Medical Staff Voice – April 15, 2019

JW Moore Tuesday Noon CME Conference – “Minimally Invasive Thoracic Surgery for Lungs and Esophagus”

Jennifer Wan, M.D., CMHS CardioThoracic Surgeon, will present a lecture on “Minimally Invasive Thoracic Surgery for Lungs and Esophagus”.  She will discuss how to 1) Describe the advantages and technical considerations associated with the minimally invasive strategies in the management of basic and complex thoracic disorders, and 2) Discuss controversial issues, emerging techniques, and future directions in minimally invasive thoracic surgery.

The conference will take place on Tuesday, April 16, 2019, 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 cvazquez1@cmhshealth.org or 805-948-5638.

CMHS CME Assessment Survey

The CME Committee wants to thank you for being a part of the Continuing Medical Education program at Community Memorial Health System. In an effort to improve upon the program and bring more CME opportunities to CMHS, we ask that you please take the time to complete the survey at the link below. Your input is invaluable and instrumental in helping the CME program grow.

You can find the survey by clicking here: CME Survey

We ask that you please complete the survey by April 24th. If you have any questions whatsoever, please do not hesitate to contact Christeva Vazquez at cvazquez1@cmhshealth.org or at 805-948-5638.

Thank you again for your support, and we hope to see you at future conferences!

Dysphagia Green Wristband                   

How do you know when your patients have dysphagia? Do you wonder what diet they currently receive, if their diet texture has been changed, or if they need thickened liquids?  How much time do you spend finding this information and would it help if the current diet was indicated on your patient’s wristband at all times?

You may have noticed your stroke patients wearing green wristbands (placed by nursing in the ED) indicating the Pass/Fail of a nursing dysphagia screen.  Patient safety is our priority and a wristband for all patients with dysphagia would help ensure awareness with aspiration prevention.  The speech pathology department is about to introduce another dysphagia green wristband to encompass all patients with dysphagia which will include their exact diet.   Each patient’s wristband will be updated immediately to reflect any changes made to the diet texture or liquid viscosity at all times.

When a Bedside Swallow Evaluation order is completed, the speech-language pathologist (SLP) will remove the former green nursing dysphagia screen band (if present) and place a green “ASPIRATION RISK/DYSPHAGIA” wristband, inclusive of accurate solid and liquid recommendations.  If the SLP upgrades or downgrades the diet later in the hospitalization, a new wristband will be placed and the former wristband will be discarded

The SLP department will be in-servicing all staff prior to the launch of this new process.   The goal is to improve the continuity of care throughout our patients’ hospitalization.  Immediate visibility of diet recommendations is valuable for our patients’ nurses, family members, dining service staff, doctors, therapists, dieticians, and all who provide care.  What if your patient goes to the therapy gym and requests a glass of water?  How does each therapist know which liquid level the patient currently needs?  The wristband will notify therapists daily and ensure that the correct liquid level is provided.  This wristband will remain on the patients’ wrists throughout the entire hospitalization.  It will also serve to inform future caregivers at the next level of care.   We hope this new wristband helps to reduce time spent searching for correct diets as well as increase safety and continuity of care at CMHS!
By Dina Tarin M.S., CCC-SLP
Senior Speech-Language Pathologist

CMHS Speech Department Dysphagia Green Wristband:

Mobile Heartbeat (MH) Upgrade

***Attention Mobile Heartbeat Android Users*** Please be advised, Android has made a change to their push notifications. If you are an Android user, please visit Android MH Upgrade to update your MH app. Android users who have not updated their MH app will no longer receive any push notifications from MH. If you require assistance, please call the CMHS Helpdesk 805-948-5090.

CMHS  Pharmacy Drug Shortage Update

We currently are unable to obtain our formulary Potassium Bicarb/Citric Acid effervescent tablets. The manufacturer is not providing an expected availability date. We have oral potassium chloride available in tablets and powder packets for those unable to take tablets as an alternative.

PACS Will Be Down For Upgrade And Maintenance

PACS Will Be Down For Upgrade And Maintenance on Wednesday, April 24th, at 3 a.m. We will continue sending exams to ATR (our nighttime radiology service) for the night. We estimate this downtime will be for 2 hours. ATR will be faxing the reports since the system will be down.

“Secret” Super-Germ Is Spreading; CDC Says It’s an Urgent Threat; Measles, E. coli Also Spreading
 
A germ, a fungus called Candida auris, preys on people with weakened immune systems, and it is quietly spreading across the globe. Over the last five years, it has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa. Recently C. auris reached New York, New Jersey and Illinois, leading the federal Centers for Disease Control and Prevention to add it to a list of germs deemed “urgent threats.”  Click here for the report.
  • From January 1 to March 28, 2019, 387** individual cases of measles have been confirmed in 15 states.  This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000. The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington. Click here for the CDC report.
  • As of April 4, 2019, 72 people infected with the outbreak strain of E. coli O103 have been reported from five states. Eight people have been hospitalized. No cases of hemolytic uremic syndrome (HUS) or deaths have been reported. Click here for the CDC report.

