Message from the President-August 2018

Posted on Aug 1, 2018 in President's Message | 0 comments

On Saturday, September 15, Jo Shapiro, M.D. from Brigham and Women’s Hospital will train a group of our physicians in Peer Support. The Wellness Branch of the Physician Wellbeing Committee will launch the Peer Support program later this fall. This program will provide one-on-one peer support to medical staff members following emotionally stressful events, including adverse clinical events, litigation, or any life stressor, in a confidential manner from a medical staff member trained in peer support. More details will follow. If you are interested in becoming trained in Peer Support, please contact the Medical Staff Office at (510) 869-6565. We will be offering an additional training session following the initial September 15 date for those who are interested.

Required Sutter Safe Care training is continuing through the end of September. Thank you to those who have already completed the training. If you have not yet completed the training, please join Dr. Filip Roos, our CME, for a dinner session (with wine) or a lunch session (without wine) scheduled in lieu of grand rounds. Please see the training dates below. Also, you can join in on any of the hospital staff training sessions. Be sure to sign in to receive credit.

Please remember to sign your verbal orders within 48 hours. Surveyors are currently focusing on timely signing of verbal orders. Another Sutter facility was recently cited for this. Remember, you can sign your colleagues’ verbal orders too! We can all help each other out.

Soon, construction will begin in the cafeteria which will disrupt food services. Please watch for a notice regarding the change in location of food services and the physician’s dining area.

Also, Fir 1 and 2 will close permanently September 1. Please look closely at your meeting schedules for changes in meeting locations. Many medical staff meetings will move to either the Bay View Conference room on the 11th floor or room 1776.

And finally, congratulations to the Department of Pathology for a successful College of American Pathologists survey and to Rehabilitation for a successful CARF survey!

I hope you are able to take a little time off and enjoy the summer! Be well.

Sutter Safe Care

Posted on Aug 1, 2018 in Announcements | 0 comments

 

One of the Sutter wide strategic goals for 2018 is moving Sutter Health in a direction that is laser focused on safety and on making sure that Sutter is what is called a “highly reliable organization”.

Sutter Safe Care is part of a multiyear effort to renew and reinforce the importance of patient safety and workforce safety across our organization. Sutter Health has always been committed to safety, but Sutter Safe Care will help us take a more holistic approach to it. We want to create a no-harm, safety-first, high-reliability culture, with new safety-reporting processes and a different approach to analyzing and solving for systemic safety risks and human error.

To that end, the goal is to train EVERY clinician and staff member in the organization in 2018

Alta Bates Summit Welcomes New CEO Dr. Jerry Kozai

Posted on Aug 1, 2018 in Announcements | 0 comments

Dr.Gerald (“Jerry”) Kozai is the new Chief Executive Officer at Alta Bates Summit. Most recently, he was president and CEO of St. Francis Medical Center in Southern California. Dr. Kozai received a Doctor of Pharmacy degree from University of the Pacific School of Pharmacy, beginning his career as a clinical pharmacist before moving into roles of increasing responsibility. Read more about Dr. Kozai.

 

Test Utilization

Posted on Aug 1, 2018 in Announcements | 0 comments

A new Alta Bates Summit Test Utilization Committee has been formed to promote strategies for appropriate laboratory testing, with the goal of providing high quality, cost effective patient care.  The initiative champion is Dr. Alejo Santa Cruz, with multi-disciplinary committee participation by laboratory/pathology, emergency medicine, neurology and infectious disease representatives.

Most effective test utilization strategies rely on EHR clinical decision support (CDS) rules to alert providers about unnecessary testing.  Given the challenges of implementing Epic CDS rules system-wide, our initial efforts will be focused on the following provider-driven strategies:

  1. Frequency Limitation on Common Tests

Daily lab orders without a default occurrence are used in some Epic order sets.  Since providers will probably not modify the occurrence, this may lead to inappropriate test utilization (i.e., daily testing during entire hospitalization).  The Epic SME groups have been asked to review these order panels and add a default occurrence of no more than 3 days, unless there is a clinical reason to justify a longer time frame.

  1. Obsolete Testing

The following tests are considered obsolete.  Consider a more appropriate alternative test to improve quality of care provided.

Obsolete Test 2017 Test Volume Alternate Test Comment
Bleeding Time (BT) Ashby:         4

Summit:  374

 

·  Detailed clinical history (family, surgical, meds) is best pre-op screening “test”

o No bleeding hx with prior procedure à don’t screen

o No bleeding hx & no prior procedure à +/- screen

o Suspicion or bleeding hx à screen (PT/PTT/PLT/FIB)

·  Platelet Function Assay (PFA)

·   BT & PFA do not predict surgical bleeding in patients with a negative bleeding history.

