Covid-19 Update – Medical Staff Voice Special Edition – April 6, 2020

Dear Colleagues:

In an effort to continue to provide you with updated and clinically relevant information to your practice and care of patients, I make every effort to make sure the information is accurate, timely and of value to you.  I know that you are being inundated with information, so I will keep the information I provide limited.  If you would like to have more information or if you would like me to elaborate on any particular topic, please contact me directly. I welcome any and all contributions to this newsletter that would fit into those aforementioned constraints.
Additionally, Dr. Jeff Brackett, Chief of Staff, provides a conference line update every Monday, Wednesday, and Friday at 7:30 am.  All Medical Staff are invited to call in and ask questions of Jeff.  Contact the Medical Staff Office for the conference call number and ID at (805) 948-5662.

“Code Intubation” Service

Our anesthesiologists have put together a Code Intubation service. Special thanks to Drs. Coppa and Barbosa for leading the effort to create this service.
We have outfitted one of our existing portable carts with meds/airways/ppe to be able to respond to airway emergencies. There are also specialized supplies available in the ED and Critical Care units.
The on call anesthesiologist can be reached anytime for intubation through the house supervisor or operator, or by dialing direct (805) 340-2437‬.  I’d recommend differentiating this service by asking for ”code intubation” rather than requesting the ”anesthesiologist on call”  who will be a different person covering the operating rooms.  Please notify the team as soon as you begin to consider intubation, as the physicians prefer to be notified sooner rather than later.

CMHS Radiology/Imaging Department Scheduling Changes – Important

As a temporary measure and in an effort to minimize exposure to patients and staff, the Imaging departments at CMH (Radiology, Ultrasound, MRI, Cat Scan, IR, Nuclear Medicine) have moved the scheduling of new non-urgent, elective, outpatient exams/ procedures and Interventional Radiology procedures to May.

  • If you feel the imaging study for your patient is urgent and cannot wait until May, please call the Radiology department at (805) 948-8160 and they will assist in scheduling the patient sooner. (for Nuclear Medicine, please call (805) 948-5026)
  • For elective outpatient exams and procedures which are currently on the schedule, the department will be reaching out to the referring physician and inquiring as to the feasibility of moving the exam/procedure to May.
  • For outpatient Interventional Radiology procedures which are considered urgent, please call (805) 948-8160 to speak directly with the Interventional Radiologist prior to scheduling.
  • As a reminder, all patients are screened prior to entering the Hospital.  If your patient is experiencing symptoms (fever, cough, headache, shortness of breath, sore throat), please call (805)948-8160 so that we can work with the screeners

Daily update on COVID-19 cases in the County of Ventura for 4/5/20

18 new cases
221 total cases
62 recovered cases
153 under home quarantine
6 deaths

Billing for Digital Visits – California Governor Executive Order on Emergency Telehealth Guidance, April 3, 2020

Health plans shall reimburse providers at the same rate, whether a service is provided in-person or through telehealth, if the service is the same regardless of the modality of delivery, as determined by the provider’s description of the service on the claim. Reimbursement should be the same for a service rendered via telephone as they would if the service is rendered via video. Requires Medi-Cal managed care plans to allow member to obtain health care via telehealth when medically appropriate.
Any out-of-state personnel, entering California to assist in preparation for, responding to, mitigating the effects of, and recovering from COVID-19 shall be permitted to provide services in the same manner as prescribed in Government Code section 179.5.

Telehealth Codes: Videoconferencing and Telephone Virtual Visits

Emergency Use Authorization Link

New public health comments about masks Ventura, CA

Ventura County Public Health Officer changes position on face masks, no longer advising against wearing them in public. Instead, he supports those residents who wish to cover their nose and mouth when leaving home for essential travel to doctor appointments, grocery shopping or pharmacy visits. The face coverings should not be hospital grade at this time because there is a shortage and our health professionals need them. Masks should be homemade and cover the nose and mouth. There are numerous sites online which demonstrate or give patterns for how to make fabric masks. The Camarillo Sewing Brigade provides video instruction at the following link. Additional instruction at the following link. Fabric masks can be washed and used again.

CMH Brent Street Café (cafeteria) Physician and Employee Grocery Pop-up Market

The Brent Street Café and the team at Morrison is offering a physician and employee grocery pop-up market starting next week.  This market is providing various grocery items for people to take home.
While the non-barcoded meals in the café are free for our physicians, it should be noted that these grocery items are not free for physicians at this time.

Designed to support our incredible physicians and staff, this market offers a variety of grocery items you can purchase and take home including loaves of bread, soup, dry pasta, rice, pancake mix, dairy products, toilet paper and much more!*
Here’s how to order:

  1. Visit the Brent Street Cafe and request an order form.
  2. Complete the order form and select an order pick-up time.
  3. Submit your order to your cashier and collect an order receipt.
  4. Bring your receipt to THE GRILL at your designated pick-up time to collect your order!

THANK YOU to the Brent Street Cafe and our partners at Morrison for providing this service to our physicians and staff!
*Pricing details are available in the Brent Street Cafe and items for purchase are subject to availability.

Michael Datlow, M.D. – In Memoriam

It is with profound sadness that I report the untimely passing  this week of Dr. Michael Datlow.  Dr. Datlow was a respected and loved Family Physician by patients, friends and family.  He trained at the Ventura County Medical Center Family Medicine residency program, along with many of his colleagues who continue to practice medicine in Ventura. Memorial services have not yet been announced and I will forward that information when it is available.

CMHS Weekly Medical Staff Calendar – April 6 – April 10

MondayTuesdayWednesdayThursdayFriday
7:30am COVID19
Teleconference Update for Medical Staff
7:30am OBGYN Department COVID Report (Teleconference)

5:30 pm MEC – BR

5:30pm COVID19 Task Force Meeting (Teleconferenced
7:30am COVID19 Update for Medical Staff (Teleconferenced)
12:00 pm General CA Conf – BR
Passover begins at sundown
12:00 pm QA & Patient Safety Cmte – BR
12:15pm Pediatrics COVID Report (Teleconference)
5:30pm COVID19 Task Force Meeting (Teleconferenced)
7:30am COVID19 Update for Medical Staff (Teleconferenced)

Good Friday

Final Thoughts,

I’ve never known any trouble than an hour’s reading didn’t assuage.”
-Arthur Schopenhauer

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

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Covid-19 Update – Medical Staff Voice Special Edition – March 30, 2020

Doctors Day – March 30, 2020

We want to take this opportunity to honor and thank the physicians of our Medical Staff for their tireless dedication to our Health System, our patients and our community.  This dedication and sacrifice is more evident now, during the COVID-19 crisis than ever before.  Thank you for the unrivaled quality of medical care and caring that all of you provide.  We appreciate your efforts and endeavor to support you in every way possible.

