Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF May 3, 2019 | Archived Issues

Cedars-Sinai Leadership Series: Hospital Flow

Watch the second video in a new series featuring executive leaders talking about the institution's most important goals and initiatives. This week, Jeff Smith, MD, JD, MMM, talks about hospital flow. Smith is executive vice president of Hospital Operations and chief operating officer of Cedars-Sinai Medical Center.

» Read more

Update on Measles Outbreak

An outbreak of at least five measles cases has been identified in Los Angeles County, involving predominantly unvaccinated adults. As measles is highly contagious, healthcare providers must remain vigilant in recognizing additional measles cases. If you have questions, contact Hospital Epidemiology at 310-423-5574.


» Read more

Albert Named Founding Chair of New Department

Christine M. Albert, MD, MPH, has been appointed the founding chair of the new Department of Cardiology in the Smidt Heart Institute. A pioneer and leading expert in the field of epidemiology of heart rhythm disorder, Albert will have responsibility for leading the strategic direction of clinical, operational, academic and research programs of the newly established department. Albert joins Cedars-Sinai from Boston's Brigham and Women's Hospital, where she directs the Center for Arrhythmia Prevention and is a professor of Medicine at Harvard Medical School. She will join Cedars-Sinai on Sept. 3.

» Read more

Sicotte, MD, Named Chair of Department of Neurology

Nancy L. Sicotte, MD, has been appointed chair of the Department of Neurology. This important leadership appointment reflects Sicotte's valued contributions to Cedars-Sinai's growing neuroscience enterprise and her distinguished record for advancing clinical care, physician education and pioneering research of novel therapies for multiple sclerosis. She will be named the Women's Guild Distinguished Chair in Neurology and maintain her roles as director of the Multiple Sclerosis Program and professor of Neurology. She will assume her new position May 15.

» Read more

Physician Wellness Tip: Managing Stress

In response to excellent feedback to the recent Physician Wellness survey, we are launching a new regular feature for Pulse where a tip, video, story or discount will be highlighted to support physician wellness. This week's tip is how to manage stress.

» Read more

Warsaw Ghetto Founded a Medical School

As death closed in on the Jews of the Warsaw Ghetto during World War II, some of those coping amid the wretched conditions affirmed life in an extraordinary way: They operated a clandestine medical school. Leo A. Gordon, MD, a surgeon on the Cedars-Sinai staff for 40 years, gave a lecture about the "Impossible Medical School" at an event organized by the Cedars-Sinai Alumni Association earlier this month.

» Read more

Couple Shares Journey Through Kidney Transplant

A couple shared their journey through a kidney transplant during a National Donate Life Month event held recently by the Comprehensive Transplant Center with Los Angeles-based OneLegacy, which describes itself as the largest organ, eye and tissue recovery organization in the world. More than 113,000 Americans were on the national transplant waiting list as of January. Every day about 20 people in the U.S. die while waiting for a transplant.

» Read more

New Assays Coming to MPO and PR3

The Special Testing and Core Laboratory divisions within the Department of Pathology and Laboratory Medicine will soon be implementing new assays for MPO and PR3. The changes take effect on Monday, May 27.

» Read more

Summer Is Coming, and So Are Fireworks

Celebrate Independence Day at the Hollywood Bowl with fireworks and music by the Hollywood Bowl Orchestra and special musical guests Nile Rodgers and CHIC. The event on Wednesday, July 3, is open to Cedars-Sinai physicians and their immediate family members. Cost is $145 per adult and $75 per child, 3-11 years of age.

» Read more

Ramadan Celebration Features Break-Fast Meal

Cedars-Sinai will mark the Islamic holy month of Ramadan with its annual iftar, a traditional meal to mark the breaking of the fast. The iftar will be held Wednesday, May 15, at 7:30 p.m. The meal is free, but those who wish to attend must RSVP to janelle.beatty@cshs.org.

» Read more

Medical Library Offers Classes to Learn New Skills

The Cedars-Sinai Medical Library is offering a variety of classes in May. Classes are now being offered at 8 a.m. and 1 p.m. in the Medical Library—Plaza Level, South Tower, Room 2815.

