Cedars-Sinai Medical Center

medical staff pulse newsletter

Text size: A A A
A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF November 2, 2018 | Archived Issues

Annual Staff Meeting Spotlights Quality and Value

Cedars-Sinai leaders took the stage during the annual meeting of the medical staff on Monday, Oct. 22, to share perspectives on the challenges and opportunities facing the medical center, specifically those relating to providing quality and value in a changing medical landscape.

» Read more

Keith Black, MD, Honored With Pioneer in Medicine Award

Keith L. Black, MD, an internationally renowned neurosurgeon and neuroscientist, is this year's Pioneer in Medicine Award winner for his groundbreaking research and clinical contributions.

» Read more

New CS-Link Panels Help Guide Antibiotics Use

Over the last year, Cedars-Sinai’s Antimicrobial Stewardship team has developed antibiotic treatment panels for various indications. The goal of these new indication- and duration-based panels, which are based on Cedars-Sinai empiric treatment guidelines, is to ensure the use of the right antibiotic for the right patient at the right time for the right duration, by providing clinicians with recommendations when they order antibiotics for a particular infection.

» Read more

Updating Find a Doctor to Enrich Digital Experience

In an effort to enhance the digital experience, the Find a Doctor feature on Cedars-Sinai’s public website has been updated and now provides basic directory information for all clinicians and clinician/investigators on our medical staff, including Cedars-Sinai Marina del Rey Hospital and in the Medical Network.

» Read more

Before You Throw: Green Repositioning Sheets Don’t Go

Before a patient leaves a room or is transferred to an ambulance or to the morgue, remove green repositioning sheets and place them in the blue laundry bag for cleaning rather than throwing them out. Properly disposing of these soiled sheets and reusing them saves the medical center $150 per linen.

» Read more

Prevent Injury With Safe Patient Handling

Safe patient handling is everyone’s responsibility. A Safe Patient Handling and Mobility specialist is here to help educate, train and assist with difficult lifts—24 hours a day, seven days a week.

» Read more

Rabbi Leads Prayers for Pittsburgh

Senior Rabbi Jason Weiner, director of the Spiritual Care Department, led a solemn prayer vigil for patients, staff members and visitors to mourn, and to call for healing and hope following the Tree of Life synagogue shooting attack in Pittsburgh that left 11 people dead.

» Read more

Staff Can Enter Drawing to Win Rams Tickets

As the official health partner of the Los Angeles Rams, Cedars-Sinai is offering staff an opportunity to receive free tickets through a random drawing to the last three home games of the storied NFL franchise this season. To participate in the drawing for the Rams tickets, fill out a brief online form.

» Read more

Immersive Sim Center Youth Program Discounted for Staff

The Women's Guild Simulation Center for Advanced Clinical Skills is offering employees discounted access to its interactive Healthcare Immersion Program, which aims to educate and inspire young minds interested in or currently pursuing healthcare careers. Staff members can now sign up their children online at a 25 percent discount.

» Read more

Apple Pay and Google Wallet Available

Google Wallet and Apple Pay are now accepted at Cedars-Sinai's retail food locations—La Brea Bakery, Plaza Cafe, Artisan Cafe, Ray Charles Cafeteria and Starbucks. 

» Read more

CS-Link Tip: Big Changes Over Weekend

When you log onto CS-Link™ after Sunday morning, Nov. 4, you will see many changes. Among the more noticeable ones are that the visit taskbar will always be at the bottom of the screen. Also, your preference list will be the icon with three sideways lollipops. With your orders at the bottom of the screen, you will be able to place an order while in Chart Review or Wrap Up—without having to navigate back.

» Read more

Annual Staff Meeting Spotlights Quality and Value

DrYang480px.jpg

Clement C. Yang, MD, chief of staff, talked about the challenges and opportunities facing the medical center at the annual meeting of the medical staff.

Cedars-Sinai leaders took the stage during the annual meeting of the medical staff on Monday, Oct. 22, to share perspectives on the challenges and opportunities facing the medical center, specifically those relating to providing quality and value in a changing medical landscape.

"As an organization, we have turned challenges into opportunities," said Thomas M. Priselac, president and CEO. "That’s what I think has allowed us to succeed over the years, and that’s at the heart of what we will be able to do going forward."

During his CEO Report, Priselac cited that many areas throughout the medical center—including inpatient flow, cardiac monitoring, NTSV C-section rates, antibiotic treatment and end-of-life care—have seen positive change and have advanced the standard for quality.

