sutures newsletter

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

P & T Approvals, FDA Warnings About DPP-4 Inhibitors, Canagliflozin

Pharmacy Focus

See highlights of the August meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued a warning about DPP-4 inhibitors and joint pain and has strengthened its warning about fracture risk with canagliflozin.

» Read more


Mark Your Calendar


Surgery Grand Rounds

Click the "read more" to see information about upcoming Surgery Grand Rounds.

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Grand Rounds

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


Education Schedule

Click the PDF links below to see the Department of Surgery's education schedule.

Education Schedule - September 2015 (PDF)

Education Schedule - October 2015 (PDF)


Surgery Scheduling

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

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Gewertz Discusses Adaptation to New Realities

Bruce Gewertz, MD, surgeon-in-chief and chair of the Department of Surgery, kicked off the current series of Surgery Grand Rounds discussions on Sept. 9 with a talk about "The New Realities in Healthcare: How the Surgery Department Is Adapting for Continued Success."

» See a video of the talk

Cardiothoracic Surgery Sees Encouraging Growth

By Alfredo Trento, MD

The Division of Cardiothoracic Surgery has grown significantly over the past several years. We perform a complete range of surgical interventions and have recently achieved a new high of 1,479 adult cases for fiscal year 2014-15.
 

» Read more

Human Caring: Our Patients' Experience

In a letter to Cedars-Sinai, a grateful patient expressed appreciation for the care they received at the medical center. The patient singled out Willis H. Wagner, MD, and his operating room colleagues and staff.

» Read more

Mending Kids International Honors Kulber

David A. Kulber, MD, will be among the honorees at the 10th anniversary celebration of Mending Kids International, which provides surgical care to children worldwide. Kulber will receive the Mend Award at the anniversary gala, which will take place Saturday, Nov. 21, at Union Station.

 

» Read more

Switch to ICD-10 Takes Effect Oct. 1

At the end of this month, the transition will be complete — the medical coding system ICD-10 will be implemented Thursday, Oct. 1. The ICD-10 project team plans to staff a command center in the days after the transition to ensure that any issues that may arise can be addressed quickly.

» Read more

Cedars-Sinai Acquires Marina Del Rey Hospital

Cedars-Sinai has purchased the 145-bed Marina Del Rey Hospital and its neighboring medical office building. The acquisition was announced Sept. 1.

» Read more

Jack Matloff, MD, Leader in Cardiothoracic Surgery

Jack Matloff, MD, the founding chair and chair emeritus of the Cedars-Sinai Division of Cardiothoracic Surgery, died at Cedars-Sinai on Aug. 20. He was 82. Matloff was a respected teacher, pioneer and visionary in medicine and in health policy.

 

» Read more

UpToDate Anywhere Available to Medical Staff

Cedars-Sinai has upgraded its UpToDate subscription to UpToDate Anywhere. Within CS-Link™ or through the UpToDate website, medical staff members can take advantage of several enhancements.

» Read more

Healing Gardens Will Bloom on Plaza

A new campus beautification project will soon transform the outdoor Cedars-Sinai Plaza Level into lush gardens of refuge. Construction of four Healing Gardens — complete with water features, seating, special lighting and more — began Sept. 8 on the terraces around the medical center's North and South towers.

» Read more and see a video

Circle of Friends Honorees for August

The Circle of Friends program honored 72 people in August. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai.

» Read more

Gewertz Discusses Adaptation to New Realities

Bruce Gewertz, MD, surgeon-in-chief and chair of the Department of Surgery, kicked off the current series of Surgery Grand Rounds discussions on Sept. 9 with a talk about "The New Realities in Healthcare: How the Surgery Department Is Adapting for Continued Success."

Click the image below to see a video of Gewertz's talk.

Cardiothoracic Surgery Sees Encouraging Growth

By Alfredo Trento, MD
Professor of Surgery
Estelle, Abe and Marjorie Sanders Chair in Cardiac Surgery
Director, Cardiothoracic Surgery
Cedars-Sinai Heart Institute

The Division of Cardiothoracic Surgery has grown significantly over the past several years. We perform a complete range of surgical interventions and have recently achieved a new high of 1,479 adult cases for fiscal year 2014-15.

