Cedars-Sinai

Medical Staff Pulse Newsletter

Letter From Chief of Staff: New Year's Greetings

By Clement C. Yang, MD, Chief of Staff

I am excited to work with you this year and to improve upon the outstanding work of our medical staff. Some of the major priorities for the medical staff for new year revolve around the following themes—improving hospital flow and clinical efficiency, and addressing physician wellness.

» Read more

Letter From Chief of Staff: New Prescription Requirements

By Clement C. Yang, MD, Chief of Staff

Please be informed of a new law which requires each controlled substance security prescription form used for prescribing after January 1 to include a unique serialized number in a format approved by the Department of Justice. As a result, you may receive calls from outpatient pharmacies to verify prescriptions written on noncompliant forms, and patients may report having difficulties filling prescriptions written on noncompliant forms (especially prescriptions for CII medications).

» Read more

Martin Luther King, III, to Speak at King Day Celebration

Martin Luther King, III, the oldest son of the famous civil rights leader, will be the keynote speaker at the 17th annual Martin Luther King Jr. Day Celebration on Tuesday, Jan. 15. The event marks what would have been King's 90th birthday. All employees, physicians, visitors and patients are welcome to attend the event, which runs from noon-1 p.m. in Harvey Morse Auditorium.

» Read more

#MeToo in Medicine Focus of Jan. 16 Talk

With the #MeToo movement as a backdrop, the subject of sexual harassment and women in academic medicine will take center stage on Wednesday, Jan. 16, in a presentation by an expert in the field: Reshma Jagsi, MD, DPhil. The event will be held from 7-8 a.m. in Harvey Morse Auditorium.

» Read more

Communicating With Gender Nonconforming Patients

As the Transgender Surgery and Health Program expands and evolves, new videos have been created to help employees be more thoughtful and welcoming when communicating with gender nonconforming patients. Watch the videos here and here.

» Read more

New Data Backs Barbershop Blood Pressure Study

New 12-month data from the Smidt Heart Institute backs up an earlier study proving that a pharmacist-led, barbershop-based medical intervention can successfully lower blood pressure in high-risk African-American men. The follow-up research was published this month in the journal Circulation.

» Read more

Leading Microbiome Scientist Joins Cedars-Sinai

Jonathan Braun, MD, PhD, a leading pathologist and pioneering researcher in inflammatory bowel disease, and an accomplished academic leader, has joined the Cedars-Sinai Inflammatory Bowel and Immunobiology Research Institute as director of Enterprise Operations.

» Read more

Physician Playlists: Azadeh Dashti, MD

A great soundtrack can bring everything together. In labs, preparation areas and sometimes even the operating room, music can help a team focus, build camaraderie and set the right mood. We're highlighting physicians and their favorite playlists. This week’s subject is Azadeh Dashti, MD, director of Education in Supportive Care Medicine.

» Read more

FDA Warns About Fluoroquinolone Antibiotics

The U.S. Food and Drug Administration has added a strengthened warning across the entire class of fluoroquinolone antibiotics. The strengthened warning has now been expanded to include an increased risk for aortic aneurysm and rupture.

» Read more

CS-Link Tip: The Power of SmartPhrases

SmartPhrases are arguably the most powerful tool in CS-Link™. Using SmartPhrases will make your documentation easier.

» Read more

Letter From Chief of Staff: New Year's Greetings

Dear colleagues,

Here ‘s a bit of medical trivia to start off 2019:

  1. The limits of the human body tend to follow a "Rule of Three": Three minutes without air, three hours without shelter in extreme conditions, three days without water and three weeks without food.
  2. The American Psychiatric Association’s DSM-V handbook classifies caffeine withdrawal as a mental disorder.
  3. Banging your head against a wall burns 150 calories an hour.

I am excited to work with all of you this year and to improve upon the outstanding work of our medical staff.