Priselac also noted that "knowledge is power," and that digital tools will play an increasingly vital role in helping the institution move forward.

"An important part of the toolset to manage both quality as well as operational and clinical efficiency has to do with technology and the use of clinical decision support," Priselac said, adding that the deployment of digital tools, among other things, has resulted in a 17 percent reduction in blood utilization in the face of increased patient acuity levels.

Clement C. Yang, MD, chief of staff, echoed Priselac's views in his Chief of Staff Report, providing examples of how digital tools, including peer rankings and cost-management solutions, can provide insights into clinical and operational efficiency as well as the opportunity for discussion.

"It’s not the perfect tool that is our goal, because the tools will change and evolve," Yang said. "Rather, it’s a hope for constant inquisitiveness and a push for improvement that asks: 'Is there a better way to do things safely?'"

Yang went on to say that due to a "truly superb" effort, the medical staff has achieved superior levels of quality and outcomes, congratulating all members for their role in Cedars-Sinai's recent US News & World Report hospital rankings success. But he stressed that, despite these wins, the marketplace continues to add pressure to increase value.

"Clinical efficiency is a component that is most under our control," Yang said. "It is very much dependent on what we do as physicians, our decisions and how we manage our patients."

Yang shared that there are currently more than 62 medical staff projects that address both quality and clinical efficiency, including projects on utilization, readmissions and turnaround times.

"Every one of these projects touches, in some way, upon value," he said.

Yang also highlighted the importance of physician wellness, acknowledging burnout as common both at the medical center and around the nation.

"We know that burnout affects different specialties at different rates, and that it impacts our patient care. It also impacts the way that we interact with each other," he said. "We recently launched a wellness task force with a mission to cultivate a culture of wellbeing at Cedars-Sinai where physicians develop resilience, practice efficiency and thrive."

Yang said the task force is set to launch a medical-staff-wide survey to better understand the challenges and identify opportunities to connect physicians with resources for healthy living.

Following Yang's presentation, Marc Edelstein, MD, gave the Secretary's Report, in which he recognized staff members who had been appointed to committee and clinical chief positions for 2019, as well as the continuation of Yang as chief of staff and Ilana Cass, MD, as vice chief of staff.

To conclude the meeting, Yang presented Robert I. Goodman with the Chief of Staff Award for his commitment to the highest standards of patient care. Cass, along with Paul Noble, MD, chair of the Department of Medicine, presented Keith L. Black, MD, with the 2019 Pioneer in Medicine Award for his groundbreaking work in neuroscience and neurosurgery.

Yang concluded the meeting by saying the organization's continued success will require teamwork, and because of that, the future is bright.

"When the medical staff and the medical center work hand-in-hand to safeguard quality and achieve value, we all succeed, and our patients and our community are the winners," he said.

Keith Black, MD, Honored With Pioneer in Medicine Award

Keith L. Black, MD

Keith L. Black, MD, an internationally renowned neurosurgeon and neuroscientist, has received the Cedars-Sinai's Pioneer in Medicine Award in recognition of his groundbreaking research and clinical contributions.

The honor was presented during the Annual Meeting of the Medical Staff, held in Harvey Morse Auditorium on Monday, Oct. 22, and was accepted on Black's behalf by his son, Keith, and his wife, Carol.

Black, who was in Uganda at the time of the event, expressed his gratitude via a video message.

"I cannot tell you how proud I am to be a part of the Cedars-Sinai family, how proud I am of all of the incredible colleagues—both on the clinical side and the scientific side—that I have at Cedars-Sinai and how proud I am of this recognition," Black said to an audience of colleagues and close friends. "It is truly humbling."

Black joined Cedars-Sinai in 1997 as professor and inaugural chair of the Department of Neurosurgery. He continues to serve in both roles and has since been appointed Ruth and Lawrence Harvey Chair in Neuroscience and director of the Maxine Dunitz Neurosurgical Institute.

During the award presentation, Paul W. Noble, MD, chair of the Department of Medicine and director of the Women's Guild Lung Institute, presented an overview of Black's achievements, saying Black has had an "extraordinary" two decades at Cedars-Sinai, which has led to worldwide recognition for both his scientific expertise and his care of brain cancer patients.

Black's breakthroughs include the development of methods to open up the blood-brain barrier, allowing chemotherapeutic agents to reach brain tumors; the development of tools to better identify brain tumor tissues by "painting" the brain using a chemical derived from scorpions; and the development of vaccines to treat glioblastoma multiforme, the deadliest form of brain tumor.

