President’s Message

Message from the President – December 2018

Posted on Dec 4, 2018 in President's Message | 0 comments

As we enter this holiday season, I want to share how grateful I am for the gifts that you give our patients each and every day. I am in awe of your extraordinary competencies as caregivers and the spirit of compassion and empathy that you bring to each of our patients, colleagues and the community. I am thankful that by working together, we are able to create the best experience and guide our patients in their healthcare journey.

Caring for people in need can be exhilarating and inspiring, but it can also be exhausting. Physicians have a suicide rate that’s three times the rate of the general population and is an important issue that I will continue to address.

Pamela Wible, M.D., a family medicine physician and founder of the ideal medical care movement has spent the last six years investigating more than 1,100 physician suicides. Her message is that we need to be there for each other during times of suffering. It’s really that simple. She suggests sharing our stories and our struggles. She also suggests being a warm line for someone and offer to listen to a colleague during a time of need.

As physicians, we may suffer greatly. Many of us have repressed our memories of difficult situations we’ve encountered as a physician. In the spirit of Dr. Wible’s advice, I’ll share a story; a repressed memory that surfaced this month. It was triggered by a physician’s response to the controversial National Rifle Association (NRA) tweet stating that physicians should “stay in their lane” in response to a paper written by the American College of Physicians. The paper wrestled with how to reduce firearm violence in the U.S. consistent with the Second Amendment. Aside: to keep politics out, as one physician stated, physicians are not anti-gun, we are anti-bullet hole.

The following paragraph is a bit graphic. If you are squeamish or do not want to read something intense, please skip the rest of this paragraph and move to the next paragraph. A physician tweeted in response to the NRA’s tweet that as physicians, we are in our lane. We try to save bullet ridden patients while listening to family members scream in the hallway. This shocking statement immediately transported me back approximately 15 years when I was UCSF Anesthesiology resident doing a trauma rotation at San Francisco General Hospital. There were three anesthesiology residents working that night, including myself, when a page came through announcing three gunshot wound patients en route to SFGH. We each quickly chose one of the three trauma bays and waited. My patient was an infant. I quickly intubated the infant to the background sound of a screaming family member in the hallway. Unfortunately, our resuscitative efforts did not save our patient. I ran to the next room to help my colleagues try to save a toddler also riddled with bullet holes. Resuscitation was still being attempted. Screams continued in the background. We could not save the toddler. In the third bay, the other family member was pronounced dead. We then quickly needed to attend to cases in the operating room and on labor and delivery. We never stopped to take a breath or discuss what had just happened; I’m sure you can relate.

We experience so many traumatic events as physicians. Often, we move from one patient to the next without stopping to recognize how these intense experiences impact us. Our training teaches us how to care for our patients and not necessarily how to care for ourselves or for each other. Our current physician culture does not allow for weakness. Emotions can get in the way of logic when we are in an acute situation caring for a critically ill patient, and we are rightly trained to brush aside our emotions in this situation. However, we often carry over this logic after the acute situation has passed. As a result, we may bury our emotional reaction. Over time, this takes a toll.

About a year and a half ago, one of our physician colleagues committed suicide. He was a partner in our group. None of us knew he was suffering. It’s not in our culture to show weakness or vulnerability. We have to be tough. Suffer alone. What if we reject these norms? What if we open up to each other and discuss what has happened or is happening to us? Let’s change our culture. Let’s open up and make it abnormal to NOT discuss our experiences. As Dr. Wible suggests, in order to prevent physician suicides and, in my opinion, to better improve our overall health and well-being, we need to be there for each other during times of suffering.

The Peer Support Program is up and running. Please reach out if you would like to talk to a physician colleague trained as a Peer Supporter. Let us know if a colleague had a tough case and you’d like a Peer Supporter to check in on them. The Peer Support email address is peeroutreachABSMC@gmail.com and phone number is 510-869-8688. A Peer Support triage volunteer checks the email and telephone messages during regular business hours. Conversations with Peer Supporters are confidential and 1157 protected. It is optional to talk to a Peer Supporter; really, it’s up to you. No record will be kept other than that a phone call was made.

Our Wellness Committee also has a website on the Sutter intranet with resources including counselors, crisis hotlines including the National Suicide Prevention Hotline, books, spiritual care support, career coaching, and other resources. If you have other resources you’d like to share, please let us know. Also, if you’d like to be a part of our Wellness Committee, please contact the Medical Staff Office.

