President’s Message

Message from the President, July 2017

Posted on Jul 7, 2017 in President's Message | 0 comments

Dear Medical Staff colleagues,

Happy Summer!

Medical Staff lounge– the ground floor physician lounge is under renovation and last month I informed you that the interim physicians lounge is now located in the expanded physicians dining room on the first floor cafeteria. Based on feedback, the following changes have occurred. There are more computers for charting. The window adjacent to the computers is now tinted to minimize the glare from the sun’s rays. There are a few phones but because of the noise and lack of privacy and HIPPA compliance, dictations are not encouraged. (Yes I know the phone dictations are wonky at the moment so may not be pertinent.) The Keurig coffee machine is available including after hours.

In regards to after-hours access to the physician lounge, we have worked with John Ramirez, Administrative Director, Support Services and Facilities. The current solution is that after cafeteria working hours, the accordion doors which blocks public entry into the cafeteria will remain partially open for physician access. Because of this change, there is enhanced security in the form of additional video monitoring installed at the cafeteria entrance and increased frequency of security guard traffic.

The administration has also added an extra computer to the surgeon’s lounge, more computers to the hospitalists working area on the second floor and there is an additional room which is near completion (next week or so) on the 5th floor (as you get out of Elevator B) with computers and secure location for dictation.

Physician sweatshirt jackets- if you signed up to receive one during Doctor’s Day please, please, pick it up. We don’t have the space to store the jackets at the medical staff office. If you have not picked it up by July 28, 2017 we will be distributing them to the physicians who signed up on the wait list.

MRI after hours- last week we messaged out (see below) the method for ordering an MRI scan after hours. Simply put, there is one phone number to call for either location. You will communicate with the radiologist on call who will then contact the MRI technician.

Please remember to order the study STAT if the study needs to be performed urgently.

Physician Chain of Command- on occasion, a situation occurs in which the medical team needs to respond to a challenge quickly and if it remains unresolved, to escalate the concern. The escalation process moves ahead until there is a satisfactory outcome. The nurses and physicians both have an escalation process. I want to highlight this topic since on occasion, you may receive calls from nursing and you may be involved in the escalation process. You should view this as a collaborative effort and all in the best interest for patient care. Furthermore, if there is a challenge, you should not feel that you are rowing the boat on your own. We have a process in which others will pick up oars to help you from both the medical staff leadership and the hospital administration. So please take time to review the Chain of Command Decision tree.

Dr Digiacomo is stepping down as Chair of the Medical Records Committee.

I want to thank Dr DiGiacomo for his time, commitment, and leadership.

Raves to nursing, physicians and the intensive care department for the Silver Award for tissue and eye donation from Donor Network West. This is our second year in a row receiving the award. Please see the article below.

Joint commission surveys – we completed the Stroke Accreditation Survey last month and we did very well. The official report is yet to come.

Next month we expect the Hip and Knee Accreditation Survey.

Dictation services- as many of you know, our electronic transcription service was severely affected by a malicious virus. There are interim solutions being worked on by the IT analysts and email updates from our Chief Health Information officers. Please follow the email updates as they are occurring frequently.

Reminder- if you have Dragon speech that capability still exists.

Pharmacy update- we distributed a list generated by Pharmacy of the medication shortages and the latest word is that those medications are still short.

We will update you with any changes to this list.

Reduction in medication error tip- if you wish to make any changes in a current medication order or wish to hold a medication i.e. Hold the dose of Coumadin tonight. Do not place this as a nursing communication order. The communication needs to occur with pharmacy and within the medication administration order.  The nurse may not see the “nursing communication” when she/he is giving the medication since it does not link directly with the medication.

Until next time,

Be well


Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center.

From the President, June 2017

Posted on Jun 5, 2017 in President's Message | 0 comments

Dear Medical Staff Colleagues,

You may have noticed the following renovations that are now occurring at the medical center:

Administration has now moved to the 5th floor of the Merritt Building – The Physician Lounge on the ground floor is now undergoing construction which is projected to last roughly 18 months. The interim location will be the physician dining area on the first floor. It is a work in progress so your patience is appreciated. – If you are interested in learning more about the new Physician’s Lounge, please swing by the Medical Staff Office, a blueprint for the floor plan is available for review. The new area will house a physician dining area, work station, exercise equipment (stationary bike, treadmill). – An in house MRI is also planned for the ground floor.