– Strategic Health Care

CMH Weekly Medical Staff Calendar – April 15 – 19

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

4:30 pm Anesthesia Cmte – BR
7:45 am- Pediatrics Cmte/Neonatal Cmte-NA (back)

12:00 pm General CA Conf – BR
12:15 pm Inpatient Medicine Division – NA (front)


5:30 Disaster Preparedness Cmte - BR

OVCH Weekly Medical Staff Calendar – April 15 – 19

MondayTuesdayWednesdayThursdayFriday
11:00am
PI/Patient Safety Committee

Final Thoughts

“When you arise in the morning think of what a privilege it is to be alive, to think, to enjoy, to love.” 
– Marcus Aurelius

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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Medical Staff Voice – April 8, 2019

JW Moore Tuesday Noon CME Conference – “PTSD”

Ronald Pollack, M.D., Psychiatrist, will present a lecture on “PTSD”.  He will discuss how to 1) Identify characteristics associated with increased or decreased risk of PTSD, 2) Compare symptoms that distinguish PTSD with other psychiatric conditions, and 3) Propose evidence-based treatment strategies for PTSD.

The conference will take place on Tuesday, April 9, 2019, 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.

Physician Forum

Last Friday’s Physician Forum provided a learning experience for the physicians that attended the luncheon.  Dr. Kwon provided us with insight on the extensive newer regulatory and compliance requirements for the expanded (and sometimes complicated) Path reports we now receive.  A few physicians in the group bemoaned the comparable note “bloat” they experience in EHR generated notes, provoked by the same compliance issues (see related EHR article below).
We watched and discussed Dr. Damania’s six-minute minute video on “Moral Injury”.
We touched on the concept of many of the overriding national problems being directly related to “jurisgenic disease.”
We ended the one-hour meeting with a review of some of the new clinical service lines having started and upcoming soon at CMHS.
Our next meeting is in two months.  I encourage you to attend, learn from your colleagues and ask any questions.

EHRs: “Death by a Thousand Clicks”

For physicians, the shortcomings of EHRs are nothing new. Unintentional changes to data in conversions, poorly conceived drop-down menus, generic and sometimes needless alerts, and perhaps the most common complaint: the number of clicks. The “how” of EHRs that have gone wrong vary greatly, but the “why” was what Kaiser Health News wanted to know.  “This is something the government mandated,” one ER doctor told KHN. “There really wasn’t the time to let the cream rise to the top; everyone had to jump in and pick something that worked and spend tens of millions of dollars on a system that is slowly killing us.” According to KHN, it’s not just the doctors, but more scarily, it’s killing patients. For the full joint investigation by Kaiser Health News and Forbes, click:

Death By 1,000 Clicks: Where Electronic Health Records Went Wrong

Strategic Health Care

My Opinion: Despite being a very well written article, a few important perspectives are neglected.  EHR’s are indispensable in our “new” healthcare delivery system.  Before EHR’s, when a physician managed the outpatient and inpatient care of the patient, assuring continuous, accountable and personalized care, we did not experience as acutely the current issues of fragmented care with the concerns for proper patient handoff,  follow up, and successful referrals. EHR’s provide a “patch” for that fragmentation that would be impossible to achieve with paper.  My memory has not faded so much that I don’t remember not being able to read at least 50% of the handwritten notes of my colleagues or even some of my own notes.  The dangers of illegible notes and even greater danger of illegible orders are completely neglected by this article.
We’d be interested in your perspectives and can publish your opinions if you are willing to allow me to do so.
– Stan Frochtzwajg, M.D.

California Academy of Family Physicians (CAFP) – Young Physician Survey: $100 gift card offer

Are you a family physician who graduated from medical school in 2008 or later?  Talk to CAFP about family medicine, women’s health, and your work!  CAFP is working with the Person-Centered Reproductive Health Program at UCSF, conducting 60-minute interviews with early-career family medicine physicians on how women’s health care, including medication abortion, fits into family medicine.
Interview participants will receive a $100 gift card for their time.
Contact Sarah Wulf, sarah.wulf@ucsf.edu or 415-206-8699 to screen for eligibility and schedule an interview.

Ojai Medical Cannabis Conference – May 4, 2019

Presenters include David Bearman, MD; Margaret Peterson, MD; James D. Adams, Ph.D.; and Susan Marks, RN, BSN, PHN. Topics will include “Cannabis in Health and Disease,” “The Human Endocannabinoid System,” “Medical Uses of Full-Spectrum Cannabis,” “The Entourage Effect of Cannabis,” and “The Safe and Effective Cannabis Patient Experience.”

