Medical Staff Voice – April 12, 2021

JW Moore Tuesday, April 13, 2020, CME Conference -“Extracorporeal Life Support (ECLS) & Extracorporeal Membrane Oxygenation (ECMO)

Jennifer Wan, M.D., Cardiothoracic Surgeon, CMHS, will present a lecture on “Extracorporeal Life Support (ECLS) & Extracorporeal Membrane Oxygenation (ECMO.)”  At the end of the conference, the learner should be able to: 1) Recognize the indications for ECMO and ECLS in the treatment of respiratory and circulatory failure, 2) Explain the components of an ECMO circuit, 3) Compare venovenous and venoarterial ECMO, and 4) Formulate different cannulation techniques for venoarterial and venovenous ECMO.

The conference will take place on April 13, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 1-A credit.

If you would like to attend this meeting, please contact CME Coordinator Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

Clinical Pearls of the Week

  • Although “curbside consults” are commonplace in medicine, when there is a challenging or complicated case, be prudent and call the specialist for a formal, documented consultation.
  • Resist the temptation of offering a “curbside treatment” to a friend or familiar Hospital staff person in lieu of doing the legal, ethical and safe approach in referring the individual to their own physician or having them schedule a “good faith” exam.
  • When requesting a consultation, place a CPOE order with the consultant’s name. To add a physician’s name look in PK Orders for “Consulting”.  This will automatically put the patient’s name in the consulting physicians patient list in PatientKeeper.
  • After performing any interventional procedure, please immediately document a Post Op note in the Chart Notation Template so that the Hospitalist, Primary care physician, consultants and staff are aware of what was done. This is a courtesy and patient safety requirement of the Medical Staff.

Medical Staff Voice Live – Dr. Chris Johnson, Medical Director Emergency Department

In Episode Six of the Medical Staff Voice Live, CMHS Chief Medical Officer Dr. Stan Frochtzwajg sits down with Dr. Chris Johnson, Community Memorial Hospital’s Medical Director of the Emergency Department. Dr. Frochtzwajg and Dr. Johnson discuss how CMHS is keeping its patients, physicians and staff safe during the pandemic and how local physicians can use the CMH Emergency Department as a resource for treating patients with more acute needs. Learn more about Community Memorial Health System at https://www.cmhshealth.org/.


Click on the link to view the 15 minute video interview: YouTube video link

Post Operative Diet Resumption 

All patients should receive the correct diet order following surgery. Many times this gets overlooked, which places the patient at higher risk for aspiration and/or a choking event.

Recommendation: Surgeons should look at the pre-op diet, and reorder the exact diet order for patient safety and continuity, unless contraindicated clinically. Another way to approach this ordering conflict would be to have the surgeon order “Please resume prior diet order, if appropriate.”

Physician to Notify HIM of Vacations

HIM (Medical Records) is requesting that physicians notify them prior to going on vacation. Failure to do so makes the suspension process very difficult and may result in added suspension days.  It would also be beneficial to let HIM know who will be taking over the care of their patients so that we may reach out to their covering physician for documentation completion if necessary. HIM can be reached by calling (805) 948-4691.

3% hypertonic saline in PCU (click on the graphic to enlarge)

P&T in consultation with nephrology and nursing, has approved the use of IV 3% NaCl in the PCU. The limitations for use in the PCU include a nephrology consult and sodium and neuro checks no more frequent than every 4 hours. The recommendation for a central line remains in place, however is not a requirement.

Oxnard Westminster Free Clinic – Seeking Physician Volunteers

The Westminster Clinic is a non-profit free clinic for patients without insurance in the Ventura County area.  The Oxnard location opened in early 2020 and is looking for Physician or Mid-level volunteers to treat adult patients (Family Medicine, Internal Medicine, Endocrinology, Podiatry, ER, Ophthalmology) on Tuesday evenings from 6-9pm at 1800 S. C Street.  They focus on the “medical home” and treatment of chronic conditions and have a lot of resources including a pharmacy staffed by a retired pharmacist, a nutritionist, counselor and case manager all on-site.  The organization provides free vaccines, food and clothing as well.

Each provider is provided a scribe and MA/translator and records are kept on an EMR; malpractice insurance is also provided.  It is a great way to give back to the community as well as mentor local high-school and college students interested in the medical field.  They do provide PPE and there are opportunities for tele-health if providers are not comfortable seeing patients in person.

For more information, see their website at https://westminsterclinic.org/home/volunteers/medical-volunteers/   or call/email Kris Pena, MD 805-765-5711 krispena@protonmail.com  or Lisa Safaeinili, M.P.H. their Medical Director at  lisa@westminsterclinic.org

CMHS Weekly Medical Staff Calendar – April 12 – 16

MondayTuesdayWednesdayThursdayFriday
Ramadan - Sundown

7:30 am COVID19 Update for Medical Staff - Teams

5:15 pm QA & Improvement Cmte – Teams
8am CMHS MERP – Teams

12:00 pm JWM Education Conf – Zoom

5:00 pm Medicine Cmte– BR & Teams
12:00 pm General CA Conf – BR4:30 pm COVID19 Task Force Meeting - Teams

5:30 pm Disaster Preparedness Committee – BR

Final Thoughts

VIGILANCE! With the COVID numbers dropping significantly in California and most states in the Union, one can notice a widespread drop in mask wearing and an increase congregation in large groups (stadiums in Texas to capacity). There is a deadly threat looming in the distance.  What with the poorer countries in the world not yet being vaccinated and India, for example, surging higher than ever, we run the risk of Dr. Fauci’s warning: “Viruses allowed to replicate, will produce variants.” Whether our vaccinations provide protection against as of yet unknown variants, only time will tell. Let’s vaccinate the world as soon as possible.

“Everything you’ve ever wanted is on the other side of fear.”
George Addair

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 5, 2021

JW Moore Tuesday, April 6, 2020, CME Conference -“Modifying Approach to Diabetes & Cardiovascular Disease- A Revolution.”

Norman Lepor, M.D., FACC, Cardiologist; Clinical Professor of Medicine at Geffen UCLA School of Medicine and Attending Cardiologist at Cedars-Sinai Smidt Heart Institute, will present a lecture on “Modifying Approach to Diabetes & Cardiovascular Disease- A Revolution.”

At the end of the conference, the learner should be able to: 1) Differentiate the cardio-protective effects of diabetic treatments, 2) Apply these cardiovascular protective treatments to mitigate CV risk in Type II diabetes and 3) Be aware of the safety issues of these treatments.

The conference will take place on April 6, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 1-A credit.

If you would like to attend this meeting, please contact CME Coordinator Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

Medical Staff Voice Live: Episode Five with Jordan Dennis, R.D.