Noble also acknowledged Black's contributions to inspiring the next generation of neuroscientists through his work with Cedars-Sinai's educational initiatives, such as Brainworks and the Pauletta and Denzel Washington Family Gifted Scholars in Neuroscience Program.

Black's significant impact as a clinician as well as a scientist was captured during a video presentation in which colleagues and former patients conveyed their gratitude for his work.

"Keith is an exceptionally brilliant man with an enthusiasm for sailing and other hobbies that matches his enthusiasm for taking care of patients," said Bruce Gewertz, MD, surgeon-in-chief and chair of the Department of Surgery. "Having said that, he brings a seriousness and a purpose, which is the kind of attitude that patients faced with a life-threatening disease really need, and he does that with a great degree of empathy. That’s what truly distinguishes him."

For his work, Black has received numerous past honors, including the prestigious Javits Neuroscience Investigator Award from the National Institutes of Health, the Charles R. Drew University of Medicine and Science President's Medal of Honor, and the Howard I. Wilner, MD, Alumnus of the Year Award from the Cedars-Sinai Alumni Association.

New CS-Link Panels Help Guide Antibiotics Use

Over the last year, Cedars-Sinai’s Antimicrobial Stewardship team has developed antibiotic treatment panels for various indications.

The goal of these new indication- and duration-based panels, which are based on Cedars-Sinai empiric treatment guidelines, is to ensure the use of the right antibiotic for the right patient at the right time for the right duration by providing clinicians with recommendations when they order antibiotics for a particular infection.

The initiative is part of the Antimicrobial Stewardship Program's ongoing efforts to help reduce the misuse, overuse and underuse of antimicrobials, which can lead to resistance, C. difficile infections, increased length of stay and readmissions.

"The Antimicrobial Stewardship Committee regularly updates empiric antibiotic treatment recommendations for common indications; however, we needed to find a way to make them more accessible to clinicians," said Jonathan Grein, MD, director of the Department of Hospital Epidemiology. "With these antibiotic panels through CS-Link™, we’re making it intuitive and easy for clinicians to order antibiotics in a way that is consistent with our recommendations based on resistance patterns here at the hospital."

The panels are integrated into the existing ordering workflow and aim to improve the appropriate use of antimicrobials. It is estimated that at least 30 percent of antimicrobials given on inpatient units have an opportunity for stewardship.

How Do They Work?

Treatment panels for UTI, pneumonia, skin/soft tissue infections and intra-abdominal infections are now available in CS-Link. The panels can be found by searching for these four indications as well as commonly used synonyms. The panels will also appear if clinicians search for the 11 most frequently used antimicrobials.

For example, if a clinician searches for "cefepime" in an effort to treat a urinary tract infection, CS-Link will present a treatment panel option titled "UTI Treatment Panel." Within the panel, various options are presented to help the clinician further define the nature of the infection.

The UTI panel asks the clinician to select "Community Acquired UTI" or "Hospital or Nursing Home Acquired UTI," and then recommends particular antibiotic therapies based on that selection. In the case of a community-acquired UTI, the recommended empiric therapy displayed in CS-Link can be seen below:

Panel-Example480.jpg

"Instead of a physician finding an antibiotic to fit the infection they are treating, these panels provide the antibiotics that have been identified as the right antibiotics based on our own internal data, as well as the type of infection the patient has," said Rita Shane, PharmD, chief pharmacy officer and professor of medicine. "It makes the selection of the right antibiotic for the right duration for the right infection a one-step process."

The Antimicrobial Stewardship team will share more information on these panels during U.S. Antibiotic Awareness Week, Nov. 12-18, 2018, an annual observance raising awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic use nationwide.

The Antimicrobial Stewardship Program also is focused on improving the accuracy of documented allergies. Research has shown that 90 percent of patients with documented penicillin allergies are not truly allergic. These patients could potentially still receive penicillin-related antibiotics instead of broad-spectrum antibiotics that may lead to resistance or treatment failure.

For more information on the treatment panels, or the Antimicrobial Stewardship Program, contact an antimicrobial stewardship pharmacist at 310-423-5352.

Updating Find a Doctor to Enrich Digital Experience

FindaDoctor480px.jpg

The Find a Doctor feature on Cedars-Sinai's public website has been updated. 

In an effort to enhance the digital experience, the Find a Doctor feature on Cedars-Sinai’s public website has been updated and now provides basic directory information for all clinicians and clinician/investigators on our medical staff, including Marina del Rey Hospital and in the Medical Network.

