MLK III Inspires Hope at Father’s Celebration

On what would have been his father’s 90th birthday, Martin Luther King III, the eldest son of the late civil rights leader, addressed a capacity crowd in Harvey Morse Auditorium for Cedars-Sinai’s 17th annual Martin Luther King Jr. Day Celebration. His address was a stirring exploration of his childhood, his father's legacy and his vision for a united America.

Results From Ambulatory High Value Care Committee

A diverse group of physicians and executive leaders recently launched the Ambulatory High Value Care Committee. These leaders worked with key clinicians and engaged in thoughtful redesign to leverage guidelines from Choosing Wisely—a national initiative to reduce healthcare utilization where harm or expense outweighs benefit to the patient—to make progress in five specialties: cardiology, gastroenterology, oncology, pain management and preoperative evaluations.

Feedback From MD/RN Collaborative Satisfaction Survey

Nearly 500 physicians and 1,200 nurses participated in the 2018 MD/RN Collaboration Survey, providing meaningful feedback on ways to enhance effectiveness, collaboration, trust and respect among caregivers.

Advance Healthcare Directive Now on CS-Link

Completing an advance healthcare directive just became easier. The directive, a legal document reflecting an individual's wishes about receiving medical care, is now available in digital form online after a recent My CS-Link™ update.

James Grant, MD, Named Chair of Anesthesiology

James D. Grant, MD, MBA, has been appointed chair of the Department of Anesthesiology and physician executive in Perioperative Services. A nationally recognized and accomplished physician leader, Grant brings to Cedars-Sinai a distinguished record of clinical excellence, organizational leadership and administrative expertise.

Kimchi, MD, Wins Lifetime Achievement Award

Asher Kimchi, MD, co-medical director of the Preventive and Consultative Heart Center of Excellence at the Smidt Heart Institute and professor of Medicine, has been announced as the recipient of the Lifetime Achievement Award in Cardiovascular Science, Medicine and Surgery from the International Academy of Cardiovascular Sciences.

Whiteman, MD, Starts New Leadership Role With AAP

Paula Whiteman, MD, a clinical assistant professor of Emergency Medicine, recently began serving as the District Vice Chairperson for the American Academy of Pediatrics (AAP), District IX. She began her three-year term on Jan. 1.

Circle of Friends Honorees for December

The Circle of Friends program honored 329 people in December. 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.

Medical Library Offers Classes to Learn New Skills

The Cedars-Sinai Medical Library is offering a variety of classes in January and February. All classes begin at noon in the Medical Library—Plaza Level, South Tower, Room 2815.

Super Bowl Tailgate Party on Friday, Feb. 1

Cedars-Sinai is hosting its first Super Bowl Tailgate Party Friday, Feb. 1, at 11:30 a.m. on the Taper rooftop. The event will feature traditional tailgate foods, a raffle, games and prizes, which will include signed NFL memorabilia from Rams players Aqib Talib, Marcus Peters and Greg Zuerlein. Tickets are $10.

Pharmacy and Therapeutics Product Updates

See production information updates for December from Pharmacy and Therapeutics.

CS-Link Tip: The Problem List

With more patients and physicians using CS-Link™, the need for Problem List etiquette is critical. The list is not a trash bag to hold every diagnosis ever coded for that patient. Rather, it should be a cogent inventory of active issues.

Wear Red on Feb. 1 for Women's Heart Day

The 2018 Wear Red group photo.

Employees are invited to dress in red, participate in heart health screenings and hear from experts in the field for the 14th annual Linda Joy Pollin Women’s Heart Health Day on Friday, Feb. 1.

Amie Mangola, country music singer-songwriter and a grateful patient in the Barbra Streisand Women’s Heart Center, will host the annual Women's Heart Health Day program, which begins at 9 a.m. in Harvey Morse Auditorium. In addition to blood pressure screenings and cardiac risk assessments, guests will also enjoy wellness stations, meditation, chair massages, Kiehl skincare sampling opportunities and a photo booth.

At 11 a.m., attendees will assemble in front of Pavilion for a group photo. Participants are urged to wear red.