In Episode Five of the Medical Staff Voice Live, CMHS Chief Medical Officer Dr. Stan Frochtzwajg introduces Jordan Dennis, R.D., Community Memorial Health System’s Director of Food and Nutrition. Jordan and Dr. Frochtzwajg discuss the new Outpatient Nutrition Services program that is now available at CMHS Centers for Family Health locations across Ventura County, as well as the new online ordering system that will be rolling out to physicians, staff and patients at Community Memorial Hospital this spring!

For more information on the Community Memorial Health System Outpatient Nutrition Services program, visit: Link to YouTube interview

CMHS Patient Visitation Policy

We are now allowing 2 visitors at a time for inpatients. For details and updates to our Visitation Policy please go to the CMHS Homepage at CMHSHealth.org.

Do we have your correct address?

Each Medical Staff member acknowledges that their current contact information will be kept up to date.  Designating a specific contact address, either email or traditional mail, whereby the member can be contacted for official medical staff purposes. The member is responsible for notifying the Medical Staff within ten (10) days of any change in this address, and accepts responsibility for all communication directed to this address by the Hospital and Medical Staff.

The following should be kept up to date:

  • Office Address
  • Email*
  • Office phone*
  • Home Address*
  • Cell phone*

*Not shared – held Confidential, unless you grant permission.

Info Blocking Law – Beginning today: April 5, 2021

Federal Rule on OpenNotes and Results Release

To comply with the Final Act of the 21st Century Cures Act, starting April 5th, CMHS will begin implementing changes to support seamless and secure patient access to their electronic health information, including clinical notes and test results. The new federal regulations are designed to acknowledge the important role patients play in their care teams and to promote patient centered care.

When these changes are complete, patients will be able to immediately view the following documents:

  • Office visit notes including telemedicine and telephone notes
  • Imaging narratives including radiology and EKG reports
  • Laboratory results
  • Pathology report narratives
  • Procedure notes

The following exceptions apply:

  • Psychotherapy notes
  • Information compiled in a reasonable anticipation of or use in a civil, criminal or administrative action or proceeding
  • HIV antibody results
  • Positive drug abuse screen
  • Positive hepatitis antigen results
  • Pathology results demonstrating malignancy

Patients will be able to view office notes once they are closed and clinical labs and radiology reports once they are resulted. The clinician does NOT have to verify the result before it is made available to the patient. We understand this may cause many patients great stress and anxiety, however the mandate does not allow this to be a reasonable cause to delay the release of the information. Only if the provider feels viewing the note can cause substantial risk of harm to life or physical safety of the patient or another person can a delay be validated.

COVID results will be the first results that we will begin releasing to patients on the April 5th compliance date. From that point, we will keep you updated on the progress of these changes and provide further education on this process.

There is no opt out of this federal mandate and we will do our best to keep our patients informed and protected while still maintaining compliance.

Graphic Current state of COVID (click on image to enlarge)

 

CMHS Weekly Medical Staff Calendar – April 5 – 9

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update for Medical Staff - Teams
12:00 pm JWM Education Conf – Zoom

12:30 pm – Interdisciplinary Practice Cmte – QCR

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

12:15 pm OB/GYN Cmte – BR/Teams
12:00pm Patient Safety & Quality
Committee– Teams

12:15 pm Cardiac Division Cmte – NA
(front) or Teams TBD
7:30am OVCH ED Subcommittee - Teams

Final Thoughts

“Only those who will risk going too far can possibly find out how far one can go.”
T.S. Eliot

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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Starting Monday, Patients Can Read Your Notes: 5 Key Things – Medical Staff Voice – Special Edition – April 4, 2021

Starting Monday, Patients Can Read Your Notes: 5 Key Things

Monday, April 5 is the official start of a US law requiring healthcare organizations to provide patients with free, full, and immediate electronic access to their doctor’s clinical notes as well as test results and reports from pathology and imaging.

The mandate, called “open notes” by many, is part of the 21st Century Cures Act, a wide-ranging piece of federal healthcare legislation. The previous deadline of November 2, 2020 for enacting open notes was extended last year because of the exigencies of the COVID-19 pandemic.

Organizations must provide access via patient portals to the following types of notes: consultations, discharge summaries, histories, physical examination findings, imaging narratives, laboratory and pathology report narratives, and procedure and progress notes. Noncompliant organizations will eventually be subject to fines from the US Department of Health and Human Services for “information blocking.”

Medscape Medical News reported on the mandate last year and some readers said it was an unwelcome intrusion into practice. Since then Medscape has run additional open notes stories about physician concerns, a perspective essay addressing those fears, and a reader poll about the phenomenon.

Now, as the legislation turns into a practical clinical matter, we offer five key points for clinicians to consider.

1 – Clinicians Don’t Have to Change Writing Style. The new law mandates timely patient access to notes and test results, but doesn’t require that clinicians alter their writing, says Scott MacDonald, MD, an internist and electronic health record medical director at UC Davis Health in Sacramento, California. “You don’t have to change your notes,” he says. However, patients are now part of the note audience and some healthcare systems are directing clinicians to make patient-friendly style changes.

Everyday experience should guide clinicians when writing notes, says one expert.

“When you’re not sure [of how to write a note], just mirror the way you would speak in the office — that’s going to get you right, including for mental health issues,” advises Leonor Fernandez, MD, an internist at Beth Deaconess Israel Medical Center, Boston, Massachusetts, in her “take-away” comments in the online video, How to Write an Open Note.

According to a 2020 Medscape poll of 1050 physicians, a majority (56%) anticipate that they will write notes differently, knowing that patients can read them via open notes. Nearly two thirds (64%) believe that this new wrinkle in medical records will increase their workload. However, actual practice suggests that this is true for a minority of practitioners, according to the results from a recent study of more than 1000 physicians in Boston, Seattle and rural Pennsylvania, who already work in open notes settings. Only about one third (37%) reported “spending more time on documentation.”

Note writing is going to change because of the addition of the patient reader — and something will be lost, argues Steven Reidbord, MD, a psychiatrist in private practice in San Francisco. By watering down the language for patients, “you are trading away the technical precision and other advantages of having a professional language,” comments Reidbord, who blogs for Psychology Today and has criticized the open notes movement in the past.

However, years of investigation from OpenNotes, the Boston-based advocacy and research organization, indicates that there are many gains with patient-accessible notes, including improved medical record accuracygreater medication adherence, and potentially improved healthcare disparities among a range of patient types. In a 2019 study, researchers said that worry and confusion among note-reading patients are uncommon (5% and 3%, respectively), which addresses two criticisms voiced by multiple Medscape readers last year.

