Medical Staff Voice – Ocean Tower Countdown: 5 days – December 11, 2018

In an effort to keep the Medical Staff updated on the continuously changing events in our move into the New CMH Ocean Tower, I will be publishing Medical Staff Voice (MSV) Special Edition Updates.

Meals for physicians and staff over the next week

The Mountain Tower (MT) Café will be closing at 9:00 a.m. after breakfast on Wed., Dec. 12th.  We are providing lunch, dinner and late-night dinner through caterers, in order to allow our Nutrition Services staff to transition to the Ocean Tower.

We will be having lunch in the Huntsinger Garden, dinner in the MT café and late night shift dinner in the MT Café as well.  There will be tables & chairs for seating outside for lunch.

The door outside the MT Café to the physician dining lounge is left unlocked so physicians can access that room using that door as they will not be able to access the lounge through the MT Café from 9:00 a.m. to 6:30 p.m.

Our caterers will be bringing more equipment for these events due to the nature of the food we’re serving.  As a result, 3 spaces in the physicians’ parking lot will be used for their equipment.   They will also be parking 2 more vans on Brent St.

Stan Frochtzwajg, M.D.
Chief Medical Officer

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Medical Staff Voice – December 10, 2018 – New Hospital Ocean Tower Move Plan for Medical Staff

JW Moore Tuesday CME Conference – “IVC Filters: the Good, the Bad, the Ugly”

Ivan Hayward, M.D., CMHS/Pueblo Radiology, will present a lecture on “IVC Filters: the Good, the Bad, the Ugly”.  He will 1) Evaluate when IVC filters are indicated, 2) Analyze complications of IVC filters, and 3) Detect when a retrievable IVC filter should be removed.

The conference will take place on Tuesday, December 11, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list.

Medical Staff Guidance for Patient Move Day into the Ocean Tower

Thank you for your tireless efforts and dedication to the transition into our Community Memorial Hospital Ocean Tower.  We gratefully enlist your assistance as we prepare to move our patients and their families into our beautiful new building.  Following is some general information about the move day.

On December 16, 2018, beginning at 0900, approximately 140 patients from the Mountain Tower inpatient units will be moved to their new location in the CMH Ocean Tower, with the moving process complete by mid-afternoon.

Physician Rounds

  1. On Patient Move day, we request that Physicians’ rounds will start no later than 0700 and physicians are encouraged to be complete by 0800.
  2. Patients will be moved in a specific sequence order in two “tracks” — Track 1 (L&D, Critical Care, Telemetry) and Track 2 (6th Floor/Med-Onc, 5th Floor/Med-Surg, 7th Mother-Baby, Peds). Round on your Track 1 patients first.
  3. Patient rounds to begin with patients planned to move first according to the two sequence tracks.
  4. Every attempt should be made to discharge patients prior to Patient Move day, if possible.
  5. Planned discharges on Move day, should strive for early discharge orders, before 0900, if possible.
  6. For Transfers, every attempt should be made to order transfers as early as possible on Saturday, December 15th or after the Patient Move on Sunday, December 16th.
  7. Critical Care patient rounds on Move Day should take place prior to Patient Move (before 0900)
  8. NICU physicians should round on patients either before or after they have arrived on the new unit.

Patient Procedures, Admission, and Discharges

  1. All admissions to the new Ocean Tower during the move will be called to the Operations Center, where the Move Chief will determine the placement into the move sequence.
  2. All Direct Admission will be re-directed to the Ocean Tower ED during the move, with notification to the Operations Center, remaining in the ED until sequenced into the move by the Move Chief.
  3. Patients with active discharge orders will be discharged from the Mountain Tower only if they will be out of the building before the first patient on that unit moves. If this cannot be accomplished, the patient will move to the new unit and be discharged from the Ocean Tower.
  4. Patients that are scheduled to be transferred to another unit will occur at the completion of the move sequence, at the direction of the Move Chief.
  5. There will be no elective surgeries or procedures scheduled for Move Day, only urgent and emergency cases, which will be handled through the departments’ move sequence.

Please direct any questions to Dr. Stan Frochtzwajg, Donna Weidetz, Cheryl Madrid, Charge Nurse on the nursing unit or another member of the Patient Move Taskforce.

Ocean Tower Wireless (WiFi) Cell and Laptop Changes

In preparation for the opening of the Ocean Tower, we are making changes to our wireless networks that improve our security posture.  One of these requires that all personal devices be moved to the “Guest” wireless network.  You can switch to this network simply by looking for available wireless networks on your device and selecting “guest”.

Note:  The network may show up as “unsecured” as no password is required, but we have taken additional precautions within the configuration to alleviate this concern.

Please remember, if you fail to do so before moving into the Ocean tower you will not have wireless connectivity until the above steps are performed.

CMH Cafe/Cafeteria Move Schedule – Food & Nutrition Services (FNS)

Department Relocation Plan

  1. The entire Food and Nutrition Services (FNS) department will move on Wednesday 12/12/18, prior to actual patient move:
    1. Shut down Mountain Tower Café after full breakfast service on Wednesday 12/12 at 9 am.
    2. A complimentary meal will be provided to all staff and visitors on Wednesday 12/12, while the FNS department is moving
      1. Lunch 11 am -1:30 pm in the Huntsinger Garden
      2. Dinner 6:30 pm – 7:30 pm in the MT café
      3. Night Shift 10pm-11pm in the MT café
  1. Patient meals will be prepared in the Mountain Tower on Wednesday 12/12 and delivered to patients in Mountain Tower
  2. Patient meals will be prepared in the Ocean Tower beginning on Thursday 12/13 and delivered to patients in Mountain Tower until the day of the move
  3. The Brent Street Café in the New Ocean Tower will open beginning Thursday 12/13 at 6:30 am, new café hours will be daily 6:30 am to 8:00 pm effective 12/13.
  4. The Mountain Tower Café will be closed permanently after breakfast on 12/12, however, the FNS department will provide complimentary coffee outside the Mountain Tower Cafe from Wednesday 12/12 after closing through the day of the move from 6:30 am – 8 pm.