We have postponed our official annual celebration of Doctors Day because of the COVID-19 crisis and hope to celebrate the event sometime in the next 6 months when we’ve succeeded in winning the battle over this disease.

CMHS Teleconference Update for Medical Staff – Monday, Wednesday, Friday at 7:30 am

Dr. Jeff Brackett, Chief of Staff, is hosting a tri-weekly, 7:30 am update for the Medical Staff, with opportunities to ask questions on the specifics of our response to COVID-19 and its impact to our Health System, Physicians and community.  If you need the conference number and ID please contact the Medical Staff Office at 805 948-5662.

Daily Ventura County COVID case report for March 28, 2020

Here is your daily update on COVID-19 cases in the County of Ventura. There are 98 cases. 1,574 people have been tested. There have been 3 deaths. Please stay informed at www.vcemergency.com.
Reported last night.

CMHS Azithromycin injection – Limited Supply

Azithromycin injection is  currently unavailable and we have only 22 vials in stock. We are expecting another 10 vials tomorrow and potentially more will be released next week.

Please use PO whenever possible to reserve supply for patients with no enteral option. Limiting courses to 5 days will also help preserve our supply. Pharmacists will be reviewing IV orders for the ability to transition per our IV to PO protocol.

Increased demand may be prompted by the interim data (Link) that added a Z-pak to hydroxychloroquine in a subgroup (n=6)  of COVID-19 patients and noted faster viral clearance in these patients. However, patients who received the additional azithromycin had lower viral loads at baseline than the those who received hydroxychloroquine mono-therapy. This likely contributed to the findings in favor of the combination. Certainly not definitive data to add azithromycin in all COVID patients getting hydroxychloroquine. Probably better to save the azithromycin for patients with CAP where there is known benefit.
Kaitlyn Moorehead, PharmD, CMHS

Current Global COVID-19 Cases

Continue reading

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Covid-19 Update – Medical Staff Voice Special Edition – March 25, 2020

Statement from Gary Wilde

Today across Community Memorial Health System (CMHS), our physicians and staff are engaged in one of the most challenging situations ever faced by the healthcare system in our country.  Our fundamental desire and need at this time is to protect these devoted individuals, and we are taking the necessary steps to screen them all and do everything we can to ensure their safety during this time.  Additionally, I want to thank the hundreds of men and women who continue to enthusiastically show up to serve our community and to support one another every day.

In response to recent reports from local news entities regarding positive COVID-19 cases among our CMHS physicians and staff, I wanted to reach out and provide complete information on the matter.  As of Monday March 23rd, three physicians and one administrator at Community Memorial Hospital have tested positive for COVID-19.  Here are the facts about these cases:

  • All of the affected physicians are confined to one medical group.
  • None of the affected individuals reported symptoms while working in the hospital.
  • All four individuals are quarantined at home and feeling fine at this time.
  • Our Infection Control team has conducted a thorough investigation to identify and notify anyone who had contact, or was potentially exposed, through these four individuals. Hospital patients and family members who were not notified can assume they were not exposed through these individuals.
  • Staff who had contact with these individuals have been notified and have received explicit self-monitoring instructions. If asymptomatic, they have been permitted to continue working provided that they wear a mask at all times.
  • All of the physical spaces that may have been impacted by these four individuals have been thoroughly cleaned using CDC recommended cleaning and sterilization protocols.

We are also treating one confirmed positive in-patient at Community Memorial Hospital in Ventura, along with other suspected cases that have not yet been confirmed or ruled out.  Out of respect for these patients and their families, and in accordance with HIPPA guidelines, no additional details on these patient will be released.

As this virus continues to spread throughout our community, our focus at CMHS has narrowed.  We are now acutely focused on meeting the immediate and emergent health needs of our community, protecting and preserving the health of our physicians and staff, and preparing for the potential influx of COVID-19 patients.  Here’s what we’re doing to protect our patients, physicians, and staff during this uncertain time:

  • We are screening everyone who seeks entry to Ojai Valley Community Hospital, Community Memorial Hospital in Ventura, the Centers for Family Health, and Midtown Medical Group. This includes patients, essential companions, physicians, staff, and essential vendors.
  • Visitation to all of our facilities has been narrowly restricted until further notice (detailed visitation guidelines are available at https://www.cmhshealth.org/coronavirus-covid-19/).
  • We are vigilantly monitoring the health and well-being of our physicians and staff, and immediately removing from service any staff who exhibit symptoms of COVID-19 or any other illness.
  • We are requiring all physicians and staff to wear a mask at all times when on campus at any CMHS facility.
  • Our cleaning teams are working day and night to ensure that all of our facilities are thoroughly cleaned according to CDC recommended sterilization protocols. This includes the use of an advanced ultra-violet cleaning system CMHS in our most at-risk spaces and other areas where applicable.

As you can imagine, one of the biggest challenges we are facing is protecting the health of the dedicated physicians and staff who are on the frontlines of this pandemic.  We applaud their commitment to our community during this time.

One of the most important things for our community to understand about this virus is that while most individuals who contract it will have only mild symptoms, it is highly contagious and can be very serious for at-risk populations, including the elderly and those with preexisting conditions.  To protect these at-risk groups as well as the healthcare professionals on the front lines, we urge everyone to adhere to county and state stay-at-home orders and social distancing guidelines.  Additionally, we highly encourage individuals with mild symptoms of fever, cough, headache, etc. to stay home and call their doctor for guidance before going to an emergency room or urgent care location.  This will help reduce the exposure of healthcare professionals and dramatically decrease the number of patients who need hospitalization and intensive care.

As always, we welcome anyone with a medical emergency to our emergency rooms at CMH in Ventura and OVCH in Ojai.