Lunch will be served at 11:40 a.m., before a host of speakers share updates in women’s heart health. Speakers will include:

• C. Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center and the Linda Joy Pollin Women’s Heart Health Program in the Smidt Heart Institute
• Margo Minissian, PhD, research scientist, cardiology nurse practitioner at the Barbra Streisand Women's Heart Center in the Smidt Heart Institute
• Balaji Tamarappoo, MD, PhD, medical director of cardio-oncology in the Smidt Heart Institute, assistant director of research in the Cardiac Imaging Department and associate medical director of the Biomedical Imaging Research Institute
• Eynav Accortt, PhD, assistant professor of Obstetrics and Gynecology
• Janet Wei, MD, cardiologist in the Smidt Heart Institute

The event is sponsored by the Linda Joy Pollin Women’s Heart Health Program at Cedars-Sinai’s Barbra Streisand Women’s Heart Center.

For more information, contact Allison Moore at 323-866-6892 or email allison.moore@cshs.org.

MLK III Inspires Hope at Father’s Celebration

Martin Luther King III

On what would have been his father’s 90th birthday, Martin Luther King III, the eldest son of the late civil rights leader, addressed a capacity crowd in Harvey Morse Auditorium, taking them on a stirring journey through his childhood, his father's legacy and his vision for a united America.

"I was just 5 years old when he delivered his 'I Have a Dream' speech at the great March on Washington," King said during Cedars-Sinai’s 17th annual Martin Luther King Jr. Day Celebration, held Tuesday, Jan. 15. "Even at the age of 5, I felt great pride that my dad had given so many Americans a sense of hope and unity. The feeling that his vision could bring people of all races together has been a part of my values ever since."

King, who himself is a passionate and longstanding advocate for human rights, said that he came to understand the burden of his father's leadership as he grew older, and that understanding led him to carry forward his father's message.

King, like his father, has "inspired communities and audiences across the country and around the world with his words and his actions and his unwavering vision for a nonviolent and just society," said President and CEO Thomas M. Priselac. "What makes his life’s work so inspiring is the strength of character and heart behind those accomplishments."

King currently serves as president of the Southern Christian Leadership Conference, an organization co-founded by his father. He also is the founder and president of Realizing the Dream Inc., which fights to eliminate poverty, racism and hostile conflict around the world.

But King shared that being raised by a pioneer who fought for a "beloved community" in a largely fractured and intolerant world came at a heavy price.

"My father was assassinated when I was 10 years old," he said. "He wasn’t just a famous leader to me, he was a warm, caring, compassionate father whose company was so, so enjoyable, and I sorely missed him after he was killed and miss him even today."

King stressed that we all have a role in supporting equal rights though courtesy, respect and nonviolence, adding that his father's teachings provide more than "an interesting history lesson."

"They offer us the closest thing we have to a road map to fulfillment of the American dream," King said. "This is the legacy we must pass on to all future generations."

King was accompanied at the commemoration by his wife, Arndrea, and daughter, Yolanda, who, in keeping with the King family tradition, has developed her own ardent voice for social change.

The hour-long event also saw a moving musical performance by Grammy Award-winning and Academy Award-nominated singer-songwriter Siedah Garrett, who performed several original songs, including "Man in the Mirror," which she co-wrote with Michael Jackson.

Results From Ambulatory High Value Care Committee

Cedars-Sinai excels at providing high-quality care. But more isn't always better. Sometimes—with the best of intentions—tests are ordered and medications are prescribed that aren't necessary and may even be harmful. This wastes patients' time and money, and exposes them to needless risk.

The Cedars-Sinai Medical Network is committed to providing high-value care to our patients, guided by the latest medical evidence. That means delivering care in a manner that is efficient, safe and affordable.

