-old father about his values or preferences regarding end-of-life care. What she learned from Green and Stone will help her initiate a conversation she hasn't been able to start.

"My dad doesn't like to talk about personal things, but if he believes I know what I'm talking about, he will trust me," she said. "It helps to know there's a structured way to approach this using the advance directive — and that there's no one right way to have the conversation. It also gives me peace of mind to realize that dealing with death is a part of life."

Previously in Medical Staff Pulse:

Straight Talk About End-of-Life Decisions (May 8, 2015)

ICD-10 Sessions for Physicians Set for Aug. 17-20

ICD-10 educational sessions for physicians are scheduled for Monday-Thursday, Aug. 17-20.

These CME activities will provide physicians with information on the International Classification of Diseases, 10th Revision (ICD-10). They will:

  • Introduce ICD-10
  • Explore the impact of ICD-10 on physicians and providers
  • Discuss the required documentation specificity of ICD-10
  • Review diagnoses that will be impacted

Sessions will take place:

  • Monday, Aug. 17, noon-1:30 p.m. in PEC 4 (Internal Medicine and medical subspecialties)
  • Monday, Aug. 17, 5-6 p.m. in PEC 5 (Orthopedics)
  • Wednesday, Aug. 19, 7-8:30 a.m. in Harvey Morse 4-5 (Surgery and surgical subspecialties)
  • Wednesday, Aug. 19, noon-1 p.m. in Pavilion A3101-3102 (Internal Medicine and medical subspecialties)
  • Wednesday, Aug. 19, 5:30-6:30 p.m. in PEC 6-7 (OB-GYN)
  • Thursday, Aug. 20, 7-8:30 a.m. in Harvey Morse 3 (Surgery and surgical subspecialties)
  • Thursday, Aug. 20, noon-1 p.m. in the South Tower, fourth floor, room 4704 (Internal Medicine and medical subspecialties).

The federally imposed deadline for implementing the medical data code sets in ICD-10 is Oct. 1.

For more information, email askicd10@cshs.org.

Previously in Medical Staff Pulse:

Resources Available to Prepare for Move to ICD-10 (Aug. 29, 2014)

Switch to ICD-10 Delayed; Preparation Continues (April 25, 2014)

Physicians and Office Staff — Not Just Coders — Need to Prepare for ICD-10 (Sept. 27, 2013)

Clinical Documentation Course Continues Aug. 4

Members of the medical staff can take a "Clinical Documentation Integrity Power Course for Physicians" that meets the first Tuesday of each month  through Dec. 1. Sessions take place from 3:30-6:30 p.m. in various locations; the Aug. 4 meeting will be in PEC 8. Participants need to attend just one session.

Under the Affordable Care Act, physicians will have to justify treatments and demonstrate satisfactory quality outcomes. Clinical documentation therefore will need to be accurate and timely and to reflect the scope of services provided.

Objectives of the course:

  • Explain the role of the Clinical Documentation Integrity Department at Cedars-Sinai
  • Discuss how hospitals and physicians are rated
  • Explore the DRG system and how documentation affects profiles
  • Understand the interplay among SOI, ROM, LOS and reimbursement
  • Compare ICD-9 and ICD-10 documentation requirements
  • Compare Cedars-Sinai’s score to those of similar hospitals
  • Learn definitions for common diagnoses
  • Recognize documentation that is vague and nonspecific
  • Identify documentation strategies to reflect the true severity of illness of the patient

Two continuing medical education credits will be available.

For more information, call Clinical Documentation Integrity at 310-423-3052. For a list of dates and locations, click the PDF link below.

CDI Power Course for Physicians (PDF)

Cedars-Sinai Brings Urgent Care to Culver City

The new urgent care center in Culver City is designed to treat patients who suffer from a range of non-life-threatening medical conditions and symptoms.

Cedars-Sinai is expanding its urgent care services to Culver City with a new facility that will offer convenient and affordable medical care for adults and children seven days a week.

The new Cedars-Sinai Urgent Care, at 10100 Culver Blvd., opened June 24. It is Cedars-Sinai's second urgent care facility. The first is at 8501 Wilshire Blvd. in Beverly Hills.

The new Cedars-Sinai Urgent Care is staffed by board-certified physicians and physician assistants. It is at 10100 Culver Blvd. in Culver City.

The new center is staffed by board-certified physicians and physician assistants. It is designed to treat patients who suffer from a range of non-life-threatening medical conditions and symptoms, including ear infections, respiratory infections, diarrhea, sore throats, nausea, vomiting, muscle pain, fever, chills and the flu.