Cedars-Sinai is nationally and internationally recognized as a primary CT surgery robotic program center. Robotic-assisted mitral valve repair cases are growing on an annual basis, with mitral repair procedures performed since 2005 approaching 550 cases.

The Heart Transplant Program is the largest in the world with a world record number of heart transplants per year for the past three years (95 in 2012, 119 in 2013, 122 in 2014 and 94 this year as of Aug. 31).

The Mechanical Circulatory Support (MCS) Program has also grown substantially over the past year. Francisco Arabia, MD, introduced the Total Artificial Heart (TAH) as a new MCS device, making Cedars-Sinai the largest implanting center in the nation. Currently there are two TAH clinical trials:

  • SynCardia 50cc TAH used as a bridge to transplant in smaller patients who are waiting for a suitable donor heart
  • SynCardia 70cc TAH implanted for destination therapy in those not eligible for a heart transplant

The SynCardia Total Artificial Heart has been introduced as a mechanical circulatory support device.

The Extracorporeal Membrane Oxygenation Program (ECMO) Program, directed by Danny Ramzy, MD, has increased to a new high of 77 implants in fiscal year 2014-15. We consistently have two to three patients on ECMO per week.

The Aortic Program also has grown under the direction of Ali Khoynezhad, MD. The complexity and spectrum of aortic pathologies treated has increased substantially, making Cedars-Sinai's program the largest on the West Coast.

We maintain the distinction of having the largest implanting program for transcatheter aortic valve replacements in the nation. Wen Cheng, MD, is the cardiothoracic surgeon who implants the devices in collaboration with interventional cardiologist Raj Makkar, MD.

I continue to work closely with Saibal Kar, MD, to implant the MitraClip device under the COAPT study, for which I am the surgical co-investigator.

In collaboration with Kar and Makkar, we will begin a transcatheter mitral valve replacement program in the near future.

Overall, the growth of the Division of Cardiothoracic Surgery has given Cedars-Sinai national and international distinction. I move forward with confidence and optimism in the coming year.

Human Caring: Our Patients' Experience

Below is a letter from a grateful patient, reprinted from Since You Asked, the newsletter produced by Human Resources and Organization Development.

Kudos to 8 Preop, 8PACU, 6NW, 6 Preop, 6OR, 5N-SICU and 6NW, With Special Kudos to Willis H. Wagner, MD

Words cannot begin to express my heartfelt thanks for the wonderful care I received while at Cedars-Sinai. After living in a number of cities across the United States during my lifetime, and having had a few surgeries as well as giving birth to four wonderful children, the care I received at the other hospitals pales in comparison to the high quality of care given to me at Cedars-Sinai.

For this, I will be forever thankful. If it wasn't for surgery performed so well by Dr. Willis Wagner, his O.R. colleagues and staff, I wouldn't be alive today writing this note of appreciation. I know firsthand why Cedars-Sinai is known as the premier hospital in California as well as this great country we live in!

Mending Kids International Honors Kulber

David A. Kulber, MD, will be among the honorees at the 10th anniversary celebration of Mending Kids International, which provides surgical care to children worldwide.

Kulber will receive the Mend Award at the anniversary gala, which will take place Saturday, Nov. 21, at Union Station.

Kulber is clinical chief of the Department of Surgery, director of the Center for Plastic and Reconstructive Surgery and director of the Cedars-Sinai Medical Group's Plastic Surgery Center.

For more information, click here or on the PDF link below.

Wings Around the World - Nov. 21 (PDF)

Switch to ICD-10 Takes Effect Oct. 1

At the end of this month, the transition will be complete — the medical coding system ICD-10 will be implemented Thursday, Oct. 1.

To prepare for the transition, Cedars-Sinai coders have been using the new system alongside ICD-9 for more than two years. The ICD-10 project team plans to staff a command center in the days after the transition to ensure that any issues that may arise can be addressed quickly. Contact the command center at 310-423-6428, option 6, or askicd10@cshs.org.