2 – Some Clinical Notes Can Be Withheld. The new rules from the federal government permit information blocking if there is clear evidence that doing so “…will substantially reduce the risk of harm” to patients or to other third parties, wrote Tom Delbanco, MD, and Charlotte Blease, PhD, of OpenNotes in Boston in a Medscape commentary in February.

There are also state-level laws that can supersede the new US law and block access to notes, points out UC Davis’ MacDonald. For example, California law dictates that providers cannot post cancer test results without talking with the patient first.

The OpenNotes organization also points out that, with regard to sensitive psychotherapy notes that are separated from the rest of a medical record, those notes “can be kept from patients without their permission, and such rules vary state by state.”

3 – Some Patients Are More Likely Readers. Some patients are more likely to peer into their files than other, says Liz Salmi, senior strategist at OpenNotes, who is also a brain cancer patient. “Those patients who have more serious or chronic conditions…are more likely to read their notes,” she commented to Medscape Medical News.

A new study of nearly 6000 medical oncology patients at the University of Wisconsin confirms that opinion. Patients with incurable metastatic disease were much more likely than those with early-stage, curable disease to read notes. Notably, younger patients were more likely than older ones to access notes, likely the result of generational tech savvy.

Despite the unpredictability of serious disease such as cancer, oncology patients find satisfaction in reading their notes, say experts. “We’ve overwhelmingly heard that patients like it,” Thomas LeBlanc, MD, medical oncologist at Duke University, Durham, North Carolina, where all patients already have access to clinicians’ notes, told Medscape Medical News in 2018.

4 – You Are Part of the Avant Garde. The United States and Scandinavian countries are the world leaders in implementing open notes in clinical practice, OpenNotes’ Blease told Medscape Medical News.

“It’s a phenomenal achievement” to have enacted open notes nationally, she said. For example, there are no open notes in Northern Ireland, Blease’s home country, or most of Europe, she points out.

In the US, there are more than 200 medical organizations, including at least one in every state, that were voluntarily providing open notes before April 5, including interstate giants such as Banner Health and big-name medical centers such as Cleveland Clinic.

It may be hard for the US to top Sweden’s embrace of the practice. The national open notes program now has 7.2 million patient accounts in a country of 10 million people, noted Maria Häggland, PhD, of Sweden’s Uppsala MedTech Science Innovation Center during a webinar last year.

5 – The Start Day Will Come and You Won’t Notice. “When April 5 happens, something brand new is going to happen symbolically,” says Salmi of OpenNotes. Its importance is hard to measure, she explains. “Patients say they trust their doctor more because they understand their thinking with open notes. How do you value that? We don’t have [financial] metrics for that.”

UC Davis’ MacDonald suggested that open notes are both new and not new. Last fall, he predicted that the launch day would come and few clinicians would notice, in part because many patients already access truncated information via patient portals.

However, there are “sensitive issues,” such as with adolescents and reproductive health, where “we know that some parents have sign-in information for their teen’s portal,” he commented. With clinical notes now on full display, potential problems “may be out of our control,” MacDonald acknowledged.

Still, the Sacramento-based physician and IT officer acknowledged that concerns about open notes may be a bit inflated. “I’ve been more worried about reassuring physicians that everything will be ok than what’s actually going to happen [as the law takes effect],” MacDonald said.

The OpenNotes organization is grant-funded and staff have disclosed no relevant financial relationships.

CMO Commentary

CMHS has been working on the implementation of this law as it relates to compliance, legal, and patient and physician care concerns for months. Contributions and counsel has been provided by IT, EHR Governance Committee, in house legal counsel, HIM department and others. Our work product is still evolving, but we are prepared and ready to be compliant with the law tomorrow.

As a practicing physician, I see both the benefits and potential harm in this implementation. The benefits substantially outweigh the downside, when the big picture is considered. Some physicians forget the fact that patients currently have the right to request and review all their records.

We welcome Medical Staff input and perspective on the new law. Please use the comment opportunity at the bottom of this blog.

For more extensive detail and understanding of the nuances of this law, please click on this link: opennotes.org

Stan Frochtzwajg, M.D.
Chief Medical Officer

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

 

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Medical Staff Voice – March 29, 2021

Doctors Day 2021 – Thank you to all our Doctors!

In honor of Doctors’ Day , March 30, 2021, E.M.P.O.W.E.R. will be  providing complimentary coffee from Simones, in the Ocean Tower Physician Lounge.  If you would like a complimentary specialty coffee, please proceed to Simones and present your CMHS badge. A gift of appreciation from CMHS will be dropped off at your office on Friday March 26 or Monday March 29th.

Happy Doctors Day from your E.M.P.O.W.E.R. Team!

JW Moore Tuesday, March 30, 2020, CME Conference -“Diagnosis & Management of Hypertension during Pregnancy & Postpartum.”

Kathryn Sharma, M.D.; Perinatologist, CMHS, will present a lecture on “Diagnosis & Management of Hypertension during Pregnancy & Postpartum.” At the end of the conference, the learner should be able to: 1) Accurately diagnose hypertensive disorders during pregnancy and postpartum, 2) Identify treatment goals for hypertension during pregnancy and postpartum, 3) Identify preferred treatment modalities for both acute severe and chronic hypertension, and 4) Provide instruction on counseling patients for prognosis and prevention in future pregnancies.

The conference will take place on March 30, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 2-A credit.

Information Blocking Rule

The Information Blocking Rule takes effect on April 5, 2021. CMA has published the attached FAQ on the rule.  As defined in the 21st Century Cures Act, information blocking is a practice that is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information. Put another way, information blocking is any act (or failure to act) that artificially restricts the free flow of patient health information. Starting on April 5, 2021, physicians are required to respond to any legitimate request to exchange or provide access to EHI stored in their EHR. Such a request could come from a patient, another provider, a health plan (seeking information for clinical purposes), or a public health agency.  More details are in this link: CMA Federal Info Blocking Rule FAQ (032321)

The eight (8) types of clinical notes that must be shared are outlined in the United States Core Data for Interoperability (USCDI), and include:

  • consultation notes
  • discharge summary notes
  • history & physical
  • imaging narratives
  • laboratory report narratives
  • pathology report narratives
  • procedure notes
  • progress notes

Clinical notes to which the rules do not apply:

  1. Psychotherapy notes that are separated from the rest of the individual’s medical record and are recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session. Note: All clinicians and organizations are required to share medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.
  2. Information compiled in reasonable anticipation of, or use in a civil, criminal or administrative action or proceeding.

Quest Lab holds on test results released to patients will be removed under Cures Act 

What is changing?

Due to changes in federal rules under the 21st Century Cures Act, healthcare providers, including laboratories, will no longer be able to intentionally delay the release of test results to patients as of April 5, 2021 unless a delay is permitted under one of the specific exceptions to the IB rules.