Urgent care offers a valuable alternative for many patients. The services are typically less expensive than those provided by the Emergency Department (ED). Most insurers also attach a lower co-pay to urgent care visits than to ED visits.

"Cedars-Sinai and its trusted physicians are now serving the Culver City community," said Tom Gordon, chief executive officer of Cedars-Sinai Medical Network. "Whether patients are feeling sick or experiencing an injury, Cedars-Sinai Urgent Care is an affordable, time-saving solution for expert walk-in family medical care."

Patients experiencing medical emergencies such as sudden onset of chest pain or bleeding should still visit the Emergency Department. Those needing medication refills or referrals for other medical services also should first consult their primary care physicians.

The new urgent care center is open weekdays from noon-9 p.m. and weekends from 9 a.m.-6 p.m. Appointments are not necessary. The phone number is 310-423-3333.

In late July, the 8,000-square-foot facility housing the new urgent care center will add primary care offices. Robert Gross, MD, and Steven Witlin, MD, two prominent Culver City physicians who are part of Cedars-Sinai Medical Group, will move their practices into the new building.

Use New Reflex Test for Ionized Calcium

Attention frequent users of calcium testing: Please order an ionized calcium reflex test, not ionized calcium directly.

On June 30, the Core Lab began offering a reflex to ionized calcium when total calcium is abnormal. In the vast majority of instances, this reflex should be ordered instead of ionized calcium directly. Research has shown that the majority of ionized calcium orders are clinically unnecessary.

The Core Lab runs more than 45,000 ionized calcium tests annually, which often wastes laboratory labor and resources. When total calcium is normal, ionized calcium should be normal, except in critically ill patients or patients with signs and symptoms consistent with hypocalcemia.

When ionized calcium is directly ordered unnecessarily, this not only increases testing expense on a per-patient basis (this test is often ordered daily) but can result in unnecessary IV calcium gluconate administration.

When this new reflex is ordered, total calcium will be tested first. This is already part of both basic and comprehensive metabolic panels. If the total calcium result is <8.0 mg/dL or >10.2 mg/dL, the patient's sample will be reflexed to ionized calcium. This reflex can be performed both with serum or heparinized plasma specimens.

Please start using this reflex for the majority of your patients who are not critically ill and who do not have signs and symptoms consistent with hypocalcemia. Order codes are as follows:

  • iCa reflex with Basic Metabolic Panel: CM1RC
  • iCa reflex with Comprehensive Metabolic Panel: CMPRC
  • Total Ca to iCa reflex: CARC

Please contact Kimia Sobhani, PhD, or Holli Mason, MD, with questions.

CS-Link Tip: Care Everywhere Data Reconciliation

Another milestone toward "one patient, one record" went live this month.

New alerts in the chart indicate there is new data from outside sources to reconcile. When records are received from another provider via Care Everywhere, clinicians may choose to reconcile allergies, medications and problems documented by the outside provider.

To see how, view this PDF at CS-Link Central.

You can schedule a training session with Alex Bram (alex.bram@cshs.org).

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

Related story:

Notes in Haiku, Canto, 'Fat Tab' Among CS-Link Upgrades

Sand 'N' Snore Set for Sept. 11

Sand 'N' Snore is just around the corner.

The dinner, sleepover and breakfast starts Friday, Sept. 11, 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 $65 per adult and $40 for each child age 3-11. Tickets for Friday's dinner only are $50 per adult and $20 for each child age 3-11.

To reserve a place, contact Cheryl Verne, in the office of Marjorie Santore Besson, at 310-423-2681 or cheryl.verne@cshs.org.

To see coverage of the 2014 event, click here.

A photo from the 2014 Sand 'N' Snore

Circle of Friends Honorees for June

The Circle of Friends program honored 249 people in June.

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.