Now more than ever, we need everyone’s cooperation in slowing the spread of this virus and protecting our healthcare workers on the frontlines.  Thank you for supporting us, and each other, as we tackle this challenge together.

Sincerely,

Gary Wilde
President & CEO
Community Memorial Health System
March 24, 2020

Check-in Screening and Masks for ALL MEDICAL STAFF

  • Medical Staff and Employees are to wear masks at all times while on any CMHS campus.
  • At the time of screening, ALL MEDICAL & HOSPITAL STAFF AND VISITORS will be issued one aseptic mask.
  • Medical Staff are to use aseptic mask until it is soiled and replace with supply in their home department.

All physicians must check in when coming into CMHS Campuses & must wear a mask at all CMHS campuses, including CMH, OVCH, and the CFH! Please thank or at least courteously respond to our Hospital Staff who have volunteered to assist in screening and provide the extra measure of safety that is needed currently.

Health System PPE Supply Depletion

Please be aware that the Health System may have adequate masks and PPE for physicians and staff, but we do not have enough for all of the physician offices and ancillary businesses in the area.
Take and use only what you need for Hospital and Center for Family Health use.  Contact your own supplier for your personal and Office use.
Thank you.

Physician Volunteers

We’ve had many active and retired physicians offering to volunteer and assist the Medical Staff in augmenting physician staffing during this COVID-19 crisis.  Your help is appreciated. If you would like to help out, please call the Medical Staff Office at 805 948-5662

Daily Ventura County Public Health Statistics

March 24, 2020.  Daily COVID-19 update from Ventura County Public Health. There are 39 positive cases of COVID-19 in Ventura County. 737 tests have been completed at public and private labs in our County. Please stay home to stop the spread. www.vcemergency.com

The Dangers of Cloth Masks

The widespread use of cloth masks by healthcare workers may actually put them at increased risk of respiratory illness and viral infections and their global use should be discouraged, according to a UNSW study.
The results of the first randomized clinical trial (RCT) to study the efficacy of cloth masks were published in the journal BMJ Open.
The trial saw 1607 hospital healthcare workers across 14 hospitals in the Vietnamese capital, Hanoi, split into three groups: those wearing medical masks, those wearing cloth masks and a control group based on usual practice, which included mask wearing.
Workers used the mask on every shift for four consecutive weeks.
The study found respiratory infection was much higher among healthcare workers wearing cloth masks.
The penetration of cloth masks by particles was almost 97% compared to medical masks with 44%.
Professor Raina MacIntyre, lead study author and head of UNSW’s School of Public Health and Community Medicine, said the results of the study caution against the use of cloth masks.
“Masks are worn to protect from infection during pandemics and outbreaks, especially when there are no drugs or vaccines available for protection,” Professor MacIntyre said.
“Masks are especially important for frontline doctors and nurses, as their protection from infection is key to maintaining the ability to tackle a pandemic effectively.
“We should be cautious about cloth mask use in healthcare settings, particularly high-risk situations such as emergency departments, intensive care, paediatric or respiratory wards.”
Cloth masks remain widely used globally because they are a cheaper option especially in areas where there are shortages of protective equipment, including in Asian countries, which have historically been affected by emerging infectious diseases, as well as in West Africa, which was the epicentre of the recent Ebola epidemic.
The authors speculate that the cloth masks’ moisture retention, their reuse and poor filtration may explain the increased risk of infection.
Professor MacIntyre, who has completed the largest body of clincial trial research on respiratory protection in health workers internationally, said emerging infectious diseases are not constrained within geographical borders.
“Effective controls of outbreaks and pandemics at the origin impacts us directly, so it is important for global disease control that the use of cloth masks be discouraged in high-risk situations,” she said.
“Despite more than half the world using cloth masks, global disease control guidelines, including those from the World Health Organisation, fail to clearly specify conditions of their use.
“These guidelines need to be updated to reflect the higher infection risk posed by cloth masks, as found in our study.”
Professor MacIntyre said the study’s results pointed to the effectiveness of medical masks, in addition to the harm caused by cloth masks.
“Additional research is urgently needed to build on our study’s findings.”
The trial was a collaboration between researchers in Australia and the National Institute for Hygiene and Epidemiology in Vietnam and was funded by an Australian Research Council Linkage Grant.
Link to the original article.

Final Thoughts,

“Adversity does not build character, it reveals it.”
– James Lane Allen 

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

 

 

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Covid-19 Update – Medical Staff Voice Special Edition – March 23, 2020

COVID-19 Testing 

Ojai Valley Community Hospital, Community Memorial Hospital in Ventura, and the Centers for Family Health Urgent Care locations in Santa Paula, Oxnard, and Camarillo have limited COVID-19 tests available.  At this time, we are experiencing an influx of individuals requesting testing.

If you are experiencing symptoms of COVID-19, please STAY HOME and call your doctor directly.  He or she will be able to provide you with guidance specific to your individual circumstances and help create a plan for testing if needed.  If you do not have a doctor, please call your local urgent care or emergency room BEFORE arriving in person and asking for a test.   

We encourage you to visit the emergency room only if you have a medical emergency or are in a state of medical distress.

Facility Closures 

The following CMHS outpatient clinics are closed until further notice:

  • Ojai Multi-Specialty Clinic
  • Premier Dermatology & Mohs Surgery Center
  • Prostate Institute of America

Centers for Family Health Update

  • Reminder: Patients with a cough, fever, or shortness of breath cannot be seen at our regular Centers for Family Health locations.  This includes patients who have already scheduled an appointment.  If you or a loved one has ANY of these symptoms, please call your doctor or local urgent care location.  CMHS Urgent Care locations can be found at www.cmhshealth.org/locations.
  • Centers for Family Health Pediatric Care:  Your child’s health is very important to us.  Children under one year of age MUST keep their appointments for regular care and vaccinations, even during stay-at-home orders and social distancing.  If your child is a patient at the Centers for Family Health, please text or call us at 805-652-6353 if your child needs any vaccines or has missed any appointments.

We are keeping sick individuals out of our pediatric clinics, and you will be able to wait outside for appointments and maintain social distancing standards.

If your child is not a Centers for Family Health patient, please call or text your pediatrician with any questions or concerns.