Thank you for the incredible care you provide to the patients in our community. Your dedication and compassion are deeply appreciated. Let’s continue to spread compassion throughout our hospital community. Let’s make it the norm to reach out and check in to see if our colleagues are OK. Let’s begin to discuss our intense experiences. Let’s start to change our culture and share our stories. Let’s be there for one another. Let’s become more connected to one another and continue to build a strong and healthy physician community.

Wishing you a very happy holiday season,

Jill Kacher Cobb, MD

President, Summit Medical Staff, ABSMC

Message from the President – November 2018

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

Crisp and cool fall air

Leaves crunching under your feet

Family, friendship

-Alta Bates Summit has been awarded the NSQIP (National Surgical Quality Improvement Program) Meritorious Award from the American College of Surgeons. This marks the sixth time since 2011 that we have received this prestigious designation.  This distinctive award is given to select hospitals for exemplary outcomes in surgical patient care. Thank you Dr. Steven Stanten for all of your hard work implementing and leading this important quality initiative! Congratulations to our surgeons, anesthesiologists, and nursing staff, along with the interdisciplinary team of physicians who work hard to prevent surgical complications and save lives!

-The Summit Campus began a new Neuro Interventional Radiology Program on October 15th. Congratulations to all involved in supporting this program! The program will be a great addition to treatment options available for patients who have suffered an ischemic stroke using state-of-the-art technology through a minimally invasive procedure, mechanical thrombectomy.

-The Closed Active Medical Staff Meeting will be held on November 7, 2018 in the Bechtel Auditorium at Samuel Merritt University. Hors d’oevres, wine, and beer will be served at 5:30 p.m, and the meeting will begin at 6:00 p.m. The meeting is open to all active Medical Staff members. We will give a Medical Staff and hospital update. This year, we will also celebrate our Medical Staff with a few new awards. We hope to see you there!

-The ABSMC Joint Medical Staff Holiday Party will occur on Wednesday, December 5, 2018 at Scott’s Seafood in Jack London Square. Come for the dinner and dancing, stay for the company. Join us for some holiday cheer, catching up with old friends and making new connections!

-Peer Support Program update: the ground work is currently being laid and a lot of work is happening behind the scenes. The Peer Support e-mail address is peeroutreachABSMC@gmail.com and the phone number is 510-869-8688. The email and telephone messages will be checked intermittently Monday through Friday during regular business hours. A Peer Supporter will make contact as soon as possible.

-The new MRI, cafeteria, and Medical Staff lounge are slated to open February 2019.

-Work continues on the new Hybrid OR.

-Transfer Center update: there have been a few bumps in the road with the change to the Bay Transfer Center. If you are having issues, please email Lory Wiviott, M.D. the medical director of the transfer center at wiviotl@sutterhealth.org. He is interested in knowing all of the issues and is working to improve the process.

-Please remember to sign your verbal and telephone orders within 48 hours. Remember, you can sign for each other if you are caring for the same patient.

Happy Fall!

Jill Kacher Cobb, MD

President, Summit Medical Staff, ABSMC

Message from the President – October 2018

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

On Saturday, September 15th, Dr. Jo Shapiro from Brigham and Women’s Hospital in Boston, trained 24 of our physicians in Peer Support. We learned about physician burnout, just culture, and most importantly coping and recovering after an adverse event or medical error. Unfortunately, many of us have been involved in an adverse patient outcome or an event that has harmed a patient. We are human, and regrettably, we are not error-free in our actions, despite the fact that many of us are perfectionists, holding ourselves to an extremely high standard. What organizations aim to do is create systems that catch errors before they reach a patient, before the error causes harm. We aim to be harm free. However, unfortunately, this does not always happen.

Being involved in an adverse event or medical error may cause significant emotional distress. We may experience shame, self-doubt, decreased self-worth, increased anxiety about a future event, fear, anger, sleep disturbances, and obsessive rumination about the event. A professional culture of blame, shame, and silence can cause isolation. Dr. Shapiro shared a study demonstrating that after a medical error, 30 percent of physicians experienced a negative impact on their work performance, personal life, or colleague relationships. After a medical error, there also is a higher risk of burnout, and burnout leads to a higher risk of medical errors.

So what can we do? First, all of the above feelings we experience when faced with an adverse event or medical error are normal. We need to be able to speak to our emotions in order to heal. Debriefings are often not an effective space for physicians discuss errors as we often act as team cheerleader. Also, physicians are viewed as a team leader and often do not feel comfortable disclosing these types of emotions to the team. As physicians, many of us feel a stigma to reaching out for help. We also may feel we lack time. However, in a study, 88 percent of physicians would like to have support from a physician colleague, someone who can more deeply appreciate what we experience. A Peer Supporter. We as physicians deserve self-care and support. This will help us to heal ourselves and get us back to what we do best, heal others.

