Medical Staff Voice – February 11, 2019

JW Moore Tuesday CME Conference – “Sexual Discrimination”

Paul Wilcox, Esq., will present a lecture on “Sexual Discrimination”.  He will 1) Define harassment, discrimination, and abuse, 2) Discuss the legal requirements, company policy and practices required to maintain an open environment, and 3) Identify resources, tools,
and strategies for treating others with respect and dignity.

The conference will take place on Tuesday, February 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.

Medical Staff Updates

  1. Physician Orders – Physicians need to write the specific route for all medication orders so no interpretations are being made by the nurses; e.g. which route to use first, second, etc.
  2. Chemotherapy Orders – CMHS pharmacy requires 48 hours advance order for all chemotherapy medications for inpatient and outpatient administration.
  3. 4 East Dictation room – We have a dictation room on 4 east with 4 computers in the room.  Some have noted that the temperature in the room is kept too cool. If it is too cool, notify the Charge Nurse to adjust the thermostat.
  4. In House, Cocci Screening Testing is going live on Monday, February 11th with a new cocci screening test.  We will no longer be offering the testing through Mayo Laboratories. Any screening test for Cocci will be done in–house with same day results.    This test has been correlated with both the Immunodiffusion and Complement Fixation tests.  Any positive screening test will reflex the Complement Fixation/Immunodiffusion panel automatically and testing will be sent to ARUP laboratories.

Laboratory Diagnosis of Gastrointestinal Pathogens – CHANGES IN TESTING

Over the past year, the laboratory has begun offering a molecular test that will detect multiple gastrointestinal pathogens from the same stool sample (FilmArray GI panel).  While the traditional stool cultures take 3-5 days to complete testing, the GI PCR panel can be completed within 18-24 hours of receipt in the laboratory.

In comparing the two methods of gastrointestinal pathogen testing, we looked at data from January to June 2018.  During this timeframe, 262 traditional stool cultures were performed.  Of these cultures, 1 Campylobacter and 2 Salmonella species were isolated.

During the same time period, 812 GI PCR panels were performed.  Positivity rates ranged from 0.1-17.7%.  See below for a breakdown of all organisms isolated.

Campy 3.8% Ecoli O157 5.8%
CdIfftoxin 17.7% Ecoli-EIEC 1.0%
Pleiso 0.3% Crypto gi 0.7%
Salmon 15.2% Cylcospora 0.0%
Vibrio 0.2% Entamoeba 0.0%
Vibcho 0.1% Giardia 0.4%
Yersi 0.9% Adeno 1.2%
Ecoli-EAEC 2.7% Astro 1.9%
Ecoli-EPEC 6.8% Norovirus 6.6%
Ecoli-ETEC 1.6% Rotavirus 1.4%
Shiga-Like 1.5% Sapo 1.3%

It is clear from the data that the PCR methodology has a greater positivity rate to detect gastrointestinal pathogens in the stool.

The only acceptable specimen type for the GI PCR panel is stool in Cary-Blair transport media (orange stool vial).  If the fresh stool is obtained it should be transported to the laboratory as soon as possible, but no later than 2 hours’ post-collection.

Effective March 4th, 2019, the Microbiology Laboratory will no longer offer Stool Culture testing in-house.  We will only perform the GI PCR panel.  If traditional Stool Culture testing is warranted, it will be sent to the ARUP reference laboratory.  Clostridium difficile by PCR and O&P testing will continue to be offered and tested separately in-house.

If you have any questions, please feel free to call: 805-948-5324.

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

Updated Flu Season Data

CMH Weekly Medical Staff Calendar – February 11 – 15

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 – BRValentine’s Day

12:00 pm QA & Patient Safety Cmte- BR

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

OVCH Weekly Medical Staff Calendar – February 11 – 15

MondayTuesdayWednesdayThursdayFriday
12:30pm
Family Medicine Department
12:00pm
CME LECTURE
@ CMH or Online
VALENTINE’S DAY

12:00pm @CMH
Quality Board

Final Thoughts

“Everything that irritates us about others can lead us to an understanding of ourselves.”
– Carl Jung

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Medical Staff Office – (805) 948-5662

 

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