Some of the major priorities for the medical staff for 2019 revolve around the following themes:

  1. Improving hospital flow: Serving the community is our priority. When our hospital is beyond capacity, patients leave our emergency room without being seen and we turn away emergency ambulances. We are partnering with the medical center to improve patient flow through daily bed huddles to identify and facilitate discharges. We are asking every physician to help in this effort.
  2. Improving clinical efficiency: With your input, we are developing tools to help physicians better understand their own practice patterns and identify practice efficiencies. As an example, we recently rolled out the Procedure Cost Reports for our surgeons and quickly identified a significant source of waste—outdated preference lists for operating room supplies.
  3. Addressing physician wellness: Our priorities are to understand the problems and develop broad wellness offerings as well as targeted local solutions. As examples, teams are working on electronic medical records, leadership development and suicide prevention. To help us understand the current state of physician wellness, please complete the brief Wellness Survey.

Please continue to share your thoughts with me. Wishing each of you the best for 2019.

Clement C. Yang, MD
Chief of Staff

Letter From Chief of Staff: New Prescription Requirements

Dear colleagues,

Please be informed of a new law which requires each controlled substance security prescription form used for prescribing after January 1 to include a unique serialized number in a format approved by the Department of Justice. As a result, you may receive calls from outpatient pharmacies to verify prescriptions written on noncompliant forms, and patients may report having difficulties filling prescriptions written on noncompliant forms (especially prescriptions for CII medications). Please review your prescription forms to ensure they include this serial number—if you are unsure whether your forms are compliant, you may contact the company that prints them for you.

A list of approved security prescription printers can be found here. Controlled substances that are e-prescribed are in compliance with this new law.

Pharmacies may reject your prescription if it is not in compliance with the new requirement. See link to the Medical Board’s Memorandum below. Please e-prescribe controlled substances via CS Link™ which complies both with the regulations and with our electronic prescribing of controlled substance Policy. If you are unable to e-prescribe and need to write the prescription, you will need to order new prescription forms.

The Medical Board of California has more information.

Clement C. Yang, MD
Chief of Staff

 

Martin Luther King, III, to Speak at King Day Celebration

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Martin Luther King, III

Martin Luther King, III, the oldest son of the famous civil rights leader, will be the keynote speaker at the 17th annual Martin Luther King Jr. Day Celebration on Tuesday, Jan. 15. The event marks what would have been King's 90th birthday.

All employees, physicians, visitors and patients are welcome to attend the event, which runs from noon-1 p.m. in Harvey Morse Auditorium. Space is limited, and seating will be required for all attendees. Boxed lunches will be available on a first-come, first-served basis in Harvey Morse Auditorium at 11:30 a.m.

An overflow room with a live feed will be available in the Samuel J. and Sarah Brisken Executive Conference Room, directly across from Harvey Morse Auditorium, and monitors will also be available for viewing in the Shaeffer Lobby in the Pavilion. The program will be shown in patient rooms on Channel 50.

A graduate of his father's alma mater, Morehouse College, King has devoted his life to promoting civil rights and global human rights in order to eradicate what his father identified as the "three major evils" of humankind—racism, militarism and poverty.

As the elected president of the Southern Christian Leadership Conference (SCLC), the organization co-founded by his father, King reinvigorated SCLC by stabilizing the governance, program and development components. As founder and president of Realizing the Dream Inc., King took his father’s message to a global audience, spearheading nonviolence training in Bosnia and Herzegovina, India, Israel, Palestine, Kenya, Sri Lanka and the United States.

King has also served as an election monitor and observer in South Africa, Nigeria and Kenya. In addition, he has conducted nearly 40 poverty study tours in a groundbreaking initiative, which has sparked public debate and law enforcement advocacy on the issue of poverty.

In conjunction with Ambassador Andrew Young and other partners, King co-founded Bounce TV, the first independently owned and operated TV network featuring African-Americans. The network’s content includes movies, sports, documentaries and original programming.

Attendees will also enjoy music by Siedah Garrett, a Grammy Award-winning and two-time Academy Award-nominated singer/songwriter. Garrett is one of the most sought-after songwriters in the world.

A collaborator and band member of Michael Jackson, Garrett is most famous for co-writing the king of pop's mega-hit “Man in the Mirror” from the chart-topping 1987 album, Bad, and for recording as a duet partner on "I Just Can't Stop Loving You." Garrett also toured with Jackson as a featured vocalist on his Dangerous World Tour.

#MeToo in Medicine Focus of Jan. 16 Talk

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Reshma Jagsi, MD, DPhil

With the #MeToo movement as a backdrop, the subject of sexual harassment and women in academic medicine will take center stage on Wednesday, Jan. 16, in a presentation by an expert in the field, Reshma Jagsi, MD, DPhil.

