Announcements

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.