» Read more

CS-Link Tip: Upgrade Success

CS-Link™ was upgraded Sunday, April 28. One of the changes you may not know is that you no longer need to search for the paper telemetry folders on the floors. You can take a look at the upgrades here.

» Read more

Cedars-Sinai Leadership Series: Hospital Flow

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Watch the second video in a new series featuring executive leaders talking about the institution's most important goals and initiatives.

This week, Jeff Smith, MD, JD, MMM, talks about hospital flow. Smith is executive vice president of Hospital Operations and chief operating officer of Cedars-Sinai Medical Center.


Update on Measles Outbreak

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An outbreak of at least five measles cases has been identified in Los Angeles County, involving predominantly unvaccinated adults. As measles is highly contagious, healthcare providers must remain vigilant in recognizing additional measles cases.

Key Messages

Measles is a highly contagious viral infection spread through the air. Consider measles in any patient presenting with an acute febrile rash illness.

Testing for measles is performed through the Health Department as a send-out test.

Vaccination is very effective; two doses of the MMR vaccine is 97% effective at preventing infection, and immunity is lifelong.

If you suspect measles:

  • IMMEDIATELY isolate the patients from others; suspect measles patients should avoid common areas, such as waiting rooms. Inpatients should be placed in negative-pressure airborne isolation.
  • IMMEDIATELY report any suspected measles case to the Health Department (do not wait for confirmation). For ED and inpatients, immediately notify Hospital Epidemiology (available 24/7 via 310-423-5574), who will assist with Health Department reporting.

Additional Clinical Information

Measles symptoms typically begin with fever, and usually include cough, coryza (runny nose) and/or conjunctivitis. This is followed by a rash, typically beginning on the head and spreads downward. Measles is highly infectious through the air and can still infect others up to two hours after the infected person has left a room. Persons with measles are contagious from four days before until four days after the rash appears. Nearly everyone who is not immune to measles will acquire it if they are exposed to someone with measles. The incubation period for developing measles is up to 21 days after exposure. Key risk factors for acquiring measles include recent international travel, recent exposure to someone with measles and lack of immunity.

For more information see the websites of:

Los Angeles County Health Department
Centers for Disease Control and Prevention

If you have questions, contact Hospital Epidemiology at 310-423-5574.

- Jonathan Grein, MD
Director, Hospital Epidemiology

Albert Named Founding Chair of New Department

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Christine M. Albert, MD

After a comprehensive national search, we are delighted to announce the appointment of Christine M. Albert, MD, MPH, as the founding chair of the new Department of Cardiology in the Smidt Heart Institute.

Albert’s selection reflects her major standing as a national cardiology leader with seminal clinical and scholarly contributions to our understanding of heart rhythm disorders. Albert is a highly respected cardiovascular and preventive medicine specialist with more than 150 peer-reviewed articles published in The New England Journal of Medicine, Journal of the American Medical Association, Nature Genetics and other top-tier scientific journals.

Albert serves on specialty editorial boards and is the principal investigator on two ongoing R01 research grants funded by the National Institutes of Health. She is the vice president of the Heart Rhythm Society and will be its president in 2020. This global and highly influential post is a testament to Albert’s reputation and recognition as a respected leader within her field.

At Cedars-Sinai, Albert will have responsibility for leading the strategic direction of clinical, operational, academic and research programs of the new Department of Cardiology. The department will be further propelled under her leadership, advancing the strong foundational legacy of cardiology at Cedars-Sinai. The Department of Cardiology aligns with the new Department of Cardiac Surgery under the umbrella of the Smidt Heart Institute, which encompasses all Cedars-Sinai heart care, research and education through the leadership of Eduardo Marbán, MD, PhD.

