Medical Staff Voice – June 10, 2019

Tuesday Noon Conference -Resident Research Forum

Please join us on Tuesday, June 11th 12 p.m. to 1 p.m. for our Resident Research Forum in place of our regular JW Moore lecture.  Come support our Residents as they present their ongoing and upcoming research and quality improvement projects.  This session gives Residents a chance to discuss their scholarly work in a public forum and engage the medical staff in their research.  Lunch will be provided and no CME credit will be provided for this event.

For any questions, please contact the CME Coordinator, Christeva Vazquez cvazquez1@cmhshealth.org or by phone 805-948-5638

In Memoriam – Charles Hair, M.D.

Charles M. Hair, M.D., CMA President 1982, and VCMA President 1958, died peacefully in Santa Paula, CA at age 99 on May 31, 2019 ending a long life of dedication to patients and organized medicine.
If you didn’t know him personally, here is an a biographical summary of his personal and professional life published a few years back. https://santapaulatimes.com/news/archivestory.php/aid/2072/Charles_M._Hair,_M.D.,_Class_of_1937.html

No public obituary memorializing his life is posted as of yet.

Sadly, Dr. Hair’s wife, Geri, to whom he had been married for 77 years passed away earlier this year on March 9th. Her obituary is here: https://www.dignitymemorial.com/obituaries/ventura-ca/geraldine-hair-8200529

CME Requirement for Physician & Surgeons Licensed On or After January 1, 2019

As a requirement to maintain your license with the Medical Board of California, all physicians and surgeons must complete a one-time continuing medical education (CME) course in pain management and the treatment of terminally ill and dying patients. This course must also include the subject of the risks of addiction associated with the use of Schedule II drugs.* This 12-hour course requirement must be met within four years of an initial license being issued. This requirement does not apply to physicians practicing in pathology or radiology specialty areas.

As an alternative, physicians and surgeons can opt to complete a one-time mandatory 12-hour CME course on the treatment and management of opiate-dependent patients.** This CME option must include 8 hours of training in buprenorphine treatment or other similar medicinal treatment for opioid use disorders to take the place of the existing CME pain management requirement. A physician who chooses this alternative must complete the CME requirements by his or her next license renewal date. Physicians who meet the definition of a “qualifying physician” as determined by the Board pursuant to 21 U.S.C. section 823(g)(2)(G)(ii) as read on January 1, 2018, shall be deemed to have met the requirements.

Please be aware that the changes that took effect January 1, 2019 only apply to physicians and surgeons who have not previously taken the mandatory continuing education in the subjects of pain management and the treatment of terminally ill and dying patients. If a physician and surgeon has already taken the required 12 hours of CME, no further action is needed.

*Business and Professions Code 2190.5(a)(2) – effective January 1, 2019 **Business and Professions Code 2190.6(a) – effective January 1, 2019

AHA & Stroke award

Congratulations CMH! We have been honored with the 2019 Get With The Guideline – Stroke Gold Plus Quality Achievement Award and also qualified for recognition on the Target: Stroke Elite Plus Honor Roll.  This award recognized CMH’s commitment and success in implementing a high standard of stroke care by ensuring that our stroke patients receive treatment that meets nationally accepted, evidence-based standards and recommendations.

A special thanks to our Stroke Medical Director, Dr. Safwan Alboiny and to our Stroke Coordinator, Stephanie Lara-Jenkins.

PT Consult order

The PT Consult order now has a new query for providers to indicate if the patient will be discharged today.  This was added to alert the therapist so that they can prioritize those patients for timely discharge, particularly patients admitted for Observation status.
View from PK:

Also, PT/OT note is being formatted for easier review with the Assessment and Plan posted to the top of the PT/OT note in PK.

