From the President, December 2016

Posted on Dec 1, 2016 in President's Message | 0 comments

Dear Medical Staff Colleagues-

Dr Tigno MS PresidentI hope you had a wonderful Thanksgiving. The holidays and winter blues can create stress and especially now, post-election, feelings of uncertainty during this time of political transition.

The following are my personal thoughts, so bear with me as I climb on my soap box.

I am sensitive to the political environment outside of our medical center, which is occurring locally and nationally. I am not here to espouse a political agenda but more to encourage respect and tolerance of those with differing views. In day-to-day discussions with members of the medical staff, nursing and even patients, the topic of politics may arise. It is probably best to not engage in discussion especially if there is a lack of agreement. However, as medical professionals, we should continue to stand by certain principles. I am going to borrow statements from a memo that Dr. Kim Erlich, the chief of staff at Mills Peninsula, distributed to his medical staff. I feel that the statements encapsulate the spirit of what we should continue to model and promote.

We should continue to promote-

  • equal justice for all
  • social justice for all
  • rejection and non-tolerance of racism, bigotry, bullying, prejudice, misogyny, sexual harassment and sexual assault in all shapes and manifestations.
  • celebration of ethnic, racial, religious, cultural and sexual identity/preference diversity

As an immigrant, I am grateful for the opportunity to live in the Bay Area, which is rich in cultural diversity and social activism. Furthermore, it is a privilege to work at a hospital that has a strong sense of community, in which we encourage and support each other in times of transition and need.

  • Annual Closed Active Medical Staff business meeting – Thank you for those who attended the Nov. 10 meeting. In the future, we are considering a noon meeting since that may accommodate most people’s schedule better than an evening meeting.
  • Holiday Party on Dec. 7 (combined medical staffs from Alta Bates and Summit) at Scottish Rite- If you have not done so already please RSVP to the Medical Staff Office 510-869-6565. Parking at the Summit Garage with shuttle service to the event has been arranged.
  • Reminder that Admission orders if they need to be cosigned must be completed before discharge or else there is a hard stop in Sutter EHR. (Tipsheet for this below.)
  • Recognition of outstanding delivery of care– Much of the great work we do here goes under recognized. We can fix that. The Quality Department can send out letters of recognition to physicians who you feel have done an exceptional job. Please send via Sutter email to Terra or leave a message on her extension 3427. Include the patient MR#, the physician(s), reason why you believe the care was exceptional, and date of service.
  • Areas of construction- There are areas of the hospital that are undergoing construction and may impact other areas.
  • One example is the 4th floor ICU located in the Merritt Pavilion. Bathrooms are being created in the ICU and due to plumbing work, the 3rd floor OR areas will be impacted. Please review the schedule below. For any questions, please ask Lorrie Stone, Nurse Director of Perioperative Services. Office-(510) 869-6754.
  • ED admissions to floor and ICU– Kudos to physicians and staff on decreasing the ED length of stay, which helps in both quality of care and in patient experience. Prior to the ED Kaizen event, which looked at the admission flow process, the time for Admit Decision to Leave ED was 140 minutes and after the Kaizen event the time was 109 minutes at the end of October. As we look ahead to increased volume, this is a good sign.

Please have safe and joyful holidays.

Until next time, be well,

Donna D. Tigno, M.D.
President of Summit Medical Staff

Areas of Construction – Details

Posted on Dec 1, 2016 in Announcements | 0 comments

There are two separate projects planned in the OR as a response to the construction occurring in the ICU remodel.

Project 1: Work in sterile core by OR 5 will have full containment and only be done on the following weekends to avoid interruption of service: Dec. 3, 10, 11, 17 and 18. On De.c 3, a hatch will be cut to access the plumbing above. On the following two weekends, the plumbing will be tied in to accommodate the ADA work in the bathroom above. We will plan to use ORs 8 to 12 during this time. There may be some noise in the ICU intermittently tied to this project and communication is being prepared for patients and families to notify them.

Project 2: Work in the corridor by OR 12 commencing on Dec. 5 for that week (five days). This is the same work as project 1 with the exception of creating the hatch, which is already in existence. This work is for the bathroom in the AIIR room in ICU. The corridor by OR 12 will be open to foot traffic, but too narrow for beds so we will reroute for that week. Signage will be posted.

