President’s Message

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.

Message from the President – June 2018

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

Medical Staff Leaders recently completed Sutter Safe Care Leadership training. A special thank you is extended to everyone who donated eight hours out of their busy schedule to participate. We learned during the training that Sutter Safe Care is about creating a safe environment for not only our patients, but also for everyone in hospital. Zero harm is our goal.

Sutter Safe Care is about having a preoccupation with failure and safety, and linking this to our decisions to help create a safe environment for all. It’s about addressing potential safety issues before they become problems and cause harm. It’s about speaking up about issues we encounter on a daily basis, and thanking individuals for bringing up their concerns. It’s about actively finding problems and fixing the proximate causes. Also, it’s about changing our culture by creating an environment of trust and cooperation.

A more technical aspect of Sutter Safe Care is changing some of the details of our reporting system to better categorize events that could lead to harm or have caused harm e.g. Intensive Analysis (IAs) and Root Cause Analysis (RCAs). This will help us as an organization better understand patterns of safety events and create solutions within our system to avoid these events from occurring in the future.

Furthermore, there is an emphasis on “Just Culture”, or in other words, having a fair and accountable culture, which is understanding that most events are unintentional. When a safety event occurs, rather than blaming the individual, we take a deep dive into our system and determine how we can prevent future incidents through improving our systems. Also, as physicians and care givers, we hold ourselves accountable to our patients and each other.

The dates, times, and location for the two hour Sutter Safe Care sessions will be emailed soon.

Remember, if you see a problem or potential problem, please report it to your unit manager or to your Medical Staff leader, either your Department Chair or Medical Director. Below is an outline of the Medical Staff leadership reporting structure.

Required two hour training sessions for physicians and staff will occur June through September. Many options will be available at varying times of the day. Specifically, there will be a few grand rounds dedicated to Sutter Safe Care training. Administration will sponsor dinner sessions at both the Summit and Alta Bates Campuses for physicians and allied health professionals. Also, you can join the hospital staff during any of their training sessions. It’s the same training. Please be sure to sign up and sign in to receive participation credit. CME credits are also available. Thank you in advance for participating in the quest toward zero harm!

A special thank you goes out to each and every physician and allied health professional caring for our patients during the unexpected downtime which began the night of May 14th. Around 10:30 p.m., activation of the fire suppression system in the Sacramento data center forced an immediate shut down of all of Sutter’s data systems. All Sutter computer services and systems were down. Our physicians, nurses and staff worked side by side quickly pulling together all available resources during this unfortunate event. While walking through every floor and visiting almost every department, I noticed a strong sense of camaraderie and team work. Adversity brought out the best in everyone despite the challenges we faced. Radiologic studies were read at the bedside. Lab results were both hand delivered and faxed. Physicians heard through the grapevine potential consultations and without being called, came to the patient’s bedside.

Two radiologists deserve recognition: Dr. Phillip Wong and Dr. Chris Lee. The night hawk service was unable to function without computer services, therefore, no teleradiology. Both radiologists came in to care for our patients the night of the outage despite not being on call so studies could be read in real time. Thank you Drs. Lee and Wong.

Sutter is doing a deep dive into the circumstances surrounding the unexpected downtime. They will report their findings to each affiliate and we will report the findings via the medical staff newsletter. Also, we are doing our own debriefing as there is a lot we can learn as this situation simulated a true disaster. Please escalate downtime concerns, or ideas to streamline downtime procedures to your unit manager, Medical Director, or Medical Staff Chair. We can learn from your experience.

Message from the President-May 2018

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

Hello everyone! First, I would like to thank the Administration on behalf of the Summit Medical Staff for a lovely Doctor’s Day breakfast and lunch, along with the donation to New Day for Children, a non-profit organization supporting victims of sex trafficking. Also, thank you Chuck Prosper for your years of service as both COO and CEO at ABSMC. We wish you well in your future endeavors.

This month’s newsletter will focus on Summit campus highlights.

-This summer, we will launch our new Neuro Interventional Program. Initially, we will perform thrombectomies on patients who have had an acute thrombotic stroke. The program may expand later to include aneurysm coiling. Staff will go to Eden for training, as Eden has a well-established program.

-Dr. Rock Liu is leading our new Robotics Hernia Mentor/Case Observation program for robotic assisted hernia repair. Physicians will come from around the country to train and learn about our program. Details were published in the March newsletter.

-Construction for the new hybrid OR begins in April and will take approximately one year to finish. The hybrid OR will have all of the capabilities of a regular operating room plus built in advanced imaging technology.

-Our Preoperative Clinic, led by Dr. Catherine Stapleton, continues to ramp up its volume and is seeing a majority of patients who come through the operating room. A satellite clinic at Ashby is currently under consideration.

-MCMI is moving to a new location on Telegraph Avenue.

-The new in-house MRI will be operational at end of 2018.

-The construction for the new Doctor’s Lounge is scheduled to finish at the end of 2018. There will be a small exercise area, plenty of space to chart, a lounge and a dining area.

-Soon, construction will begin disassembling the West wing of the hospital. The disassembly will occur over five weekends, and construction will continue in this area of the hospital for 12-15 months.

-The Medical Staff has been engaging Sutter leadership about growth strategies for ABSMC. Suggestions or ideas? Please let myself, the Chair of your Department, or the Medical Staff Office know, as this is a collaborative effort.

-Sutter Safe Care Leadership training has begun. Dates and times for the two hour training for all physicians and staff will soon be released and will occur June through September. Administration will provide dinner for physician training on a few selected evening dates at both the Summit and Alta Bates campuses. Two hour training sessions will also be available during a few selected grand rounds on each campus. Physicians also may join in on the staff training sessions. The content is the same no matter which venue you choose. CME credits will be available.

Jill Kacher Cobb, MD
President, Summit Medical Staff