The switch, mandated by the federal Department of Health and Human Services, will result in an increase from about 17,000 codes in ICD-9 to more than 140,000 in ICD-10.

ICD-10, the 10th revision of the World Health Organization's International Classification of Diseases, has procedure codes that correspond to virtually all claims for hospital services and are used together with diagnosis codes.

For detailed information surrounding changes in CS-Link — including FAQs, job aids and an e-learning module — please visit CS-Link Central.

For general resources and project updates, visit the ICD-10 Watch page on the Intranet.

ICD-10 - Get Ready Now (PDF)

ICD-10 Communication (PDF)

Using Dot Phrases (PDF)

Cedars-Sinai Acquires Marina Del Rey Hospital

Cedars-Sinai has purchased the 145-bed Marina Del Rey Hospital and its neighboring medical office building. The acquisition was announced Sept. 1.

Marina Del Rey Hospital will operate as a distinct community hospital affiliate of Cedars-Sinai and will continue to provide its existing services, including a 24-hour emergency room.

In addition to general acute-care medical services and emergency care, Marina Del Rey Hospital offers expertise in several specialty areas, including minimally invasive surgery, spine, weight loss, orthopedics, women's health and internal medicine.

"Cedars-Sinai looks forward to working closely with Marina Del Rey Hospital's medical staff, management team and employees to understand the needs and opportunities for enhanced service to the community," said Thomas M. Priselac, president and CEO of Cedars-Sinai.

The acquisition of the hospital is part of Cedars-Sinai's ongoing development as a comprehensive healthcare organization offering hospital and physician services operating in multiple locations, making it easier for more people to access coordinated quality care close to home. The region that includes Marina del Rey and surrounding communities has been one of the areas of Cedars-Sinai growth. Cedars-Sinai recently opened an urgent care and primary care center in Culver City and will open a similar facility in Playa Vista in 2016.

Marina Del Rey Hospital will convert to nonprofit status, which will result in an enhanced mission to serve the healthcare needs of the local community, including provision of community benefit programs. Previously, Marina Del Rey Hospital was owned by a partnership led by Westridge Capital.

Marina Del Rey Hospital's CEO, Sean Fowler, will report to Cedars-Sinai Chief Operating Officer Mark Gavens. All 660 employees will remain employees of Marina Del Rey Hospital.

"This is a positive move for Marina Del Rey Hospital," Fowler said, "allowing our management team to accelerate our progress toward achieving strategic goals while creating opportunities for additional growth and program enhancement."

Jack Matloff, MD, Leader in Cardiothoracic Surgery

Jack Matloff, MD, the founding chair and chair emeritus of the Cedars-Sinai Division of Cardiothoracic Surgery, died at Cedars-Sinai on Aug. 20. He was 82. Matloff was a respected teacher, pioneer and visionary in medicine and in health policy.

Jack Matloff, MD

Matloff was recruited to Los Angeles in 1969 by Jeremy Swan, MD, and Board Chair Steve Broidy to develop a cardiothoracic surgery division at Cedars of Lebanon Hospital, a predecessor of Cedars-Sinai. During his almost 30 years at Cedars-Sinai, Matloff and the world-class team he recruited grew the division into one of the most highly respected centers for cardiothoracic surgery in the world, as it remains today. Matloff also shared responsibility for starting Cedars-Sinai's heart and lung transplant programs.

He and his team cared for more than 10,000 patients during his tenure and advanced the science by establishing a comprehensive database of patient treatments and ongoing progress decades ahead of other efforts to track patient outcomes. This knowledge base supported his division's academic contributions, which included more than 275 peer-reviewed journal articles and book chapters and 235 abstracts, five edited books, and numerous visiting professorships and lectureships.

In recognition of his contributions to Cedars, the Cedars-Sinai staff named Matloff Alumnus of the Year in 2002 and awarded him the Pioneer in Medicine Award in 2008 for being "a master physician, teacher, author and philanthropist whose worldwide efforts and scientific contributions set the highest standards for cardiac surgery."