·   Use the HAS-BLED bleeding risk tool

 

Myoglobin 24 Troponin Troponin is more specific and rises as early as or earlier than myoglobin after AMI.
Amylase 1,107 Lipase Lipase has improved specificity and similar sensitivity as amylase
  1. Commonly Misordered Tests

Be alert to the following “look-alike” and other tests, which may be incorrectly ordered:

1,25-Dihydroxyvitamin D Vitamin D (1,25-dihydroxy) is NOT useful in routine screening for vitamin D deficiency.  Consider as an alternative to order Vitamin D, 25-hydroxy.
Beta-2-microglobulin Verify that you want “Beta 2 microglobulin” and not “Beta 2 glycoprotein I IgG” or “Beta 2 glycoprotein I IgM”.  Beta 2 glycoprotein is ordered mainly for hypercoagulable workup.
Protein C Resistance Verify that you want Protein C and not C-Reactive Protein (CRP)
Creatine Verify that you want “Creatine” and not “Creatinine”
Manganese Verify that you want “Manganese” and not “Magnesium”.
Paraneoplastic Autoantibody Panel, Serum The paraneoplastic autoantibody evaluation panel is intended for workup of patients with paraneoplastic neurologic symptoms AND malignancy.  Screening for unexplained neurologic symptoms in the absence of reasonable suspicion for malignancy has low diagnostic yield and leads to false positives. Individual autoantibodies, such as NMDA Receptor antibodies, are available.  Consider if this panel is clinically indicated for the patient.

Please let us know if you have any questions.

ABSMC Test Utilization Committee
Alejo Santa Cruz, MD
Annette Shaieb, MD

 

IMPROVING PATIENT BLOOD MANAGEMENT

Posted on Aug 1, 2018 in Announcements | 0 comments

Our initial focus on a single unit transfusion strategy has shown success.  The % of transfuse orders for 1 RBC unit has increased from 37% to 50%, while 2 unit transfuse orders has decreased from 61% to 42%.

Recommendation: Give single unit RBC transfusions in stable, non-bleeding hospitalized patients, with reassessment of the patient after the single-unit transfusion to decide if a second unit is needed.

To achieve this strategy:

  • Place Type & Crossmatch and/or Transfuse orders for 1 unit in Epic.
  • Order post-transfusion hemoglobin [LABHGB] and reassess patient to determine if a second RBC unit is needed.  A post-transfusion HGB can be drawn as soon as 15 minutes after the transfusion is completed.

 

Use the Blood Transfusion Navigator to place orders.  To access the Navigator:

  • Click on the Blood icon in the patient list toolbar or under More Activities.

 

 

 

 

  • Once in the Navigator, access individual blood product order sets by clicking on the appropriate icon, then check the box under Order Sets and click the open order set

 

 

 

  • Use the Potential Transfusion order set to place Type & Crossmatch orders when a transfusion is NOT yet needed.

Please let us know if you have any questions.

ABSMC Blood Utilization Committee
Catherine Stapleton, MD
Rajesh Behl, MD
Annette Shaieb, MD

 

 

SEBMF Neurologist Receives Public Service Award from KPIX-5 TV

Posted on Aug 1, 2018 in Announcements | 0 comments

Clayton Warren | July 6th, 2018

Dr. Joanna Cooper, a Sutter East Bay Medical Foundation (SEBMF) neurologist has received the Jefferson Award from KPIX-5 San Francisco for her work co-founding Maya’s Music Therapy, a music therapy nonprofit that improves the quality of life developmentally disabled participants.

Watch to learn more about this inspirational program on @CBSSanFrancisco.

Maya’s Music Therapy Fund honors Dr. Cooper’s severely disabled daughter, Maya who died at age 14 from a rare neurologic disorder.

“She was nonverbal, but she could really come alive with music,” Dr. Cooper recalled.

When Dr. Cooper and Maya’s father founded the nonprofit in 1989, they started with a handful of children. Today, the nonprofit is 29 years old and serves more than a hundred children and adults. Read More

CURES Training

Posted on Aug 1, 2018 in Announcements | 0 comments

The Medical Board of California is contacting you on behalf of the California Department of Justice (DOJ), please see the message below:

CURES 2.0 WEBINARS AND TRAINING

The DOJ has created a special series of webinars designed to teach prescribers and dispensers the ins and outs of the CURES 2.0 system. The webinars will cover a variety of the CURES 2.0 system’s features including Patient Safety Alerts, Compacts, and Peer Messaging. The DOJ will also provide step-by-step instructions on how to access CURES Patient Activity Reports and how to reset user passwords. Webinar registration and schedule information can be accessed by clicking the links below.

Webinars are scheduled on the following dates and times (all times PDT):

After registering, you will receive a confirmation email containing information and instruction about joining the webinar.