A Massachusetts native, Albert joins Cedars-Sinai from Boston’s Brigham and Women’s Hospital, where she directs the Center for Arrhythmia Prevention and is a professor of Medicine at Harvard Medical School. She earned her medical degree and masters of public health at Harvard. She also completed her clinical fellowships in cardiology and cardiac electrophysiology at Massachusetts General Hospital and a research fellowship in epidemiology at Brigham and Women’s Hospital, both in Boston. She is board-certified in cardiovascular disease and cardiac electrophysiology.

Albert is a pioneer and leading expert in the field of epidemiology of heart rhythm disorders. She is best known for making major contributions to our understanding of how diet and lifestyle affect heart rhythm disorders, including atrial fibrillation and sudden cardiac death. She conducted some of the seminal studies that examined the role of omega-3 fatty acids in preventing and predicting sudden cardiac death in healthy populations, and is leading a 5,800-patient, multicenter clinical study that aims to identify those at increased risk for sudden cardiac death by employing combinations of clinical, lifestyle, biomarker, genetic and imaging data.

We thank Ravi Thadhani, MD, MPH, for leading the successful national search and also extend special thanks to Robert J. Siegel, MD, who served as the interim chair of the Cardiology Division during the past year. Albert will assume her new position on Sept. 3. Please join us in warmly welcoming her to Cedars-Sinai.

- Shlomo Melmed, MB, ChB
Executive Vice President, Academic Affairs, and Dean of the Medical Faculty

- Jeff Smith, MD, JD, MMM
Executive Vice President, Hospital Operations, and Chief Operating Officer, Cedars-Sinai Medical Center

- Eduardo Marbán, MD, PhD
Director, Smidt Heart Institute

Sicotte, MD, Named Chair of Department of Neurology

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Nancy L. Sicotte, MD

After a comprehensive national search, we are delighted to announce the appointment of Nancy L. Sicotte, MD, as Chair of the Department of Neurology. This important leadership appointment reflects Sicotte's valued contributions to Cedars-Sinai's growing neuroscience enterprise and her distinguished record for advancing clinical care, physician education and pioneering research of novel therapies for multiple sclerosis.

Sicotte will be named the Women's Guild Distinguished Chair in Neurology and maintain her roles as director of the Multiple Sclerosis Program and professor of Neurology.

Sicotte is an internationally recognized leader in her field and a prolific author and lecturer, having presented at dozens of conferences and seminars in the U.S. and abroad. The recipient of important honors and teaching awards, her research has focused on developing informative imaging outcome measures of novel therapies as well as measures of disease progression, depression and cognitive dysfunction in multiple sclerosis. She is board-certified by the American Board of Psychiatry and Neurology and is a fellow of the American Academy of Neurology.

Sicotte has been instrumental in establishing important education programs for residents and fellows at Cedars-Sinai. She was founding director of the Neurology Residency Program and the Neuroimmunology Fellowship Program as well as founding site director of the Medical Student Neurology Clerkship.

In her role as chair, Sicotte will lead strategic direction of clinical, operational, academic and research programs in the Department of Neurology. She will focus on attracting, mentoring and promoting translational and clinical neuroscientists while supporting excellence in education, research and patient care. She will lead the delivery of high-quality patient care within the Department of Neurology and work collaboratively with other departments and service lines to integrate and coordinate services across Cedars-Sinai.

Sicotte earned her medical degree from the University of California, Irvine, School of Medicine, where she was ranked first in her class. She completed her neurology residency and a fellowship in neuroimaging at UCLA's David Geffen School of Medicine. She recently joined the National Medical Advisory Board of the National Multiple Sclerosis Society and has been a volunteer physician at the Venice Family Clinic for two decades.

We thank Paul W. Noble, MD, chair of the Department of Medicine and director of the Women's Guild Lung Institute, for leading the successful search. Sicotte will assume her new position on May 15. Please join us in congratulating her on this exciting achievement.

- Shlomo Melmed, MB, ChB
Executive Vice President, Academic Affairs, and Dean of the Medical Faculty

- Jeff Smith, MD, JD, MMM
Executive Vice President, Hospital Operations, and Chief Operating Officer, Cedars-Sinai Medical Center

Physician Wellness Tip: Managing Stress

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Stress is a part of modern life. While we can’t always avoid it, we can figure out how to cope more effectively.