Conference Website: Ojai Medical Cannabis Conference

CMH Weekly Medical Staff Calendar – April 8 – 12

MondayTuesdayWednesdayThursdayFriday
5:15 pm QA & Improvement Cmte – BR7:00 am Medicine Cmte – BR

12:00 pm JWM Education Conf – NA
12:00 pm General CA Conf – BR12:00 pm QA & Patient Safety Cmte – BR
12:15 pm Cardiac Division Cmte – NA (front)
12:15 pm OB/GYN Dept –NA (back)

OVCH Weekly Medical Staff Calendar – April 8 – 12

MondayTuesdayWednesdayThursdayFriday
12:30pm
Medicine Department
7:30am
MERP Subcommittee
(10)

12:30pm
Quality Board
@ CMH Boardroom
7:15am
Emergency Medicine Department

Final Thoughts

“The only sure weapon against bad ideas is better ideas.” 
– Alfred Whitney Griswold

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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Medical Staff Voice – Special Edition – Physician Forum, Friday, April 5th

 

All Medical Staff Invited – Inpatient/Outpatient

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Medical Staff Voice – April 1, 2019

JW Moore Tuesday Noon CME Conference – “Mohs Micrographic Surgery”

Michael Trauner, M.D., will present a lecture on “Mohs Micrographic Surgery”.  He will discuss how to; 1) identify important Mohs practice efficiencies including the use of specialized instrumentation, and 2) Summarize technical skill and/or precision necessary in the execution of the Mohs technique.

The conference will take place on Tuesday, April 2, 2019, 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.

CMHS Cardiothoracic Surgery & Dr. Tedesco Transition
by Lamar Bushnell, M.D.

There are new developments in the CMH Cardiothoracic Surgery realm to share with the medical community. Dr. Jennifer Wan joined our team January 1st, after six years at the Kaiser Thoracic Surgery Referral Center for the California Central Valley, and fresh out of a five-month Cardiac Surgery  “Super – Fellowship” at the Mayo Clinic. She brings fresh enthusiasm and added scope to our program, especially in the areas of minimally invasive thoracic oncology surgery and foregut procedures, and has worked closely with Dr. Omid Fatemi in the development and launch of the successful new Trans-Aortic Valve Replacement (TAVR) program now established at CMH. She has been very pleased with the friendly reception she has received and the exceptional practice environment she has encountered here.

As many have heard, Dr. Dominic Tedesco has accepted and moved into a practice opportunity with Dr. Peter Baay ( a fellow surgery resident with me many years ago and longtime friend ) at Cottage Hospital starting this month. Needless to say, Dr. Tedesco’s impressive 30-year tenure at CMH has been an instrumental part of what has allowed the Cardiac Surgery Program to grow and thrive, and he and I have enjoyed a long successful partnership virtually unheard of in the Cardiac Surgery world.  Dr. Tedesco and Dr. Baay both have and maintain medical staff privileges at CMH and we all look forward to continued mutual assistance and cross-coverage to support and advance the established history of cardiac surgery excellence at both hospitals.

The only constant is change, but what has not changed is the long-standing commitment of CMH administration, staff, and physicians that has allowed the Cardiac and Thoracic programs here to excel and thrive, and will continue as we advance forward in our new Community Memorial Hospital.

Fifth generation HIV test

In an effort to provide the best quality results, beginning April 3rd, 2019, the CMHS laboratory will now offer the 5th generation HIV assay replacing the current methodology.

The new assay will detect and report the following tests:

  • HIV-1 Ab (groups M & O)
  • HIV-2 Ab and
  • HIV-1 p24 Ag

If any of the 3 assays are reported as presumptive positive, confirmation testing will be sent out.  This new assay will enable clinicians to detect acute HIV infection sooner. If you have any questions regarding this testing, please feel free to call: 805-652-5324

Meeae Y. Kwon, M.D.
Laboratory Medical Director

The New CMHS Medical Library Temporary location is open!

The new location is Mountain Tower, Basement (old cafeteria). The Library has three networked computers, a networked printer and dedicated study space.
The Library subscribes to many evidence-based resources including:

All content can be accessed via the library web page (internal and external).
Let me know how the library can assist with any informational needs.
Thank you,

Janet L Hobbs, MLIS, MBA, AHIP
Medical Library Services Manager

Intranet Library Page
Internet Library Page

Phone (805) 948-5683
Fax (805) 585-3060

CMH Weekly Medical Staff Calendar – April 1 – 5

MondayTuesdayWednesdayThursdayFriday
12:00 pm JWM Education Conf – NA
12:30 pm – Interdisciplinary Practice Cmte – QA conf room 8th Fl

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

12:15 pm OB/GYN Cmte – NA – (front)

OVCH Weekly Medical Staff Calendar – April 1 – 5

MondayTuesdayWednesdayThursdayFriday
12:30pm
CMHS IDP Committee
@ Medical Staff Office
(No OVCH Catering)
12:30pm
MEC

Final Thoughts

“The price of anything is the amount of life you exchange for it.” 
– 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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Medical Staff Voice – March 25, 2018

JW Moore Tuesday CME Conference – “Think in Ink”

Scott Goodfriend, M.D. & Stacey McCarthy, will present a lecture on Clinical Document Review.  They will discuss; 1) How complete and accurate documentation assists with quality, compliance and determining the medical necessity of admissions; and 2) How to describe common diagnostic terms needed for accurate coding.