For questions on webinar registration or to request in-person CURES training, please contact the CURES HelpDesk at CURES@doj.ca.gov or (916) 210-3187.

 

Manage Orders – Haiku Push Notification for Lab Results

Posted on Aug 1, 2018 in EHR Updates | 0 comments

EPIC/Haiku now provides the ability to send a Haiku push notification to a physician indicating that a lab has been resulted. 

This includes lab and radiology orders.

 

 

Welcome New Providers

Posted on Aug 1, 2018 in New Physicians | 0 comments

Ted E. Apstein, MD
Emergency Medicine
Berkeley Emergency Medical Group
2450 Ashby Ave.
Berkeley, CA  94705
(510) 204-4723

Michael W. Cho, MD
Radiology, Diagnostic
Bay Imaging Consultants Medical Group, Inc.
2125 Oak Grove Rd., Ste. 200
Walnut Creek, CA  94598
(925) 296-7150

Daniel T. Oberlin, MD
Urology
Golden Gate Urology
2999 Regent St., Ste 612
Berkeley, CA  94705
(510) 848-1727

Armen Serebrakian, MD
Otolaryngology
Armen Serebrakian, MD
1599 Tara Hills Dr.
Pinole, CA  94564-2519
(510) 724-7629

Timothy L. Vo, MD
Emergency Medicine
Berkeley Emergency Medical Group
2450 Ashby Ave.
Berkeley, CA  94705
(510) 204-4723

Robinson K. Yu, MD
Radiology, Diagnostic
Bay Imaging Consultants Medical Group
2125 Oak Grove Rd., Ste 200
Walnut Creek, CA  94598-2520
(925) 296-7150

From the Medical Staff Office

Message from the President – July 2018

Posted on Jul 2, 2018 in President's Message | 0 comments

Hi All,

First, I would like to welcome Gerald Kozai, our new Alta Bates Summit CEO. He comes to us from St. Francis Medical Center in Southern California where he was CEO for 16 years. He has experience managing a multi campus hospital with a high medi-cal population and was able to grow the hospital during his tenure. Welcome Gerald! We look forward to working with you.

Over the past year, it seems the frequency of disasters is increasing. From the Las Vegas shootings, to the North Bay Fires, to the multiple school shootings across the country, sadly, there are disasters abound. Plus, the Bay Area has another unique potential natural disaster, an earthquake. The unexpected computer failures of last month was a keen reminder of our vulnerability. According to our Emergency Preparedness Committee Chair, ER physician Ronn Berrol, MD, our hospital needs will vary depending on what type of disaster occurs. If there is an outbreak, we will primarily need ICU, Internal Medicine, Family Practice, ID and ER physicians. If there is an earthquake, we will rely on our Orthopedic Surgeons to fix broken bones with the help of our Anesthesiologists, our Surgical colleagues to take care of other injuries, and ICU and Medicine docs to stabilize our patients. A shooting will initially involve General Surgeons and Anesthesiologists. Our ER colleagues will help triage and stabilize our patients no matter what we encounter, and our Hospitalists will help manage their hospital course. Also, depending on the type of disaster, some forms of communication may work better than others, i.e. text messaging may work better than cell phones vs land lines vs email. Of note, our hospital has an Emergency Operations Plan and 72 hours worth of supplies. Each department has a disaster plan and copies are maintained within each department/unit.

So, many have asked, what do I do as a physician when faced with a disaster? We do include in your re-credentialing packet instructions about how to respond in a disaster. However, we all know there is a lot in that packet and a reminder is helpful. If you are in the hospital, an overhead announcement will be made. If you are at home, you may receive an email or text message depending on whether these systems are working. If you are aware of a disaster and have not heard from the hospital, please come in if you are able. Once you are in the hospital, report to what will be called the “Incident Command Center”. As of now, this will be located in the Fir 1 & 2 conference rooms. Please bring and present your badge. There will be a sign in sheet; please sign in. Your assignment will be made according to your Department Chairperson. Dissemination of information and instructions from the hospital command center regarding the emergency will be communicated through your Department Chairperson. Also, if you have a physician colleague who lives in the East Bay and cannot make it to their hospital, please ask if they would like to provide services at ABSMC. They would need to bring their badge and/or any other information identifying them as a physician. We have a way to temporarily credential physicians in an emergency situation. Also, if you are interested in participating in our Emergency Preparedness Committee, please contact the Medical Staff Office. The more, the merrier!

Recently, there have been privacy breeches in EPIC at other Sutter facilities involving both staff and physicians inappropriately accessing patient’s medical records for personal interest. The employees have been terminated. Please take time to review the privacy policy summary below regarding appropriate accessing of patient records, including accessing family member’s records (you must have a release from HIM on file in EPIC if you are not a treating physician) and your own records (preferred route to access is via my health online).

I hope you all are enjoying your summer! Take care.