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.

Our Best Doctors

Posted on Feb 3, 2015 in Uncategorized | 0 comments

An article in the January 2015 San Francisco magazine, listed the best doctors in eight Bay Area counties. The list was compiled by Castle Connolly Medical Ltd., a health-care research and information company that has made it its mission to guide patients to the finest physicians and hospitals in the country.

The company asks doctors to nominate their own. (And, no, doctors can’t nominate themselves, nor can they pay to be included.) The company also requests recommendations from medical professionals in the Bay Area, including hospital executives and members of county medical societies.

After sifting through nearly 3,000 nominees in the counties of Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara and Sonoma, Castle Connolly’s team narrowed the list of top docs down to 551 names.

The Summit Medical Staff members included in the list:

Internal Medicine
Samuel Dong, MD
Robert Sandberg, MD

Cardiac Electrophysiology
Nitish Badhwar, MD
Paul Ludmer, MD
Carleton Nibley, MD

Cardiovascular Disease
John Edelen, MD

Hand Surgery
Kendrick Lee, MD

Interventional Cardiology
Robert Greene, MD

Neurology
Bradley Wrubel, MD
Robyn Young, MD

Obstetrics and Gynecology
Heidi Wittenberg, MD

Otolaryngology
Richard Kerbavaz, MD

Pediatric Hematology & Oncology
Elliott Vichinsky, MD

Plastic Surgery
Stephen Daane, MD

Pulmonary Disease
Christopher Brown, MD
Brandon Lu, MD

Rheumatology
Brian Kaye, MD
Molly Magnano, MD

Thoracic and Cardiac Surgery
Russell Stanten, MD

Urology
Charles Wen, MD

Vascular Surgery
Lamont Paxton, MD

From, Medical Staff Services

Save the Date – Annual Picchi Lecture

Posted on Feb 3, 2015 in Events | 0 comments

The 25th Annual Picchi Memorial Lecture

Presents

“Speaking Sexually:

About Matters Affecting Emotional and Physical Health”

Guest Lecturer: Isadora Alman, MFT

Thursday, March 12, 2015

5:30 p.m.

Health Education Center
400 Hawthorne Avenue
Oakland, CA 94609

Reception to follow lecture

To make a reservation, please call 510-869-8628 by March 5, 2015

By Gena Caya, Samuel Merritt University  

Welcome New Physicians

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

Please welcome the physicians who joined our staff in January:

Samuel Choi, M.D.
Diagnostic Radiology
2125 Oak Grove Rd. Suite 209
Walnut Creek, CA. 94598
925-296-7150

Sonja Kassuba, M.D.
Hospice & Palliative Care Medicine
350 Hawthorne Ave. Suite 2304
Oakland, CA. 94609
510-869-8373

Tun Maung, M.D.
Hospitalist, Medical
3901 Lone Tree Way
Antioch, CA 94509
925-756-1192

Joan Reynolds, M.D.
Diagnostic Radiology
2125 Oak Grove Rd. Suite 209
Walnut Creek, CA. 94598
925-296-7150

Eric Saldinger, M.D.
Diagnostic Radiology
2125 Oak Grove Rd. Suite 209
Walnut Creek, CA. 94598
925-296-7150

Keith Tao, M.D.
Diagnostic Radiology
2125 Oak Grove Rd. Suite 209
Walnut Creek, CA. 94598
925-296-7150

Janice Timm, PhD
Neuropsychology
2001 Dwight Way, 5N
Berkeley, CA. 94704
707-225-5462

David Wixson, M.D.
Diagnostic Radiology
2125 Oak Grove Rd. Suite 209
Walnut Creek, CA. 94598
925-296-7150

David Woo, M.D.
Diagnostic Radiology
2125 Oak Grove Rd. Suite 209
Walnut Creek, CA. 94598
925-296-7150

 From, Medical Staff Services

 

 

From the President, January 2015

Posted on Jan 5, 2015 in President's Message | 0 comments

Junaid H. Khan, M.D.

Junaid H. Khan, M.D.

Happy New Year:

  • The new PCP continues to get rave reviews from patients, visitors and physicians.
  • The ability to adequately staff remains a significant challenge particularly during the holidays. The problem was exacerbated by the labor action at Kaiser, utilizing a portion of the traveling nurse pool. A significant number of new nurses have been hired in the past month and we anticipate many will start in the first week of January. The Medical Staff Leadership will be having a special meeting with Administration in the first week of January to discuss some opportunities for improvement. In the meantime, please let me know of any specific concerns, as well as letting our CNE, Denise Navellier, know.
  • $500 Best Buy gift certificates were awarded to physicians following a raffle drawing at the holiday party for participation in the Physician Satisfaction Survey.  Honors went to the Department of Surgery and the Department of Emergency Medicine for having the most improved participation and to the Department of Anesthesia for being the Department with the highest over-all participation. Donnis Hobson, M.D., and Christine Riguzzi, M.D., won for the Departments of Surgery and Emergency Medicine.  Karin Klika, M.D. won for Department of Anesthesia.

Congratulations to all the winners! Next year, only those completing the survey will be eligible to participate.  And you may have to be in attendance at the Medical Staff Holiday Party to claim your prize!  Stay tuned next year for further information. We expect the results of the survey early in January.