The conference will take place on Tuesday, March 26, 2019, 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.

Clinical Documentation (CDI) Integrity Week

Stacey McCarthy, CDI Consultant from Navigant, will be our guest for this week.  She will be giving a series of enlightening talks and discussions on the value, importance, and insights into how clinical documentation can be enhanced for patient safety and quality of care.  She will speak at the Tuesday Noon conference and at Resident and Hospitalist meetings throughout the week, leaving plenty of time for one on one meetings.  Please call Dr. Scott Goodfriend at (805) 701-3514 for questions or for arranging a time to meet with Stacey McCarthy to answer any questions you may have.

The goal is really to “capture reality” meaning clarifying what is really happening with the patient and what are we really thinking about in our plan for capturing the risks and complexities of our patient’s care (“Think in Ink”).

Doctors’ Day 2019 Celebration

Thank you to Tracey Shoop, the Doctors’ Day Committee and Administration for supporting the wonderfully successful celebration for our hardworking and dedicated physicians of CMHS.

Mobile Heartbeat Use Reminders

  1. Be mindful of mobile device use in the presence of patients.
  2. Texting guidelines:
    1. Use texting for non-urgent communication that relates to patient care or hospital business (not for personal use).
    2. Include appropriate information:
      1. Patient specific details (e.g. name, room number) available inpatient pick list.
      2. Use approved abbreviations so the receiver understands the intended message.
    3. Do not text or accept texted orders.
    4. Ensure a system acknowledgment is received for each communication. Do not send extra acknowledgments via text.
    5. If a response is expected and not received (including communication to off duty users) escalate communication to a telephone call following the proper chain of command.
    6. Do not use texting:
      1. When extensive details or clarification is needed.
      2. When urgent action or response is needed.
      3. For clinical emergencies or as a replacement for rapid response or code blue.
      4. For handoff communication.
      5. For Orders
  3. Broadcast and group texts should only be used by leadership designee to communicate the same information to multiple users simultaneously.

Palliative Care Moves to Ocean Tower

The Inpatient Palliative Care Team has moved their offices to room 6241 in the Ocean Tower. This was the room originally designated for the discharge lounge. 

Benefactors’ Ball Invitation to Medical Staff

Time is running short to purchase tickets to attend the Ball to show support for our Medical Staff Honorees who have been honored by the Foundation and Medical Staff Leadership.  If you’re not able to attend, you can purchase tickets or a table for your staff or others who you would like to treat to this celebration.

The Rise of Crypto-jacking – CMHS Cyber Security Corner

As cryptocurrencies (Bitcoin, Ethereum, etc.) have become more valuable, many hackers are moving away from ransomware and into a new form of malware.  Crypto-jacking is defined as the secret use of your computing device to mine cryptocurrency.  In times past,  victims unknowingly installed a program that secretly mined cryptocurrency.  Unfortunately, new strains don’t require programs to be installed and can run directly in a web browser.  This means any website you browse has the ability to hijack your browser and begin running unauthorized processes.  To protect yourself please remember the following:

  1. Only click on email links that are from trusted senders
  2. Only browse trusted and authorized websites
  3. If you notice any suspicious activity please contact the helpdesk (x5090) or email privacy@cmhshealth.org

Michiel de Bruin, CISSP, PgMP
CMHS Information Security Officer

Final Thoughts

“That which is not good for the bee-hive cannot be good for the bees.”
– Marcus Aurelius

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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Medical Staff Voice – March 18, 2019

JW Moore Tuesday CME Conference – Polycystic Ovarian Disease “PCOS”

Daniel Rychlik, M.D., will present a lecture on “PCOS”.  He will discuss how to 1) Formulate practice guidelines for the diagnosis and treatment of PCOS.
The conference will take place on Tuesday, March 19, 2019, 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.

Doctors’ Day Celebration CMHS 2019

Come to the celebration to enjoy a great catered luncheon and the camaraderie of your colleagues and friends.

 

Doctors Take the MOC® Stick: Legal Avalanche Unfolds

In light of the ABMS boards ignoring working physicians’ demands to end MOC®, or even allow a meaningful alternative to MOC®, physicians across specialty boards have felt empowered to initiate litigation against time-limited certification. Rather than thinking of this as doctors suing other doctors, it is more accurate to say that this is doctors taking a collective stand against insulated, self-elected, answer-to-no-one bureaucratic bodies; organizations that hide behind humanistic slogans while churning billions of hidden dollars for themselves.