Midtown Medical Group Update

Effective immediately, patients with a cough, fever or shortness of breath who cannot be seen at the Centers for Family Health in Ventura, or who live in Ventura, Oak View, or Ojai can be seen at the Midtown Medical Group (MMG) Family Medicine Clinic.  If you are experiencing any of these symptoms and would like treatment at MMG please call 805-667-2841 BEFORE showing up at the clinic.  This clinic is located at:

2721 E. Main Street
Ventura, CA 93003

Hospital Visitation

Visitor access to Ojai Valley Community Hospital and Community Memorial Hospital in Ventura remains restricted for the foreseeable future.  We understand the frustration this may cause for those of you who have friends or loved ones who are hospitalized, and we appreciate your understanding as we do everything we can to protect our patients during this uncertain time.

To anyone who is accessing our hospitals, we appreciate your patience with the screening process.

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

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Covid-19 Update – Medical Staff Voice Special Edition – March 22, 2020

Dear Colleagues,

I wish safety for you and your families.
Three of our physicians have been identified as being tested positive for COVID-19 and are staying home.
The MSV is being consolidated as COVID-19 Special Editions going forward, as the greatest amount of information needing to be communicated is on the crisis and so many of our meetings have been postponed, practicing social distancing, or are being conducted virtually.  Invites to the meetings will be sent out by the Medical Staff Office and the invitation will clarify if the meeting can be attended virtually.

I welcome your questions and contributions.  Please click on the blog site link at the bottom of the page to comment online or to see prior COVID-19 MSV archived editions. Our Chief of Staff, Jeff Brackett, M.D., can be reached through the Medical Staff Office at (805) 652-5662, for questions, concerns or input and feedback and Medical Staff issues and CMHS issues.  He provides Medical Staff input to and works collaboratively with CMHS Administration and the Board of Trustees.

Daily Administrative Update

In an effort to keep everyone informed regarding our communication with the public, we are providing daily updates on the statements that have been published for our community.  This update is not intended to answer internal questions.

To: CMHS All Staff
From: Gary K. Wilde, CEO
Friday, March 20th Update

Ventura County Coronavirus (COVID-19) Status: At this time, Ventura County has very manageable volumes of suspected and confirmed COVID-19 cases.  According to VCEmergency.com (https://www.vcemergency.com/), Ventura County has 17 known positive cases.  These cases stated as travel-related cases and have expanded to include cases of community spread.

Community Memorial Health System has tested several positive patients in our outpatient clinics, but we have zero positive inpatients in either of our hospitals.

State of California “Stay at Home” Order: The California State Public Health Office. Director of the Department of Public Health and Governor Gavin Newsom is ordering all individuals living in the State of California to stay home or at their place of residence, except as needed to maintain continuity of operation of the federal critical infrastructure sectors (hyperlink: https://www.cisa.gov/identifying-critical-infrastructure-during-covid-19) critical government services, schools, childcare, and construction (including housing instruction).

  • How Long Is This Order in Effect? The “Stay at Home” order went into effect on Thursday, March 19th and remains in place until further notice.
  • Where Does This Order Apply?  This order is in effect throughout the entire State of California.
  • What Can We Leave Our Homes For? What Services Remain Open?  Some essential services remain open, including:
    • Gas Stations
    • Pharmacies
    • Food: Grocery stores, farmers’ markets, food banks, convenience stores, take- out and delivery restaurants.
    • Banks
    • Healthcare Facilities (hospitals, clinics, etc.)
    • Laundromats/Laundry Services

Essential state and local government functions will also remain open, including law enforcement and offices that provide government programs and services.

What’s Closed? 

  • Dine-in Restaurants
  • Bars and Nightclubs
  • Entertainment Venues
  • Gyms and Fitness Studios
  • Public Events and Gatherings
  • Conventions Centers

For additional information, including the full executive order, please visit https://covid19.ca.gov/stay-home-except-for-essential-needs/.

Patient Information:  For questions about upcoming surgeries or procedures, or if you are experiencing a fever, cough, shortness of breath or any other flu-like symptoms, PLEASE CALL YOUR DOCTOR OR LOCAL URGENT CARE FOR GUIDANCE.

Reminders:

  • As of Friday March 20thentrances to the Community Memorial Hospital Mountain Tower (old hospital) are closed.  Patients and essential companions who require access to the Mountain Tower for services will need to enter through the Ocean Tower (new hospital), and will be assisted, as needed into the Mountain Tower from the Ocean Tower.
  • As of Thursday March 19th, the main entrance to Ojai Valley Community Hospital is CLOSED.  All patients and essential companions are required to enter through the Emergency Department entrance.
  • Effective Thursday March 19th, patients with a cough, fever, or shortness of breath cannot be seen at our regular Centers for Family Health locations.  This includes patients who have already scheduled an appointment.  If you or a loved one has ANY of these symptoms, please call or text 805-652-6353 or visit one of our Urgent Care sites.  Urgent Care locations can be found at www.cmhshealth.or/locations.
  • Effective Friday March 20th, Midtown Medical Group patients with a cough, fever, or shortness of breath will only be seen at our Midtown Medical Family Medicine Clinic location at 2721 East Main Street.   If you or a loved one has ANY of these symptoms, please call or text 805-667-2841, or visit one of our Urgent Care sites.  Urgent Care locations can be found at www.cmhshealth.or/locations.

Physician Direct Admits to CMH

Any and all direct admits should be called to the Nurse Supervisor/Admit Nurse, (805)  910-9332, before we will accept the patient for admission. Please provide the Nurse Supervisor with an accepting physician’s name if you are not admitting the patient to yourself as the attending physician.

PatientKeeper (PK) COVID-19 Order Set

For any suspected COVID-19 admission, please use the protocol defined in the COVID order set.  It can be found easily by putting the word COVID in the order search space.

CMH West Parking Structure Physician 1st Floor Spaces Repurposed for ED COVID-19

The physician’s designated parking spaces on the 1st floor near the Ocean Tower ED in the CMH West Parking structure hav been repurposed during this crisis for providing a holding area for ED patients to stay in their cars while being evaluated by the ED staff for COVID-19 and possible admission or sent home.
We know that this inconvenience is less than ideal, but appreciate your understanding during these times in which we are all are trying to best care for our patients.