CMH Weekly Medical Staff Calendar – June 10 – 14

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 – NA (front)
13
12:00 pm QA & Patient Safety Cmte – BR
12:15 pm Cardiac Division Cmte – NA (front)
5:30 pm Bylaws Cmte - BR

OVCH Weekly Medical Staff Calendar – June 10 – 14

MondayTuesdayWednesdayThursdayFriday
12:30pm
MSQA Committee
7:15am / 7:45am
Emergency Medicine
Department

Final Thoughts

“Those who would give up essential liberty to purchase a little temporary safety, deserve neither liberty nor safety.”
– Thomas Jefferson

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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Physician Forum – Friday, June 7th – Special Edition – Medical Staff Voice

Join your colleagues in an opportunity to share experiences, ask questions and get direction about these dynamic times in Medicine in Ventura County.  Everyone on the Medical Staff and Residents are invited.

Stan Frochtzwajg, M.D.
Chief Medical Officer

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Medical Staff Voice – June 3, 2019

JW Moore Tuesday Noon CME Conference – Cancelled

The June 4th CME conference has been Cancelled.

Please join us on Tuesday, June 11th 12 p.m. to 1 p.m. for our Resident Research Forum in place of our regular JW Moore lecture.  Come support our Residents as they present their ongoing and upcoming research and quality improvement projects.  This session gives Residents a chance to discuss their scholarly work in a public forum and engage the medical staff in their research.  Lunch will be provided and no CME credit will be provided for this event.

For any questions, please contact the CME Coordinator, Christeva Vazquez cvazquez1@cmhshealth.org or by phone 805-948-5638

ACGME Tools and Resources for Resident and Faculty Member Well-Being

The ACGME’s Task Force on Physician Well-Being Tools and Resources Subcommittee created this compendium of materials and other references for residents and faculty members as a resource for well-being, wellness, and related tools. It is the Task Force’s hope that these resources will support the elements in Section VI of the ACGME’s Common Program Requirements. The requirements emphasize that psychological, emotional, and physical well-being are critical in the development of the competent, caring, and resilient physician.

The Task Force assembled this list of resources to help programs and institutions identify solutions that best meet local needs. Neither the ACGME, nor the Task Force, endorse the use of any specific tool or resource.

These resources can be used as part of program and institutional efforts to improve faculty member and resident/fellow well-being. Resources can support, but cannot take the place of local commitment to fostering well-being, and to assessing and assisting residents/fellows, faculty members, or others in distress.

All of the tools and resources included have been reviewed for relevance in graduate medical education settings. This compendium includes open access (free) resources, as well as proprietary (fees may apply) programs, tools, and materials.

Click on the link for access to the ACGME resource: Tools and Resources Link

New Law Requires Naloxone HCl Prescriptions in Certain Instances

A law (AB 2760) which took effect January 1, 2019, requires prescribers to offer a prescription for naloxone HCl or another drug approved by the FDA for complete or partial reversal of opioid depression in certain circumstances.

Naloxone (or another FDA-approved opioid antagonist) must be offered:

  • If the patient is taking a daily prescription dose of 90 or more morphine milligram equivalents of an opioid medication;
  • If an opioid medication is prescribed concurrently with a prescription for benzodiazepine, or
  • If the patient presents with an increased risk for overdose, including:
    • the patient has a history of overdose;
    • the patient has a history of substance use disorder; or
    • the patient is at risk for returning to a high dose of opioid medication to which the patient is no longer tolerant.

In addition, the new law requires a prescriber to provide education to a patient, or patient’s designee, or for a minor patient, the patient’s parent or guardian, on overdose prevention and use of naloxone (or similar FDA-approved drug).

The law specifies that a prescriber who fails to offer a prescription or provide education, as required by this law, must be referred to the appropriate licensing board solely for the imposition of administrative sanctions deemed appropriate by that board.

For more information about naloxone, including a video on administering nalozxone nasal spray – sold as Narcan, click on the link: the California Department of Public Health’s Get Naloxone website.