In an effort to achieve this goal, a diverse group of physicians and executive leaders launched the Ambulatory High Value Care Committee. These leaders worked with key clinicians and engaged in thoughtful redesign to leverage guidelines from Choosing Wisely—a national initiative to reduce healthcare utilization where harm or expense outweighs benefit to the patient—to make progress in five specialties: cardiology, gastroenterology, oncology, pain management and preoperative evaluations. Promising results from their small pilot projects suggest much greater returns for the broader Medical Network going forward. Accomplishments in FY18 included the following:

Cardiology

• Goal: Decrease inappropriate cardiac stress testing
  Why is this important? For many patients, cardiac stress testing rarely changes a treatment plan or outcomes but does cause excess radiation exposure and unnecessary expense.
  What were the results? Cardiac imaging orders decreased by 2.5 percent in FY18 compared to previous year, saving $106,000.
• Goal: Decrease inappropriate lab testing
  Why is this important? The most common medical activity, lab testing often drives clinical decision-making. However, in many circumstances it may not change treatment and can result in low-value care.
  What were the results? Lab orders for specific tests frequently ordered by cardiologists decreased by 37 percent in FY18 compared to previous year, saving almost $42,000.

Gastroenterology

• Goal: Decrease unnecessary colonoscopies by recommending that normal-risk patients wait 10 years before undergoing a follow-up colonoscopy after normal findings
  Why is this important? Every procedure has risk, and unnecessary procedures increase these risks along with costs. Guidelines from the U.S Preventive Services Task Force and the American College of Gastroenterology recommend waiting 10 years for a follow-up colonoscopy after normal findings.
  What were the results? Increased physician adherence to following guidelines and recommending an appropriate 10-year interval colonoscopy screening to 92 percent of patients, representing a 19 percent improvement over the previous year.

Oncology

• Goal: Increase the number of referrals to Supportive Care Medicine (palliative care) for patients with metastatic cancer
  Why is this important? Early consultation with palliative care not only leads to greater longevity and better quality of life, but resulting patient care also tends to be less costly.
  What were the results? Increased referrals to Supportive Care Medicine by 55.4 percent in the first half of 2018 compared with the previous six months. In addition to giving more patients earlier access to this valuable service, these additional referrals will potentially generate up to $288,000 in healthcare cost savings in the care of these patients during the last three months of their life, according to a 2016 study published in the Journal of Palliative Medicine.
• Goal: Reduce unnecessary imaging for breast cancer patients at low risk of metastasis
  Why is this important? High-cost imaging is commonly overused in early-stage breast cancer patients whose cancer is unlikely to spread. This exposes patients to unnecessary radiation, expense and worry due to incidental findings.
  What were the results? Could not quantify due to lack of a reliable data source on cancer staging.

Pain Management

• Goal: Increase the number of “pain contracts” with patients who were part of a pilot program for chronic opioid therapy
  Why is this important? Aligning treatment goals and establishing shared expectations between physicians and patients help to build trust, reduce opioid requirements over time and make opioid-related complications (and subsequent healthcare utilization) less likely.
  What were the results? Increased number of contracts signed during first half of 2018 amongst the pilot patients so that 85.5 percent of eligible patients on opioids had contracts in place.
• Goal: Increase enrollment in one of several assistance programs for patients taking both opioids and benzodiazepines (sedative hypnotics)
  Why is this important? This drug combination has been linked to increased risk of ED visits, hospitalization and death.
  What were the results? New assistance programs enrolled 30 patients during first half of 2018, and an additional 27 patients discontinued medications.

Preoperative Evaluations

• Goal: Reduce preoperative chest X-rays for patients with no history of cardiac or pulmonary disease
  Why is this important? Unnecessary chest X-rays expose patients to radiation, increase costs and are unlikely to change treatment.
  What were the results? Reduced chest X-ray orders by 18.5 percent during third quarter of FY18 compared to FY17 quarterly average. When annualized, the reduction in orders translates to $3,745 in estimated cost savings.

Feedback From MD/RN Collaborative Satisfaction Survey

Nearly 500 physicians and 1,200 nurses participated in the 2018 MD/RN Collaboration Survey, providing meaningful feedback on ways to enhance effectiveness, collaboration, trust and respect among caregivers.

"We are excited to report that we have maintained the high level of collaboration and team excellence achieved over the past decade," said Chris Ng, MD, co-chair of the MD/RN Collaborative and former Chief of Staff. "However, some areas saw declines since the last survey, and the valuable feedback from our physicians and nurses will be the foundation for our improvement efforts in the coming year. We look forward to continuing to enhance the communication and respectful work environment of our caregivers and, in turn, enhance patient safety and satisfaction."

