Message from the President, January 2018

Posted on Jan 10, 2018 in President's Message | 0 comments

Dear Medical Staff Colleagues,

Happy New Year,

As you are aware, the census is high and in retrospect, the previously low census was the calm before the storm. There are many patients with high medical acuity and who are positive for Influenza. Thank you for all your hard work! Special thanks to the Emergency Department, Hospitalists, Surgeons and Intensivists.

Sutter Safety Care- This is the High Reliability project focusing on our processes to decrease patient harm. This a Sutter system initiative and we will be one of the early adopters. We can anticipate a roll out in the spring with Physician leadership training and then will be disseminated to the rest of the staff.

Drug shortages- For several reasons, we are facing challenging drug shortages. We need to make wise choices and consider alternative medications. It is vital to be aware of which drugs these are and to be abreast on the latest changes. There is an icon on the Sutter computer desktops which gives the weekly updates. (See screenshots below). I recommend being familiar with how to access the information and checking on a regular basis.

Currently physician representatives from ED, Hospitalists, Cardiologists, Critical Care, and Anesthesia are engaged with pharmacy and nursing administration on providing recommendations for alternative drugs.

Interpretation services- We are fortunate to care for a diverse patient community. This does make it more important to rely on interpretive services. From the Patient Safety Risk Committee, a theme is recognized in regards to patient falls and in practically every case, upon review, interpretive services were not used. This is not the main reason for the fall but likely contributed. It is recommended not to rely solely on family members. There are interpreters physically present at the hospital during the work week. There are telephone interpreters on every unit (ask the charge nurse for a phone if not present in the room). You are encouraged to ask for an interpreter off hour if you require one. Simply ask the house supervisor and they will work on obtaining one for you.

Dr Ursi Boynton has moved on to be the CME at Delta Medical Center. Congratulations Ursi! They are very fortunate and lucky to have you.  Thank you for all your physician support these past several years.

I am completing my term as your Medical Staff President. It has been a humbling experience and an honor serving you all. I want to thank my fellow officers Dr Junaid Khan, Immediate Past President, Dr Charu Puri, Secretary/Treasurer and Dr Jill Kacher Cobb, Vice -President and Physician Leaders on the Medical Executive Committee for their council and much needed advice. The ladies in the Medical Staff Office Heidi Van Waveren, Terri Smith, Karen Souvandara, and Joanne Jellin who not only provide support for our medical staff meetings but create magic behind the scenes by keeping  the medical staff operations running smoothly. I would like to thank the Administration Chuck Prosper, Rose Calhan, Denise Navellier, Dr Ursi Boynton for their partnership in working toward our shared goals- the continued success of Alta Bates Summit Medical Center and providing quality care to patients.

But most of all, thank you to the dedicated and hardworking medical staff physicians who are the heart of the medical community.

Drug shortages

Posted on Jan 10, 2018 in Announcements | 0 comments

Kudos to Physicians with Excellent Verbal Order Signing Compliance

Posted on Jan 10, 2018 in Clinical Documentation | 0 comments

Welcome New Providers

Posted on Jan 10, 2018 in New Physicians | 0 comments

Esther Kwon, DPM
2299 Post St., Ste. 205
San Francisco, CA  94115-3473
(415) 292-0638

Joseph B. Nakhleh, MD
Hospitalist, Medical
Sutter East Bay Medical Foundation
350 Hawthorne Ave Rm 2346
Oakland, CA  94609-3108
(510) 869-6883

From the Medical Staff Office

Message from the President, December 2017

Posted on Dec 5, 2017 in President's Message | 0 comments

Dear Medical Staff Colleagues,

The hospital is facing tough financial challenges. As you know, the hospital needed to make difficult decisions by laying off several management positions. This has created a restructuring in administrative support for certain departments and services. We will be learning more about what the new structure is going to look like. My understanding is that the goal is not to have a disruption in the front line delivery of care. My recommendation is to continue to ask questions of the Administration. Our medical staff leadership and I will continue to have a dialogue, provide feedback and partner with Administration on shared goals.

Shortages in medications- Pharmacy is keeping us updated on the latest medication shortages. Apparently IV KCL is on the short list. This is a frequently used medication. With help from the nephrologists, a protocol is being developed and will be rolled out very soon.

Telemetry usage- we were doing really well, but more recently there has been a drop off on appropriate cardiac monitoring usage. This is just a gentle reminder to use the guidelines for usage and to take patients off monitoring once it is no longer needed.

Much appreciation and thanks to Dr. Ursi Boynton for her years of service as the Administrative Medical Director.  Delta Medical Center will be fortunate to have her as their new Chief Medical Executive.

The Summit Medical Staff has generously donated $1,000.00 for the Holiday Giving – Grocery Gift Cards for Families in Need.

Best wishes during this Holiday Season.

Stay safe and be well,


Donna D. Tigno, M.D.

President of Summit Medical Staff

Co-Director of Critical Care at Summit Medical Center.


Health Services Advisory Group

Posted on Dec 5, 2017 in Uncategorized | 0 comments

In-Patient Acute Stroke Guidelines: Physician Reference

Posted on Dec 5, 2017 in Uncategorized | 0 comments


Posted on Dec 5, 2017 in EHR Updates | 0 comments


Posted on Dec 5, 2017 in Uncategorized | 0 comments

Malnutrition is common in hospitalized patients but under recognized and undertreated.  Since patients with malnutrition are at increased risk for poor outcomes, including a 4-5-fold higher mortality rate, it’s worth learning how to recognize this condition.

Most physicians aren’t familiar with the diagnostic guidelines published by the American Academy of Nutrition and Dietetics (the Academy) and the American Society for

Parenteral and Enteral Nutrition (ASPEN).  Fortunately, the hospital registered dieticians (RDs) are a great resource for evaluating, verifying clinical indicators and assigning appropriate nutritional diagnoses and treatment plans for these patients.

If you suspect malnutrition (eg patients with weight loss, pressure ulcers, cancer or SNF residents), order a dietician consult.  And before saying that your patient is “well-nourished, well-developed”, pause to consider whether this description is accurate.  Proper nutritional assessment is actually quite complicated AND even obese patients can be malnourished.  For these reasons, it might be better if we use the description “well-developed” when appropriate but leave the nutritional assessment to the RDs.

In order for the diagnosis of malnutrition to be properly coded, the diagnosis and the degree of malnutrition (mild, moderate or severe) must be documented by the physician.

Make it a habit to read the RD notes (located under the “Care Team” tab in Notes section of EPIC) and if you agree with the diagnosis and treatment plan, document this in your note and discharge summary and monitor the condition during the hospitalization.

To avoid getting a query about malnutrition, read the RD notes and if you agree with the diagnosis and treatment plan, including degree of severity of malnutrition, document this in your note and discharge summary.   The diagnosis of malnutrition can impact both severity of illness (SOI) and risk of mortality (ROM) so remember to check the RD notes for help with recognizing malnutrition.

Beth Gong, MD–  CDI Physician Champion

Welcome New Physicians

Posted on Dec 5, 2017 in New Physicians | 0 comments

Shadi I. Battah, MD
East Bay Region Critical Care & Pulmonary Medicine
411 30th St Fl 3
Oakland, CA  94609-3310
Phone (510) 841-0689

Ajitha K. Nair, DPM
3007 Telegraph Ave., Ste. A
Oakland, CA  94609

Vikram Suri, MD
East Bay Nephrology Medical Group
2905 Telegraph Ave
Berkeley, CA  94705-2017
Phone (510) 841-4525