Message from the President-April 2018

Posted on Apr 6, 2018 in President's Message | 0 comments

Welcome back to another edition of the medical staff newsletter! As many of you know, we have been encountering shortages of both medications and supplies. Medications have included items such as amiodarone, many antibiotics, KCL, local anesthetics, and compounded medications including drips and epidural solutions. If possible, please use oral medication for your patients, saving the limited supply of IV medications for those patients who need it the most. Also, please call ahead to pharmacy if you anticipate needing a compounded medication, such as a drip. Regarding supplies, we have experienced shortages of IV bags, sterile irrigation solution, connectors, extension sets, adaptors, stopcocks, and many more items.

Currently, we have limited allocations of certain drugs and supplies from many companies. The landscape changes weekly, and sometimes daily. Every now and again, we avert a crisis with an unexpected allotment. Emergency teams are pulled together immediately to address this ever-changing atmosphere of shortages as needed. Thank you to everyone who has participated on these teams. As this is a fluid situation, please look for the rainbow colored icon, located on every ABSMC computer, titled “Supply Backorders” listing both the current medication and supply shortages. We asked about sharing medications and supplies with other Sutter hospitals. Unfortunately, they too are on limited allotments from manufacturers and often do not have extra supplies or medications to share. Sutter has a committee, above the affiliate level, coordinating efforts whenever possible.

What has lead up to these issues? Well, there are many factors. I’ll touch on a few. Pfizer’s Kansas facility experienced quality problems leading to an almost full shut down of its major production facility impacting availability of opoids and local anesthetics. The Baxter manufacturing facility in Puerto Rico, damaged during hurricane Maria, lead to shortages in small volume drug bags. The FDA did take action to import supplies from other manufacturers located in other countries, which eased some of the supply issues.

As part of an effort to decrease misuse of opiod pain killers, the DEA called for a 25% reduction in the manufacturing of opoids last year, and an additional 20% reduction this year. This, along with the manufacturing issues at Pfizer’s Kansas facility, has led to opoid shortages. Many hospital systems across the country are experiencing opoid shortages, causing staff either to be judicious with usage and using alternative medications that are less potent, or, if available, giving alternative opoid medications in concentrations that RNs are unfamiliar. As a result, there have been reports from other hospitals of inadequate pain control, elective surgery cancellations, and overdoses due to lack of familiarity and mistakes in dosage administration. A letter was written on February 27, 2018 jointly by the American Hospital Association, the American Society of Clinical Oncology and the American Society of Health-System Pharmacists to the US Drug Enforcement Administration stating that the shortages “increase the risk of medical errors” and are “potentially life threatening”. The American Society of Anesthesiology is working with other national organizations to address these issues and stay ahead of drug shortage problems. They have been a leading advocate in Congress and are partnering with the FDA and their Office of Drug Shortages to monitor these issues and work toward solutions. So far, our hospital has not been significantly affected by opoid shortages.

On February 27, 2018, the California State Board of Pharmacy sent a Cease and Desist order to Pharmedium Services as an investigation demonstrated noncompliance with state regulations and federal good manufacturing practices. The California Pharmacy Board is currently working to identify alternative manufactures and alternative strategies in lieu of Phamedium sterile compounded and nonsterile drug products. This has placed an enormous burden not only on our pharmacy, but on all hospital pharmacies in California. At a recent ABSMC committee meeting pharmacy stated that we went from compounding 10% of compounded drugs to compounding 90% of compounded drugs in our pharmacy. What this means: first, the increase in compounding medication on site is a large burden for the pharmacy staff. Second, drugs compounded on site have a 12 hour shelf life, limiting the number of premade compounded medications available on demand. The company has 30 days to respond to this issue and hopefully we will see a resolution soon. In the meantime, please call ahead to pharmacy, if possible, if you need a compounded medication, such as a drip, STAT. Also, please give your pharmacy colleagues a kind word for their hard work.

Jill Kacher Cobb, MD

President of the Summit Medical Staff, ABSMC

Pharmacy Shortages

Posted on Apr 6, 2018 in Uncategorized | 0 comments

Dr. John Joseph Becchetti

Posted on Apr 6, 2018 in Announcements | 0 comments

HIM Reminders

Posted on Apr 6, 2018 in Health Information Management | 0 comments

HIM Reminders:

  • Summer is around the corner. Please inform the HIM Department if you are planning a leave or vacation. HIM will place all chart deficiencies on hold while you are out. It is advised that you complete and sign all records before you leave.
  • Please sign your Verbal orders within 48 hours. This includes canceled and or discontinued orders which are currently counting towards our compliance rate.