Sponsored by the Cedars-Sinai Office of Faculty Development and Diversity, Jagsi's presentation, "#MeToo: Navigating Sexual Harassment, Power Differentials and Gender Inequity in Academic Medicine," will explore the current participation of women in medicine, evidence suggesting dysfunction in the pipeline, causes of gender inequality, the nature of sexual harassment in medicine and interventions.

The event will be held from 7-8 a.m. in Harvey Morse Auditorium.

A professor and deputy chair in the Department of Radiation Oncology and director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan, Jagsi has extensively studied gender equity and success in academic medicine.

A graduate of Harvard University, Harvard Medical School and the University of Oxford, Jagsi has authored more than 200 articles in peer-reviewed journals, including multiple high-impact works in publications such as the Journal of the American Medical Association and the New England Journal of Medicine.

Communicating With Gender Nonconforming Patients

Cedars-Sinai strives to be an organization that values diversity and provides a safe, healing place for all.

To ensure employees feel informed and trained on how to care for the many diverse populations treated at the medical center, the Department of Human Resources and Organization Development created a new video to help employees be more thoughtful and welcoming when communicating with gender nonconforming patients. The department is also sharing a previously created video featuring a firsthand account from a transgender patient.

"As doctors, nurses and people in the healthcare industry, we alleviate human suffering with treatment and compassion," said Maurice Garcia, MD, MAS, director of the Transgender Surgery and Health Program, an interdisciplinary program that provides comprehensive medical and surgical care for transgender people. "We all must work toward resolving the marginalization of the transgender and non-binary communities in today’s healthcare environment. One of the first steps is ensuring we communicate well without mislabeling or assumptions."

As Garcia’s program continues to expand and evolve, it’s more likely employees—regardless of their role within the medical center—will encounter gender nonconforming patients. These videos are intended to help guide those conversations.

The first video can also be accessed via HealthStream.

New Data Backs Barbershop Blood Pressure Study

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Barber Eric Muhammad takes patron Marc Sims' blood pressure. Photo by Cedars-Sinai.

New 12-month data from the Smidt Heart Institute backs up an earlier study proving that a pharmacist-led, barbershop-based medical intervention can successfully lower blood pressure in high-risk African-American men. The follow-up research was published this month in the journal Circulation.

"Our initial six-month data showed a marked reduction of blood pressure in the intervention group," said C. Adair Blyler, PharmD, CHC, an author on the study and one of two clinical pharmacists from the Smidt Heart Institute who traveled to black-owned barbershops to treat patients. "Now, our 12-month data show that this significant reduction in blood pressure can be sustained, and in some cases, even improved, despite fewer in-person visits with a pharmacist."

The novel study involving 52 Los Angeles County barbershops stationed pharmacists in barbershops to prescribe, monitor and adjust blood pressure medication for patrons. The six-month data were published in March, 2018 in The New England Journal of Medicine.

The study was led by the late Ronald G. Victor, MD, one of the world’s foremost experts on hypertension and community-based healthcare interventions. Victor, professor of Medicine, was the first to study, and prove, that high-risk populations are more likely to be receptive to medical care in an environment where they’re most comfortable.

"This study will have lasting impact on one of our nation’s most at-risk populations when it comes to high blood pressure," said Eduardo Marbán, MD, PhD, director of the Smidt Heart Institute. "As an institution, we are proud of these results and know Ron Victor would have been proud to see his vision produce such successful results that will have a positive effect on thousands of lives."

Patients with hypertension have a blood pressure score above 130 over 80, although those with the first number above 120 are now considered to have elevated blood pressure. If left untreated, hypertension can lead to heart failure, stroke and kidney disease. It’s often considered a silent killer because patients typically don’t feel symptoms.

According to the research, at 12 months, the average systolic blood pressure—the top number in a blood pressure reading – fell by nearly 29 mmHg in the intervention group and by 7.2 mmHg in the control group—a difference of just over 21 mmHg.

With these positive results, Smidt Heart Institute researchers will now shift their focus to identifying cost-effective ways to broaden barbershop-based care and implement this novel model to other high-risk communities outside of Los Angeles County.