What this means for Quest test reporting after April 5th 

In compliance with the 21st Century Cures Act, any existing requests healthcare providers have with Quest to delay test results from being released to patients will be removed.

 For patients, we will release most results in MyQuest™ at or about the same time the results are released to the ordering provider. Only patients with a MyQuest™ account receive electronic test results without specifically requesting the results. Patients are not required to set up a MyQuest™ account to receive their results, though it is preferred.

Quest is currently evaluating whether certain tests qualify for an IB exception according to all Cures Act requirements. California, Oregon, Maryland, and Pennsylvania have state regulations in place which determine notification and/or the timing for releasing certain or all patient lab results. We will continue to comply with state laws.

Medical Staff Voice Live

In Episode Four of the Medical Staff Voice Live, CMHS Chief Medical Officer Dr. Stan Frochtzwajg sits down with cardiothoracic and cardiovascular surgeon Jennifer Wan, M.D. Dr. Frochtzwajg and Dr. Wan discuss her extensive education, knowledge, and training and the advanced surgical procedures she performs right here at CMH in Ventura. Click on this Link to the video interview.

For more information about the Heart & Vascular program at Community Memorial Hospital, visit https://www.cmhshealth.org/services/h….

For more information about Dr. Jennifer Wan, visit http://www.californiacardiovascular.com/.

CMHS Weekly Medical Staff Calendar – March 29 – April 2

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update for Medical Staff - Teams

12:00 pm CME Cmte - Teams
8:30 am ED Division – BR/Teams

12:00 pm JWM Education Conf – Zoom

12:00 pm Board of Trustees – BR

HAPPY DOCTOR’S DAY

12:30 pm OVCH Campus Committee- TEAMS

4:30 pm COVID19 Task Force Meeting - Teams
4:00 pm Surgical M&M - Virtual

Final Thoughts

“Not what we have, but what we enjoy, constitutes our abundance.”
– Epicurus

Keep the faith,

Stan Frochtzwajg, M.D.
Chief Medical Officer

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

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
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 22, 2021

CMHS Updates

  • We came through our DNV accreditation survey last week with flying colors, thanks to our remarkable Hospital, Nursing, and Medical Staff.  Also, a shout out to the Quality Department for their stewardship and support.
  • Eye protection is no longer required on nursing floors but is required in patient rooms.
  • As of this publication, 72% of our Hospital Staff have been COVID vaccinated.
  • The current Hospital patient visitation policy is posted on the CMHShealth.org home page.

JW Moore Tuesday, Noon CME Conference -“Emergency Medical Treatment & Labor Act (EMTALA): Physician Responsibilities.”

Ann McCullough, J.D., Polsinelli Law Firm, will present a lecture on “Emergency Medical Treatment & Labor Act (EMTALA): Physician Responsibilities.” At the end of the conference, the learner should be able to: 1) Recognize when a patient has “come to the emergency department” for EMTALA purposes, 2) Describe on-call physician obligations under EMTALA, and 3) Distinguish between an appropriate transfer and an inappropriate transfer.

The conference will take place on March 23, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 2-A credit.

If you would like to attend this meeting, please contact CME Coordinator Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

EMPOWER Committee – Outdoors Activity

On behalf of the EMPOWER Committee we would like to invite you to a guided hike around the estuary (that flows into the ocean north of surfer’s point) on Sunday March 28, at 8 am. We will meet at the main street parking lot by the bike path.

We are fortunate to have landed Ventura Land Trust Executive Director, Derek as a tour guide.

Please email or text Kala Parker if you have any questions.
805-585-7342

EMPOWER Committee – Women’s Physicians group

The Women’s Physicians Committee for the EMPOWER group would like to invite you to a fun event this Saturday March 27th at 1 pm at the Painted Cabernet in Oxnard at the Collections. We will be sitting outside,  painting, and enjoying wine and food from Luna Grill.

Please sign up with the link below if you would like to join us!

Please let me know if you have any questions and I look forward to meeting you!

Sandhya Patel, MD FAAP
Ventura Coast Family Care
Internal Medicine/Pediatrics

EHR Downtimes – Heads up

Meditecth: Saturday, March 27, 7 pm – March 28, 7 am (12 hours)

PatientKeeper: April 5, Midnight x 5 hours.

CMHS Drug Shortage Update (click on chart to enlarge)

Elevated Lactic Acid Reflex Protocol

The Laboratory has initiated a new protocol for elevated lactic acid.  If the result is >2.0 a reflex is set up in the background. The lab will set up a new lactic acid timed draw 3 hours from the first critical lactic acid.

Medical Staff Voice Live: Episode Three with Dr. Pedro Eva

Welcome to Episode Three of the Medical Staff Voice Live! In this week’s episode, CMHS Chief Medical Officer Dr. Stan Frochtzwajg sits down with Dr. Pedro Eva, our new inpatient Psychiatrist. Dr. Frochtzwajg and Dr. Eva cover a variety of topics, from Dr. Eva’s unique background and training, to his hobbies and interests, and of course, the services he provides to our patients at Community Memorial Hospital.


Link to YouTube interview

Flat curve  for 2  weeks – Race: Vaccinations vs. Variants

Health Insurances Profits

CMHS Weekly Medical Staff Calendar – March 22 – 26

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update for Medical Staff - Teams

12:00 pm CME Cmte - Teams
12:00 pm JWM Education Conf – Zoom

5:30 pm CMHS Credentials Cmte- QCR & Teams

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

12:00 pm Bioethics Cmte – Teams

12 :00 pm EMPOWER Teams
7am HIM Cmte - Teams

Final Thoughts

“Experience is the hardest kind of teacher. It gives you the test first and the lesson afterward.”
– Oscar Wilde

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 15, 2021

JW Moore Tuesday, Noon CME Conference -“Fatty Liver Disease & the KP SCAL Approach”

Steven Steinberg, M.D., Regional Chief of Family Medicine, Southern California Permanente Medical Group, Kaiser Permanente, and Amandeep Sahota, M.D., Assistant Medical Director of Transplant Services KPSCALwill present a lecture on “Fatty Liver Disease & the KP SCAL Approach.”

At the end of the conference, the learner should be able to: 1) Differentiate between clinical features & presentation of NAFLD, NASH, and cirrhosis, 2) Diagnose NAFLD & severity based on clinical profile and non-invasive tests (lab results, imaging) in order to develop recommended care plan, and 3) Manage treatment and counsel patients who may be at risk for cirrhosis.

The conference will take place on March 16, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 2-B credit.

