Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Sept. 11, 2015 | Archived Issues

New Calendar Is a Better Way to Find Events

Keeping track of medical staff events at Cedars-Sinai just got easier. A new medical staff calendar is available on the Cedars-Sinai website. It contains all the events that traditionally have appeared in the Meetings and Events section of Medical Staff Pulse, but the new calendar is easier to digest and contains useful new features.

» Read more


P & T Approvals, FDA Warnings About DPP-4 Inhibitors, Canagliflozin

Pharmacy Focus

See highlights of the August meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration (FDA) has issued a warning about DPP-4 inhibitors and joint pain and has strengthened its warning about fracture risk with canagliflozin.

» 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 - September 2015 (PDF)


Milestones

Gary Sugarman, MD, has died.

» Read more

Cedars-Sinai Acquires Marina Del Rey Hospital

Cedars-Sinai has purchased the 145-bed Marina Del Rey Hospital and its neighboring medical office building. The acquisition was announced Sept. 1.

» Read more

ICD-10 Sessions for Physicians Set for Sept. 21-22

ICD-10 educational sessions for physicians are scheduled for Monday-Tuesday, Sept. 21-22. These CME activities will provide physicians with information on the International Classification of Diseases, 10th Revision.

» Read more

CS-Link Tip: Web/VS Direct Access Discontinued

Effective Sept. 8, the only way to access Web/VS is through CS-Link™. Thanks to your feedback over the past few weeks, key areas of concern have been identified regarding the transition and are addressed in a "crosswalk" document.

» Read more

Case Management Has Reason to Celebrate

The Cedars-Sinai Case Management Department will celebrate National Case Management Week from Oct. 12-16. Case management is the process of assessing, planning, coordinating, implementing and evaluating care across the patient continuum. The department's goals are to achieve quality, cost-effective outcomes, patient satisfaction and an appropriate use of resources.

» Read more

Clinical Documentation Course Continues Oct. 6

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 Oct. 6 session will take place from from 3:30-6:30 p.m. in Harvey Morse 4-5. Participants need to attend just one session. Two continuing medical education credits will be available.

» Read more

Healing Gardens Will Bloom on Plaza

A new campus beautification project will soon transform the outdoor Cedars-Sinai Plaza Level into lush gardens of refuge. Construction of four Healing Gardens — complete with water features, seating, special lighting and more — began Sept. 8 on the terraces around the medical center's North and South towers.

» Read more

High Holidays Services Begin Sept. 14

Senior Rabbi Jason Weiner, manager of Spiritual Care, will conduct services for the High Holidays at Cedars-Sinai. The services also will feature cantor Jordan Gorfinkel.

» Read more

Learn About Mission to Guatemala on Sept. 13

2016 Medical Trip Scheduled for May 7-17

Anyone interested in taking part in Cedars-Sinai's annual medical mission to Guatemala next May should attend a recruitment meeting on Sunday, Sept. 13, from 10-11:30 a.m. in Education Conference Center Room B, in the North Tower, Plaza Level. Information on how to volunteer and what to expect will be available.

» Read more

Gary Sugarman, MD, Longtime Cardiologist

Gary Sugarman, MD, died Aug. 29 at age 72. Sugarman was an active member of the medical staff in the Division of Cardiology from 1974 until 2008, when he became a member of the emeritus medical staff.

» Read more

Circle of Friends Honorees for August

The Circle of Friends program honored 72 people in August. 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

Resisting Heart Failure

Larry Lewis literally lost his heart on a July day a few years ago, but with his optimism and determination — and the expertise of the cardiac-care team at the Cedars-Sinai Heart Institute — the retired Marine Corps staff sergeant and educator is going strong today.

» Read more

Cedars-Sinai Acquires Marina Del Rey Hospital

Cedars-Sinai has purchased the 145-bed Marina Del Rey Hospital and its neighboring medical office building. The acquisition was announced Sept. 1.

Marina Del Rey Hospital will operate as a distinct community hospital affiliate of Cedars-Sinai and will continue to provide its existing services, including a 24-hour emergency room.

In addition to general acute-care medical services and emergency care, Marina Del Rey Hospital offers expertise in several specialty areas, including spine, weight loss, orthopedics, minimally invasive surgery, women's health and internal medicine.

"Cedars-Sinai looks forward to working closely with Marina Del Rey Hospital's medical staff, management team and employees to understand the needs and opportunities for enhanced service to the community," said Thomas M. Priselac, president and CEO of Cedars-Sinai.

