From the President, March 2015

Posted on Mar 3, 2015 in President's Message | 0 comments

 

Junaid H. Khan, M.D.

Junaid H. Khan, M.D.

  • The Volunteer Shadowing Program has started. Thank you to all the physicians who have agreed to allow our excellent volunteers to shadow them. The volunteers have done 200 hours of service to the hospital before they are eligible for this program.
  • The acute rehab portion of the patient care pavilion is operational.
  • HIM (medical records) will gradually increase suspensions from the top 10 offenders to all delinquent records over the next few months to be complaint with Medical Staff Rules and Regulations.
  • EMIM issues appear to be improving. Please let Dr. Linda Gordon know if your imaging needs are not being met.
  • Doctor‘s Day is March 30 and Administration will make a charitable contribution on our behalf to Operation Access.
  • Dr. David Chang has been elected Chair of Orthopedics. Dr. Basil Alwattar has been elected Vice Chair of Orthopedics.
  • EHR op-time is on track to go live in August 2015 in the Operating Room.
  • The physician satisfaction survey revealed significant opportunities for improvement. Summit scores were the lowest in the Sutter system. Scores for the hospitalists were at the lowest level ever recorded. Dr. Steve O’Brien will be working with the various departments to address issues that were raised.

By Junaid Khan, M.D.

 

 

 

 

E H R: Tips and Timesavers

Posted on Mar 3, 2015 in EHR Updates | 0 comments

Co-sign Orders.  Verbal orders must be signed within 48 hours. In the paper chart, these verbal orders were on the infamous “green sheets,” and were marked for signing. In the EHR world, you get an alert upon signing in: “Jump to In-basket.” Although there may be many items in your In basket, signing of your verbal orders is very time sensitive for the Medical Staff to stay compliant.

Additionally, you could help your colleagues and the hospital by signing all verbal orders for your patient, even if not ordered by you. You would do this by going to the Manage Orders Activity (on the left hand side), and then clicking the “Cosign” tab (on the top of the screen). You can access all verbal orders for the patient in this tab. Please consider this as part of your daily workflow.

Transfusion Consent. How do you document consent for transfusions? The workflow for ordering transfusions is challenging, at best. Because it is a combination of orders and documentation, the ordering provider has to document in numerous places.

In addition to placing the order for a transfusion (usually via the transfusion order set), you should also document that the patient has given consent, and has been given the Paul Gann materials. A system SmartPhrase has been created “.INFTransfusion.” You can type this into any part of your note and the proper verbiage for transfusion consent will be added.

Too many mouse clicks? Can’t always remember what an order is named? Find yourself typing the same discharge instructions and wonder if there isn’t a better way? Now that we have been live on the EHR for almost two years, it may be a good time to revisit some of the SMART TOOLS in our EHR and fine tune them.

Patty Fitzgibbons has teamed with two of our system trainers to hold refresher classes to help anyone interested update the use Smart Phrases, Smart Links, Smart Lists, Multiple Versions of Order Sets, Preference Lists and In Basket Tips and Tricks.  Her schedule is:

  • March 24             7 a.m.-2 p.m.          Nursing Administration Conference Room
  • April 28                7 a.m.-2 p.m.          Nursing Administration Conference Room

Reservations are for one hour blocks of time. Drop-ins are welcome, but priority will be given to those with a reservation.  To schedule a personalized session, please contact Patty Fitzgibbons at 510-325-9618.

Do you find the EHR navigator page just too busy with a lot of Activity Buttons you never use? Over the next few months we will continue to roll out new Specialty Navigators designed to better meet the needs of individual specialties and minimize the clutter on the navigator page. The updated schedule for rolling these out is:

DEPARTMENT GO LIVE DATE
Peds, Newborn, NICU March 10
General Surgery and Urgent Care March 10
Ortho, Podiatry, Plastic Surgery April 7
Cardiology and CT Surgery April 7 (or May 12)
Infectious Disease, GI, Rheumatology May 12

 

Presentations will be made at Department meetings, and training materials will be made available. Contact Patty Fitzgibbons at FitzgiP@Sutterhealth.org, or 510-325-9618 for additional information.