If you would like to attend this meeting, please contact CME Coordinator Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

Vaccination Prioritization from Public Health – Phase 1B – March 15th
Individuals aged 16-64 who are deemed to be at the very highest risk to get very sick from COVID-19 because they have the following severe health conditions:
  • Cancer, current with weakened immune system
  • Chronic kidney disease, stage 4 or above
  • Chronic pulmonary disease, oxygen dependent
  • Down syndrome
  • Solid organ transplant, leading to a weakened immune system
  • Pregnancy
  • Sickle cell disease
  • Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies (but not hypertension)
  • Severe obesity (Body Mass Index ≥ 40 kg/m2)
  • Type 2 diabetes mellitus with hemoglobin A1c level greater than 7.5%

OR

If as a result of a developmental or other severe high-risk disability one or more of the following applies:

  • The individual is likely to develop severe life-threatening illness or death from COVID-19 infection
  • Acquiring COVID-19 will limit the individual’s ability to receive ongoing care or services vital to their well-being and survival
  • Providing adequate and timely COVID care will be particularly challenging as a result of the individual’s disability.

To protect confidentiality, verification documentation of the diagnosis or type of disability is not required but instead anyone meeting the eligibility requirements will be asked to sign a self-attestation that they meet the criteria for high-risk medical conditions or disabilities

Medical Staff Voice Live

In episode two of the Medical Staff Voice Live, CMHS Chief Medical Officer Dr. Stan Frochtzwajg sits down with Centers for Family Health Physician Dr. Cathy Kim. Dr. Kim is a Board Certified Family Practice Physician who specializes in Integrative and Functional Medicine. Tune in to learn more about Dr. Kim’s background, training, and unique approach to patient care.
Click this link to the YouTube Video

March 9, 2021 — The U.S. Preventive Services Task Force (USPSTF) has released an updated, final recommendation for CT lung cancer screening that lowers the starting age from 55 to 50 and adjusts smoking history from 30 pack years to 20 pack years. The final recommendation was published March 9 in JAMA.

Click on the link for the full article: Screening for Lung Cancer_ USPSTF 2021

DNV Survey – March 15 – 17, 2021

The DNV, our Health System accreditation organization, is conducting their regular survey, virtually this week. They will be visiting our two campuses, CMH and OVCH, as well as our CFH clinics.

CDC gives go-ahead for mask less gatherings of the fully vaccinated

The Centers for Disease Control and Prevention has updated its guidance on COVID-19 vaccinations, clearing the way for fully vaccinated individuals to gather with other vaccinated people indoors without masks or social distancing.

The CDC considers individuals to be fully vaccinated about two weeks after receiving their complete inoculation. So far, there are three available vaccines in the U.S., including the Pfizer-BioNTech and Moderna vaccines, which require two doses, and the Johnson & Johnson vaccine, which requires just one.

“We know that people want to get vaccinated so they can get back to doing the things they enjoy with the people they love,” CDC Director Rochelle Walensky said in a statement. “There are some activities that fully vaccinated people can begin to resume now in the privacy of their own homes. Everyone—even those who are vaccinated— should continue with all mitigation strategies when in public settings.”

Already, the U.S. has administered more than 90 million vaccines, according to the CDC. There are nearly 29 million cases of Covid-19 in the U.S., resulting in more than 522,000 total deaths. President Biden previously advised that the U.S. will have enough vaccine supply for all Americans by the end of May 2021.

While vaccinated groups will be able to resume some activities with other vaccinated people, the CDC still urged Americans to take precautions, including wearing a facemask around others and continuing to practice social distancing.

CMHS Weekly Medical Staff Calendar – March 15 – 19

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update for Medical Staff - Teams

12:00 pm Cancer Cmte – Virtual
12:00 pm JWM Education Conf – Zoom

12:15 pm Pharmacy & Therapeutics Cmte – TEAMS

4:30 pm Anesthesia Cmte – BR/Teams
12:00 pm General CA Conf – BR

7:45 am- Pediatrics Cmte/Neonatal
Cmte-BR/Teams

12:15 pm OB/GYN Dept – BR/Teams
12:00 pm Radiation Safety/Radiology Division – Teams

12:15 pm Inpatient Medicine Division – Teams

4:30 pm COVID19 Task Force Meeting – Teams

5:30 pm Surgery Dept - Teams

Final Thoughts

“You never know what worse luck your bad luck has saved you from.”
– Cormac McCarthy

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 8, 2021

JW Moore Tuesday, Noon CME Conference -“Cardiac Complications of COVID”

Irving Loh, M.D., Cardiologist and founder of the Ventura Heart Institute will present a lecture on “Cardiac Complications of COVID-19.”

At the end of the conference, the learner should be able to: 1) Have a more comprehensive understanding of the cardiovascular complications of COVID-19, 2) Discuss the pathophysiology of cardiovascular complications of COVID-19 to better assess & treat patients, and 3) Outline the potential therapeutic options.

The conference will take place on March 09, 2021, from 12:00 pm – 1:00 pm, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 2-B credit.

If you would like to attend this meeting, please contact CME Coordinator Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

Medical Staff Voice – Live – Inaugural Interview
by Tracey Shoop

 Prior to the Pandemic, I was able to bring new physicians through the hospital and to many of your offices to introduce,  and to spotlight their areas of expertise.  Well, out of our Pandemic we have created a new, quick way for introductions-  our MEDICAL STAFF VOICE LIVE.   MSV LIVE will video record interviews with new (newer) physicians on our CMHS Medical Staff, as well as highlight service lines.   With the help of Dr. Stan Frochtzwajg, CMO and Briana Kallas, Marketing Department Director, we have launched our first MSV LIVE!  Our goal is to heighten the awareness of new services that  physicians provide in under 15 minutes!  The interviews are professionally produced in our very own studio and will be posted on YouTube .

A YouTube “playlist” has also been created for the MSV LIVE on our CMHS YouTube channel.  This allows us to categorize and collect all the MSV LIVE episodes on one YouTube playlist, which makes it easy for users to watch multiple episodes or get “caught up” on content they may have missed.  Each episode will still show up in the “recent uploads” category on our channel as well.  The Marketing Department  will also be publishing the MSV LIVE on social media. 

 I hope you enjoy the link below and find this useful! Please feel free to subscribe to the CMHS YouTube channel and like us on social media!
 https://youtu.be/1nlJn_nX-Dw

iConnect Merge new PACs Imaging Software 

The CMHS IS department will be conducting a series of trainings on the new system iConnect (aka iCA, Merge). CMHS PACS users experienced a disruption at the end of 2020 and CMHS has been working on migrating the PACS users to the more stable system, iConnect. Below you will find multiple training options to attend. Feel free to click on the link to your desired date and time and you will be connected to a meeting room with a trainer. If you cannot attend one of the scheduled trainings, please see the attached iConnect job aid with instructions on how to log into iConnect, basic navigation, and basic functionality.