Patient Meals on Move Day

Breakfast Meal on Move Day

  1. Hot Breakfast will be served to patients as normal in the Mountain Tower; prepared in Ocean Tower and delivered to Mountain Tower
  2. Trays will be picked up as quickly as possible to be ready for move starting at 9 am

Lunch and Dinner Meals on Move Day

  1. Lunch will be provided as a nice boxed meal to all patients to provide more flexibility during moving of patients
  2. Dinner will be served hot, regular tray service to all patients moved to the Ocean Tower. If needed, boxed meals will be provided to any remaining patients in Mountain Tower for ease of mobility.
  3. The Brent Street Café in the Ocean Tower will be open 6:30am-8:00 pm on move day

Move Team Meals & Refreshments on Move Day

  1. Breakfast will be served 6:30 am – 8:30 am, and Lunch, served 11:00 am – 1:30 pm, will be set up in the Mountain Tower Café to staff designated as “move team” members from an outside vendor. Volunteers will distribute meals from the Mountain Tower Café to the staff lounges in both the Mountain and Ocean Towers.
  2. Breakfast and Lunch will be set up and provided for Operations and Move Support Centers in the Ocean Tower.
  3. Dinner for the “move team” members will be set up and provided in the Mountain Tower.
  4. Bottled Water will be available outside the Mountain Tower Café the entire week of the move from Wednesday 12/12 through Move Day Sunday 12/16

Staff Meals and Refreshments on Move Day

  1. Brent Street Café in the Ocean Tower will be open on move day Sunday 12/16 6:30am-8:00p for staff and visitors
  2. Move Team Meals will be provided as noted above
  3. Breakfast and Lunch will be set up and provided in the Mountain Tower Café from an outside vendor as above.

CMH Ocean Tower Dedication and Ribbon Cutting

 

CMH Weekly Medical Staff Calendar – December 10 – 14

MondayTuesdayWednesdayThursdayFriday
7:00 am Practitioner Well Being Cmte – BR

12:30 pm Neonatal Cmte – NA (back)

5:15 pm QA & Improvement Cmte – BR
7:00 am Medicine Cmte – BR

12:00 pm JWM Education Conf – NA
12:00 pm CA Conf – BR

12:15 pm Cardiac Division Cmte – NA (front)

OVCH Weekly Medical Staff Calendar – December 10 – 14

MondayTuesdayWednesdayThursdayFriday
12:00pm
CME Lecture Available ONLINE

Final Thoughts

“Do what you can, with what you have, where you are.”
– Theodore Roosevelt

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
Medical Staff Office – (805) 948-5662

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Medical Staff Voice – Special Edition – Ocean Tower Passes State Inspection!

Ocean Tower Passes State Inspection

Sent on Behalf of Gary Wilde

I am pleased to announce that we’ve completed the State inspection of the new Ocean Tower at Community Memorial Hospital and we received an exemplary report as we passed with no noted deficiencies.  You should all be commended for this extraordinary accomplishment!  This commitment to excellence is exactly what makes Community Memorial Health System so special.

As we await the final letter from the State, I would like to take this opportunity to personally thank each of you for your dedication and support in realizing this dream.  This new facility will allow us to take care of our community for the next 50 to 60 years.

I hope that each one of you takes as much pride in this accomplishment as do our senior leaders, board members, and volunteers.  This is a very exciting moment for all of us, and now we turn our attention to moving into the new facility on Sunday, December 16th.

Again, I’d like to extend my heartfelt appreciation to each one of you for the role you play in making Community Memorial Health System so exceptional.

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Medical Staff Voice – December 3, 2018

JW Moore Tuesday Noon CME Conference – CANCELLED this week

Next week Dr. Ivan Hayward will present a lecture on Interventional Radiology and the use of IVC Filters.

Physician Forum Invitation open to All Medical Staff

Cath Lab Transition Schedule to the Ocean Tower 

  • November 29, 2018:  Last day to schedule procedures in CVL 1
  • November 30-December 12:  CVL 2 and 3 available for scheduling procedures.
  • November 30:  All equipment and supplies removed from CVL 1 to allow for the construction of corridor to the new hospital
  • December 3, 2018:  CDPH licensing visit for Ocean Tower (Managers, Directors, and some staff will be required to be in Ocean Tower for the day)
  • Monday, December 10:  Move week begins with frequent move meetings for leadership/staff
  • December 13-15 (Thursday through Saturday):  No scheduled outpatient procedures. Emergencies and urgent inpatients only (attempting to reduce hospital census for move day)
  • Sunday, December 16:  MOVE DAY! Any emergencies or urgent inpatient to be done in Ocean Tower after 7 am.
  • Monday, December 17:  CVL 1 open for scheduled procedures (cardiac procedures)
  • Tuesday, December 18:  CVL 1 and 3 open for scheduled procedures (cardiac and IR/vascular procedures)
  • Wednesday, December 19:  CVL 1, 3, and 5 open for scheduled procedures (cardiac, IR/vascular, and EP/structural procedures)
  • Thursday, December 20:  CVL 1, 2, 3, and 5 open for scheduled procedures.

