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PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY February 2015 | Archived Issues

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Surgery Grand Rounds

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Grand Rounds

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Education Schedule

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Education Calendar - February 2015 (PDF)

Education Calendar - March 2015 (PDF)


Surgery Scheduling

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Cedars-Sinai Launches Inpatient Hospice Program

To help ensure that Cedars-Sinai patients who are experiencing acute symptoms at the end of life receive the best care possible, Cedars-Sinai has launched an inpatient hospice program, effective Feb. 10. The program is designed to provide comfort-oriented care in the hospital, after a patient enrolls in hospice, if they are having acute symptoms that cannot be managed adequately in a setting other than the hospital.

Cedars-Sinai has contracted with Seasons Hospice, a leading national hospice organization, to collaborate in the delivery of care for these vulnerable patients. Patients who are enrolled in inpatient hospice will be cohorted to beds on 4 Southeast whenever possible, with the option of being cared for in any bed throughout the hospital (including in an intensive care unit) using a "scatterbed" approach if no beds are available on 4SE.

The patient's care plan will be established and managed closely on a daily basis by an interdisciplinary team consisting of the patient's hospice attending MD of record, Cedars-Sinai clinical providers and other physicians who have been involved in the patient's care, as well as an experienced hospice team from Seasons.

"Our goal is to take a person-centered, family-oriented approach to caring for patients with advanced illness who are acutely symptomatic so that we can provide them with world-class care while honoring their wishes and expertly managing their symptoms," said Bradley T. Rosen, MD, medical director of the Office of Care Transitions and Complex Medical Management. "Patients who qualify for inpatient hospice will receive aggressive pain and symptom management, while their loved ones benefit from emotional, spiritual and psychological support by members of the hospice team.

"In addition, Medicare requires 13 months of bereavement support for the family and loved ones of patients who die on hospice," Rosen said. "This kind of support can make the difference between loved ones being able to work through the necessary grieving process versus suffering from debilitating, complex grief."

Inpatient hospice provides an additional layer of support for hospice patients and families who are experiencing acute symptoms associated with advanced illness, said Rishi Gupta, MD, medical director of the inpatient hospice program.

"The inpatient hospice team will work closely with the patient's physicians and nursing staff to ensure that care is personalized to achieve comfort in a manner that reflects each patient's values and goals," Gupta said.

If a patient's acute pain or symptoms are brought under control and the patient is clinically stable, the team will work with the patient and family to seamlessly transition the patient to another care setting out of the hospital, still with hospice care. The Seasons clinical nurse liaison and social worker will work closely with the Cedars-Sinai team to coordinate discharge planning, and the Seasons staff will continue to care for the patient and family after discharge.

To request an inpatient hospice evaluation, a physician or nurse practitioner can place an order in CS-Link™. If a physician would like assistance to assess whether a patient will qualify for inpatient hospice or to manage complex symptoms, the Supportive Care Medicine team is available to assist 24/7 via CS-Link order or at 310-423-9520.

For more information about the inpatient hospice program, please contact Gupta at rishi.gupta@cshs.org, cell/text 310-926-4930, or Rosen at rosenb@cshs.org, cell/text 310-948-7930.