This two-minute video offers some good suggestions, including tending to the basics—getting enough sleep, eating well and being active.

The next time you’re feeling stressed, consider prescribing yourself some quality time with someone special. To help promote social wellbeing, Cedars-Sinai has partnered with an activities platform that gives discounted prices for amusement parks, sporting events, movie tickets and other things. Start connecting here.

Warsaw Ghetto Founded a Medical School

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Poland held special ceremonies in 2018 to commemorate the 75th anniversary of the uprising in the Warsaw Ghetto. (Photo by Getty Images)

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Leo A. Gordon, MD

As death closed in on the Jews of the Warsaw Ghetto during World War II, some of those coping amid the wretched conditions affirmed life in an extraordinary way: They operated a clandestine medical school.

By one estimate, as many as 500 students received some medical education through the school while it operated for 15 months from 1941-1942. Only a small number, at most a dozen, survived the massive deportations to death camps that began in July 1942, the destruction of the ghetto in May 1943 and the rest of the Holocaust.

Yet for Leo A. Gordon, MD, a surgeon on the Cedars-Sinai staff for 40 years, the short-lived secret school endures as a source of inspiration.

"It is a story of hope pitted against hopelessness. It's a story of courage pitted against carnage. It's a story of defiance pitted against domination, but most of all, it is a story of the essence of education pitted against the essence of attempted cultural annihilation," Gordon told an April 8 gathering organized by the Cedars-Sinai Alumni Association.

The secret school never had an actual name. But in his presentation, a synthesis of various historical accounts, Gordon called it "The Impossible Medical School."

For Gordon, the medical school story was an apt way to recognize Yom Ha'Shoah—also known as Holocaust Remembrance Day—and to reflect on the 20th anniversary of the dedication of the "Jewish Contributions to Medicine" mural in Harvey Morse Auditorium. That anniversary and this year's "Yom Ha'Shoah Holocaust Memorial Day Program" at Cedars-Sinai both are May 2. The Yom Ha'Shoah program will include music, prayers of mourning and a talk by author Rick Richman titled, "History, Alternative History and The Holocaust: The 1940 Campaign for a Jewish Army to Fight Hitler."

Gordon has been captivated by the story of the medical school since learning about it while serving on the Cedars-Sinai committee that grappled with how the mural should represent the Holocaust. The group ultimately decided to show a heroic Polish Jewish doctor, Janusz Korczak, who refused to abandon the 200 children in a Warsaw Ghetto orphanage. Korczak wound up being taken to Treblinka and murdered, along with the orphans.

While doing research on Korczak, Gordon said he came across "just half a sentence, just a snippet" about the clandestine medical school. "And, for some reason, it just stuck with me."

The school was an exception to the general clampdown by the Nazis on education in the Warsaw Ghetto. The Nazi authorities—apparently motivated by a fear that Jews were especially vulnerable to typhus—approved instruction intended for sanitation workers, who would be taught to fight typhus by burning clothing and cleaning rooms with disinfectants. Using that low-level technical program as a cover, doctors operating the school developed a full-fledged program to train future physicians. But to fool anyone who might be spying on them, they would do things such as leaving behind disinfectants and public health leaflets after class. "It was brilliant," Gordon said.

Gordon cited a seminal paper about the school by a Canadian medical historian, the late Charles G. Roland, MD, that described deplorable conditions in the ghetto hospitals. Roland noted that students sometimes were raped or beaten while walking to classes.

One student who survived and went on to practice medicine in the United States remembered that, "We would have one day a lecture at one o'clock and the teacher wouldn't show up. A few days later we would find out that he was killed."

Yet in his 1989 paper, nearly a half-century after the school operated, Roland found that some of the smattering of students who survived the Holocaust were still practicing medicine.