  • Kenneth Adashek, MD
  • Paul Y. Aguilar
  • Maryam Ahmadian, MSN, RN, NP
  • Anne L. Alayon, RN
  • Michael J. Alexander, MD
  • Howard N. Allen, MD
  • Daniel C. Allison, MD
  • Farin Amersi, MD
  • Neel A. Anand, MD
  • Paula J. Anastasia Davis, RN, MN, AOCN
  • Ronald M. Andiman, MD
  • Mario D. Angel
  • Stephanie L. Anger, RN
  • Pedrina Arguera
  • Arash Asher, MD
  • M. William Audeh, MD
  • Laura G. Audell, MD, MS
  • Babak Azarbal, MD
  • Michel Babajanian, MD
  • Robert H. Baloh, MD, PhD
  • Mark Bamberger, MD
  • Babak R. Bamshad, MD
  • Tina G. Ban, RN
  • Leon I. Bender, MD
  • Jason A. Berkley, DO
  • Satinder J. Bhatia, MD
  • Anton J. Bilchik, MD
  • Keith L. Black, MD
  • Vanessa Booker
  • Earl W. Brien, MD
  • William W. Brien, MD
  • Angela Brown, RN, CVN
  • Eileen G. Brown, OCN, RN
  • Neil A. Buchbinder, MD
  • Dana Burlingame, RN
  • Marlon C. Bustamante, BSN, PHN, RN
  • Allison H. Canavan, MD
  • Ilana Cass, MD
  • Bojan Cercek, MD, PhD
  • Michael L. Chaikin, MD
  • David H. Chang, MD
  • Kirk Y. Chang, MD
  • Yuming (Rose) Chang, RN, CGRN
  • Derek Cheng, MD
  • Wendy W. Cheng, MD
  • Elaina P. Chu, PA
  • Ray M. Chu, MD
  • Alice P. Chung, MD
  • Eugenio Cingolani, MD
  • Susan B. Clark, RN
  • Paul Cohart, MD
  • Katherine Cohen, RN
  • Martin Cooper, MD
  • Stephen R. Corday, MD
  • Lawrence S. Czer, MD
  • Ram C. Dandillaya, MD
  • Teresa M. Dean, MD
  • Robert W. Decker, MD
  • Premal J. Desai, MD
  • Stephen C. Deutsch, MD
  • Alice R. Dick, MD
  • Suhail Dohad, MD
  • Noam Z. Drazin, MD
  • J. Kevin Drury, MD
  • Cheryl L. Dunnett, MD
  • Karyn Eilber, MD
  • Joshua D. Ellenhorn, MD
  • Jonathan C. Ellis, MD
  • Richard Essner, MD
  • Moses J. Fallas, MD
  • Yvette B. Federizo, BSN, RN, OCN
  • Joel D. Feinstein, MD
  • Jack F, Felmann
  • Marion D. Ferguson, BSN, RN, CPON
  • Fozia Ferozali, MSN, EdD
  • Marshal P. Fichman, MD
  • Robert A. Figlin, MD
  • Stuart Friedman, MD
  • David M. Frisch, MD
  • Larry Froch, MD
  • Tiyana E. Garcia
  • Avrom Gart, MD
  • Eli Ginsburg, MD
  • Lisa Girard, RN
  • Armando E. Giuliano, MD
  • Julian A. Gold, MD
  • Neil J. Goldberg, MD
  • Richard E. Gould, MD
  • Stephen L. Graham, MD
  • Jon B. Greenfield, MD
  • Lloyd B. Greig, MD
  • Robert A. Gross, MD
  • Jennifer Hajj, RN
  • Behrooz Hakimian, MD
  • Michele A. Hamilton, MD
  • Genevieve A. Harlocker, RN
  • Arman Hekmati, MD
  • Donald R. Henderson, MD, MPH
  • Fernando P. Hernandez
  • Sonia M. Hernandez
  • Allen S. Ho, MD
  • David M. Hoffman, MD
  • Gabriel E. Hunt Jr., MD
  • Leonel A. Hunt, MD
  • Andrew F. Ippoliti, MD
  • Abraham Ishaaya, MD
  • Mariko L. Ishimori, MD
  • Michelle Israel, MD
  • Gail N. Jackson, MD
  • Patricia A. Jenkins, RN
  • Stanley C. Jordan, MD
  • David Y. Josephson, MD
  • Lauren N. Kaldjian, PT, DPT
  • Steven Kamara, MD
  • Saibal Kar, MD
  • Sousan Karimi, MD
  • Beth Y. Karlan, MD
  • Ronald P. Karlsberg, MD
  • Harold L. Karpman, MD
  • David Kawashiri, MD
  • Elizabeth M. Kim, MD
  • Hyung L. Kim, MD
  • Joan C. Kirschner, MSN, RN, ANP-BC
  • Michelle M. Kittleson, MD, PhD
  • Charles F. Kivowitz, MD