  • 2014 Sutter EHR upgrade to Epic occurred seamlessly in December. Optimization is the key going forward in being more efficient in using the E H R.  I would encourage all of you to reach out to our liaison, Patty Fitzgibbons, for access to all the resources available to you.  Patty also has lunchtime hours in the physician cafeteria area.
  • Thursday lunch meal service will be moving to the Fir Room for a three month trial for physician convenience. The hours will remain the same before and after the Medical Grand Rounds.
  • Outpatient physician contact information accuracy remains a challenge in certain circumstances. Please notify Medical Records Director Alisa Stinn when you identify a problem and she will help facilitate correction via S3 (Sutter Shared Services).  StinnAl@sutterhealth.org
  • Rehabilitation services have moved into the lower floors of the PCP. We welcome those physicians to the medical staff at Summit.
  • Medical Staff Performance Improvement will be reaching out to inform physicians that PET/CTs should only be ordered on an inpatient basis when the results will impact care on that admission. Drs. Dean Nickles and Manj Gunawardane will be reaching out to key stake holders in developing a policy/guidelines on when PET/CT can be ordered on an inpatient.
  • A coffee truck has started operations in front of the new PCP.

By Junaid Khan, M.D.

Ebola Update

Posted on Jan 5, 2015 in Infection Prevention | 0 comments

Preparations for the arrival here of a patient suspected of having Ebola virus disease are part of greater planning efforts Sutterwide and more generally in coordination with public health authorities at the local, state and federal levels. Our efforts here at Summit fall into two categories, policies and equipment.

A bi-campus Ebola Steering Committee, including physicians and representatives of the hospital, has formed and met to guide activities, as has a physician-specific task-force. The major areas of organizational effort are:

  • Hospitals nationwide will be in one of three tiers: front line, assessment and treatment. Locally, if current plans play out, UCSF and Oakland’s Kaiser will be the treatment facilities. Summit will be in the front line, that is, where a patient who on presentation meets criteria as a “person under investigation” for Ebola will be isolated, and from which the patient will be transported to an assessment facility, that is, where the patient will reside for the anticipated 3-5 days needed to confirm or exclude the diagnosis of Ebola. (Planning is underway for Alta Bates to be an assessment facility, but the authority for that decision is the public health sector’s, not the hospital’s or Sutter’s, and the decision is at the time of this writing pending.) The ultimate site for management of a patient confirmed to have Ebola will be a treatment facility.
  • Policies are in a state of refinement, materials and equipment are being obtained and updated, and training (and confirmatory drills) are proceeding to accommodate the isolation, initial management, and subsequent transport of the suspected patient, regardless where the patient presents (ER, registration, etc.).

By Roger Phelps, M.D. and Merrilee Newton, R.N.

 

 

Sutter EHR Update

Posted on Jan 5, 2015 in EHR Updates | 0 comments

As we’ve closed out the month of December, it is a good opportunity to reflect on the status of the Sutter EHR at Summit. A few key points:

The Epic 2014 upgrade that was initiated Dec. 6 went remarkably well, thanks in no small part to the patience and diligence of our medical staff. As a reminder, some of the new and improved functionality with this upgrade includes:

  1. The ability to save different personalized versions of an order set.
  2. A search feature that allows one to more easily find clinical data
  3. A more intuitive “Manage Orders” function that makes it easier to track active orders and eliminate duplicate orders or orders that are no longer needed. Since this is essentially the same view as that which the nurses see, it should facilitate better communication between ordering providers and nurses.

These are just a few of the improvements. Please connect with your physician liaison, Patty Fitzgibbons, to learn more.  Patty can be reached at 510-869-8339 or on her cell, 510-325-9618.

A word about Meaningful Use: Congratulations are in order to medical and clinical staff for achieving excellent results in various Stage 1 Meaningful Use categories that are reported to CMS. This is a complicated program whose objective is to provide incentives to use the EHR tool to improve patient care and the fact that we have performed well reflects well on both the clinical and administrative sides of this program.

As of October 2014, Summit entered Stage 2 of the Meaningful Use program. Many of the basic incentives are still in place although with somewhat different measurements. The one area in Stage 2 where we are at risk has to do with the consistency with which we send post discharge information to our providers. It is very important for any discharging provider to update the “Follow up” provider field as one moves through the discharge navigator. Your help in this is greatly appreciated, primarily as it improves the transition of care from the inpatient setting to the outpatient follow up.

Looking forward to 2015, your EHR team including the physician champions, analysts and physician liaison are working together to give one-on-one or small group sessions to optimize the use of the EHR. This can be done by appointment or drop in to Patty’s office. These sessions have been very helpful to take a fresh look at preference lists, Smart Phrases and other tools to make the use of the EHR more efficient.

As a point of information, the “Hotel Order Set” is being reviewed at the system level with representatives from the East Bay participating to make it more user friendly and to address some of the problems we have had with either missing orders, duplicate orders or confusing admission workflows. More to come on this as work progresses.

Lastly, as we look at the calendar for 2015, we anticipate the implementation of Optime around August. This will bring our East Bay facilities in line with colleagues elsewhere in the Sutter system to make possible more automated capture of anesthesia orders and documentation. Work is currently scheduled to upgrade the ORs to accommodate the power and network improvements that are necessary for Optime.

By Bill DeWolf, M.D.