The physicians who ran the school and their students persisted by clinging to the hope that the persecution they were enduring was no worse than what previous generations of European Jews had survived. "Some people in the ghetto knew that, for hundreds of years before this event, there were cyclical pogroms in Europe," Gordon said. "They all ended eventually. Many said, 'This is just another pogrom. It's tough. We're going to get through it.'"

What's more, Gordon said, there were plenty of motivated students because, idled by the repression in the ghetto, they "had nothing to do," and they were "searching for some intellectual activity" while trying to avoid sinking into complete despair. The ghetto also was well-stocked with qualified medical school faculty "because the Jewish professors of medicine had been kicked out of the universities and relocated to the ghetto. So, within the ghetto, you would have the chief of pediatrics from this hospital, the chief of surgery from that medical school."

Couple Shares Journey Through Kidney Transplant

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Hermine and Mark Rule celebrate at the Comprehensive Transplant Center's annual gathering to mark Donate Life Month.

After Hermine Honarvar Rule was told that she was in critical need of a kidney transplant, two relatives and a friend each volunteered to give up a kidney to help save her.

But Rule, 50, a state administrative law judge from Huntington Beach, soon learned that none of those generous offers would be the solution to her struggle with kidney disease. During medical screening, all three of the donor candidates were discovered to have health issues that would disqualify them from going ahead.

Thankfully, Rule could turn to one more person—her husband, Mark, 58, a trucking industry consultant. He already had decided to donate a kidney to secure a higher priority for Hermine on the organ donation waiting list. To his surprise, it turned out that his kidney was the right match for his wife. "We were truly made for each other," he jokes today.

They headed off together to Cedars-Sinai last September for their surgeries, and the outcome was a success for both. Mark, a one-time marathoner, resumed running and working out after six or seven weeks, and Hermine was back at work within three months after receiving the kidney.

"Honestly, if it wasn't for for the 17 or 18 pills a day that I take, and my scar, it would be very easy to imagine that it never happened," Hermine said, before quickly emphasizing that not all transplant patients are as fortunate or receive the same quality of care that she has gotten.

The need for more organ and tissue donors was highlighted at a National Donate Life Month event recently held at the Comprehensive Transplant Center with Los Angeles-based OneLegacy, which describes itself as the largest organ, eye and tissue recovery organization in the world. It featured the Rules and others whose lives were dramatically touched by organ transplants, including a liver recipient who said, "I got a second chance at life."

Hearing that never gets old for Andrew Klein, MD, MBA, director of the Comprehensive Transplant Center and the Esther and Mark Shulman Chair of Surgery and Transplant Medicine. "The rejuvenation provided by a lifesaving organ transplant is truly remarkable," Klein said. "As a member of the transplant team, it is a gift to observe a transplant recipient's metamorphosis from sick and debilitated to healthy and full of life."

Tsuyoshi Todo, MD, a liver and kidney transplant surgeon, tried to ease apprehension among potential living donors about the risks. "Only the healthiest people can become donors," Dr. Todo explained. "The risk of donation and renal failure or end-stage renal disease is negligible for a donor compared to the general population."

The number of organ transplants nationally has climbed in recent years, yet more than 113,000 Americans remained on the national transplant waiting list as of January. Every day about 20 people in the U.S. die while waiting for a transplant.

According to preliminary federal statistics, 36,528 organ transplants were performed in the U.S. last year, up 5 percent from 2017 and marking the sixth straight year with a record-setting total. In 2018, Cedars-Sinai physicians completed 214 kidney, 122 heart, 112 liver, 21 lung, two kidney-pancreas and one pancreas transplants.

Nationally, transplants from living donors showed an especially sharp gain in 2018, accounting for 6,849, or 19 percent, of the total, and Todo said they represent the best potential source for new organ donations. One of the reasons that living donors are crucial: Only about 3 in 1,000 people die in a way that allows their organs to be donated.

Yet living donors are not covered by the federal Family and Medical Leave Act, and they can face discrimination when they try to buy life, disability or long-term care insurance. Todo, working with the American Society of Transplant Surgeons, will visit Washington in May to lobby lawmakers to support a proposal, the Living Donor Protection Act, that is intended to prohibit such discrimination.