Routine Weekend CMH Outpatient Phlebotomy Services Suspended 3/28/20

Letter from Dr. Petroff to OVCH Primary Care Physicians – Valuable Message for All Medical Staff

A couple updates for everyone:

Quest notified us today that a patient we saw at our office on Thursday 3/19 and tested for COVID was positive. He lives just outside of Carpenteria, (ie: not in Ojai). When we reached out to him today, he had clinically deteriorated, so we contacted the hospitalist group at CMH and alerted them that the patient was coming to the hospital. The hospitalist got everything arranged so that the patient just called the ER when he arrived, stayed in his car until staff in proper PPE came and smoothly whisked him up to the ICU, bypassing the ER and avoiding needlessly exposing other people.  

If/when you have a COVID-positive patient, they should stay at home unless they sound more than mildly-moderately ill when you do your follow-up evaluation.  If they sound quite ill, call the Hospitalist on call for further steps.  You want to coordinate direct admission with the person who knows what’s available in terms of rooms, personnel, expertise, etc.

This reinforces the reality that some of the patients with cough and fever who we will see in our offices over the next few weeks WILL have COVID.  It is vitally important that we protect ourselves and our staff by having proper isolation and PPE available. 

IF YOU DO NOT HAVE PROPER PPE (N95 MASK, SURGICAL MASKS, GOGGLES, DISPOSABLE GOWNS) DO NOT SEE PATIENTS WITH POSSIBLE COVID SYMPTOMS IN YOUR OFFICE!!!

We primary care physicians should be doing as many phone calls and virtual visits with patients (respiratory and otherwise) as we can, and encouraging them to stay home if they are not particularly sick. Per recent emergency guidance from CMS, we can use Facetime or Skype for video telecommunication and bill Medicare as if it were a face to face visit.

If patients absolutely feel that they need to be evaluated for respiratory symptoms with fever, the ATA tent at OVCH is up and running! I just completed my 4 hour shift of being the community doc on call. This consisted of me getting work done in my office and having my phone nearby in case anyone needed me to walk over and see someone which they didn’t. I don’t guarantee that it will stay this way, but for now at least, if we community docs/NPs/PAs can be available to help out in the ATA if needed, it will give some peace of mind to our ER colleagues and so far is not particularly burdensome. 

Currently our ability to test for COVID at the hospital is limited by a shortage of test kits. Today we only have about 30 kits available. We recommend you check with the lab on the day you are volunteering to see what our test kit situation is. This will help guide how liberal or conservative you are with ordering COVID tests on people who are not sick enough to be admitted to the hospital.

Please contact Dr. Constantine (who is putting together the ATA schedule) if you can do a shift or two as the community doc on call. Currently we are looking for people to do 4 hour shifts from 2-6 pm. Feel free to pass the invite along to colleagues in any speciality who have privileges at CMHS and would like to help out.

Thanks everybody for reading this far, everyone has been doing an amazing job.

🙂 Helen

Helen Petroff, M.D.
Valley Oak Family Practice
March 21, 2020

COVID-19 Documentation & Coding Tips

The Brundage Group

Propper Donning and Doffing of PPE – youtube videos

HealthCare Professionals Resources

CDC – COVID19 Information for Healthcare Professionals
https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html

AMA COVID19 Resource Center
https://www.ama-assn.org/delivering-care/public-health/covid-19-2019-novel-coronavirus-resource-center-physicians

CMA COVID19 Resource Center
https://www.cmadocs.org/covid-19

American College of Physicians (Dynamed) – General comprehensive info on COVID19
https://www.dynamed.com/condition/covid-19-novel-coronavirus

General Resources 

Ventura County Health Department —  there is a Coronavirus Hotline: 805-465-6650
http://www.vchca.org/agency-divisions/public-health

VCEmergency.com – Official Ventura County Incident Information Source
http://www.vcemergency.com/

CDC – COVID19 homepage
https://www.cdc.gov/coronavirus/2019-ncov/index.html

WHO – COVID19 homepage
https://www.who.int/health-topics/coronavirus

Statistics

County Stats for COVID19
www.ventura.org/covid19/

Statistics updated daily of COVID-19 in the US – CDC
https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

Situation Report updated daily re: COVID-19 globally  – WHO
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

CMHS Weekly Medical Staff Calendar – March  23 – 27

MondayTuesdayWednesdayThursdayFriday
7:00 am Practitioner Well Being Cmte – NA (back)5:30 pm CMHS Credentials Cmte- NA (front)
5:30 pm Surgery Cmte – BR
12:00 pm General CA Conf – BR 12:00 pm Bioethics Cmte – NA (front)CANCELLED: HIM Cmte
CANCELLED: Pharmacy & Therapeutics Cmte
CANCELLED - 11:00 – 1:30 Doctors’ Day CMH - NA

Final Thoughts

“Every calamity is to be overcome by endurance.”
– Virgil

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

 

 

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Covid-19 Update – Medical Staff Voice Special Edition – March 20, 2020

 

Notification of Enforcement Discretion for Telehealth Remote Communications during the COVID-19 nationwide public health emergency

We are empowering medical providers to serve patients wherever they are during this national public health emergency. We are especially concerned about reaching those most at risk, including older persons and persons with disabilities. – Roger Severino, OCR Director.
A covered health care provider that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients.  OCR is exercising its enforcement discretion to not impose penalties for noncompliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency.  This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.
Please click on the Link to read the details of the whole Notification.

Medication Availability at CMHS

Our distributor, Cardinal Health, is implementing a weekly fair share allocation process to ensure all primary customers have access to supply of the available products on hand. This methodology looks as a hospital’s past ordering in terms of items and quantity. If there is a medication we have not ordered recently, we are unable to add it to our ordering at this time. At this time Cardinal Health will not be processing any One Time Buys, Special Orders, or overrides. They are not allowing bulk buys.

This may prevent CMHS from being able to order new or less commonly used medications, since they will not be on our recent order history. In such instances, provider and pharmacist collaboration can help determine the best care for our patients with available items.