The acquisition of the hospital is part of Cedars-Sinai's ongoing development as a comprehensive healthcare organization offering hospital and physician services operating in multiple locations, making it easier for more people to access coordinated quality care close to home. The region that includes Marina del Rey and surrounding communities has been one of the areas of Cedars-Sinai growth. Cedars-Sinai recently opened an urgent care and primary care center in Culver City and will open a similar facility in Playa Vista in 2016.

Marina Del Rey Hospital will convert to nonprofit status, which will result in an enhanced mission to serve the healthcare needs of the local community, including provision of community benefit programs. Previously, Marina Del Rey Hospital was owned by a partnership led by Westridge Capital.

Marina Del Rey Hospital's CEO, Sean Fowler, will report to Cedars-Sinai Chief Operating Officer Mark Gavens. All 660 employees will remain employees of Marina Del Rey Hospital.

"This is a positive move for Marina Del Rey Hospital," Fowler said, "allowing our management team to accelerate our progress toward achieving strategic goals while creating opportunities for additional growth and program enhancement."

ICD-10 Sessions for Physicians Set for Sept. 21-22

ICD-10 educational sessions for physicians are scheduled for Monday-Tuesday, Sept. 21-22.

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, Sept. 21, 7-8:30 a.m. in PEC 8 (Surgery and surgical subspecialties)
  • Monday, Sept. 21, noon-1:30 p.m. in Harvey Morse 1-2 (Internal Medicine and medical subspecialties)
  • Monday, Sept. 21, 5-6:30 p.m. in PEC 4 (Surgery and surgical subspecialties)
  • Tuesday, Sept. 22, 7-8 a.m. in PEC 4 (Hematology/Oncology)
  • Tuesday, Sept. 22, noon-1:30 p.m. in Cafeteria Conference Room A (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.

ICD-10 - Get Ready Now (PDF)

Related story:

More Details About Oct. 1 Transition to ICD-10 (Aug. 28, 2015)

ICD-10 Readiness: Oct. 1 Change Is Coming Soon (July 31, 2015)

CS-Link Tip: Web/VS Direct Access Discontinued

Effective Sept. 8, the only way to access Web/VS is through CS-Link™. The Web/VS system architecture is more than 20 years old and cannot be sustained indefinitely.

Thanks to your feedback over the past few weeks, key areas of concern have been identified regarding the transition and are addressed in a "crosswalk" document. This document lists where certain Web/VS functions can be found in CS-Link, such as creation of a patient list, office printing and more.

The team at Enterprise Information Services is available to arrange one-on-one or small-group sessions to review these changes or help improve your efficiency with common tasks within CS-Link.

To arrange a training session, please contact Shaun Miller, MD, at 310-423-8759 or shaun.miller@cshs.org.

Case Management Has Reason to Celebrate

The Cedars-Sinai Case Management Department will celebrate National Case Management Week from Oct. 12-16.

The Case Management office is in the South Tower, Plaza Level, near Starbucks.

The Case Management Department consists of registered nurse case managers, RN home health coordinators, master's-prepared social workers and support staff.

Case management is the process of assessing, planning, coordinating, implementing and evaluating care across the patient continuum. The department's goals are to achieve quality, cost-effective outcomes, patient satisfaction and an appropriate use of resources.

The case managers and social workers partner with members of the multidisciplinary clinical team to manage length of stay along with leading daily progression of care rounds.

Attending physicians are an integral part of the discharge planning process, with an emphasis on planning for the day, planning for the stay and planning for discharge in a unit-based model.

Clinical Documentation Course Continues Oct. 6

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 Oct. 6 meeting will be in Harvey Morse 4-5. 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)

Healing Gardens Will Bloom on Plaza

The Healing Gardens project will bring water features, seating, special lighting and more — shown in these illustrations — to the terraces around the North and South towers.

A new campus beautification project will soon transform the outdoor Cedars-Sinai Plaza Level into lush gardens of refuge.

Construction of four Healing Gardens — complete with water features, seating, special lighting and more — began Sept. 8 on the terraces around the medical center's North and South towers. The project will be split into two phases, with work beginning on the outer plazas first, then moving into the inner plazas — those facing Gracie Allen Drive — in January 2016.

The project is part of an effort to beautify the campus and improve exterior wayfinding for a more positive patient experience.