  • Dee Dee L. Klute-Evans, MSN, RN, CIC
  • Honore G. Kotler, NP
  • Stephanie Koven, MD
  • Amanda Kuehl, RN BSN
  • Megan S. Laib
  • Leslie S. Lane, RN
  • Rachel M. Leon
  • Madeline S. Lerman, BSN, RN
  • Keren Lerner, MD
  • Roger L. Lerner, MD
  • Ronald S. Leuchter, MD
  • Richard A. Lewis, MD
  • Aliza A. Lifshitz, MD
  • Michael C. Lill, MD
  • Debora Lindsay
  • Milton Little, MD
  • Gene C. Liu, MD
  • Ning-Ai Liu, MD, PhD
  • Simon K. Lo, MD
  • Patrick D. Lyden, MD
  • Dharshini Mahadevan
  • Rajendra Makkar, MD
  • Adam N. Mamelak, MD
  • Christine Manimtim, BSN, RN
  • Harumi O. Mankarios, RN, OCN
  • Cindy Margolis, RN
  • Annalissa C. Marquez
  • Philomena McAndrew, MD
  • Robert J. McKenna Jr., MD
  • Denisse Medina Lopez
  • Gil Y. Melmed, MD, MS
  • Amin Joseph Mirhadi, MD
  • Monica M. Mita, MD, MDSc
  • Joel D. Mittleman, MD
  • Nancy Moldawer
  • Jaime D. Moriguchi, MD
  • Mary C. Nasmyth, MD
  • Ronald B. Natale, MD
  • Eve Makoff Newhart, MD
  • Alan C. Newman, DDS
  • David G. Ng, MD
  • Mei (Judy) Ng, LCSW
  • Nicholas N. Nissen, MD
  • Guy D. Paiement, MD
  • Dorothy J. Park, MD
  • Dale Pastel, PharmD
  • Michelle S. Pearl Davis, DO
  • Nichola L Pew, RN
  • Howard E. Pitchon, MD
  • Edwin M. Posadas, MD
  • Villa J. Powell
  • Lupita Rabago
  • Tania K. Ranasinghe, RN
  • Charlotte Roberts, RD, CDE
  • Eileen M. Rodriguez, MSN, RN
  • Kristina H. Rojas, MSN, RN
  • Stacey P. Rosenbaum, MD
  • Barry E. Rosenbloom, MD
  • Fred P. Rosenfelt, MD
  • Teresa Rowen, RN
  • Bruce A. Samuels, MD
  • Tanya M. Sanders, BSN, RN
  • Howard M. Sandler, MD, MS
  • Yeni Santizo, BSN, RN
  • Marilou Sarmiento, RN
  • Gregory P. Sarna, MD
  • Jay N. Schapira, MD
  • Irwin Segal
  • Randolph Sherman, MD
  • Wende Sherman, RN, OCN
  • Dean Sherzai, MD
  • Robert J. Siegel, MD
  • Allan W. Silberman, MD, PhD
  • Richard Sokolov, MD
  • Andrew Ira Spitzer, MD
  • Jasminka Stegic, MS, ANP-BC, CCRN
  • Jay J. Stein, MD
  • Theodore N. Stein, MD
  • Jerrold H. Steiner, MD
  • Sally A. Stewart
  • Colin Stokol, MD
  • Mabel A. Stringfellow
  • Kathryn Sunico, BSN, RN
  • Kazu Suzuki, DPM
  • Charles D. Swerdlow, MD
  • Nicholas R. Szumski, MD
  • Steven W. Tabak, MD
  • Michele Tagliati, MD
  • Michael D. Tajon
  • Heather Thompson, MS, CCC-SLP
  • David B. Thordarson, MD
  • Tram T. Tran, MD
  • Alfredo Trento, MD
  • Leo Treyzon, MD, MS
  • Mark P. Tuazon, RN
  • Doreen Tustison, RN-BC
  • Mark K. Urman, MD
  • Richard J. Van Allan, MD
  • Michael B. Van Scoy-Mosher, MD
  • Sharon Vancleave, RN
  • Angela Velleca, BSN, RN, CCTC
  • Swamy R. Venuturupalli, MD
  • Robert A. Vescio, MD
  • Tracy A. Vidal
  • Natasha Walker
  • Daniel J. Wallace, MD
  • Christine S. Walsh, MD
  • Arthur I. Waltuch, MD
  • Xunzhang Wang, MD
  • Alan Waxman, MD
  • Ariel E. Weber, BSN, RN, CCRN
  • Alan Weinberger, MD
  • Naomi Weiss, MA, CCC-SLP
  • Alexandra M. Wierzbicki, BSN, RN
  • Kenyetta Wilson
  • Deane L. Wolcott, MD
  • Edward M. Wolin, MD
  • Lisa Wong, RN
  • Paige Woodward, NP
  • Clement C. Yang, MD
  • Payam R. Yashar, MD
  • John S. Yu, MD
  • Tina Q. Yu
  • Hong Zhou, NP