Doctors’ Day Celebration 2020 March 27/30 – Postponed

Three Midnight rule – COVID Waved

Due to the COVID-19 Emergency Declaration, CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay. Patients will be able to transfer to a SNF, directly from the Inpatient setting without a 3 day inpatient stay, observation status, Emergency Department, or physician’s office.  The patient must require a skilled need, e.g. skilled nursing, IV antibiotics more than once daily, complicated wound care, physical or occupational therapy, new tube feedings.  This applies to Medicare fee-for-service patients. All other patients will be covered according to their health plan requirements. Please contact the health plan for specifics.

If a patient is in a physician’s office, and requires transfer to a SNF based on a skilled need, please do the following:

Contact a skilled nursing facility so a referral can be sent directly to them. Ask for the admissions department. Below are contact numbers and addresses of our the Ventura County SNF’s:

Camarillo Healthcare 205 Granada St. 805-482-9805
Coastal View Health Care 4904 Telegraph Road (Ventura) 805-642-4101
Glenwood Care Center 1300 N. “C” Street (Oxnard) 805-983-0305
Shoreline Care Center 5225 South “J” Street (Oxnard) 805-488-3696
Ventura Post-Acute 4020 Loma Vista Road 805-642-4196
Victoria Care Center 5445 Everglades Street

Ventura)

805-642-1736
Brookdale at Camarillo 6000 Santa Rosa Rd. 805-388-8086

 

Greenfield Care Center 118 “B” Street (Fillmore) 805-524-5250

 

 

Mary Health of the Sick 2929 Theresa Drive (Newbury Park – Thousand Oaks) 805-498-3644
Maywood Acres 2641 S. “C” Street (Oxnard) 805-487-7840

 

                                                                                                                                   

Oak View Health Center 3557 Campus Drive (Newbury Park – Thousand Oaks) 805-241-2000
Oxnard Manor 1400 W. Gonzales Road 805-983-0324

 

Providence Ojai Gardens 601 N. Montgomery St. 805-646-8124

 

Simi Valley Health Care Center 5270 Los Angeles Avenue 805-522-9155

 

Thousand Oaks Health Care Center 93 W. Avenida De Los Arboles 805-492-2444

 

Vista Cove Care Center @ Santa Paula 250 March St. 805-525-7134

 

Windsor Terrace of Westlake Village 250 Fairview Road 805-494-1233

 

 

 

CMHS Surge Plan – We are currently at Level 2

Level 1:

  • Screen all visitors: No one with a fever or travel admitted
  • No children allowed

Level 2

  • Visitors restricted to essential companions only
  • No visitors to CCC

Level 3

  • No visitors at CMH or OVCH (rare exceptions)
  • Open Mountain Tower ER, followed by the ICU, then 4th, 6th and 5th floor.

Level 4

  • Request State and Federal Resources

Hospital entrances

All entrances to the Mountain Tower are closed to the Public.  Labs, Physiology studies, Respiratory Therapy, and Physical Therapy must come through the main entrance of the Ocean Tower to access those service in the Mountain Tower.

The Ocean Tower (OT) has two entrances: 1) The main entrance has a screening tent for patients using OT services or for very select visitors, 2) The Emergency Department (ED) entrance for patients to be seen in the ED is open and patients will be screened upon entering.  

Meeting Cancellations

  • Benefactors Ball
  • CMHS Public lectures
  • Maternal Child Health classes
  • Respiratory Care classes
  • NICU high risk follow up clinic

Final Thoughts

In these trying times, it is heartening to see and hear of the dedication, caring and commitment of our healthcare team at CMH.  Everyone from nursing, physicians, techs, and housekeeping have volunteered to provide extra support and back up to our current workforce. We’ve had retired physicians and community physicians offering to work in the Hospital or support our physician staff in caring for our inpatients.  One can surely feel the Love.

Keep the Faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

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Covid-19 Update – Medical Staff Voice Special Edition – March 17, 2020

Dear Colleagues,

The Monday Medical Staff Voice was delayed and is titled as a COVID-19 Update Edition, because the information and thoughtful decisions that required further Medical Staff Leadership discussions in order to make the best decisions in our current fluid state of affairs.  I will continue to publish frequent updates as they develop. I will focus on concise excerpts that are most useful to physicians in the care of their patients. 

CMHS is Mandating Postponement of all Elective Surgeries and Procedures

To the Medical Staff and Allied Health Staff of Community Memorial Health System,

As the COVID-19 crisis escalates, the administration and medical staff of CMHS is continuing to evaluate the current literature in order to provide optimal care for the members of our community.  Currently, the high rate of asymptomatic carriers, insensitivity of screening criteria, and lack of available testing make it necessary  to take aggressive precautions to protect the health and safety of our patients.

After reviewing  national directives and national society recommendations, and in keeping with measures being taken  at hospitals nationwide, CMHS is mandating postponement of all elective surgeries and procedures.  This includes any procedure which can be postponed at least eight weeks without posing a substantial risk of medical harm to the patient.   Semi-urgent, urgent, and emergent cases should still be scheduled.

The decision to move forward with this mandate was made with the leadership of the Medical Staff, including Dr. Jeff Brackett, Chief of Staff, and the Chairs of the Anesthesia and Surgery Departments in collaboration with CMHS Administration.

We thank you for your understanding, and will continue to update you as events unfold.   Please reach out to administration, the medical staff office, or surgery management if you need any clarification or additional information.

Hospital Wide Visitation Policy

Important CMHS Meetings – COVID-19 on Tuesday,  3/17/2020

In an effort to keep our Medical Staff informed regarding the preparation and response by CMHS to COVID-19, we will be holding the following meeting on TUESDAY, MARCH 17, 2020:

  • 5:30 pm – webinar (please click on hyperlink below)

Join Microsoft Teams Meeting

+1 925-421-1086   United States, Concord (Toll)

Local Numbers: (805) 724-0202, (805) 724-0205, (805) 724-0208, (805) 724-0209

Conference ID: 732 923 381#

Local numbers | Reset PIN | Learn more about Teams | Meeting options

The panel will consist of:

Jeffrey Brackett, MD, Chief of Staff
Neil Canby, MD, Emergency Medicine, Chair of Disaster Preparedness Committee
Gail Simpson, MD, Medical Director, Infectious Disease
Gary Wilde, President & CEO
Adam Thunell, VP and COO
Elyse Fritschel, MPH, CIC, Manager of Infection Prevention

Medical Staff Committee Meetings Calendar

Scheduled Weekly Medical Staff Committee meetings are in a fluid state as well.  As a member of the committee, you will be notified by email if the committee will meet or be cancelled or if it will be held digitally.  If digital, instructions and invitees will be designated by email.  Please call the Medical Staff Office for questions or clarifications at the number below.