"The redesigning of the exterior plaza not only provides a much-needed green sanctuary for our patients and visitors, but also a wonderful space for our physicians and staff to recharge throughout the day," said Mark Gavens, chief operating officer. "It also ensures beautiful, serene landscapes can be seen from patient room windows."

The Healing Gardens project is part of a more comprehensive effort to beautify the campus and improve exterior wayfinding for a more positive patient experience. Additional construction to enhance navigation and signage will commence in the year ahead.

Each of the four gardens will have a unique design and will include shaded seating areas, improved lighting features and specially selected foliage such as bamboo, fruitless olive trees, lavender and aloe. The green spaces also will include built-in concrete pads for future art installations.

Project managers say construction will take place between 7 a.m. and 3:30 p.m. on weekdays to minimize noise and disruption for patients. During phase one construction, which is expected to be completed by Dec. 31, the outer outdoor plazas will be closed. Visitors, patients and staff will use the inner plazas to access the medical center and adjoining buildings from the exterior Plaza Level.

Once phase one is completed, the renovated outer plazas will be opened, and the inner plazas will be closed as phase two commences. Construction on phase two is expected to be completed by June 30, 2016. Those inner plaza gardens also will include extra features, such as a trellis structure on the south side of the North Tower, and night lighting and reflecting pools on the north side of the South Tower.

"There is so much evidence on the impact that therapeutic landscapes and nature can have on a patient's recovery," Gavens said. "We're excited at this opportunity to beautify our campus and provide soothing, tranquil areas where our community can rest and heal."

Click the image below to see a video of the project.

High Holidays Services Begin Sept. 14

Senior Rabbi Jason Weiner, manager of Spiritual Care, will conduct services for the High Holidays at Cedars-Sinai. The services also will feature cantor Jordan Gorfinkel.

  • Rosh Hashanah — Monday, Sept. 14, 10 a.m.-12:30 p.m. in Harvey Morse Auditorium
  • Kol Nidre — Tuesday, Sept. 22, 7-8:30 p.m. in Harvey Morse Auditorium
  • Yom Kippur — Wednesday, Sept. 23, 10 a.m.-noon in Harvey Morse Auditorium

The services will be available for viewing on channel 50 of the inpatient TV system. The Rosh Hashanah service will be rebroadcast Tuesday, Sept. 15, at 10 a.m.

High Holidays 2015 (PDF)

Learn About Mission to Guatemala on Sept. 13

For many residents, a visit from Cedars-Sinai medical professionals marks their only access to healthcare all year.

2016 Medical Trip Scheduled for May 7-17

Anyone interested in taking part in Cedars-Sinai's annual medical mission to Guatemala next May should attend a recruitment meeting on Sunday, Sept. 13, from 10-11:30 a.m. in Education Conference Center Room B, in the North Tower, Plaza Level. Information on how to volunteer and what to expect will be available.

"We need not only doctors and nurses and other medical staff, but people who speak Spanish to act as translators, people who can do clerical work, can cook, are willing to clean and can offer all kinds of general support," said Jim Laur, vice president of Cedars-Sinai Legal Affairs and a participant in missions for 16 years.

The missions are done in partnership with HELPS International, a nonprofit group that organizes a wide range of volunteer activities in Guatemala. Volunteers use vacation days for the 10-day missions, and they pay their own transportation costs.

"It's a very special time for everyone who volunteers," Laur said. "You're helping people who are in great need in a direct way."

The Cedars-Sinai team, which generally numbers about 80 people, travels to a rural village. Using equipment and supplies they bring with them, the team sets up a clinic and an operating room. The team sees hundreds of patients, most of whom have no other access to healthcare. In 2015, the team saw 1,133 patients and performed 131 surgeries over five days.

The 2016 mission will take place May 7-17.

The meeting and participation in the mission are open to all Cedars-Sinai employees and medical staff members, along with family members and friends.

For more information, please contact Olivia Marroquin at oliviamr531@gmail.com.

Gary Sugarman, MD, Longtime Cardiologist

Gary Sugarman, MD, died Aug. 29 at age 72. Sugarman was an active member of the medical staff in the Division of Cardiology from 1974 until 2008, when he became a member of the emeritus medical staff.

Click here to read Sugarman's obituary in the Los Angeles Times and sign the guest book.

Circle of Friends Honorees for August

The Circle of Friends program honored 72 people in August.