"We can help more people," Todo said.

For their part, the Rules have become advocates, too. Two weeks before they were to head to Cedars-Sinai for their surgeries, they were stunned to suddenly learn that a kidney could be made available from a pedestrian who was taken off life support after being struck by a car. Still, the outlook for Hermine wasn’t quite as good as it was with Mark's kidney, and Mark said he liked the idea of two people benefiting—both Hermine and someone else who could get the pedestrian's kidney.

"I was healthy and able to, so I figured let's keep going," he said. "If you can give the gift, do it!"

New Assays Coming to MPO and PR3

The Special Testing and Core Laboratory Divisions within the Department of Pathology and Laboratory Medicine will soon be implementing new assays for MPO and PR3. The changes take effect on Monday, May 27.

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For more information on the new assays, contact melissa.cervania@cshs.org or call 310-423-5571.

Summer Is Coming, and So Are Fireworks

 

The Hollywood Bowl

Celebrate Independence Day at the Hollywood Bowl with fireworks and music by the Hollywood Bowl Orchestra and special musical guests Nile Rodgers and CHIC. The event on Wednesday, July 3, is open to Cedars-Sinai physicians and their immediate family members. Cost is $145 per adult and $75 per child, 3-11 years of age.

Parking passes also are available.

To reserve a place, contact Cheryl Verne at 310-423-2681 or cheryl.verne@cshs.org.

Ramadan Celebration Features Break-Fast Meal

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Cedars-Sinai will mark the Islamic holy month of Ramadan with its annual iftar, a traditional meal to mark the breaking of the fast.

Ramadan, observed by Muslims through nightly prayers, charity and spiritual reflection, and by abstaining from food, water and intimacy from dawn to sundown, begins on Sunday, May 5, and concludes with the celebration of Eid ul-Fitr on Tuesday, June 4.

The iftar will be held Wednesday, May 15, at 7:30 p.m. Halal and kosher food will be available. The meal is free, but those who wish to attend must RSVP, at which time the location will be provided.

Iftar is open to the community. Sweet dates (traditional for the breaking of one's fast) will be available in the chapel and the Ray Charles Cafeteria, and for patients upon request throughout the holiday. The chapel is open 24 hours a day for prayer, and every Friday there is a communal Jumu’ah prayer at 1:15 p.m.

To reserve a place and learn the location of the iftar, email janelle.beatty@cshs.org.

Medical Library Offers Classes to Learn New Skills

The Cedars-Sinai Medical Library is offering new classes in May.

Classes are now being offered at 8 a.m. and 1 p.m. Each 30-minute class is in the Medical Library—Plaza Level, South Tower, Room 2815.

PubMed

Learn to create search strategies and search the medical literature. Learn medical subject heading terms and field codes to get a more sensitive search. Create alerts to keep up with the latest research. The class will meet Tuesday, May 7, at 8 a.m. and 1 p.m.

EndNoteX9 for PC

Learn how to use this citation manager to organize your search results for manuscripts and grants. The class will meet Tuesday, May 21, at 8 a.m. and 1 p.m.

Evidence-Based Resources 

Learn how to search for evidence-based research and discover which databases are best to use. The class will meet Tuesday, May 28, at 8 a.m. and 1 p.m.

Classes also are available by appointment. Call Caroline Marshall at ext. 3-2315 or RSVP to caroline.marshall@cshs.org.

CS-Link Tip: Upgrade Success

CS-Link™ was upgraded Sunday, April 28. One of the changes you may not know is that you no longer need to search for the paper telemetry folders on the floors. There is a new button in the cardiology tab of chart review, and also in On-Base. This allows you to review your patient's telemetry strips anywhere. For a closer look at the upgrades, see the CS-Link web page.

To learn more, attend a CS-Link Efficiency and Review for Physician meeting on the second Thursday of each month. The classes, which begin at 7:30 a.m., are held in PEC 4.

If you have questions, contact groupeisphysicians@cshs.org.