The first floor cath labs are still in the process of being updated in a sequential staged fashion.

Call Rooms Update– There is a call room corridor on the 4th floor Merritt Building, adjacent to the EKG dept. We have four two existing call rooms – one for the in house hospitalist, and one for in house intensivist. The two additional call rooms are assigned to 1) one for surgery, and 2)one “extra” room for anyone on call needing a place to sleep. Please contact the Medical Staff office for details. The House Supervisor will have the code lock passcode for entry.

Cardiac Arrhythmia (Telemetry) Monitoring Bed Assignment- you may have noticed the roll out several weeks ago for cardiac monitored bed assignment based on set defined clinical criteria. The goal is to decrease unnecessary telemetry over usage which impacts on patient flow throughout the hospital.  Please review the guidelines included in the newsletter. You may receive a query if you are the attending physician for a patient on telemetry/cardiac monitored bed who does not meet the guideline criteria. By familiarizing yourself with the information, you will improve communications with the charge nurse and house supervisor.

Have a great month and Happy Father’s Day for all dads.

Until next time, Be well

Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center


From the President, May 2017

Posted on May 2, 2017 in President's Message | 0 comments

Dear Medical Staff Colleagues,

Thanks to all for your work on co-signing verbal orders which is a Joint Commission requirement. Overall we are now 85 percent compliant with co-signing within 48 hours. Cheers to the Anesthesia and Emergency Departments for reaching more than 90 percent compliance.

C diff– Our hospital as many hospitals in the Sutter system is working on decreasing our C difficile infection rate. On PCU 7 & 4E, there is a process being piloted where a floor mat reminds you as you enter the patient room to properly gown up and wash your hands before you leave.

Call rooms– currently we have call rooms for overnight hospitalists and intensivists. For those of you that are taking call overnight and require a place to rest, we will soon have two additional call rooms on the 4th floor of the Merritt building to utilize. Thank you to our administration for making this possible. For questions on access to the call room and for assistance please contact the Med Staff office.

Ethics Committee– Beginning June 2017, new Co-Chairs for the Ethics Committee will be Dr. Leif Hass and Lucia Tanassi. Special thanks to the outgoing Co-Chairs Dr. Janice Manjuck and Dr. Andrea Green for your dedication and hard work.

Our Annual Hospital Week BBQ will be held on May 12th at Summit and May 8th at Alta Bates.

Happy Memorial Day and Mother’s Day.

Until next time

Be well,


Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center.


From the President, April 2017

Posted on Apr 7, 2017 in President's Message | 0 comments

Dear Medical Staff Colleagues,

I hope you enjoyed the Doctor’s Day buffet breakfast and lunch on March 30. I want to extend a thank you to the Administration for the delicious meals and for the physician fleece jackets donation.

CDI– Clinical Documentation Improvement has now been rolled out. As you may know, there is a bigger emphasis on accurate documentation. This is not just coming from the hospital but also from governmental regulations like MACRA. Whether we like it or not, documentation now impacts physician reimbursement. In addition, accurate documentation reflects the severity of illness which  we should get credit for in the form of length of stay should be observed to expected mortality. I would encourage you to respond to the queries you may receive in your inbox or as questions posed within the progress notes. Many of you reading this may be rolling your eyes that this is another demand on your time and contributing to burnout, and I understand the frustration. I share the same frustration and this is difficult to message. I hope that as we become more accustomed to the use of accurate terminology, this will become more second nature and the queries will drop off. But this takes attention and a group effort. Please read the detailed explanation below by our CDI Physician Champion, Dr. Beth Gong

 Language interpreters– As a reminder, foreign language interpretive services are available by person and by phone. I encourage you to take advantage of these services since we do have a multi-cultural patient population. From a patient safety standpoint, we are identifying that the use of an interpreter can play an important role in preventing falls.