 Tuesday – March 9th from 7am to 8am
Click here to join the meeting

Tuesday – March 9th from 12pm to 1pm
Click here to join the meeting

Wednesday – March 10th from 7am to 8am
Click here to join the meeting

Wednesday – March 10th from 12pm to 1pm
Click here to join the meeting

Friday – March 12th from 7am to 8am
Click here to join the meeting

Friday – March 12th from 12pm to 1pm
Click here to join the meeting

Prior to attending the training, it would be prudent to confirm that you have access to the iConnect system. If you do not have access, please call the help desk at (805) 652-5090 and they will be able to assist.

We understand that the transition from the older ZDA PACS application to the new iConnect has caused disruptions and we thank you for your patience. We are committed to restoring and enhancing the level of functionality you previous had.

iConnect link: User Aid

Frank Martin
Associate Director of Information Systems

CMHS

Updated CMHS Lab Draw Stations – Camarillo, CMH, and Ojai

The Centers For Family Health Camarillo location at 422 Arneill Rd is open for lab draws Monday -Friday 7:30am-4pm.

In addition, patients can also go to the following Hospital sites to have lab draws:

Community Memorial Hospital Mountain Tower
147 North Brent St.
Hours: Monday through Friday 6:30 AM to 6 PM, Saturday 6:30 AM to 2:30 PM.

Ojai Valley Community Hospital
Hours: Monday through Friday 7 AM to 7:30 PM, Saturday through Sunday 8 AM to 2:30 PM.

Unfortunately, CMHS Lab does not accept HMO’s, Cigna or Gold Coast Medi-Cal.

Below is the website link for CMHS outpatient lab draw stations:
Link to Outpatient Draw Stations

Metformin Removed from Inpatient Formulary.

Most often we remember that renal function and the use of contrast agents must be considered when using metformin. But for an acutely ill patient, the drug’s benefits do not outweigh the risks during a short hospital stay where renal function could change, hypoxemia is possible, and lesser remembered comorbidities contributing to lactic acid accumulation may be present (e.g., concurrent liver disease, alcohol abuse, unstable or acute heart failure, decreased tissue perfusion or hemodynamic instability).

Many institutions have moved away from metformin to regular sliding scale insulin when needed for these patients.

Metformin is still allowed at the CCC and for SWING patients because those are long-term care patients, and do not fall under inpatient care.
Renu Bajwa, PharmD

This March we celebrate National Nutrition Month® and RD Day at CMHS

National Nutrition Month® (NNM), created by the Academy of Nutrition and Dietetics (AND), is a nutrition education and information campaign celebrated annually each March. The national campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. As part of NNM,

March 10th, 2021 is Registered Dietitian (RD) Day. Registered Dietitians (RD) or Registered Dietitian Nutritionists (RDN) are professionals that are trained in helping individuals and communities make choices to support healthier lives through food and nutrition. RDs work in a variety of settings such as schools, research labs, outpatient clinics, and hospitals.
Click on link for full Poster: National Nutrition Month CMHS March 2021

Alon Steinberg, M.D. – Prone restraint cardiac arrest: A comprehensive review of the scientific literature and an explanation of the physiology

Just published in Medicine, Science and the Law, Feb. 25, 2021.  Click on the Link to read the complete Review:  Alon Steinberg – Prone restraint cardiac arrest_ A comprehensive review of the scientific literature and an explanation of the physiology

CMHS Weekly Medical Staff Calendar – March 8 – 12

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update
for Medical Staff - Teams
10:00 am Audit & Compliance Cmte – BR

12:00 pm JWM Education Conf – Zoom

5:00 pm Medicine Cmte – BR & Teams
12:00 pm General CA Conf – BR

12:30 pm Family Medicine Cmte –Teams
TBD
12:00 pm Quality & Patient Safety Committee – Teams

12:15 pm Cardiac Division Cmte –Teams

4:30 pm COVID19 Task Force Meeting - Teams
7:30am OVCH ED
Subcommittee - Teams

Final Thoughts

“We cannot change anything until we accept it. Condemnation does not liberate, it oppresses.”
– 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
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 1, 2021

COVID-19 Updates

  • Our CMH COVID inpatient numbers continue to drop. We’re down to 18 positive  inpatients this morning.
  • We are ending our community for first COVID vaccine program located at CMH this week, and migrating the vaccination program for the community patients to our clinic system.
  • We are converting 5W back from a COVID floor to its traditional  Surgical floor status.
  • Although we are still in the Purple Zone, with our overall improving COVID numbers, we are rolling out a limited Hospital visitation program, starting today.  Details will be forthcoming.
  • CMHS has been assisting the County of Ventura in administering vaccines to our citizens in Ojai, at Nordhoff High School. We are in discussions with the County on starting to assist with vaccinating our school teachers.
  • Over 2/3 of our Hospital Staff have been vaccinated.
  • We resumed surgery scheduling at Ojai 2 weeks ago.

JW Moore Tuesday, March 2 CME Conference – CANCELLED

This is just a reminder that we will NOT be having a JW Moore noon conference this week, Tuesday March 2nd, due to the speaker needing to reschedule on short notice.

We will resume on Tuesday, March 9th, with Dr. Irving Loh, Cardiologist, who will be speaking on Cardiac Complications of COVID-19.

SUSPICIOUS/PHISHING EMAILS

CMHS has seen a sharp increase in the amount of phishing emails targeting our users. Cyber-attacks (including phishing) in the healthcare industry has grown by 45% since November 2020.

Reporting suspicious emails is the number one way you can prevent cyber-attacks. Below are some tips for you to follow in helping to keep CMHS safe.

 Do’s:

  • If you have clicked on a link or opened an attachment in a suspicious email – Call the help desk immediately (805) 948-5090.
  • What to do when you see a Suspicious Email in your inbox.
    • Report it! See How to Report a suspicious email as Junk or Phishing (below).

Don’ts:

  • Don’t delete suspicious email. We will securely delete the email once our investigation concludes.
  • Don’t forward suspicious email as this may spread the problem and the likelihood of the person you forwarded the email to clicking a link or opening an attachment by mistake.


(Click on the image to enlarge)

Medical Staff Voice – Live!

We did it!  Our first video recorded interview, in an ongoing series to introduce new physicians on our CMHS Medical Staff.  We’ve sought to heighten the awareness of Medical Staff to the unique new services that these physicians provide.  The interviews are professionally produced in our very own studio and will be posted on YouTube. We will announce when and who has been interviewed in the Medical Staff Voice and post a new dialogue weekly. Our goal is to keep the interview under 15 minutes.  We have a long list of physicians we plan to present, but if there is someone you’d like to learn about, let us know.