The recent litigation timeline:

– Westby G. Fisher, MD, (link to the full article)

Dr. Michael Trauner and MOH’s surgery at the Centers for Family Health

Dr. Michael Trauner is joining our long-standing Dermatologist, Dr. Joel Siegel. Dr. Trauner in addition to practicing dermatology specializes in Mohs Surgery.

Michael Trauner, M.D., is a fellowship-trained Mohs micrographic surgeon. He earned his medical degree from Duke University. Dr. Trauner completed his residency in dermatology at the University of California at Davis Medical Center and a fellowship in dermatologic surgery at the New England Medical Center in Boston.

His main location will be at Premier Dermatology & Mohs Surgery Center, 3655 West 5th St., Oxnard 805/948-6920 cmhspremierdermatology.org

About Mohs Surgery

Developed by Dr. Frederick Mohs in the late 1930s, Mohs surgery has been widely embraced by surgeons as the most advanced, precise and effective technique for treating a wide variety of skin cancers.

Unlike traditional surgery, which involves removing visible cancer as well as the surrounding healthy tissue, Mohs surgery ensures that all traces of cancer are removed without causing unnecessary harm to healthy skin.

Security Rx Fix Signed by Governor

After intense lobbying from the California Medical Association (CMA), Gov. Gavin Newsom signed a bill on Monday that will end the confusion caused by the flawed implementation of the state’s new prescription pad law. AB 149 will delay implementation of the new law until January 1, 2021, ensuring that patients will continue to have access to the medicine they need while the state creates a system to better track prescriptions across the state. Physicians will be required to order a new set of prescription pads by that date, and the Department of Justice (DOJ) will determine the specs of those new pads sometime next year.

CMHS  Pharmacy Drug Shortage Update

We’ve just been notified of another sodium bicarbonate shortage. Both the abbojects and vials are unavailable from our distributor until mid-June. We have a very limited stock of 50 meq/50mL abbojects remaining in a few pyxis machines and in crash carts. We have stock of about 150 50 meq/50mL vials but don’t expect this to last until June.

We will be reinstituting the management strategies we used during the last bicarb shortage in 2017 to preserve our remaining stock for crash carts, severe metabolic acidosis, and TCA/salicylate overdoses. Call CMHS Pharmacy for management protocols as needed.

Thank you,
Kaitlyn Moorehead, PharmD

CMH Weekly Medical Staff Calendar – March 18 – 22

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

12:00 pm Finance Cmte – BR

4:30 pm Anesthesia Cmte - BR
7:45 am- Pediatrics Cmte/Neonatal Cmte-NA (back)

12:00 pm General CA Conf – BR
12:00 pm Radiation Safety/Radiology Division – NA (front)11:00 am – 1:30 pm Doctors’ Day Luncheon - NA

OVCH Weekly Medical Staff Calendar – March 18 – 22

MondayTuesdayWednesdayThursdayFriday
12:00pm
CME LECTURE
@ CMH or Online.
11:00am
PI Patient Safety Committee

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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Medical Staff Voice – March 11, 2019

JW Moore Tuesday CME Conference – “Colorectal Cancer: Current Landscape of Molecular Diagnosis”

Brad Barrows, D.O., will present a lecture on “Colorectal Cancer: Current Landscape of Molecular Diagnosis”.  He will; 1) Identify pathologic stages of colon cancer and which stages molecular studies are indicated, 2) Identify the spectrum of primary carcinomas of the colon, 3) Familiarize the audience with the current distribution of clinically significant molecular markers for adenocarcinoma of the colon, and 4) Demonstrate some of the methods for molecular testing of adenocarcinoma in the colon and how to interpret results.

The conference will take place on Tuesday, March 12, 2019, 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.

Doctors’ Day Celebration – Friday, March 22, 2019

A Special Thanks to our CMHS Hospital and Medical Staff

Last Thursday we experienced an unplanned Meditech downtime that created a great deal of extra work and diligence on the part of everyone involved in caring for our patients.  Our Hospital Staff, Nursing and support services, and our Medical Staff stepped up to the plate and saw to the exceptionally good care and safety of our patients. This effort can only be characterized as dedicated and tireless, despite the need to go to paper downtime procedures without the convenience of the electronic health record with which we have all become so reliant.

Thank you to all for showing your true colors of professionalism, collaboration and calm in the face of challenges faced that day.  You are the greatest!

Registered Dietitian Nutritionist Day on Wednesday, March 13

CMHS would like to recognize our RDNs on March 13 by posting this message on our blog for all employees:

In 2019, the Academy of Nutrition and Dietetics celebrates Registered Dietitian Nutritionist Day on Wednesday, March 13. As the nation’s food and nutrition experts, registered dietitian nutritionists are committed to improving the health of their patients, clients, and communities. Registered Dietitian Nutritionist Day and National Nutrition Month® promote the Academy and RDNs to the public and the media as the most valuable and credible source of timely, scientifically-based food and nutrition information.