Alisa Stinn, RHIT
Health Information Manager / HIM Leader
Alta Bates Summit Medical Center-Oakland Campus
stinnal@sutterhealth.org
(Office) 510-869-8741
(Cell) 510-381-5181
(Fax)  510-869-8856

Provider Query Response

Posted on Apr 6, 2018 in Health Information Management | 0 comments

April 15th Mindfulness for Physicians Retreat

Posted on Apr 6, 2018 in Announcements | 0 comments

Happy Together

Posted on Apr 6, 2018 in Committee Briefings | 0 comments

Maternal Medicine Open House

Posted on Apr 6, 2018 in Announcements | 0 comments

Workplace Violence Training

Posted on Apr 6, 2018 in Announcements | 0 comments

On Behalf of William Isenberg, M.D., Ph.D. Vice President, Patient Safety, Sutter Health

By April 1, California law (Title 8 Section 3342) requires adoption of certain standards to protect healthcare workers from aggressive and violent behavior. Since all hospital employees our care team colleagues with whom we work every day will be taking Sutter-developed mandatory training, I strongly encourage that all of us view this Workplace Violence Prevention training (https://360.articulate.com/review/content/03fc41e3-c7d6-48dd-b55d-f5e155ff4a54/review) and review Workplace Violence Prevention plans for facilities where we enjoy hospital privileges. There are three broad categories of physicians defined by their relationship with the hospital, and training obligations vary among them:

  1. Physicians who are directly employed by Sutter Health are subject to Cal-OSHA jurisdiction and should complete this Sutter-developed training program (https://360.articulate.com/review/content/03fc41e3-c7d6-48dd-b55d-f5e155ff4a54/review) and submit attestation that they have done so to their respective Medical Staff Offices.
  2. Physicians who are members of medical groups that are contracted by a Sutter Health affiliate for the provision of care to our patients (e.g. ED physician groups, anesthesia physician groups, etc.) similarly fall under Cal-OSHA jurisdiction and should participate in training. This may be accomplished using the Sutter-developed training referenced above. You’re also welcome to use training materials that your medical group might have already provided you. Given the interdependence of roles and documentation requirements within the electronic health record, the Sutter training will likely most effectively describe the workflows we will experience in daily work. Regardless of which training this group of physicians chooses, submission of an attestation of completion to the Medical Staff Office is needed.
  3. Physicians not affiliated in any other way, or are exclusively independent contractors, are not mandated under law to complete Sutter-developed training. That said, as we are seeing with increasing frequency in the news, persons with violent behaviors rarely, if ever, take the time to check credentials before escalating and hurting others. In fact, the opposite is true – their actions are unpredictable. This is precisely why I encourage each of us take this training, whether legally mandated or not.

This law applies to all Sutter Health-affiliated general acute care hospitals, psychiatric facilities and Sutter Care at Home. Additionally for hospitals, the regulation applies to any hospital-based outpatient clinics, and other operations located at a health facility and all off-site operations included under the hospital license. While we are committed to fully comply with this law, Sutter Health’s broader goal is to reduce assaults, injuries and aggressive behavior in all of our facilities.

Workplace Violence Prevention Training and Facility Plan

  1. Please complete this training (https://360.articulate.com/review/content/03fc41e3-c7d6-48dd-b55d-f5e155ff4a54/review) and review the attached facility Workplace Violence Prevention plan by June 30, 2018.
  2. Please review affiliate-specific Workplace Violence Prevention (http://mysutter/Resources/SystemDepartments/protective-services/Pages/Violence-Prevention-Plans-Affiliates.aspx) Plans for each affiliate at which you provide services. (Note: you will need to be on a Sutter Health network connected computer to access.)
  3. Please complete this attestation form (https://emma-assets.s3.amazonaws.com/ou92/9f838c3036f33884cff262b896c91d3e/WPV_Training_Medical_Staff_Attestation_03_28_18_1130_am.pdf) and return to your local Medical Staff Office. Attestation forms are needed to meet the record-keeping provisions of the law.
  4. We estimate time for the training and plan review to take approximately 45 minutes.
  5. For more information about the Workplace Violence Prevention Program, see this fact sheet (https://emma-assets.s3.amazonaws.com/ou92/61e7c7fe4ffedbaeeac78636ff8bdac6/Workplace_Violence_Program_Fact_Sheet_03_30_18.pdf).

Thank you for your attention to this important program. Consistent with being a high reliability organization, the Workplace Violence Prevention Program is one more way Sutter Health seeks to eliminate harm to our patients and workforce and to improve our ability to provide safe patient care.

For more information, please contact the Program Administrator at your Sutter Affiliate or email workplaceviolence@sutterhealth.org:

Facility Name WPV Program Administrators Email Address Phone Number
ABSMC – Summit Erick Wilkinson wilkig1@sutterhealth.org 510-869-8724
ABSMC Merritt Pavilion Erick Wilkinson wilkig1@sutterhealth.org 510-869-8724

 

Special Thank You

Posted on Apr 6, 2018 in Uncategorized | 0 comments