Reminder: Proctoring requirements for all Medical Staff 

  • All members of the Medical Staff are required to provide proctoring to new physicians.  Proctoring is a Medical Staff obligation, defined by the Bylaws.
  • Proctoring is required of everyone and begins with your first case and every case until completed – do not do cases without notifying a proctor.
  • A maximum of half of your cases may be proctored by a partner, the other half must be proctored by a non-partner.
  • There are two types of Proctoring:
    • Procedural – Where your proctor must be by your elbow for the proctoring, prior to starting the procedure.
    • Non-procedural – After requesting proctoring, the proctor may review your chart retrospectively.
  • The proctor cannot bill for proctoring.  A proctor may bill if they are a surgical assistant.
  • Documentation of proctoring at another hospital may be accepted if the Medical Staff members have privileges at our Hospital as well as the other Hospital.
  • In a true emergency – call the Proctor and then attend to the patient’s emergency, always putting the patient’s safety and welfare first.
  • It is the responsibility of the physician being proctored to make sure the proctoring forms have been submitted to the Medical Staff Office (805 652-5662).

CMH Ocean Tower Dedication and Ribbon Cutting

CMH Weekly Medical Staff Calendar – December 3 – 7

MondayTuesdayWednesdayThursdayFriday
5:30 pm MEC - BR12:00 pm CA Conf – BR

12:15 pm OB/GYN Cmte – NA – (front)

OVCH Weekly Medical Staff Calendar – December 3 – 7

MondayTuesdayWednesdayThursdayFriday
No OVCH Medical Staff Meetings this week.

Final Thoughts

“Nothing is enough for the man to whom enough is too little.” 
– Epicurus

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
Medical Staff Office – (805) 948-5662

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Medical Staff Voice – November 26, 2018

W Moore Tuesday Noon CME Conference – “Hippocratic Oath”

Jim Hornstein, M.D., CMHS Ethics Committee Chair, will present a lecture on the “Hippocratic Oath”.  He will 1) Recognize the inclusion of healthcare and ethical principles in the composure of the Hippocratic Oath, 2) Identify, with applications, currently established best practices/guidelines for upholding ethical principles, and 3) Examine and identify with self-awareness one’s professionalism/behavior as well as areas of practice risk-taking.

The conference will take place on Tuesday, November 27, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list.

PatientKeeper (PK) Update

The software update of November 14th broke the document rejections process in the inbox. We are working with PK to resolve this issue and expect a patch to be delivered in the middle of the week of November 26th.

In the meantime please continue to use the ‘Decline’ button and the offending document will not be removed from your inbox until the fix is in place.

CMH Update on Drug Shortages

We have some good news: Sodium Phosphate injection is available again!
Continued and recently resolved shortages are in the table below.

Kaitlyn Moorehead, PharmD
Pharmacy Clinical Coordinator

CyberSecurity Corner

Phishing attacks are skyrocketing.  Before you fall victim to the next malicious email, complete these steps before clicking on attachments or links:

  1. Always check who the email is from.  Simply check the “From” address to be sure it is legitimate.  Remember, all emails from outside our organization are marked “EXTERNAL” in the subject line.
  2. Also, check the reply to address.  There are times the “From” address will look legitimate, but the “Reply to” address is fraudulent.
  3. Check for typos.  Often times the body of the email originates in a foreign language, and translation tools are used.  These will result in typos or grammar errors.
  4. Hover over links (DO NOT CLICK THEM) to see where the link will take you.  The text may say “Wells Fargo” but the hyperlink may be taking you elsewhere.
  5. If you question the email, reach out to who “sent” it to you.  For example, if your boss is asking for a wire transfer to be done, call your boss directly to ensure this request is legitimate.  Or if Amazon is claiming you have a package coming, but you never ordered anything, call them.
    • When you do so, never use the contact information within the email.  If it is a scam, you will be reaching out to the scammer, who will put your mind at ease about clicking the link or sending the funds

Remember, hackers know they only need one individual from our organization to fall victim to their attack.

If you receive any suspicious emails, please contact privacy@cmhshealth.org.

CMH Ocean Tower New Hospital Ribbon Cutting

Discharge Summary HIPAA Compliance Tip

In order to help assure HIPAA compliance, when discharging a patient, please document in the discharge summary that you discussed with the patient that you’ll be sending some of their medical records to the doctors that the patient will see in the outpatient consultant or primary care offices.
– Dr. Scott Goodfriend, CMHS Physician Advisor

CMH Weekly Medical Staff Calendar – November 26 – 30

MondayTuesdayWednesdayThursdayFriday
8:30 am Emergency Division – NA (front)
12:00 pm JWM Education Conf – NA
12:00 pm Board of Trustees - BR
5:30 pm Surgery Cmte – BR
7:45 am- Pediatrics Dept - NA (Front)
12:00 pm General CA Conf – BR
12:00 Bioethics Cmte – NA (front)
12:15 pm Pharmacy & Therapeutics Cmte – NA (BR)

OVCH Weekly Medical Staff Calendar – November 26 – 30

MondayTuesdayWednesdayThursdayFriday
12:30pm
Surgery Department
12:30pm
MSQA Committee
12:00@CMH
CMHS Bioethics Committee
6:00PM
OVCH General Medical Staff Meeting

Final Thoughts

“Educating the mind without educating the heart is no education at all”
– Aristotle

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

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Medical Staff Voice – November 19, 2018

CMH Quarterly General Medical Staff Meeting

JW Moore Tuesday CME Conference – “Introduction to Cannabis as Medicine”

Margaret Peterson, M.D., CMHS, will present a lecture on “Introduction to Cannabis as Medicine”.  She will; 1) Identify the potential benefits and risks of cannabis-based medicine inpatients, 2) Describe elements of patient and family education regarding cannabis, and 3) Discuss the evidential basis, potential clinical inclinations, and limitations of medical marijuana.