CMHS Pathology Department Medical Staff Survey

Dear Physicians,

We value your feedback. Please take a moment and share your experience with the CMHS Pathology Department.  This brief survey should take only a few minutes. Thank you for your participation. Click on this link:  https://www.surveymonkey.com/r/NBTPX67

MeeAe Kwon, MD, Pathologist
CMHS Medical Director

CMH Weekly Medical Staff Calendar – June 3 – 7

MondayTuesdayWednesdayThursdayFriday
12:30 pm – Interdisciplinary Practice Cmte – Quality Conf Rm
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 – June 3 – 7

MondayTuesdayWednesdayThursdayFriday

12:30pm @CMH CMHS IDP Committee12:30pm Medical Executive Committee

Final Thoughts

“There are only two mistakes one can make along the road to truth; not going all the way, and not starting.”
– Buddha

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 – May 27, 2019

JW Moore Tuesday, CME Conference – “Effective Communication in Patient Hand Off”

Hannah Robinson, D.O., will present a lecture on “Effective Communication in Patient Hand Off”.  She will discuss how to: 1) Recognize effective vs ineffective hand offs, 2) Identify the components of an effective hand off, and 3) Internalize the importance of communication.

The conference will take place on Tuesday, May 28, 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 by phone 805-948-5638.

CMH Quarterly General Medical Staff Meeting

Last week we had another very successful General Medical Staff meeting.  Attendance reached 120 physicians.  Chef Brian outdid himself with a delicious array of hors devours and desserts.  Dr. Brackett kept the meeting short, to just over 30 minutes, and Gary Wilde, CEO, Cindy Demotte and I gave our updating reports on the State of the Health System, Quality measures and Medical Staff updates.  These are the salient components of the info I presented at the meeting:

  • Mobile Heartbeat – IT support was present at the Quarterly Meeting, call 948-5090 for assistance.
  • Verbal Orders – only use when unable to readily access a computer
  • Direct Admit – Nurse Supervisor: 805 208-8544(24/7)
    • Direct Admit Nurse – 805 910-9332 (8 am – 3:30 pm)
  • Pathology Department Survey for the Medical Staff: https://www.surveymonkey.com/r/NBTPX67
  • medicalstaffvoice.com/voice – Medical Staff Newsletter Blog Site
  • Interventional Radiology (IR) Hotline 805–879–7568 (24/7)

CMH Medical Staff Alert – Policy Change – Pre-Op Labs, EKG’s and X-rays

Beginning June 3, 2019, we are directing all pre-op patients to go to the Medical Office Building, 168 N. Brent, 3rd floor draw station, in the Outpatient Radiology area, for all their Lab, EKG and radiology needs.

Any patients with only EKG orders should be directed to the 2nd floor Physiology Department in the Mountain Tower.

Therapy Dogs at CMH

We have had a therapy dog program at CMH for the past four years. Pam Schuman gave a presentation at the Quarterly Medical Staff meeting with one of the most behaved dogs you’ve ever seen.  The healing power of therapy dogs for adults and children is well documented.  Medical Staff that would like a therapy dog visit should contact Debbie in Nursing Services or directly, Pam Schuman at 805-407-4208 for a patient therapy dog visit. They have teams available outside of regularly scheduled visits which are the second and fourth Mondays of each month at 11am, and the third Saturday each month at 11am.

Pantoprazole (Protonix) Shortage

Pharmacy has just become aware that pantoprazole (Protonix) 40mg injectable vials are on backorder. This shortage is due to manufacturing delays which in turn is leading to insufficient supply for usual ordering. Recovery dates are estimated to be September 2019.

In the past, we have switched to our non-formulary option of esomeprazole (Nexium) injectable. Currently, Nexium injectable is unavailable for ordering. Our distributer only has short-dated items, which it is not shipping out.

Our strategy during this shortage will be:

  1. Existing orders and all new order for pantoprazole injectable will be evaluated by Pharmacy for conversion to PO doses, per the CMHS Intravenous to Oral Therapeutic Interchange Policy HS-PHA155 (copy attached).
    1. Pantoprazole IV criteria are patients who are strict NPO or those being treated for an active GI bleed.
    2. Nursing will not receive a written change order from Pharmacy for these conversions, as they are per policy. Pharmacy will note the change in the label comments.
  2. Once our pantoprazole injectable supply is depleted, we do have a few remaining vials of esomeprazole (Nexium) which we can exhaust. The goal is to reserve injectables for GI bleed patients we may see throughout the summer months.As always, thank you for your assistance in helping our health system manage national drug shortages.
    – Renu Bajwa, Pharm.D.