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.

  • Monique R. Acosta, RN
  • Lilit Baldjyan, MSN, RN
  • Babak R. Bamshad, MD
  • Eli Baron, MD
  • Leon I. Bender, MD
  • Satinder J. Bhatia, MD
  • Scott A. Braunstein, MD
  • Earl W. Brien, MD
  • Merla O. Caermare
  • Ilana Cass, MD
  • Dorrie Chang, MD
  • Cheryl G. Charles, MD
  • Alice C. Cruz, MD
  • Lawrence S. Czer, MD
  • Catherine M. Dang, MD
  • Itai Danovitch, MD
  • Robert M. Davidson, MD
  • Audra Davila, RN
  • Noam Z. Drazin, MD
  • Jillian M. Felice, CNIII
  • Marshal P. Fichman, MD
  • Wendel Fortenberry
  • Marilyn A. Friedberg
  • Stuart Friedman, MD
  • Armando E. Giuliano, MD
  • Sherry L. Goldman, RN, NP
  • Theodore B. Goldstein, MD
  • Rowena M. Gonzalez, RN
  • Steven B. Graff-Radford, DDS
  • Omid Hamid, MD
  • Michele A. Hamilton, MD
  • Michael D. Harris, MD
  • Leonel Jimenez, RN
  • J. Patrick Johnson, MD
  • David Kawashiri, MD
  • Ilan Kedan, MD, MPH
  • Juanita Keith, PSR
  • Michelle M. Kittleson, MD, PhD
  • Robert Klapper, MD
  • Jon A. Kobashigawa, MD
  • Michael A. Kropf, MD
  • Gary E. Leach, MD
  • Roger L. Lerner, MD
  • Andrew J. Li, MD
  • Cierra N. Lukers, RN
  • Ali Mahtabifard, MD
  • Adam N. Mamelak, MD
  • Paula McAllister, MD
  • Puja K. Mehta, MD
  • Nancy Moldawer
  • Jaime D. Moriguchi, MD
  • Kristine Norland, RN
  • Sara Oliva, BSN, RN, OCN
  • Shi-Hui Pan, PharmD
  • Jignesh K. Patel, MD, PhD
  • Christine Paulino
  • Barry J. Pearlman, MD
  • Edward H. Phillips, MD
  • Edwin M. Posadas, MD
  • Madison F. Richardson, MD
  • Sonja Louisa Rosen, MD
  • Jeremy D. Rudnick, MD
  • Vivian L. Salle, RN
  • Prediman K. Shah, MD
  • Edward J. Share, MD
  • Haley L. Sims Saunders, RN
  • Gena T. Smith, RN
  • Andrew Ira Spitzer, MD
  • Vinay Sundaram, MD
  • Teaunna R. Thomas
  • Alfredo Trento, MD
  • Jill A. Trunecek, NP

Resisting Heart Failure

Larry Lewis chats with his surgeon, Francisco Arabia, MD, surgical director of the Mechanical Circulatory Support Program.

Larry Lewis literally lost his heart on a July day a few years ago, but with his optimism and determination — and the expertise of the cardiac-care team at the Cedars-Sinai Heart Institute — the retired Marine Corps staff sergeant and educator is going strong today.

"On that day in 2013, I had a plane ticket to attend my wife's family reunion," Lewis said. "I was supposed to fly to the event after one last heart test. By the grace of God, I never got on that flight."

Larry Lewis is thriving with his new transplanted heart.

For seven years, Lewis had been suffering from fatigue, insomnia and tenacious head colds — problems he knew were connected to his heart's slow decline. When cardiologists conducted that test at the Heart Institute, they determined he was suffering from complete heart failure.

Eight days later, Lewis went into surgery to have a device implanted in his chest that would take over the job of pumping his blood. But when the surgeons removed a portion of his heart, they discovered cancerous tumors in it that had been at the root of his health problems. To make things worse, the cancer had already spread to his lower intestine, diminishing his chances of survival.

Not one to be counted out, however, Lewis is living today at his home in Victorville. He has a new donor heart, he's cancer free, and he's in excellent spirits.

"Cedars-Sinai provided the boost of confidence for me to get through this," Lewis said. "I knew the hospital's reputation, and as I got to know the doctors and staff I realized that everyone was a consummate professional."

But there was more to his survival than trust in his expert caregivers.