By Michael Kim, M.D.                                  

Kudos to Physicians With Excellent Verbal Order Signing Compliance

Posted on Mar 3, 2015 in Announcements | 0 comments

These physicians have a high volume of verbal orders (20+ orders) and a 90 percent or higher compliance rate for signing their orders within 48 hours.

Thanks for a job well done!

Physicians

  • Stanten, Steven 100%
  • Gunawardane, Manjula  100%
  • Valand, Ronack 100%
  • Marquis, Kimberly  98%
  • Green, Robert 97%
  • Moorstein, Bruce 96%
  • Shroff, Yoshita  96%
  • Lin, Ludwig 95%
  • Khan, Junaid 94%
  • Manjuck, Janice 94%
  • Phelps, Roger  94%
  • Rivera, Alvin 93%
  • Sharma, Kanika 93%
  • Wong, Christine 93%
  • Kao, Susan 92%
  • Munzni, Kalpna  92%
  • Cohn, Jennifer 92%
  • Aplyn, Monika  90%

Departments/Services

  • Emergency Medicine 98%
  • Cardiovascular Surgery 93%
  • Anesthesia 92%
  • Vascular Surgery 92%

By Junaid Khan, M.D.

 

Update: Delinquent Medical Records Suspension or How to Avoid Suspension for Delinquent Medical Records

Posted on Mar 3, 2015 in Announcements | 0 comments

Current: Suspension Process

  • Only top 10 physicians with most delinquent records are considered for suspension each week
  • Suspension occurs at approximately 12:00 noon every Thursday
  • Courtesy calls are made 3-4 times a week, starting on the Monday prior to suspension day
  • 3 notification letters are sent to your current notification preference  (same as below), starting on the Monday the week prior to suspension week
  • Notify leadership via email 3-4 times a week
  • 100% of all delinquent records validated by HIM before suspension occurs
  • Suspension list is posted on hospital intranet site.  The suspension list is updated as changes occur
  • Not currently suspending for interval H&P notes and CDI /Coding queries
  • Failure to respond within timeframes specified in notification letters will result in suspension of the following hospital privileges, pending full compliance
  • Admitting / Attending privileges for elective and emergency admissions
  • Scheduling new surgeries or perform previously scheduled elective surgeries
  • Suspended physicians can continue to care for their current patients including:  documenting in the chart, signing records, giving orders and can continue as members as the treatment team
  • Extending privileges:  A physician whose privileges have been suspended may be granted an extension if approved by their Department Chair or Chief of Staff

 Future State: Suspension Overview

  • Incremental increases by 25% per month leading to full suspension to include MD, PA and NP implemented by June 2015
  • Suspension occurs at approximately 12:00 noon every Thursday
  • 1 Courtesy call will be made to physicians between Tues-Thurs if on track for suspension
  • 100% review of document / dictate delinquent deficiencies only validated by HIM before suspension
  • Notify leadership via email on Wednesday informing of proposed suspension list for Thursday at noon
  • Notify leadership via email on Thursday information of confirmed suspension list
  • Suspension list is posted on hospital intranet site.  The suspension list is updated as changes occur
  • No suspension for Interval H&P and CDI / Coding queries
  • Notification Preference memo will be sent out from Medical Staff Office via email
  • 3 Notification letters will be sent to your notification preference
  • First Notification Letter-  Monday-  sent to providers with deficient but not delinquent medical records.  If records are not completed by the following Monday
  • Second Notification Letter is sent for Thursday suspension
  • Suspension Notification Letter sent at noon on Thursday  if delinquent records are not completed
  • Failure to respond within timeframes specified in notification letters will result in suspension of the following hospital privileges, pending full compliance
  • Admitting / Attending privileges for elective and emergency admissions
  • Scheduling new surgeries or perform previously scheduled elective surgeries
  • Suspended physicians can continue to care for their current patients including:  documenting in the chart, signing records, giving orders and can continue as members as the treatment team
  • Extending privileges:  A physician whose privileges have been suspended may be granted an extension if approved by their Department Chair or Chief of Staff