CMH Weekly Medical Staff Calendar – May 27 – 31

MondayTuesdayWednesdayThursdayFriday
Memorial Day8:30 am ED Division – NA (front)
12:00 pm JWM Education Conf – NA
12:00 pm Board of Trustees – BR

5:30 pm Surgery Committee – BR

5:30 pm Credentials Cmte NA-(Front)
12:00 pm General CA Conf – BR

12:00 pm Bioethics Committee –NA (front)
12 :15 pm Pharmacy & Therapeutics Cmte – BR

OVCH Weekly Medical Staff Calendar – May 27 – 31

MondayTuesdayWednesdayThursdayFriday

Memorial Day
12:00pm
Board of Trustees@ CMH

5:15pm
CMHS Credentials Committee

Final Thoughts

“It is not the mountain we conquer but ourselves.”
– Edmund Hillary

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 – May 20, 2019

jJW Moore Tuesday, May 21, 2019 CME Conference – “Critical Conversations: Communicating About What’s Most Important in the End”

Colin Scibetta, M.D., will present a lecture on “Critical Conversations: Communicating About What’s Most Important in the End”.  He will discuss how to: 1) Develop a structure for approaching patients and families to deliver bad news, 2) Provide strategies to help the patient identify and address those complex feelings, concerns, and fears created by bad news, and 3) Developing a plan that incorporates clinical realities with the values of the patient.

The conference will take place on Tuesday, May 21, 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.

CMH Quarterly Medical Staff Meeting

Mobile Heartbeat (MH) IT Staff will be at the meeting and will be available to assist you with loading the MH app onto your cell phone or to trouble shoot any issues you might have with the app.

CMHS Pathology Department Medical Staff Survey

Dear Physicians,

We value your feedback. Please take a moment and share your experience with the CMHS Pathology Department.  This brief survey should take only a few minutes. Thank you for your participation. Click on this link:  https://www.surveymonkey.com/r/NBTPX67

MeeAe Kwon, MD, Pathologist
CMHS Medical Director
805/948-4201 • CELL: 805/477-8288
MKwon@cmhshealth.org

VCMC FP Reunion – May 24–25

CMH Weekly Medical Staff Calendar – May 20 – 24

MondayTuesdayWednesdayThursdayFriday
21 12:00 pm JWM Education Conf – NA
12:00 pm Finance Cmte – BR

Please see schedule above for Gen. Med Staff & Dept. Meetings.
12:00 pm General CA Conf – BR

6:30 am HIM Cmte- BR

OVCH Weekly Medical Staff Calendar – May 20 – 24

MondayTuesdayWednesdayThursdayFriday

12:30pm
MSQA Committee


Final Thoughts

“Remember upon the conduct of each depends the fate of all.”
– Alexander the Great

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 – May 13, 2019

JW Moore Tuesday Noon CME Conference – “Updates to Evidence Based Medicine Research”

Janet Hobbs, MLIS, Library Services Manager, Community Memorial Hospital, will present a lecture on “Updates to Evidence Based Medicine Research”.  She will: 1) Identify and apply new information, treatment protocols and therapies within scope of practice, and 2) Integrate strategies for obtaining new information and treatment protocols directly relating to patient care.

The conference will take place on Tuesday, May 14, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.

CMHS Pathology Department Medical Staff Survey

Dear Physicians,

We value your feedback. Please take a moment and share your experience with the CMHS Pathology Department.  This brief survey should take only a few minutes. Thank you for your participation. Click on this link:  https://www.surveymonkey.com/r/NBTPX67

MeeAe Kwon, MD, Pathologist
CMHS Medical Director
805/948-4201 • CELL: 805/477-8288
MKwon@cmhshealth.org

EHR Downtime – Thursday, May 16, 12:05 AM – 6:00 AM

We have a scheduled Inpatient systems downtime scheduled for Thursday morning, starting just after midnight until 6 AM. The systems affected will be: Meditech, Picis, Mobile Heartbeat, Perigen, Teletracking & Rauland. Users may loose data filed after 0001.
PK will remain available but there will be no CPOE. PACs will be unaffected.