Topline survey results include:

• Effectivness of unit-based MD/RN collaboration committee meetings as a forum for thoughts and concerns:
  o Overall, 73.6 percent of responses were favorable
  o Nurses responded less favorably than physicians (78.8 percent versus 75.9 percent)
• Views on work team’s pursuit of excellence:
  o Overall, 91.7 percent of responses were favorable (97.9 percent from physicians; 92 percent from nurses)
• Nurse-only survey results found perceptions of "physician responsiveness" and "physician respectfulness" have increased; "nurse inclusion in physician rounds" and "physician order explanations" have declined since the 2016 survey.
• Physician-only results showed that overall favorability remained high with an average of 92.3 percent, yet with declines in "rounding with nurses" effectiveness, "nurse-physician communication" effectiveness and "satisfaction with quality of care" for both day and night shift.  

Survey results have been shared with all clinical staff, and leadership continues to work on ways to improve interpersonal relationships and build stronger collaboration among physicians and nurses.

"The tremendous utility of this survey lies in the unit-specific results and feedback," said Peachy Hain, RN, MSN, executive director of Nursing. "We will be able to identify the most effective initiatives and spread them to other units. As we continue to create tests-of-change to tackle areas of concern, we must remember to celebrate our successes. We take great pride in the remarkable work done each day."

Members of the care team are encouraged to attend MD/RN Collaborative Committee meetings to ensure all voices and input are heard. Learn more about upcoming meetings and ways to share feedback.

Advance Healthcare Directive Now on CS-Link

My CS-Link™ now features an Advance Healthcare Directive page.

Completing an advance healthcare directive just became easier. As part of the most recent My CS-Link update, a new Advance Healthcare Directive is now available in digital form online. (An advance healthcare directive is a legal document reflecting an individual's wishes about receiving medical care.) 

Navigating to the advance healthcare directive is simple:

• Log in to your My CS-Link account
• Click on the Resources tab
• Select Advance Healthcare Directive from the Resources drop-down menu

Thanks to its digital makeover, the advance healthcare directive can be filled in online. For legal purposes, the completed form must be printed out and either notarized or signed by two witnesses.

As a final step, the advance healthcare directive can be uploaded to your electronic medical record directly from the advance healthcare directive page in My CS-Link. That way, care-team members throughout Cedars-Sinai can access the document and provide care that aligns with your wishes.

"Our new advance healthcare directive is the result of hundreds of hours of thoughtful redesign by clinicians and patients across the health system," said Bradley Rosen, MD, vice president of Physician Alignment and Care Transitions. "The new document was designed to more easily communicate a person's goals, values and preferences."

Rosen added, "Creating a digital option is a huge step forward. This redesigned advance directive is only one part of the Quality Council's efforts to improve the culture of how we care for seriously ill patients at Cedars-Sinai."

The new advance healthcare directive page in My CS-Link includes general instructions for completing the document and a step-by-step guide for each section. Another helpful resource is a free Advance Care Planning class offered by Cedars-Sinai twice a month.

Taught by licensed clinical social workers, the class is open to the public, Cedars-Sinai employees, patients and families. The new directive is available in English, Farsi, Korean, Russian and Spanish.

James Grant, MD, Named Chair of Anesthesiology

We are delighted to announce the appointment of James D. Grant, MD, MBA, as chair of the Department of Anesthesiology and physician executive in Perioperative Services. A nationally recognized and accomplished physician leader, Grant brings to Cedars-Sinai a distinguished record of clinical excellence, organizational leadership and administrative expertise.

Grant joins us from Beaumont Hospital, Royal Oak, in Michigan, where he has served as chief of the Department of Anesthesiology and professor and chair of Anesthesiology at Oakland University William Beaumont School of Medicine.
A Michigan native, Grant served on the Michigan Board of Medicine for seven years and as its chair from 2003-2006 and was president of the Michigan Society of Anesthesiologists and the Michigan State Medical Society.

Grant has held major national leadership roles and in 2018 was elected as the 100th president of the American Society of Anesthesiologists. He is on the board of directors of the Anesthesia Foundation and the Foundation for Anesthesia Education and Research. Grant is an examiner of the American Board of Anesthesiology and chair of the Michigan delegation to the American Medical Association.

