sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY September 2013 | Archived Issues

OpTime and Anesthesia Will Go Live Nov. 9

The transition to the CS-Link™ OpTime and Anesthesia modules is just weeks away. In the early hours of Saturday, Nov. 9, Cedars-Sinai will move one step closer to achieving its vision of "one patient, one record" as it begins using these modules to deliver patient care.

» Read more

Get Your Flu Shot

Be sure to protect yourself and our patients from getting the flu this year. Cedars-Sinai is offering free flu shots for employees and members of the medical staff now through Dec. 30.


» Read more

Thoracic Surgery: a Focus on Education and Community Outreach

In keeping with the mission statement of Cedars-Sinai, the Division of Thoracic Surgery is committed to education and community outreach. The division has been at the forefront of thoracic surgery, with education and training of current and future surgeons being one of the major components of the mission of the division.

» Read more

Paper Documents Long-Term Outcomes of Minimally Invasive Spine Surgery

A paper published by four members of the Spine Center has received considerable national attention as the first to document long-term outcomes of minimally invasive surgery for spinal deformity.

» Read more

Annual Meeting of Medical Staff Is Oct. 21

The annual meeting of the medical staff is scheduled for Monday, Oct. 21, from 11:30 a.m.-1:30 p.m. in Harvey Morse Auditorium.

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P and T Committee Adds Augmentin ES to Formulary; FDA Warns About Arzerra and Rituxan

Pharmacy Focus

The Pharmacy and Therapeutics Committee added Augmentin ES  to the formulary, among other actions at its Aug. 5 meeting. Also, the U.S. Food and Drug Administration has added warnings about the anti-cancer drugs Arzerra (ofatumumab) and Rituxan (rituximab). And the FDA warned of an increased risk of death when intravenous Tygacil (tigecycline) is used.

» Read more

OpTime and Anesthesia Will Go Live Nov. 9

The transition to the CS-Link™ OpTime and Anesthesia modules is just weeks away. In the early hours of Saturday, Nov. 9, Cedars-Sinai will move one step closer to achieving its vision of "one patient, one record" as it begins using these modules to deliver patient care.

OpTime will replace all functionality of the current Surgery Information Systems application – scheduling, materials management, charge capture and intraoperative documentation in the perioperative and procedural areas.

Anesthesia will replace the paper anesthesia record and will include clinical documentation for all phases of anesthesia care, including device integration.

Enhancements Coming When OpTime and Anesthesia Go Live

  • Intraoperative and intraprocedure documentation, including anesthesia, will be in the CS-Link integrated patient record. One patient, one record.
  • Improved reporting – data fields consistent across all intraprocedure areas
  • 310 operative and procedure areas live with CS-Link
  • Scheduling in CS-Link – a single integrated system
  • PPTP/APEC workflow integration with preoperative process
  • Surgeon's schedule available with office schedule, providing quick access to the patient record
  • OR schedule accessible in CS-Link for quick access to the patient record
  • Communication to families in waiting rooms and to clinicians and staff in the preop, postop, intraoperative and procedural areas via large status board monitors

Go-Live Readiness Activities

How we prepare for this change is just as important as the transition itself. A number of "go-live ready" activities will help ensure we are fully prepared.

Training, Sept. 21-Oct. 10

  • End user training is underway and will continue up until go-live.
  • CS-Link playground available to practice new skills prior to go-live.

Anesthesia device validation, Oct. 14-25

  • Anesthesia device validation will take place in mid-October. This will allow anesthesiologists to observe incoming device integration patient data in CS-Link (as time permits during a case).
  • As part of the device validation process, the technical team will ensure that the touch screen computers are working properly in preparation for go-live.
  • Office hours will be available to surgeons and anesthesiologists, providing the opportunity to view new workflows and ask questions. Details, such as times and locations, will be forthcoming.

Appointment conversion, Oct. 26

  • Beginning in late October, all areas going live with the OpTime application will schedule procedures for Nov. 9 and forward using the OpTime scheduler. Starting this process two weeks in advance of go-live will provide a smooth transition to the new scheduling process.