First celebrated in 2008, Registered Dietitian Nutritionist Day commemorates the dedication of RDNs as advocates for advancing the nutrition status of Americans and people around the world. Registered Dietitian Nutritionist Day, celebrated each year on the second Wednesday in March, was created by the Academy of Nutrition and Dietetics to increase the awareness of registered dietitian nutritionists as the indispensable providers of food and nutrition services. This occasion also serves to recognize both RDNs and nutrition and dietetic technicians, registered for their commitment to helping people enjoy healthy lives.
Please thank our dietitians working at CMH and Ojai this week!

Benefactor’s Ball Invitation

CMH Weekly Medical Staff Calendar – March 11 – 15

MondayTuesdayWednesdayThursdayFriday
7:00 am Practitioner Well Being Cmte – BR

12:15 pm CME Committee - BR
7:00 am Medicine Cmte – BR

10:00 am Audit & Compliance Cmte – BR

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

12:30 pm Family Medicine Cmte – NA (back)
6:30 am HIM Cmte- BR

12:00 pm Quality Assurance Committee – BR

12:15 pm Cardiac Division Cmte – Quality CR

OVCH Weekly Medical Staff Calendar – March 11 – 15

MondayTuesdayWednesdayThursdayFriday
12:00pm
CME LECTURE
@ CMH or Online
12:00pm @CMH
Quality Board

Final Thoughts

“The love we give away is the only love we keep.” 
– Elbert Hubbard
 

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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Medical Staff Voice – March 4, 2019

CME Tuesday Noon Conference – CANCELLED

Pathology Department Moves into New Offices – Mountain Tower

Our pathologists have officially moved in the Mountain tower to the former radiology reading area. The Pathologists retain their same phone numbers as previously held. Individuals will be able to access the pathologists through the former front radiology area where radiology office staff use to be.

Transcatheter Aortic Valve Replacement (TAVR) Program

Congratulations to the Community Memorial Hospital TAVR Team on their first successful TAVR procedures in our NEW Ocean Tower last week! With our expanded surgical center and state-of-the-art heart catheterization and electrophysiology labs, we are excited about the future of TAVR and other structural heart procedures. Stay tuned as we share more on this exciting program!  Dr. Omid Fatemi, Structural Heart Medical Director, has led our team to these first two successful TAVR’s and we look to his leadership for our future success in Structural Heart.

In Memoriam – Gary Nishida, M.D.

It is with sadness that I must announce the untimely death of our colleague Dr. Gary Nishida on Feb. 24th.

Dr. Nishida was a well-respected and admired obstetric and gynecology physician. He was most active at St. John’s Hospital, but often had patients at CMH. Dr. Nishida’s family had a memorial service at the Poinsettia Pavilion in Ventura, last Saturday. There also will be a hospital-based memorial service to honor his life and share memories with colleagues and work friends, Tuesday, March 5th from 12 p.m. to 1 p.m. in St John’s Regional Medical Center Conference Rooms 2 & 4.

VCMA General Membership Dinner Meeting

Thursday – March 14, 2018 –  TWO WEEKS AWAY! – RSVP today!
Spanish Hills Country Club
999 Crestview, Camarillo

“Good Things Happening In Ventura County”
A Panel Discussion of Top Issues & Services in Our County
Keynote Speakers:

Mike Powers – CEO, County of Ventura
Josh Lemore, PhD -Clinical Director, Casa Pacifica
Emergency Services Representative: Status of Services & First Responders
New Feature: “Medical Mission (10) Minutes”

At each General Meeting, one Medical Mission will be featured and shared (10 minutes Powerpoint) by a VCMA Member. Get to really know your fellow colleagues.

5:30-7pm – VCMA Exhibitor Reception
7 pm – Buffet Dinner
7:20pm – Program

 RSVP – ASAP! (no later than Monday, March 11) to marycarr@venturamedical.org

Extortion Scam Targeting DEA Registrants

DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel.  The criminals have masked their telephone number on caller id by showing the DEA Registration Support 800 number.  Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration.

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “Extortion Scam Online Reporting” posted on the DEA Diversion Control Division’s website, www.DEADiversion.usdoj.gov.

CMH Weekly Medical Staff Calendar – March 4 – 8

MondayTuesdayWednesdayThursdayFriday
12:00 pm JWM Education Conf – NA - CANCELLED!