The conference will take place on Tuesday, November 20, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list.

CMH Cath Lab Schedule for Transition to the Ocean Tower

  • November 29, 2018:  Last day to schedule procedures in CVL 1
  • November 30-December 12:  CVL 2 and 3 available for scheduling procedures.
  • November 30:  All equipment and supplies removed from CVL 1 to allow for the construction of the corridor to the Ocean Tower.
  • December 3, 2018:  CDPH licensing visit for Ocean Tower (Managers, Directors, and some staff will be required to be in Ocean Tower for the day
  • Monday, December 10:  Move week begins with frequent move meetings for leadership/staff
  • December 13-15:  No scheduled outpatient procedures. Emergencies and urgent inpatients only (attempting to reduce hospital census for move day)
  • December 16:  MOVE DAY! Any emergencies or urgent inpatient to be done in Ocean Tower after 7 am.
  • December 17:  CVL 1 open for scheduled procedures
  • December 18:  CVL 1 and 3 open for scheduled procedures
  • December 19:  CVL 1, 3, and 5 open for scheduled procedures
  • December 20:  CVL 1, 2, 3, and 5 open for scheduled procedures.

Clinical Pearl

Be cautious with renal transplant immunosuppressive medications in that inadvertently missed doses can be quite serious. Discuss the medications with the physician managing the transplant patient on the handoff.  In addition, be sure to review the Medication Administration Record (MAR) daily.

Physicians vs. Electronic Health Records (EHR’s)

Most of you know that I am an EHR advocate and champion.  The eventual potential of EHR’s in enhancing patient care is only beginning to be realized.  But the incremental challenges of development and evolution of the EHR is and will be gradual and certainly not as soon as we would prefer.  Until then, we’ll struggle and endure rough road of progress.  The following excellent article, published in The New Yorker by the well known Dr. Gawande, merits reading and will provide you with an understanding and perspective worth gleaning.  Click on the title of the article, but leave yourself some time, it’s not a quick read:
Why Doctors Hate Their Computers by Dr. Atul Gawande.

CMH Weekly Medical Staff Calendar – November 19 – 23

MondayTuesdayWednesdayThursdayFriday
12:00 pm Cancer Cmte - BR12:00 pm JWM Education Conf – NA
12:00 pm Finance Cmte – BR

Committee Meetings Tonight on announcement above.
12:00 pm General CA Conf – BRThanksgiving Day

OVCH Weekly Medical Staff Calendar – November 19 – 23

MondayTuesdayWednesdayThursdayFriday

11:00am
P.I. Patient Safety Committee
THANKSGIVING

Final Thoughts

“Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for.”
– Epicurus

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

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Medical Staff Voice – November 12, 2018

JW Moore Tuesday CME Conference – “Current Concepts in Minimally Invasive Lumbar Spine Surgery”,

Sohrab Pahlavan, M.D., Orthopedic Spine Specialist, will present a lecture on “Current Concepts in Minimally Invasive Lumbar Spine Surgery”.  He will; 1) Discuss the benefits and limitations of different diagnostic tests, 2) Identify decision-making strategies for choosing between surgical and nonsurgical treatment, and 3) Discuss current best practices for minimally invasive lumbar spine surgery.

The conference will take place on Tuesday, November 13, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list.

U.S. Antibiotic Awareness Week

November 12th-16th is U.S. Antibiotic Awareness Week! It is a one-week observance to raise awareness of the importance of appropriate antibiotic use to combat the threat of antibiotic resistance.

Physicians are key members of the Antimicrobial Stewardship Team. CDC’s Be Antibiotics Aware educational effort encourages physicians to:

  • Follow clinical guidelines when prescribing antibiotics.
  • Always remember to prescribe the right antibiotic, at the right dose, for the right duration, and at the right time.
  • Review antibiotic therapy 48 to 72 hours after it is started based on the patient’s clinical condition and microbiology culture results, and stop or change antibiotic orders as needed —a critical step in care.
  • Talk to patients and families about when antibiotics are and are not needed and discuss possible harms such as allergic reactions, C.difficile, and antibiotic-resistant infections.
  • Be aware of antibiotic resistance patterns in your facility and community; use the data to inform prescribing decisions.

Perform hand hygiene and follow infection prevention measures with every patient.

Sent on behalf of CMHS Administration

The City of Ventura has begun parking enforcement in all public parking lots, including the 99 Cent Store parking lot, and the streets around the CMH Mountain and Ocean Towers.

On Monday, November 12, 2018, the Ventura Police Department will also begin parking enforcement (ticketing parked cars) on the first level (below the gate) of the Mountain Tower parking structure and the first two levels of the Ocean Tower parking structure for not complying with posted parking signs.

These areas in both parking structures are designated as public parking.

Employees parked out of compliance with posted parking signs in both the Mountain and Ocean Tower parking structures will be subject to ticketing by the Ventura Police Department.

Designated employee parking remains as follows:

  • Mountain Tower Parking Structure – Please be sure to park on the 2nd level above the gate.  Employees and Residents, please do not park in designated Medical Staff physician parking spaces.
  • Ocean Tower Parking Structure – Please be sure to park on the 3rd level and above.

The City of Ventura wishes to ensure there’s ample public parking for visitors and patrons of the hospital and surrounding businesses which operate in and around CMH.

Medical Staff Physician Parking areas in the Loma Vista open lot and the 20 spaces in the Mountain Tower Parking structure remain available and unchanged.