If you have questions about the CS-Link OpTime/Anesthesia go-live, please contact Jan Decker, director of Perioperative Services, 310-423-5545, or Despina Hopkins, EIS Perioperative Service Line manager, 310-248-8604.

You can find more information by visiting the OpTime/Anesthesia page at CS-Link Central.

Get Your Flu Shot

Gail Grant, MD, MPH, gets a flu shot from Amanda Mongiello, RN.

Be sure to protect yourself and our patients from getting the flu this year. Cedars-Sinai is offering free flu shots for employees and members of the medical staff now through Dec. 30.

Please note the following dates, times and locations for upcoming clinics:

  • Sept. 30 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 1 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 1 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 2 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 2 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 3 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 3 – 8:30 a.m.-3:30 p.m., Pacific Theaters Room 400
  • Oct. 3 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in HMCC 3
  • Oct. 4 – 9 a.m.-2 p.m. on South Plaza Level Terrace, north side
  • Oct. 4 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 7 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 7 – 8:30 a.m.-3 p.m., 6420 Wilshire Blvd., fourth floor
  • Oct. 7 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 8 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 8 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 9 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 9 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 10 – 7:30 a.m.-11 a.m. and 11:45 a.m.-2:45 p.m. in Thalians West 135
  • Oct. 10 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3
  • Oct. 11 – 9 a.m.-2 p.m. on South Plaza Level Terrace, north side
  • Oct. 11 – 4 p.m.-7 p.m. and 7:45 p.m.-9:45 p.m. in AHSP PEC 3

For more information, or to schedule an appointment for a flu vaccination, please call Employee Health Services at ext. 3-3322.

Thoracic Surgery: a Focus on Education and Community Outreach

In keeping with the mission statement of Cedars-Sinai, the Division of Thoracic Surgery is committed to education and community outreach. The division has been at the forefront of thoracic surgery, with education and training of current and future surgeons being one of the major components of the mission of the division. Robert J. McKenna Jr., MD, Harmik J. Soukiasian, MD, and Heather Merry, MD, have published a combined two books and more than 400 articles and chapters.

Having developed minimally invasive surgery for lung cancer, they share their knowledge with 15 courses in video-assisted thoracoscopic surgery per year at Cedars-Sinai and trips to four or five countries per year to operate and lecture. Almost every day, McKenna and his team host visiting professors and surgeons from around the world to demonstrate leading-edge surgical techniques. Each year, several foreign surgeons do extended observational shadowing externships.

The commitment to education extends to residents and fellows in training as well. Soukiasian and McKenna created a general thoracic educational course for cardio-thoracic residents to supplement their training programs. This unique course offers didactic lectures relevant to current topics in thoracic surgery, hands-on surgical techniques tissue laboratory and observation of surgical procedures with leaders in thoracic surgery.

In additional to the Cedars-Sinai faculty, the faculty includes Daniel Miller, MD, chief of thoracic surgery at Emory University, and Scott Swanson, MD, chief of minimally invasive thoracic surgery at Harvard Brigham and Women's Hospital. The success and popularity with residents and fellows led to offering the course twice per year.

Community outreach is also quite important to the division of thoracic surgery. Our newest partner, Heather Merry, MD, is expanding the respiratory failure program through lectures on shortness of breath, emphysema and lung transplantation to both practicing physicians in the community and patients in pulmonary rehabilitation programs and better-breather clubs.

This year, we will host the 12th annual lung cancer survivors day, during which faculty from different specialties at Cedars-Sinai deliver educational lectures. Additionally, Soukiasian, Mark Pimentel, MD, director of GI Motility, and Christopher Chang, MD, PhD, also from the GI Motility service, established an educational seminar for patients and the community on reflux, Barrett's, irritable bowel syndrome and small bowel intestinal bacterial overgrowth.

McKenna and his team continue to develop and improve the thoracic division to maintain the division's world-renowned reputation as a leader in thoracic surgery.

Paper Documents Long-Term Outcomes of Minimally Invasive Spine Surgery

A paper published by four members of the Spine Center has received considerable national attention as the first to document long-term outcomes of minimally invasive surgery for spinal deformity.