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

12:15 pm OB/GYN Cmte – NA - Front
5:30 pm Credentials Cmte – BR

OVCH Weekly Medical Staff Calendar – March 4 – 8

MondayTuesdayWednesdayThursdayFriday
5:15pm
CMHS Credentials Committee - CANCELLED
12:00pm
CME LECTURE - CANCELLED!
12:30pm
Medical Executive Committee
7:15am (Physicians)
7:45am (Hospital Staff)
Emergency Medicine Department

Final Thoughts

“A gem cannot be polished without friction, nor a man perfected without trials.”
– Lucius Annaeus Seneca

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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Medical Staff Voice – February 25, 2019

JW Moore Tuesday CME Conference – “Adult Congenital Heart Disease: Preparing for the Surge”

Rose Tompkins, M.D., Assistant Director of Cedars-Sinai Adult Congenital Heart Program, will present a lecture on “Adult Congenital Heart Disease: Preparing for the Surge”.  She will 1) Discuss awareness about the increasing prevalence of Adult Congenital Heart disease, and 2) Discuss common congenital heart disease diagnoses encountered in adult practice.

The conference will take place on Tuesday, February 26, 2019, 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.

Restraints Applied for Violent Behavior

Patients who have restraints ordered and applied for violent behavior must be seen by the physician within one (1) hour of having the restraints applied.  The “one-hour-face-to-face” assessment must include documentation of the following.

  • The patient’s immediate situation;
  • The patient’s reaction to the intervention;
  • The patient’s medical and behavioral condition; and
  • The need to continue or terminate the restraint or seclusion.

The time-frame for the renewal of restraints applied for violent behavior is based on the age of the patient. For example:  if after 4 hours an adult patient (age 18 or greater) still requires restraint for violent behavior, a nurse may get a 4 hr. renewal from the physician for up to 24 hours.  At the end of the 24 hours, it is determined the patient still needs restraint, the physician must see and assess the patient before issuing a new order.

  • 4 hours for adults 18 years of age or older;
  • 2 hours for children and adolescents 9 to 17 years of age; or
  • 1 hour for children under 9 years of age.

Hospital Acquired Infections Notification

A reminder that the CMHS Infection Prevention and Control Department expects to be notified whenever a hospital or healthcare-associated infection is suspected or recognized.  While we have surveillance systems in place, immediate notification by the physician is preferred and allows us to begin the investigation process quickly to determine cause and solution. The Department will complete the investigation, keep you informed and work to ensure the best outcomes for your patients. Contact information:

Physician Suspension for Medical Records Policy Update

As of Monday, 02-18-19 CMHS implemented the approved updated Physician Suspension for delinquent Medical Records Policy. This policy affects CMH, OVCH and CMHS Clinics.

  1. Physicians will be given 7- and 14-day notifications of their delinquent charts prior to suspension.
  2. Physicians on a rotating schedule are expected to complete any potential suspendable deficient items prior to going off rotation.  When the Hospitalist scheduled rotation ends they will have 48 hours to complete their chart deficiencies.  For example, when a physician is off of rotation starting on 10/1/18 midnight, they have until 10/3/18 midnight to complete chart deficiencies.
  3. Physicians scheduled for vacation or rotation are to notify the Health Information Management (HIM) Department prior to going on vacation; any potential suspendable items are to be completed prior to going on vacation. To advise HIM of your impending vacation please send your communications to kcarrillo2@cmhshealth.org or lmac@cmhshealth.org

Please contact the HIM Department if you would like to receive a copy of the complete updated CMHS Physician Suspension for Medical Records Policy at 805 948-4691.

Thank you,
Health Information Management

Sodium Bicarbonate shortage

We’ve just been notified of another sodium bicarbonate shortage. Both the abbojects and vials are unavailable from our distributor until mid-June. We have a very limited stock of 50 meq/50mL abbojects remaining in a few pyxis machines and in crash carts. We have stock of about 150 50 meq/50mL vials but don’t expect this to last until June. Our buyer is reaching out to 503B compounders to increase our order of compounded syringes but often in shortage situations they cannot increase our order amount.

We will be reinstituting the management strategies we used during the last bicarb shortage in 2017 to preserve our remaining stock for crash carts, severe metabolic acidosis, and TCA/salicylate overdoses.

CMH Weekly Medical Staff Calendar – February 25- March 1

MondayTuesdayWednesdayThursdayFriday
8:30 am Emergency Division – NA (front)

12:00 pm Board of Trustees- BR
12:00 pm JWM Education Conf – NA

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

OVCH Weekly Medical Staff Calendar – February 25 – March 1

MondayTuesdayWednesdayThursdayFriday
12:30pm
Surgery Department
12:00pm
CME LECTURE
@ CMH or Online

12:00pm @CMH
Board of Trustees

Final Thoughts

“There is nothing noble in being superior to your fellow men. True nobility lies in being superior to your former self.”

– Ernest Hemingway

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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Medical Staff Voice – February 18, 2019

JW Moore Tuesday CME Conference – “Is My Patient Having a Stroke?”

Nicholas Tarlov, M.D., CMHS Interventional Stroke Neurologist, will present a lecture on “Is My Patient Having a Stroke?”.  He will 1) Discuss utilization of recommended stroke-evaluation time benchmarks to stabilize patients within 60 minutes of arrival in the emergency department, including initial evaluation, assessment, imaging, and laboratory studies., 2) Outline current treatments for acute ischemic stroke, including IV thrombolytic therapy with tissue-type plasminogen activator and endovascular therapies, such as intra-arterial thrombolytic therapy and the use of clot-retrieval devices, and 3) Discuss how to utilize tools to predict patients’ clinical response and risk of hemorrhagic complications following IV thrombolytic therapy.