Saranya Reghunathan, M.D., ENT  & Laryngology specialist at our CMHS Centers for Family Health, graciously agreed to launch our inaugural interview.  In the 15 minute interview, I was impressed how much she was able to teach me about laryngology. The interview also provides us with a glimpse into the person, as well as the professional. Dr. Reghunathan is poised, well spoken and has a lighthearted side to her.

A special acknowledgement and thank you to the people who helped facilitate and create this program.  Tracey Shoop helped develop the concept and kept us on task.  Mike Ellingson sponsored and saw to the creation of the production studio. Briana Kallas, Director of Marketing, provided the expertise and vision in its final realization, and Christopher Charles saw to the technical filming and sound, as well as the construction of the studio.

Infection Prevention Newsletter – Bug Bites

Full issue: Bug Bites 2.2021

Field EKG Mounting Form

On Friday, February 19, 2021, the new Field EKG Mounting Form was launched. There was a soft roll-out through the end of February while all affected parties trained their respective teams.  The start date of this new process and form is Monday, March 1, 2021. This project involved our ED, HIM, IT , Patient Access departments as well as Ventura County EMS Leadership and the training leads for all ambulance services.

The initial request came from the Cardiology Division. Their concern involved Cardiologists being called to consult on an ED patient brought in via ambulance.  In this scenario, the Cardiologists did not have access to the field EKG and other pertinent information to allow them to make a comprehensive judgement regarding the patient’s condition.  This was because the field EKGs, are scanned into PICIS and are not distributed.

The Cardiologists requested that the field EKGs be made available in Patient Keeper so they have access to these results when consulted on an ED patient brought in by ambulance. This new process involves securing the field EKG to a new form and scanning this document into Meditech, which will transfer to Patientkeeper.

Attached is the PowerPoint presentation link which addresses the details and the locations the EKG Mounting form can be found in Patientkeeper: New Field EKG Mounting Form Process Kick-off

The Art of medicine: a patient’s perspective
– Michele Luckenbaugh/patient advocate – Feb. 11, 2021

[excerpt] One of the most sacred and intimate relationships is that which exists between patient and physician. A patient shares feelings and fears as he traverses the path of illness or chronic disease. As roadblocks in health emerge, a patient looks to his physician for encouragement and guidance. This is especially important to the older patient since, with advancing age, comes the potential increase in health-related issues.The world of medicine has certainly evolved from when Sir William Osler practiced and instructed future physicians. The corporate world has overtaken how medicine is practiced. Smaller independent practices that provided autonomy for the physician have practically disappeared. 

Increases in governmental regulation, restrictions additionally imposed by health insurance corporations, and mandates of health care systems have all pushed physician burnout and suicide rates to an all-time high. Meditation may somewhat help to lessen stress, but it certainly is not a long- term solution. The major burden of responsibility should be placed on corporate medicine’s shoulders.  Many physicians feel that they are watching their lifeblood drain out; their love of medicine, which initially drew them into the field, is evaporating. The root causes of this critical situation are, seemingly, an ever-increasing workload, an inefficient electronic health record system, high-stress levels innate to the job,  and the loss of autonomy in the manner in which physicians practice medicine. All have had a deleterious effect, all forming the “perfect storm.”
Link to full article

Types of COVID-19 Vaccines Work (click on the image to enlarge)

Common COVID-19 Variants

CMHS Weekly Medical Staff Calendar – March 1 – 5

MondayTuesdayWednesdayThursdayFriday
12:00 pm JWM Education Conf – Zoom

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

12:15 pm OB/GYN Cmte – BR

5:15 pm Ethical Allocation of Scarce Resources Triage Team
12:30 pm OVCH Campus Committee /Provision of Patient Care Committee TEAMS

4:30 pm COVID19 Task Force Meeting - Teams
4:00 pm Surgical M&M -
Virtual
Final Thoughts
“The time you enjoy wasting is not wasted time.”
– Bertrand Russell
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 linkTracey 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 22, 2021

JW Moore Tuesday, February 23, 2021, CME Conference via ZOOM – “Critical Conversations: A Framework for Serious Illness Communication.”

Colin Scibetta, M.D., Palliative Care Specialist & Internist at CMHS will present a lecture on “Critical Conversations: A Framework for Serious Illness Communication.” At the end of the conference, the learner should be able to: 1) Identify personal and professional barriers to initiating conversations around treatment goals and preferences with patients, 2) Discuss the evidence-based benefits of serious illness conversations for patients and families, 3) Identify the role that emotional responses play in serious illness conversations, 4) Understand ways to identify and respond to strong emotions in a clinically competent and empathic way, and 5) Describe clinical tools designed to facilitate earlier and higher quality conversations with patients/families around serious illness.

The conference will take place on February 23, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 2-B credit.

If you would like to attend this meeting, please contact CME Coordinator, Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

Medical Staff Voice (MSV) – Live!

Over the past year, we’ve added, interviewed and oriented nearly 100 new physicians and allied health professionals to our Medical Staff. In years past you would get to know them in meetings, social gatherings the doctor’s dining room and surgical lounges.  Our physician liaison, Tracy Shoop would often bring new physicians around for introductions.  With COVID that all fell by the wayside. Well, we think we’ve figured out a second best way to meet and learn what all the new physicians have to offer in the way of new procedures, skills and referral opportunities.

We are planning to launch our own MSV Live, via TEAMS for the Medical Staff.  Our goal is to have a virtual interview of a new physician weekly, from 12:30 – 12:45 pm.  The interview will be limited to 15 mins and take place during most physician’s lunch times which we hope will be convenient. You can view and hear the interview on your cell phone, laptop or any device that allows you to download TEAMS.

We expect our own internal “YouTube” channel to go live in March. Stay tuned for updates.

PK Down Time

IT would like to give everyone advanced notice of the following planned downtime this week:

Wednesday, 2/24, 0300-0430: To help with the reports of PK Slowness/Freezing, IT will be initiating a rolling reboot of all PK mobilizers. This will be done one at a time, so  PK will remain up. Users should expect some interruptions such as getting booted out, but you will be able to log back in immediately.

If you are an MD or DO, consider joining the Ventura County Medical Association (VCMA)!

VCMA established in 1890, is a professional association of physicians throughout Ventura County who are dedicated to addressing local health issues of concern to their patients and their profession. 

VCMA and its physician leadership have always been an integral part of the formation of medical care in Ventura County, being patient advocates on community committees and boards, as well as representing their colleagues at local, state and national legislative arenas.

There are so many benefits: practice management, referral services, workshops, social functions, and so much more. You matter and so does your membership! Please contact Mary Carr, Executive Director, marycarr@venturamedical.org or by phone (805) 484-6822.