Final Thoughts

“My religion is very simple. My religion is kindness.”
Dalai Lama

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

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Covid-19 Update – Medical Staff Voice Special Edition – March 15, 2020

March 12, 2020

To:          CMHS Physicians

From:    CMHS Medical Staff and Administration

Subject: Testing Patients for COVID-19

______________________________________________________________

Many physicians have asked for guidance in testing patients if they call or present to the office with symptoms suggestive of novel coronavirus (COVID-19).  Community Memorial Health System is continuously monitoring CDC direction and communicating with the Ventura County Public Health Department.  As of the date on this memo, we recommend the following:

Patients who call in:  If a patient calls your office with symptoms of fever and/or signs of respiratory illness (e.g., cough, difficulty breathing), ask the patient if they have had:

  • Contact with a known COVID-19 patient within 14 days of symptom onset, OR
  • Recent history of travel from affected geographic areas (China, Iran, Italy, Japan, South Korea) or other areas of epidemiological concern (e.g., cruise ship travel, locations with community spread of COVID-19)

We are NOT testing the worried well.  If the patient answers ‘yes’ to any of the items above, please call the Ventura County COVID-19 hotline at 805-465-6650 to receive a person under investigation (PUI) number and notify CMHS Infection Prevention (805-948-5004; on call: 936-203-0606).  Without a PUI number, the Ventura County Public Health Laboratory will not process specimens.

Patients who present to your office:  If a patient presents with fever and/or signs of respiratory illness (e.g., cough, difficulty breathing) AND they meet any of the conditions below, test the patient and call the Ventura County COVID-19 hotline for details:

  • Contact with a known COVID-19 patient within 14 days of symptom onset OR
  • Recent history of travel from affected geographic areas (China, Iran, Italy, Japan, South Korea) or other areas of epidemiological concern (e.g., cruise ship travel, locations with community spread of COVID-19) OR
  • Clinical suspicion of COVID-19 for patients

If your office carries N95 respirators, disposable gowns, gloves, and goggles, you may obtain nasopharyngeal specimens in viral transport medium.  We recommend setting up a process for obtaining swabs outside in the patient’s car with their approval.  Specimens may be tested by the Ventura County Public Health Lab (805-981-5131) or other commercial laboratories.

If you do not have the equipment listed above, we recommend routing the patient to an area hospital Emergency Room.  For the CMH Emergency Department, in order to prevent exposure to others, you must call (805) 948-8100 with patient information as soon as possible so that staff can coordinate outdoor testing prior to patient arrival.  We would appreciate the referring physician speak personally with the Emergency Department (ED) Charge Nurse to provide clinical handoff information. The patient will be met by ED staff, evaluated, and directed to a special entrance at the back of the Ocean Tower, near the ambulance entrance if they fulfill COVID-19 criteria for further testing and care.

As a reminder, report all suspected COVID-19 cases to Ventura County Public Health immediately (805) 981-5201. Feel free to reach out to our Emergency Department leadership staff for further guidance, or call CMH Infection Prevention.

If you have additional questions, please see the following resources:

CDC’s novel coronavirus resources: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Ventura County COVID-19 updates: https://www.vcemergency.com/

Thank you for your dedication to patient safety.

COVID-19 now on Reportable Conditions per CA Dept. of Public Health

The California Department of Public Health, in consultation with the California Conference of Local Health Officers, recently updated Title 17 Section 2500 of the California Code of Regulations to include Coronavirus Disease 2019 (COVID-19) on the list of reportable conditions. Cases of Coronavirus Disease 2019 (COVID-19) must be reported immediately by providers via telephone to the local health officer for the jurisdiction where the patient resides.

Ventura County phone numbers:
805-981-5201 during weekday business hours, 805-214-7057 on-call

Please see below for a letter to healthcare providers regarding COVID-19 reporting as well as a list of all conditions required to be reported by healthcare providers to public health.

CMS Inpatient, Outpatient & Lab testing Payment FAQ’s March 11, 2020

For the latest updates on CMS reimbursement rates and questions refer to this link for FAQ’s with a number of links to valuable resources:

CMS Inpatient, Outpatient & Lab testing Payment FAQ’s link

I will continue to provide frequent updates on the very dynamic changes with the COVID-19 Pandemic, as it affects our Medical Staff.

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

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Medical Staff Voice – March 9, 2020

Tuesday, Noon CME Lecture cancelled this week – Please see event in it place below: To Err is Human Documentary showing Today at Noon

COVID-19 Letter from Gary Wilde

Date:              March 6, 2020
To:                 CMHS Physicians and Employees
From:             Gary Wilde, President & CEO
Subject:          COVID – 19

______________________________________________________________

Late this morning we were notified by Ventura Public Health Department that an individual in Ventura County tested positive for the COVID-19 virus.  This individual, prior to identification, was treated at one of our outpatient clinics early last week, and to the best of our knowledge, had minimal contact with our staff.

The patient had traveled on the Grand Princess Cruise Ship from San Francisco to Mexico and returned to the port of entry in San Francisco on February 21, 2020.  The cruise destination was not on the list of at-risk destinations so the travelers that disembarked the ship on February 21, 2020 were not under travel restrictions or subject to health checks upon return.

The Centers for Family Health physician and staff members who had direct contact with the patient have all been notified.  In addition, all staff who were working in the clinic the day the patient presented will be self-monitoring symptoms through the end of the 14-day incubation period which is early next week.

At this time, we have not had any presumptive positive cases at Community Memorial Hospital in Ventura, Ojai Valley Community Hospital, or our Continuing Care Center.