Hospital Week Celebrations – May 13 – 17

CMHS Nurses Week Videos

In addition to their exemplary nursing skills in caring for our patients, our CMHS nurses also have creative performing art skills that were depicted in a series of self made videos by four different Hospital departments.  Fun was obviously had by all.  I’ve included a link to the video made by our Main OR nurses.  Just click on this link or the video: 

For the other three department videos please visit the CMHS Intranet.  They’re posted right on the center of the main page.

CMH Weekly Medical Staff Calendar – May 13 – May 17

MondayTuesdayWednesdayThursdayFriday
7:00 am Medicine Cmte – BR

10:00 am Audit & Compliance Cmte – BR

12:00 pm JWM Education Conf – NA
7:45 am- Pediatrics Dept -NA (back)

12:00 pm General CA Conf – BR
12:00 pm Radiation Safety/Radiology Division – NA (front)


5:30 pm Orthopedic Division - BR

OVCH Weekly Medical Staff Calendar – May 13 – May 17

MondayTuesdayWednesdayThursdayFriday
12:30pm
Family Medicine Department
11:00pm
P.I. Patient Safety Committee
12:30pm
Pharmacy & Therapeutics Committee

Final Thoughts

“He who angers you conquers you.”
Elizabeth Kenny

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 – May 6, 2019

JW Moore Tuesday Noon CME Conference – “Aortic Dissection”

Ali Azizzadeh, M.D., Director of Vascular Surgery, Cedars-Sinai will present a lecture on “Aortic Dissection”.  He will: 1) Demonstrate symptomology, diagnostic tools and treatment protocols for aortic aneurysms and dissections, and 2) Provide tools to differentiate and diagnose aortic aneurysms and dissections.

The conference will take place on Tuesday, May 7, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.

Nurses Day and Hospital Week

Join CMHS in honoring and celebrating our extraordinary nursing staff this week.

Influenza Mask Requirement Lifted – Alert!

The current situation in California, as reported on the California Department of Public Health website for the week of April 21-27, is “Sporadic”.  This activity rating indicates a very low activity level and allows the CMHS Infection Control department to lift the requirement for mask use at CMHS for the non-vaccinated as of Friday, May 3, 2019.

Allscripts – Out of Country Access

If you are leaving the USA and plan to bring your laptop in order to access Allscripts, please call the IT Helpdesk at 805 948-5090 and submit your request at least two weeks prior to your departure in order to assure your access to the Electronic Health Record.

CMHS Pharmacy Medication Shortages Alert!

Major Physician Shortage Expected in the Next 12 Years

According to a recent report released by the Association of American Medical Colleges, America is facing a physician shortage of between 46,900 and 121,900 by 2032. The group projects that the primary care physician shortage will be 21,100 to 55,200 physicians, the non-primary care specialties shortage will be 24,800 to 65,800 physicians, and the shortage for physicians in surgical specialties will be 14,300 to 23,400. An additional growing concern is that more than two out of five currently active physicians will be 65 or older within the next decade, and that continuing changes in physician retirement decisions could greatly impact supply. To view the report, click here.
Strategic Health Care

VCMC FP Reunion – May 24–25

Prior Authorization Requirements Delaying Care for Cancer Patients: Survey

A recent poll by American Society for Radiation Oncology of 673 of its members found that 93-percent of radiation oncologists stated that their patients are delayed from life-saving treatments, and 31-percent said the average delay lasts longer than five days due to prior authorization requirements from their insurers. 32 percent of radiation oncologists said they were forced to use a different therapy due to the delays and 62 percent said authorization denials were turned over on appeal. Another recent report from Kaiser Health News details how cancer patients find themselves caught between providers and insurers on which clinicians and treatments they are approved to use, leading to the Pennsylvania Attorney General filing a lawsuit to protect patient choice. To view the poll results, click here, and for the KHN report, click here
Strategic Health Care

CMH Weekly Medical Staff Calendar – May 6 – May 10

MondayTuesdayWednesdayThursdayFriday
12:00 pm JWM Education Conf – NA

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

12:30 pm Family Medicine Cmte – NA (back)
12:00 pm QA & Patient Safety Committee – BR