At Cedars-Sinai, Grant will establish the strategic direction for the Department of Anesthesiology's clinical, administrative, research and educational missions. A member of the full-time faculty, he will collaborate with leaders across the organization to integrate and coordinate services to improve clinical outcomes and build a unified patient experience. Grant will oversee residency and fellowship programs and develop clinical and research-focused physicians to ensure excellent clinical care.

Julian Gold, MD, and Ron Wender, MD, have been outstanding department leaders for many years, and we look forward to celebrating their institutional and departmental accomplishments in the near future. They have established an outstanding program that is now poised for further growth, as we thank them for their wonderful stewardship.

Thank you to members of the search committee, chaired by Keith L. Black, MD, who conducted an extensive national search. Please join us in extending our congratulations and a warm welcome as Grant assumes his new responsibilities at Cedars-Sinai on April 15.

- Shlomo Melmed, MD
Executive Vice President, Academic Affairs, Dean of the Medical Faculty

- Jeff Smith, MD, JD, MMM
Executive Vice President, Hospital Operations, and
Chief Operating Officer

Kimchi, MD, Wins Lifetime Achievement Award

Asher Kimchi, MD, co-medical director of the Preventive and Consultative Heart Center of Excellence at the Smidt Heart Institute and professor of Medicine, has been announced as the recipient of the Lifetime Achievement Award in Cardiovascular Science, Medicine and Surgery from the International Academy of Cardiovascular Sciences.

The organization, which promotes global sharing of research and education in heart health, is scheduled to present the award to Kimchi in February during its international conference in Bangalore, India.

Whiteman, MD, Starts New Leadership Role With AAP

Paula Whiteman, MD, a clinical assistant professor of Emergency Medicine, recently began serving as the District Vice Chairperson for the American Academy of Pediatrics (AAP), District IX. She began her three-year term on Jan. 1.

The AAP, whose mission is to attain optimal physical, mental and social health and wellbeing for infants, children, adolescents and young adults, is divided into ten national districts. District IX is the state of California, which represents more than 5,000 board-certified pediatricians.

Whiteman previously served from 2014-2016 as president of the AAP, California Chapter 2, which includes areas between Long Beach to San Luis Obispo.

Circle of Friends Honorees for December

The Circle of Friends program honored 329 people in December. 

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 acknowledgment.

See more information about the program and a list of past honorees.

Medical Library Offers Classes to Learn New Skills

The Cedars-Sinai Medical Library is offering a variety of classes in January and February.

Each 30-minute class begins at noon in the Medical Library—Plaza Level, South Tower, Room 2815.

Systematic Reviews

Learn how to improve your search strategy, choose databases and manage your results. The class meets on Tuesday, Jan. 29.

EndNoteX9 for PC

Learn how to use this citation manager to organize your search results for manuscripts and grants. The class will meet Tuesday, Feb. 5.

Creating Scientific Posters

Learn how to arrange information to make the best scientific posters for conferences. The class will meet Tuesday, Feb. 12.

Classes also are available by appointment. Call Caroline Marshall at ext. 3-2315 or RSVP to caroline.marshall@cshs.org.

Super Bowl Tailgate Party on Friday, Feb. 1

Cedars-Sinai is hosting its first Super Bowl Tailgate Party Friday, Feb. 1, at 11:30 a.m. on the Taper rooftop.

The event will feature traditional tailgate foods, a raffle, games and prizes, which will include signed NFL memorabilia from Rams players Aqib Talib, Marcus Peters and Greg Zuerlein.

Tickets, which include lunch, raffle entry and access to all games, are $10. They can be purchased in advance at the Plaza Restaurant or at the Ray Charles Cafeteria or on the day of the event at the entrance of the Taper rooftop.

The Los Angeles Rams will play the New England Patriots in this year’s Super Bowl on Sunday, Feb. 3. Cedars-Sinai is the official health partner of the Los Angeles Rams.

For questions, contact debra.castro@cshs.org or luke.paustenbaugh@sodexo.com.

Pharmacy and Therapeutics Product Updates

Product information updates for December from Pharmacy and Therapeutics are summarized in the PDF link below.

P and T Approvals - December 2018 (PDF)