Donna D. Tigno, M.D.
President of Summit Medical Staff

ABSMC Medical Staff’s Holiday Party

Posted on Dec 1, 2016 in Events | 0 comments


From Medical Staff Services


Well-Being Lecture Series to Start in 2017

Posted on Dec 1, 2016 in Announcements | 0 comments

To address concerns about provider burnout, Medical Staff leadership has set up a Provider Well-Being Committee. We on this Committee have established a lecture series for 2017 with the help of the Medical Education Committee.

The Lectures will be roughly every other month and will cover a board range of topics – from medical errors to compassion, with a focus on providers, our non-provider selves, our patients and institutions such as our medical groups and medical center.

We have lined up a number of distinguished speakers. The list includes Dacher Keltner PhD, UC Berkeley professor of Psychology and author of “Born to be Good” and “The Power Paradox.” He is a leader in the field of pro-social emotions.  He will give us a talk on “Happiness for Healthcare Providers.” Emiliana Simon-Thomas is the Scientific Director of the Greater Good Science Center at UC Berkeley and she will talk about “Creating Compassionate Providers and Health Care Institutions.”  Dr. Louis Wu, the Chief Medical Officer of EBPMG, will talk about “Medical Errors and Shame.”  Our own Jack Edelen, M.D., will talk about a stress reduction mindfulness meditation practice he has been doing for 20 years.

We have other talks lined up as well. If you have thoughts or ideas, please let me know.  And let me know if you are interested in joining the Well-Being Committee or have ideas for us.

Leif Hass, M.D.

Hospital Inpatient Admission Order and Certification

Posted on Dec 1, 2016 in Health Information Management | 0 comments

Did you know that CMS requires admission orders to be signed by an MD prior to a patient’s discharge in order to be billed for that encounter?

As a condition of payment for hospital inpatient services under Medicare Part A, section 1814(a) of the Social Security Act requires physician certification of the medical necessity that such services be provided on an inpatient basis. The order to admit as an inpatient (“practitioner order”) is a critical element of the physician certification, and is therefore also required for hospital inpatient coverage and payment under Part A. The physician certification, which includes the practitioner order, is considered along with other documentation in the medical record as evidence that hospital inpatient service(s) were reasonable and necessary. When a physician signs the certification, they are certifying that inpatient hospital services were reasonable and necessary.

The following guidance applies to all inpatient hospital and critical access hospital (CAH) services unless otherwise specified. For the remainder of this guidance, when we refer to hospitals, we are also referring to CAHs. The complete requirements for the physician certification are found in 42 CFR Part 424 subpart B and 42 CFR 412.3. An electronic version of the CFR is available online at:

Alisa Stinn, RHIT
Client Location Lead / Health Information Manager
Alta Bates Summit Medical Center-Oakland Campus
(Office) 510-869-8741
(Cell) 510-381-5181
(Fax)  510-869-8856





Admit Order Changes

Posted on Dec 1, 2016 in EHR Updates | 0 comments

As noted above, CMS now requires that hospitalized patients have a valid admission order in place prior to discharge.  These orders must be entered and signed or co-signed by the attending provider prior to discharging the patient.

Please see the Admit Order tip sheet:

From Patty Fitzgibbons
EHR Physician Liaison


EHR Tips

Posted on Dec 1, 2016 in EHR Updates | 0 comments

Popular Order Sets: Several physicians have found these order sets very helpful.  We recommend using these orders sets to streamline orders and follow best practice guidelines.

  • IR PARACENTESIS/THORACENTESIS [8071] – Contains lab orders!

What is a Radar Dashboard?

