sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY December 2014 | Archived Issues

P and T Approvals, FDA Warnings

Pharmacy Focus

See highlights of the Oct. 7 meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued warnings about lenalidomide, duloxetine hydrochloride, alglucosidase alfa and methoxy polyethylene glycol-epoetin beta.


Mark Your Calendar


Grand Rounds

Click here to view a schedule of all upcoming grand rounds.


Educational Schedule

Click the PDF link below to see the Department of Surgery's educational schedule.

Educational Schedule - December 2014 (PDF)


Surgery Scheduling

Click the "read more" for hours and contact information for surgery scheduling.

Share Your News

Know an interesting colleague we should profile? A story we should tell? Submit your ideas, meetings and events for consideration.

Click here to submit your news to Sutures

Physician Advocates Serve as Attendings' Eyes, Ears

Bill Stanford, MD, (left) and Chase Coffey, MD, are among Cedars-Sinai's five physician advocates.

With a role in patient care so new it is literally being defined at Cedars-Sinai, Bill Stanford, MD — a physician advocate — spends a fair amount of time explaining what he does.

That's fine with him. As medical director of the Physician Advocate Program, Stanford welcomes the opportunity to discuss how physician advocates are making a difference in quality, efficiency and patient satisfaction.

"Physician advocates act as the eyes and ears for medical staff attendings during daily multidisciplinary progression of care rounds," said Stanford, whose specialty is hospital medicine. "Cedars-Sinai is a pioneer of this strategy, and the response from attendings has been overwhelmingly positive."

The program, launched in February as part of a broader effort to deliver high-value healthcare, was developed by Scott Weingarten, MD, MPH, senior vice president and chief clinical transformation officer, in conjunction with the High Value Care Committee led by Zab Mosenifar, MD, and Harry Sax, MD.

Preliminary results of the program are encouraging, according to the Cedars-Sinai Department of Resource and Outcomes Management. Current data show that the average length of stay and the length of stay index are significantly lower in units where physician advocates participate in multidisciplinary rounds. For example, the average length of stay on med/surg units with the advocates is 4.37 days, compared to 6.19 days on med/surg units without them.

In addition, the length-of-stay improvements have resulted with no statistically significant increase in the readmission rate.

The program is expanding and now has five physician advocates. In addition to Stanford, who assists attending physicians on 5 Southeast and 5 Southwest, are:

  • Harry Sax, MD, professor and vice chair of Surgery and a physician advocate on 7 Northeast and 7 Northwest
  • Chase Coffey, MD, a hospitalist and advocate on 5 Northeast and 5 Northwest who is working to improve efficiency in Cedars-Sinai intensive care units
  • Nattapaun Thepyasuwan, MD, a hospitalist and advocate on 6 Southwest
  • Henry Horton, MD, a hospitalist and advocate on 7 Southeast.

"We are so fortunate to have these true advocates to facilitate the rapidly changing inpatient care of our patients, especially when we may be busy in the office several miles away, or in the operating room," said Chief of Staff Chris Ng, MD.

The program initially has focused on identifying gaps in care coordination throughout the medical center and improving communication between the healthcare team and attending physicians.

"It's the only program I know of that uses this model of multidisciplinary care that includes an experienced hospitalist to assist private attendings in a pluralistic hospital model," Stanford said.

Stanford noted that physician advocates become familiar with cases prior to multidisciplinary rounds and often spot clinical issues or potential delays in treatment before they would normally come to the attention of attending physicians. Nurses, social workers, case managers, pharmacists and clinical documentation integrity specialists have proven to be the "difference makers" in using the expertise of the advocates to improve care, he said.

"The types of things we discuss and the clinical orientation of these enhanced progression of care rounds empower them to proceed with superior knowledge of what needs to be done," Stanford said.

Among the next steps for the Physician Advocate Program is looking for ways to improve the quality and safety of discharges with the goal of reducing readmissions. For more information, contact Weingarten at scott.weingarten@cshs.org or Stanford at william.stanford@cshs.org.