Headed in the right direction (click on image to enlarge)

Importance of prompt vaccine rollout (click on image to enlarge)

CMHS Weekly Medical Staff Calendar – February 22 – 26

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update for Medical Staff – Teams

12:00pm Cancer Cmte – Virtual
8:30 am Emergency Division – NA (front)

12:00 pm Board of Trustees- BR

12:00 pm JWM Education Conf – ZOOM

5:30 pm CMHS Credentials Cmte- QCR & Teams

5:30 pm Surgery Cmte – NA & Teams
7:00 am CMHS Outpatient Division- BR or Teams

12:00 pm General CA Conf – BR

12:00 pm E.M.P.O.W.E.R. (Employment of Metrics for the Promotion Of Wellness and the Enhancement of Resilience )- TEAMS
7am HIM Cmte Teams

4:30 pm COVID19 Task Force Meeting - Teams

5:30 pm Orthopedic Division - BR

Final Thoughts

“The wish for healing has always been half of health.”
– 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 15, 2021

Successful COVID Vaccination Campaign – Thank you CMHS Hospital Staff

Thank you to our CMHS Hospital Staff for volunteering to assist us in providing so many vaccines to our employees, Medical Staff and last week, to our community.  So many of our community neighbors receiving the vaccines were impressed and grateful with the helpfulness, kindness and attention that our Staff offered. The secret to our success as a Health System is our Hospital and Medical Staff, with guidance by our leadership.

We are finishing our vaccine administration to the public at CMH and transitioning the vaccinations for the community to our CMHS clinics.

CMHS GENERAL STAFF MEETING – TUESDAY, FEBRUARY 16, 2021

Meeting Notice with link will be forwarded to the Medical Staff

6:00 p.m.  – call to order

The quorum requirement for this meeting is 75 Active Medical Staff members.

Reappointment Fines for Active Staff

  • $125 per year if 50% of General Staff meetings (2) are not attended.
  • $125 per year if 50% of Department meetings (2) are not attended

JW Moore Tuesday, Noon CME Conference via ZOOM – “Impaired & Disruptive Behavior- Prevention and Intervention.” 

Steven Schandler, Ph.D., Professor of Psychology at Chapman University, Orange, CA, will present a lecture on “Impaired & Disruptive Behavior- Prevention and Intervention.”  This will be a recording of Dr. Schandler’s presentation that was initially scheduled for December 08, 2020, but due to technical difficulties, had to be canceled.

At the end of the conference, the learner should be able to 1.) Identify the causes & different types of disruption & impairment, 2.)  Implement methods to control and manage stress while treating patients, 3.) Prevent and/or eliminate physician disruption & impairment, 4.) Identify how physicians of different ages, cultures, and gender deal with stress and impairment and burnout, and 5.) Review the methods of intervention for preventing or managing physician impairment

The conference will take place on February 16, 2021, at noon, via ZOOM. This activity qualifies for AMA PRA Category 1 Credit™ & AOA Category 2-B credit.

If you would like to attend this meeting, please contact CME Coordinator Erin Parker at eparker@cmhshealth.org or 805-948-5638, and an invite with a link to the meeting and instructions on how to join will be emailed to you.

Medical Staff Chain of Command – Dr. Carlson, Chief of Staff

I apologize if the following is evident to you; however, we add many new physicians
to our staff each month. My intent below is to clarify the medical staff chain of
command for any who are unaware. Whenever you first experience medical-staff related concerns at work, please contact your Division or Department Chair to help
you address them.

Such physicians are as follows:

  • Anesthesia: Raj Reddy
  • Family Medicine: Margaret Peterson 
  • Medicine: Alon Steinberg 
  • Cardiology Division: Alon Steinberg 
  • Emergency Division: Chris Johnson 
  • Inpatient Division: Christina Desai 
  • Critical Care: Amir Arfaei 
  • Kaiser Hospitalists: Scott Smith 
  • Pacific Inpatient Physicians: Christina Desai 
  • Radiology Division: Jason Barksdale 
  • OB/GYN: Kami Poole 
  • Pediatrics: Lilia Coppa 
  • Surgery: Mike Salehpour 
  • Orthopedic Division: Sohrab Pahlavan 

In the event, you communicated the concern(s) to the identified physician, and yet
it persists, then please express the unresolved concern(s) to any of the following
physicians.

2021 Medical Staff Leaders

  • Chief of Staff: Debby Carlson 
  • Past Chief of Staff: Jeff Brackett 
  • Vice Chief of Staff: Chris Johnson 
  • Secretary/Treasurer: Allison Shuman 

CMHS Drug Shortage Update

At long last,  IV Hydralazine is back in stock and we can lift the limitations that we instituted to preserve the supply! We will be re-stocking pyxis machines today. Thank you for your understanding during the shortage.

The only new shortage to report is injectable haloperidol. This item has been intermittently unavailable but our buyer has been able to secure a steady inventory. Our current stock is approximately a 2.5 month supply. (clicking on the chart will enlarge it in a separate frame).

Oxnard Westminster Free Clinic – Seeking Physician Volunteers

The Westminster Clinic is a non-profit free clinic for patients without insurance in the Ventura County area.  The Oxnard location opened in early 2020 and is looking for Physician or Mid-level volunteers to treat adult patients (Family Medicine, Internal Medicine, Endocrinology, Podiatry, ER, Ophtho) on Tuesday evenings from 6-9pm at 1800 S. C Street.  They focus on the “medical home” and treatment of chronic conditions and have a lot of resources including a pharmacy staffed by a retired pharmacist, a nutritionist, counselor and case manager all on-site.  The organization provides free vaccines, food and clothing as well. 

Each provider is provided a scribe and MA/translator and records are kept on an EMR; malpractice insurance is also provided.  It is a great way to give back to the community as well as mentor local high-school and college students interested in the medical field.  They do provide PPE and there are opportunities for tele-health if providers are not comfortable seeing patients in person. 

For more information, see their website at https://westminsterclinic.org/home/volunteers/medical-volunteers/   or call/email Kris Pena, MD 805-765-5711 krispena@protonmail.com  or Lisa Safaeinili, M.P.H. their Medical Director at  lisa@westminsterclinic.org

Are we going to experience a 4th Surge from the B.1.1.7 Variant?


(Click on the graph to enlarge it in a separate frame)

CMHS Weekly Medical Staff Calendar – February 16 – 19

MondayTuesdayWednesdayThursdayFriday
7:30 am COVID19 Update for Medical Staff - Teams 10:00am Infection Control Committee –Teams

12:00 pm Finance Cmte – BR

4:30 pm Anesthesia Dept. - BR

6:00 Quarterly Medical Staff Meeting – Teams
7:45 am- Pediatrics Dept - NA (back)

12:00 pm General CA Conf – BR
4:30 pm COVID19 Task Force Meeting – Teams

Final Thoughts

“Life shrinks or expands in proportion to one’s courage.”
– Anais Nin

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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