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

OVCH Weekly Medical Staff Calendar – May 6 – May 10

MondayTuesdayWednesdayThursdayFriday
12:00pm
Quality Assurance Committee @ CMH
7:45am / 7:45am
Emergency Medicine Department

Final Thoughts

“Man is free at the instant he wants to be.” 
– Voltaire

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 29, 2019

JW Moore Tuesday Noon CME Conference – “Anti-Xa Monitoring”

Kaitlyn Moorehead, PharmD, CMHS, will present a lecture on “Anti-Xa Monitoring”.  She will: 1) Review pharmacology and indications for factor Xa inhibitors, and 2) Describe appropriate use and interpretation of anti-Xa chromogenic assays in clinical practice.

The conference will take place on Tuesday, April 30, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  This week’s lecture will not be available for online viewing.

Physician Alert! – Please guide patients clearly to the Ocean Tower for Labs and Imaging

Auxiliary members at the front desk at the Mountain Tower are routinely redirecting patients sent for outpatient labs and imaging to the Ocean Tower.  Especially for our senior citizens, this can be a significant inconvenience after having made the initial trek to the Mountain Tower.

Dr. Lois Barnes – Congratulations on your Retirement!

Dr. Barnes has served the Ojai and Ventura communities for decades as a highly respected and loved Obstetrician and Gynecologist. She was one of the pioneers of our nascent robotic surgery program along with a handful of other surgical specialties. Her teaching skills in Obstetrics for the CMHS Family Medicine residents are unparalleled. The residents’ accolades and praise for her teaching style and encouragement are innumerable. A core group of us have had the privilege of serving on the EHR Governance Committee for over the past 10 years with Dr. Barnes.  She is best known for her candor and wisdom.  Her absence will be sorely missed and will not easily be replaced.
We all wish her a wonderful next chapter with her grandchildren, her husband Steve and a long deserved respite.

In Memoriam – Dr. Dale Gosaynie

It is with sadness that I report the passing of Dr. Dale Gosaynie. Dr. Gosaynie, 81, died peacefully in his home in Ventura, California, on Friday, April 19, 2019.  Dr. Gosaynie was respected and well liked by all of us, colleagues and patients. He practiced Cardiology for 50 years, initially at CMH and then up until 10 years ago at VCMC. A Celebration of Dr. Gosaynie’s Life will be held on Saturday, May 4, 2019, 3:00 p.m., at Ted Mayr Funeral Home, 3150 Loma Vista Road, in Ventura. Reception to follow the service at the same location. Link to the obituary.

Ransomware breakout in California

A ransomware variant has taken down Imperial County (San Diego) for the last 6 days and Ventura County is taking the precaution of blocking email from them due to security concerns.  This malware can infect your computer merely by clicking on a link or opening an attachment.

Please be on high alert and only open links/attachments from trusted sources.  Please do not hesitate to email infosec@cmhshealth.org or contact the helpdesk at 805.652.5090 with any questions or concerns.  Thank you.
https://www.latimes.com/local/lanow/la-me-imperial-county-website-down-20190418-story.html


Please Don’t Call Me ‘Provider’

ROBERT B.TAYLOR, M.D.
Oregon Health Sciences University School of Medicine Portland, Oregon

Recently I received a memo: “Provider Meeting: All PCPs should attend.” I don’t know about you, but I am fed up with being called a “provider.” Yes, I know, I provide medical care to my patients. And “provider” is part of “primary care provider,” or PCP.

Let’s look at how these terms came into use. The word “primary” used in regard to physicians appeared in the 1966 Millis Report, which called for “physicians who can put medicine together again.” The report proposed a “primary physician” who “would, by assuming primary responsibility for the patient’s welfare in sickness and health, provide continuing and comprehensive care to the citizens of the United States.” In describing health care, we came to use the phrase “primary care” to distinguish first contact, continuing and comprehensive care from secondary care (still in debate) and tertiary care provided in large medical centers. Over the years, “primary physician” and “primary care” were melded into “primary care physician” as government and others sought a comprehensive term to refer to family physicians, general internists, and general pediatricians. The “provider” term arose with insurance companies as they have invaded health care over the past two decades. Thus “provider” (or “primary care provider/PCP”) can be considered to be the brainchild of federal bureaucrats and the managed care industry. Certainly, no physician ever woke up one morning and stated, “From now on, I want to be called a PCP.”