  • This is a tab in EPIC that provides easy, convenient access to several important and helpful links. Some useful links are:
    • Uptodate
    • Cures
    • SHIS
    • Sutter EHR Wiki
    • Provider Directory
    • Google Images

EHR Tips


Welcome, New Physicians

Posted on Dec 1, 2016 in New Physicians | 0 comments

Brad G. Angeja, MD
Cardiovascular Disease
1501 Trousdale Dr., Fl 2
Burlingame, CA 94010-4506
(650) 652-8600

Frank C. Chen, MD
3300 Webster St., Ste. 410
Oakland, CA 94609-3149
(510) 549-4220

Ranvir S. Dhillon, MD
Internal Medicine
350 Hawthorne Ave., Rm. 2346
Oakland, CA 94609
(510) 869-6883

Ryan H. Dougherty, MD
Critical Care Medicine
2351 Clay St., Ste. 501
San Francisco, CA 94115-1931
(415) 923-3421

David A. Lindenberg, DO
Pain Medicine
2850 Telegraph Ave., Ste. 120
Berkeley, CA 94705-1159
(510) 204-8140

Lakshminarayan Srinivasan, MD
Radiology, Diagnostic
2125 Oak Grove Rd., Ste 200
Walnut Creek, CA 94598-2520
(925) 296-7150

Amanda M. Stephenson, MD
Emergency Medicine
2000 Crow Canyon Pl., Ste. 260
San Ramon, CA 94583-1367
(925) 962-1067

Xingbo Sun, DPM
445 30th St.
Oakland, CA 94609-3337
(510) 465-8012

Christopher H. Swan, MD
2700 Grant St., Ste. 319
Concord, CA 94520
(925) 674-2880

From Medical Staff Services

From the President, November 2016

Posted on Nov 1, 2016 in President's Message | 0 comments

Dear Medical Staff Colleagues-

Dr Tigno MS President

  • Eden Transfers We anticipate a surge of patients this fall and winter. On occasion, some Sutter affiliates are even more challenged by capacity, such as Eden Medical Center. There is a commitment from both Administration and Medical Staff to help our sister hospital by accepting overflow from Eden ED. This is a coordinated effort with many moving parts. Please let Dr. Ursula Boynton know of any challenges to that end.
  • Length of stay is an area of focus and a continued work in progress. The ED process of admissions and flow was a focus in a recent Kaizen event. Thank you Hospitalists and Intensivists for your attention and partnership with the ED Physicians and staff. Goal is to improve the patient experience and improve safety by a timely admission. Once patients are admitted, the length of stay is also an area of focus. The goal is a timely appropriate discharge without compromising quality and safety. It must be done smartly. Understandably, it’s a balance – the “yin” to discharge is the “yang” of readmission.
  • For those of you that have been here long enough, our beloved 3North on the old Merritt Tower will be reborn as a med-surg unit. The anticipated start date is Nov. 10, 2016.
  • Parking Friendly reminder: There are areas dedicated to physician parking, so please make sure your car has the grey octagonal sticker. You can either drop by the parking office or the Med Staff Office, 2nd floor (located by C elevators), to pick up a sticker if you do not already have one.
  • Our Wellness Committee has a speaker series starting in January 2017 focusing on mindfulness, burnout and compassion. Dr. Leif Hass, co-chair of the committee, has lined up a series of talks to be held during Thursday Grand Rounds. Please contact him for further details.
  • Please fill out the online Physician Engagement Survey, which only takes a few minutes. The survey is out until Nov. 18, 2016. Last year’s survey indicated that satisfaction and engagement were not at the level that both Medical Staff and Administration would like them to be. Our Administration and the Sutter system are very interested in physician input. The only way that changes can occur is if they are aware of concerns and feedback. So the first step is completing the online survey. If you have not already done so, please take those few minutes of your time and many thanks in advance.

Holidays are coming around the corner and so warm thoughts to you and your family.

Until next time, be well,

Donna D. Tigno, M.D.
President of Summit Medical Staff


2017 Annual Medical Staff Dues

Posted on Nov 1, 2016 in Announcements | 0 comments

The Medical Executive Committee has determined that the 2017 Annual Medical Staff Dues will increase to $350. This is a $25 increase.  The Allied Health Professional Staff members will begin paying dues of $175 annually. The first dues letters will be mailed to your office November 16 and subsequent reminder letters will be emailed to the address we have on file for you in the Medical Staff Office. If you are in a group, one letter will be mailed to your office with a list of doctors in the group owing dues.   The dues are due no later than March 1, 2017.

Please keep your email address current with the Medical Staff Office by calling 510-869-6565 or by emailing

From Medical Staff Office