In addition to programmatic contributions, Matloff's work significantly benefited Cedars-Sinai's physical plant, as many of its buildings and spaces bear the names of Matloff's grateful patients who made Cedars-Sinai the beneficiary of their generosity. Matloff's legacy continues in the ongoing work — at Cedars-Sinai and at many other institutions — of many excellent physicians, nurses and others who were on Matloff's teams in the Cardiovascular Surgical Intensive Care Unit and on 6 Northeast. Many are still part of Cedars-Sinai's staff and community today.

Share Your Memories

The family of Jack Matloff, MD, asks that members of the medical staff share their remembrances of him at rememberingdrjack@gmail.com. A message sent to the address will trigger a return email with a link to an online form where you can share your story.

Matloff was an influential figure in cardiothoracic surgery and health policy beyond Cedars-Sinai. He held a faculty appointment at Harvard University, having spent a midcareer sabbatical earning a master's degree in public administration at the Kennedy School of Government. He later co-founded and co-managed a successful series of healthcare executive courses at the Kennedy School that educated influential members of the healthcare industry on policy-related topics pertinent to "the new world of healthcare."

He also served as president of the Society of Thoracic Surgeons (STS) and developed the strategic plan for the specialty of cardiothoracic surgery that was implemented and continues to be applied. In addition, he served as the chair of the Joint Society, Government Relations Committee and Education Committee of the Thoracic Surgical Foundation. For his service to the STS, other professional societies and the specialty of cardiothoracic surgery, Matloff received the Distinguished Service Medal of the STS and the David J. Dugan Distinguished Service Award of the Western Thoracic Surgical Association.

Matloff also advised state and foreign governments on the future of healthcare and the implementation of population-based healthcare programs, again demonstrating a vision for healthcare that was decades ahead of its time. For his contribution as architect of the Jesselson Heart Center at Shaare Zedek Medical Center in Jerusalem, Matloff received the Jerusalem Medal, the highest honor accorded foreign nationals who have worked on behalf of Israel.

UpToDate Anywhere Available to Medical Staff

Cedars-Sinai has upgraded its UpToDate subscription to UpToDate Anywhere. Within CS-Link™ or through the UpToDate website, medical staff members can take advantage of the following enhancements:

  • Free continuing education credit (CME/CE/CPD) possible when you research a clinical question using UpToDate
  • Easy access to UpToDate with automatic login via CS-Link Web Activities
  • Remote access from any computer with an Internet connection
  • Free access to the UpToDate mobile app

To register, simply log in to UpToDate from the Cedars-Sinai network. You can do this in two ways: 

  • Access UpToDate via the Web Activities link within CS-Link
  • Or, when connected to the Cedars-Sinai network, go to UpToDate.com, click the login link on the top right and then enter your username and password

Your registered account is then linked to your affiliation with Cedars-Sinai. To keep your account active and maintain benefits, simply log in through the Cedars-Sinai network every 90 days. 

For more help with CS-Link, you can schedule a training session with Alex Bram (alex.bram@cshs.org).

Healing Gardens Will Bloom on Plaza

The Healing Gardens project will bring water features, seating, special lighting and more — shown in these illustrations — to the terraces around the North and South towers.

A new campus beautification project will soon transform the outdoor Cedars-Sinai Plaza Level into lush gardens of refuge.

Construction of four Healing Gardens — complete with water features, seating, special lighting and more — began Sept. 8 on the terraces around the medical center's North and South towers. The project will be split into two phases, with work beginning on the outer plazas first, then moving into the inner plazas — those facing Gracie Allen Drive — in January 2016.

The project is part of an effort to beautify the campus and improve exterior wayfinding for a more positive patient experience.

"The redesigning of the exterior plaza not only provides a much-needed green sanctuary for our patients and visitors, but also a wonderful space for our physicians and staff to recharge throughout the day," said Mark Gavens, chief operating officer. "It also ensures beautiful, serene landscapes can be seen from patient room windows."

The Healing Gardens project is part of a more comprehensive effort to beautify the campus and improve exterior wayfinding for a more positive patient experience. Additional construction to enhance navigation and signage will commence in the year ahead.