The conference will take place on Tuesday, February 19, 2019, 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 Outpatient Lab Locations and Hours

Print, save as a PDF or bookmark the following link as a valuable reference.
Drs. Scott Goodfriend and Stan Frochtzwajg – Medical Staff Resources

Dr. Goodfriend and I were discussing how often Medical Staff is unsure of who to call or hesitant to ask about issues that may be confusing or unclear.  One oft-heard reason is that colleagues don’t want to bother us. Dr. Goodfriend’s general knowledge and expertise are in the realm of appropriate chart documentation and compliance.  As your CMO, I will assist or point you in the correct direction with most everything else.

Part of our job descriptions is to be a resource for the Medical Staff.  Dr. Goodfriend can be reached through his cell phone: 805 701-3514.  I can be reached through the Medical Staff Office at 805 948-5418 or directly at 805 701-1466.

The following systems will be down for scheduled maintenance:
 
Allscripts PM and EHR – 3-hour downtime starting 2/19 at 10:00 PM.

Patient Keeper and Intelex – 3-hour downtime starting 2/20 at 1:00 AM.

Are you ready for another year of Tax Season Scams? – Cybersecurity Update

The IRS saw an approximate 450% surge in phishing and malware incidents during the 2017 tax season.  CMHS has already started to experience an uptick in email’s requesting W-2’s and other documents preferred for identity theft.

To help keep our users informed we are implementing a technology which will inform you when an email originated from outside our organization.  Please treat these with additional caution before clicking links or opening attachments

Example:  This email originated from outside the organization.  Please verify the sender and proceed with caution, Do not click any links, open any attachments, or reply unless you are certain of the sender.

Remember:  Scam emails are designed to trick taxpayers into thinking these are official communications from the IRS or others in the tax industry, including tax software companies. These phishing schemes can ask taxpayers about a wide range of topics. Emails can seek information related to tax refunds, filing status, confirming personal information, ordering transcripts, verifying PIN information and asking people to verify their tax software account.

Variations of these scams can be seen via text messages, and misleading communications can be seen in every section of the country.

When people click on these email links, they are taken to sites designed to imitate an official-looking website, such as IRS.gov. The sites ask for Social Security numbers and other personal information, which could be used to help file false tax returns. The sites also may carry malware, which can infect people’s computers and allow criminals to access your files or track your keystrokes to gain information.

Keep in mind that the IRS will never contact you by telephone if there are issues with your returns, or if they need information. They will always send information by U.S. mail, and only by email if you have requested and provided them with an address. Do not respond to any contact that is threatening or attempts to alarm you. Always contact the IRS through their official website (www.irs.gov) or call for telephone assistance.

UHC moves from denial to downcoding of E/M claims

UnitedHealthcare (UHC) is changing how it handles claims for evaluation and management (E/M) services when the medical record documentation does not support the E/M level submitted. Currently, UHC denies such claims, in which case the physician must either appeal, resubmit the claim with the appropriate level of service, or amend the documentation to support the level of service billed.Under a policy change effective in the second quarter of 2019 (www.uhcprovider.com), UHC will no longer automatically deny a claim based on the documentation but instead may adjust the level of a submitted code to reflect what it believes is appropriate and then pay it. The policy appears aimed at Level 4 and 5 services. If a physician disagrees with the adjustment, he or she could still appeal as that process will not change.

Your billing staff will need to be on their game and know what the appropriate payment is for the E/M codes they submit to catch potential downcoding by UHC. Close review of remittance advice may be in order. Otherwise, your practice risks being underpaid and not knowing it.
– Kent Moore, Senior Strategist for Physician Payment at the American Academy of Family Physicians

CMH Weekly Medical Staff Calendar – February 18 – 22

MondayTuesdayWednesdayThursdayFriday
President’s Day12:00 pm JWM Education Conf – NA
12:00 pm Finance Cmte – BR

General Staff Meeting - see announcement above.
7:45 am- Pediatrics Dept/Cmte/Neonatal Cmte-NA (back)

12:00 pm General CA Conf – BR
12:15 pm Inpatient Medicine Division – NA (front)

5:30 pm Orthopedic Division - BR

OVCH Weekly Medical Staff Calendar – February 18 – 22

MondayTuesdayWednesdayThursdayFriday
PRESIDENT’S DAY12:00pm
CME LECTURE
@ CMH or Online.

12:30pm
MSQA Committee
(12)

11:00am
PI Patient Safety Committee
11:00am
PI Patient Safety Committee

Final Thoughts

“Before you heal someone, ask him if he’s willing to give up the things that made him sick.”
– Hippocrates

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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