Meditech EHR Downtime

Meditech downtime Tuesday, November 13th, 5 AM to 6 AM. Only Meditech will be impacted. Those applications that depend on Meditech will receive no information during this time. Picis & PatientKeeper will remain active but there will be no Computerized Physician Order Entry (CPOE).

The hardware that stores all of the Meditech data is failing. We are moving all Meditech data to a new, redundant, Storage Area Network (SAN).  A week ago the SAN for every application, except Meditech, failed. The SAN for Meditech is now showing signs of failing. We will move all Meditech data to a new, redundant SAN.

Medical Staff Bylaw Changes – Approved by Board of Trustees

MEDICAL STAFF GENERAL RULES & REGULATIONS III. MEDICAL RECORDS

A. General Provisions, paragraph 3

  • All EHR orders and patient care documentation will be entered exclusively via digital means in the EHR when digital means are available. All entries in the medical records must be authenticated, dated and timed by the responsible practitioner in the form of a signature or electronic signature. Use of electronic signature must be in accordance with the established Medical Staff policy and procedure.

C. History & Physicals

  • A complete admission history and physical examination (H&P) shall be recorded within 24 hours of admission. The H&P shall include the reason for admission, history of the present illness, past medical & surgical history, medications, and medication allergies. For all patients admitted for 48 hours or more, this report should include pertinent findings resulting from an assessment of all the systems of the body. For other patients, an assessment shall be conducted and recorded on cardiovascular and respiratory systems, and all other body systems relevant to the patient’s medical or surgical conditions.
  • If a complete H&P has been performed within 30 days prior to the patient’s admission to the hospital, a reasonably durable, legible copy of these reports may be used in the patient’s hospital medical record in lieu of the admission H&P. Any H&P prepared more than 24 hours prior to the time of admission must be updated within 24 hours of admission. These reports must be recorded by a duly licensed physician and the context must be consistent with that required by the Medical Staff.
  • In the event, the practitioner dictates the H&P or it is not entered immediately in the EHR, the practitioner shall enter a brief assessment and plan in the EHR at the time of admission.
  • A member of Community Memorial Hospital’s Medical Staff must affix his/her signature to each H&P, attesting to the fact that he/she has assumed responsibility for its contents and can verify the information reflected.
  • An H&P, and an update if the H&P was prepared greater than 24 hours prior to admission shall be recorded and signed by a Medical Staff member with admitting privileges, before any operation or potentially hazardous diagnostic or therapeutic procedure. If a written H&P is not available, the procedure shall be postponed until the written H&P is complete. In a life-threatening emergency, the surgeon shall make a comprehensive note regarding the patient’s condition as soon as possible after stabilization of the patient.

F. Consultations

  • A consulting practitioner shall promptly record the consultation report. In the event the practitioner dictates the consultation report, the practitioner shall enter a brief assessment and plan in the EHR at the time the consultation occurs. Consultation reports shall show evidence of review of the patient’s record by the consultant, pertinent findings on examination of the patient, the consultant’s opinion and recommendations. This report shall be made a part of the patient’s record. A limited statement such as “I concur” or “The patient is cleared for surgery” does not constitute an acceptable report of the consultation.

Approved by:
Bylaws Committee: 8/2/18
Medical Executive Committee: 8/7/18
Active Medical Staff: 9/25/18
Board of Trustees: 10/30/18

The CDC recommends sequential administration of 2 pneumococcal vaccines for appropriate adults aged ≥65 years
However, many adults aged ≥65 years may still need to complete their
CDC-recommended pneumococcal vaccination regimen with PNEUMOVAX 233
CDC-recommended sequential administration and intervals for immunocompetent adults aged ≥65 years2,b,c
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“Peter Gaal, M.D. Dog Therapy Program”

The Program is named in honor of Dr. Peter Gaal, a cardiovascular surgeon and longtime animal lover who passed away at 82 in January 2013. The Dog Therapy Program has proven to be a success at CMH.  The Peter Gaal, M.D., Dog Therapy Program is run through the auspices of Love on a Leash. A longtime volunteer for Love on a Leash, Pam Schuman was invited to help start the dog therapy program at CMH.

All 6 teams (dog + handler) visit the hospital two scheduled Mondays per month (the schedule is available from Tinette Hood or Debbie Ostrander).  Generally, they visit the 6th and 7th floors, but any patient on any floor (with nurse and physician approval) can request a visit on these scheduled days.

Additionally, we have 3 teams that live close enough to take “call” and come over for special visits when a Physician or Nurse feels that a patient would benefit from a dog visit! The Physician or Charge Nurse would just need to call or email Pam directly to arrange the visit.  Pam can be reached at 805-407-4208 or pssfifty@gmail.com

CMH Weekly Medical Staff Calendar – November 12 – 16

MondayTuesdayWednesdayThursdayFriday
7:00 am Medicine Cmte – BR

10:00 am Audit & Compliance – BR

12:00 pm JWM Education Conf – NA
12:00 pm General CA Conf – BR

12:30 pm Family Medicine Cmte – NA (back)
12:00 pm Radiation Safety/Radiology Division – NA (front)

5:30 pm Orthopedic Division - BR

OVCH Weekly Medical Staff Calendar – November 12 – 16

MondayTuesdayWednesdayThursdayFriday
12:30pm
Family Medicine Department
12:30pm
Pharmacy & Therapeutics Committee

Final Thoughts

The past week, nearly on the anniversary of our Thomas Fire disaster last year has resulted in insult added to injury.  The senseless Borderline shooting and loss of life have been terribly painful for the families and community at large.  Our hearts go out to all who are mourning.  That followed by the county fires has been a further burden and loss for so many.  Many of our Hospital Staff and Medical Staff have suffered damage to and loss of their homes.  Yet the human spirit has shown itself to be resilient and boundless.  There are many stories that reflect the VenturaStrong attitude.  One of our surgeons lost his home on Thursday and was in the operating room on Friday, caring for his patients.  This is just one of many of the examples of dedication and resilience that is so common in our Health System and community.
CMHS Human Resources are keeping a list and assisting Hospital Staff that have experienced losses.  Please advise the Medical Staff Office (805 948-5662) of any physicians that may have had damage to or lost their home or property.  We want to be there to support one another.

