MACRA(MIPS) is coming

Posted on Jul 7, 2017 in Announcements | 0 comments


The new MIPS “Quality Payment Program” under the MACRA act is changing the way Medicare pays clinicians and offers financial incentives for providing high value care.

Now, more than ever, a strong partnership with your EHR vendor can simplify the process and provide resources and support. Are you prepared for the evolution of MIPS requirements and how this will impact your practice?

Learn how Sutter Community Connect (SCC) is working closely with our Epic and Sutter Health partners to ensure that our eligible clinicians have the necessary EHR features, reports and tools in order to report MIPS in 2017 and beyond.






*Maximum amount of incentive payments under MIPS could increase further for “exceptional performers.” Maximum incentive payments in a given year may also be subject to a “scaling factor” to ensure budget neutrality.

Contact Larraine Ewing at (510) 590-1241 or via email at for more information on SCC and how we can support your practice with the new MIPS requirements.

Proprietary and confidential. Not to be released without the permission of Sutter Community Connect.

Medication Safety Alert: BID Order in EPIC

Posted on Jun 5, 2017 in Announcements | 0 comments

Event details:
An order for Lantus was placed at midnight as a BID dose, with the dosing schedule of 2100 and 0900. The patient received Lantus at 01:30 and 08:00 and was scheduled to receive again at 2100. 

Potential risk of long acting Insulin overdose when placing BID order in EPIC.

Medications orders for twice a day dosing include: BID, q12 and q12hrs.
When ordering a medication BID there are multiple choices to select from, depending on the category chosen. This is of particular concern with high alert medications such as long acting insulin or an anti-coagulant.

Medications can be ordered with the intent of twice a day dosing with the potential for being administered 3x within 24 hours depending on the time a medication is ordered and the dosing interval selected.

The same scenario can occur with any dosing schedules where there may be an extra dose calculated due to the 50% rule (i.e. QD, TID, and QID dosing) within the initial 24 hours.


  • Pay attention to the dosing times.
  • Pay particular attention to the designated times that EPIC designates for administration times.
    • These times will show up in your order.  
    • EPIC cannot calculate the administration times per your intent.
  • Be aware of the EPIC 50% rule
    • To prevent medications from being administered too closely together, there are standard administration times. 
      • If the next scheduled dose is more than 50% of the time interval between doses, the medication will be given at the next schedule time after ordered is placed.
      • If the medication is ordered in less than 50% of the time interval between scheduled doses, the medication will not be given “now.”

A request was made at the system level to create an alert to prevent this from happening but this may take some time. In the interim, we need to be aware of this potential problem and pay attention when placing orders, especially with high alert medications.

Lois Wong, MSN, FNP
Risk Officer

Cardiac Monitoring Performance Improvement Team

Posted on Jun 5, 2017 in Announcements | 0 comments

For several months a team has been meeting to improve the use of cardiac telemetry monitoring. This is important because appropriate use of cardiac monitoring leads to improved patient flow (from the ED, ICU, and PACU), patient safety (improved mobility, less noise), and cost (to the patient and hospital).

The interdisciplinary, cross campus team of physicians, nurse managers, nursing supervisors and charge nurses from ICU, cardiac monitoring units and ED first came together on April 24, 2017 to review evidence based practices and cardiac monitoring criteria. The practices and criteria discussed that day had previously been reviewed by our hospitalists, intensivists, cardiologists, neurologists, and surgeons and were developed from national guidelines. The team also formalized a process for downgrading with the goal of empowering nursing to ask the question daily about the need for continued monitoring.

The ABSMC Indications for Cardiac Monitoring process went live on May 16, 2017, both for admission or transfer to a cardiac monitor and for downgrading off the monitor.

As part of their standard work, the nursing supervisors and charge nurses will be looking for the indication for cardiac monitoring for their patients. At times there may be a phone call made to the physician if the indication is unclear or to request discontinuation based on the criteria.

Many thanks to the team members for their time and engagement in this great (and ongoing) process!

Denise Navellier, Chief Nursing Executive, Summit
Ursula Boynton, Administrative Medical Director


Doctor’s Lounge Relocation

Posted on Jun 5, 2017 in Announcements | 0 comments

Some of the Lounge furniture, refrigerator, and coffee machine along with additional furniture, PC’s stations and additional seating will be RELOCATED to the temporary Doctor’s Lounge located at the end of the cafeteria on the 1st floor (currently the Doctor’s Cafeteria).

Food Services will continue stocking the two refrigerators with snack and cold drinks as well as providing breakfast and lunch in the Doctor’s Cafeteria area.

Additional patio furniture will be placed outside the Cafeteria area for any physician that may like to take outdoor lunch.

John Ramirez
Administrative Director Support Services & Facilities

Patient Satisfaction Survey

Posted on May 2, 2017 in Announcements | 0 comments

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a “national, standardized, publicly reported survey of patients’ perspectives of hospital care” (Ketelsen, L, et al. The HCAHPS Handbook, 2014).  National Research Corporation (NRC) is Sutter Health’s vendor for mailing this CMS required survey to a random sample of ABSMC inpatients that meet the surveying criteria.  Surveys are mailed in English and Spanish.  A minimum of 300 returned surveys is required for each of our inpatient campuses. Last year we had 3,288 surveys returned for both campuses combined.

The HCAHPS domains/questions differ from a patient satisfaction survey as they are designed to measure the frequency with which the patient experienced specific behaviors. Responses are rated as -“Did the patient experienced a behavior Always, Usually, Sometimes, Never? “ The top box score or percent “Always” is what is publically reported, counts and is accessible to consumers.

One of the eight domains is Doctor Communication. It has three questions that roll up into the domain as a composite score:

– During this hospital stay, how often did doctors treat you with courtesy and respect?
– During this hospital stay, how often did the doctors listen carefully to you?
– During this hospital stay, how often did doctors explain things in a way you could understand?

How are we scoring? The minimum ABSMC dashboard target (P50) is 80.3% and by campus we are trending YTD 76.8% (Alta Bates) and 77.6% (Summit).

The question to ask yourself is: “Do I use all of these tactics with every patient every time?”

– Use AIDET (Acknowledge, Introduce, Duration Explain, and Thank)
– Use every day language or words the patient/family can understand when explaining
– Sit down when talking to the patient.
– Use reflective listening and empathy skills

We are proud of our physicians and staff and believe that ABSMC is the best place to receive care. We appreciate the help of our physicians as we work to develop a culture of Always in the way we communicate with our patients. Please contact Leslie Costa at for any questions.

Working together to Create a culture of Always by Leslie Costa, RN, PhD, Director Patient Experience

Sutter Community Connect

Posted on May 2, 2017 in Announcements | 0 comments

Please click on link to review the Sutter Community Connect: Ambulatory Specialty Optimization