Wellness and Burnoutplease see the article below by Dr Hass. In addition there is an all day  presentation “The Science of Burnout”  in Berkeley on April 29th . If you wish to learn more and to register, please see the link below. 

http://greatergood.berkeley. edu/news_events/event/the_ science_of_burnout_what_is_it_ why_it_happens_and_how_to_ avoid_it/objectives#. WOblBTxHaEc

 Until next time, be well,

Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center.



From the President, March 2017

Posted on Mar 7, 2017 in President's Message | 0 comments

Dear Medical Staff Colleagues,

I hope this newsletter reaches you in good spirits and in good health. Spring is around the corner, March 20, to be precise and although the rain has been much needed, I am looking forward to sunnier skies. Another important date to remember is Doctor’s Day which is March 30. Thank you all for your caring attitude and delivery of quality care for our patients at Alta Bates Summit Medical Center.

The Physician Engagement Survey results were released and although there are still areas that can be improved, overall the scores are much better compared with last year and show a significantly more positive trend. For more details please ask Dr. Ursi Boynton and Dr. Steve O’Brien.

The Wellness Committee continues to focus on physician burnout, stress and wellness. Here are dates to remember:
1) May 6th retreat at Green Gulch
2) April 29th at UC Berkeley – The Science of Burnout, What it is, Why it Happens and How to avoid it (see information below).

On a more serious note, as a reminder, if there are any changes to your attestation on the application and reapplication to the Medical Staff which pertains to malpractice lawsuits, medical board actions, restriction or suspension of your privileges or criminal activity other than a misdemeanor, including for instance DUI, please inform the medical staff office in a timely fashion. This has always been required in the Medical Staff Bylaws which is not new but can be overlooked and at times forgotten.

There is going to be construction to the ED parking lot and the timeline and details of this project will be announced as we get closer to the date. An important detail is that as construction ensues and as parking space becomes limited, the ED parking lot will be restricted to physicians who are on call, i.e. you won’t be able to badge in for access.

– New Appointments

Vice Chair of Emergency Department- Dr. Jeff Chen
Vice Chair of Anesthesiology Department – Dr. David Blacklock

As a reminder, if there are highlights you would like me to announce from your department, please let me know. We can include the information either in my President’s Report or as an article in the newsletter.

Be well,

Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center

From the President, February 2017

Posted on Feb 8, 2017 in President's Message | 0 comments

Dear Medical Staff Colleagues,

When it rains it pours… the hospital is in full swing and at full capacity.

If you feel that you are working harder than ever, it’s because you are. In the month of December 2016 there were 890 admissions and in January 2017, the latest numbers are 902 admissions from the Summit Emergency Department. We are talking historic numbers! Yet despite this daunting number, our ED length of stay was lower in December than the same time last year. In addition, this holds true for our hospital acute care length of stay.

This takes cooperation and collaborative efforts from multiple departments, Administration and Medical Staff.

So thank you everyone for maintaining a commitment to delivering quality care to our patients and maintaining a professional collegiality which is so tough under this degree of stress.

Special “thank you” to the ED department, hospitalists, surgeons, and intensivists for all your hard work. Please let them know your appreciation when you see them in the hospital.

Influenza: we are also seeing a higher number of test positive +influenza cases. This is also a historic high compared to prior years. Please take care of yourselves and wear appropriate protective masks when you care caring for your patients.

Cardiac Cath Labs: Renovation and upgrades to each room continue in this phased project.

MPI program: our inpatient chemical dependency program recently passed an accreditation survey, CARF. Congratulations team! (see below)

Podiatry now has a regular call schedule. Many days of the month are covered but not all. You can refer to the Central Logic call schedule available on the Intranet to determine who might be taking call that day.

Wellness Retreat on May 6th at Green Gulch, please register for the event and mark your calendars. If you want more information please contact Dr. John Mouratoff or come by the Medical Staff Office.

Until next time,

Be well, Donna

Donna D. Tigno, M.D.

President of Summit Medical Staff

Co-Director of Critical Care at Summit Medical Center