“When we meet real tragedy in life, we can react in two ways – either by losing hope and falling into self-destructive habits or by using the challenge to find our inner strength.”
– 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 & 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & 207-8216

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Medical Staff Voice – November 5, 2018

JW Moore Tuesday, November 6th, 2018 CME Conference – “Seizures 101”

Mostafa Hammoudi, M.D., Neurologist, Seizure/EEG specialist, CMHS, will present a lecture on “Seizures 101”.  He will discuss; 1) How to apply existing diagnostic recommendations and criteria to practice in the management of epilepsy, 2) Identifying the treatment modalities currently available for management of epilepsy and apply them to patient cases using evidence-based medicine, 3) How to evaluate a treatment plan for a specific patient based on a seizure history to optimize safety and efficacy, suggesting modifications for improvement.

The conference will take place on Tuesday, November 6, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list

PatientKeeper (PK) upgrade to v. 8.4 with ePrescribe

CMHS is updating to the PK 8.4 platform on Wednesday, 11/7. Effective immediately upon update are a number of improvements and bug fixes in 8.4.  The most noticeable change for users is a redesign of the inbox.  In 8.4 the inbox sorts documents by type, including:

  • Notes
  • Scanned/Transcribed
  • Orders
  • Mail (messages)

Additionally, notes and orders you save as drafts will now save to your inbox where you can complete and sign them.

The overall design is intuitive and easy to navigate but it is a departure from the current inbox.  Hopefully, you will find it an improvement.

ePrescribe (eRx): This new platform supports e-prescribing on non-controlled meds. We continue to pilot the eRX function with specific providers and will role this out in a phased approach.

PK & CURES Link

PK has added a link to the CURES website in the middle pane.  Upon clicking on the link it simply launches CURES in a new window.  There is no integration between PK and CURES, but it makes it easier for physicians to access that system.  This feature goes live and will be available on Thursday, November 8, 2018.

Medical Staff Services Week

Our Medical Staff flourishes in great part due to the professionalism, service, and friendliness of our Medical Staff Office Professionals.  Take an opportunity this week to come by personally or email the Office to thank them and acknowledge their dedication and assistance to all of us.

Medical Staff Required Sexual Harassment Education 

Though it was high profile celebrity cases that sparked the wave of debate over sexual harassment at work, the problem is known to exist in virtually all sectors of society.

Surveys have shed some light on the extent of the problem in health care. For example, survey results published in JAMA in 2016 found that among physician-scientists, almost a third (30%) of females and 4% of males reported that they had experienced sexual harassment. To address this problem and help to correct it, many hospital systems have put in place educational requirements for medical staff members.

The Community Memorial Medical Staff Bylaws address Harassment in Article II, 2:8-8 HARASSMENT PROHIBITED.  The Medical Staff Leadership at Community Memorial Hospital is committed to continuing to provide a safe and protected environment for everyone who comes into our facility.  Recognizing this, a Medical Staff requisite is now in place that requires sexual harassment awareness education of all its current medical staff members. This training module will need to be completed by December 31, 2018.  The training will also be required of all new applicants and again for practitioners going through reappointment in 2019 and the subsequent years.  Physicians who exclusively practice Telemedicine are excluded from this requirement.

Understanding that we all have busy schedules, the MEC has strived to make this education easy to access and complete. The “Sexual Harassment in Healthcare” is a 15-minute training module that can be accessed through the CMHS website at www.cmhshealth.org.  Click on the Medical Staff tab at the bottom of the page.  You will see the Harassment Education tab on this page.  To sign in, enter the prefix “CMHS” and your four-digit identification number (e.g., CMHS1111) as your Username.  This will also be your initial password. You will be prompted to set a new password upon login. There is a short ten question posttest associated with this training.  The posttest must be repeated if you score less than 90%.

In addition, please be aware that the MEC will accept Harassment Education from another hospital or healthcare organization if completed within the last two years.  Please forward your dated certificate to Credentials@cmhshealth.org or fax it to (805) 648-4295.

Thank you in advance for your prompt attention to this important matter. If you have any questions, please feel free to contact the Medical Staff Office at (805) 948-5662.

Sincerely,
Lamar Bushnell, MD
Chief of Staff

Ventura County Medical Association (VCMA) Annual Installation Reception

The California Medical Association (CMA) is the singular most influential voice for all physicians in California, with substantial national influence.   The CMA lobbying efforts have helped prevent efforts in the erosion of physician autonomy and the quality of patient care on innumerable instances at the legislative and executive levels.  Your opportunity to have an effective voice and advocacy requires your membership and participation in CMA and VCMA.