"I never felt that I had a chance to fail — it was not an option," he said. "I've had to fight my whole life. That's my personality."

Indeed, the same steely resolve he tapped to pull himself from death's door at age 50 had empowered him decades earlier to free himself from a potentially ruinous start to his adult life.

"I was 'that' kid, and I should be a statistic," Lewis said of his teen years. "The places where I grew up and the situations that I was in. … Well, several people I knew then have been in and out of prison. Several are dead."

Lewis was not born into a life on the edge of crime. His dad was a Navy man, his mother a stay-at-home mom. The family lived in Oakland, and his parents had a clear vision for their four sons, whom they sent to private school.

"My parents only had ninth-grade educations, but they had unbelievably high expectations for me and my brothers," Lewis said. "My mother was a beast with education."

But when Lewis was barely a teenager, the family disintegrated. His parents divorced. His dad moved to Southern California with the two oldest boys. Shortly thereafter his mother suffered a stroke.

"At 12, 13 years old I grew up," Lewis said. "I paid the bills. I went to the store with the food stamps. And we moved from the Oakland hills to the Oakland ghettos."

‘I never felt that I had a chance to fail — it was not an option. I've had to fight my whole life. That's my personality.’

— Larry Lewis,
Cedars-Sinai heart transplant patient

Ridiculed by the kids on his new block for "talking proper," Lewis had to learn how to play by the rules of the street. His mother eventually moved away to get care for her illness.

"I lost my identity because I didn't have older brothers or a father to identify with any more," Lewis said. "I was doing all the things you think teenagers do in the streets."

He recalled a day when he was 18 and talking to a friend about what they were going to do for money after high school graduation.

"My buddy said, 'I'm going to start slinging hard'" — selling drugs. "I said, No, I'm going into the military.

"I didn't have anyone telling me I needed to do this, but I knew I had to escape the inner city. My father and brothers were military, so it was the family business. I had the presence of mind and the foundation to get out."

Lewis would spend the next 20 years in the Marine Corps, where he served as an aircraft maintenance data systems analyst, an advocate for victims of domestic violence and a substance-abuse counselor.

After the end of his military career, Lewis threw himself into being an educator and teaching young people his brand of optimistic resilience. He was already acting as a youth director at his church and a coach of sports teams, so it was a natural transition to pick up a teaching credential and then master's degrees in curriculum and instruction, and educational leadership.

"There are not enough African-American educational leaders — especially men," Lewis said. "My job is to fight for kids who can't fight for themselves. I understand the dynamics of their lives. I know that if those kids have an opportunity to thrive, they will."

From 2000-11, Lewis was a teacher, assistant principal and eventually a principal in the Adelanto School District in San Bernardino County. His medical condition forced him to retire in 2011 from his position as principal of Desert Trails Elementary School in Adelanto.

Then came that critical July day in 2013.

After surgeons removed his heart, they implanted a SynCardia Total Artificial Heart. The device helps the sickest of the sick, replacing the lower chambers of the heart (the ventricles) and all four valves. An external driver powers the implant, enabling it to pump. It is a remarkable, temporary therapy for patients who might otherwise die while waiting for a heart transplant.

Yet the device could do nothing about the fear Lewis was feeling.

"I was uncertain about my future and uncertain about my ability to come back from heart failure," he said. "I felt fear, but I wanted independence. I was going to have to earn that."

Lewis lived for 16 months with the SynCardia device. He said he drew strength from his faith, his love for his wife and children, and his desire to work again with young people.

He was back in the hospital at Cedars-Sinai when he got one of the most emotional phone calls of his life.

"They had a donor heart for me, if I chose to have it," Lewis recalled. "I certainly chose to have it!"

When he awoke after his heart transplant, he felt a profound difference.

"When you wake up, you just know that you're alive. You're attached to about a thousand wires, but through it all you can feel that, in fact, there is a heart that's beating."

Lewis plans to continue mentoring youth. Although retired from teaching, his fond memories of serving students from myriad backgrounds has inspired him to start a group called My Brother's Keeper through the church where he is an ordained deacon.

"The idea is that, yes, I am my brother's keeper," he said, "and I do have a responsibility to help the next young man to be successful, to navigate life and to move forward."

Lewis said he also feels a responsibility to the donor heart beating in his chest:

"I need to make sure that I'm positive in the things that I do, to honor the person who I got the heart from."

Click the image below to hear Larry Lewis talk about his transplant experience.