As the virus is introduced into our community, and as we observe the spread both nationally and internationally, we strongly encourage physicians, staff and our community to focus on the following basic precautions:

  • Always cover your coughs/sneezes and clean your hands afterward.
  • Wash your hands often using soap and water for at least 20 seconds or an alcohol-based sanitizer with at least 60% alcohol.
    • Rub your hands including wrists until dry.  This should take 20 seconds.
  • Be aware of patients who are coughing, sneezing, or showing any other signs of respiratory illness.  Patients exhibiting any of these symptoms should be given a mask, and PPE measures should be taken by any physician or staff in contact with the patient.
  • Keep your hands away from your mouth, nose and eyes to avoid transfer of germs.

Hospital leadership is keeping a close eye on this situation as the virus is introduced into our community.  We have developed and communicated all the protocols necessary to protect our physicians, staff, and patients should any potential COVID – 19 cases present at any of our facilities.

We thank all of our physicians and staff for their dedicated service during this time and will continue to provide updates as needed.

Sincerely,

Gary K. Wilde
President and CEO
Community Memorial Health System

To Err is Human documentary on Tuesday, March 10, 2020

We are excited to celebrate Patient Safety Awareness next week. Each day we will be highlighting a department and an employee that exemplify the efforts being taken to focus on patient safety. Please take time to read the stories and congratulate each of our recognized colleagues.

We will be showing the documentary, To Err is Human, on Tuesday, March 10 at 12:00 in the Nichols Auditorium. Bring your lunch – we will provide the popcorn and candy!

Medical mistakes lead to as many as 440,000 preventable deaths every year. To Err Is Human is an in-depth documentary about this silent epidemic and those working quietly behind the scenes to create a new age of patient safety.

Through interviews with leaders in healthcare, footage of real-world efforts leading to safer care, and one family’s compelling journey from victim to empowerment, the film provides a unique look at our healthcare system’s ongoing fight against preventable harm.

The Documentary is 1 hour and 20 minutes long.

Musab Saeed, M.D. – New Infectious Disease (ID) Specialist – Joins CMHS

Dr. Saeed is an Infectious Disease specialist recently coming to us from Ogden, Utah. He is excited about being here and looks forward to meeting the Medical Staff. He is taking ID call this week for CMHS physicians in any capacity in which they need his expertise.  He is willing to answer any ID questions you may have and is available for consults through Mobile Heartbeat for HIPAA compliance or his cell: (217) 779-5579.  Dr. Saeed is on call every 3rd week in rotation with Drs. Oster and Savitch.  Dr. Simpson is also available for ID telephone questions as our Infection Control and Antibiotic Stewardship Director.

Feds Sue Yale Hospital for Age Discrimination of Older Clinicians

Yale New Haven Hospital, the teaching hospital of the Yale School of Medicine, is accused of discriminating against older physicians in a lawsuit filed February 11 by the US Equal Opportunity Commission (EEOC).
According to the EEOC’s filing in the US District Court for Connecticut, the hospital’s “late career practitioner policy” requires any individual aged 70 and older who applies for or seeks to renew staff privileges to take neuropsychological and eye examinations.
Individuals and employees younger than age 70 are not subject to these requirements, the EEOC said.
Because those subject to this policy are required to undergo testing solely because of their age, the policy violates the Age Discrimination in Employment Act (ADEA), the suit said.
Click on the Link to the whole article.

CMHS Weekly Medical Staff Calendar – March  9 – 13

MondayTuesdayWednesdayThursdayFriday
7:00 am Medicine Cmte – BR
10:00 am Audit & Compliance Cmte – BR 12:00 pm JWM Education Conf – NA
4:30 pm MEC FAC – NA (front)
12:00 pm General CA Conf – BR
12:30 pm Family Medicine Cmte – NA (back)
12:00 pm Quality & Patient Safety Committee – BR
12:15 pm Cardiac Division Cmte – NA (Front)
5:30 pm Bylaws Cmte – BR

Final Thoughts

“A man is rich in proportion to the number of things he can afford to let alone.”
– Henry David Thoreau

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

 

 

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Covid-19 Update – Medical Staff Voice Special Edition – March 6, 2020

This Update was produced by the CDC, as of this week.  There is a large volume of information available through the CDC COVID-19 website. Because of the importance in keeping Medical Staff informed, I will be publishing regular, concise updates. 
The information is very dynamic and evolving.  I will try and provide the most important information for physicians to care for their patients. I welcome all input and comments available on the Blog Site. The link is at the bottom of this page.
As clinicians, our mission is our patients.  We need to be there to assure their safety and provide most accurate and updated care and information possible. An important facet of care is to counteract some of the hysteria and misinformation.

CDC Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV) (COVID-19)

The CDC has issued interim guidance for the COVID-19 outbreak, including evaluation and testing of persons under investigation (PUIs) for COVID-19. [36]

The CDC now recommends that COVID-19 be considered a possibility in patients with severe respiratory illness regardless of travel history or exposure to individuals with confirmed infection.

Criteria to guide evaluation and testing of patients under investigation for COVID-19

Whether a patient is a PUI for COVID-19 should be determined by the local health department in consultation with clinicians. CDC’s clinical criteria have been developed based on known information about this novel virus and are informed by details known about SARS and MERS.

Table 1. CDC Clinical Criteria for COVID-19

Reporting, testing, and specimen collection

In the event that a patient is classified a PUI for COVID-19, infection-control personnel at the healthcare facility should immediately be notified. Upon identification of a PUI, state health departments should immediately contact CDC’s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019-nCoV PUI case investigation form. Currently, diagnostic testing for COVID-19 is being performed at state public health laboratories and the CDC. Testing for other respiratory pathogens should not delay specimen testing for COVID-19.

The CDC recommends collecting and testing upper respiratory specimens (oropharyngeal and nasopharyngeal swabs) and lower respiratory specimens (sputum, if possible) in patients with a productive cough for initial diagnostic testing. Sputum induction is not indicated. If clinically indicated, a lower respiratory tract aspirate or bronchoalveolar lavage sample should be collected and tested. Once a PUI is identified, specimens should be collected as soon as possible.

For CMHS Health System Hospitals and Clinic physicians, please contact Elyse Fritschel, CMHS Manager of Infection Control at (805) 948-5004 or (936) 203-0606 (cell) for assistance and guidance in the management of patients suspected of being a PUI.  Other community physicians should contact the CDC EOC through the number provided above.

Stan Frochtzwajg, M.D.
Chief Medical Officer

Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

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