CMH Weekly Medical Staff Calendar – November 5 – 9

MondayTuesdayWednesdayThursdayFriday
5:30 pm Credentials Cmte- NA frontElection Day

12:00 pm JWM Education Conf – NA

5:30 pm MEC - BR
12:00 pm General CA Conf – BR

12:15 pm OB/GYN Cmte – NA (front)
12:00 pm QA & Patient Safety Cmte – BR

12:15 pm Cardiac Division Cmte – NA (front)

OVCH Weekly Medical Staff Calendar – November 5 – 9

MondayTuesdayWednesdayThursdayFriday
5:15pm
CMHS Credentials Committee
12:00pm @ CMH
Quality Assurance Committee
7:15am
Emergency Medicine Department

Final Thoughts

“The greatest of follies is to sacrifice health for any other kind of happiness.” 
– 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 & 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & 207-8216

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Medical Staff Voice – October 29, 2018

JW Moore Tuesday CME Conference – “Body Medicine”

Cathy Kim, M.D., Integrative Body Medicine, will present a lecture on “Body Medicine”.  She will: 1) Discuss how to employ the mind-body approaches that form the foundation of modern self-care, and 2) Discuss management of pain treatment through alternative therapies.

The conference will take place on Tuesday, October 30, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list.

CMHS Computers Downtime – Kudos to our Hospital Staff, Medical Staff & IT Department

Last Tuesday, October 23rd, our Health System experienced a near total downtime of our IT systems.  Touring the clinical floors showed a Hospital Staff, Medical Staff and IT department that rose to the challenge of the occasion.  Downtime paper procedures were implemented unceremoniously, orderly and efficiently, providing our patients with the level of excellence in care that reflected the dedication and professionalism of our Hospital family.  Thank you one and all for coming through the way you always do.

CMHS email will be migrated on Sunday, November 4th at 8 am.   Please review the information below so you can maintain external access to your email.

Mobile Device

  1. At some point during the day on Sunday, you will stop receiving email to your Boxer application.
  2. Download Outlook for Android or iOS from their respective app stores.
  3. Monday morning open Outlook on your mobile device, when prompted to add an account enter your CMHS email address, and password (next screen).
  4. Delete Boxer

Desktop / Laptop Computer

  1. Shut down your pc before Sunday, November 4th (failure to do this may require IT to perform additional setups).
  2. Monday Morning turn on your computer and login to Windows as you normally would.
  3. Open Outlook on your computer and when prompted enter you CMHS email and Windows password. You may be prompted to sign in and then choose account type if so use your email address and then choose the “Work or School” option

Post-migration, email for mobile devices will only be supported using the Outlook app. Below are a couple of links that provide install and setup information for your device, the apps can be found in your device app store.

CyberSecurity Corner

Question:   How do I create a good password?
Answer:
Long passwords are stronger. These tips can help you create longer passwords that are easier to remember. Try using:

  • A lyric from a song or poem
  • A meaningful quote from a movie or speech
  • A passage from a book
  • A series of words that are meaningful to you
  • An abbreviation: Make a password from the first letter of each word in a sentence

With so much personal information available online, avoid choosing passwords that could be guessed by:

  • People who know you
  • People looking at easily accessible info (like your social media profile)Michiel de Bruin, Information Security Officer, CMHS

Boosting emotional intelligence in physicians can protect against stress, burnout

People with high emotional intelligence have more effective coping strategies, enabling them to be more resilient and better able to manage stress.

WHAT HAPPENED

A Loyola Medicine study demonstrated that an educational curriculum for physicians in training improves their emotional intelligence, which may help protect against burnout. Before and after completing the educational intervention, doctors took a test measuring their emotional intelligence and significant increases in scores for emotional intelligence, stress management, and overall wellness were found at the end.

HERE’S THE IMPACT

Teaching emotional intelligence skills “may improve stress management skills, promote wellness and prevent burnout in resident physicians,” the researchers wrote.

Emotional intelligence is the ability to recognize and understand emotions in yourself and others and to use this awareness to manage your behavior and relationships. People with high emotional intelligence have more effective coping strategies, enabling them to be more resilient and better able to manage stress. And unlike IQ, emotional intelligence can be taught.

The Loyola study included 20 pediatric and 11 med-peds residents (combining pediatrics and internal medicine) at Loyola, who completed a 133-item emotional intelligence survey before and after undergoing emotional intelligence training. The survey is called Bar-On Emotional Quotient Inventory 2.0, EQ-i 2.0.

The emotional intelligence training was integrated into the resident educational curriculum and focused on self-awareness (being aware of one’s emotions), self-management (ability to manage one’s emotional reactions to situations and people), social awareness (ability to pick up emotions in others) and social skill. The educational intervention included didactic teaching, discussions and videos.

THE BIGGER TREND: PHYSICIAN BURNOUT

Physician burnout has reached alarming levels, with some studies finding it affects at least half of all doctors. Burnout is defined as overwhelming exhaustion, cynicism, detachment from work and a sense of ineffectiveness and lack of accomplishment.

The trend is even worse among healthcare leaders, 73 percent of whom feel at least some degree of overstress, according to one poll.

Earlier this year, a Medscape National Report on Physician Burnout and Depression found that nearly two-thirds of U.S. physicians report feeling burned-out, depressed or both, with one in three admitting that their feelings of depression have an impact on how they relate to patients and colleagues.

And physician burnout can hurt the bottom line. Research has shown, for instance, a consistent relationship between higher levels of physician burnout and lower levels of patient safety and quality of care.
– Jeff Lagasse, Associate Editor

Most Medicare Advantage Denials are Wrong, Providers Biggest Losers: OIG Report

A new HHS Inspector General’s report details how most coverage denials from insurers and plans in the Medicare Advantage program were flat-out wrong, leading to major loses for providers. After reviewing hundreds of MA contracts, the OIG discovered that the plans “overturned 75% of their own denials during 2014-16, overturning approximately 216,000 denials each year.” The study also found that 82% of the wrongful denials arose from appeals by the providers themselves for payment for services already rendered. The OIG’s key takeaway from the study: “High numbers of overturned denials upon appeal, and persistent performance problems identified by CMS audits, raise concerns that some beneficiaries and providers may not be getting services and payment that MAOs are required to provide.” To view the report, click here.
Nearly half of all Medicare Advantage plans are offering additional supplemental benefits to members in 2019 under new rules meant to provide greater flexibility in what’s covered, according to an analysis of plan filings. Click here for details.