I am a physician and proud of it. I worked hard to obtain my degree, and I continue to work hard to keep my medical knowledge and skills up to date. I am also a medical doctor, in the sense that the word “doctor” comes from the Latin “docere,” meaning to teach. I highly value my role as an educator for patients, students, residents and sometimes colleagues.

The word “provider” also encourages us to consider health care a commodity and the physician­ patient encounter a business transaction. Pellegrino describes the implications of this paradigm shift in writing about the commodification of medical and health care. If we, as physicians, move from a professional to a market ethic, then we surrender professionalism to a commercial mentality.

There are racial, ethnic and even gender insults, and we all know what they are. We protest when they occur. Well, I consider “provider” a professional insult; it is personally demeaning, and it devalues my education and my degree. Why should you and I be forced to suffer repeated use of a derogatory professional insult?

If you agree, I suggest that you photocopy this editorial. Keep copies in your desk and send one—with a short personal note—to anyone who calls you a “provider.”

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 29 – May 3

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

12:00 pm JWM Education Conf – NA

12:00 pm Board of Trustees – BR
12:00 pm General CA Conf – BR
12:15 pm OB/GYN Cmte – NA - Front

OVCH Weekly Medical Staff Calendar – April 22 – May 3

MondayTuesdayWednesdayThursdayFriday
12:30pm
Board of Trustees
@ CMH Boardroom
12:30pm
Medical Executive Committee

Final Thoughts

“I follow three rules: Do the right thing, do the best you can, and always show people you care.”
– Lou Holtz

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 22, 2019

JW Moore Tuesday Noon CME Conference – CANCELLED

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. ATR will be faxing the reports to CMH during this time. We estimate this downtime will be for 2 hours. 

National Medical Laboratory Professional Week

National Medical Laboratory Professional Week, April 21-27, 2019 is an annual celebration of medical laboratory professionals and pathologists who play a vital role in health care.  Our highly skilled CMH and OVCH Laboratories and 8 draw stations throughout the Community Memorial Health System are made up of over 110 medical professionals.  Each laboratory is nationally accredited by the College of American Pathologists (CAP).  In addition, the CMH laboratory is accredited by the American Association of Blood Banks (AABB).  Join us in celebrating our medical laboratory professional.

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 atcvazquez1@cmhshealth.org or at 805-948-5638.

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

Radiology phone numbers

The best way to communicate directly with the radiologist you’re looking to speak with is by contacting them using the Mobile Heartbeat app.

  • Radiology reading rooms – ext. 5647 (rings in all reading rooms including Ojai. Calls will roll over to the main desk)
  • Radiology front desk – ext. 8160
  • Radiology nurse – ext. 8161

Other important phone numbers include

  • Interventional Radiology (IR) Hotline 805–879–7568.
  • Pueblo answering service 805–879–7595
  • ATR/nighthawk 888–225–0386

A list of covering Radiologists, with cell phone numbers, is posted in the reading room area in the new department.
This list is updated each day and sent to the house operator, emergency room, nurse supervisor and intensive care units.

Dr. Tom Kong and Dr. Craig Mansour won Corporate Games GOLD for team CMHS in doubles tennis

CMH Weekly Medical Staff Calendar – April 22 – 26

MondayTuesdayWednesdayThursdayFriday
7:00 am CMHS Outpatient Division – BR12:00 pm Finance Cmte – BR
12:15 CMHS Infection Control Cmte –Quality
5:30 pm Credentials Cmte NA-(Front)
5:30 pm Surgery Cmte – BR
12:00 pm General CA Conf – BR

OVCH Weekly Medical Staff Calendar – April 22 – 26

MondayTuesdayWednesdayThursdayFriday
12:15pm
CMHS Infection Control Committee-
Teleconferenced

5:30pm
CMHS Credentials Committee
@ Medical Staff Office

12:30pm
Provision of Care Committee

Final Thoughts

“The key is to keep company only with people who uplift you, whose presence calls forth your best.”
– Epictetus

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 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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