There are many next steps to fully implement our Peer Support Program, now that we are trained. We plan to link our systems that learn about adverse events to Peer Support and have automatic triggers where we will send an email or make a phone call to check in and see how you are doing. Also, if you or another physician is in need of Peer Support, for any reason, we will establish an email and telephone line where you can leave a message and someone will reach out to you or your colleague.

Peer Support is not linked to Peer Review or a root cause analysis. It also is not a legal discussion about a case. It is gift of compassionate listening from a colleague. The conversation is confidential. Also, if you do not want to talk about an event, there is no pressure to discuss. We are here if you change your mind.

More to come as our program develops!

Take care and be well,

Jill Kacher Cobb, MD
President, Summit Medical Staff, Alta Bates Summit Medical Center

Message from the President – September 2018

Posted on Sep 5, 2018 in President's Message | 0 comments

I hope everyone enjoyed their summer! It continues to amaze me how quickly time passes. Another summer has come and gone. And with the change in the season, we wish our beloved Medical Staff Director, Dr. Joanne Jellin, a very happy retirement. She has effectively lead, and been the heart and soul of the Summit Medical Staff for almost 22 years. Dr. Jellin began working at Providence Hospital in the Medical Staff Office in 1981 and came to the Summit Medical Staff Office in 1996. Her breadth and depth of knowledge and professionalism has lead us through many challenging times. Thank you Dr. Jellin for your many years of dedication to the Summit Medical Staff! We wish you the best in retirement.

Medical Staff Updates:

-Sutter Safe Care Training for physicians will extend through the end of this month. The training is required for ALL active medical staff members. Dates are included below. Dr. Roos, our CMO, is leading the physician training. You can attend any training session that fits with your schedule, not just the physician only training. Please sign in so you receive attendance and CME credit.

-Please remember to sign your verbal orders within 48 hours. Remember, you can sign your colleagues’ verbal orders if responsible for the care of the patient.

-The Modesto Transfer Center will “sunset” (a nice way of saying close) November 1st. ABSMC will become part of the Bay Transfer Center in Novato which also covers CPMC, Mills, Eden, etc. September 3 is our go-live date. The intake individual at the center will be an RN rather than a clerical person. Also, there is a new Medical Director, Dr. Lory Wiviott, who will oversee the transfer center. 

– Alta Bates Summit and the Oakland Police Department have opened a resource center across the street from the Summit Campus Emergency Room. The goal of the resource center is to provide beat officers and especially those working the night and swing shift a space to complete reports and use between police calls. Located at 400 34th Street in Oakland, the resource center is equipped with internet access, coffee/beverages and other items. The resource center is not a police sub-station and will not be staffed 24-7 by police but all officers will be able to utilize and access the office 24 hours a day.

-The Neurointerventional Program will begin in September.

-Facilities update: Conference rooms Fir 1, 2, and Elm will permanently close mid-September. All meetings will move to other locations on campus. Please closely check your meeting schedule for changes in meeting locations. Grand Rounds will also be relocated to the Bayview Room on the 11th floor.

-My Virtual Workspace will launch soon. This update will allow you to tap in and out of a workstation, and your exact screen will reappear on the next workstation you tap into. At the end of the day, please remember to log out of My Virtual Workspace. Stay tuned for tip sheets.

-Please remember to secure your EPIC workstation after you finish your work. There was an episode (at another facility) where an employee was caught on tape accessing another employee’s workstation to look up unauthorized patient information under the other person’s username and password. They had forgotten to log out and left their computer open. Unfortunately, both employees breached Sutter privacy policy.

-Sutter is developing a Mental Health Access Center which will create a centralized call center in Utah to help Sutter facilities find inpatient beds, access detox centers, and perform insurance authorizations for patients with mental health needs. The plan is for Sutter to go live in early 2019.

-Medication Reconciliation is required after a patient undergoes a procedure prior to returning to the floor. Patty Fitzgibbons is willing to help any physician with this task. Reminder/tip sheets will be posted in the PACU.

-Sutter Health Institute for Health and Healing is sponsoring a Physician Wellness Retreat October 5-7 in Scott’s Valley https://1440.org/programs/professional-development/from-burnout-to-brilliance/. This is an overnight retreat that will review research on burnout for healthcare practitioners and it’s prevention, and also help reconnect individuals with a sense of meaning in their work. More information is below.

 

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.

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.