Cedars-Sinai

Medical Staff Pulse Newsletter

Meetings and Events


Reversing Heart Disease
March 12

Ethics Noon Conference
March 20

Virtual Medicine Symposium
March 27

These events and more can be found in the medical staff calendar on the Cedars-Sinai website.

Grand Rounds


Upcoming CME Conferences


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue.

Submit your milestones and comments.

Letter from Chief of Staff: New Wellness Focus

By Clement C. Yang, MD, Chief of Staff

In response to excellent feedback to the recent Physician Wellness survey, we are launching a new regular feature for Pulse where a tip, video, story or discount will be highlighted to support physician wellness. The first tip focuses on getting a good night's sleep.

» Read more

Cedars-Sinai Earns Highest Distinction Again

Cedars-Sinai Medical Center has again earned a five-star hospital rating from the Centers for Medicare and Medicaid Services—the highest distinction offered by the federal agency. The ratings, which assess hospital performance, are based on 57 quality measurements that fall into categories such as patient experience, mortality and readmissions for treatment of common conditions. Of the 3,725 U.S. hospitals included in the assessment, only about 8 percent earned five stars.

» Read more

Mosenifar, MD, to Run His 100th Marathon

Zab Mosenifar, MD, is a man of routines. He has spent his entire career at Cedars-Sinai, lived in the same house for 39 years and runs every day—rain or shine, without fail. And on March 9, he will run his 100th marathon—the Catalina Island Marathon, rated the sixth toughest in the world. By the time he completes his latest marathon, Mosenifar will have run the equivalent of roughly 5.6 times around the earth, a total of about 135,200 miles.

» Read more

Study in African-American Barbershops Honored

The Clinical Research Forum has recognized the Smidt Heart Institute with a 2019 Top Ten Clinical Research Achievement Award for its study aimed at developing a blood-pressure control program for African-American men in the comfortable and convenient environments of their barbershops. In just six short months, the study—first published in the New England Journal of Medicine and led by the late hypertension expert Ronald G. Victor, MD—improved the outcomes and control of high blood pressure in more than 60 percent of participants. 

» Read more

Making Waves in Science: Janine Bilsborough

In honor of National Women's History Month in March, Pulse is celebrating Cedars-Sinai's talented female leaders with a Q&A series, "Making Waves in Science." This week's interview is with Janine Bilsborough, PhD, associate professor of Medicine and director of the Inflammatory Bowel Disease Drug Discovery and Development Unit.

» Read more

Alexa Tapped for Smart Hospital Room Pilot

A pilot program underway in more than 100 patient rooms at Cedars-Sinai is allowing patients to use an Alexa-powered platform known as Aiva to interact hands-free with nurses and control their entertainment. Aiva is the world's first patient-centered voice assistant platform for hospitals.

» Read more

FDA Issues Warnings About Medications

The U.S. Food and Drug Administration (FDA) is warning that there is an increased risk of death with Uloric (febuxostat) compared to another gout medicine, allopurinol. Also, the FDA is warning that there is an increased risk of blood clots in the lungs and death with Xeljanz, Xeljanz XR (tofacitinib).

» Read more

Medical Library Users Asked to Take Online Survey

The Cedars-Sinai Medical Library wants your opinion. The library's annual customer service survey is available now and runs through Sunday, March 17. The survey aims to better understand the information-seeking behavior of the Cedars-Sinai community, and to measure awareness and satisfaction with library services. You can take the survey here.

» Read more

Pharmacy and Therapeutics Product Updates

See production information updates for February from Pharmacy and Therapeutics.

» Read more

CS-Link Tip: Using F2 as a Verb

In CS-Link™, "F2" is a verb. You cannot close documentation until you have addressed wild cards and lists. After typing F2, your cursor will be right there. You don't need your mouse.

» Read more

Letter from Chief of Staff: New Wellness Focus

sleep220px.jpg

A committee of peers is currently working to address your concerns and ideas raised by the excellent feedback to our recent Physician Wellness survey. As the committee works on addressing these broader issues, we will be adding Physician WIN (Wellness Information and Notable) as a regular feature in Pulse. The new item will support physician wellness with a variety of tips, videos, stories or discounts.

Physician WIN

Getting a good night’s sleep can help you in many ways. Yet 70 percent of American adults report they don’t get enough rest. And not only are they missing the great health benefits of sleep, they’re also raising their chances of having memory loss, low energy, altered mood and accidents. If better sleep is something you are seeking, Cedars-Sinai has developed a corporate discount for you to connect with a powerful app called Pzizz.

Clement C. Yang, MD
Chief of Staff

Cedars-Sinai Earns Highest Distinction Again

Cedars-Sinai Medical Center has again earned a five-star hospital rating from the Centers for Medicare and Medicaid Services (CMS)—the highest distinction offered by the federal agency.