The update also addresses the growing trend of consumers seeking online healthcare reviews (via sites like Yelp and Healthgrades) by posting physician outpatient satisfaction ratings and comments for doctors we are currently surveying. These ratings and comments are found on the Find a Doctor section of the website.

"Our recent update to the Find a Doctor application demonstrates our continued commitment to improving the Cedars-Sinai digital experience," said Alan Dubovsky, chief patient experience officer. "It’s another way Cedars-Sinai keeps patients fully informed, while delivering outstanding healthcare service for our patients."

Before You Throw: Green Repositioning Sheets Don’t Go

LinenCart480px.jpg

A properly stocked linen cart is shown on the left. A properly discarded green repositioning sheet in the blue laundry bag is shown on the right. 

Did you know green repositioning sheets and black handy tubes can be washed and reused?

Before a patient leaves a room or is transferred to an ambulance or to the morgue, remove green repositioning sheets and place them in the blue laundry bag for cleaning rather than throwing them out.

By properly disposing of these soiled sheets, the medical center can clean and reuse them, saving the organization $150 per linen.

For more information, contact a member of the Safe Patient Handling and Mobility (SPHM) team.

Prevent Injury With Safe Patient Handling

It’s no secret getting patients out of bed earlier can decrease length of stay and promote patient independence. But did you know that safe patient handling also is required by law, and is effective and available for use to anyone who interfaces with patients?

"Moving patients is everyone’s responsibility," said Danielle Gabele, MSN, RN, CCRN, CENP, associate director of the Safe Patient Handling and Mobility (SPHM) program. "We count on our nursing and clinical staff to be proactive in mobilizing their patients and in requesting equipment and assistance."

The SPHM team has eight full-time mobility specialists available to educate and train on lifting best practices and equipment must-haves. This team of experts also is available to demonstrate equipment usage during difficult moves.

"Our goal is to give our nursing staff, along with everyone who works directly with patients, the skills and confidence necessary to utilize SPHM equipment on all appropriate patients 100 percent of the time," said Gabele. "If we do this, we will have shorter patient length of stay, fewer caregiver injuries, fewer falls and greater patient independence."

The SPHM team has saved more than $14 million over the past four years by preventing workers compensation injuries and lost work days.

Mobility specialists are available 24 hours a day, seven days a week, and can be requested via CS-Link™ order for SPHM consult, or by group texting the team under the SPHM department on Voalte. In areas with no access to Voalte or CS-Link, call the Nursing office at 310-423-5180 to request SPHM assistance.

For more information about the program, contact Gabele at 310-423-6654 or danielle.gabele@cshs.org.

Rabbi Leads Prayers for Pittsburgh

Rabbi Jason Weiner listens while Cantor Nati Baram sings a prayer at Cedars-Sinai's memorial service for the victims of the Pittsburgh synagogue shooting.

Senior Rabbi Jason Weiner, director of the Spiritual Care Department, led a solemn prayer vigil on Monday, Oct. 29, for patients, staff members and visitors to mourn, and to call for healing and hope following the Tree of Life synagogue shooting attack in Pittsburgh that left 11 people dead.

The attack on Oct. 27 by a 46-year-old man whose social media posts were filled with anti-Semitic diatribes that included comparing Jews to Satan has rocked the Jewish community throughout the U.S., Weiner told the gathering in the medical center’s chapel.

"We watch the news and look at the world around us and we sometimes feel despair that there are so many bad things happening in our world," said Weiner, who also serves as president of the Southern California Board of Rabbis. "But look around and be reminded that yes, even when there are bad things happening in our world there is much more good than bad…and if we embrace the good, the good will far outweigh the bad."

Weiner encouraged the standing-room-only crowd to reaffirm Cedars-Sinai’s commitment to help others, especially other groups that face discrimination for their beliefs.

"We are a strong people," Weiner said. "We are a people that keeps hope alive."

Rabbi Sarah Barukh read a poem written especially for the Tree of Life Congregation by Rabbi Naomi Levy.

"Work through us, God," Barukh read. "Turn our helplessness into action, teach us to believe that we can rise up from this tragedy and banish the hate that is tearing our world apart."

As each shooting victim’s name was read along with a short biographical description, a member of the staff lit a flameless candle and placed it on the chapel’s altar.

Another speaker, Ahmed Ibrahim, a Cedars-Sinai employee who also serves as a volunteer leader of the health system’s Muslim community, said the shooter and those who share his discriminatory beliefs want to "stoke separation and division" among people who practice kindness and caring for others. "They have failed and failed miserably," Ibrahim said.