– Strategic Health Care

Anthem ER Policy Could Invalidate 17% of Visits: Study 

Nearly 1 in 6 emergency room visits could be deemed inappropriate, and therefore ineligible for coverage if insurers nationwide adopt a controversial policy implemented by Anthem of retroactively reviewing such claims, according to a study published in JAMA Network Open. The policy is currently in place in six states where Anthem is the main Blue Cross Blue Shield plan. Providers have expressed outrage about the policy, arguing that patients will be endangered if they’re required to self-diagnose, and the Medical Association of Georgia is suing Anthem.  Click here for the report.
– Strategic Health Care

CMH Weekly Medical Staff Calendar – October 29 – November 2

MondayTuesdayWednesdayThursdayFriday
8:30 am ED Division – NA (front)
12:00 pm Board of Trustees - BR
12:00 pm JWM Education Conf – NA
12:00 pm General CA Conf – BR

OVCH Weekly Medical Staff Calendar – October 29 – November 2

MondayTuesdayWednesdayThursdayFriday
12:30pm
MEC

Final Thoughts

“If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present.”
– Lao Tzu

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 & 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & 207-8216

 

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Medial Staff Voice – October 22, 2018

JW Moore Tuesday CME Conference – “Understanding Hospice”

William Rajala, M.D., Palliative Care, Community Memorial Hospital, will speak on “Understanding Hospice”.  He will: 1) Identify the role and responsibilities of the hospice care team, 2) Construct patient care plan including appropriate time to refer to hospice, and 3)  List examples of common misconceptions and barriers related to palliative care.

The conference will take place on Tuesday, October 23, 2018, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez at cvazquez1@cmhshealth.org or 805-948-5638 to be added to the webinar list.

Medical Staff Influenza Vaccine Requirement – Time Sensitive

It is the policy of Community Memorial Health System to require proof of Influenza Vaccine administration or a signed declination form of all physicians and Allied Health Professionals annually in accordance with the CDC’s recommendation.  All Medical Staff and Allied Health Professional Staff members will be required to submit proof of vaccination or a completed Influenza Vaccine declination form.  If you wish to decline the vaccine please complete, sign and return the attached declination form to the Medical Staff Office (form will be sent in a separate email as the pdf form causes the email to automatically encrypt).

Influenza Vaccines are available through the hospital’s Occupational Health Department or may be done at another healthcare facility.  Attached is the CMHS October 2018 Flu Vaccination Clinic schedule.  If you have any questions regarding the clinics, the Occupational Health Department can be reached at (805) 948-2886.  If you choose to have your flu vaccine administered at a non-CMHS clinic please provide a copy of your vaccination record to the Medical Staff Office and pick up the green hologram security sticker to affix to your badge.

Effective November 1, 2018, individuals who do not display a green hologram security sticker on their badge will be required to wear a surgical mask during influenza season while working with patients.

You can fax your Influenza Vaccine record to fax number 805-648-4295 OR e-mail CREDENTIALS@CMHSHEALTH.ORG

It is important to note that Flu vaccine documentation or a signed declination must be received by October 31, 2018.  Failure to submit this documentation prior to October 31, 2018, will result in the suspension of your clinical privileges pursuant to the policy.  If within 90 days after the final past due warning the results have not been received by the Medical Staff Office, the member shall be considered as having voluntarily resigned from the Medical Staff or Allied Health Staff.

Thank you in advance for your prompt attention and support of our 2018-2019 Influenza Vaccination Program.  If you have any questions, please feel free to call us at (805) 948-5662.

CMH Flu Vaccine Schedule for Medical Staff Members:

If you have not had your flu vaccine administered, you can plan to visit the occupational health dept. at one of their vaccine clinic openings noted below:

Tuesday, October 23, 2018 time – 4:30 pm to 6:30 pm, location:  back auditorium 8th floor

Friday, October 26, 2018 time – 3 pm to 5 pm, location:  2827 E. Main St, Ventura (occupational health office)

Monday, October 29, 2018 time – 3 pm to 5 pm, location:  2827 E. Main St, Ventura (occupational health office)

CMH Weekly Medical Staff Calendar – October 22 – 26

MondayTuesdayWednesdayThursdayFriday
7:00 am CMHS Outpatient Division – NA (front)12:00 pm JWM Education Conf – NA
12:00 pm Finance Cmte – BR
5:30 pm Surgery Cmte – BR
12:00 pm General CA Conf – BR6:30 am HIM Cmte – BR

OVCH Weekly Medical Staff Calendar – October 22 – 26

MondayTuesdayWednesdayThursdayFriday
12:30PM
CMH P&T Committee

Final Thoughts

Backpacking Trip results in shortened Medical Staff Voice (MSV)

I apologize for the truncated MSV this week.  I was backpacking Central Oregon last week with my oldest son, Gabriel.  We hiked the 50 mile Three Sister’s Loop in the Oregon Cascades.  The peacefulness and opportunity to connect so intimately and thoroughly with the pristine beauty of the forest and natural wonders provoke insight, perspective and balance to life at large.  I recommend the experience, in one form or another, to all.

“Keep close to Nature’s heart… and break clear away, once in a while, and climb a mountain or spend a week in the woods. Wash your spirit clean.” 
– John Muir

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 & 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & 207-8216

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