Each of the four gardens will have a unique design and will include shaded seating areas, improved lighting features and specially selected foliage such as bamboo, fruitless olive trees, lavender and aloe. The green spaces also will include built-in concrete pads for future art installations.

Project managers say construction will take place between 7 a.m. and 3:30 p.m. on weekdays to minimize noise and disruption for patients. During phase one construction, which is expected to be completed by Dec. 31, the outer outdoor plazas will be closed. Visitors, patients and staff will use the inner plazas to access the medical center and adjoining buildings from the exterior Plaza Level.

Once phase one is completed, the renovated outer plazas will be opened, and the inner plazas will be closed as phase two commences. Construction on phase two is expected to be completed by June 30, 2016. Those inner plaza gardens also will include extra features, such as a trellis structure on the south side of the North Tower, and night lighting and reflecting pools on the north side of the South Tower.

"There is so much evidence on the impact that therapeutic landscapes and nature can have on a patient's recovery," Gavens said. "We're excited at this opportunity to beautify our campus and provide soothing, tranquil areas where our community can rest and heal."

Click the image below to see a video of the project.

Circle of Friends Honorees for August

The Circle of Friends program honored 72 people in August.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Monique R. Acosta, RN
  • Lilit Baldjyan, MSN, RN
  • Babak R. Bamshad, MD
  • Eli Baron, MD
  • Leon I. Bender, MD
  • Satinder J. Bhatia, MD
  • Scott A. Braunstein, MD
  • Earl W. Brien, MD
  • Merla O. Caermare
  • Ilana Cass, MD
  • Dorrie Chang, MD
  • Cheryl G. Charles, MD
  • Alice C. Cruz, MD
  • Lawrence S. Czer, MD
  • Catherine M. Dang, MD
  • Itai Danovitch, MD
  • Robert M. Davidson, MD
  • Audra Davila, RN
  • Noam Z. Drazin, MD
  • Jillian M. Felice, CNIII
  • Marshal P. Fichman, MD
  • Wendel Fortenberry
  • Marilyn A. Friedberg
  • Stuart Friedman, MD
  • Armando E. Giuliano, MD
  • Sherry L. Goldman, RN, NP
  • Theodore B. Goldstein, MD
  • Rowena M. Gonzalez, RN
  • Steven B. Graff-Radford, DDS
  • Omid Hamid, MD
  • Michele A. Hamilton, MD
  • Michael D. Harris, MD
  • Leonel Jimenez, RN
  • J. Patrick Johnson, MD
  • David Kawashiri, MD
  • Ilan Kedan, MD, MPH
  • Juanita Keith, PSR
  • Michelle M. Kittleson, MD, PhD
  • Robert Klapper, MD
  • Jon A. Kobashigawa, MD
  • Michael A. Kropf, MD
  • Gary E. Leach, MD
  • Roger L. Lerner, MD
  • Andrew J. Li, MD
  • Cierra N. Lukers, RN
  • Ali Mahtabifard, MD
  • Adam N. Mamelak, MD
  • Paula McAllister, MD
  • Puja K. Mehta, MD
  • Nancy Moldawer
  • Jaime D. Moriguchi, MD
  • Kristine Norland, RN
  • Sara Oliva, BSN, RN, OCN
  • Shi-Hui Pan, PharmD
  • Jignesh K. Patel, MD, PhD
  • Christine Paulino
  • Barry J. Pearlman, MD
  • Edward H. Phillips, MD
  • Edwin M. Posadas, MD
  • Madison F. Richardson, MD
  • Sonja Louisa Rosen, MD
  • Jeremy D. Rudnick, MD
  • Vivian L. Salle, RN
  • Prediman K. Shah, MD
  • Edward J. Share, MD
  • Haley L. Sims Saunders, RN
  • Gena T. Smith, RN
  • Andrew Ira Spitzer, MD
  • Vinay Sundaram, MD
  • Teaunna R. Thomas
  • Alfredo Trento, MD
  • Jill A. Trunecek, NP