Leading Microbiome Scientist Joins Cedars-Sinai

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Jonathan Braun, MD, PhD

Jonathan Braun, MD, PhD, a leading pathologist and pioneering researcher in inflammatory bowel disease (IBD), and an accomplished academic leader, has joined the Cedars-Sinai Inflammatory Bowel and Immunobiology Research Institute as director of Enterprise Operations.

"Dr. Braun is both an innovator and present-day thought leader pushing the frontier of microbiome research," said Stephan R. Targan, MD, director of the Inflammatory Bowel and Immunobiology Research Institute. "His creative and innovative approach to studying the gut microbiome has yielded an invaluable understanding of just how the tens of trillions of microorganisms that comprise the microbiome interact with genes and each other to shape the origins and course of IBD."

Braun’s numerous recognized achievements include the development of novel measurements and analytics of the genetic, immunological and clinical aspects of disease. Targan describes Braun’s expertise as a critical new pillar of the IBD team’s "bench to bedside" research excellence at Cedars-Sinai.

As director of Enterprise Operations, Braun is part of the IBD institute’s leadership team, supporting and helping to integrate the many established and emerging areas of research.

"Cedars-Sinai is one of the most outstanding centers for IBD research in the world," said Braun, who will also serve as a senior research scientist. "I am eager for this opportunity and look forward to working with my new colleagues to improve the outlook for patients with inflammatory diseases and other conditions affected by the gut microbiome."

Braun, who started his new role Jan. 4, comes to Cedars-Sinai after three decades at the David Geffen School of Medicine at UCLA, having achieved international recognition for his inspired research and leadership in IBD. He is a member of the Scientific Advisory Board for the International Early Onset Pediatric IBD Cohort Study, and chair of the Scientific Advisory Board for the Milieu Interieur Consortium of Institut Pasteur, Paris.

"We are proud to have succeeded in attracting a leader and scholar with the stature, impact and influence of Dr. Braun," added Targan, who also holds the Feintech Family Chair in Inflammatory Bowel Disease.

Physician Playlists: Azadeh Dashti, MD

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Azadeh Dashti, MD

A great soundtrack can bring everything together. In labs, preparation areas and sometimes even the operating room, music can help a team focus, build camaraderie and set the right mood. We're highlighting physicians and their favorite playlists. This week’s subject is Azadeh Dashti, MD, director of Education in Supportive Care Medicine.

"It's really important for us especially in supportive care to process our emotions and to appreciate life," said Dashti. "Music is like a conduit of human emotions and storytelling. It helps lift you up and helps you be present in the moment, which is crucial."

Dashti loves a wide range of music, from classical to soul to international.

"Music brings a sense of harmony and joy," she added. "At the end of the day, especially when you've had a long day, it brings the pieces of life together again."

Her favorite playlists include:

  • "Etude in D-Sharp Minor, Op.8"—Alexander Scriabin (played by Vladimir Horowitz)
  • "Hungarian Rhapsody No. 2"—Franz Liszt
  • "Feeling Good"—Nina Simone
  • "All These Things That I’ve Done"—The Killers
  • "Home Again"—Michael Kiwanuka
  • "Days Like This"—Van Morrison
  • "Spanish and Cuban music: Est Tu Mirada"—Leoni Torres
  • French music: "Non, Je Ne Regrette Rien"—Edith Piaf
  • And, of course, Persian dance music

FDA Warns About Fluoroquinolone Antibiotics

The U.S. Food and Drug Administration (FDA) has added a strengthened warning across the entire class of fluoroquinolone antibiotics. The strengthened warning has now been expanded to include an increased risk for aortic aneurysm (AA) and rupture (AR). Surveillance data has suggested that fluoroquinolone exposure carries a two-fold increased risk of AA/AR, compared to non-exposure.

The FDA has more information.

CS-Link Tip: The Power of SmartPhrases

SmartPhrases are arguably the most powerful tool in CS-Link™. Using SmartPhrases will make your documentation easier.

Rather than each of us individually creating useful phrases, they can be shared or borrowed from each other. It’s easy to look at a colleague’s SmartPhrases file. To access in your SmartPhrases editor, click "Open," then type your colleague’s name.

From here, you can add yourself as a user of the phrase. If you want to be able to edit the phrase, you need your own copy. To do this, click "Share" and then "Copy selected phrase."

For more information about SmartPhrases, watch this video.

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.