Suspension Tips 

  • Clear your In basket by Thursday morning at the latest
  • Read the deficiency messages:  A deficiency asking you to document may be just for missing criteria or interval  H&P note
  • Complete your interval H&P note directly in Sutter EHR
  • Complete your documentation under the correct note navigators

 Duplicate Record Information

  • Clinicians now have the ability to mark a record for merge.  Please follow-up with Patty Fitzgibbons for training
  • Notify nurse of duplicate record.  Communicate if merge is needed urgently
  • Nursing informs Patient Access or HIM to mark record for merge. Nurse Supervisor can also mark record for merge if urgent.
  • After-hours urgent merge requests are to be emailed to *S3-HIM MERGE@sutterhealth.org. A direct line is also being established.
  • This information has been sent to Nursing Administration, Patient Access and HIM

By Alissa Stinn
Manager, Health Information Management

 

 

 

 

 

Doctor’s Day Celebration: March 30th

Posted on Mar 3, 2015 in Events | 0 comments

SAVE THE DATE

2015 Doctor’s Day Celebration

Monday, March 30, 2015

Breakfast & Lunch

Medical Staff Lounge – Ground Floor

(Invitation to Follow)

Welcome New Physicians

Posted on Mar 3, 2015 in New Physicians | 0 comments

Please welcome the physicians who joined our staff in February:

Shoko Abe, M.D.
General Surgery
3300 Webster St. #212
Oakland, CA. 94609
510-835-990

Ephraim Aklilu, D.D.S
Oral Maxillo Facial Surgery
2 MacArthur Place #700
Santa Ana, CA. 92707
714-474-7681

Sravana Chennupati, M.D.
Radiation Oncology
2001 Dwight Way
Berkeley, CA 94704
510-204-6561

Shirley Chi, M.D.
Physical Medicine and Rehab
2001 Dwight Way
Berkeley, CA 94704
510-204-4411

Talia Gracer, M.D.
Internal Medicine
350 30th St. #320
Oakland, CA. 94609
510-465-6700

Henry Koh, M.D.
Physical Medicine and Rehab
43523 Puesta Del Sol
Fremont, CA. 94539
510-213-1154

Ariel Palanea, MD
Orthopedic Surgery
80 Grand Ave. 5th Floor
Oakland, CA. 94612
510-451-6266

Stephen Post, M.D.
Ophthalmology
2149 Central Ave.
Oakland, CA. 94501
510-769-0477

By,  Medical Staff Services

 

From the President, February 2015

Posted on Feb 3, 2015 in President's Message | 0 comments

Junaid H. Khan, M.D.

Junaid H. Khan, M.D.

  • Overall medical center quality scores, which suffered during our transition to Sutter EHR (really an issue of documentation identification), are for the most part going back to green after a “rapid process improvement” cycle under the leadership of Merrilee Newton, R.N., and Donna Tigno, M.D.
  • Acute Rehabilitation Services completed their transition from the Herrick campus to the new Patient Care Pavilion.
  • Staffing remains a critical challenge. A significant number of new RN hires are set to start in early February. In addition to staffing challenges, the campus has had a historically high census over the past few months.  The Emergency Department has been impacted significantly with increased patient hold time.  The Medical Staff leadership and Administration have identified the staffing challenge as the most significant opportunity for improvement for the next quarter. The Medical Staff can help by assessing the need for telemetry on a daily basis and processing patient discharges early in the day.
  • EMIM (new X-ray system) is generally working well. There are a few specific challenges. A task force has been created to process our local challenges to the system. Robin Gagnon (GagnonR@sutterhealth.org) and Linda Gordon, M.D., are key contacts for any concerns of the Medical Staff.
  • Dr. Lee Hambrick has been elected the new Ob-Gyn chair. Dr. Anna Frick has been elected the new vice-chair.
  • Kaizen events continue in the OR and ED to improve patient flow.
  • The transition of food service to Firs 1 and 2 on Thursdays appears to have been smooth, with the vast majority of the physician feedback being positive.
  • The Volunteer Shadowing Program will start after Valentine’s Day under the leadership of Drs. Christine Wong, Justin Lee and Hussain Gilani.  A special thank-you to all the physicians who have agreed to participate in the program.

By Junaid Khan, M.D.