The ratings, which assess hospital performance, are based on 57 quality measurements that fall into categories such as patient experience, mortality and readmissions for treatment of common conditions. Of the 3,725 U.S. hospitals included in the assessment, only about 8 percent earned five stars.

Found on Medicare's Hospital Compare website, the ratings range from one to five stars and are meant to provide consumers with an easily understandable way to compare hospital performance. This year's top honor for Cedars-Sinai was driven by continued strong performance in mortality measures and improvements in readmissions and patient experience.

These high rankings reflect Cedars-Sinai's continued focus on improving patient safety wherever possible and providing excellent care, said Rekha Murthy, MD, vice president of Medical Affairs and acting chief medical officer. As an example, she pointed to ongoing work in the Emergency Department to reduce wait times by getting incoming patients to needed care as quickly as possible.

"The professionals working here every day taking care of our patients are simply focused on doing their very best," Murthy said. "While it’s nice to be recognized for high performance, Cedars-Sinai is focused on providing our staff with the support they need to continue providing excellent care."

Mosenifar, MD, to Run His 100th Marathon

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Zab Mosenifar, MD, will run in his 100th marathon this weekend.

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Mosenifar holds some of his marathon medals.

Zab Mosenifar, MD, professor and executive vice chair in the Department of Medicine, is a man of routines. He has spent his entire career at Cedars-Sinai, lived in the same house for 39 years and runs every day—rain or shine, without fail.

"I don’t remember a day I haven’t run in the last 50 years," said Mosenifar, who just turned 70. "I also don’t remember ever being sick in my adult life."

On Saturday, March 9, Mosenifar will run his 100th marathon—the Catalina Island Marathon, rated the sixth toughest in the world. It's a rugged course he has already conquered 37 times. By the time he completes this latest marathon, Mosenifar will have run roughly 5.6 times around the earth, a total of about 135,200 miles.

"Only my last car had more miles on it than my own knees," said Mosenifar, although he admittedly shares he has only owned three cars in his entire life—all black Porsches—that he drives until they can be driven no more. "I’m frugal."

The same cost-saving approach comes into play when buying his running shoes—the biggest expense in his life. Mosenifar, who puts about 450 miles on each pair of shoes, shops various online retailers to see if his favorite brand, Hoka, is on sale.

Mosenifar laces up his Hokas by 5 a.m. each morning, then he’s out the door running in the Santa Monica Mountains. Monday through Thursday he runs six miles. On Fridays, he’s alongside a group of men he’s trained with for years and runs eight miles. On the weekends, he goes 11 to 12 miles—a total of 50 miles per week.

After each run, Mosenifar enjoys a cup of black coffee and half a bagel. He's in his office at Cedars-Sinai by 7 a.m., and by noon he's sipping on vegetable soup from the Plaza Café for lunch. At 3 p.m., he takes an espresso break, using the same yellow mug his oldest daughter—now 30—made for him as a young child. And for dinner every night, Mosenifar enjoys pasta with pesto and a salad with his wife of 35 years, though she eats a different meal.

Mosenifar’s love of running was born out of the stress of higher education and medical school. Running continues to be his best form of relieving stress.

"I use running not just for my own solitude, but as a tremendous release of stress from work, because there can be some really tough, sad days," said Mosenifar. "I am disciplined. I am not someone who will have a few drinks. I go home and go for a 10-mile run, even if I already ran in the morning. That’s my bar. That’s how I try to get over some of these stresses of my life."

He completed his first marathon 45 years ago in Philadelphia. Since then, Mosenifar has run competitively in all the big city marathons—at a record 3 hours flat—as well as international races in European countries. He's even competed in marathons in Death Valley during the dead heat of summer. Today, Mosenifar finishes his races in about 4 hours and 35 minutes, typically finishing in first or second place for his age group.

"Catalina remains my favorite marathon, by far," said Mosenifar. "It mimics my daily runs in the mountains."

And though his eyes are set on Catalina this weekend, Mosenifar said he isn’t focused on the milestone number of 100 completed marathons.

"I’m more impressed that I’ve been able to run all of these years," said Mosenifar. "To me, it’s less about 100 marathons and more about the fact that I’m still healthy enough to run 50 miles per week and put so many miles on my body. That’s human nature—and to me, that’s much more impressive than running 5.6 times around the globe."

Study in African-American Barbershops Honored

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Barber Wally Riddle takes the blood pressure of Ronald Victor, MD.

The Clinical Research Forum has recognized the Smidt Heart Institute with a 2019 Top Ten Clinical Research Achievement Award for its study aimed at developing a blood-pressure control program for African-American men in the comfortable and convenient environments of their barbershops.