"Long-term 2- to 5-Year Clinical and Functional Outcomes of Minimally Invasive Surgery for Adult Scoliosis" was published in the August issue of the journal Spine.

The authors are Neel Anand, MD, Mch Orth, Eli M. Baron, MD, Babak Khandehroo, MD, and Sheila Kahwaty, PA-C.

MIS Adult Scoliosis - Spine 2013 (PDF)

Annual Meeting of Medical Staff Is Oct. 21

The annual meeting of the medical staff is scheduled for Monday, Oct. 21, from 11:30 a.m.-1:30 p.m. in Harvey Morse Auditorium.

Agenda items include the chief of staff report, CEO report and executive update, the Chief of Staff Award, and the 2013 Pioneer in Medicine Award.

Annual Meeting of the Medical Staff - Oct. 21 (PDF)

P and T Committee Adds Augmentin ES to Formulary; FDA Warns About Arzerra and Rituxan

Pharmacy Focus

The Pharmacy and Therapeutics Committee added Augmentin ES  to the formulary, among other actions at its Aug. 5 meeting. The committee's actions are summarized in the PDF link below.

Also, the U.S. Food and Drug Administration has added warnings about the anti-cancer drugs Arzerra (ofatumumab) and Rituxan (rituximab). And the FDA warned of an increased risk of death when intravenous Tygacil (tigecycline) is used.

P and T Committee Approvals - Aug. 5, 2013 (PDF)

FDA Warns About Hepitatis B Reactivation With Arzerra and Rituxan

The U.S. Food and Drug Administration has approved changes to the prescribing information of the immune-suppressing and anti-cancer drugs Arzerra and Rituxan to add new boxed warning information about the risk of reactivation of hepatitis B virus (HBV) infection. The revised labels also will include additional recommendations for screening, monitoring and managing patients on these drugs to decrease this risk.

In patients with prior HBV infection, HBV reactivation may occur when the body’s immune system is impaired. HBV reactivation has occurred in patients with prior HBV exposure who are later treated with drugs classified as CD20-directed cytolytic antibodies, including Arzerra and Rituxan. Some cases have resulted in fulminant hepatitis, hepatic failure and death.

Arzerra is used to treat chronic lymphocytic leukemia (CLL). Rituxan is used to treat non-Hodgkin’s lymphoma and CLL. It is also used to treat other medical conditions, including rheumatoid arthritis, granulomatosis with polyangiitis, and microscopic polyangiitis.

To decrease the risk of HBV reactivation, FDA recommends that healthcare professionals:

  • Screen all patients for HBV infection before starting treatment with Arzerra or Rituxan by measuring hepatitis B surface antigen and hepatitis B core antibody.
  • Consult with hepatitis experts regarding monitoring and use of HBV antiviral therapy when screening identifies patients at risk of HBV reactivation.
  • Monitor patients with evidence of prior HBV infection for signs of hepatitis B or HBV reactivation during Arzerra or Rituxan therapy and for several months thereafter, since reactivations have occurred several months following completion of therapy with these drugs.
  • In patients who develop reactivation of HBV while on Arzerra or Rituxan, immediately discontinue the drug and start appropriate treatment for HBV. Discontinue any chemotherapy the patient is receiving until the HBV infection is controlled or resolved.

Click here for more information.

Warning About Arzerra and Rituxan - Sept. 24, 2013 (PDF)

FDA Warns of Increased Risk of Death with Intravenous Tygacil

The FDA has approved a new boxed warning describing an increased risk of death when intravenous Tygacil is used for FDA-approved uses as well as for nonapproved uses. These changes to the Tygacil prescribing information are based on an additional analysis that was conducted after the agency warned about this safety concern in 2010.

This analysis showed a higher risk of death among patients receiving Tygacil compared to other antibacterial drugs: 2.5 percent (66/2640) vs. 1.8 percent (48/2628). In general, the deaths resulted from worsening infections, complications of infection or other underlying medical conditions.

Tygacil is FDA-approved to treat complicated skin and skin structure infections, complicated intra-abdominal infections and community-acquired bacterial pneumonia.

The FDA recommends that healt care professionals reserve Tygacil for use in situations when alternative treatments are not suitable.

Click here for more information.