 

 

 

Isolation of Patients for MRSA: Policy Change

Posted on Feb 3, 2015 in Infection Prevention | 0 comments

The hospital’s policy for isolation of patients with MRSA has changed. Specifically, patients are already, by law-driven policy, screened at admission with a swab of the nares to determine the presence or absence of MRSA.  The change in policy is that patients who have only that positive screen for MRSA, but no other evidence of disease due to it, are not to be placed in Contact Isolation, as previously they were.  It’s important for physicians to know this change so that, if questions arise, all MDs, RNs, etc., are “on the same page.”

Note that screening for pre-operative patients occurs in the Pre-Op Clinic (under the supervision of Dr. Tessa Collins), where at present only pre-operative orthopedics patients are being seen, and where in coming months other pre-operative patients also will be seen.  Results of screening these patients go to the clinic, where interventions are in place to manage patients whose screening results are positive for MRSA.  For questions, please call Infection Control at 510-869-8363.

By Roger Phelps, M.D.

Transfer of Suspected or Confirmed Infectious Aerosol Transmissible Disease Patients

Posted on Feb 3, 2015 in Infection Prevention | 0 comments

Patients with potential or confirmed Aerosol Transmissible Disease that requires airborne isolation should be placed in an Airborne Infection Isolation Room (AIIR). (An AIIR is a room, area, booth, tent or other enclosure that is maintained at negative pressure to adjacent areas in order to control the spread of aerosolized M. tuberculosis and other airborne infectious pathogens.)

Upon identification of a potential or confirmed ATD, the patient will be placed into airborne isolation. If transfer to an AIIR room within the facility is required, this shall occur within five hours.

In the new patient care pavilion at Summit, we have several AIIRs equipped with negative pressure systems. However, in our Critical Care Units, we have none that have negative pressure.

When providing care for Summit patients who require Critical Care and require Airborne Isolation, the physician must transfer the patient to a facility that has fully functional AIIRs.

Exception:

Where the treating physician determines that transfer would be detrimental to the patient’s condition, the patient need not be transferred.

  •  Employees who enter the room or area housing the individual are provided with and use, appropriate personal protective equipment and respiratory protection in accordance with 5144 (g).5199(e) (5) (B) (as above)
  •  The physician must document daily in the medical record the patient’s inability to tolerate transport.

By Joseph B. Marzouk, M.D., Chair Infection Control Committee &
Fred Deneau, CMS, CIC Manager Infection Control ABSMC

EHR: What’s In It for You? Optimization

Posted on Feb 3, 2015 in EHR Updates | 0 comments

Too many mouse clicks? Can’t always remember what an order is named? Find yourself typing the same discharge instructions and wonder if there isn’t a better way?

Now that we have been live on the EHR for almost two years, it may be a good time to revisit the smart tools and fine tune them. Patty Fitzgibbons has teamed with two of our system trainers to hold refresher classes on Smart Phrases, Smart Links, Smart Lists, Multiple Versions of Order Sets, Preference Lists and In Basket tips and tricks:

  • March 24             7 a.m.-2 p.m.          Nursing Administration Conference Room
  • April 28                7 a.m.-2 p.m.          Nursing Administration Conference Room

Reservations are for 1 hour blocks of time. Drop-ins are welcome, but priority will be given to those with a reservation.  To schedule a personalized session, please contact Patty Fitzgibbons at 510-325-9618.

Do you find the EHR navigator page just too busy with many Activity Buttons you never use? Over the next few months we will roll out Specialty Navigators designed to better meet the needs of individual specialties and minimize the clutter on the navigator page. The schedule for rolling these out is as follows:

DEPARTMENT GO LIVE DATE
Peds, Newborn, NICU February 24
General Surgery and Urgent Care March 10
Ortho, Podiatry, Plastic Surgery April 7
Cardiology and CT Surgery April 21
Infectious Disease, GI May 19
Rad Onc, Oncology, Endocrinology June 2
Pulmonology, Neurology and ENT June 16

 

We will provide training materials in conjunction with each of these rollouts. We are also working with the training team to create the opportunity to view these new navigators in the Playground environment. Look for more information about login instructions.

By Michael Kim, M.D.