In just six short months, the study—first published in the New England Journal of Medicine and led by the late hypertension expert Ronald G. Victor, MD—improved the outcomes and control of high blood pressure in more than 60 percent of participants. The 12-month data published recently in the peer-reviewed journal Circulation backs up the results, proving that a pharmacist-led, barbershop-based medical intervention can successfully lower blood pressure in African-American men who face a higher risk of disability and premature death due to uncontrolled high blood pressure.

The collaboration between physicians, pharmacists and barbers showed that medical intervention in neighborhood settings can profoundly improve the health of hard-to-reach, underserved communities. Cedars-Sinai was nominated for the award by researchers at UCLA.

"This esteemed award is a true honor for our institution and the medical team who was driven to change and improve outcomes for this at-risk community," said Ravi Thadhani, MD, MPH, vice dean of Research and Education, who accepted the award at the National Press Club in Washington, D.C.

The barbershop study was funded in part by a grant from the National Heart, Lung and Blood Institute of the National Institutes of Health and a CTSI grant from the National Center for Advancing Translational Sciences. It is one of 10 award-winning studies identified by the Clinical Research Forum. Winners must exemplify major advances, resulting from the nation’s investment in research, to benefit the health and welfare of its citizens, and reflect the influential work being conducted by investigators at nearly 60 research institutions and hospitals across the United States, as well as at partner institutions from around the world. All nominated studies were published in peer-reviewed journals between November 2017 and December 2018.

Winners were selected based on the degree of innovation and novelty involved in the advancement of science; contribution to the understanding of human disease and/or physiology; and potential impact upon the diagnosis, prevention and/or treatment of disease.

"It has been the privilege of a lifetime to work on this novel research and equally as rewarding to be part of an elite group of researchers recognized for their outstanding contributions to science," said C. Adair Blyler, PharmD, an author on the study and one of two clinical pharmacists from the Smidt Heart Institute who traveled to African-American barbershops throughout Los Angeles to treat patients. "With these positive results behind us, we will now shift our 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."

Eduardo Marbán, MD, PhD, director of the Smidt Heart Institute, noted that Victor was the first to prove that if barbers offered blood pressure checks during men's haircuts and encouraged patrons with hypertension to follow up with physicians, hundreds of lives could be saved annually.

"Not only do we miss Ron's smile and smarts, but science is all the much poorer for his loss," said Marbán. "Our institution will forever attempt to carry on his scientific ingenuity, passion for serving his community and commitment to advancing the field of clinical research. Right now, plans are underway to expand the barbershop study."

Victor’s barbershop-based study was supported by Cedars-Sinai, the Smidt Heart Institute, National Institutes of Health grants to Dr. Victor and NIH CTSI grant UL1TR001881.

Making Waves in Science: Janine Bilsborough

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Janine Bilsborough, PhD

In honor of National Women's History Month in March, Pulse is celebrating Cedars-Sinai's talented female leaders with a Q&A series, "Making Waves in Science." This week's interview is with Janine Bilsborough, PhD, associate professor of Medicine and director of the Inflammatory Bowel Disease Drug Discovery and Development Unit.

How are you making an impact on science?

I lead a team of research scientists and clinicians who are working to develop new drugs to help the millions of inflammatory bowel disease (IBD) sufferers worldwide achieve long-term remission. Many drugs have been developed, but most haven't been effective. Part of the problem is we don't fully understand what causes IBD, which is the umbrella term for disorders involving chronic inflammation of the digestive tract. Another challenge is that IBD varies widely in terms of symptoms, severity and other factors. Approved drugs don't work for everyone, so we're taking a precision-medicine approach by selecting treatments for patients based on their particular disease characteristics. We've also identified a pathway that may be important for the development of severe, complicated IBD, and we've created an antibody that potentially could disrupt this pathway as a means of treating this form of IBD. The next step is clinically testing this antibody to assess its potential as a new drug.

What leadership advice would you give to your younger self?

I would have said to focus on understanding other peoples's points of view. When we're younger, there's a tendency to want to make your point and convince others to your way of thinking. If you want to move a project forward and achieve your goals, the people you're working with need to know their opinions matter and that you understand where they're coming from. By putting yourself in someone else's shoes, contentious, counterproductive interactions usually can be avoided.

Who is your favorite science heroine from history and why?

I don't have a famous science heroine, but I've had amazing women mentors who've had a tremendous impact on me. Two supervisors at previous jobs immediately come to mind. When I encounter challenging situations I ask myself, "What would they do?" These women’s personalities are very different, and I've been able to draw on strengths I observed in each of them. One has strong opinions but presents them in a calm, rational way that forces people to consider what she’s saying. The other is more of a people person, always upbeat and empathetic, which makes her very approachable. Different situations call for different strategies, and I'm fortunate to have learned from the best.

Alexa Tapped for Smart Hospital Room Pilot

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Cedars-Sinai patient John Gooch said his voice-activated assistant is "super cool." He uses it to listen to music and contact his nurses.