In his closing prayer, Weiner asked attendees to "recognize all the good in this room, in this hospital. May we fight for a world in which goodness permeates and there’s no more suffering."

Staff Can Enter Drawing to Win Rams Tickets

As the official health partner of the Los Angeles Rams, Cedars-Sinai is offering staff an opportunity to receive free tickets through a random drawing to the last three home games of the storied NFL franchise this season.

Winners will receive a pair of tickets. Employees may enter the drawing only once and can win only once this season. Winners will be notified by email.

The Rams remaining home games this season are:

  • Sunday, Nov. 11 v. Seattle Seahawks
  • Sunday, Dec. 16 v. Philadelphia Eagles
  • Sunday, Dec. 30 v. San Francisco 49ers

To participate in the drawing for the Rams tickets, fill out a brief online form.

Immersive Sim Center Youth Program Discounted for Staff

Students from Chatsworth Charter High School's Medical Careers and Sciences Academy work with a mannequin at the Women’s Guild Simulation Center for Advanced Clinical Skills.

The Women's Guild Simulation Center for Advanced Clinical Skills is offering staff members discounted access to its interactive Healthcare Immersion Program, which aims to educate and inspire young minds interested in or currently pursuing healthcare careers.

The program's gold- and platinum-tiered packages, which take place over one and two days respectively, previously were open to school groups only. Both are now available to the children of Cedars-Sinai staff members at a 25 percent discount. The program is aimed primarily at high school students. 

During the program, attendees work in the center's state-of-the-art facility under the guidance of a team of clinical educators, practicing a range of healthcare skills and techniques in a realistic, hands-on operating room environment.

"We're giving parents the opportunity to send children to experience some truly incredible things they would normally only get to do as a doctor or a nurse," said Russell Metcalfe-Smith, the center’s associate director. "It helps to inspire attendees to consider a career in healthcare, or, if they were already considering a career in healthcare, it motivates them to study hard and achieve their dreams."

The one-day Gold Program— [Gold Program (PDF)] —involves eight hours of healthcare simulation, during which attendees take part in a series of hands-on workshops on a range of topics, from surgical procedures to ethical dilemmas, using the same state-of-the-art mannequins employed in physician training. Attendees also practice surgery using virtual reality, take part in the 3D printing of a human bone and experience true-to-life clinical scenarios that foster teamwork.

The Platinum Program— [Platinum Program (PDF)] —expands on the Gold Program's first day with an additional eight-hour day of interactive workshops focusing on areas such as augmented reality, pediatrics, cardiopulmonary life support, and labor and delivery. Platinum Program attendees also get the chance to network with Cedars-Sinai's doctors, nurses, physical therapists and other healthcare professionals during the second day.

Both programs are limited to 40 participants per day and include breakfast, lunch and light refreshments. The programs, held on select weekends, will run until the end of 2019, with extended summer programs currently being planned.

"I dream of reading diverse stories that start with young minds reaching for the stars after the seeds of inspiration were planted at the Women’s Guild Simulation Center," said Rex Chung, MD, the simulation center's medical director. "The Healthcare Immersion Program was planned with this dream in mind, and I would be most proud if it adds to the rich legacy of Cedars-Sinai reaching out and influencing the world for the better."

Staff members now can register their children online for 2018 and 2019 weekend dates.

For more information, or for details on pricing and receiving a 25 percent staff discount code, contact arleen.orozco@cshs.org.

Apple Pay and Google Wallet Available

Google Wallet and Apple Pay are now accepted at Cedars-Sinai's retail food locations—La Brea Bakery, Plaza Cafe, Artisan Cafe, Ray Charles Cafeteria and Starbucks.

These apps stored on your phone or other mobile device allow you to simply tap and go. 

CS-Link Tip: Big Changes Over Weekend

When you log onto CS-Link™ after Sunday morning, Nov. 4, you will see many changes. Among the more noticeable ones are that the visit taskbar will always be at the bottom of the screen. Also, your preference list will be the icon with three sideways lollipops. With your orders at the bottom of the screen, you will be able to place an order while in Chart Review or Wrap Up—without having to navigate back.

The upgrade has many other features, including being able to bookmark documents or notes for easier reference. Another upgrade will be easily finding reports in the media tab any time by giving bookmarks a name such as "procedure note" or "path report." Using this new feature will allow you to easily find those documents next time you are in the patient’s chart.

See the other changes here.