A pilot program underway in more than 100 patient rooms is allowing patients to use an Alexa-powered platform known as Aiva to interact hands-free with nurses and control their entertainment. Aiva is the world's first patient-centered voice assistant platform for hospitals.

In the pilot project, patient rooms are equipped with Amazon Echos and patients simply tell the device what they need. For example, patients can turn their TV off and on and change channels by giving verbal commands like, "Alexa, change the channel to ESPN." A patient who needs assistance getting out of bed might say, "Alexa, tell my nurse I need to get up to use the restroom."

The patient's request is routed to the mobile phone of the appropriate caregiver, whether a nurse, clinical partner, manager or administrator. A pain medicine request would be routed to a registered nurse, for example, while a bathroom request would be routed to a clinical partner. If the request is not answered in a timely manner, the Aiva platform sends it up the chain of command.

"Whereas previously nurses were frequently asked to help with the in-room television, Alexa does that job for us, allowing nurses to focus on providing the highest level of patient care," said Golda Morales, assistant nurse manager of General Surgery.

In addition to interaction with the patient's healthcare team, the devices at Cedars-Sinai include standard Alexa features, allowing patients to feel more connected to the outside world. The most common request is for the device to play music, followed by content like weather, sports and games.

Abdominal surgery patient Adrienne Edwards was one of the early users of Alexa. "It rocks," Edwards said. "I was lonely in the hospital and I said, 'Alexa, would you be my friend?' The device responded, 'Of course we could be friends. You seem very nice.'"

Peachy Hain, executive director of Medical and Surgical Services, was one of the driving forces behind bringing Alexa to patient rooms.

"Patients young and old are now used to voice-activated devices in their homes. Since it's familiar to them, it helps enhance their hospital experience," said Hain. "In the hospital, patients have little to distract them from pain or loneliness."

Cedars-Sinai and Aiva are moving patient interaction into the 21st century, when hospital rooms will need more intelligence and convenience to accommodate changing patient needs.

"Smart rooms are all about improving satisfaction for both patients and nurses," said Sumeet Bhatia, founder and CEO of Aiva. "Cedars-Sinai and Aiva are giving patients more entertainment options, more control over their environment and closer communication with their care team."

The Alexa program joins innovations such as the MyChart Bedside app and Cedars-Sinai's iPad project in modernizing patient communications at Cedars-Sinai. More than 250 tablets equipped with the MyChart Bedside app are now available for hospitalized patients, who can use the app to check their medical record information, including lab results, as well as the names and photos of their care team.

Aiva participated in the Cedars -Sinai Accelerator in 2017, where the product was further developed and tested. Cedars-Sinai, through the Accelerator, was one of the company's first investors. Aiva has since received funding from the Google Assistant Investment Program and Amazon's Alexa Fund. Aiva also works with other voice assistants, such as Google Home. In addition to its use in hospitals, the Aiva platform also can be used at home and in senior living communities.

FDA Issues Warnings About Medications

The U.S. Food and Drug Administration (FDA) is warning there is an increased risk of death with Uloric (febuxostat) compared to another gout medicine, allopurinol. The FDA is instructing healthcare professionals to reserve Uloric for use only in patients who have failed or do not tolerate allopurinol.

The FDA website has more information.

FDA: Xeljanz, Xeljanz XR Warning

The FDA is warning that a safety clinical trial found an increased risk of blood clots in the lungs and death when a 10-mg, twice-daily dose of tofacitinib (Xeljanz, Xeljanz XR) was used in patients with rheumatoid arthritis. Healthcare professionals should follow the recommendations in the tofacitinib prescribing information for the specific condition they are treating.

The FDA website has more information.

Medical Library Users Asked to Take Online Survey

The Cedars-Sinai Medical Library wants your opinion. The library's annual customer service survey is available now and runs through Sunday, March 17.

The survey aims to better understand the information-seeking behavior of the Cedars-Sinai community, and to measure awareness and satisfaction with library services.

The Medical Library Survey

Pharmacy and Therapeutics Product Updates

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

P and T Committee - February 2019 (PDF)  

CS-Link Tip: Using F2 as a Verb

In CS-Link™, "F2" is a verb.

F2 takes you to the next wild card, which looks like three asterisks, or to a list. You cannot close documentation until you have addressed wild cards and lists. After typing F2, your cursor will be right there. You don't need your mouse.

If you want to add text at the asterisks, start typing. If you want to get rid of them, hit the space bar. Hitting the space bar is much faster than clicking delete or backspace three times.

When you hit F2 and end up at a list, the contents of the list will be visible. If the list is blue, you can choose as many of the items as you want. If the list is yellow, you can only choose one item. Right click to choose the items you want, and left click to accept.

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.